Could You Have Brain Hypothyroidism?

By Daniel Stickler M.D. | Articles


Ever experience extreme tiredness, sluggishness or brain fog? Is it something that seems to occur every day? Is it affecting your work, your relationships and the way you are getting through life? 

What is Hypothyroidism?

More than three percent of Americans have clinical hypothyroidism, a condition that affects the thyroid — a tiny, but essential gland found in your lower neck area.  

Thyroid hormones are important. They influence everything from growth and genetic development, to bone health and bodily functions. Your thyroid gland can help stabilize your metabolism, which results in a healthier body that is less prone to disease.

Through new cutting-edge technology for genetic investigations, it is possible to better understand how your body works, and how to treat it naturally. Dietary habits play a big role in thyroid performance — what you eat can determine how healthy you will be in life.

Thyroxine is a hormone consisting of four iodine atoms. That’s why it’s sometimes referred to as T4. Your thyroid gland secretes this hormone, and how much is produced is determined by TSH, or Thyroid Stimulating Hormone, produced in your pituitary gland. This gland is found at the bottom portion of your brain.

Your thyroid gland produces predominantly T4 (>90%) and T3 (<10%). T4 is not nearly as active as T3 and generally the T4, once in the circulation, will be converted to the more active T3 by an enzyme called DIO (deiodinase). The liver is the primary area for activity of this enzyme and conversion of T4 into T3 is important for homeostasis of our energy and metabolism. 


Nutrigenomics and the Thyroid

When we look at a systems based approach to optimized thyroid function, it is important to support the entire process and the production of thyroid hormone requires certain nutrients to maintain proper production. In addition to this, the DIO enzymes also require certain cofactors. Iodine (especially sea kelp derived), tyrosine, and selenium are keys to optimized function, see Nutrigenomic Thyroid Formula. Deficiencies in any of these nutrients can lead to diminished function of the thyroid system.



Genetics and the Brain

Now here is where things can get a little crazy, there are two forms of DIO that convert T4 into the more active T3; one is DIO1, which is the main enzyme in the liver, the other is DIO2 which is present mainly in the thyroid and the brain. The brain uses DIO2 almost exclusively. These local specific enzymes are important to maintain T3 levels in the target organs. Now imagine that you have a healthy DIO1 enzyme but a genetic variant (not uncommon) of DIO2, your blood tests will reveal normal thyroid function and yet your brain may be experiencing a localized hypothyroidism. So, blood tests alone will not provide the answer without fully understanding the genetics as well.

What is Brain Hypothyroidism

The most common symptom of brain hypothyroidism is the feeling of brain fog, which makes you sluggish, slow and unable to perform daily tasks at your best energy level. You may experience difficulty remembering details and processing information, and experience blank episodes.

This can result in becoming easily irritated, moody and impatient with colleagues or even family members, decreased well-being and depression. 

 The delicate balance of thyroid hormones can be impacted by a malfunctioning thyroid, genetic variations or a combination of both. The complexity of this condition requires a complete analysis of symptoms, thyroid hormone blood and tissue levels, and genetic testing. 

Genetic Variations Known to Cause Brain Hypothyroidism

There are a number genetic variations or polymorphisms that have been identified as being associated with brain hypothyroidism. These genes have helped lead the way in understanding that there are different subgroups of hypothyroidism. Understanding these different subgroups, allows doctors to hone treatments so they impact the differences in genetic makeups of each patient. 

One such genetic variation is the Thr92AlaD2 polymorphism. Studies have identified combinations of thyroid hormone replacement therapies that are more successful for people with this gene. Other genes such as the DIO2 and the OATP1C1 polymorphisms have allowed doctors to specify their thyroid hormone treatments to specifically address the variations of brain hypothyroidism. 

Fine-tuning treatments for brain hypothyroidism is showing promise as more genetic testing is done in tandem with thyroid hormone replacement therapies. Identifying the genes that are likely to cause brain hypothyroidism, helps doctors develop comprehensive treatments that include diet, exercise, mindset, and serum therapy. 

Blood Tests

Many people will go to their physician and get the blood tests run based on having classic symptoms of brain hypothyroidism and come away being told that their labs are “normal” and frequently recommended to start an antidepressant. Click To Tweet With a variant of the DIO2 gene and a normal DIO1, this is a common scenario. Even if your clinician decides to begin treatment based on symptoms, the type of thyroid replacement can make a big difference. Most commonly prescribed thyroid medications only contain T4 so they will require the localized brain tissue to have adequate DIO2 activity to convert to T3 – the result is that the blood work will improve but the symptoms remain. A T4/T3 combination medication usually is all that is required to get you back into a thriving state.

Getting Help from an Epigenetic Performance Coach

Having a coach on hand to guide you on this journey can be invaluable. He or she will be able to prepare a personalized diet plan for you based on your body’s nutritional requirements and a nutrigenomic plan that can optimize your gene expressions. It’s not an across-the-board approach, your diet will be based on your own genes, hormone secretion, and physical and cognitive history as well as your goals.

The thyroid helps keep your body balanced and your immune system intact. It works in an interconnected way with different body systems, particularly the lymphatic, digestive and nervous systems. It’s important to give your body the right “fuel” and eliminate any foods that may be causing an imbalance in your body’s natural processes.


Hypothyroidism can be addressed successfully, and patients with genetic variations can live optimized lives when a full systems-based approach is used to identify the underlying issue. 

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Daniel Stickler M.D.

Daniel L. Stickler, M.D. is the medical director and Co-Founder of Apeiron ZOH Corporation.He is the visionary pioneer behind systems-based precision performance medicine, a new paradigm that re-defines medicine from the old symptoms based disease model to one of limitless peak performance in all aspects of life. A physician to high-performing executives and entrepreneurs who want to upgrade their current state, he’s also an author, speaker, blogger and podcaster. He is a Google consultant for wearable technology, epigenetics, and AI in healthcare and a guest lecturer at Stanford University on Epigenetics in Clinical Practice.
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3 Replies to “Could You Have Brain Hypothyroidism?”

  1. Excellent article! Thank you for the clear distinctions made between general Hypothyroidism and brain Hypothyroidism. The article is a nice balance between science and information our clients or the public can understand and incorporate.

    Nice layout with summary on the right side of the page. The Tweetable quote with link is very convenient.

    Thank you! Looking forward to more articles such as this!

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