Hypothyroidism is defined as an underactive thyroid. But it isn't always as simple as the thyroid just being "slow." 

There are actually four different types of hypothyroidism, all of which act and present slightly differently.

If you’re not addressing the proper type of hypothyroidism, even if you’re medicating or doing other treatments, you still might struggle with hypothyroid symptoms. 

Let’s dive into what the four different types of hypothyroidism are.

Primary Hypothyroidism

This is when your thyroid gland isn't producing enough hormones. One of the most common causes of primary hypothyroidism is Hashimoto’s disease, when your body attacks the thyroid, leading to tissue damage. 

Central Hypothyroidism

Central or secondary hypothyroidism is when the pituitary gland and/or hypothalamus are not functioning optimally. In other words, there is an issue in the brain. 

This is common to see when TSH and thyroid hormones are low. Chronic stress can be a big culprit here.

Subclinical Hypothyroidism

This type of hypothyroidism can happen when thyroid hormones (T3 and T4) look normal but TSH is starting to creep up. Meaning, this is the early stage of hypothyroidism and the person may or may not show symptoms yet.

Cellular hypothyroidism 

As the name suggests, cellular hypothyroidism happens when the issue is at the cellular level. 

Thyroid hormones typically look "normal" or close to "normal" on a blood test but they aren't necessarily going into the cells. In other words, you may have all the right thyroid hormones, but they aren't actually doing their work. 

I often see this caused by things like stress, inflammation, mineral imbalances, poor liver and gut health, and so on.

So, what does this mean?

This means that hypothyroidism is not always a simple problem with the thyroid gland. There are many other systems and organs, or lifestyle factors that could be at fault.

Always make sure you demand a full thyroid panel from your health care provider, so you can be sure you get the proper diagnosis and the right treatment for whatever type of hypothyroidism is causing your issues.