What you're experiencing isn't just a thyroid problem," Dr. Ramos said, leaning forward.
She pulled out a piece of paper and drew three circles.
"Let me show you what's actually happening."
"First — Hashimoto's keeps inflammation permanently switched on. It never shuts off. And that constant flood of inflammation has one place it hits hardest — your liver."
"Second — your liver is where T4 becomes active T3. And yes — the T3 on your labs, the T3 in meds— that's not the same thing.
Active T3 at the cellular level, the one that runs your metabolism, can only be produced through proper liver conversion. And when the liver is overwhelmed by inflammation, that conversion stops happening."
"Third — your minerals have nowhere to work. Selenium, zinc, magnesium — they're supposed to fuel this conversion. But you can't fuel a process that's already blocked. So they just pass through."
"Where all three circles meet," she said, tapping the center of the page, "is where your metabolism has been stuck."
"So my liver was the missing piece this whole time?"