Areas of expertise
Thyroid Health
Exhausted, cold, foggy, and told your thyroid is normal. Normal on paper and well are not the same finding, and thyroid problems in women are missed and under-treated more than almost anything else I see.
What is happening
One gland, and almosteverything it touches.
Your thyroid helps regulate metabolism and weight, energy and body temperature, mood and mental clarity, digestion, heart rate and blood pressure, menstrual health and fertility, and the condition of your skin, hair and nails. When it does not produce enough hormone, a great many systems slow down at once, which is exactly why the symptoms rarely look like a thyroid problem from the outside.
Hashimoto’s thyroiditis is the most common cause of low thyroid function in this country. It is autoimmune, meaning the immune system gradually attacks the thyroid, and because levels shift over time the symptoms come and go. Women often describe stretches of feeling better followed by feeling worse again, and are told the fluctuation means nothing is wrong.
It is worth asking about if you notice fullness in your neck, if autoimmune conditions run in your family, or if your symptoms have never quite matched what your results say. Thyroid care is not a single lab value, and treating one number while ignoring how you feel is how so many women end up medicated and still unwell.
What you may recognize
Common signs of low thyroid function.
- Persistent fatigue that sleep does not fix
- Weight gain, or weight that will not shift
- Feeling cold when nobody else does
- Constipation or sluggish digestion
- Dry skin, brittle nails, thinning or falling hair
- Brain fog, low mood or depression
- Irregular, heavy or painful periods
- A slower heart rate, or lower blood pressure
Left unaddressed, low thyroid function also has consequences further out, for fertility, cardiovascular health and bone health.
How this is approached
What your care can include.
- 01
A full thyroid evaluation where appropriate, which often means TSH, Free T4, Free T3, thyroid antibodies and the related nutrient markers, rather than one value on its own.
- 02
A look at what sits alongside it, including sleep, stress, nutrition and gut health, all of which influence how you feel and how well treatment works.
- 03
Medication management where it is indicated, including levothyroxine or combination T3 and T4 therapy, chosen for your case rather than by default.
- 04
Direct attention to the symptoms affecting your life now, whether that is fatigue, weight, mood, or menstrual and menopausal changes.
- 05
Nutritional support where it is relevant, including selenium, zinc, vitamin D and B vitamins, and screening for gluten sensitivity when the pattern warrants it.
- 06
Ongoing monitoring and adjustment, with the goal of you feeling well rather than simply reading normal on paper.
You will always be part of the decision, and you will always know what the plan is.
← All areas of expertiseQuestions
The three I am asked most.
Do my labs have to be abnormal to get help?
Not necessarily. A great many women feel unwell while their results sit inside a normal range, and that range is wide. I look at your symptoms, your history and the fuller thyroid picture where appropriate, rather than a single number on its own.
What do you actually test?
Depending on your symptoms, a more complete evaluation than most women have had, which may include TSH, Free T4, Free T3, thyroid antibodies and related nutrient markers. I only recommend testing that will meaningfully change your plan.
Can this be managed virtually?
Yes, and thyroid care suits it well. Symptoms are reviewed, labs are ordered where appropriate, medication is managed where indicated, and progress is monitored over time. If an examination or imaging is needed, I help you arrange it locally and bring the findings back in.