January was Thyroid Awareness Month, however, thyroid health is a topic that should be discussed year-round. It’s estimated that as many as 20 million people in the United States have a thyroid problem such as Hashimoto’s disease or Graves’ disease. The alarming part is that nearly half of those people with thyroid disease have no idea they do. 

I’ve had my own battle with thyroid disease. During my second year of medical school, I was having panic attacks, tremors, and insomnia. My tremors got so bad that my friends noticed it and convinced me to see a doctor. My doctor brushed off my concerns telling me it was just stress. She told me it was common to think I have every disease I’m studying.

I finally found a doctor who listened to my concerns and it turned out my instincts were right. I was diagnosed with Graves’ disease, an autoimmune disease in which my thyroid was attacking itself and causing it to become overactive.

As both a functional medicine physician and a thyroid patient, I hate thinking how badly conventional medicine is failing people with thyroid dysfunction because I know how awful it feels to go through the medical mill. The doctors who tell you all the early warning signs of thyroid problems are all in your head.. The early signs of thyroid problems get worse and worse and worse, while your doctor brushes them off and insists that you are getting standard‑of‑care treatment.

I’m going to tell you the early warning signs of thyroid problems to look for, how to understand thyroid test results, and proven solutions to reverse your symptoms. First, let’s discuss what the thyroid is and how it works. 

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How Your Thyroid Works

The thyroid, a butterfly-shaped gland at the center of the front of your neck, is the master gland of metabolism. How well your thyroid is functioning is interrelated with every system in your body. If your thyroid is not running optimally, then neither are you.

Your thyroid powers every cell in your body through the hormones it produces. These hormones determine the energy level and reproduction of each cell, keeping your organs powered up and managing your overall metabolism. The process of creating, regulating, and delivering these hormones begins in your brain.

The hypothalamus, which is responsible for managing hunger, thirst, sleep, hormones, and body temperature, among other important functions, monitors the level of thyroid hormones present in your bloodstream. If it determines energy levels are low, it sends out Thyroid Releasing Hormone (TRH), to your pituitary gland. Your pituitary gland, a pea-sized gland at the base of your brain, releases Thyroid Stimulating Hormone (TSH) directly to the thyroid.

Your thyroid is then prompted to produce thyroid hormone using an amino acid called tyrosine and iodine. It converts the tyrosine into thyroglobulin and attaches between one and four iodine atoms, creating T1, T2, T3, and T4 respectively.

T4 is the primary output of your thyroid. It is circulated throughout the bloodstream and stored in tissues. A much smaller percentage of the hormones produced is T3, the active form of thyroid hormone. T2 and T1 make up an even smaller percentage. T2 is involved in metabolism rate, however, researchers are still unsure of what role these two hormones play.

What Can Go Wrong?

Thyroid disease is one of the most underdiagnosed and improperly treated health conditions. 

When your thyroid isn’t working properly, it can cause an array of issues. There are two primary types of thyroid disease: hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Conventional medicine doctors who suspect a patient has something wrong with their thyroid only check their thyroid hormone levels, which indicate if the patient has hypo- or hyperthyroidism. They will not determine if it is caused by an autoimmune disease. Don’t worry, I’ll tell you about the warning signs in just a minute. Let’s dive deeper into what can go wrong with your thyroid. 


The most common form of thyroid disease is hypothyroidism, which is when your thyroid is underactive and does not produce enough thyroid hormone. This can happen because your pituitary gland is malfunctioning and not sending enough Thyroid Stimulating Hormone (TSH) to your thyroid, or your TSH levels are normal, but your thyroid isn’t producing enough T4 and T3 to adequately fuel your cells. I’ll explain how you can read your thyroid test results and what tests are done to check thyroid function later. 

warning signs of a thyroid problemwarning signs of a thyroid problem https://content.amymyersmd.com/article/thyroid-problem-solutions/Early warning signs of a thyroid problem – infographic – Amy Myers MD®

Early Warning Signs of Hypothyroidism

One of the most common causes of hypothyroidism is Hashimoto’s disease, an autoimmune disease where your immune system attacks your thyroid. Actually, most patients’ thyroid disease is triggered by an autoimmune condition.1 


On the other end of the thyroid spectrum is hyperthyroidism, which is less common yet more dangerous than hypothyroidism.2 When thyroid hormones are too high, energy metabolism will speed up, causing the body to burn through nutrients too quickly. This can result in malnutrition and lead to a wide range of problems. I personally was eating everything in sight and went from a size 4 to a size 0 in a matter of months. Trust me when I tell you that it was not healthy!

