Functional medicine — thyroid
Thyroid Treatment in St. Louis
Thyroid treatment that stops at a single TSH number misses how thyroid actually works — and misses why so many patients feel terrible despite being told their thyroid is 'normal.' At Simply Health Integrated Medical in St. Louis, thyroid evaluation is done within a functional medicine framework that looks at TSH, Free T3, Free T4, reverse T3, thyroid antibodies (TPO and TgAb), and the broader hormonal, nutritional, and metabolic context. Dr. Bryan Deloney holds a Master of Science in Human Nutrition and Functional Medicine and leads the functional medicine evaluation.
What to expect
Simply Health Integrated Medical helps patients understand symptoms, goals, and options before recommending a care path.
The next step is a consultation request or direct call so the team can determine whether the clinic is a good fit for your needs.
Why a thyroid workup needs to go beyond TSH
TSH alone is the conventional screening test for thyroid problems, and it catches obvious hypothyroidism well. But it misses subclinical hypothyroidism, T4-to-T3 conversion problems, autoimmune thyroid disease, and the broader picture of thyroid function. Patients with classic hypothyroid symptoms — fatigue, weight resistance, cold intolerance, hair changes, mood changes, brain fog, sluggish digestion — who have 'normal TSH' are often the ones who need the deeper workup.
What a complete thyroid panel includes
A functional medicine thyroid workup typically includes TSH, Free T3, Free T4, reverse T3, thyroid antibodies (TPO and TgAb to screen for Hashimoto's autoimmunity), and depending on the case ferritin, vitamin D, B12, iron studies, and selenium markers because thyroid function depends on those nutrients. Some patients also benefit from a TRH stimulation context or evening cortisol context if adrenal patterns are part of the picture.
Hashimoto's thyroiditis evaluation
Hashimoto's is the most common cause of hypothyroidism in the United States and is missed without antibody testing. A patient can have rising TPO antibodies for years before TSH ever shifts out of range. Identifying Hashimoto's earlier opens up nutritional, gut, stress, and broader functional medicine interventions that can affect the trajectory of the disease — not just the medication conversation.
T4-to-T3 conversion and reverse T3
T4 is the inactive thyroid hormone; T3 is the active form. The body has to convert T4 to T3, and stress, illness, inflammation, certain medications, and nutrient deficiencies can shift conversion toward reverse T3 (an inactive metabolite) rather than active T3. Patients on levothyroxine alone sometimes feel only partially better because conversion is the bottleneck, not T4 supply. The workup looks at this.
When thyroid evaluation belongs in the BHRT and weight conversation
Thyroid sits at the center of metabolism, energy, mood, and weight. Many patients arrive at Simply Health Integrated Medical for BHRT or weight loss, and the functional thyroid workup reveals an upstream contributor that explains why prior plans did not work. Pulling thyroid into the broader hormone and weight conversation is a routine part of how the clinic operates — not a separate appointment.
Realistic expectations for thyroid treatment
Thyroid recovery is rarely fast. Once a comprehensive workup identifies what is actually happening, the plan may include medication (levothyroxine, sometimes T3 or natural desiccated thyroid depending on the case), nutritional support, gut and stress work, and follow-up monitoring. Lab improvements typically lag clinical improvement and vice versa. The evaluation sets milestones at the start so progress is tracked rather than guessed.
Request a thyroid evaluation
If you have classic thyroid symptoms with 'normal' TSH, a confirmed thyroid diagnosis where you still do not feel right, or autoimmune thyroid concerns, request a thyroid evaluation. The next step is a complete workup that takes the symptoms seriously rather than chasing one lab number.
Frequently asked
Common questions
▸Where can I get a real thyroid workup in St. Louis?
Simply Health Integrated Medical at 12977 N Forty Dr, Suite 105, St. Louis, MO 63141 offers a beyond-TSH functional medicine thyroid workup including Free T3, Free T4, reverse T3, and thyroid antibodies. Led by Dr. Bryan Deloney, DC, MS-Functional Medicine. By appointment 24/7. Call (636) 590-4686.
▸Why does my doctor only test TSH?
Conventional thyroid screening uses TSH because it catches obvious hypothyroidism efficiently. But TSH alone misses subclinical hypothyroidism, T4-to-T3 conversion problems, autoimmune thyroid disease, and patients whose symptoms come from broader thyroid dysfunction. A functional medicine workup looks at the full picture.
▸Can I have hypothyroidism with normal TSH?
Yes. Patients with classic hypothyroid symptoms and normal TSH may have subclinical hypothyroidism, T4-to-T3 conversion problems, low Free T3 with normal TSH, or autoimmune thyroid disease that has not yet shifted TSH. A complete panel identifies these patterns.
▸What is Hashimoto's thyroiditis?
Hashimoto's is an autoimmune condition where the immune system attacks the thyroid, leading to eventual hypothyroidism. It is the most common cause of hypothyroidism in the United States. Diagnosis requires antibody testing (TPO and TgAb) — not just TSH. Functional medicine interventions for nutrition, gut health, and stress can affect the trajectory.
▸Do you prescribe natural desiccated thyroid (NDT) or T3?
For patients where T4-to-T3 conversion is the issue or where levothyroxine alone has not resolved symptoms, T3-containing options including natural desiccated thyroid may be appropriate. The decision is based on the workup, symptoms, and clinical context rather than patient preference alone.
▸Will functional medicine cure my thyroid problem?
Functional medicine does not 'cure' thyroid problems, but a thorough workup can identify upstream contributors — nutritional, gut, stress, autoimmune — that affect how thyroid function operates. Many patients see meaningful symptom improvement when the broader picture is addressed alongside any necessary medication.
▸How long does it take to feel better with thyroid treatment?
Recovery is rarely fast. Some patients notice meaningful improvement within 4 to 8 weeks of starting treatment; others take 3 to 6 months. Lab improvements and clinical improvement do not always move in sync. Milestones are set during the evaluation.
▸Is functional medicine thyroid treatment covered by insurance?
Some labs and prescriptions may be covered depending on the plan and indication. The functional medicine evaluation itself and bundled programs are often not insurance-billed. Cost is reviewed during the evaluation.
Next step
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If this page sounds like what you are looking for, request a consultation or call the office so the team can help you choose the right starting point.