Hypothyroidism Support Guide

The thyroid gland, often called the “master regulator” of metabolism, plays a critical role in how the body uses energy. It affects nearly every organ system — influencing heart rate, temperature regulation, digestion, mood, fertility, and more. When thyroid function slows down, so does the body — and symptoms can ripple across physical and emotional health.

But here's the truth we stand by: your body never does anything by mistake. If the thyroid is under-functioning or 'under attack', there’s a deeper reason why — and functional medicine is about uncovering that “why.”

The Adrenal-Thyroid Connection: Why Stress Comes First

Before diving into thyroid support, we must acknowledge the critical relationship between your adrenal glands and your thyroid. Chronic stress — whether emotional, physical, or inflammatory — places a huge burden on the body and often precedes or worsens thyroid dysfunction.

When there's stress, stress, stress --> thyroid comes next.

The hypothalamic-pituitary-adrenal-thyroid (HPA-T) axis is a complex communication network. When your brain senses stress, it signals your adrenals to produce cortisol. If cortisol remains high due to poor sleep, skipped meals, overexercising, or lack of rest and rhythm, the body may intentionally dial down thyroid output to conserve energy — it’s a survival mechanism.

Common patterns that stress the thyroid-adrenal axis:

• Skipping meals or going too long without eating

• Relying on caffeine instead of food for energy

• Burning the candle at both ends (poor sleep + overcommitting)

• Restrictive or low-protein diets

• Chronic inflammation or blood sugar dysregulation

Key Insight: You cannot fix the thyroid without supporting adrenal resilience. Rest, blood sugar stability, protein-rich meals, and consistent routines are essential.

What Is Hypothyroidism?

Hypothyroidism is a condition where the thyroid gland is underactive and produces insufficient thyroid hormones. This can be due to a variety of causes, including nutrient deficiencies, chronic stress, autoimmune disease, gut infections, and toxic burden.

Symptoms of Hypothyroidism:

• Fatigue or daytime sleepiness

• Weight gain or difficulty losing weight

• Cold intolerance (cold hands and feet)

• Brain fog, forgetfulness

• Hair thinning or loss of outer eyebrow

• Constipation

• Dry skin or brittle nails

• Menstrual irregularities or heavy cycles

• Depression, low motivation

• Joint or muscle pain/stiffness

• Slow heart rate

• Hoarseness

• Puffy face or swelling

• Infertility or low libido

Lab Testing: The Full Thyroid Panel and What It Reveals

Most conventional doctors only test TSH (thyroid-stimulating hormone) — but TSH alone is not enough to understand thyroid function. Functional medicine uses a complete thyroid panel to see the full picture, including hormone production, conversion, and autoimmunity.

Request the following labs:

• TSH

• Total T4 and Free T4

• Total T3 and Free T3

• Reverse T3

• T3 Uptake

• Thyroid Peroxidase Antibodies (TPOAb)

• Thyroglobulin Antibodies (TgAb)

Other indicators in basic labs:

• High cholesterol or triglycerides

• Elevated calcium or magnesium

• Elevated BUN

• Low ferritin or low serum iron

• Low vitamin D

Even if your labs are “normal,” you may not be in the optimal functional range. We can help you interpret your results with a prevention-focused lens.

Understanding Hashimoto’s and Autoimmunity: It Starts in the Gut

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the U.S. It’s an autoimmune condition where the immune system 'targets' thyroid tissue, usually in response to deeper triggers — not by accident.

Here’s the functional medicine view:

• When the gut becomes inflamed or permeable (“leaky gut”), undigested food particles, toxins, or microbes can enter the bloodstream.

• The immune system flags these as threats — in some cases, their molecular structure resembles that of the thyroid tissue (like gluten - molecular mimicry) OR these foods, microbes settle in organs or joints.

• In trying to neutralize the invaders, the immune system activates a response that can lead to thyroid damage over time. Trying to get to the invader.

  
  

This is why we focus heavily on gut health in Hashimoto’s. If you work on healing gut permeability and remove the triggers (foods, infections, toxins), the immune system calms — and thyroid tissue is protected.

Gut-healing strategies include:

• Elimination Diets and or Food Sensitivity Panels to identify and remove food triggers (often gluten, dairy, soy, and sugar)

• GI Microbiome testing to assess for H. pylori, candida, parasites, dysbiosis, etc.

• Gut-repair nutrients: L-glutamine, zinc carnosine, collagen, marshmallow root

• Targeted probiotics and short-term antimicrobials when needed

• Supporting the vagus nerve and digestion through stress reduction and mindful eating

Functional Testing Beyond Thyroid Labs

• DUTCH Test: Assesses sex hormones, cortisol rhythm, and DHEA — crucial for thyroid-adrenal balance.

