Thyroid Specialist in Orem, Utah | Functional Medicine Approach
Your TSH came back "normal" but you still feel terrible. You are not making it up. Conventional thyroid testing checks one or two markers out of nine. That means your doctor is making decisions with less than a quarter of the information. Dr. Drussel runs the full thyroid panel at Integrative Motion to find what standard testing misses.
Does this sound like you?
If you are checking off multiple items on this list, your thyroid deserves a closer look than it has been getting.
- You are always cold, even when everyone around you is comfortable
- Your hair is thinning, falling out, or breaking more than it used to
- You are gaining weight despite eating well and exercising
- Brain fog, difficulty concentrating, or word retrieval problems that feel like they came out of nowhere
- Crushing fatigue that sleep does not fix
- Dry skin, brittle nails, or a puffy face, especially in the morning
- Your doctor tested your TSH and told you everything is "normal"
- You are on thyroid medication but you still feel terrible
- Irregular menstrual cycles, heavy periods, or difficulty getting pregnant
- Constipation, sluggish digestion, or bloating that never fully resolves
Why standard thyroid testing misses the problem
Here is the core issue: insurance typically covers two thyroid markers. TSH and maybe Free T4. That is what your primary care doctor orders because that is what gets reimbursed. But there are nine thyroid markers total. Those other seven tell you whether your thyroid is under-converting T4 to T3, over-converting to Reverse T3, not creating enough hormone in the first place, or being attacked by your own immune system.
Think about it this way. If someone handed you a 1,000-piece puzzle and only gave you 200 pieces, you would not be able to see the picture. That is what your doctor is working with when they only test TSH and T4. They are doing the best they can with the tools insurance allows, but the picture is incomplete.
Dr. Drussel sees this pattern constantly at Integrative Motion. A patient comes in after years of feeling awful. They have been to their doctor multiple times. Each time, the TSH comes back in the "normal" reference range and they are told nothing is wrong. But TSH alone does not tell you what the thyroid is actually doing. It tells you what the brain is asking the thyroid to do. Those are two very different things.
Utah has higher-than-average rates of thyroid disorders, particularly Hashimoto's thyroiditis. Between the altitude, the hard water, environmental factors, and the stress of daily life in Utah County, thyroid dysfunction is one of the most common conditions Dr. Drussel investigates at Integrative Motion in Orem.
The full thyroid panel: 9 markers, not 2
This is what Dr. Drussel orders when he suspects thyroid dysfunction. Each marker tells a different part of the story.
- TSH (Thyroid Stimulating Hormone) — what the brain is asking the thyroid to do. High TSH means the brain is screaming at a sluggish thyroid. This is the only marker most doctors check.
- Free T4 — the inactive thyroid hormone your thyroid produces. This is the raw material that needs to be converted into the active form.
- Free T3 — the active thyroid hormone that actually does the work in your cells. If this is low, you feel it, regardless of what your TSH says.
- Reverse T3 — a parking brake. Your body converts T4 into Reverse T3 instead of active T3 when it is under stress, fighting inflammation, or dealing with chronic illness. High Reverse T3 means your body is diverting thyroid hormone away from where it is needed.
- TPO Antibodies (Thyroid Peroxidase) — the primary marker for autoimmune thyroid disease. Elevated TPO antibodies mean your immune system is attacking your thyroid. This is Hashimoto's.
- TgAb Antibodies (Thyroglobulin) — a second autoimmune marker. Some patients have elevated TgAb with normal TPO. If you only test one, you miss the other.
- Total T3 — measures all T3 in the blood, both bound and free. Helps identify binding protein issues that affect how much active hormone is available.
- Total T4 — measures all T4 in the blood. Combined with Free T4, this reveals whether binding proteins are trapping your thyroid hormone before it can be used.
- T3 Uptake — an indirect measure of thyroid binding proteins. Abnormal uptake values point to protein-level issues that standard testing completely ignores.
When you see all nine together, the picture becomes clear. You can identify exactly where the breakdown is happening and build a protocol that targets the actual problem instead of guessing.
How Dr. Drussel treats thyroid issues
There is no cookie-cutter thyroid protocol at Integrative Motion. A lot of functional medicine practitioners have a standard "thyroid stack" that every patient gets. Dr. Drussel does not work that way. You cannot out-supplement yourself out of a thyroid problem. The protocol has to match the mechanism, and the mechanism is different for every patient.
Once the full panel identifies where the breakdown is, Dr. Drussel builds a personalized plan that may include:
- Targeted supplementation based on your specific deficiency pattern. Selenium, zinc, iodine, vitamin D, iron, and B vitamins all play roles in thyroid conversion, but blindly supplementing without testing can make things worse.
- Diet modifications to reduce inflammation and support thyroid function. For autoimmune thyroid, this often means identifying and removing dietary triggers that are fueling the immune attack.
- Gut health investigation because a significant portion of T4-to-T3 conversion happens in the gut. If your gut is compromised, your thyroid will never function optimally no matter how many supplements you take.
- Stress and lifestyle changes because chronic stress drives Reverse T3 production. Your body interprets ongoing stress as a reason to slow down metabolism, and no supplement overrides that signal.
