The 4 Questions We Ask When Someone Is Struggling With Their Thyroid
A Wellness Way Chiropractic Perspective
If you’ve been told you have a thyroid issue — or that your thyroid labs are “normal” even though you don’t feel normal — this blog is for you.
After years of having thyroid conversations with patients, I’ve learned something important:
Most people aren’t confused because they aren’t trying hard enough– they’re confused because no one ever taught them how their thyroid actually works.
At The Wellness Way – Lake Forest, we don’t start with solutions. We start with questions — because the thyroid doesn’t operate in isolation, and symptoms rarely happen without context.
As a chiropractor, my role is not to diagnose or treat thyroid disease. My role is to support health restoration by helping people identify what may be interfering with normal function, improve communication between systems through chiropractic care, and use appropriate testing and education to guide the body back toward balance.
That’s where The 4 Questions come in.
Why the Right Questions Matter More Than the Right Answer
In most conventional medical settings, the gold standard for thyroid testing is TSH — a hormone made by the brain, not the thyroid.
TSH, or thyroid-stimulating hormone, reflects how strongly the brain is signaling the thyroid. TSH levels can be a helpful piece of information, but it is only one piece of a much larger conversation. TSH does not measure how much thyroid hormone is being produced, how it’s being converted, or how it’s being used throughout the body.
As a result, most thyroid conversations end up focusing on:
• A lab value
• A diagnosis
• A prescription
But very few focus on why the thyroid may be struggling in the first place.
So here’s what I want you to do right now: pull out your existing thyroid lab work. Open your health app. Look at what has actually been tested and see if your labs help you answer the questions in the below sections. Do they give you clarity about what your body is doing — or do they leave you with more confusion?
If your testing has given you answers and you’re feeling better, that’s wonderful. But if you’re still searching for understanding, it may be time for a different approach to your thyroid. And that’s where I come in.
When we ask better questions, patterns start to make sense. Symptoms stop feeling random. And people often feel something they haven’t felt in a long time: Hope.
Question #1: Do I Produce Enough Thyroid Hormone?
This is the most basic — and often most overlooked — question.
The thyroid cannot produce hormones out of thin air. It requires specific building blocks to do its job. If those building blocks are missing or poorly absorbed, hormone production may be affected.¹
To produce thyroid hormone, the body relies on nutrients such as:
• Iodine – the backbone of thyroid hormone
• Tyrosine – an amino acid that combines with iodine
• Iron – needed for thyroid hormone synthesis
• Selenium – supports hormone production and protection
• B vitamins – essential for metabolic support
• Vitamin D – influences immune and endocrine signaling²
When was the last time your vitamin B, vitamin D, or iron levels were checked — or even discussed in the context of your thyroid? And beyond testing, do you actively monitor whether you’re getting enough of the nutrients (such as the nutrients listed above) your body needs day to day? What gets tracked gets managed, what doesn’t get tracked can start to drift away — and many people don’t realize how easy it is to run low when life gets busy, stressful, or demanding.
What’s important to understand is that nutrient deficiencies aren’t always about what someone is eating. Increased stress, inflammation, digestive changes, or periods of high demand — such as pregnancy, illness, or long-term stress — can all increase how much the body needs. When those needs aren’t met consistently, the thyroid may adapt quietly at first. Over time, that adaptation can show up as fatigue, changes in temperature tolerance, or shifts in energy — often before lab values clearly reflect a problem.
A Quick Word About Goiters
A goiter simply refers to an enlargement of the thyroid gland. It’s not a diagnosis of a thyroid problem by itself, and it does not automatically mean something dangerous is happening.
The thyroid sits at the front of the neck, just below the Adam’s apple. When it’s under increased demand — especially when it’s working harder to make thyroid hormone — it may enlarge as an adaptive response.
Some people notice:
- A visible fullness or swelling at the base of the neck
- A feeling of pressure or tightness in the throat
- A sensation of “something there” when swallowing
Others don’t notice anything at all, which is why goiters are sometimes found incidentally.
One of the classic contributors to thyroid enlargement is when the body doesn’t have enough of the raw materials it needs — such as iodine — to keep up with hormone production. In that situation, the thyroid may enlarge in an effort to work harder and cover more surface area for absorption.
This is where I often remind patients: the thyroid isn’t being dramatic — it’s being resourceful.
From an educational standpoint, a goiter is best understood as a signal that the thyroid is under stress and asking for support. Understanding why that stress is there matters far more than simply noticing the enlargement.