• GI Microbiome or comprehensive stool testing: Evaluates microbiome health, hidden infections and the state of your gut lining.

• Heavy metal testing (urine or hair): Especially important if there’s a history of dental amalgams or chemical sensitivity.

• Food sensitivity testing: Helps uncover immune triggers.

• Genetic and methylation pathways (MTHFR, COMT, etc.): Guides detox and nutrient needs.

Key Nutrients for Thyroid Function

Iodine & Tyrosine

• Make thyroid hormone

• Found in sea vegetables, cod, shrimp, turkey, eggs, and potatoes

Selenium

• Converts inactive T4 to active T3

• Supports immune balance in Hashimoto’s

• Tip: 2-3 Brazil nuts per day is usually sufficient

Zinc, Copper, Vitamin A & E

• Essential for hormone synthesis and immune regulation

B Vitamins (B2, B3, B6, B12), Vitamin C

• Crucial for hormone conversion and adrenal support

Vitamin D

• Modulates immune response, reduces autoimmune activation

• Aim for levels between 50–70 ng/mL

Iron & Ferritin

• Necessary for thyroid hormone production and oxygen delivery

• Low ferritin is common in women with fatigue, hair loss, or heavy cycles

Meal Planning for Thyroid and Adrenal Health

• Eat protein, healthy fat, and fiber-rich carbs at every meal

• Avoid going more than 5-6 hours without your next meal

• Limit caffeine and avoid skipping breakfast

• Stay hydrated — aim for ½ your body weight in ounces of pure, filtered water

Best Foods to Include:

Wild-Caught Salmon & Sardines

• Rich in omega-3 fatty acids → reduce inflammation

• Provide selenium and vitamin D → support hormone production and immune regulation

Pastured Eggs

• Contain iodine, selenium, vitamin A, and tyrosine (needed to make thyroid hormone)

• Support energy, brain health, and detox pathways

Cooked Leafy Greens (e.g., kale, collards, spinach)

• High in magnesium and folate

• Lightly cooking them reduces goitrogens while preserving nutrient value

Root Vegetables (sweet potatoes, beets, carrots)

• Excellent sources of slow-burning carbs to support adrenal and thyroid balance

• Rich in antioxidants and fiber to support gut health

Seafood (shrimp, cod, sea bass, salmon, sardines, mackerel, herring, anchovies)

• Rich in iodine and tyrosine → building blocks of thyroid hormone

• Also provide zinc and selenium for hormone activation

Sea Vegetables (nori, dulse, kelp — in moderation)

• Excellent source of natural iodine

• Support healthy T4 levels

  
  

Coconut Oil & MCTs

• Provide quick energy without spiking blood sugar

• Support metabolism and hormone production, especially in low-thyroid states

Brazil Nuts (1–3 per day)

• Nature’s richest source of selenium → essential for converting T4 to T3 and modulating autoimmunity

Cruciferous Vegetables (broccoli, cauliflower, Brussels sprouts) — cooked

• Support liver detox of hormone metabolites

• Cooking reduces goitrogenic effects, making them thyroid-friendly

Lentils & Chickpeas

• Rich in plant-based protein, fiber, zinc, and iron

• Support blood sugar balance and gut health

Berries (blueberries, blackberries, raspberries)

• Packed with antioxidants → protect thyroid tissue from oxidative damage

• Low glycemic and supportive of blood sugar balance

Garlic and Onions

• Support liver detox pathways and immune health

• Contain sulfur compounds that help reduce inflammation

Foods to Avoid (especially for Hashimoto’s):

• Gluten and conventional dairy (often cross-reactive)

• Refined sugars and simple carbs

• Industrial seed oils

• Unfermented soy

• Goitrogenic vegetables in excess when raw (e.g., kale, cauliflower) — light cooking deactivates this issue

Lifestyle: Stress, Movement & Recovery

• Exercise increases tissue sensitivity to thyroid hormone — aim for gentle, consistent movement

• Prioritize sleep (7–9 hours)

• Use relaxation techniques (breathing, walking, nature, journaling)

• Establish a daily rhythm for meals, movement, and wind-down time

• Consider natural adaptogens as supplement/tea when needed

Final Thoughts

Thyroid dysfunction is not just a hormone issue — it's often a full-body message that something deeper needs attention. Whether that’s a gut imbalance, immune trigger, nutrient deficiency, or chronic stress, functional medicine gives us a map back to balance.

You can feel like yourself again — with the right testing, nourishment, and support, your thyroid can heal.

If you're ready to dig deeper into your thyroid health, reach out to us for a personalized consultation. We offer comprehensive lab reviews, personalized protocols, and support that meets you where you are. Schedule your Thyroid & Adrenal Health Review

Hypothyroidism