Most hypothyroidism care: TSH test, levothyroxine dose, annual recheck. Functional medicine asks: why is the thyroid dysregulating?
Functional approach uses complete thyroid panel: TSH, free T3, free T4, reverse T3, TPO antibodies, thyroglobulin antibodies.
Identify the driver: Autoimmune (Hashimoto), iodine deficiency, selenium deficiency, intestinal permeability, chronic stress, post-viral thyroiditis.
Address the root: If autoimmune, gut-barrier repair and gluten elimination. If post-viral, nattokinase plus Chinese herbs plus acupuncture.
Optimize T4 to T3 conversion with selenium, zinc, iron, adequate leptin.
Support with herbs and acupuncture: Liver support and Kidney Yang tonification.
Results: normalized free T3/T4 ratios, reduced antibody titers, symptom resolution at lower doses, sustained energy.