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Could you have Cellular Hypothyroidism even if your thyroid tests are normal?



If you have noticed some changes to your health lately such as weight gain despite eating well, digestive issues, hair loss, PMS, menstrual irregularities, a cold bottom, hands or feet and high cholesterol then read on….


This topic is close to my heart for two reasons, I experienced this myself and many of my patients suffer with this too. I have a family history of thyroid disorders; my grandma was on thyroid medication all her adult life and mum had some thyroid nodules. So, after my third child, no surprise I had started suffering with some hardcore “hypo” thyroid symptoms such as brain fog, finding it hard to finish a sentence and constant bloating. I looked more pregnant than I was in my pregnancy’s, despite eating well. I got my thyroid blood tests done and the standard TSH test was within range and everything was normal even though I didn’t feel “normal”.


Cellular hypothyroidism – what is it?

Cellular hypothyroidism is a condition where the thyroid hormones are in a normal range, the thyroid gland is working fine at this stage, however the thyroid hormones don’t reach the cell to be activated and produce energy. This leads to reduction in thyroid transport and deactivation of thyroid hormones. The symptoms are very similar to primary hypothyroidism such as irregular periods, heavy periods, bloating, fatigue, brain fog, dry cracked skin, yet all the thyroid studies T3, T4, TSH results come back normal.

So frustrating!



What are the symptoms that Women may feel?

· Weight gain despite eating well.

· Irregular Periods – heavy, painful, spotting during cycle.

· Gut issues – bloating, constipation, SIBO (small intestinal bacterial overgrowth)

· Cold bottom, hands, feet.

· Brain fog, anxiety, depression. Unable to cope as well as they once used to.

· Dry cracked skin

· Headaches

· Decreased libido

· Hair loss, hair thinning

· Eyebrows – out 1/3 loss

· Water retention, puffiness

· Fertility issues, issues conceiving




What are the causes of cellular hypothyroidism?


As mentioned before this is a cellular issue not a thyroid gland issue. The transport of thyroid hormones into cells is energy dependant. If the mitochondria (guys that produce energy in the cells) sense danger, they won’t produce energy. Instead they will act in “defence” mode and not accept the normal amount of thyroid into the cell. Cellular metabolism, growth, repair, and development slow down to address and control the threat. This reduces transport of thyroid hormone into the cell and instead can increase the levels of reverse T3 (RT3). Hence a high level of RT3 can be a valuable tool when testing for cellular hypothyroidism.



Conditions that are linked with reduced cellular energy include:




· Insulin resistance

· Dieting

· Stress

· Migraines

· Inflammation

· Toxins – SIBO, parasites, candida overgrowth.

· Hypoxia – low oxygen into cells – mouth breathers

· Chronic fatigue syndrome, Fibromyalgia



Stress and Thyroid


Stress can be from any physical and emotional response that puts extra tension on the body. Triggers of stress can be overexercising, a microorganism such as parasite, bacterial or fungal overgrowth, trauma, worries about finances, deadlines, caring for children and or sick parents, career pressure and illness such as covid.

Stress can reduce the transport of T4 the storage thyroid hormone into cells by up to 42%.

Dieting and Cellular Hypothyroidism



For the chronic dieters out there, this one is for you, Chronic dieting can worsen the thyroid and can even lead to increased weight gain. Reduction of calories can decrease the uptake of T4 (thyroid hormone) into cells – meaning it is very difficult to lose weight while restricting calories or yoyo dieting. A study on the impact of dieting, showed that weight loss occurred at half the rate compared to people that consumed the same calorie intake. Also noted was that weight gain occurred at three times the rate compared to the non-dieters.

What happens if Cellular hypothyroidism is misdiagnosed?

According to Eric Balcavage, author “The Thyroid debacle”, if cellular hypothyroidism is misdiagnosed, then damage to the thyroid gland over the next few years, months or even days can occur. By the time people get a thyroid diagnosis such as primary hypothyroidism, the gland is mostly damaged and more than 90% of the thyroid gland tissue is destroyed. Autoimmune attack to the thyroid gland such as Hashimoto’s is a common finding. Dr Balcovage believes that hypothyroidism starts in your cells and is not a mistake, but a protective mechanism.


Can you test for cellular Hypothyroidism?

At this stage there is no specific test for cellular hypothyroidism, however using some markers can be very helpful. A full thyroid panel including reverse free T3 ratio to RT3, metabolic and stress markers and optional gut testing. Basal body temperature charting in conjunction with signs and symptoms of cellular hypothyroidism. Sex hormone binding globulin (SHBG) can be lower in cellular hypothyroid patients. SHBG is formed in the liver in response to tissue levels of thyroid and oestrogen and is lower in insulin resistance, obesity, diabetes due to lower transport of thyroid hormones into cells.


So, what can we do to help our cells take in the thyroid hormones?

We may not even need to treat the thyroid, if we can get to the cause of the underlying condition then this can is the right path to treatment. If stress is a player, then identifying stressors and seeing what you can let go of. Asking for help can reduce a stress load, perhaps a cleaner, assistance at work. Putting up strong boundaries, saying no and having regular self-care habits. Managing inflammation, insulin resistance and any other hormonal imbalances.




Vitamin A – great for people on T3 medication who feel worse! It sensitises the cells to taking in thyroid hormone and activates the thyroid receptors, the ones that take in the thyroid hormone. Sources of vitamin A include cod liver oil, liver, eggs, salmon. Only a small dose of 200Iu is required.




Acetyl L carnitine is a fantastic supplement for “happy mitochondria” taken first thing in the morning before a workout. It helps to transport fatty acids to the mitochondria to be converted to energy. It’s made in the liver however if you have fatty liver, insulin resistance or cellular aging then the levels will most likely be low.


Exercise is a great way at activating the cellular receptors. All in balance not too much or too little. Pilates, strength training and yoga have long term benefits on weight loss, muscle growth and mental health benefits.




If you think you may have cellular hypothyroidism and are struggling finding answers, make an appointment with Alysia Raftery. Alysia has over 14 years Naturopathy experience helping women find their purpose and energy back. Her mission is to get the message out, that the thyroid symptoms are not in your head, and that there is help for this.


Book Here for an appointment with Alysia Raftery Naturopath, Myotherapist.








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