Dr. Sasha Fluss, ND at NatureMed Clinic Boulder/Denver
Thousands of people search “thyroid” each day on Google. What comes up is a confusing assortment of chat groups, conventional treatments, alternative treatments, a mix of symptoms and in general a lot of information but no real answers. The question is: Why are so many people searching for info on their thyroid health? Aren’t they being treated? Cured? Shouldn’t they feel better?
What is the Thyroid?
The thyroid gland is a butterfly shaped gland that sits behind the trachea in the lower part of the neck. The thyroid is stimulated to release thyroid hormone; T3 (triiodothyronine) and T4 (thyroxine) by the pituitary gland through TSH (thyroid stimulating hormone). T3 and T4 are essential for the function of every single cell in the body. T4 is the main circulating hormone and it is converted to T3 (active thyroid hormone) in the peripheral tissues.
No wonder you don’t feel well when your thyroid gland is malfunctioning: These thyroid hormones regulate heart rate, blood pressure, body temperature, metabolism and the rate at which food is converted into energy.
Now lets define some terms:
Hypothyroidism: a “low” functioning and sluggish thyroid gland. Less thyroid hormone is being released leading to:
Fatigue and sluggishness
Dry skin, nails and hair and hair loss
Increased cold sensitivity
Pain, stiffness and swollen joints
Heavy menstrual cycles
Increased cholesterol levels
Symptoms are often mild to start and increase over time making them easy to overlook. As you can tell the symptoms are varied and could easily be confused with other conditions or be attributed to aging without recognizing the thyroid connection.
Hyperthyroidism: a “high” functioning and overactive thyroid gland. More thyroid hormone is being released leading to:
nervousness, anxiety and irritability
fine, brittle hair
Hypothyroidism is far more common than hyperthyroidism and Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the US. The incidence of Hashimoto’s thyroiditis is estimated to be 10-15 times higher in females with the most commonly affected age range being 30-50 years.
So what causes Hashimotos? Hashimotos thyroiditis is an autoimmune disease. Meaning, the body literally attacks it’s own thyroid gland and destroys the tissue. Less tissue = less thyroid hormone produced and excreted leading to a sluggish gland, aka. hypothyroidism.
Now this begs the Question: Why does the body start attacking the thyroid in the first place?
It all starts with Inflammation. Inflammation can come from a variety of sources; stress, food allergens, leaky gut, high sugar, highly processed diet ect.
Dr. Mark Hyman says it well when he notes: “[rheumatoid arthritis, lupus, MS, psoriasis, celiac disease, thyroid disease] these are all autoimmune conditions, and at their root they are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues.”
Antibodies, immune “warriors” are used to identify foreign or harmful objects and mark them for destruction. This internal immune system army that we have is essential. It protects us from foreign bacteria, viruses, food allergens ect. An autoimmune condition occurs when this army can no longer distinguish between friend (your own cells) and foe (foreign invaders). Think of inflammation as being a thick fog covering the battlefield. When inflammation is present your body can no longer tell who is on their team and your thyroid gland (and other tissues) suffer the consequences.
Now that we have introduced the concept of Autoimmunity it makes sense that there is a huge link between food allergens (especially gluten) and developing Hashimotos thyroiditis. AntiTPO antibodies (the antibodies produced by the immune system that attack the thyroid gland) can be tested in the blood and are often greatly reduced with a gluten free diet and eliminating food allergens. When we eat foods that the body has an immune response to, it creates more and more of these antibodies and thus more destruction of the thyroid gland occurs.
Most conventional doctors don’t test thyroid antibodies (AntiTPO) as for them, treatment doesn’t change if the hypothyroidism is autoimmune in origin or not. However, Naturopathic Medicine looks at the issue a little differently: Why treat the smoke when you can treat the fire? By reducing the inflammation the autoimmune attack of the thyroid can be greatly reduced.
TSH is the most commonly tested hormone to determine thyroid function and to diagnose hypothyroidism or hyperthyroidism. However, it must be said, the range given is arbitrary and may not reflect the true range for Optimal Health. For example, say your labs come back with a TSH of 3.5 (technically still inside the range of “normal”) but you are gaining weight, you feel tired, your skin is dry, you have low motivation and mood. Should you not be treated based on your symptoms rather than based on your lab numbers?
I believe that many people are being under-treated for their hypothyroidism and that more patient centered care and a focus on the patient Not the labs can help a lot of people feel a lot better.
Why if being treated, are so many people still searching for answers on their thyroid health?
The conventional treatment for hypothyroidism is with synthetic T4 (Synthroid). This can make a huge difference with symptoms and often patients feel much better within a few days to a week of treatment. However, many patients still feel “not quite right” even when they are on Synthroid and their TSH levels return to the normal range. An issue with conversion must be looked at with these patients. Synthroid takes care of the issue of low T4 but does not address the possibility of low T3. In these patients a combination of Synthroid and Cytomel (T3) or the use of Armour thyroid (dessicated porcine thyroid which contains T4 and T3) is often much more successful. More on this conversion issue in another blog to come!
So What can you do?
1. Decrease Inflammation: Identify and remove your food intolerances, manage stress, increase anti-inflammatory foods such as fish oils and turmeric, remove high sugar and highly processed foods
2. Make sure you are getting adequate Selenium, Zinc, Iron, Copper and Iodine: all are critical for thyroid function and conversion to active thyroid hormone (T3). Adequate amounts can be obtained from foods. 2 large Brazil nuts pack a good daily dose of Selenium. Zinc and Copper are high in seafood as well as nuts and seeds. Have your iron levels tested, Iron deficiency is common in menstruating women. Find iodine in sea vegetables including seaweeds (great to add in when cooking beans or into a soup).
3. Eat goitrogenic foods in moderation: non-fermented soy (soy bean oil, processed soy, soy milk and tofu) and vegetables in the brassica family (cabbage, broccoli, cauliflower, brussel sprouts). However because these foods offer other health benefits, steam or cook to remove the goitrous effects.
4. Adrenal support: the body is not made up of mutually exclusive parts, it functions as a unit. If the adrenal glands are taxed (through stress, poor diet and lifestyle) then the thyroid will suffer. Have your adrenal function evaluated and treated as part of a thorough thyroid treatment protocol.
Have your thyroid tested with a full thyroid hormone panel. Consider alternatives to Synthroid if you are still feeling your symptoms. Even if you don’t suspect a thyroid issue it is good to have it monitored as a part of your regular check ups.
Most Importantly: Find a doctor who treats You not your lab values
Dr. Sasha Fluss, ND at NatureMed Clinic Boulder/Denver