Most people
realize that their thyroid is important for controlling their
metabolism and body weight.
But did you
know that depression, heart disease, chronic fatigue, fibromyalgia,
PMS (premenstrual syndrome), menopausal symptoms, muscle and joint
pains, irritable bowel syndrome, or autoimmune disease could actually
indicate a problem with your thyroid?
The classic
signs of a sluggish thyroid gland include weight gain, lethargy,
poor quality hair and nails, hair loss, dry skin, fatigue, cold
hands and feet, and constipation and these symptoms are
relatively well known.
However,
some of the conditions you might not associate
with your thyroid include:
- High cholesterol
- Irregular
menstruation
- Low libido
- Infertility
- Gum disease
- Fluid
retention
- Skin conditions
such as acne and exzema
- Memory
problems
- Poor stamina
And there
are, in fact, many more conditions that can be associated with
poor thyroid function. Your thyroid plays a part in nearly every
physiological process. When it is out of balance, so are you.
This is why it is so important to understand how your thyroid
gland works and what can cause it to run amok.
The sad fact
is, half of all people with hypothyroidism are never diagnosed.
And of those who are diagnosed, many are inadequately treated,
resulting in partial recovery at best.
Hypothyroidism:
The Hidden Epidemic
Hypothyroidism
simply means you have a sluggish or underactive thyroid, which
is producing less than adequate amounts of thyroid hormone.
“Subclinical”
hypothyroidism means you have no obvious symptoms and only slightly
abnormal lab tests. I will be discussing these tests much more
as we go on since they are a source of great confusion for patients,
as well as for many health practitioners.
Thyroid problems
have unfortunately become quite common.
The same
lifestyle factors contributing to high rates of obesity,
cancer and diabetes are wreaking havoc on your thyroid… sugar,
processed foods, stress, environmental toxins, and lack of exercise
are heavy contributors.
More than
10 percent of the general population in the United States, and
20 percent of women over the age of 60, have subclinical hypothyroidism.
But only a small percentage of these people are being treated[1].
Why is that?
Much of it
has to do with misinterpretation and misunderstanding of lab tests,
particularly TSH (thyroid stimulating hormone). Most physicians
believe that if your TSH value is within the range of “normal,”
your thyroid is fine. But more and more physicians are discovering
that the TSH value is grossly unreliable for diagnosing hypothyroidism.
And the TSH
range for “normal” keeps changing!
In an effort
to improve diagnosis of thyroid disease, in 2003 the American
Association of Clinical Endocrinologists (AACE) revised the “normal”
TSH range as 0.3 to 3.04[2].
The previous range was defined as 0.5 and 5.0, which red-flagged
only the most glaring hypothyroidism cases.
However,
the new range is still not wholly reliable as the sole indicator
of a sulky thyroid gland. You simply cannot identify one TSH value
that is “normal” for every person, regardless of age, health,
or other factors.
Having said
that though most physicians who carefully follow this condition
recognize that any TSH value greater than 1.5 could be a strong
indication that an underactive thyroid is present.
Your TSH
value is only part of the story, and your symptoms, physical findings,
genetics, lifestyle and health history are also important considerations.
Only when physicians learn to treat the patient and not the lab
test will they begin to make headway against thyroid disease.
Understanding
How Your Thyroid Works is Step One
The thyroid
gland is in the front of your neck and is part of your endocrine,
or hormonal, system. It produces the master metabolism hormones
that control every function in your body[3].
Thyroid hormones interact with all your other hormones including
insulin, cortisol, and sex hormones like estrogen, progesterone,
and testosterone.
The fact
that these hormones are all tied together and in constant communication
explains why an unhappy thyroid is associated with so many widespread
symptoms and diseases.
This small
gland produces two major thyroid hormones: T4 and T3. About 90
percent of the hormone produced by the gland is in the form of
T4, the inactive form. Your liver converts this T4 into T3, the
active form, with the help of an enzyme.
Your thyroid
also produces T2, yet another hormone, which currently is the
least understood component of thyroid function and the subject
of much ongoing study.
Thyroid hormones
work in a feedback loop with your brain particularly your
pituitary and hypothalamus in regulating the release of
thyroid hormone. Your pituitary makes TRH (thyroid releasing hormone),
and your hypothalamus makes TSH. If everything is working properly,
you will make what you need and you’ll have the proper amounts
of T3 and T4.
