Are you feeling off and unsure why? Are you wondering if some, or all, of your health complaints could be due to an unhealthy and dysfunctional thyroid? This article will cover some thyroid basics, ways to assess thyroid dysfunction, causes of thyroid dysfunction, and tools you can employ to optimize your thyroid function and improve your health overall.
The thyroid gland, a butterfly-shaped gland that lies at the base of your neck, is a major component of your endocrine system. Its main job is to make the thyroid hormones T3 and T4. Both T3 and T4 are major metabolic hormones. They influence growth and development, body temperature, nervous system and cognitive function, cardiovascular function, skeletal health, muscle contraction, reproduction, digestion, and many more cellular and tissue processes.
The thyroid gland is part of a complex system, starting with signals from your brain and ending with metabolic effects in all the cells of your body. Because of the complexity of this system, there are many steps along the pathway where things could go wrong. [See Appendix 1 for more details.]
How do I know if I have thyroid dysfunction?
There are two parts to establishing whether or not you have thyroid dysfunction: clinical symptoms and laboratory evaluation. Both help your physician determine if your thyroid dysfunction is due to your thyroid being underactive or overactive.
Here are some symptoms of an underactive thyroid:
- Fatigue, lethargy, and poor stamina
- Weight gain and difficulty losing weight
- Cold intolerance, sensation of feeling cold, and cold hands & feet
- Slow pulse
- Shortness of breath with exertion
- Constipation and sluggish digestion
- Menstrual irregularities, heavy or absent menstrual bleeding, and infertility in females
- Erectile & ejaculatory dysfunction, reduced libido, and low sperm counts in males
- Joint pain and muscle pain
- Dry & coarse skin, brittle hair & nails, hair loss, and poor healing wounds
- Weakness & slow movement
- Brain fog, concentration difficulties, slow thinking, and slow speech
- Depression, mood disturbances, and sleep difficulties
Here are some symptoms of an overactive thyroid:
- Weight loss and difficulty gaining weight
- Heat intolerance, sensation of feeling hot, sweating, and clammy hands & feet
- Protrusion of one or both eyeballs and visual disturbances
- Fast pulse, heart palpitations, and cardiac arrhythmias
- Shortness of breath
- Diarrhea, nausea & vomiting, overactive digestion, and malabsorption
- Menstrual irregularities, little or absent menstrual bleeding, and infertility in females
- Breast development and reduced libido in males
- Osteoporosis and increased fracture risk
- Skin flushing, rashes, and itching
- Tremors and muscle weakness
- Anxiety, nervousness, restlessness, agitation, and insomnia
A comprehensive laboratory evaluation of thyroid function should include: TSH, free T4, total T4, free T3, total T3, reverse T3, T3 uptake, and TBG (thyroxine-binding globulin). It should also include the following autoantibodies to assess for autoimmunity: anti-TPO (thyroid peroxidase antibodies), anti-TG (thyroglobulin antibodies), and TSI (thyroid stimulating immunoglobulin).
Also, because thyroid hormones impact virtually every cell in the body, a comprehensive work up will also look at laboratory tests that assess how thyroid dysfunction is influencing other systems in your body. Other laboratory tests to evaluate include: complete blood count, iron panel, comprehensive metabolic panel, lipid panel, hemoglobin A1c, homocysteine, reproductive hormones, adrenal function tests, micronutrients, and other markers of autoimmunity.
Make sure your physician includes these tests in his or her work up for a complete, holistic approach to your health.
What causes thyroid dysfunction?
When investigating thyroid dysfunction, it is important to work with your physician to find the underlying cause of the dysfunction and address it properly.
