Do I Have Low Thyroid Function?
Thyroid disorders are not always easy to identify and treat. The thyroid gland is a butterfly-shaped gland located at the front of the neck that produces the hormones that regulate metabolism. Thyroid hormones essentially stimulate our cells to produce energy. Dr. Broda Barnes, a pioneer in the treatment of thyroid disorders, wrote one of the first books that identified the fact that many people with chronic and unexplained conditions had undiagnosed and untreated thyroid disease. This book was titled “Hypothyroidism, the Unsuspected Illness.” It was one of the first texts to detail many of the signs and symptoms of hypothyroidism (low levels of thyroid hormone).
Signs and Symptoms of Low Thyroid Function (hypothyroidism)
- Brittle nails
- Aching joints
- Chronic fatigue
- High cholesterol
- Cystic breasts and Polycystic ovaries
- Low sex drive
- Dry skin
- Fluid retention
- Hair loss
- Infertility or frequent miscarriages
- Intolerance to cold
- Low functioning immune system
- Inability to concentrate
- Muscle weakness
- Restless leg
- Weight gain
- Irregular menstrual cycles
- Premature aging
- Poor eyebrow growth
- Low basal body temperature
Most doctors will rely on a blood test called TSH (Thyroid Stimulating Hormone) to determine if the thyroid gland is functioning normally. Unfortunately, TSH levels may not give enough information to completely evaluate thyroid problems. TSH is a hormone signal released from the brain and directed at the thyroid gland to make the thyroid hormones T4 and T3. After these hormones are released into the blood the body converts most of the T4 hormone to T3. The T3 hormone is the more active hormone (by over 300 times!) and it is the hormone that stimulates metabolism and energy. When there is not enough thyroid hormone circulating, the body will increase the TSH signaling hormone in the brain. If you have an elevated TSH level on a blood test, then most doctors would diagnose you as hypothyroid. Many holistic physicians believe the optimal range for TSH level should be between 0.5-2.0. Thyroid specialists will also test the levels of T4 and T3 in addition to TSH. Some people do not make enough T4 or T3 despite normal TSH levels. These low T4 and T3 levels can cause many of the same hypothyroid symptoms listed above. This condition is sometimes called “sub-clinical hypothyroidism.” Unfortunately, those with sub-clinical hypothyroidism will often get missed by the standard medical work-up for thyroid function.
Blood tests to measure thyroid function have some limitations because it is impossible to measure how much thyroid hormone gets into the cell. Basal body temperatures are often used as an alternative measurement of metabolism and thyroid function. Basal body temperatures are typically taken from the arm pit and range from 97.8-98.2 degrees. Basal body temperatures are best measured in the morning before getting out of bed. This is usually done for 5 consecutive days. Menstruating women should take temperatures the first 5 days after the beginning of menses. Those with chronically low basal body temperatures may have a thyroid problem.
Common reasons for low thyroid levels (hypothyroidism)
After identifying a problem with the thyroid, it is important to investigate the underlying reason for the dysfunction. Some of the most common causes for an underactive thyroid include the following:
- Nutritional deficiencies such as zinc, selenium and iodine.
- Consumption of daily non-fermented soy products and large volumes of raw cruciferous vegetables can decrease thyroid function. These foods are known as goitrogens.
- Pesticide and heavy metal exposures.
- High insulin levels, poor blood sugar control and diabetes.
- Stress and aging.
- Over training with endurance exercise.
- Oral estrogen replacement and birth control pills. These medications will increase the production of a protein (Thyroid Binding Globulin) that binds up the thyroid hormone and makes it less available for the body to use.
- Consumption of gluten grains, aspartame and sucralose (Splenda) may contribute to the development of an autoimmune thyroid condition called Hashimoto’s Thyroiditis and increase damage to the thyroid gland.
- Those with a family history of hypothyroidism have a higher chance of developing a thyroid problem.
- Damage to the thyroid gland and detection of nodules can decrease thyroid hormone production.
The Naturopathic approach to support thyroid function
A comprehensive approach to evaluating and treating a thyroid condition involves a comprehensive blood test looking at all thyroid hormones rather than just one (TSH) and includes thyroid antibodies to assess potential immune attack and damage to the thyroid gland.
Integrative medical treatments will consist of dietary changes, nutritional and herbal supplementation and hormone replacement. The standard medication used to treat hypothyroidism is Levothyroxine (Synthroid®) which is the equivalent of the T4 hormone. However, many benefit from a bio-identical hormone replacement approach that includes both T4 and T3 hormone therapy. Sometimes a T3 hormone medication known as Cytomel® or Liothyronine can be added when someone is already taking a T4 medication. Others may find benefit from trying a natural desiccated thyroid medication such as Armour®, Nature-Throid®, or WP Thyroid®. Natural desiccated thyroid is made from an animal (primarily porcine) source and contains both T4 and T3, as well as other hormones and elements that would be organically occurring in a normal thyroid gland. Some believe that this is a superior way to replace thyroid hormone as it gives all the components the body needs for optimal thyroid support and regulation. Although natural desiccated thyroid has been the target of controversy, it has gained support from patients and practitioners over the last decade. Many report feeling better on this type of medication. A study in 2013 (J Clin Endo-crinol Metab 2013:98:1982-90. Epub March 28,2013) confirmed that after taking desiccated thyroid medication for 12-16 weeks 49% of the patients preferred the desiccated thyroid medication to the standard Levothyroxine. This is compared to only 22% who felt better on the standard Levothyroxine. As an extra bonus the desiccated thyroid medication was associated with more weight loss! Both medication types were found to normalize the abnormal thyroid blood tests.
The endocrine system is designed as a complex communication system between all the hormones. When addressing a thyroid problem, it is important that all the glands of the endocrine system (adrenal glands, ovaries/testes and pituitary glands) are working properly for optimal hormone balance. The adrenal glands are particularly important for optimal thyroid function. The adrenal glands are responsible for the production of the stress hormone cortisol. Cortisol and thyroid hormones work together and one cannot work well without the other. For this reason, we often include a functional adrenal assessment as part of a comprehensive thyroid evaluation. Many times, we find that by treating an adrenal insufficiency or excessive stress hormone production the thyroid symptoms and labs will normalize.
If you have been diagnosed with a thyroid disorder or suspect that you have a thyroid problem, it is important to work with a physician well versed in the different options for evaluation and treatment. Often a combination of natural therapies and medications are required to help the body reach optimal function.