Signs You Have Low Thyroid and What to Do About It

Low thyroid, or hypothyroidism, is a quiet problem that affects millions of people, yet many don’t realize they have it. Its symptoms often masquerade as everyday complaints, leaving people tired, foggy, and frustrated without answers. If you want more energy, clarity, and health, recognizing the signs and knowing what to do can be life-changing.

Signs of Low Thyroid That Are Common and Unusual

Most people know about fatigue and weight gain, but the thyroid slowing down can show up in surprising ways:

• Being sensitive to the cold: If you’re always cold—even when others aren’t—it could be a thyroid issue, not just “getting older.” 
• Constipation: When digestion slows, low thyroid can be the cause. 
• Dry skin and hair loss: Often blamed on stress or weather changes, these can signal low thyroid hormones. 
• Brain fog and trouble focusing: Hypothyroidism can leave you forgetful, “fuzzy,” or mentally sluggish.
• Mood changes: Depression, apathy, or loss of enthusiasm are tied to thyroid function.
• Irregular periods: Heavier, less frequent, or unpredictable cycles in women may be thyroid-related.

Less Common or Overlooked Signs

• Hoarse voice or slow speech: Caused by changes in vocal cords and tissue. 
• Stiffness, muscle and joint pain: Often mistaken for aging or overexertion. 
• Puffiness in face, hands, or feet; thinning eyebrows: Classic but frequently missed signs. 
• Carpal tunnel, sleep apnea, delayed growth/puberty in children: Less common but important to recognize. 

How to Tell If You Have Low Thyroid

Specialized Lab Testing – Because symptoms overlap with many conditions, testing is key. Doctors typically check TSH and T4 levels, which often reveal early thyroid issues before bigger problems occur. Functional medicine specialist go even deeper. They do more detailed tests and address the root cause. 

• • Free T3 and free T4: Measures active hormones that are “free to get into the cells” whereas total T3 and T4 have most bound to proteins that can’t get into cells. 
  • Reverse T3: Detects metabolic “brakes” from stress or inflammation (which is why adhering to an anti-inflammatory diet helps.)

• Thyroid antibodies (TPO, TgAb): Identify autoimmune activity like Hashimoto’s the most common cause of low thyroid in the United States.

What to Do If You Have Hypothyroidism 

Functional medicine goes deeper, asking: Why is the thyroid underperforming? A functional medicine physician looks beyond standard TSH and T4. Functional medicine addresses the root cause. 

Functional Medicine Recovery Strategies

The most common cause of hypothyroidism in the United States is Hashimoto’s disease which is an autoimmune disorder. The immune system can make antibodies that attack the thyroid gland. 1Identifying and removing  the triggers such as toxins, infections and food sensitivities is key. 

Personalized Diet to Reduce Inflammation 

• Food Intolerances: People with Hashimoto’s are more likely to develop food intolerances that may even be the cause of autoimmune thyroid disease. 2 A personalized elimination and detoxification diet has you temporarily removing common  foods that trigger an immune response such as dairy, wheat, corn, soy and sugar. After a period of time, you add them back in and look for a response to see which foods cause symptoms or you can do a specialized blood test that looks for antibodies to foods. Intolerances may be unique to an individual and even if you don’t have an autoimmune disorder, decreasing inflammation that is the root cause of many chronic conditions can improve health and the microbiome. 
• AIP Diet: Approximately 70-80% of immune cells are located in the gut and the gut microbiome (the bacteria that live in the gut) affects your immune system.3  Identifying and removing these can calm inflammation. An autoimmune protocol (AIP) has been shown has been shown to improve the quality of life, induce a positive change in mental state, reduce stress and improve the many symptoms of Hashimoto’s disease. 4

• Fats vs. Plants: Saturated fatty acids found in meat, poultry, dairy, and processed foods can cause inflammation and contribute to hypothyroidism. A diet with more plants such as legumes, fruits, and vegetables is rich in vitamins, minerals, polyphenols, and phytosterols, and antioxidants such as vitamins A, C and E are aid in the prevention or treatment of thyroid autoimmunity.5

Optimize Nutrients 

Iodine, selenium, iron and vitamin D, are essential to promote the proper synthesis of thyroid hormones and regulate their activity. 5 It is tempting for people to take generic thyroid supplements that contain selenium and iodine. However, all of the above mentioned nutrients can become toxic at high levels. You must measure these nutrients to avoid toxicity!