The type of thyroid disease I was diagnosed with, Graves’ disease, is a form of hyperthyroidism. In patients with hyperthyroidism, the thyroid produces an excess of thyroid hormones, sending your body into overdrive. 

Early warning signs of a thyroid problem – infographic – Amy Myers MD®Early warning signs of a thyroid problem - infographic - Amy Myers MD® https://content.amymyersmd.com/article/thyroid-problem-solutions/Early warning signs of a thyroid problem – infographic – Amy Myers MD®

Early Warning Signs of Hyperthyroidism

  • Hot flushes, sweating
  • Unintentional weight loss
  • Frequent stools, loose stool or diarrhea
  • Difficulty sleeping and insomnia
  • Anxiety, irritability, or constant fatigue
  • Elevated heart rate
  • Changes in menstrual cycles
  • Reduced libido
  • Bulging eyes
  • Thick red skin on shins or feet
  • Increased appetite
  • Osteoporosis
  • Hand tremors
  • Muscle weakness

How Thyroid Disease is Diagnosed

It should come as no surprise given conventional medicine’s “one-size-fits-all” approach to thyroid disease focuses on treating symptoms rather than getting to the root cause of your condition. Unfortunately, conventional doctors are still using this outdated model.

One question I am most frequently asked is, “What are the most important thyroid tests to assess my thyroid’s function?” This, along with what the thyroid test results mean, are two of the most important topics to understand to determine if you truly have thyroid disease or not. And let me tell you, there is a lot of misinformation on the internet and in the conventional medicine world surrounding thyroid tests and thyroid test results.

Here are three methods to determine if you have a thyroid problem: 

  • Blood testing: This is the first step. In hyperthyroidism, the thyroid-stimulating hormone (TSH) will be very low and the Free T4 and Free T3 will be elevated. In autoimmune conditions, you will see elevated levels of antibodies as well. 
  • Radioactive iodine uptake (RAIU): This is the next step in diagnosing a thyroid imbalance. An RAIU using a small dose of I-131 will determine how much iodine the thyroid takes up. A high iodine uptake is indicative of Graves’ disease. This test can be helpful in ruling out other possible causes of an overactive thyroid.
  • Ultrasound: This is helpful to look at nodules on the thyroid, and your doctor may request you have a fine needle biopsy to confirm that the nodules are not cancerous.

Which Lab Tests are Best to Determine if You Have A Thyroid Problem?

To get a complete picture of a patient’s thyroid health and medical needs, I recommend a doctor order all six tests listed below. It’s important that the results are read for optimal levels, not “normal” levels. I’ll tell you the difference between optimal levels and normal levels next. 

  • TSH Levels: This test is based on the activity of the pituitary gland. High TSH levels indicate hypothyroidism whereas a low TSH level indicates hyperthyroidism. 
  • Free T4 (FT4): FT4 refers to the unbound T4 – i.e. the one found in the bloodstream. High FT4 levels indicate hyperthyroidism whereas low FT4 levels indicate hypothyroidism. 
  • Free T3 (FT3): High FT3 indicates hyperthyroidism whereas low FT3 indicates hypothyroidism. 
  • Reverse T3 (RT3): High RT3 levels indicate that there’s a high conversion of T4 to RT3 instead of FT3. This is an indicator of hypothyroidism. 
  • Antibodies test (TPO – TgAb levels): Since the most common forms of thyroid disease are autoimmune diseases, detection of thyroid antibodies is essential to get an accurate result. There are two antibodies of concern: TPOAb and TgAb. TPOAb refers to the thyroid peroxidase antibodies that target the enzyme that mediates the iodination of thyroglobulin. TgAb refers to the antibodies that attack thyroglobulin.