Those two
hormones T3 and T4 are what control the metabolism
of every cell in your body. But their delicate balance can be
disrupted by nutritional imbalances, toxins, allergens, infections
and stress.
If your T3
is inadequate, either by insufficient production or not converting
properly from T4, your whole system suffers.
You see,
T3 is critically important because it tells the nucleus of your
cells to send messages to your DNA to crank up your metabolism
by burning fat. That is why T3 lowers cholesterol levels, regrows
hair, and helps keep you lean.
How
to Know if You are Hypothyroid
Identifying
hypothyroidism and its cause is tricky business. Many of the symptoms
overlap with other disorders, and many are vague. Physicians often
miss a thyroid problem since they rely on just a few traditional
tests, so other clues to the problem go undetected.
But you can
provide the missing clues!
The more
vigilant you can be in assessing your own symptoms and risk factors
and presenting the complete picture to your physician in an organized
way, the easier it will be for your physician to help you.
Sometimes
people with hypothyroidism have significant fatigue or sluggishness,
especially in the morning. You may have hoarseness for no apparent
reason. Often hypothyroid people are slow to warm up, even in
a sauna, and don’t sweat with mild exercise. Low mood and depression
are common.
Sluggish
bowels and constipation are major clues, especially if you already
get adequate water and fiber.
Are the upper
outer third of your eyebrows thin or missing? This is sometimes
an indication of low thyroid. Chronic recurrent infections are
also seen because thyroid function is important for your immune
system.
Another telltale
sign of hypothyroidism is a low basal body temperature (BBT),
less than 97.6 degrees F[4]
averaged over a minimum of 3 days. It is best to obtain a BBT
thermometer to assess this.
How about
your family history? Do you have close relatives with thyroid
issues?
Some of the
family history that suggests you could have a higher risk for
hypothyroidism includes:
- High or
low thyroid function
- Goiter
- Prematurely
gray hair
- Left-handedness
- Diabetes
- Autoimmune
diseases (rheumatoid arthritis, lupus, sarcoidosis, Sjogren’s,
etc.)
- Crohn’s
disease or ulcerative colitis
- Multiple
sclerosis (MS)
- Elevated
cholesterol levels
It might
be useful to take an online thyroid assessment quiz, as a way
to get started. Mary
Shomon has a good one. Some of the classic symptoms are mentioned
above, but there are many more too many to list here.
If you suspect
you might be hypothyroid, you should see a healthcare provider
who can evaluate this, including ordering the basic lab tests
for thyroid function.
Laboratory
Testing
Even though
lab tests are not the end-all, be-all for diagnosing a thyroid
problem, they are a valuable part of the overall diagnostic process.
The key is to look at the whole picture.
New studies
suggest a very high incidence of borderline hypothyroidism in
Westerners. Many cases are subclinical, and even “sublaboratory,”
not showing up at all in standard laboratory measurements.
Coexistent
subclinical hypothyroidism often triggers or worsens other chronic
diseases, such as the autoimmune diseases, so the thyroid should
be addressed with any chronic disease.
Many physicians
will order only one test a TSH level. This is a grossly
inadequate and relatively meaningless test by itself, as well
as a waste of your money. It would be like saying you know your
water is pure because it tastes fine.
I recommend
the following panel of laboratory tests if you want to get the
best picture of what your thyroid is doing:
- TSH
the high-sensitivity version. This is the BEST
test. But beware most all of the “normal” ranges are simply
dead wrong. The ideal level for TSH is between 1 and 1.5 mIU/L
(milli-international units per liter)
- Free
T4 and Free T3. The normal level of free T4 is between
0.9 and 1.8 ng/dl (nanograms per deciliter). T3 should be between
240 and 450 pg/dl (picograms per deciliter).
- Thyroid
antibodies, including thyroid peroxidase antibodies and anti-thyroglobulin
antibodies. This measure helps determine if your body
is attacking your thyroid, overreacting to its own tissues (ie,
autoimmune reactions). Physicians nearly always leave this test
out.
- For
more difficult cases TRH can be measured
(thyroid releasing hormone) using the TRH stimulation
test. TRH helps identify hypothyroidism that’s caused
by inadequacy of the pituitary gland.
