Having thyroid symptoms problems? Your first inclination might be to find a hormone specialist, or an endocrinologist, to get a diagnosis or a treatment plan. Endocrinologists diagnose, treat, and manage several different conditions that affect your endocrine system, including your thyroid.
The specialty of endocrinology is an incredible one and like all specialists, endocrinologists go through years and years of training to take care of the specialty’s most complex conditions. And as with all specialties, conventional medicine is great at treating you if you’re severely sick, a very complex case, or needing complex interventions.
Where they may fall short is two-fold: if you’re feeling very symptomatic, but aren’t needing or wanting prescription intervention, OR if you’re feeling symptomatic, but your lab values fall within your clinic’s reference range.
Let’s talk first about when you do need to seek out an endocrinologist for their valuable opinion and speciality.
When you DO need an endocrinologist: collaborative care
Even with functional medicine, we realize there are collaborative reasons to intermingle with our conventional colleagues. Endocrinologists have great perspective on complex conditions: they have seen the range of disease severity and have a good idea of where you as a patient land on that spectrum. They can help us rule out the worst possible scenarios and give all involved the peace of mind that utilizing natural medicine is the best option for you.
With their broad and vast experience, endocrinologists are also important for giving you and your integrative practitioner a second opinion on a diagnosis that just isn’t responding how we think it should to natural treatments. They can help us answer the question: is there something else going on here?
When you need more complete integrative care, and not just endocrinology
Yes, you need the labwork an endocrinologist would order, but you if you’re having thyroid symptoms problems, you also need a bigger, more holistic perspective.
I fully believe that endocrinologist know A LOT—but whether they just don’t have time for OR don’t see a need for comprehensive testing, I’m not quite sure. In conversations between patients and endocrinologists, I’ve heard “we don’t need to know your T4 levels because your TSH is within normal range” or “cellular hypothyroidism isn’t a real condition” or “I’m not running your thyroid antibodies because your TSH isn’t abnormal.”
All of those comments can a) be damaging to patients who are looking for support and b) lack the perspective needed to help treat a condition that might not be a full blown disease yet.
Your hormones (ALL of them) work intertwined, so understanding the full thyroid picture is very important. Many endocrinologists monitor your thyroid function with just a TSH, which in functional medicine we know fails to give information on how your body is actually responding to that TSH value. If your TSH is fine, but thyroid output (T4 & T3) is low or your cells aren’t utilizing the hormone correctly (Reverse T3), we can target the specific block in the thyroid hormone cascade, most commonly without prescription needs.
Endocrinologist also don’t typically run ‘screening tests,’ meaning running thyroid antibodies without an abnormal TSH, or blood nutrients such as iodine ,iron, zinc or selenium (all of which we know are important for thyroid health).
Why does having a more complete picture help with thyroid symptoms problems?
We believe having the information, at least 1 data point, is very important to understanding your long term health. We’ve found Hashimoto’s thyroiditis several times in patients who do not have abnormal TSH values. What’s important here is that while it may not be impacting their TSH today, the autoimmune disease will destroy their gland until it’s no longer functional in a few decades. We focus on what to do today to help elongate the life of your gland.
That’s the overall goal of functional, integrative medicine: to treat potential issues NOW, to prevent bigger issues and disease later. We can help if you’re dealing with thyroid symptoms problems, whether you have an endocrinologist or not.
Learn more about what we can do to support you and your thyroid here.
Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.