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Hypothyroidism is when the thyroid gland is under functioning. With low thyroid, the thyroid gland is not producing enough thyroid hormones. Symptoms can include fatigue, hair loss, decreased nail growth, excessive dry skin, cold hands and feet, unusual weight gain, weakness, certain muscle pains, extreme fatigue for no reason, depression, weakness, persistent sleepiness with adequate rest, and decreased hair growth of outer eyebrows. If a person has a thyroid imbalance or disease including low thyroid production, the condition will progress and needs to be treated.

These same symptoms of tiredness and weight gain may or may not be due to a thyroid imbalance. In fact, many of the symptoms mentioned are common when people do not have low thyroid or any thyroid disease. Proper testing and giving Dr. Miller your symptoms and history are required to determine what is wrong when you feel bad. Unfortunately, sometimes medicine does not have the right tests or more advanced medical information, to determine the cause for feeling tired and other associated symptoms. Regardless, Dr. Miller in Oklahoma continues to work with patients to find medications, supplements, and counsel to help each person feel healthier.


Thyroiditis is inflammation of the thyroid gland.

Hashimoto's thyroiditis

Hashimoto's thyroiditis (also called “autoimmune” or chronic lymphocytic thyroiditis) is the most common type of thyroiditis. It is named after the Japanese physician, Dr. Hakaru Hashimoto that first described it in 1912. Treatment is to start thyroid hormone replacement, thyroxine and liothyronine or desiccated thyroid, corrects the hypothyroidism component, but not the antibody and inflammation. Thyroid antibodies may remain for years after the disease has been adequately treated by thyroid hormone replacement. There is still no prescription for the elevated thyroid peroxidase antibody, but some authorities promote selenium 200 mcg each day. David Brownstein, m.d. recommends testing for iodine for optimum therapy. A pharmacist Dr. Isabella Wentz promotes a 90-day eating plan for treatment. With observation of lab values of at least hundreds of patients, the levels may vary but hardly ever do they go away. Probably the reason why there is no clear cure, is that there are so many causes of this inflammatory disease.

Autoimmune disease

Hashimoto’s or chronic thyroiditis- inflammation of the thyroid is commonly explained by medical doctors, that it is an auto immune disease. The standard medical explanation is that the person’s immune system attacks its own thyroid gland, damaging it to where it does not produce enough thyroid. If true, why is the antibody still high when the thyroid hormone is adequately replaced with thyroid medication? There is no adequate research or explanation for this theory and thus. No solution.

Antibodies are defenders in the body and are present to try and keep harm away. The known invaders that can attack us are bacteria, viruses, fungus, parasites, environmental chemicals, and emotional stress. Unfortunately, there is no easy noninvasive way to test the thyroid gland to determine if one or more problems is the cause and treat it specifically.

Thyroid and weight loss

Many women think their thyroid must be low because they are tired and gaining weight or not losing. Comprehensive thyroid lab values will give the verdict. Many doctors only test the TSH. Dr miller does enough tests to diagnose thyroid disease properly. There are some people whose thyroid lab is normal and yet they may have a sluggish functioning thyroid. Dr miller will interpret your labs and listen to your symptoms and help determine if thyroid disease is your problem or if something else is the issue. There is no medical knowledge that can give the cause of all low thyroid disease. However, there are treatments. If low functioning thyroid is not the cause of weight gain, Dr. Ruth Miller will help you decide on a doable weight loss plan for you.

Sub-acute hypothyroidism

When lab values are borderline normal and symptoms are prevalent, there may be sub-acute, or thyroid abnormalities not showing on lab. If only the TSH, thyroid stimulating hormone, is tested, it is only part of the picture and not even a thyroid gland hormone. Often the medical community diagnoses simply by high TSH only, which can lead to no diagnosis. If nodules, irregularities, or enlargement of the thyroid gland is noticeable on examination, a thyroid ultrasound may be needed to obtain more information.


Hyperthyroidism is when the thyroid gland over produces thyroid hormones. The thyroid gland is responsible for our metabolism, the way we use energy in our bodies. The thyroid affects many functions of our body such as heart rhythm and rate, muscles, nerves, breathing, skin, hair, nails, and energy. When the thyroid hormones are over producing or overactive, they can cause dangerous and uncomfortable symptoms like fast or irregular heartbeats, pseudo anxiety, shakiness, unusual weight loss, fatigue, sleep problems, exophthalmos (development of "bug eyes"), and staying awake for excess hours. Oddly, many of the symptoms like fatigue and lethargy are common to both (low and high.) Hyper and hypo- thyroid conditions. The usual treatments are chemical radiation ablation of the thyroid, or surgical removal. Sometimes, there is no “hyperness” even with hyperthyroid.

Thyroid cancer

There are several types of thyroid cancers named by the type of cells where the cancer begins. The most common is papillary cancer. Thyroid cancer symptoms might be chronic hoarseness, or more commonly, a lump on the thyroid. It is diagnosed first with an ultrasound of the thyroid. Other thyroid cancers are follicular, medullary, anaplastic and hurthle cell. Thyroid biopsies, not fine needle aspirations provide a definitive diagnosis. Thyroid cancer is 3.2% of all new cancers and usually responds well to treatment.

Lab tests

Most doctors only test TSH=thyroid stimulating hormone. All doctors are taught to check TSH only and maybe t4 free. Doctors are educated that if the TSH is high, then give the patient Synthroid. Test it later after the patient is taking Synthroid or the generic levothyroxine. If the TSH is in the perfect lab test range, keep the dose the same. If the TSH is over the limit, increase the prescription by a higher milligram. If the TSH is below the range (usually .3 – 5), then lower the dose. Regardless of how the patient feels. It’s that simple. But it isn’t. More thyroid tests will give additional information.

If a patient takes thyroid replacement, the TSH may show below the range. Doctors are taught that is unacceptable and the Dr. is prescribing too much thyroid medicine. That is true and the dose should be lowered if the t4 and t3, total and free, are high, above their range. If the t4 and t3 is not high with a low TSH, it is useless to treat the TSH, thyroid stimulating hormone.

Dr miller has a lot of experience and additional training to evaluate and treat thyroid problems. When you come to your appointment, bring any previous labs and the names and dosages of any previous and current thyroid medication that have been prescribed. Sometimes patients in desperation will take supplements that include, kelp, iodine, or bovine thyroid. If you are taking anything like these, bring them to your appointment. This can cause diagnosis confusion, but dr miller will help figure out your problems and prescribe treatments that are appropriate to help you feel better.


There are several options for treatment when a patient needs thyroid medication. There are Synthroid / levothyroxine, Cytomel / Liothyronine, amour, westhroid, nature thyroid medications and bioidentical t4 and t3 compounded.

Dr ruth miller seeks to help patients feel the best possible.