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The Functional Medicine Approach to Thyroid Health

Thyroid health is an essential part of overall wellness. Our thyroid gland is responsible for a lot, including regulating our metabolism, cholesterol, blood sugar, temperature, reproductive health, and weight. Thyroid health can be complicated since this gland produces many thyroid hormones, but here is an easy breakdown of some of the dysfunctions you may experience and a functional medicine approach to healing through diet and lifestyle changes. 

What is the thyroid, and what does it do?

The small, butterfly-shaped organ located in your neck is your thyroid gland. Your thyroid is responsible for a few hormones, including TSH (thyroid-stimulating hormone), T3 (triiodothyronine) T4 (thyroxine). That may be a mouthful, but basically, your thyroid gland produces thyroid hormones. Your thyroid influences your metabolism, cholesterol and blood sugar regulation, growth and development, body temperature, and brain development from infancy and childhood.

The most common thyroid dysfunctions


Hyperthyroidism happens when your thyroid becomes overactive and releases too much thyroid hormone. People with hyperthyroidism can experience increased metabolism, rapid heartbeat, increased appetite, weight loss, and anxiety. 

Grave’s disease

Grave’s disease is an immune disorder due to hyperthyroidism or overproduction of thyroid hormones. Grave’s disease symptoms can include a goiter, weight loss, heat sensitivity, anxiety, irritability, menstruation changes, erectile dysfunction, fatigue, sleep issues, rapid heartbeat, thick/red skin, and bugling eyes.


Hypothyroidism happens when your thyroid becomes underactive and releases too little thyroid hormone. People with hypothyroidism can experience weight gain, fatigue, cold intolerance, joint pain, dry skin, thinning hair, slowed heartbeat, depression, and menstrual and fertility issues.

Hashimoto’s Disease

Hashimoto’s disease is one of the most common forms of autoimmune hypothyroidism – also known as underactive thyroid). When someone has Hashimoto’s, their immune system makes antibodies that attack the thyroid gland, and the thyroid then doesn’t produce enough thyroid hormones.

Thyroid dysfunctions can include hyperthyroidism, hypothyroidism, Grave’s disease, and Hashimoto’s disease.

Functional medicine and your thyroid

Functional Medicine determines how and why illness occurs and restores health by addressing the root causes for everyone. 

Thyroid health is approached in functional medicine to restore health and wellness as a whole and look for the root causes of symptoms. Typically, your practitioner will begin with a comprehensive evaluation of your health challenges while considering a variety of factors, including:

  • Root causes
  • Underlying triggers
  • Biochemical and genetic factors
  • Individual lifestyle including diet and exercise

Underlying triggers and root causes of thyroid dysfunctions

Some of the triggers and causes of thyroid dysfunction include:

Food intolerances

It is essential to eat a diverse and healthy diet to support overall wellness and longevity. However, there are situations when the food we eat can make us sick and cause chronic health problems. Food sensitivities can include inflammatory foods such as gluten, dairy, sugar, wheat, corn, rice, nuts, seeds, and nightshade vegetables (i.e., eggplant, tomatoes). Food sensitivities and intolerances can be tricky to pinpoint since most people eat a varied diet and don’t tend to keep track. A functional medicine practitioner would help figure out what foods your body is having trouble with through testing and elimination diets. Knowing how your body reacts to different foods and which foods you should avoid can be helpful for not only thyroid health but also overall wellness and inflammation reduction.


Chronic stress can lead to many health issues, including thyroid dysfunction and autoimmune diseases.   First of all, the stress hormone cortisol produced by your adrenal glands is increased when you are stressed. Higher cortisol levels have been correlated with suppressed thyroid hormones and inflammation. Take time to lower your stress with exercise, creative activities, journaling, and other stress-reducing routines. If your stress lasts for an extended time, a functional medicine doctor can recommend dietary and lifestyle changes for stress reduction.

Gut microbiota imbalance

Your thyroid hormone T4 is converted into T3 in your gut, and an imbalance in your gut microbiota or microbiome can cause this process to slow down or stop. Studies show that those with thyroid disorders have imbalanced gut microbiota compositions. Your gut microbiota is the microorganisms that keep your gut’s beneficial bacteria and harmful bacteria balanced. Especially those with leaky gut syndrome are more likely to experience bacterial overgrowth and autoimmune thyroid conditions.

In addition, leaky gut can be a root cause of thyroid health issues – read more about leaky gut and how to heal your gut here.

Hormone imbalances

Hormone imbalances and estrogen dominance can also be a culprit adding fuel to thyroid dysfunction and some of its underlying triggers and root causes.

  • Estrogen dominance
  • Hypothyroidism
  • Cortisol dysfunction
  • Adrenal dysfunction
  • Low DHEA
  • Low progesterone
  • Androgen imbalances
  • Insulin resistance

Other root causes that increase inflammation and can trigger thyroid dysfunctions include nutrition deficiencies, environmental and toxin exposure, iodine levels, blood sugar issues, and infections (many autoimmune disorders can be connected to bacterial, parasitic, fungal, and yeast infections). Other factors include using artificial sweeteners, smoking, and selenium, iron, copper, and vitamin A deficiencies.

Foods to add to your diet to support thyroid health

Foods that are beneficial to thyroid health

Depending on your thyroid dysfunction, your doctor will want to add or omit certain foods that will help to reduce inflammation in your body while helping your thyroid function correctly. They will give you nutritional counseling for your own individualized needs.

However, adding the foods below to your diet can help support overall thyroid function

Nutrition for your TSH or thyroid-stimulating hormone

  • Magnesium – spinach, kale, nuts, and seeds
  • Protein – Fish (wild-caught), beef (grass-fed), and algae (blue and green)
  • Vitamin B12 – beef (grass-fed), egg yolks, salmon, and liver
  • Zinc – beef (grass-fed), lobster, mussels, oysters, seeds, and nuts

Nutrition for your T4 hormone

  • Iodine – nori, arame, kelp, and kombu
  • Vitamin B2 – liver, lamb, greens, and mushrooms
  • Vitamin C – red peppers, oranges, raspberries, and strawberries

Nutrition for your T3 hormone

  •  Selenium – Brazil nuts

Nutrition for gut health

  • Probiotic-rich foods – yogurt, kefir, miso, kimchi, and kombucha

Food is the preferred method of healing your thyroid health, but sometimes supplements may be necessary due to your dietary and lifestyle needs.  Your practitioner can help you develop a supplement routine that works for your constitution and considers any health issues you have.

What will a functional medicine practitioner do to help me with my thyroid dysfunction?

Functional medicine testing and labs are done in a comprehensive and in-depth way. These tests can include TSH, Total T4, T3 Uptake, Total T3, Free T4, Free T3, Reverse T3, and thyroid antibodies. Your medical doctor would discuss the results of these tests with you while also taking a look at the big picture.

Finally, after looking at your complete health history, lab results, and the root causes and underlying triggers of your thyroid dysfunction, your functional medicine practitioner will develop the best plan for your healing.