Your thyroid is most likely impacting your health and you are told otherwise
Millions of Americans are suffering with feelings of fatigue, weight gain, cognitive impairment and depression. Seemingly unrelated and sometimes even attributed to other causes, the thyroid can actually be at play.
Thyroid disorders can have a widespread effect on your health. Due to it’s function as essentially our body’s thermostat, the thyroid governs everything from our body temperature, hunger levels and how much energy we use. Consequently, the deregulation of the thyroid can lead numerous issues, including weight fluctuations, mood disturbances, and a varied of physical symptoms.
There are many problems that can occur with our thyroid, however, there are two main types of thyroid problems we usually hear about: an underactive thyroid (hypothyroidism) and an overactive thyroid (hyperthyroidism).
Role of the Thyroid
So, how does the thyroid do exactly all that it does?
The thyroid is filled with an iodine-rich protein called thyroglobulin along with the thyroid hormones thyroxine (aka T4) and triiodothyronine (aka T3). T3 and T4 work by regulating the metabolism due to their ability to control the rate at which the body converts oxygen and calories to energy.1 This energy is essential to cognitive functions, mood, digestive processes, reproduction and much more. The gland, which is often described to be in the shape of a butterfly, is imperceptible to the touch in healthy individuals. When the thyroid becomes visibly enlarged, it is often referred to as a goiter. This condition is much more a concern in countries where lack of dietary iodine is common.
Problems arise when the thyroid gland pumps out too much or too little of certain hormones. Knowing now what the thyroid is responsible for, you can imagine that when it isn’t working optimally, it will wreak havoc with things such as body weight regulation, mood stabilization and more.
Of the problems surrounding the thyroid, hypothyroidism is by far the most common.1 So, lets talk about it!
Hypothyroidism, as you’ve probably guessed, happens when the thyroid does not make enough thyroid hormones, thus resulting in a reduction in metabolic rate. Most of the symptoms related to this “slowing down” will take years to develop, and the slower the metabolism gets, the more obvious these signs and symptoms will become.
The main symptoms of hypothyroidism are:1
- Persistent fatigue, lethargy, and sometimes depression or low motivation to exercise
- Unexpected weight gain
- Muscle weakness, sometimes aches or pains, and other discomforts
- Constipation, bloating and other digestive issues
- Increased sensitivity to cold and frequently feeling chilly
- Moodiness and sometimes anxiety
- Dry skin — including skin might feel cool to the touch and the toes/fingers might look a blue/purple color in some cases
- Hair loss or coarse dry hair
- Brain fog, trouble concentrating and forgetfulness
- A horse voice
In the United States, the most common cause of hypothyroidism is Hashimoto’s thyroiditis.2 Hashimoto’s thyroiditis is a condition by which the body attacks the thyroid, consequently, compromising its functioning. This “attack” is in fact an autoimmune response, that is, when the body attacks its own thyroid tissue. In return, this will interfere with the thyroid’s normal ability to produce hormones. But take note, although Hashimoto’s disease usually causes hypothyroidism, it may also trigger hyperthyroid symptoms! A particular population at risk for hypothyroidism are pregnant women. During pregnancy, the thyroid gland produces more thyroid hormone than when a woman is not pregnant.2
In addition, individuals with something called subclinical hypothyroidism, are at greater risk for developing overt hypothyroidism. Subclinical hypothyroidism, an often under-diagnosed thyroid disorder, manifests as elevated thyroid stimulating hormone (TSH) with normal T4 and normal T3 levels.3
There are many causes which can lead to Hashimoto’s disease, some of which include high amounts of stress, nutrient deficiencies (such as low iodine or due to poor absorption), low immune function (immunosuppression) and toxicity.2,4
The Consequences of Hypothyroidism
I briefly listed the most common signs and symptoms of hypothyroidism above, but let’s take a closer look at some of those concerns.
Fatigue and weakness: Both fatigue and weakness are quite common in hypothyroid patients. While weight gain, intolerance to cold and cramps are often seen in younger patients, it is a less frequent observation in the elderly.
Gastrointestinal issues5: Constipation is often a common symptom of hypothyroidism. This constipation may be a result of decreased motility of the intestines. Similarly, there may also be diminished motility in the esophagus, which causes difficulty when swallowing, nausea and/or vomiting, heartburn, and indigestion. Consequently, abdominal discomfort, flatulence (gas), and bloating may occur in those with small intestinal bacterial growth (SIBO) due to the resulting poor digestion.
Cardiovascular Disease: Hypothyroidism and subclinical hypothyroidism are associated with increased risk of cardiovascular disease with increased levels of blood cholesterol and increased blood pressure.6 Hypertension (increased blood pressure) is relatively common among patients with hypothyroidism. Increased peripheral vascular resistance and low cardiac output has been suggested to be the possible link between hypothyroidism and diastolic hypertension. Hypercholesterolemia (high cholesterol levels) and a marked increase in low-density lipoproteins (LDL) and apolipoprotein B are also seen in those with hypothyroidism.6 These changes accelerate atherosclerosis, which causes coronary artery disease. The risk of heart disease increases proportionally with increasing TSH, even in subclinical hypothyroidism.
Reproductive system problems: In women, hypothyroidism is associated with menstrual irregularities and infertility. Proper treatment can restore a normal menstrual cycle and improve fertility. Uncontrolled thyroid function during pregnancy can lead to preterm birth, developmental issues for the newborn, and hemorrhage in the postpartum period. It is therefore important to work closely with a physician to monitor thyroid function during pregnancy.
