# Hypothyroidism

Category: Metabolism

Also known as: underactive thyroid, low thyroid

Hypothyroidism is a slowing of the oxidative metabolism, a state in which biological efficiency falls drastically because the body is forced to rely on inefficient glycolytic metabolism, producing a chronic elevation of lactic acid even at rest. Peat defined the condition as a…

12 passages · 3 authors · 1976–2026 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/hypothyroidism

## Synthesis

**Hypothyroidism** is a slowing of the oxidative metabolism, a state in which biological efficiency falls drastically because the body is forced to rely on inefficient glycolytic metabolism, producing a chronic elevation of **lactic acid** even at rest. [Source 2, 6, 9] Peat defined the condition as a systemic energy failure, noting that for a hypothyroid person, "just sitting passively... can be the same as running at high speed for a healthy person." [Source 6] This metabolic suppression is not a simple glandular deficit but an adaptation to stress, where the body downregulates thyroid function to prevent the total destruction of tissues by *adrenaline* and *cortisone*. [Source 4, 12]

The clinical picture of hypothyroidism extends far beyond the textbook presentations of myxedema and cretinism, manifesting in diverse and often paradoxical symptoms. [Source 5] Peat observed that a very large group of hypothyroid people become hyperactive, anxious, and tachycardic due to a compensatory surge of adrenaline, which can be 20 to 40 times higher than normal. [Source 1, 12] This stress-driven compensation frequently leads to a misdiagnosis of hyperthyroidism, especially when physicians rely solely on a suppressed **TSH** without assessing metabolic rate, as stress hormones like cortisol artificially lower TSH. [Source 1, 11] Other common indicators include cold hands and feet, low blood sugar, fatigue, depression, dry skin, edema, and an inability to maintain weight despite high calorie intake due to the catabolic wasting of muscle tissue. [Source 3, 12]

Diagnosis, in Peat's framework, relies on functional and physiological markers rather than the standard blood tests he considered deeply flawed. He argued that the reference range for TSH had been distorted since the 1940s to obscure widespread hypothyroidism, which he estimated might affect 60% to 80% of the population. [Source 11] Instead, he prioritized a *basal body temperature* below the normal range of 97.8 to 98.2 degrees Fahrenheit, a slow pulse rate, and elevated **cholesterol** as reliable indicators, noting that cholesterol rises immediately upon thyroid removal and falls with supplementation because thyroid is required to convert cholesterol into protective steroids like pregnenolone and progesterone. [Source 4, 5, 11] Roddy has extended this view, suggesting that a TSH suppressed below 1.0 in an unmedicated person can paradoxically indicate an extreme hypothyroid state rather than health. [Source 8]

The systemic consequences of low thyroid function involve a vicious cycle of tissue destruction and hormonal dysregulation. The compensatory rise in adrenaline drives the adrenal glands to produce more cortisone, but the adrenals themselves require thyroid hormone to synthesize cortisone from cholesterol, leading to a state of *adrenal failure* that Peat insisted was "really thyroid failure." [Source 12] This catabolic state destroys muscle tissue to provide amino acids, which in turn signal the body to further suppress thyroid function. [Source 12] Additionally, the slowed metabolic rate causes digestive sluggishness, allowing bacterial overgrowth in the small intestine and impairing nutrient absorption, which further deprives the thyroid gland of essential nutrients like magnesium and vitamin A. [Source 10]

Therapeutically, Peat advocated for thyroid supplementation, noting that a balanced product containing both T4 and T3 is often necessary because a stressed pituitary gland may not be adequately suppressed by T3 alone. [Source 8] He documented that proper supplementation could rapidly lower cholesterol by 50 points a week and resolve symptoms of high tension by bringing adrenaline and cortisone under control. [Source 4] Roddy has emphasized the value of Broda Barnes's book *Hypothyroidism: The Unsuspected Illness* for understanding the vast range of manifestations, noting that even subtle neurological traits like clumsiness or differences in intelligence can be linked to thyroid status. [Source 7] Peat also noted that in cases of genuine hyperthyroidism, a simple intervention like drinking raw cabbage juice could suppress the gland, but he maintained that the vast majority of diagnosed "hyperthyroid" cases were actually hypothyroid individuals compensating with stress hormones. [Source 1]

## People also ask

### How does hypothyroidism cause high adrenaline and anxiety?

Peat argued that the body compensates for low oxidative metabolism by releasing adrenaline at levels 20 to 40 times higher than normal, which creates a hyperactive, anxious, and tachycardic state that is often misdiagnosed as hyperthyroidism.

