The average person who can't lose weight often has a thyroid hormone imbalance.

We ask our doctor to run a test, and lo' and behold' the results often come back "normal".

How can this be we ask, especially when weight gain continues to be an issue and/or we suffer from other hypothyroid hallmarks - feeling cold, old, stressed and depressed?

Given that so many of the symptoms of low thyroid overlap with other hormone imbalances, we may not get the answers we need unless we are working with a provider who goes beyond the standard TSH test to address thyroid disorders in the greater context of hormone imbalance.

Our bodies produce more than one thyroid hormone, the most abundant being thyroxine (T4), which converts to triiodothyroinine (T3), the most active thyroid hormone in the body. We need our bodies to make adequate levels of these two hormones since we rely heavily on them for an active metabolism.

So back to our original question: a TSH test alone that comes back 'normal' is nevertheless not a true measure of thyroid function since it does not take active levels into account. Nor can a single thyroid test identify imbalances of steroid or adrenal hormones that can seriously inhibit thyroid function.

To find out how well our thyroid is actually working requires a big-picture assessment of all hormone levels that matter

When it comes to a healthy thyroid, the efficient conversion of T4 to T3 has to occur. T3 is, in fact, five times more active than T4, so, anything that interferes with that crucial conversion process will decrease thyroid function, slow metabolism (to make weight loss even harder), and trigger a raft of low thyroid symptoms.

From hormone imbalances to mineral deficiencies and environmental pollutants, a range of factors can interfere with thyroids' crucial conversion. Testing can help identify the worst culprits:

Thyroid problems are more prevalent in women, particularly those in the menopause transition Note: excess estrogens bind up active thyroid hormones

• Estrogen dominance
• Elevated cortisol stress hormones
• Iodine deficiency
• Selenium and zinc deficiency
• Vitamin D deficiency
• Arsenic or mercury toxicity
• Xenoestrogen burden (environmental chemicals that disrupt estrogen metabolism)

Taking action to target and take out these hidden saboteurs of thyroid health can help us master the thyroid game. We'll talk more about natural ways to win the battle in part 2.