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You've Got An Underactive Thyroid, Are Taking Levothyroxine, But Continue To Feel Rubbish?

Updated: May 26

Why It's Important To See What's Going On With Your Thyroid Through Testing!


So, you've found out you have a problem with your thyroid, specifically that you have an underactive thyroid? Perhaps the doctor has prescribed Levothyroxine, and sent you on your way?


You can head on over to this blog article for more information about the thyroid and its role in our energy levels and overall health.


For starters, a lot of people who have been told that they have an underactive thyroid aren't actually aware of why their thyroid isn't working as it should be. An underactive thyroid is tested by the NHS via a thyroid function test, which checks something called TSH (thyroid stimulating hormone) and thyroxine (T4), sometimes referred to as "Free T4", to see if anything is off kilter with your thyroid.

~Empty Blood Test Tubes

Testing for the hormone Triiodothyronine (also called "T3", which is converted from T4, and is a more active form) is less commonly checked by the NHS. In addition, an investigatory test called a thyroid antibody test might be ordered after you've had the thyroid function test, but this is not something that is recommended as standard, so often we are only getting access to part of the picture when it comes to seeing what might be happening with your thyroid! Something else that is not routinely checked is something called "Reverse T3", which might be raised in periods of illness or chronic stress - more about this in another article!


If a problem has been identified with your thyroid, something that is also important to check for is for certain antibodies. Antibodies are a protein that is made by our immune system in response to something called an antigen, which is a foreign substance that causes an immune response. You might be thinking, why are antibodies relevant when it comes to my thyroid? Antibodies are generally helpful, but they can also be problematic, especially in terms of something called "Autoimmunity." Autoimmunity is when the body's immune system mistakenly identifies its own tissue as "foreign" and attacks it. This can happen in many different areas of the body, including the thyroid! The presence of certain antibodies can therefore help to identify if you have an autoimmune thyroid condition (also referred to as "Hashimoto's Thyroiditis").


Hashimoto's Thyroiditis (In case you're wondering, it was named after a Japanese doctor who discovered its presence in 1912!). It's considered one of the most common causes of an under-active thyroid, yet will often not be identified, due to an overreliance on the thyroid function test, or looking at TSH in isolation.


In case you are curious, there are three main types of antibodies that are usually checked in relation to thyroid disease, namely:


  • Anti-thyroid peroxidase (TPOAb),

  • Anti-thyroglobulin antibody (TgAb)

  • TSH receptor antibodies (TrAb)

The most common antibody associated with the presence of Hashimoto's specifically is TPOAb (Anti-thyroid peroxidase). The presence of the other antibodies - TgAb might be present in Hashimoto's, but TrAb is most commonly associated with Graves disease (which is auto-immune over-active thyroid).

Tired Person lying down with hand over face

Now, why is it important to know whether your thyroid problem is auto-immune or not? When it comes to a holisitic approach to nutrition, looking at the root cause of symptoms and conditions that we have is key to figuring out a way forward! Autoimmunity can be caused by both genetic and environmental factors; which means that implementing changes that support your environment around you (e.g. managing stress, movement, sleep and a healthy diet) has the potential to improve your symptoms.


Autoimmune conditions (linked to thyroid or other conditions), can indicate not only that your immune system needs support, it can also indicate that inflammation is present. By looking at what is happening with your thyroid, and identifying if you have Hashimoto's, you have a better chance of managing your symptoms and seeing improvements in your quality of life, because taking Levothyroxine (synthetic thyroid hormone replacement) doesn't always help reduce symptoms that you might be experiencing!


My advice to you therefore is to ask your doctor to test for autoimmunity, as well as making sure that they do a full thyroid panel (which includes TSH, T4, T3), so that you can understand what might be going on. Even if the tests come back within normal ranges, there is a chance that they aren't optimal - that's something a nutritionist can help you to understand! If you aren't able to get all of these things tested on the NHS, don't worry - you can consider getting it tested privately, and luckily, it is not generally an expensive test to perform.


Person Enjoying the outdoors

Being told you have an underactive thyroid or Hashimoto's thyroiditis can be daunting, but the symptoms that you experience are not something you have to put up with! The thyroid may be a small gland, but it has a mighty impact on how we feel, and it's often not given the attention it deserves!


If you have an underactive thyroid, subclinical hypothyroidism, or even Hashimoto's and perhaps you are now taking Levothyroxine, yet you are still experiencing symptoms, such as on-going fatigue, lingering weight gain, brain fog and you don't know where to start, it's time to book a 30-minute no-obligation call with me, so I can help you to break down this complicated condition and pave a way forward for you!






Amy Cottrell


Registered Nutritional Therapist


Dip CNM, mANP , mBANT, mCNHC


Please note that Amy Cottrell Nutrition does not claim to prevent, treat or cure any physical, mental or emotional conditions. These blog articles are written for educational & informational purposes only and are not a substitute for medical advice.


Do not stop or start taking medication or supplements without first talking to your primary health care provider.


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