Thyroid problems are often missed when only TSH is tested. Conventional labs often look only at TSH and declare everything normal while patients continue to struggle with fatigue, weight gain, hair loss, cold intolerance, constipation, depression, and brain fog. At Cima Health in Palm Beach Gardens, we take a functional medicine approach to thyroid health that goes deeper than the standard workup.
Why Thyroid Problems Are Missed
Standard thyroid testing typically includes only TSH, the hormone that signals the thyroid to produce more hormones. But TSH alone tells only part of the story. We also test Free T4, Free T3, Reverse T3, and thyroid antibodies (TPO and TgAb). Many patients with normal TSH have elevated antibodies indicating Hashimoto’s thyroiditis, or have poor conversion of T4 to the active T3 form their cells actually use.
What Is Hashimoto’s Thyroiditis?
Hashimoto’s is an autoimmune condition in which the immune system attacks thyroid tissue. It is the leading cause of hypothyroidism in the United States. Many people with Hashimoto’s cycle through periods of underactive and overactive thyroid function, which can make symptoms confusing and unpredictable.
Standard treatment for Hashimoto’s is typically levothyroxine (T4 only). Many patients do well on this, but others continue to have symptoms because they do not convert T4 efficiently to T3. We evaluate each patient individually and discuss whether adding T3 or switching to a desiccated thyroid extract like Nature-Throid or WP Thyroid might be appropriate.
Addressing the Root Cause
Hashimoto’s is an autoimmune disease, which means suppressing the immune attack is just as important as replacing the hormones. We look at triggers that drive immune activation, including gut permeability (commonly called leaky gut), food sensitivities such as gluten and dairy, nutrient deficiencies including selenium, zinc, and vitamin D, chronic infections, and environmental toxins.
Many patients see significant improvement in their antibody levels and symptoms when these underlying drivers are addressed alongside thyroid hormone optimization.
Thyroid and Hormone Balance
Thyroid hormones do not operate in isolation. They interact closely with cortisol, estrogen, progesterone, and insulin. At Cima Health we look at the full hormonal picture when evaluating thyroid function, because an imbalance in one area often drives dysfunction in another.
What to Expect at Cima Health
Your first visit includes a detailed intake, comprehensive thyroid labs, and a conversation about your symptoms and history. We develop a personalized plan that may include thyroid hormone therapy, nutritional support, dietary changes, and protocols to support immune balance. We monitor your progress with follow-up labs and adjust your protocol as needed.
Get to the Bottom of Your Thyroid Symptoms
If you have been told your thyroid is fine but you still do not feel well, or if you have a known thyroid condition that is not fully controlled, we can help. Call or text Cima Health at (561) 775-9111 or visit our thyroid treatment page to schedule a consultation in Palm Beach Gardens.