### Why did Peat consider TSH tests unreliable for diagnosing hypothyroidism?

Peat believed the TSH reference range had been distorted since the 1940s to hide widespread hypothyroidism, and that stress hormones like cortisol can artificially suppress TSH, making a low value a possible sign of an extreme hypothyroid state rather than health.

### What role does cholesterol play in identifying low thyroid function?

The corpus describes that cholesterol rises immediately when thyroid function is lost because thyroid hormone is needed to convert cholesterol into protective steroids, so Peat used elevated cholesterol as a reliable functional marker of hypothyroidism.

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## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Weight Loss, Macros, Prolactin, Cancer, Cold Therapy & More, Q&A

Ray Peat · Interview · Oct 11, 2020 · https://www.youtube.com/watch?v=EK8qhzo4w9s

> **Ray Peat:** make sure that you're actually hyperthyroid because over the last 50 years I've run across I don't know a few dozen people with that diagnosis but when I actually got them to describe their symptoms and their measurements that there were only two or three actually People who, according to the classical definitions, recognizing that thyroid is a hormone that does particular metabolic functions in the body. If you don't see those functions operating to an excessively high degree, Doctors are diagnosing hyperthyroidism in very unfounded ways. For example, there are many things that can cause TSH to be low. Stress can lower the TSH. Malnutrition can lower it. So just having low TSH excitable, tense, having a fast heart rate. Those are very common in hypothyroid people because sometimes the body will produce 30 or 40 times more than the normal amount of adrenaline to keep the body functioning in spite of low thyroid. And if a doctor looks at only the TSH and their speedy behavior, they can guess that it might be hyperthyroid. But if they actually look at what's going on chemically, it usually turns out that they're really hypothyroid, compensating with... adrenaline or catecholamines production and cortisol production and you should look at several other hormones as well and the temperature pattern high cortisol can keep your temperature up so you want to see what If it's really temperature produced by thyroid excess, sugar will increase it by increasing the amount of T3, the active hormone, being produced. But if it's being produced by cortisol, a big sugary meal. And the total amount of food consumed, if you're eating 4,000 calories a day and losing weight and getting skinny, then that's hyperthyroid, almost for sure. who are in danger of being given radioactive iodine to destroy the gland or having it surgically removed. Most of these people are maintaining their weight on a 2,000 calorie a day diet, so they can't be hyperthyroid.

### Source 2 — Ask the Herb Doctor: Thyroid, Polyunsaturated Fats and Oils

Ray Peat · Interview · Apr 1, 2009

> **Andrew Murray:** Welcome to this month's Ask Your Herb Doctor. My name is Andrew Murray.
>
> **Sarah Murray:** My name is Sarah Murray.
>
> **Andrew Murray:** For those of you who have never listened to our shows, we are both licensed medical herbalists who trained in England. We run a clinic in Garberville where we consult with clients about a wide range of conditions, and we manufacture our own certified organic herbal extracts. This month we are very pleased to welcome Ray Peat back to the show. We will be examining some common misconceptions surrounding thyroid treatment and the apparently normal thyroid test in clients with obvious manifestations of thyroid imbalance. We have seen remarkable progress made with clients whose symptoms improve dramatically with diet and lifestyle changes that promote thyroid health, revealing a prior lowered thyroid function even in the absence of diagnostic tests that show obvious problems. Welcome again, Dr. Peat.
>
> **Ray Peat:** Thank you.
>
> **Sarah Murray:** Dr. Peat has over 40 years of experience in lecturing, teaching, writing, editing, and nutritional counseling. He has a PhD in biology, but his work was all in physiology and biochemistry. We wanted to talk about thyroid disease because it seems to be a chronic epidemic. Dr. Peat, what would you describe low thyroid disease, or hypothyroidism, to be?

### Source 3 — Herb Doctors: Environmental Enrichment-Bad Science

Ray Peat · Interview · Aug 16, 2013 · http://l-i-g-h-t.com/files/herb-doctors-environmental-enrichment -bad-science.mp4

