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La Mesa, CA

Hypothyroidism Treatment in Rancho Santa Fe, CA

A picture of Dr. Mark Stengler

Hypothyroidism Treatment and Support

Dr. Stengler encounters a significant number of individuals each year who are dealing with thyroid issues. This observation, shared by many other physicians, leads to the belief that thyroid disorders have reached epidemic levels in our country. Several factors contribute to this rise, including environmental toxins, side effects from pharmaceutical drugs, and stress. The thyroid gland, located in the front of the neck and resembling a butterfly in shape, produces hormones that play a crucial role in regulating the metabolism of every cell in the body.

Hypothyroidism, characterized by low thyroid activity, is the most common thyroid disorder. While approximately 10 million Americans are diagnosed with hypothyroidism, Dr. Stengler estimates that the actual number of people affected is closer to 30 million, including those who remain undiagnosed. It is possible for individuals, as well as their doctors, to be unaware of an underactive thyroid.


Symptoms such as fatigue, cold hands and feet, unexplained weight gain, dry skin, hair loss, and depression can often be attributed to a busy and stressful lifestyle. However, they can also indicate low thyroid activity. While some individuals may experience multiple symptoms, others may not exhibit any at all. The typical hypothyroid patient is a woman in her late 40s or early 50s, but hypothyroidism can affect anyone at any age.

Common Causes

The most prevalent cause of hypothyroidism is Hashimoto's thyroiditis, an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, leading to inflammation and underproduction of thyroid hormones. Hypothyroidism is more commonly found in women, with a five to ten times higher occurrence rate compared to men. Genetic predisposition, hormonal imbalances (such as insulin resistance in diabetes), food allergies (such as gluten intolerance), and stress can all contribute to this condition. Less common causes include pituitary gland failure or a pituitary tumor.

Diagnosis Confusion

Properly diagnosing low thyroid activity can be challenging for many physicians, both traditional and holistic. Often, they rely solely on the thyroid-stimulating hormone (TSH) test, which provides a general indication of thyroid activity but overlooks the nuances of thyroid function. To ensure a comprehensive diagnosis, it is advisable to consult with a holistic doctor who can conduct a complete thyroid test panel, including assessing free T3 and free T4 (the primary thyroid hormones) as well as testing for thyroid antibodies.

In some cases, patients may have low free T3 and/or free T4 levels, confirming a diagnosis of low thyroid function. However, it is essential to consider that many individuals fall within the low side of the "normal" range for these hormones. While some conventional doctors may consider these levels acceptable, Dr. Stengler believes that the standard for "normal" is set too low. For example, the normal range for free T3, the most active thyroid hormone, is typically stated as 230 picograms per deciliter (pg/dL) to 420 pg/dL. A result of 240 pg/dL might be deemed acceptable by many doctors, but Dr. Stengler has observed that patients tend to feel significantly better when their T3 levels are closer to the mid-range, around 320 pg/dL or higher.

The same principle applies to free T4 levels. The normal range is usually defined as 0.8 nanograms per deciliter (ng/dL) to 1.8 ng/dL. Dr. Stengler has found that patients generally experience improved well-being when their free T4 levels are increased from 0.9 ng/dL to 1.2 ng/dL or higher.

It is important to note that while an individual may have normal free T4 levels, they may still have low or low-normal free T3 levels. This situation suggests difficulties in converting T4 to T3 within the body, which may require supplemental T3 or assistance with the conversion process. Given the high prevalence of undiagnosed low thyroid in the general population, understanding the complexities of these test results can greatly aid in treatment.

Hormone Replacement

Traditional physicians commonly prescribe synthetic T4 (sold as Synthroid, Levoxyl, and Levothroid) as the sole treatment for hypothyroidism. However, Dr. Stengler has found that synthetic T4 alone is often ineffective, particularly for individuals who struggle with converting T4 to T3. Simply increasing the dosage of T4 in such cases does not yield significant benefits.

In Dr. Stengler's practice, the preference is for natural, bioidentical thyroid hormone replacement therapies. Options such as Armour Thyroid and Nature-Throid Westhroid, which are derived from desiccated pig thyroid, provide both T3 and T4. Compounded bioidentical T4 and T3, which do not have an animal origin, are also considered suitable alternatives. These treatment options have rare side effects.

Nutritional Support

Dr. Stengler recommends specific nutrients to support the body in producing its own thyroid hormones for patients with low thyroid activity. These nutrients are safe for everyone and include:

  • L-tyrosine: This amino acid serves as the foundation for thyroid hormones. Taking 500 mg approximately 30 minutes before breakfast is advised.
  • Multivitamins: These supplements contain several nutrients, such as selenium, zinc, and B vitamins, which are essential for converting T4 to T3.
  • Iodine: An important component of T4 and T3, iodine intake is crucial. Consuming at least 150 micrograms (mcg) of iodine daily is recommended. However, individuals with Hashimoto's thyroiditis should seek medical guidance before starting iodine therapy. Higher doses may be beneficial but should be prescribed by a nutrition-oriented physician.

For further information about Dr. Stengler's practice and his clinic in Rancho Santa Fe, California, please visit our website at or give us a call at (760) 274-2377.

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