The following list outlines the potential causes of thyroid dysfunction:
- Genetic defects (rare)
- Hypothalamic or pituitary disorders (rare)
- Oxidative stress and inflammation
- Autoimmune disorders
- Prolonged fasting or starvation
- Life stress
- Nutrient deficiencies: tyrosine, iodine, selenium, zinc
- Nutrient excesses: iodine, dietary goitrogens in high quantities like isothiocyanates from cruciferous vegetables and isoflavones from soy that prevent the thyroid’s utilization of iodine (note: goitrogens are inactivated by cooking or fermenting)
- Drugs: ones that decrease thyroid secretion (e.g., methimazole and propylthiouracil) or ones that treat non-thyroid conditions (e.g., lithium, p-aminosalicylic acid, amiodarone, corticosteroids)
- Environmental toxins: organophosphates, perchlorates, nitrites, heavy metals, fluorides, chlorides, bromides, contrast agents
- Surgery and radiation
What can I do to improve my thyroid function?
There may be situations where supplementation with either T4, T3, or both is necessary (note: hormone therapy requires a physician’s prescription and supervision). However, there is a lot you can do to optimize your thyroid function and support this important gland naturally!
1. Optimize nutrition
Your thyroid needs certain nutrients to produce thyroid hormones. The first of these is tyrosine. Tyrosine is an amino acid found in many high-protein foods like animal meats, fish, dairy products, nuts, seeds, and legumes. It is non-essential, meaning your body can make tyrosine on its own from the amino acid phenylalanine. The Recommended Dietary Allowance (RDA) for tyrosine is 7.3 mg per pound of body weight per day.
Next is iodine. Iodine is bound to tyrosine to make thyroid hormones. T4 has 2 tyrosine molecules plus 4 iodine atoms, and T3 has 2 tyrosine molecules plus 3 iodine atoms. Seaweeds are some of the best dietary sources of organic iodine, followed by seafood like haddock, cod, shrimp, and halibut. The RDA for iodine is 150 mcg per day for adults. You’ll note above that both iodine deficiency and iodine excess can lead to thyroid dysfunction. It is important not to exceed 1,000 mcg per day, but even quantities less than this may cause problems.
Your cells also need certain nutrients to convert T4 to T3. The first of these is selenium. Brazil nuts are one of the best sources of selenium. The RDA for selenium is 55 mcg per day for adults.
Zinc is another nutrient that supports the conversion of T4 to T3 and helps sensitize your cells to thyroid hormones. Zinc is also an important nutrient to support immune function, which is important when investigating underlying causes. Oysters have the highest zinc content of any food, but meat, dairy products, beans, whole grains, and nuts are also good sources. The RDA for zinc is 8-11 mg per day for adults.
In general, a whole food, plant-based diet low in saturated fat, refined sugar, and simple carbohydrates and high in colorful fruits and vegetables, legumes, whole grains, nuts, and seeds is best for overall health and especially for thyroid health. Colorful fruits and vegetables contain a variety of phytochemicals and phytonutrients that are anti-inflammatory and antioxidant. Legumes and whole grains are great sources of fiber that helps to stabilize and regulate blood sugar levels. Balanced blood sugar is important for thyroid health. Nuts and seeds, in addition to cold-water fatty fish, are great sources of protein and healthy fat, specifically poly-unsaturated omega-3 fatty acids that have powerful anti-inflammatory properties.
2. Decrease inflammation
In addition to an anti-inflammatory diet as described above, there are other things you can do to decrease inflammation.
First, incorporate herbs and spices with strong anti-inflammatory properties in your daily cooking. Examples include: turmeric, ginger, garlic, onion, cinnamon, clove, basil, rosemary, sage, and thyme. Other anti-inflammatory herbs like licorice, marigold, green tea, pine bark, frankincense, Japanese knot weed (very high in resveratrol), cat’s claw, and devil’s claw can be taken in tea, tincture, or capsule form.
Second, avoid your known food sensitivities and/or allergies. Food intolerances can often cause inflammatory symptoms in the body beyond just the gut. The most common allergens are wheat and other gluten-containing grains (like rye or barley), dairy, eggs, corn, soy, peanuts, and shellfish. Avoiding wheat and other gluten-containing grains is especially important if you have Hashimoto’s thyroiditis.