Cognitive decline: As with many of the processes that occur in hypothyroidism, there is a “slowing down” of cognitive ability. Individuals with hypothyroidism can suffer from slowed thinking, delayed processing and retrieving of information, etc.7 Patients with subclinical hypothyroidism show signs of decreased working memory, and decreased speed of sensory and cognitive processing.
Depression and psychiatric disorders: Changes in cognition, some of which we mention above, panic disorders and depression, are often associated with disorders of the thyroid gland.7 It is important to be aware that hypothyroidism is often misdiagnosed as depression!
Miscarriage: is also seen in research. There is research showing patients with Hashimoto’s thyroiditis had less miscarriages and complications when taking thyroid hormones during pregnancy.
What Can Be Done?
The tests we use to diagnose and monitor hypothyroidism include: Thyroid Stimulating Hormone (TSH), Total T4, Total T3, Free T4 (fT4), Free T3 (fT3), Reverse T3 (rT3), Thyroid peroxidase antibody (TPOAb), Thyroglobulin antibody (TgAb).4
Conventional treatment almost always begins with providing a synthetic formulation of T4 (levothyroxine) like Synthroid® or Levoyxl®.1 Desiccated thyroid on the other hand is a prescription medication that is created from desiccated porcine (pig) thyroid gland, and will therefore contain both T3 and T4.8 When taking thyroid hormone medications, it is important to know that their absorption can be altered by many things including coffee, iron, some antacids, soy, grapefruit, etc. It is therefore recommended that patients take their medication away from any food or drink.
And How Can You Be Helping Your Thyroid?
- Stress Management
When we are under stress, be it emotional or physical, our body responds by elevating stress hormones like adrenaline and cortisol. In turn, these hormones will contribute to the narrowing of blood vessels, increased blood pressure, increase in muscular tension, as well as, promoting the release of inflammatory proteins and antibodies. These processes can then work to suppress the immune function and damage both the adrenal glands as well as the thyroid.9
To be able to combat this from happening, we need to tackle stress as much as possible. There are various ways in which you can do this. Be sure to get enough sleep and rest each night, get the optimal amount of exercise, consider meditation and other activities that cultivate mindfulness and well being. Community groups and/or support groups are also a great way to deal with stress and get help to deal with particular struggles with a group of supportive people.
- Get Enough of The Appropriate Nutrients
Iodine is known to be a key player in helping convert thyroid hormones as well as release them into the circulation.10 However, the problem is that foods rich in iodine are not frequently eaten in the standard Western diet. Other than consuming sea vegetables like kelp for example, you can also obtain some iodine from foods like raw dairy, certain wild-caught fish and some fermented grains. However, you do need to tread lightly – too much iodine can actually make symptoms associated to thyroid disorders worse.
Selenium is another micronutrient that is known to help balance T4 hormone levels.11 Foods such as Brazil nuts, spinach, halibut, canned sardines, grass-fed beef, turkey, and even beef liver are high in selenium. Individuals with other autoimmune disorders or with Celiacs, may be most deficient in this nutrient and so supplementation may also be necessary.
Zinc is another mineral that is needed for thyroid health, as are the B vitamins. The best sources to obtain these nutrients are usually animal proteins, as well as Brussels sprouts, green peas, asparagus, chickpeas, sesame seeds, flaxseeds, nuts like pistachios, cocoa, and mushrooms.
- Reduce Levels of Toxicity
In order to optimize health, one must minimize the exposure to toxins. From ingestion of chemical toxins that can be found in certain medications, food products and things like tobacco, to that which we put on our bodies or use in our homes to clean, can all play a role in dysfunction in the body.2 Use green/natural products whenever possible and be mindful on the things you put in and on your body.
- When Necessary Reduce Inflammation via Supplementation
Even after reducing stress and cleaning up your diet, you may need to consider a supplement to really help you optimize the anti-inflammatory game in your body. Things such as probiotics can help deal with issues of poor health gut that can be at play with inflammation in the body as well as improve overall immunity. Probiotics, can be found in foods like fermented dairy (yogurt or kefir), cultured vegetables and also supplements. Incorporating adaptogen herbs can also help your body buffer mental and emotional stress thereby helping support the adrenals and balancing hormones.
- Kostoglou-Athanassiou I, Ntalles K. Hypothyroidism – new aspects of an old disease. 2010; 14(2): 82–87.
- Zaletel K, Gaberšček S. Hashimoto’s Thyroiditis: From Genes to the Disease. Curr Genomics. 2011; 12(8): 576–588.
- Raza S, Mahmood N. Subclinical hypothyroidism: Controversies to consensus. Indian J Endocrinol Metab. 2013; 17(Suppl 3): S636–S642.
- Akamizu T. Hashimoto’s Thyroiditis – Endotext. NCBI Bookshelf. December 20, 2013. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK285557/.
- Ebert EC. The thyroid and the gut. J Clin Gastroenterol. 2010;44(6):402-6.
- Graisand I, Sowers J. Thyroid and the Heart. Am J Med. 2014 Aug; 127(8): 691–698.
- Pilhatsch M, Marxen M, Winter C, Smolka M, Bauer M. Hypothyroidism and mood disorders: integrating novel insights from brain imaging techniques. Thyroid Res. 2011; 4(Suppl 1): S3.
- Hoang TD, Olsen CH, Mai VQ, Clyde PW, Shakir MK. Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol Metab. 2013;98(5):1982-90.
- Walter K, Corwin E, Ulbrecht J, Demers L, Bennett J, Whetzel C, et al. Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Res. 2012; 5: 13.
- Chung H. Iodine and thyroid function. Ann Pediatr Endocrinol Metab. 2014 Mar; 19(1): 8–12.
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017; 2017: 1297658.