What are the symptoms of central hypothyroidism?
Central hypothyroidism can cause classic hypothyroid symptoms even when standard labs look normal. Common signs include constipation, feeling cold all the time, unexplained weight gain, fatigue, dry or brittle hair, and thinning of the outer third of the eyebrows. What makes central hypothyroidism distinctive is that these symptoms persist despite thyroid lab results that a provider may read as normal.
What if your labs look normal, according to your healthcare provider, and you still feel awful?
You have hypothyroid symptoms:
- Constipated
- Cold all the time
- Gaining weight
- Fatigued
- Dry, brittle hair
- Thinning of the outer third of your eyebrows
Classic hypothyroid signs, but your labs look normal.
You probably have central hypothyroidism.
Central hypothyroidism is when your hypothalamus is not communicating appropriately with your pituitary gland. So your pituitary gland is not stimulating your thyroid to make enough thyroid hormone for you.
Oftentimes your hypothalamus is resistant to your thyroid hormone - so your TSH is actually normal or low even though your T4 and T3 levels are low end of normal. Free T3 is the most active thyroid hormone and is not often measured. And if free T4 and free T3 is not looked at in comparison to TSH, central hypothyroidism can be missed.
When T4 and T3 are high, TSH should be low. When T4 and T3 are low, TSH should be high. If free T4 and free T3 levels do not correspond with serum TSH then that is a classic sign of central hypothyroidism.
Central hypothyroidism is typically caused by hypothalamic dysfunction.
Hypothalamic dysfunction means you have microinflammation in the hypothalamus. Your hypothalamus is no longer doing its job appropriately, in this case, not stimulating your thyroid to produce enough thyroid hormone.
In order to normalize thyroid hormone production, have better thyroid hormone metabolism and function, and ultimately feel better, you need to optimize hypothalamus function.
The best way to optimize hypothalamus function is to take Genesis Gold® - four grams per 50 pounds of body weight every day. With optimal hypothalamus function, your free T3 and free T4 levels will start to rise.
You will have more energy.
Your bowels will move regularly.
You'll sleep better.
Your memory will be better.
Your temperature regulation will normalize.
And over time, your blood work will reflect how you feel.
If you have questions, please join us in our Hormone Reboot Training.
Frequently Asked Questions
What is central hypothyroidism?
Central hypothyroidism is a form of low thyroid function that originates in the brain rather than the thyroid gland itself. It occurs when the hypothalamus and pituitary gland don't communicate properly, so the pituitary doesn't signal the thyroid to make enough thyroid hormone. Because the problem is in the signaling rather than the thyroid gland, it can be missed by standard testing that focuses mainly on TSH.
Can you have hypothyroid symptoms with normal labs?
Yes. It's possible to have significant hypothyroid symptoms while standard thyroid labs, especially TSH, appear normal. This can happen in central hypothyroidism, where the signaling between the hypothalamus, pituitary, and thyroid is disrupted. In these cases, free T3 and free T4 may sit at the low end of normal while TSH is normal or low — a mismatch that can be missed unless those values are compared directly.
Why do my TSH, T4, and T3 not match up?
Normally, thyroid hormones and TSH move in opposite directions: when T4 and T3 are high, TSH should be low, and when T4 and T3 are low, TSH should be high. When free T4 and free T3 levels don't correspond appropriately with serum TSH, that mismatch can be a classic sign of central hypothyroidism. Reviewing these values together, rather than TSH alone, is key to catching it.
Why isn't free T3 usually tested?
Free T3 is the most active thyroid hormone, but it's often not included in standard thyroid panels, which frequently measure only TSH or TSH plus T4. Because free T3 isn't routinely measured, a meaningful part of the thyroid picture can be missed. If you have persistent hypothyroid symptoms with normal TSH, it's reasonable to ask your healthcare provider about testing free T3 and free T4.
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