Living with Hashimoto’s: What I Wish I Knew from the Start (Part 1)

In 2017, I finally got an answer that explained years of confusing symptoms. But like many women with thyroid issues, the road to a diagnosis was long and frustrating.

The Early Signs

My body started sending me signals years before my official diagnosis. I experienced sudden heart palpitations, waves of anxiety that seemed to come out of nowhere, and a strange lump in my throat that sometimes made it hard to breathe. The hardest part was the inconsistency. Some days I felt fine, and then suddenly everything would flare again. It was both scary and exhausting.

Like many patients, I went through every heart test imaginable, EKGs, echocardiograms, stress tests, because my doctors were sure the problem was cardiovascular. Every test came back “normal.” The conclusion was that my symptoms must be stress.

The Turning Point

In 2017, things shifted when I developed severe lower back pain. My family doctor referred me to an endocrinologist. They began investigating my pancreas and ordered additional labs. By chance, my family doctor included a full thyroid panel, and those results revealed something new: elevated thyroid antibodies.

That was the day I first heard the words Hashimoto’s thyroiditis.

The treatment plan I was given was standard: start Synthroid, check TSH every six months, and adjust as needed.

For the next year, I rode the rollercoaster of hypo- and hyperthyroid symptoms. Some days I felt sluggish and depressed, other days anxious and wired. It was only later that I learned this back-and-forth is very common in Hashimoto’s.

But something was missing. No one asked me about my nutrition, gut health, hormone balance, or stress levels. No one looked for the root causes that might have been driving my immune system to attack my thyroid in the first place.

That was the turning point. I reached out to a functional medicine doctor, began digging into the science, and eventually trained in functional nutrition and functional medicine myself. Through that process, I got my Hashimoto’s into remission, and I discovered my calling: helping other women find answers beyond the prescription pad.

Why TSH Isn’t the Whole Picture

When someone comes to their doctor with thyroid concerns, the standard test ordered is TSH (thyroid-stimulating hormone). It’s a valuable marker, but it tells only part of the story.

Think of TSH as the thermostat in your home. If the room gets too “cold” (low thyroid hormone), the thermostat signals the heater to turn on. If the room gets too “hot” (high thyroid hormone), it signals the heater to turn off.

Here’s the catch: most conventional labs use a very wide “normal” range of 0.5 to 5.0 mIU/L. Functional medicine practitioners typically look at a narrower “optimal” range of 0.5 to 2.5 mIU/L.

Why does this matter? Imagine your TSH is 3.8. Your doctor may tell you that’s “normal.” But you may still be struggling with fatigue, hair loss, or weight changes. Looking at whether your levels are optimal, not just technically normal, can make a huge difference in how you feel.

And beyond that, TSH itself isn’t a thyroid hormone. It’s just a signal from your brain. By itself, it can’t tell us how much active thyroid hormone is circulating, whether it’s being converted properly, or if antibodies are attacking the thyroid.

The Bigger Thyroid Picture

To truly understand thyroid health, we need a fuller panel:

• Free T4 (fT4): The main hormone your thyroid makes. It’s like stored energy, but not very useful until it’s converted into T3.

• Free T3 (fT3): The active hormone that powers your metabolism, gut function, brain chemistry, and energy. Low levels can cause fatigue, depression, constipation, and brain fog, even if TSH looks normal.

• Reverse T3 (rT3): The brake pedal. Instead of activating your cells, it blocks them. Stress, illness, and crash dieting can all raise rT3.

• Thyroid antibodies (TPO and Tg): These markers tell us if the immune system is attacking the thyroid. They can appear years before thyroid hormones drop, making them critical for early detection.

This wider lens is how many patients finally find answers that TSH alone never revealed.

The Missing Conversation

When I first started medication, no one discussed the role of nutrition, gut health, stress, or nutrient status in thyroid function. And yet, these factors are at the very root of why the immune system becomes dysregulated in Hashimoto’s.

That’s where functional medicine and nutrition step in. We look not only at labs, but also at what fuels the thyroid, what stresses it, and what supports healing.

In Part 2 of this series, I'll go deeper into:

• The pros and cons of different thyroid medications

• Why iron and nutrients like selenium, zinc, vitamin D, and inositol are key for thyroid balance

• What we know (and don’t know) about special diets for Hashimoto’s

• How nutrition and lifestyle can move antibodies in the right direction

If you’ve ever felt dismissed because your labs looked “normal” but your body didn’t, Part 2 will be for you. Stay tuned, it’s coming next week.

And, if you’re living with Hashimoto’s and finding yourself dealing with stubborn symptoms like fatigue, weight changes, brain fog, or skin issues, it might be time to look deeper at your gut and thyroid connection.

Book your FREE call with me today.

Let’s work together to support your thyroid, calm your symptoms, and help you feel like yourself again from the inside out.

To your best health,

Zahra