The Optimal Treatment for Hypothyroidism: Sara Gottfried, MD

Dr. Sara Gottfried Shares Her Approach to Treating an Underactive Thyroid

Dr. Sara Gottfried feels that an important part of optimizing hypothyroidism treatment is ensuring that the adrenal function is normalized.

One of the nation's leading experts on hormonal health, Sara Gottfried, MD, an integrative gynecologist and bestselling author, has shared her thoughts about what constitutes optimal treatment for hypothyroidism, as part of a series on optimal hypothyroidism treatment, featuring a diverse group of thyroid practitioners.

When it comes to treating hypothyroidism -- an underactive thyroid -- integrative physician, author, and educator Dr. Sara Gottfried sets two key intentions for hypothyroid treatment "optimization" with her patients.

Her first intention is for patients to feel at least 80 percent better, looking at the various hypothyroidism symptoms they're experiencing -- for example, low energy, weight gain, irregular menstrual cycles, hair loss, low sex drive, and sore and creaky joints and muscles. Some other common hypothyroidism symptoms include constipation, feeling cold all the time, dry skin, a hoarse voice, puffiness around the eyes and face, forgetfulness, snoring and sleep apnea, dry eyes, recurrent infections, sensitivity in the neck area, and throat discomfort. 

She has a second key intention for optimizing hypothyroidism treatment: for patients to achieve a targeted TSH level of between 0.3 and 1.0 as well as a Free T3 level that falls at least in the top half of the normal reference range for the laboratory used for testing.

At these levels, Dr. Gottfried finds that the majority of her patients will feel their best, resolve or at least improve the majority of symptoms, and reach a level of "optimal" treatment.

According to Dr. Gottfried:

Not all my patients can tolerate such an aggressive goal with TSH, but I find that range is the sweet spot for surfing the hormonal upheaval of perimenopause and menopause.

Another key aspect of optimization is that the adrenal function, meaning cortisol and DHEA-S, are in the normal range. So many of my hypothyroid patients also have adrenal dysregulation, and don't feel better on thyroid augmentation unless their adrenals are optimized simultaneously.

In our patient/physician partnership, we optimize most readily when a patient is primed for focus on all-things-thyroid: she is reading Rich Shames' or Mary Shomon's books; she is taking her supplements; she is addressing her adrenal issues; and eating whole grains that don't act goitrogenic.

Optimization often is hardest in women with autoimmune thyroiditis – there we have to work not only on the endocrine system but on quieting the immune system as well.

About Sara Gottfried, MD

Sara Gottfried, MD is an integrative physician and holistic gynecologist, and founder of the Gottfried Center in Oakland, California. She is a bestselling author of The Hormone Cure, and The Hormone Reset Diet. 

Her website is located at

More Thyroid Resources from Dr. Sara Gottfried

Other Doctors Discuss Their Approaches to Optimal Hypothyroidism

Learn More About Hypothyroidism

Source: Email interview with Sara Gottfried, MD - December 2010