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Instead, functional medicine identifies these root causes: Autoimmune Thyroiditis (Hashimoto’s Disease): The most common cause of hypothyroidism in iodized salt regions Immune system attacks thyroid tissue Often triggered by: Intestinal permeability (“leaky gut”) Gluten sensitivity Chronic infections Chronic stress Environmental toxins Nutrient deficiencies Impaired T4-to-T3 Conversion: Nutritional deficiencies (selenium, iron, zinc) Liver dysfunction Gut dysbiosis Chronic inflammation Chronic stress and elevated cortisol Estrogen dominance Secondary Hypothyroidism: Pituitary dysfunction Hypothalamic dysfunction Chronic illness or stress Medication and Supplement Interference: Certain medications suppress thyroid function Nutrient malabsorption Timing of supplement/medication interactions Functional Medicine Treatment Approach: Rather than simply prescribing levothyroxine (synthetic T4), functional medicine addresses root causes: Identify and eliminate triggers (gluten, infections, toxins) Restore nutrient status (selenium, iron, zinc, vitamin D) Heal the gut (restore barrier function, optimize microbiome) Reduce inflammation (anti-inflammatory diet and lifestyle) Optimize conversion (support liver and peripheral tissue function) Balance cortisol (stress management, sleep optimization) Consider combination therapy (T4 + T3, or desiccated thyroid) Monitor comprehensively (full thyroid panel, not just TSH) Hyperthyroidism: The Accelerator Gone Wild Hyperthyroidism (overactive thyroid) is less common but equally problematic, causing: Anxiety and nervousness Rapid heart rate Weight loss despite eating Heat intolerance Tremors Sleep disturbances Irritability Common Causes: Graves’ disease (autoimmune) Thyroiditis (inflammation) Thyroid nodules Excessive iodine intake Medication side effects Functional Medicine Approach: Identify and address autoimmune triggers Reduce inflammation Support immune regulation Optimize nutrient status Address underlying infections or toxins Consider natural anti-thyroid compounds (PTU, methimazole under medical supervision) Hashimoto’s Thyroiditis: The Autoimmune Connection Hashimoto’s disease is an autoimmune condition where your immune system attacks your thyroid, causing progressive thyroid destruction and hypothyroidism