How Do I Know if I Have a Thyroid Problem? A Naturopathic View
*Note: this blog is not meant to diagnose or substitute medical treatment. Schedule a new patient intake with Dr. Cordova to answer specific questions and/or receive treatment.
The Great Regulator: The Body’s Wizard of Oz
The thyroid is a small, butterfly-shaped endocrine gland located at the base of your neck. Despite its size, it serves as the master regulator of your body's metabolism. It is multitalented! It dictates the speed of every cell in your body. When it is off-balance, your entire system either races or grinds to a halt. And neither side of the coin feels good!
How do I know if I have thyroid disease?
Symptoms, Symptoms, Symptoms: Do I have any of these?
You are tired and your hair is thinning. For both men and women, losing hair rapidly can have a devastating effect on your confidence and psyche. In addition, you may see clumps of hair in the shower or sink drain. You may be seeing a large amount of hair on your brush. You may shed drastically. It can be very concerning.
Are there other symptoms besides losing hair? YES.
Other symptoms: stubborn weight gain or the inability to lose weight.
Perhaps you just don't feel like yourself. You suspect it is your thyroid—but how can you be sure? Maybe in addition to losing your hair, you realize you are not losing weight as easily as you used to. Or, you are gaining weight with no good explanation despite doing everything you can think of: exercise, hydration, and calorie counting. The situation feels hopeless and defeating.
Are there other symptoms besides losing hair and unexplained weight gain? YES.
Other symptoms: Chronically cold hands/feet, thinning skin.
You may have cold feet every night and need to wear socks to fall asleep comfortably. Your hands may always be cold with no reasonable explanation for it. The setting on the thermastat might have you at odds with other family members because you prefer it on a lower setting. You are not trying to be difficult; you are trying to feel comfortable in your own home.
You may notice your skin is thinner than it has been at other times in your life. This can affect your confidence to attend social outings or affect how good you feel in your own skin.
And finally……….brain fog.
I find brain fog to be the most frustrating for patients. The typical scenario is a high-functioning employee who manages others or makes countless executive decisions at work. The patient finds that they no longer store facts or information like they used to. They find that the mind “goes blank” in the middle of a meeting creating more frustration and embarrassment. In this case, stress can mimic thyroid dysfunction making a medical workup even more important so that all the conditions that look like a poorly functioning thyroid can be determined and treated appropriately.
The symptoms described above are typical of hypothyroidism.
Getting a complete picture of the thyroid involves diligently collecting all your information. I then pause and ask if we have a full picture. The goal is to be as close to 100% thorough as possible in understanding what you are experiencing. This clinical picture is to be correlated with a full lab panel that will be discussed later in this blog. However……let’s keep going with thyroid concerns patients want answers to.
A Deeper Dive into Thyroid Symptoms: Less Common But Still Important!
1. The Outer Third Eyebrow Thinning, also called Hertoghe’s Sign
While hair loss on the scalp is a well-known symptom, a classic clinical sign often noted in naturopathic chart notes is the thinning or complete loss of the outer third of the eyebrows.
The Research: This is often linked to the thyroid’s role in regulating the cell cycle of hair follicles. When thyroid hormones are low, the resting phase (telogen) of the hair cycle is prolonged, leading to noticeable thinning in this specific area. It is best practice to take pictures of any hair loss whether it’s on the scalp or the eyebrows so that it can be added to your chart and used as a baseline for progress once treatment is started.
2. Neurological "Muffled" Senses
Research in journals like Thyroid and The Journal of Clinical Endocrinology & Metabolism has highlighted how low T3 and T4 levels can affect the nervous system's processing speed.
Auditory Muffling: Some patients report a "fullness" in the ears or a mild, non-organic hearing loss that improves with thyroid optimization.
Delayed Reflexes: Doctors check the Achilles tendon reflex. In hypothyroid patients, the relaxation phase of the reflex is noticeably delayed, a hung-up reflex, a phenomenon documented in clinical textbooks as a key physical diagnostic.
3. High Cholesterol or technically: dyslipidemia
It is common to see patients in clinic who have been prescribed a statin for high cholesterol when the root cause is actually an undiagnosed sluggish thyroid.
The Mechanism: Thyroid hormones are required for the expression of LDL receptors. LDL stands for low-density lipoprotein. Without enough thyroid hormone, the body cannot effectively clear LDL ("bad") cholesterol from the blood, causing levels to spike even in patients with a pristine diet.
4. Dysautonomia and Temperature Rigidity
While feeling cold is standard and even normal, the research into the Autonomic Nervous System (ANS) shows that hypothyroid patients often lose their ability to adapt to temperature changes entirely.
Patients may describe "internal tremors" or a feeling of being "chilled to the bone" that doesn't resolve with a heater. Or the opposite may occur. They may become easily overheated because their body’s thermoregulation—controlled by the hypothalamus-thyroid axis—is dysfunctional.