Question #2: Am I Converting Thyroid Hormone?
Producing hormone is only step one.
Most thyroid hormone is produced as T4, which must be converted into more active forms — particularly T3 — before the body can actually use it⁴.
This conversion process (of T4 to T3) is influenced by several organ systems, including:
- The liver
- The gut
- The nervous system
- Overall metabolic and stress load
If these systems are overwhelmed or under stress, conversion may be less efficient.
This helps explain why someone can:
- Produce enough hormone
- Have “acceptable” lab values
- Yet still feel fatigued, foggy, or off
This doesn’t mean something is “wrong.”
It means the body may be prioritizing survival over efficiency.
(We’ll go much deeper into this gut–liver–thyroid connection in Blog 3.)
Question #3: Is My Thyroid Being Destroyed?
This is often the most emotional question — and the one many people are never fully educated about.
A large percentage of thyroid conditions are autoimmune in nature, most commonly Hashimoto’s thyroiditis⁶. In these cases, the immune system produces antibodies that target thyroid tissue.
It’s important to understand this clearly:
➡️ This is not the thyroid attacking itself.
➡️ This is the immune system responding to perceived stress or threat.
From an educational perspective, the presence of antibodies tells us:
- The immune system is activated
- Inflammation is involved
- The thyroid is caught in the crossfire⁷
This reframes the conversation from “My thyroid is failing” to
“My immune system is under stress.”
And that shift matters.
Here is a patient of mine who has been on thyroid medication for 30 years. His doctor was only testing TSH, but he was still struggling with weight, bloating, digestive issues and more. We tested his thyroid antibodies and his thyroid peroxidase (TPO) antibody was high! His doctor never dug deeper to find out his why. TPO is an immune system issue. We then dug deeper and did food allergy testing and stool testing to find immune system and inflammatory triggers.
Question #4: Is Something Interfering With My Thyroid Function?
Even when hormone production and conversion look adequate, interference can still disrupt thyroid signaling (think sheep in the road while you’re driving through Ireland).
Common categories of interference include:
- Chronic stress
- Inflammation
- Chemical exposures
- Blood sugar instability
- Digestive stressors
- Nervous system overload⁸
At The Wellness Way, we often talk about stress through the lens of the 3 Ts:
- Traumas (physical stress)
- Toxins (chemical stress)
- Thoughts (emotional stress)
The body doesn’t separate these — it experiences them together.
This is why addressing thyroid concerns often requires looking beyond one category of stress. Someone may feel they’re managing things “well enough,” yet their body is still responding as though it’s under constant demand.
Often, it isn’t one big stressor that tips the system — it’s the accumulation. Little things that don’t feel urgent on their own can add up over time and subtly change how clearly the body communicates, including through the thyroid.
When interference is high, the thyroid may adapt by slowing down, changing signaling patterns, or altering output. Again, this is not failure. It’s a communication roadblock.
How These 4 Questions Change Everything
When we walk through these questions together, people stop blaming their body.
Instead of asking:
“Why is my thyroid not working?”
They begin asking:
“What has my body been responding to?”
That shift creates clarity — and clarity creates direction.
The Swiss Watch Principle (Why This Matters)
The thyroid is not a standalone organ. It’s part of a complex, intelligent system.
Just like a Swiss watch, when one part of the system is under stress, other parts adapt. The thyroid often reflects those adaptations because of its central role in energy, metabolism, and regulation⁹.
Looking at the thyroid this way changes the entire conversation.
What Comes Next
These questions don’t give instant answers — and they’re not meant to.
They provide context.
They guide understanding.
They help people feel less afraid and more informed.
In the next blog, we’ll explore how the gut and liver physically handle thyroid hormones — and why supporting these systems is often a missing piece in thyroid conversations.
It Still Starts With a Conversation
If no one has ever explained your thyroid this way before, you’re not alone.
At The Wellness Way – Lake Forest, we believe understanding your body changes how you experience your health journey.
Have questions about your thyroid or labs?
📧 Email us — I’m always happy to talk.
It starts with a conversation. And I’m all ears.
Disclaimer: This content is for educational purposes only. It’s not intended as a substitute for the advice provided by your Wellness Way clinic or personal physician, especially if currently taking prescription or over-the-counter medications. Pregnant women, in particular, should seek the advice of a physician before trying any herb or supplement listed on this website. Always speak with your individual clinic before adding any medication, herb, or nutritional supplement to your health protocol. Information and statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.