- Collaboration with your endocrinologist or MD if you are currently on thyroid medication. Dr. Drussel does not prescribe or manage medications, but he works alongside your prescribing doctor. If the functional approach improves your numbers, your MD may decide to adjust your medication over time.
This is a marathon, not a sprint. Thyroid recovery takes time because your body needs to repair and rebalance. Dr. Drussel monitors progress with follow-up labs and check-ins every 4 to 8 weeks, adjusting the protocol as your body responds.
Hashimoto's thyroiditis: the autoimmune connection
Hashimoto's thyroiditis is the number one cause of hypothyroidism in the United States. It is an autoimmune condition where your immune system produces antibodies that attack and gradually destroy your thyroid gland. Over time, the thyroid loses its ability to produce adequate hormone, and you develop the classic symptoms of hypothyroidism: fatigue, weight gain, cold intolerance, brain fog, hair loss.
Here is the problem. Most doctors do not test for Hashimoto's. They test TSH, see it is high, prescribe levothyroxine, and call it done. The medication replaces the hormone your thyroid can no longer make, but it does nothing to address the immune system that is destroying the gland in the first place. That is like mopping the floor while the faucet is still running.
Dr. Drussel's functional medicine approach to Hashimoto's addresses the immune dysfunction directly:
- Gut health restoration — roughly 70% of your immune system lives in your gut. Intestinal permeability (leaky gut), bacterial imbalances, and chronic gut inflammation are strongly linked to autoimmune flare-ups. Fixing the gut calms the immune response.
- Inflammation reduction — systemic inflammation triggers and amplifies autoimmune attacks. Anti-inflammatory dietary protocols, targeted supplementation, and lifestyle modifications bring inflammation levels down.
- Immune modulation — specific nutrients like selenium, vitamin D, and omega-3 fatty acids have been shown in research to reduce thyroid antibody levels and calm the autoimmune response.
- Dietary trigger identification — gluten is the most well-documented dietary trigger for Hashimoto's due to molecular mimicry (gluten proteins resemble thyroid tissue, confusing the immune system). Dairy, soy, and other foods may also play a role depending on the individual.
The goal is not to cure Hashimoto's. Autoimmune conditions do not have a cure. The goal is to reduce the antibody levels, slow or stop the destruction of the thyroid gland, and get you feeling significantly better. Many patients at Integrative Motion see measurable antibody reduction within 3 to 6 months of consistent follow-through.
Frequently Asked Questions
Insurance dictates which labs get covered, and TSH is the standard screening marker for thyroid function. Your doctor is working within the constraints of the insurance model, which typically reimburses for TSH and maybe Free T4. It is not that your doctor does not care. It is that the system limits what they can order without justification for each additional marker. A full thyroid panel with all nine markers gives a much more complete picture of what your thyroid is actually doing.
Absolutely. Many of Dr. Drussel's thyroid patients are already on levothyroxine or Synthroid when they come to Integrative Motion. Functional medicine works alongside your medication, not against it. The goal is to optimize the environment your thyroid is working in: reduce inflammation, support conversion of T4 to active T3, address autoimmune triggers, and fix nutritional deficiencies. If your body responds well and your prescribing doctor determines your medication can be adjusted, that conversation happens between you and your MD.
Hypothyroidism means your thyroid is not producing enough hormone. Hashimoto's is the most common reason why. It is an autoimmune condition where your immune system attacks your thyroid gland, gradually destroying it. The symptoms look the same (fatigue, weight gain, cold intolerance, brain fog), but the underlying cause is completely different. Treating Hashimoto's effectively requires addressing the immune dysfunction, not just replacing the hormone with medication.
Most patients begin noticing symptom improvements within 4 to 8 weeks of starting their protocol. Measurable changes in lab values typically show up at the 8 to 12 week mark. For Hashimoto's patients, antibody levels often take 3 to 6 months to show significant reduction. This is a marathon, not a sprint. Your body did not get here overnight, and it will not fully recover overnight. Dr. Drussel monitors progress at regular check-ins and adjusts the plan as needed.
Standard thyroid markers like TSH and Free T4 are typically covered by insurance. The additional markers in a full thyroid panel (Free T3, Reverse T3, TPO and TgAb antibodies, Total T3, Total T4, T3 Uptake) may or may not be covered depending on your plan and the diagnostic codes used. The functional medicine consultation itself is a cash-pay service ($250 initial, $150 follow-up). Dr. Drussel explains all costs before ordering any labs so there are no surprises.
Yes. Your thyroid controls your metabolic rate. When thyroid function is low, your body burns fewer calories at rest, retains more water, and stores fat more readily, regardless of what you eat. This is one of the most frustrating symptoms patients report. They are doing everything right nutritionally and the scale will not budge. Until the thyroid dysfunction is identified and addressed, diet and exercise alone often cannot overcome the metabolic slowdown.
Related conditions
Thyroid dysfunction rarely exists in isolation. These conditions frequently overlap and share common root causes.
Get the Full Picture
Stop guessing with two markers when there are nine. Call Integrative Motion to schedule a thyroid consultation with Dr. Drussel and find out what your labs have been missing.