5. Pseudo-Carpal Tunnel and Joint Effusion
Many patients seek care for numbness and tingling in the hands (paresthesia), assuming it is a repetitive strain injury.
The Connection: Hypothyroidism can cause a buildup of mucopolysaccharides (a type of sugar molecule) in the tissues. When these accumulate in the wrist, they put pressure on the median nerve. The resulting symptoms end up mimicking carpal tunnel syndrome.
6. Vocal Change or the Voice that Sounds Deeper
A subtle outlier seen in long-term undiagnosed cases is a deepening or "gravelly" quality to the voice (hoarseness).
The Cause: This is caused by myxedema—the infiltration of the vocal cords with fluid and mucopolysaccharides which cause them to thicken and vibrate at a lower frequency.
Hypothyroidism vs. Hyperthyroidism: Which One Fits?
Most patients fall into one of two categories.
Hypothyroidism (The Slow Down): This is the most common thyroid condition. Symptoms include stubborn, unexplained weight gain, extreme intolerances to heat or cold, constipation, brain fog, and depression.
The thyroid helps to regulate a lot of different processes! It’s no wonder you have questions. None of these symptoms are good; however, brain fog can be the most frustrating.
If you’re high-functioning and make many executive decisions each day on your job, this is often the #1 complaint from patients interested in having further thyroid testing.
Hyperthyroidism (The Speed Up): This feels like your engine is revving. Symptoms include unintended weight loss, rapid heartbeat, anxiety, tremors, and heat sensitivity. However, due to the severity of this condition, it’s often managed by an endocrinologist. A naturopathic doctor can be extremely useful in designing appropriate diet and lifestyle modifications to support a healthy thyroid.
The Mimic Symptoms: Vague symptoms and how it can mimic other problems
Sometimes thyroid issues do not look like a textbook case. Vague symptoms such as brittle nails, a change in your voice, or even high cholesterol can actually be your thyroid crying for help.
Peri- and Menopausal Symptoms can exacerbate existing thyroid conditions.
Thyroid conditions can become complex if the patient is peri- or menopausal. Many thyroid and menopause symptoms overlap. A woman may experience night sweats or hot flashes. Mean and women may report increased anxiety or a change in sleep patterns. There may even be changes in moods that you are rightfully concerned about and don’t feel like you’re getting the support you need and deserve.
Because thyroid symptoms overlap with so many other conditions, many patients are told everything is normal when it clearly is not.
And finally………Conversion of Free T4 to Free T3
Who knew the thyroid gland had so many facets to its health? It becomes easy to see why so many patients have questions about their thyroid health.
The conversion of thyroxine or T4 for short (this is what appears on your lab order) to Triiodothyronine or T3 is a critical metabolic process. T4 acts primarily as a pro-hormone with relatively little biological activity. For your body to actually use thyroid hormone, it must be converted into the active T3 form by removing one iodine atom. This task is performed by enzymes known as deiodinases. While the thyroid gland produces some T3 directly, the majority of this conversion occurs in peripheral tissues such as the liver, kidneys, and gut.
This biochemical transition is highly sensitive and can be hindered by factors like chronic stress, nutrient deficiencies in selenium or zinc, and systemic inflammation. When this conversion is sluggish, patients may present with hypothyroid symptoms even if their TSH levels appear within the normal range. This is why looking at the data for both free T4 and free T3 is essential to determine if your cells are actually receiving the fuel they need. By optimizing this conversion, I can effectively shift the body from a state of metabolic conservation to one of active energy production.
Nodules on the Thyroid
Nodules are typically monitored yearly with an ultrasound that I can order for you.
When a physical examination or patient symptoms suggest an irregularity in the neck, a thyroid ultrasound is the primary diagnostic tool used for detailed visualization. This non-invasive imaging technique uses sound waves to create a high-resolution map of the thyroid gland, allowing us to detect nodules—small lumps or fluid-filled cysts—that are often too deep to be felt by hand.
An ultrasound provides critical data regarding the size, shape, and internal composition of these nodules, such as whether they are solid or cystic, and if they possess micro-calcifications. While many thyroid nodules are non-functioning and do not affect hormone levels, some can become hot nodules. This mean they autonomously produce excess hormones and lead to symptoms of hyperthyroidism. Even if they don't affect hormones, larger nodules can cause physical discomfort. Symptoms can include but are not limited to: a sensation of fullness in the throat, difficulty swallowing, or a persistent cough.
If an ultrasound reveals a nodule with suspicious characteristics, the next clinical step is typically a Fine Needle Aspiration (FNA) biopsy to analyze the cellular makeup of the growth. It is important to remember that the vast majority of thyroid nodules—roughly 90 to 95 percent—are benign and simply require periodic monitoring to ensure they aren't growing.