> **Caller:** Well, if it’s going to help me, I might try it. How long will it take to show before the test shows differently?
>
> **Ray Peat:** Well, if your TSH is in the low normal range and if your temperature and pulse rate are good and if you don’t have any symptoms, then you are handling it properly.
>
> **Caller:** What are the symptoms of having a low thyroid?
>
> **Ray Peat:** Cold hands and feet are very common, low blood sugar, anxiety, fatigue, depression, dry skin, oedema inability to go very long without getting hungry, craving sweets.
>
> **Caller:** Ahhh, I don’t think I have too much of that. What happened is I had atrial fibrillation and they discovered I have an over-active thyroid, which I never had before. I don’t know what caused it, it came on and the only symptom I had was the heart beat, irregular heartbeat, so they told me basically I could take something called Methimazole which lowers the thyroid but it would make me very susceptible to bad infections and had lots of difficult side effects. And the other thing I could do was have my thyroid basically most of it destroyed by taking a radioactive iodine treatment and that sounds drastic but it seemed like well, if I shrink my thyroid down below normal with this, then that’s it and all I have to do is take thyroid and that’s not going to have the side effects of the Methimazole. So I chose to do that and then, you know, gradually the thyroid started to shrink and seems to have stabilised where I need to add 88mcg and then I am OK. What do you think about doing that if you have hyperthyroid....?

### Source 4 — The Thyroid 1996 Gary Null Radio Show

Ray Peat · Interview · 1996 · http://l-i-g-h-t.com/files/gary-null-thyroid.mp4

> **Ray Peat:** And when it gets to an extreme, it can lead to a hyperactive state, with a loss of attention or extreme irritability and depression, and a lot of strange symptoms that, if you can get your cortisone and adrenaline under control by normalizing your thyroid and blood sugar, these strange symptoms of high tension just disappear. One of the common stereotypes about low thyroid people is that they are just lethargic and sluggish. But a very large group of low thyroid people become hyperactive because of this very high adrenaline compensating for the low blood sugar. Broda Barnes, who was one of the best thyroid researchers in the '30s and '40s wrote a book called "Hypoglycemia: It's Your Liver, not Your Mind," because he found that almost all hypoglycemics were low thyroid, and that the liver simply wasn't able to store enough glycogen to keep their blood sugar steady. The high cholesterol that develops in most people as they age is another thing that, in the '30s and '40s, many researchers recognized that high cholesterol was nothing but an indicator of low thyroid, the same way low blood sugar was mostly an indicator of low thyroid. There were published studies in the middle 1930's which showed that when you took out someone's thyroid gland, immediately the cholesterol went up, and when you gave them a thyroid supplement, immediately the cholesterol goes down. That's because thyroid is needed to produce products that the cholesterol turns into, such as bile acids, progesterone and pregnenolone, which are youth associated hormones. Vitamin A and cholesterol are used up by thyroid in producing these essential hormones and bile materials. I've seen people, just like the published studies 60 years ago, I've seen people consistently -- in one case, the cholesterol went down almost 100 points a day with very frequent big doses of quick acting thyroid. But usually you can see it go down 50 points a week with very careful thyroid supplementation.

### Source 5 — Hypothyroidism: The Unsuspected Illness

Broda Barnes · Book · 1976

> A reading below the normal range of97.8 to 98.2 strongly suggests low thyroid function. If the reading is above the normal range, one must be suspicious of some infection or an overactive thyroid gland.
>
> For small children who are likely to resist being quiet for ten minutes, more accurate readings often can be obtained by taking the temperature rectally for two minutes. The normal range of rectal temperature is about one degree higher than that of the armpit—98.8 to 99.2.
>
> ### A True Picture of Low Thyroid
>
> Over the past four decades there have been reports from discerning physicians that hypothyroidism is commonly unrecognized—and if part of the reason has been the confusion of tests for the condition, another important part has been confusion over the condition itself.
>
> As far back as 1933, Dr. O.P. Kimball, after a ten-year study—five years of it carried out at the famed Cleveland Clinic and five years in private practice—was reporting that "In the practice of medicine today no more important condition is encountered or so often unrecognized as such, as hypothyroidism."
>
> And Dr. Kimball went on to note that a cardinal reason for this was a theory that hypothyroidism couldn't exist without myxedema. On the very face of it, the theory was ridiculous, presupposing as it did that there couldn't be milder degrees of hypothyroidism, only a failure of the thyroid gland so great that it produced extreme symptoms. Yet that was the theory that he had been taught as a medical student. Dr. Kimball noted, and went on to add: "Just why this teaching should persist now in the face of all the experimental evidence to the contrary is hard to understand."
>
> There was to be more experimental evidence to the contrary in the years that followed—and still the theory persisted. Half a dozen years after Dr. Kimball published his report. Dr. G.K. Wharton of the University of Western Ontario published another which decried essentially the same thing: "Many patients who could be helped by thyroid treatment are not recognized as hypothyroid.
>
> Cretinism and myxedema are the textbook examples of the hypofunctioning thyroid gland. Very little has been written about the milder degrees and the atypical forms of deficient thyroid activity.