Third, feed and support the good bacteria in your gut. A healthy microbiome will help reduce inflammation. Include fermented foods like sauerkraut, kimchi, kombucha, miso, tempeh, natto, kefir, and yogurt in your daily meal plans. Also include adequate amounts of dietary fiber, which will feed your gut bacteria and promote a diverse microbiome. Supplementation with probiotics may be necessary in some cases.
Finally, exercise (but don’t overdo it)!
3. Decrease exposures to environmental toxins
Environmental toxins are a huge contributor to endocrine dysfunction. Decreasing exposure to common toxins and chemicals will help your thyroid and benefit your health overall. Eat organic as much as possible. Organic produce is important to limit your exposure to pesticides and herbicides. Organic eggs and dairy products, pasture-raised poultry, grass-fed meat, and wild caught fish is important to limit your exposure to hormones, antibiotics, heavy metals, and other toxins that bioaccumulate up the food chain.
Pay attention to the hidden toxins in your home. Opt for safe, nontoxic cleaning products, laundry detergents, soaps, cosmetics and personal care products (ladies, check your makeup!). Consider a water filter for drinking and showering and an air filter that captures allergens, pollutants, gases, and formaldehyde. Get rid of all plastics – containers, bottles, bags, and cling wrap. Opt for glass, stainless steel, or ceramic containers and bottles; reusable or paper bags; and parchment paper. Don’t be ashamed to bring your own thermos when getting coffee out of the house or your own food storage containers when going out to restaurants!
Lastly, consider having your home tested for mold, radon, arsenic, or any other toxins that may be problematic in your area.
4. Manage stress
Chronic stress messes with a lot of systems in your body – thyroid, adrenal, reproductive, immune and many more. Thus, it is an important piece of the puzzle when discussing thyroid health. Engage in daily activities to enhance parasympathetic nervous system activity (your calming “rest and digest” nervous system) – diaphragmatic breathing, warm Epsom salts baths, soothing music, aromatherapy, yoga, meditation, prayer, time in nature, and other activities that bring you joy and fill your cup.
5. Strengthen your immune system
Because infections and autoimmune disorders are causes of thyroid dysfunction, working on building a robust, strong immune system is very important. Many of the things we’ve discussed already are also great for your immune system – zinc, an anti-inflammatory diet low in refined sugar and simple carbohydrates, a healthy microbiome (70% of your immune system is in your gut!), exercise, minimal exposure to environmental toxins, and stress management. Another way to strengthen your immune system is to ensure you are getting adequate sleep (7-9 hours per night). Sleep is when your body repairs and regenerates. Vitamins A, C, D, E and all the B vitamins are also important supporters of proper immune function. Lastly, medicinal mushrooms like reishi, cordyceps, turkey tail, chaga, shiitake, maitake, and agaricus are rich in polysaccharides, which are powerful immune modulators. Using these mushrooms in culinary or supplemental form will offer you a broad spectrum of immune support.
Written by: Dr. Alyssa Christoforou
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The hypothalamus region of the brain releases thyrotropin-releasing hormone (TRH), which in turn stimulates the pituitary gland in the brain to secrete thyrotropin (also known as thyroid stimulating hormone, or TSH). TSH binds to receptors on a thyroid cell and stimulates the thyroid gland to produce thyroid hormones. T4 is the primary product of the thyroid gland, but it is biologically inactive until it is converted to T3 in target tissues. T3 is the biologically active thyroid hormone responsible for the majority of thyroid hormone effects. The liver is the major conversion site for T4 to T3, followed closely by the kidney, central nervous system, bone, skeletal muscle, skin, and other tissues.
Thyroid dysfunction can be due to a supply issue (any defect along the pathway that leads to the production of T4) or a conversion issue (any defect in the periphery that prevents T4 from becoming T3).