However, because my role focuses on primary naturopathic care and metabolic optimization, any finding that suggests malignancy or confirmed thyroid cancer must be immediately referred out to an oncologist or an endocrine surgeon for specialized treatment. My priority is to provide the initial screening and monitoring to ensure your thyroid remains healthy, while ensuring you have access to the appropriate specialist should the data indicate a need for higher-level surgical or oncological intervention.
Which labs are ordered to have a better picture of thyroid function?
A full panel includes: TSH, free T3, free T4, and checking for the appropriate antibodies for either or both hypo and hyperthyroidism. A few patients may need antibodies for both hypothyroidism and hyperthyroidism. Typically other labs are ordered, but this is the starting point for evaluating the thyroid gland and how it is functioning.
Additional labs may include (but are not limited to) lipid/cholesterol panel, fasting glucose, and sex hormones. Each person may differ in which additional labs are ordered based on the answers in your intake. These are some examples.
How a Naturopathic Approach is Different
This is where scheduling with me, Dr. Cordova, can be of great benefit: I take an in-depth intake of all your symptoms and concerns. I follow up with my questions and clarifications for a greater picture of what you are experiencing. This helps me design a treatment plan that provides results and reflects who YOU ARE.
I order complete bloodwork for you. I explain it in a follow up visit in a meanginful way (Check out my blog on reading your labs). Within your appointment time, you may ask as many questions as needed to understand your body, your labs, and your care plan better. You will have a detailed care plan in a PDF to download and follow making naturopathic medical care easy to obtain and unique to your specific symptoms.
When to Seek Immediate Attention
If you experience what is called a thyroid storm such as severe rapid heart rate, high fever, and confusion, or notice a visible, fast-growing lump in your neck, you need to seek emergency care. These symptoms can not be managed via Telemedicine.
The Naturopathic Difference
While allopathic medicine often looks at a single lab value such as TSH (thyroid stimulating hormone), my approach looks at the whole person. I don't just ask the question Is it broken? I ask why is it struggling?
An Overview of The Tools A Naturopath May Use
I use a broad toolkit to customize your care plan for thyroid health. A typical treatment plan usually starts with diet and working towards eliminating foods that do not support the body. There may be supplements to add such as selenium or iodine. Next, I like to look at the functionality of the central nervous system and shifting more towards operating in the parasympathetic nervous system. In this state, the body repairs, heals, and mends making it a gold mine for thyroid support. The adrenal glands and their hormone cortisol may need to be checked. There is typically bloodwork and a follow up to discuss the results. The follow up is key because I can then dial in more to you, your habits, your goals, and your labs. In addition, herbal teas, homeopathy, and well-vetted supplements may be used to support your journey.
A Q&A guide to help navigate symptoms and prepare for your consultation.
1. Have you had recent blood work performed?
The first step in any data-driven plan is establishing a baseline. If you have labs from the last six months, I look for more than just a normal range. I look for optimal ranges. If you haven't had blood work recently, a comprehensive panel including TSH, Free T3, Free T4, and thyroid antibodies is the most efficient way to see exactly what your gland is doing at the chemical level.
2. Do you have any of the symptoms mentioned in our recent blog?
Because the thyroid controls your metabolic speed, its dysfunction presents in two distinct ways. Are you experiencing the slowing down markers of hypothyroidism (weight gain, cold hands/feet, constipation, or thinning hair)? Or are you feeling the "racing" markers of Hyperthyroidism (palpitations, anxiety, or unexplained weight loss)? Mapping your physical journey is just as important as the numbers on the page.
3. How is your energy throughout the day?
Thyroid hormones act as the gas pedal for your energy production. If you find that you are tired but wired (exhausted but unable to sleep) or if you hit a wall every afternoon regardless of how much caffeine you consume, it may indicate that your T3 levels—the active form of the hormone—are not reaching your cells effectively.
4. Are you experiencing brain fog or memory lapses?
Many people assume that forgetting keys or feeling fuzzy is just a sign of aging or stress. However, your brain is a highly metabolic organ that requires consistent thyroid hormone to function. If you feel like your cognitive processing speed has slowed down, it is a clinical indicator that I need to look closer at your metabolic data and correlate them with your symptoms.
5. Have you tried standard treatments without feeling better?
This is a vital question. If you are already on a thyroid medication but still feel sluggish or symptomatic, the "one-size-fits-all" approach may be failing you. I can explore whether your body is struggling to convert T4 to T3 or if common fillers in mass-produced medications are causing a low-grade inflammatory response.
Next Steps: If you answered "Yes" to several of these questions, you don't have to guess about your health. As a practitioner who values the intersection of science and personalized care, I’m here to help you interpret these signs.
Ready to see what the data says? Telemedicine appointments are currently available. I can review your recent labs and create a custom-compounded strategy that fits your unique biology.
Dr. Evelyn Cordova | Telemedicine Naturopath