### Source 6 — Ask the Herb Doctor: Thyroid, Polyunsaturated Fats and Oils

Ray Peat · Interview · Apr 1, 2009

> ## Defining Hypothyroidism and Metabolism
>
> **Ray Peat:** It is a slowing of the oxidative metabolism, which means your biological efficiency falls drastically. We rely almost entirely on oxidative metabolism. In emergencies, we can use glycolytic, non-oxidative metabolism, but then we have to make up for it by re-oxidizing the lactic acid that was produced during the oxygen deprivation or energy stress. Everything that is human, mammalian, or even a complex organism depends on the thyroid because all cellular activity requires oxidative metabolism to be efficient.
>
> **Sarah Murray:** So the thyroid is controlling the oxygen to all the cells in our system?
>
> **Ray Peat:** Yes. One of the effects is that our carbon dioxide production is kept at a fairly high rate in relation to oxygen consumption, and that keeps our tendency to produce lactic acid very low. If a person is low thyroid, even at rest, they can seem metabolically as if they are doing stressful activity. They can chronically have elevated lactic acid.
>
> **Sarah Murray:** Is this why people experience chronic fatigue? Are their muscles fatigued even though they aren't doing exercises that seem to use their muscles?

### Source 7 — Thermo Diet Podcast Episode 36 - Danny Roddy

Danny Roddy · Interview · Jun 14, 2020 · https://www.youtube.com/watch?v=p-S0wfDbWeI

> **Danny Roddy:** And we didn't really get into it, but like things like thyroid, those can be macro therapies and can really move a person, I think, in a good direction if they're really not doing well, you know? And you mentioned it earlier, but the hypothyroidism, the unsuspected illness, I think that's like an essential read. Because, again, I wouldn't want people trusting me to, like, take thyroid. They should check out Broda's book because he goes over how many different, like, manifestations of, like, poor health the low thyroid can result in. And so, like, clumsiness or whatever can be a result of low thyroid.

### Source 8 — Bioenergetic Helpline #13: Depression, Fruit Trees, Fertility, Essentiality of T4, Reverse T3, Iron

Danny Roddy · Interview · May 18, 2026 · https://www.youtube.com/watch?v=fEKWI7ezh50

> **Danny Roddy:** Is that physician open to allowing you to try armor?
>
> **Caller:** He might be. I could try and talk him into it.
>
> **Danny Roddy:** What was your TSH when you got tested?
>
> **Caller:** Gosh, I don't remember. I feel like it was towards the lower end. It was like under one? I think so.
>
> **Danny Roddy:** That sounds right. from talking to people and some things that ray said i think when it's under one and the person is not taking thyroid i think it means the person's extremely hypothyroid it's even worse than the tsh being at two or three or something
>
> **Caller:** but you not reacting you know
>
> **Danny Roddy:** i'm not a doctor i'm just a random person on the internet you not reacting to the t3 is way better than having some crazy adrenaline reaction
>
> **Caller:** have you checked your temperature uh yeah it's usually upon waking is a little over 97.
>
> **Danny Roddy:** And then do you have a lot of those symptoms?
>
> **Caller:** Of what? Low thyroid? Yes, definitely.
>
> **Danny Roddy:** I mean, the T4 will help a lot. So that's why a balanced, a more balanced thyroid product is very valuable. So like, for example, I talk about this, I feel like almost every episode, but there's a paper called Hypothyroidism Diversity of Presentation. And it talks about how a low thyroid person, their pituitary is like lit up and it can enlarge. And so thyroid T3 is not enough to suppress the pituitary for long enough, especially in a person that's been chronically low thyroid for a long time. And so the T4 will provide great relief if that's what the issue is. You know, recently I

### Source 9 — Herb Doctors: Thyroid, Polyunsaturated Fats And Oilsnew

Ray Peat · Interview · Apr 1, 2009 · http://l-i-g-h-t.com/files/herb-doctors-thyroid-polyunsaturated-fats-and-oils-new-56-mins.mp4

