Functional Medicine and Thyroid Conditions in Women

Thyroid conditions are among the most common hormonal imbalances affecting women, especially between the ages of 35 and 65. Women are up to eight times more likely than men to develop thyroid dysfunction, which can show up as fatigue, weight gain, hair thinning, mood swings, irregular cycles, hot flashes, or brain fog. The thyroid gland plays a critical role in regulating metabolism, body temperature, mood, and energy. When it is out of balance, the effects ripple across every system of a woman’s body.

At O’Keefe Matz Functional Health Clinic in Saint Paul, we focus on helping women uncover the underlying causes of thyroid dysfunction. Experts such as Dr. Wayne Sodano, author of Integrative Medicine Approach to Thyroid Disorders 

emphasize that thyroid dysfunction cannot be understood by TSH testing alone. Instead, a full thyroid panel, immune system evaluation, and assessment of nutrient status are essential for lasting thyroid health.


Standard Medical Approach to Thyroid Conditions in Women

In conventional medicine, thyroid conditions in women are usually divided into:

  • Hypothyroidism: An underactive thyroid leading to fatigue, weight gain, hair loss, cold intolerance, dry skin, and low mood.

  • Hyperthyroidism: An overactive thyroid causing weight loss, anxiety, tremors, heart palpitations, and heat intolerance.

  • Autoimmune Thyroid Conditions: Such as Hashimoto’s thyroiditis (a leading cause of hypothyroidism in women) or Graves’ disease (a leading cause of hyperthyroidism).

The standard medical route typically involves:

  • Ordering a TSH (thyroid-stimulating hormone) test. If levels are high, it suggests hypothyroidism; if low, hyperthyroidism.

  • In hypothyroidism, treatment usually involves thyroid hormone replacement medication such as levothyroxine.

  • In hyperthyroidism, treatment may involve medication to block thyroid hormone production, radioactive iodine, or in some cases, surgery.

While these approaches can help manage symptoms, they often do not fully address why the thyroid is out of balance, particularly for women going through hormonal transitions such as perimenopause or menopause.


Comprehensive Functional Medicine Lab Testing

Women’s thyroid health is influenced by many factors beyond TSH. That is why functional medicine uses a broader set of labs to provide a more complete picture.

  • TSH: Thyroid Stimulating Hormone

  • Free T4: The inactive thyroid hormone

  • Free T3: The active thyroid hormone that drives metabolism and energy

  • Reverse T3: A blocking hormone that can interfere with T3 function

  • Thyroid Antibodies: Anti-TPO and Anti-TG to identify Hashimoto’s, and TSI for Graves’ disease

  • Comprehensive Metabolic and Nutrient Labs: CBC, liver panel, vitamin D, ferritin, B12, magnesium, selenium, zinc, and iodine levels

  • Cortisol and Adrenal Testing: To assess how chronic stress impacts thyroid hormone conversion

  • Sex Hormone Testing: Since estrogen, progesterone, and testosterone balance can strongly influence thyroid function in women

This kind of lab work is especially valuable for women in midlife, when thyroid imbalance often overlaps with symptoms of perimenopause, menopause, or adrenal fatigue.


Functional Medicine Approach to Underlying Causes

Functional medicine seeks to uncover why thyroid dysfunction is happening in the first place. For women, the most common contributors include:

  • Autoimmunity: Women are more likely to develop Hashimoto’s or Graves’. Supporting gut health, calming inflammation, and balancing immunity can reduce flare-ups.

  • Nutrient Deficiencies: Low selenium, zinc, iron, and vitamin D are common in women and can block thyroid hormone production.

  • Hormonal Shifts: Estrogen dominance, low progesterone, or changes during perimenopause and menopause can stress the thyroid.

  • Chronic Stress: Elevated cortisol can disrupt thyroid conversion and leave women feeling burned out.

  • Gut Imbalances: Women with digestive symptoms or leaky gut may also struggle with thyroid antibodies and poor hormone metabolism.

  • Environmental Toxins: Fluoride, mercury, mold, and pesticides can disrupt thyroid signaling.

  • Blood Sugar Imbalance: Insulin resistance, often tied to weight changes in midlife, can worsen thyroid-related fatigue and metabolism issues.

By addressing these root causes, women often experience improvements not just in thyroid markers but in energy, metabolism, sleep, mood, and overall vitality.

Research Spotlight: Dr. Wayne Sodano

For deeper clinical insights, Dr. Wayne L. Sodano is a leading educator in integrative and functional medicine with a strong focus on thyroid conditions. His work expands beyond conventional thyroid testing, looking at nutrient cofactors, immune dysregulation, and environmental influences on thyroid health.

  • His book, Integrative Medicine Approach to Thyroid Disorders: Clinician’s Desk Reference, offers practitioners a comprehensive guide to evaluating and supporting patients with thyroid conditions Amazon link 

  • Dr. Sodano also created educational modules such as “Functional Medicine Approach to Diagnosis and Treatment of Thyroid Dysfunction”, available through Functional Medicine University

  • His clinical blog contributions and teaching videos, including Clinical Pearls – The Thyroid Panels help practitioners better interpret advanced thyroid labs.
  • You can read more about his role at the College of Integrative Medicine and his work with Evexia Diagnostics here: iMedLogics About Page

Why Choose O’Keefe Matz Functional Health Clinic

At our Saint Paul clinic, we believe that thyroid conditions in women deserve more than a one-size-fits-all approach. By combining functional medicine insights with individualized care, we help women move beyond symptom management toward true healing and restored vitality.

Meet Dr. Shannon O’KeefeShead  shot

Dr. Shannon O’Keefe is a specialist in Functional Medicine and a Board Certified Clinical Nutritionist. She is also a graduate of the Internal Medicine program and brings a deep understanding of how body systems interact. Dr. O’Keefe works closely with women to uncover the root causes of thyroid dysfunction, autoimmune conditions, and hormonal imbalances. Her compassionate and detail-oriented approach helps women find solutions that restore balance, energy, and long-term health.


Dr. Shannon A. O'Keefe

Dr. Shannon A. O'Keefe

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