Other tests
that might be indicated for more complex cases are a thyroid scan,
fine-needle aspiration, and thyroid ultrasound. But these are
specialized tests that your physician will use only in a small
number of cases, in special situations.
Even if all
your lab tests are “normal,” if you have multiple thyroid symptoms,
you still could have subclinical hypothyroidism.
Keeping
Your Thyroid Healthy in a Toxic World
Now that
you have some understanding of the importance of your thyroid
and how it works, let’s take a look at the factors that can readily
cause problems with your thyroid gland.
Diet
Your lifestyle
choices dictate, to a great degree, how well your thyroid will
function.
If you follow
my plan to eat for your nutritional type[5],
and my nutritional
plan your metabolism will be more efficient, and your thyroid
will have an easier time keeping everything in check. Eating for
your type will normalize your blood sugar and lipid levels and
enhance your immune system, so that your thyroid will have fewer
obstacles to overcome.
Eliminate
junk food, processed food, artificial sweeteners, trans fats,
and anything with chemical ingredients. Eat whole, unprocessed
foods, and choose as many organics as possible.
Gluten
and Other Food Sensitivities
Gluten and
food sensitivities[6] are
among the most common causes of thyroid dysfunction because they
cause inflammation.
Gluten causes
autoimmune responses in many people and can be responsible for
Hashimoto’s thyroiditis, a common autoimmune thyroid condition.
Approximately 30 percent of the people with Hashimoto’s thyroiditis
have an autoimmune reaction to gluten, and it usually goes unrecognized.
How this
works is, gluten can cause your gastrointestinal system to malfunction,
so foods you eat aren’t completely digested (aka Leaky Gut Syndrome[7]).
These food particles can then be absorbed into your bloodstream
where your body misidentifies them as antigens substances
that shouldn’t be there our body then produces antibodies
against them.
These antigens
are similar to molecules in your thyroid gland. So your body accidentally
attacks your thyroid. This is known as an autoimmune reaction
or one in which your body actually attacks itself.
Testing can
be done for gluten and other food sensitivities, which involves
measuring your IgG and IgA antibodies[8].
Soy
Another food
that is bad for your thyroid is soy[9].
Soy is NOT the health food the agricultural and food companies
would have you believe.
Soy is high
in isoflavones (or goitrogens), which are damaging to your thyroid
gland. Thousands of studies now link soy foods to malnutrition,
digestive stress, immune system weakness, cognitive decline, reproductive
disorders, infertility and a host of other problems in
addition to damaging your thyroid[10].
Properly
fermented organic soy products such as natto, miso, and tempeh
are fine it’s the unfermented soy products that you should
stay away from.
Coconut
Oil
Coconut oil
is one of the best foods you can eat for your thyroid[11].
Coconut oil is a saturated fat comprised of medium chain triglycerides
(MCTs), which are known to increase metabolism and promote weight
loss.
Coconut oil
is very stable (shelf life of 3 to 5 years at room temperature),
so your body is much less burdened with oxidative stress than
it is from many other vegetable oils. And coconut oil does not
interfere with T4 to T3 conversion the way other oils can.
Iodine
Iodine is
a key component of thyroid hormone[12].
In fact, the names of the different forms of thyroid hormone reflect
the number of iodine molecules attached T4 has four attached
iodine molecules, and T3 has three showing what an important
part iodine plays in thyroid biochemistry.
If you aren’t
getting enough iodine in your diet (and most Americans don’t[13]),
no matter how healthy your thyroid gland is, it won’t have the
raw materials to make enough thyroid hormone.
Chlorine,
fluorine and bromine are also culprits in thyroid function, and
since they are halides like iodine, they compete for your iodine
receptors.
If you are
exposed to a lot of bromine, you will not hold on to the iodine
you need. Bromine is present in many places in your everyday world
plastics, pesticides, hot tub treatments, fire retardants,
some flours and bakery goods, and even some soft drinks. I have
written a special
article about bromine and its influence on your thyroid gland
and I encourage you to read it.
Also make
sure the water you drink is filtered. Fluoride is particularly
damaging to your thyroid gland[14].
Not all water filters[15]
remove fluoride, so make sure the one you have does.
