The conventional approach is to only consider the laboratory tests to determine hypothyroidism, where the TSH (thyroid stimulating hormone) and the T4 levels are evaluated to determine thyroid malfunction. This does not consider the conversion of T4 to T3 (the active thyroid hormone) and the possibility of reverse T3, which is produced particularly at times of stress and inhibits the conversion of T4 to T3.
An integrative practitioner will consider the physical signs of thyroid dysfunction. This includes symptoms such as dry skin, thinning of the outer margins of the eyebrows, subtle accumulation of fluid in the ankles, constipation, lack of sweating, weight gain and high cholesterol.
Taking the body temperature every morning before getting out of bed might also be suggested – if it is low, it is an indication of an under active thyroid.
The laboratory tests, which should include thyroid-stimulating hormone (TSH), total T4, free T4, total T3, free T3, and reverse T3, will be used to support the diagnosis.