The Case: Sally is 41 year old mom working part time. She was experiencing extreme fatigue, needing naps to get through the day and unable to find the energy to do anything. She thought it might be a thyroid issue because it runs in her family but her doctor said her levels were in the normal range. The Investigation When fatigue is a symptom, the thyroid is often involved. I wasn’t about to take that possibility off the table. According to the American Thyroid Association, an estimated 20 million Americans have some form of thyroid disease. But, it is more prevalent in women. One in eight women will develop a thyroid condition in their lifetime. I invited Dr. Justin Marchegiani to join me in discussing Sally’s case. He is a virtual functional medicine doctor and the author of the Thyroid Reset. He knows all too well that the typical tests done in traditional medicine don’t tell the whole thyroid story. We spend the first part of our discussion explaining exactly how the thyroid works, it’s connection to the brain (the hypothalamus), the pituitary gland, the adrenal glands, and how that all affect metabolism. Which is why symptoms can vary widely. Most will experience fatigue as Sally did, while others may also experience feeling cold all the time, hair loss, moodiness, depression, and/or constipation. A Normal TSH Doesn't Mean the Thyroid is Functioning Properly. Dr. J explained that the TSH (thyroid stimulating hormone) range that is considered normal by traditional medicine doesn’t tell the whole story. There are too many other factors at play in how the thyroid gland actually functions. It’s important to look at how the connected systems are functioning too. Hashimoto’s Thyroiditis May be the Cause Studies have found that the antibody associated with Hashimoto’s disease is much more common than previously thought and may be the cause of hypothyroidism even at a subclinical level. This was something I knew I needed to test Sally for. Consider Optimal Range Not Normal Range If there is one thing that Dr. J stressed throughout this interview it’s that we can’t just look at whether TSH, T3, or T4 each fall into the normal range. We need to look at the relationships of these hormone levels. And, we need to strive to have them all in optimal range because when they are not in optimal range, they are not functioning properly which means they are not supporting the other glandular systems that dictate how we feel on a day to day basis. Mystery Solved Testing your thyroid function is far more complex than what traditional labs will cover. As Dr. J pointed out, thyroid function is critical to optimal health so we need to dig a little with the appropriate tests, to ensure that it’s truly is functionally optimally. For Sally, doing a few more tests revealed that her original hunch was correct - her thyroid was the cause of her fatigue. We were able to uncover where the system was breaking down and correct it. While medication was an option, she chose to try a functional medicine approach first. After a liver cleanse, we were able to help support her thyroid conversion through natural supplements and an anti-inflammatory diet. After a month, her energy had returned and she no longer needed naps to get through the day. If you are dealing with fatigue (or any other hypothyroid related symptoms like hair loss, feeling cold, moodiness, depression and/or constipation) but your doctor says your lab results are ‘normal’ do yourself a favor and do more in depth tests to determine if in fact your thyroid is not functioning optimally. If could totally change how much energy and joy you have to face your day. Eliminating Health Mysteries For Sally, we were able to find that missing piece of the health puzzle and help her regain her health. Could this be the missing clue for you or someone in your life? Resources and products mentioned on the podcast: ThyroCNV - You must create an account to access this regulated product. Zinc Selenium Free