• Selenium is very beneficial at the right levels to decrease thyroid antibodies and provide antioxidant and anti-inflammatory support. However too much selenium increases the risks of type 2 diabetes, non-alcoholic fatty liver disease, and may  cause hypothyroidism or thyroid hormone imbalances.6,7

• Iodine However too much iodine can cause hypothyroidism or hyperthyroidism that can be life threatening. 8

Reduce Toxins

Thyroid tissue is highly sensitive to environmental toxins such as:

• Heavy metals: Mercury (fish, amalgams), arsenic (rice, juices). 9
• Endocrine disruptors: Plastics, receipts, packaging, contaminated fish. 
• Pesticides, herbicides, nitrates/nitrites: Common in produce, water, and processed meats. 
• Other: smoking, radiation, viruses, drugs. 

Choosing organic foods, filtered water, and safer household products supports recovery. 

Medication: Sometimes Necessary, Not the Full Story

Many people need thyroid hormone replacement. But pairing it with nutrition, gut healing, and root-cause treatment offers a fuller recovery. 

Conventional medicine generally replaces:

• T4 with thyroxine (Synthroid, Tirosint), 
• T3 some people may benefit from adding T3 liothyronine (Cytomel). 
• Combination: Many functional medicine doctors use a combination of T4 and T3 such as NP thyroid or Armour thyroid and some may have a compounding pharmacy make a formula specific for your needs when a fixed dose does not work. 

Why Taking Action Early Matters

Ignoring symptoms can lead to high cholesterol, infertility, heart disease, weight gain, poor memory, depression, constipation, muscle weakness, joint pain, goiter, kidney disease, peripheral neuropathy and even coma. If many signs sound familiar, get checked and explore both conventional and functional medicine solutions. 

Conclusion

Hypothyroidism is common, but often overlooked or mislabeled as aging, stress, or “just life.” Recognizing patterns—fatigue, cold intolerance, brain fog, or unusual changes—can alert you that something is wrong and you can do something about it. Functional medicine offers deeper testing, diet, and lifestyle strategies to restore thyroid health and vitality. Apply for a no obligation clarity call to see if we are a good fit. 

Get healthy and be happy NOW!

References:

1. Hashimoto’s Disease – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed August 29, 2025. https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
2. Yan M, Wu H, Zhang K, Gong P, Wang Y, Wei H. Analysis of the correlation between Hashimoto’s thyroiditis and food intolerance. Front Nutr. 2024;11:1452371. doi:10.3389/fnut.2024.1452371
3. Wiertsema SP, van Bergenhenegouwen J, Garssen J, Knippels LMJ. The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients. 2021;13(3):886. doi:10.3390/nu13030886
4. Ihnatowicz P, Gębski J, Drywień ME. Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto’s disease. Ann Agric Environ Med. 2023;30(3):513-521. doi:10.26444/aaem/166263
5. Street ME, Shulhai AM, Petraroli M, et al. The impact of environmental factors and contaminants on thyroid function and disease from fetal to adult life: current evidence and future directions. Front Endocrinol (Lausanne). 2024;15:1429884. doi:10.3389/fendo.2024.1429884
6. Liu F, Wang K, Nie J, et al. Relationship between dietary selenium intake and serum thyroid function measures in U.S. adults: Data from NHANES 2007–2012. Front Nutr. 2022;9. doi:10.3389/fnut.2022.1002489
7. Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
8. Koukkou EG, Roupas ND, Markou KB. Effect of excess iodine intake on thyroid on human health. Minerva Med. 2017;108(2):136-146. doi:10.23736/S0026-4806.17.04923-0
9. Ferrari SM, Fallahi P, Antonelli A, Benvenga S. Environmental Issues in Thyroid Diseases. Front Endocrinol. 2017;8. doi:10.3389/fendo.2017.00050

 

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