Thyroid: conventional medicine misses the mark on this hormone crucial for healthy aging (& weight loss)!
So your Dr says your thyroid is “normal”...
Based a “normal” TSH test (argh).
But you’re tired all the time, gaining weight, feeling “meh”, your skin is dry, you feel cold a lot, have dry skin, poor focus and your hair is thinning.
You might also experience muscle cramps, constipation, anxiety and moodiness most of the time (unrelated to your cycle if you’re female).
Common story.
Many of us are told “everything looks fine,” yet we know we’re not. We FEEL it.
Let’s break down why thyroid function is so vital, why the conventional approach doesn’t cut it, and what to do to better understand your thyroid health.
🌡 Why we need to pay closer attention to our thyroid health later in life (for men and women)
Your thyroid is crucial for overall metabolic and hormone balance, which impacts your energy levels, fat storage, cholesterol, blood pressure, blood sugar, brain function, immune health…and more.
Basically, a healthy thyroid is essential for healthy aging…and yet it’s one of the most overlooked but critical pieces of the mid / late-life puzzle.
Why?
Here I’ll speaking generally to perimenopause, menopause and andropause (the male equivalent), but I’ll point specifically to perimenopause as the example:
In perimenopause, estrogen and progesterone fluctuate wildly until they reach low levels in menopause. These hormonal shifts can directly affect thyroid function in several ways:
Estrogen dominance (common in perimenopause) can increase thyroid-binding globulin (TBG), which reduces free thyroid hormones in your body.
Progesterone decline impacts thyroid receptor sensitivity, meaning even if you have enough thyroid hormones, your cells may not “hear” the signal.
The stress of hormonal changes (and modern life!) can raise cortisol, which suppresses thyroid function.
Bottom line? If your thyroid isn’t supported during this transition or the male transition to andropause, your symptoms can feel exponentially worse.
⚠️ Why so many of us are slipping through the cracks in conventional medicine
Most doctors run a simple TSH (Thyroid Stimulating Hormone) test to determine how your thyroid functions, and leave your symptoms out of the equation.
This is absolutely ABSURD.
Why?
1. TSH is a pituitary hormone, NOT a thyroid hormone.
T3 and T4 are the actual thyroid hormones; TSH just tells the thyroid to produce them.
Judging thyroid function by looking solely at TSH is like checking your thermostat to see how warm your house is. T3 is like actually walking into the room to feel the temperature. One tells you intent; the other tells you reality.
2. If TSH falls within the “normal” lab range, you’re told your thyroid is “normal.” But that reference range is insanely broad! You have to be VERY unwell to fall outside those ranges.
3. Providers who do test thyroid hormones often only test T4 WITHOUT testing T3, the active form of thyroid hormone that actually powers your metabolism, brain, energy, digestion, and mood. We NEED to understand your T3 to know how well you are converting inactive T4 to active T3 (which can be a major problem).
4. As we age, we often develop hormone “receptor resistance”, meaning the hormone’s receptor (which executes its functions) doesn’t “hear” its signal very well anymore.
In other words, the body’s cells become less responsive to hormones, even if those hormones are present in normal or high amounts.
This means that despite lab results falling within "normal" reference ranges, the hormones may not be effectively performing their functions at the cellular level. As a result, you can experience clear symptoms of hormonal imbalance despite "normal" labs.
For this reason, your symptoms matter SO much more than your labs because they doesn’t necessarily reflect what’s happening at a cellular level in your body. You could have perfect TSH, T3 and T4 and you could still be low thyroid (or hypothyroid).
In functional medicine, this disconnect is recognized, so practitioners prioritize a symptom-based approach - treating the individual, not just the numbers - to address underlying dysfunction and restore optimal health. In other words, it’s NOT sufficient for your provider to treat you based on your labs alone!
(This is the same thing that happens with insulin resistance, meaning that insulin receptors on cells doesn’t “hear” the sugar signals as well as they should, causing blood sugar to rise. Similarly, we can get thyroid resistance in which we may have enough T3 signal around, but the receptor doesn’t hear that signal and so we get low thyroid symptoms.)
Side-note: It’s tricky for doctors in the public or insurance-based systems because they’re strictly trained to look only at your labs to made judgement calls about your treatment, partly to save tax-payer / insurance agency dollars on "unnecessary" treatments. So it’s not their fault that this is the norm - that’s how they are taught in conventional medicine.
🔬 A smarter way to assess thyroid health: Functional Medicine
Functional medicine looks at more comprehensive labs (cellular level) and your symptoms (systems level) to determine what’s really going on.
A complete thyroid panel should include:
TSH - useful, just not the full picture
Free T4 – the inactive, “storage” form of thyroid hormone
Free T3 – the active, usable form (this is KEY!)
Reverse T3 – can block T3 and indicate stress or poor conversion
Thyroperoxidase (TPO) + Thyroglobulin (TG) antibodies – to screen for autoimmune thyroid disease (like Hashimoto’s), which is quite common and impairs thyroid function
But as I mentioned, labs alone don’t tell the whole story. Functional medicine always pairs lab results with your symptoms.
It can be tricky to distinguish between thyroid and sex hormone symptoms in midlife, as there is a lot of overlap, and yes, they do influence each other’s functions…
But here are some questions to ask yourself when it comes to thyroid function:
Do I struggle with fatigue no matter how much I sleep?
Is my hair thinning or my skin drier than usual?
Do I feel cold all the time?
Stubborn weight gain?
Muscle weakness or cramping?
Are my periods more irregular or heavier than usual?
Am I losing my mental sharpness or motivation?
These are some real signs your thyroid (and / or sex hormones) may need support—even if your labs are “normal.”
💡 Takeaways
If you’re in peri/menopause/andropause and not feeling like yourself, it’s time to stop settling for “everything looks fine.”
You deserve a deeper look at your thyroid function, especially as you grow older — because optimal health is about more than just surviving, it’s about thriving and we can’t thrive without healthy hormones.
A Functional Medicine approach in combination with targeted lifestyle medicine can offer you the tools to get there, with a more accurate and holistic assessment of your hormones, metabolism and overall well-being.
If you’re concerned about your thyroid or hormone health in general, or have questions about your symptoms, book a free Discovery Call. Let’s get you some answers - and a real plan to feel like you again.