> **Andrew Murray:** It is very kind of you to join us again. Okay.
>
> **Sarah Johannesen Murray:** I think we should – Dr. Peat has over 40 years’ experience. I want to introduce Dr. Peat’s experience for those of you who haven’t Dr. Peat on our radio show last year. But he has over 40 years’ experience in lecturing, teaching, writing, editing and nutritional counseling. So we’re very happy to have him join our show tonight. And he also has a PhD in biochemistry and he also teaches on physiology and basically functions as an endocrinologist. Does that sound right, Dr. Peat?
>
> **Ray Peat:** Yeah. My PhD is in biology, but my work was all in physiology and biochemistry.
>
> **Sarah Johannesen Murray:** So we wanted to talk about thyroid disease because it seems to be such a chronic epidemic. And we thought we just start by introducing what thyroid disease is in case there are listeners that are not aware of what their thyroid is or where it is located. So, Dr. Peat, what would you describe low thyroid disease to be or hypothyroidism?
>
> **Ray Peat:** It’s basically a slowing of the oxidative metabolism. And that means your biological efficiency falls drastically because we rely almost entirely on oxidative metabolism. In emergencies, we can use glycolytic non-oxidative metabolism, but then we have to make up for it by re-oxidizing the lactic acid that was produced in the oxygen deprivation or energy over-stressing. And so, everything that is human or mammalian or even a complex organism depends on the thyroid because all cellular activity to be efficient requires oxidative metabolism.

### Source 10 — Endocrinology Part 3 — KMUD, 2017

Ray Peat · Interview · 2017

> **Caller:** And am I correct in understanding that the lack of thyroid hormone is often times a root cause of small bowel overgrowth or SIBO, which is the root cause of leaky gut?
>
> **Ray Peat:** Yeah, because your digestion slows down when your metabolic rate slows down from hypothyroidism. And so your stomach becomes sluggish, doesn’t secrete much, and doesn’t move fast enough. People might eat a carrot today and it might not come out for 4 or 5 days. That's what happens with hypothyroidism. And speeding up your digestion and secretions... [ideally,] it should be so active...[the] streaming fluid from your stomach, pancreas and liver should wash your whole small intestine clean so that no bacteria can thrive in it.
>
> **Caller:** Is there a good quality nutrition based textbook that you find favourable, that gets into good mechanisms of nutrition and hormones and their relations?
>
> **Ray Peat:** Not that I know of! Years ago, I had seen some really good monographs on particular topics like how the intestine works, how the digestive glands work, and so on. But I don’t know of one that has put anything together.

### Source 11 — One Radio Network: Milk

Ray Peat · Interview · Jul 18, 2019

> ## Thyroid Health and Diagnosis
>
> **Patrick Timpone:** One of the biggest complaints when people go to the doctor is low energy. Talk a bit about that.
>
> **Ray Peat:** Mostly that turns out to be a low thyroid state. Even in the 30s and 40s, experts estimated that probably 40% of the population was practically hypothyroid. Since then, the diet has deteriorated. Using those same standards, probably 60% or 80% of people are suffering from hypothyroidism. However, the standards for measuring it have changed since the 1940s to revise the definition of "normal." The standard they use now is TSH (Thyroid Stimulating Hormone). What they overlook is that the stress caused by hypothyroidism and bad diet produces stress hormones that lower TSH, the same way an excessive thyroid hormone would. So, a stressed, tired, low-energy person will have very low TSH production because of the stress hormones.
>
> **Patrick Timpone:** Wow.
>
> **Ray Peat:** Quite a few people have had a diagnosis of *hyperthyroidism* because their TSH is so low, but their symptoms—water retention, fatigue, hair loss—are typical of hypothyroidism. Several people have told me, "I'm both hyperthyroid and hypothyroid." It makes absolutely no sense, but doctors are actually saying that.

### Source 12 — Ask the Herb Doctor: Thyroid and Polyunsaturated Fatty Acids

Ray Peat · Interview · Jul 1, 2008 · http://www.l-i-g-h-t.com/files/herb-doctors-thyroid-and-polyunsaturated-fatty-acids-new-56-mins.mp4

> ## Adrenaline, Cortisone, and Stress
>
> **Andrew Murray:** This would be the classic wasting of a hyperactive or sympathetically stimulated person.
>
> **Ray Peat:** I've seen several very hypothyroid men who, no matter how much they ate, couldn't put on weight. They weighed 130 or 135 pounds and were very frail looking. When they took thyroid, they didn't have to eat so much, but they could suddenly put on muscle because their cortisone went down. At the same time that your adrenaline is driving your adrenal glands to produce more cortisone, your adrenals need the thyroid hormone to convert cholesterol into cortisone. The destruction of your muscles to turn them into food liberates tryptophan and cysteine amino acids, which are signals to turn your thyroid down so that you don't totally destroy yourself in the first two days.
>
> **Sarah Murray:** So it's a vicious cycle.
>
> **Ray Peat:** Yes. The stress turns your thyroid down. When your thyroid is low, you can't convert cholesterol into cortisone, and that's what is called adrenal failure. But it's really thyroid failure.

_Generated 2026-07-20 from the Bioenergetic Oracle corpus._