Thyroid testing and treatments in Cincinnati OH

The thyroid gland, located in the front of the neck, is responsible for taking certain nutrients that are consumed from the food we eat and converting them into thyroid hormones.

The hormones produced by the thyroid have an impact on nearly every single tissue and organ in the body. Thyroid hormones are vital in how your body uses energy, regulates body temperature, controls metabolism, and maintains optimal health within the brain, heart, GI tract, muscles, and other organs.

Patients with suboptimal thyroid function are at an increased risk for: heart disease, heart failure, high cholesterol, weight gain, metabolic syndrome, elevated blood pressure, birth defects, infertility, depression.

What are the causes of Hypothyroidism or Low thyroid function?
Hashimoto’s Thyroiditis Adrenal/Cortisol imbalance Bromide toxicity Prescription medications Age/Menopause Dysbiosis Environmental toxins Poor conversion of T4 to T3 Thyroid hormone resistance

Hashimoto’s Thyroiditis is an autoimmune disease that affects the thyroid and destroys the thyroid tissue. This is the most common cause of thyroid dysfunction.

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High cortisol interferes with the conversion of T4 to T3. High cortisol also suppresses TSH.

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Bromide is a chemical compound found in commercially prepared baked goods, soft drinks, some vegetable oils, pesticides and plastics, carpets and mattresses. Bromide displaces iodine from the thyroid molecule so that thyroid hormones are not getting made.

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Selenium is needed to convert T4 into the active hormone T3.

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Birth control pills, Lithium, seizure medications, sulfonylureas and amiodarone interfere with how thyroid hormones are made.

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It is known that the prevalence of thyroid disorders increases with age. Thyroid hormones are not made as effectively as we age.

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There are trillions of microbes- bacteria, fungi, viruses, even parasites- living together in our gastrointestinal tract. These organisms are meant to live synergistically, keeping us healthy. Dysbiosis is an imbalance in the types of microbes present, which can contribute to a range of health conditions, including thyroid dysfunction. Not only can disturbances in the microbiome suppress thyroid function and lead to an autoimmune condition called Hashimoto’s, but the reverse is true also. Low thyroid function can lead to inflammation and poor gut health.

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Fluoride, mercury (usually from tooth fillings), bisphenol A, phthalates and tobacco can block thyroid hormone function.

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Optimal conversion of T4 (pro-hormone) to T3 (active thyroid hormone) plays a critical role in addressing the symptoms associated with low thyroid. Several factors that decrease this conversion include: poor gut health or dysbiosis, low protein diet, heavy metal toxicity, environmental pollutants, medications (such as birth control pills), nutrient deficiencies, liver and kidney disease, and excessive alcohol consumption.

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With classic hypothyroidism a failure of the thyroid gland itself has occurred. In thyroid hormone resistance, the cause is not that the thyroid is under-functioning, but rather that the body’s cells aren’t responding to the hormones being produced. The thyroid stimulating hormone (TSH) test will often come back within “normal” range despite experiencing all of the symptoms. Causes of thyroid hormone resistance include: nutritional deficiencies, genetic predisposition, and imbalances in the stress hormone, cortisol.

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Symptoms of Hypothyroidism
or Low thyroid function

  • Weight gain
  • Difficulty losing weight
  • Dry skin
  • Hair loss or thinning hair
  • Swelling in face, hands, ankles, or feet
  • Feeling cold – especially cold hands and feet
  • Hertogue’s sign (lateral eyebrow thinning)
  • Heavy periods or irregular bleeding
  • Fatigue
  • Constipation
  • Slower thinking
  • Goiter (swelling of the thyroid gland that is visible in the neck)
  • Feeling down or depressed
  • Memory loss
  • Anxiety
  • Arthralgias, muscle aches
  • Headaches
  • Hoarseness
  • Too tired to exercise
  • May have heat intolerance as well as cold intolerance
  • Fluid retention
  • Periorbital or ankle edema
  • Hypertension (elevated blood pressure)
  • Brain fog
Thyroid Testing Process

The step-by-step patient experience.

Assessing gut health is vital to understand the root cause of thyroid disease. Diet, exercise, strategies for treating gut health, optimal supplementation to support thyroid function, as well as additional testing and resources within our office, are all discussed as an important part of this treatment plan.

Step 1 Step 2 Step 3
Step 1

The Consultation

Your initial consultation with one of our providers will begin with a thorough look into your past medical and surgical history, family history, and current medications, with specific attention paid to the symptoms you are struggling with. This visit will be billed to your insurance company.

Step 2

Make the Correct Diagnosis

What is a comprehensive thyroid panel? The thyroid is best tested with a blood test. The labs that we look at include: TSH, Free T4, Free T3, Reverse T3, Thyroid peroxidase (TPO) and Anti-thyroglobulin antibodies. Other useful tests include: vitamin/nutrient testing, 4 point salivary cortisol kit, food sensitivity/allergy testing. Assessing gut health is vital to understand the root cause of thyroid disease. We will discuss with you the testing and treatments we offer to promote gut health.

Step 3

Follow up & Results

We will see you back in the office in 1 to 2 weeks, review your test results and initiate therapy if appropriate. This visit is billed to your health insurance company. Diet, exercise, strategies for treating gut health, optimal supplementation to support thyroid function, as well as additional testing and resources within our office, are all discussed as an important part of this treatment plan.

Additional Information
Testimonials FAQ's

I have had a thyroid issue since 2002. I switched couple doctors, all were the same. They were checking my blood work and prescribing the exact same medicine every visit. But Dr Jennifer Thieman is different and changed my life 3 years ago. At every visit she gave me print outs comparing with my last year blood work result and discuss what is my problem, how it can be improved, explained all my questions, listened to me and try to help me. She is my Angel! Thank you Dr Thieman!

Aygen G

Thank you, thank you, thank you to Dr. Thieman for listening to me and taking care of me these past few months. I am such a better version of myself now!"

Why is treatment with Synthroid or Levothyroxine alone unsuccessful in many patients?

Levothyroxine (brand names Synthroid, Levoxyl, Tirosint) is T4 hormone. The thyroid gland secretes T4 in response to TSH and the body’s needs for thyroid hormones. However, many patients don’t adequately convert the prohormone, T4, into the more active hormone, T3. When this conversion is not happening adequately, symptoms of hypothyroidism will occur – even with a “normal” TSH! Therefore, our approach to treating thyroid dysfunction is often to use a combination of T3 and T4 hormones, as well as optimize the T4 to T3 conversion. This approach has been shown in the literature to be more effective than using T4 alone to address hypothyroid symptoms.
Traditionally – perhaps because of large pharmaceutical companies, doctors have been trained to test only the TSH and occasionally the T4 levels and thus, replace only the T4 hormones.

My doctor told me that my low TSH would put me at risk for osteoporosis and atrial fibrillation. Is this true?

In the traditional medical community, there is a lot of concern that suppressing the TSH will cause medical conditions such as osteoporosis and atrial fibrillation. It is true that endogenous hyperthyroidism (patients developing hyperthyroidism on their own – not treating hypothyroidism) is associated with osteoporosis. There is medical literature on both sides of the fence as to whether bone loss occurs or not with suppressed levels of TSH. We monitor bone turnover closely in our patients who have a suppressed TSH.

It's simple— identify the problem areas of your body and we will recommend the right treatment plan for you.