Stress
and Adrenal Function
Stress is
one of the worst thyroid offenders. Your thyroid function is intimately
tied to your adrenal function, which is intimately affected by
how you handle stress.
Many of us
are under chronic stress, which results in increased adrenalin
and cortisol levels, and elevated cortisol has a negative impact
on thyroid function. Thyroid hormone levels drop during stress,
while you actually need more thyroid hormones during stressful
times.
When stress
becomes chronic, the flood of stress chemicals (adrenalin and
cortisol) produced by your adrenal glands interferes with thyroid
hormones and can contribute to obesity, high blood pressure, high
cholesterol, unstable blood sugar, and more.
A prolonged
stress response can lead to adrenal exhaustion[16]
(also known as adrenal fatigue), which is often found alongside
thyroid disease.
Environmental
toxins place additional stress on your body. Pollutants such as
petrochemicals, organochlorines, pesticides and chemical food
additives negatively affect thyroid function.
One of the
best destressors is exercise, which is why it is so beneficial
for your thyroid.
Exercise
directly stimulates your thyroid gland to secrete more thyroid
hormone. Exercise also increases the sensitivity of all your tissues
to thyroid hormone. It is even thought that many of the health
benefits of exercise stem directly from improved thyroid function.
Even something
as simple as a 30-minute walk is a great form of exercise, and
all you need is a good pair of walking shoes. Don’t forget to
add strength training to your exercise routine, because increasing
your muscle mass helps raise your metabolic rate.
Also make
sure you are getting enough sleep. Inadequate sleep contributes
to stress and prevents your body from regenerating fully.
Finally,
one excellent way to reduce stress is with an energy psychology
tool such as the Meridian Tapping Technique (MTT). More and more
people are practicing MTT and experiencing amazing results[17].
Treatment
Options for a Sluggish Thyroid
Here are
some suggestions that can be used for general support of your
thyroid, as well as treating an underperforming one:
- Eat plenty
of sea vegetables such as seaweed, which are rich in minerals
and iodine (hijiki, wakame, arame, dulse, nori, and kombu).
This is probably the most ideal form of iodine supplementation
as it is also loaded with many other beneficial nutrients.
- Eat Brazil
nuts, which are rich in selenium.
- Get plenty
of sunlight to optimize your vitamin D levels; if you live where
sunlight is limited, use vitamin D3 supplementation[18].
- Eat foods
rich in vitamin A, such as dandelion greens, carrots, spinach,
kale, Swiss chard, collard greens, and sweet potatoes.
- Make sure
you are eating enough omega-3 fatty acids.
- Use pure,
organic coconut oil in your cooking it’s great for stir
fries and sautéing many different meats and vegetables.
- Filter
your drinking water and your bathing water.
- Filter
your air, since it is one of the ways you take in environmental
pollutants.
- Use an
infrared sauna to help your body combat infections and detoxify
from petrochemicals, metals, PCBs, pesticides and mercury.
- Taking
chlorella[19] is another
excellent detoxification aid.
- Many women
suffering with hormonal imbalances report significant benefits
from the South American herb maca. For more information, please
review this article
by thyroid expert Mary Shomon, or her Q&A
session with Dr. Viana Muller on this topic.
- Take active
steps to minimize your stress ... relaxation, meditation, hot
soaks, EFT, whatever works for you.
- Exercise,
exercise, exercise!
Thyroid
Hormone Replacement
If you know
your thyroid function is poor, despite making the supportive lifestyle
changes already discussed, then it might be time to look at thyroid
supplementation.
Taking thyroid
hormone should be done only after you have ruled out other conditions
that could be causing the thyroid dysfunction such as adrenal
fatigue, gluten or other food allergies, hormonal imbalance, etc.
It is always best to get your thyroid working again by treating
the underlying cause, as opposed to taking an external source
of thyroid hormone.
But sometimes
supplementation is necessary.
Conventional
pharmaceutical treatment usually consists of replacing only T4
in the form of Synthroid, Levoxyl, Levothyroid, Unithroid, and
levothyroxine, leaving your body to convert this to T3.
However,
research has shown that a combination of T4 and T3 is often more
effective than T4 alone. The conversion to T3 can be hampered
by nutritional deficiencies such as low selenium, inadequate omega-3
fatty acids, low zinc, chemicals from the environment, or by stress.
