The Dr. Josh Axe Show

The Real Cause of Hypothyroidism (It’s Not Just Your Thyroid)

Mar 16, 2026
They unpack the thyroid hormone cascade and why the thyroid alone may not be the problem. They trace how blood sugar, insulin, adrenals, and the brain influence thyroid signaling. They discuss conversion of T4 to T3 in the liver and gut and why meds can miss upstream issues. They cover stress, diet, nutrients, warming practices, and lifestyle steps to restore hormonal balance.
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ANECDOTE

Patients Still Symptomatic After Single Hormone Treatment

  • Many patients treated with single hormone therapies still had symptoms because clinicians treated symptoms not the upstream signal.
  • Dr. Josh Axe recounts seeing patients on thyroid meds, birth control, antidepressants or TRT who remained fatigued and symptomatic until cascades were addressed.
INSIGHT

Hormones Function As Cascades Not Isolated Switches

  • Hormones work as cascades not isolated switches with upstream signals triggering downstream hormones.
  • Dr. Josh Axe compares them to dominoes and a waterfall where one disrupted signal causes multiple downstream imbalances.
INSIGHT

Blood Sugar Swings Can Kick Off Wide Hormone Cascades

  • Blood sugar dysregulation often initiates an endocrine cascade: high insulin stresses adrenals, alters pituitary output, then affects thyroid and sex hormones.
  • Dr. Josh Axe maps how processed carbs or certain dairy trigger blood sugar swings that propagate through HPA axis signaling.
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