If you want to test your thyroid levels at home, I recommend using LetsGetChecked home thyroid tests. You can do the test in the privacy of your own home and then discuss your results with your functional medicine doctor. 

What are the Optimal Lab Values for Thyroid Tests?

I found that these are the ranges below are the ones in which my patients thrive:3  

  • TSH 1-2 UIU/ML or lower (Armour or compounded T3 can artificially suppress TSH)
  • FT4 >1.1 NG/DL
  • FT3 > 3.2 PG/ML
  • RT3 less than a 10:1 ratio RT3:FT3
  • TPO – TgAb – < 4 IU/ML or negative

How to Improve Your Thyroid Function

Managing your thyroid hormone levels through thyroid medication is only part of the process. The real work comes in identifying the early warning signs of a thyroid problem, addressing the underlying factors that caused your thyroid disease, and making healthy lifestyle changes to remove them. I call this The Myers Way®

This proven approach is a lifestyle that relieves and reverses your symptoms of thyroid disease, helps you get off your harsh medication, and enables you to live a healthy, energetic, and pain-free life.

This approach rests on four pillars, each of which has been tested through extensive research and have seen amazing results with thousands of patients over my own years of practice as a physician and while empowering the world to achieve optimal health through Amy Myers MD®.

The Myers Way® starts by healing your gut. Once you’ve healed your gut, it’s time to make a lifestyle change by getting rid of gluten, grains, and legumes from your diet.

For many people, 80% of the healing occurs while addressing the first two pillars. If you haven’t seen a full reversal of your symptoms, you need to dig deeper and that means reducing your exposure to toxins. Once Pillar III is addressed, I turn to the next piece of the puzzle: underlying infections and stress

To support optimal thyroid function while following The Myers Way®, I recommend adding The Myers Way® Multivitamin to your supplement regimen. This specially-formulated multivitamin is jam-packed with micronutrients in the forms your body wants and the amounts your thyroid needs. With optimal levels of thyroid-supporting minerals such as zinc, selenium, and iodine, alongside antioxidants including vitamins C and E and other free radical scavengers, no other multivitamin on the market does more to support your thyroid!

I personally lived with thyroid disease and I’m here to tell you that vibrant, glowing health is not a fantasy. Recognizing the early warning signs of thyroid problems is the first step to getting to the root cause of your symptoms. When you finally get your thyroid back into balance, you won’t believe how terrific you feel.

FAQs about Thyroid Disease


What’s the difference between hyperthyroidism and hypothyroidism?

The most common form of thyroid disease is hypothyroidism, which is when your thyroid is underactive and does not produce enough thyroid hormone. In contrast, hyperthyroidism is when your thyroid produces too many thyroid hormones and energy metabolism will speed up, causing the body to burn through nutrients too quickly.


What are early warning signs of hyporthyroidism?

Some of the early warning signs of a underactive thyroid include fatigue, brain fog, weight gain or inability to lose weight, cold hands or feet, hair loss, constipation, poor concentration, and low libido, depression, and decreased heart rate and body temperature.


What are the early warning signs of hyperthyroidism?

The early signs of an overactive thyroid include hot flushes, sweating, unintentional weight loss, frequent stools, loose stool or diarrhea, difficulty sleeping and insomnia, anxiety, irritability, or constant fatigue, an elevated heart rate, changes in menstrual cycles, reduced libido, bulging eyes, thick red skin on shins or feet, an increased appetite, hand tremors, and muscle weakness.

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Article Sources

  1. Hypothyroidism (primary). Birte Nygaard, MD, PhD. BMJ Clinical Evidence. 2010.
  2. Hyperthyroidism. Simone De Leo, Sun Y Lee, and Lewis E Braverman. Lancet. 2016.
  3. Interpreting Thyroid Levels Tests. Corey Whelan. Healthline. 2019.