Oftentimes,
taking T4 alone will result in only partial improvement.
Taking T3
alone is usually too stimulating. The drug Cytomel is a very short-acting
form of T3 that can cause palpitations, anxiety, irritability
and insomnia. I never recommend this drug.
By far, the
better approach is combined T4 and T3 therapy.
Natural thyroid
products, like ArmourThyroid[20]
are a combination of T4, T3 and T2 made from desiccated, or dried,
porcine thyroid. Armour Thyroid has gotten a bad rap over the
years, perceived by physicians to be unstable and unreliable in
terms of dosage. However, many improvements have been made in
the product, making it a safe and effective option for treating
hypothyroidism today.
In fact,
a study done ten years ago clearly demonstrated that patients
with hypothyroidsim showed greater improvements in mood and brain
function if they received treatment with Armour Thyroid than if
they received Synthroid[21].
The optimal
dose for Armour Thyroid ranges from 15 to 180 milligrams, depending
on the individual. You will need a prescription.
Once on thyroid
replacement, you will not necessarily need to take it for
the rest of your life, which is a common misconception. Once
all the factors that have led to your thyroid dysfunction have
been corrected, you may be able to reduce or discontinue the thyroid
hormone replacement.
Once on thyroid
hormone replacement, I recommend you monitor your progress by
paying attention to how you feel, in addition to regular lab studies.
You can also
routinely check your basal body temperature. If you are on the
correct dose, your BBT should be about 98.6 degrees F.
If you begin
to feel symptoms such as anxiety, palpitations, diarrhea, high
blood pressure, or a resting pulse of more than 80 beats per minute,
your dose is likely too high as these are symptoms of hyperthyroidism,
and you should let your physician know immediately.
Final
Thoughts
A thyroid
problem is no different than any other chronic illness
you must address the underlying issues if you hope to correct
the problem. The path to wellness may involve a variety of twists
and turns before you find what works for you.
But hang
in there.
If you approach
it from a comprehensive, wholistic perspective, you will find
in time that all of the little steps you take will ultimately
result in your feeling much better than you could have ever imagined.
Notes
[1]
Mary Shomon, “Thyroid
Disease 101,” June 19, 2006
[2]
“Major
Revision of Hypothyroid Diagnosis Guidelines” March 1, 2003
[3]
Mark Hyman M.D., The Ultra Thyroid Solution: A 7-Step Plan
to Reverse Hypothyroidsim Permanently, 2008, copyright UltraWellness
L.L.C. (ebook)
[4]
Thyroid-Info,
Mary Shomon, guidelines for taking BBT,
[5]
“Nutritional
Typing: Your Next Generation Key to Stupendous Lifelong Health
(and Simpler Weight Management),”
[6]
“Food
Allergies—Do You Have Unexplained Symptoms?” July 13, 2007
[7]
“’Leaky
Gut’ Intestinal Protein Linked to Autoimmune Disorders” May
14, 2000
[8]
Labcorps.com
[9]
“The
Evidence Against Soy” October 7, 2008
[10]
“More
Evidence Soy is Not as Healthy as Originally Believed” August
10, 2006
[11]
Cherie Calbom and Brian Shilhavy, “How
to Help Your Thyroid With Virgin Coconut Oil” November 8,
2003
[12]
“Hidden
Toxins Disrupting Your Thyroid and Iodine Production?” September
5, 2009
[13]
American Thyroid Association website, “Iodine
Deficiency,”
[14]
“Fluoridated
Water Affects Your Thyroid Gland” December 6, 2003
[15]
Mercola Water
Filters page
[16]
“Tired
All the Time? Exhausted for No Reason? You Could Have Adrenal
Fatigue” August 18, 2009
[17]
“Simple
Treatment Improves Weight Loss, Thyroid Disease, and Rheumatoid
Arthritis” September 12, 2008
[18]
“My
One Hour FREE Vitamin D Lecture to Clear Up All Your Confusion
on this Vital Nutrient” December 16, 2008
[19]
Mercola Chlorella
product page
[20]
The Armour Thyroid
website
[21]
“NEJM
Study Proves Armour Thyroid Better Than Synthroid” January
2, 2008