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Cellular Hypothyroidism - The Sneaky Thyroid Disease

Do you still feel exhausted, cold and sad even with 'normal' thyroid levels? Not all thyroid diseases can be diagnosed with a simple TSH test.


One sneaky thyroid disease that I often see flying under the radar is cellular hypothyroidism.


What is cellular hypothyroidism?

When we talk about hypothyroidism, it’s usually in the context of low thyroid hormone levels. But cellular hypothyroidism is different. You may have ‘normal’ thyroid hormone levels, but the hormones cannot get into your cells.


Why is this a problem? We need the thyroid hormones to make it into the cell before we can reap all of the metabolic effects.


If the thyroid hormones don’t enter the cells, it is just as much of a problem as not having enough thyroid hormone. In fact, it can be worse because it allows hypothyroidism to go untreated.


This can be incredibly frustrating for people. You might be haunted by hypothyroid symptoms, but your doctor tells you that you’re fine because your TSH, T4 and T3 levels are fine.


What causes cellular hypothyroidism?

The number one reason I see leading to cellular hypothyroidism is stress.


High cortisol levels suppress the thyroid and conversion from T4 into active T3. Instead, it is forced to produce more reverse T3, which competes with active T3.


There are also many conditions that affect the transport of thyroid hormone into the cells. Some of these include:

  • Insulin resistance and diabetes

  • Obesity

  • Chronic dieting

  • Depression

  • Anxiety

  • Bipolar disorder

  • Neurodegenerative disease

  • Aging

  • Chronic fatigue syndrome

  • Fibromyalgia

  • Migraines

  • Chronic infections

  • Chronic stress

  • Heart disease

  • Inflammation

  • Chronic illness

  • High cholesterol and triglycerides

So if you have one or more of these concerns and have stubborn thyroid symptoms, it might not be your levels that are the biggest issue.

How can we identify cellular hypothyroidism?

We know that cellular hypothyroidism can occur even with normal test results. So how do we identify it?


It usually comes down to a combination of specific test results and how you present. If you present with normal TSH, we may consider:

  • Tallying thyroid-related symptoms such as low basal body temperature, weight gain, fatigue, depression, cold extremities and cold intolerances

  • Checking the ratio of T3/reverse T3

  • Other testing options such as resting metabolic rate and sex hormone-binding globulin (SHBG) levels

We'll also consider any potential underlying causes that could be causing cellular hypothyroidism such as chronic stress or health conditions.

What to do if you think this is the cause of your thyroid symptoms

There are 3 simple steps to take if you think that you might have cellular hypothyroidism.


#1 - Request further testing

Start by speaking to your healthcare professional about testing your T4, T3 and reverse T3 levels.


Be aware that you will likely need to pay out of pocket for one or more of these tests. But it is often worth the investment to uncover what is going on.


#2 - Take steps to manage your stress levels

We know that cortisol levels are typically behind this concern. High stress levels also impact on the other potential contributing issues we discussed. So a simple way to start working on your symptoms now is managing your stress levels effectively.


Don't know where to start? Give this article a read.


#3 - Seek tailored advice from a professional who understands cellular hypothyroidism

This is not a simple condition to navigate solo. That's why it's best to work with a practitioner who has experience working with this form of hypothyroidism.


You don't have to do this alone - there is help available. To get started, book an appointment with Tara here.

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