John was 70 years old when he signed up for Quantify, after struggling for years with fatigue, depression, brain fog, and constipation, and not getting anywhere with conventional medicine.
His primary care doctor had diagnosed him with hypothyroidism when his thyroid-stimulating hormone (TSH) came back elevated, but he didn’t have anything to offer, other than a prescription for levothyroxine—the standard treatment for hypothyroidism—and a quick comment that John was “just getting old.”
An avid long-distance cyclist since his thirties, John had been committed to his health for decades (often keeping up with others half his age), so he was understandably reluctant to accept the implication that his chronological age should determine his health.
While he recognized that maintaining his performance would be increasingly difficult over time, given the natural breakdown of physiological function, he didn’t think it was appropriate for his doctor to suggest that age was the primary contributing factor to his hypothyroidism, without ordering any tests to investigate the causes.
Frustrated by his doctor’s lack of outside-of-the-box thinking, John decided to pursue a more data-driven approach.
In his first appointment at Quantify, John’s health coach recommended a hypothalamic-pituitary-adrenal (HPA) stress profile and Epstein-Barr virus test, to evaluate the health of his HPA axis, the system that regulates the body’s response to acute and chronic stress, and test for Epstein-Barr virus, the virus that causes mononucleosis.
Test results
His first time conducting a comprehensive evaluation of his health, John’s HPA stress profile showed an abnormally shallow diurnal cortisol pattern, indicating HPA axis dysregulation, or the condition of having an exhausted stress response, which commonly contributes to hypothyroidism, chronic fatigue syndrome, fibromyalgia, and other chronic conditions.
Providing an additional clue as to what was going on, John’s Epstein-Barr virus test showed significantly elevated IgM and IgG antibodies, indicating reactivated Epstein-Barr virus, which was likely further contributing to his hypothyroidism, given the pathogen’s propensity to target the thyroid.
Having regularly pushed himself to his physical limits as a cyclist—fueling 100+ mile rides with ultra-processed bars and gels in the name of “performance”—John’s extreme commitment to his health had likely exhausted his body’s ability to produce cortisol, causing HPA axis dysregulation, compromised immune function, reactivated Epstein-Barr virus, and, ultimately, his hypothyroidism.
Recovery
John had picked up biking to stay healthy, so to learn that his seemingly health-promoting long-distance rides had paradoxically caused his hypothyroidism was quite the surprise.
He would often get sick after races, once the adrenaline wore off, so he knew that pushing himself to physical exhaustion wasn’t conducive to healthy immune function.
What he didn’t realize, however, is that even when it felt like he had fully recovered, days later, his HPA axis was likely still playing catch-up, producing just enough cortisol for him to function, but not enough to create the conditions for optimal health.
Working closely with his health coach, John eliminated processed foods, sugar, and grains from his diet, increased consumption of fruits and vegetables, took certain supplements, such as magnesium malate, glycine, and Rhodiola rosea, and started dialing back the intensity of his biking.
Within a few months, his fatigue, depression, brain fog, and constipation started to improve, an encouraging indication that his thyroid was coming back online.
Within a year, his symptoms had completely resolved, his TSH was back to normal, and a follow-up HPA stress profile showed healthy cortisol production, further validating the work he had done to reverse the condition that he was told he would have to live with.