Understanding the Basics of Hypothyroidism
Many of my patients come in with questions about hypothyroidism. Maybe someone told them to “check their thyroid,” or they’ve had it checked and were told it “looks fine”, but they still don’t feel like themselves. Fatigue, weight gain, brain fog, feeling cold all the time, these are some of the common hypothyroidism symptoms that can be frustratingly vague. So let’s break it down.
What is hypothyroidism, really?
Hypothyroidism happens when your thyroid gland isn’t making enough of the hormones your body needs to function at its best. The thyroid is a small gland in the front of your neck that uses iodine (from food) to make hormones like T3 and T4. These hormones affect energy, mood, digestion, sleep, temperature, and more.
Most of the time, when doctors “check your thyroid,” they’re looking at a blood test called TSH (Thyroid Stimulating Hormone), which comes from your brain.
But that’s just one piece of the puzzle.
TSH levels can be within the “normal” range, even when the thyroid itself isn’t producing enough hormones. That’s why some people are told everything looks fine, but they still feel off. To really evaluate thyroid function, we also look at T3 and T4 levels as well as antibodies against the thyroid.
Is hypothyroidism genetic?
It can be. There’s a strong genetic link, especially in cases where hypothyroidism is an autoimmune disease. The most common cause in areas where iodine intake is adequate is Hashimoto’s thyroiditis, an autoimmune condition. That means the immune system mistakenly attacks the thyroid gland.
People with a family history of thyroid disease, especially first-degree relatives, are more likely to develop hypothyroidism themselves. Studies show a high degree of heritability, so genetics definitely plays a role (1).
Is hypothyroidism an autoimmune disease?
Often, yes. In Hashimoto’s thyroiditis, the immune system targets the thyroid gland and gradually wears it down over time. This process is influenced by both genetic susceptibility and environmental triggers (like infections or nutrient deficiencies). The immune system gets confused and starts producing antibodies that attack thyroid cells, leading to inflammation, damage, and lower hormone production.
What’s the treatment for hypothyroidism?
Hypothyroidism treatment is usually simple and effective. Most people take a daily dose of synthetic thyroid hormone (levothyroxine) to restore normal hormone levels. With the right dose and regular monitoring, many people feel dramatically better, more energized, clear-headed, and balanced.
As naturopathic doctors we can add to the improvement by also helping the immune system calm down and reduce the attacks on the thyroid gland.
If you’re experiencing symptoms and wondering if your thyroid might be the cause, it’s worth digging a little deeper. Testing more than just TSH can often give us better insight and help you start feeling like yourself again.
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(1) Familial Risk of Hashimoto’s Thyroiditis in a Large Genealogical Database. Bujnis M, DeSalvo K, Neklason DW, Madsen MJ, Jorde LB. The Journal of Clinical Endocrinology and Metabolism. 2025;:dgaf251. doi:10.1210/clinem/dgaf251.
