Are you feeling sluggish? Lost your spark? Depressed? Anxious? Gaining weight with no appetite? Lost all tolerance for cold or heat? Struggling with digestive issues? Or maybe just feel like everything's falling apart, and you've lost your ability to #deal? Your thyroid may be blame!
The thyroid is sort of a big deal. Addressing my own thyroid issues has recently revolutionized my life. (For the backstory of my thyroid history and SIBO connection, check out my recent post.) But enough about me: let's talk about your thyroid, and how it may be casting a shadow on your life.
Somewhere between 20-60 million Americans suffer from thyroid problems. When thyroid hormone levels are off, many things can go awry, resulting in a myriad of symptoms which may or may not seem thyroid related. This includes mental problems like ADHD, learning disabilities and dementia; mood problems like anxiety and depression; digestive issues like IBS, SIBO (oh hey me!), constipation and diarrhea; adrenal, stress, and fatigue issues; sleep disturbances and insomnia; hormonal issues; menstrual irregularities; cardiovascular disease; autoimmune conditions; as well as a host of other issues. Since these issues, created or exacerbated by wonky thyroid hormones, create states often requiring adequate thyroid to resolve in the first place, the whole shebang can become a quickly escalating downward spiral. Oh my!
The two main types of thyroid dysfunction include hypothyroidism, in which too little thyroid is received by the cells, and hyperthyroidism, in which too much thyroid hormone is received by the cells. We'll look at each of these in detail in a little bit!
HOW THE THYROID WORKS
It's not like the thyroid simply releases thyroid hormone when the body needs it. That would be just too easy. Instead, three different organs are involved with regulating thyroid levels in the body: the hypothalamus, the pituitary gland, and the thyroid gland. Here's how it goes down, school-metaphor style.
The Hypothalamus, Pituitary, And Thyroid Connection
Let's say a Student at a school represents the Thyroid Gland, and is in charge of making Thyroid Hormone for his school project.
The Principle at the school is like the Hypothalamus. Principle Hypothalamus sits in his office in the brain, and oversees and regulates a lot of stuff to keep everything in the school functioning homeostatically. We're talking everything from the school's environment (body temperature), to the cafeteria (appetite levels), to operational hours (sleep and circadian rhythms) to the hormones produced by the student (thyroid!).
When Principal Hypothalamus notices that thyroid hormone levels are low, he contacts the Teacher Pituitary via Thyrotropin-Releasing Hormone (TRH), which is like the intercom system.
Teacher Pituitary is in charge of a few different "subjects", including growth, reproduction, lactation, and stress. When Mrs. Pituitary gets the signal from Principal Hypothalamus about the need for more thyroid hormone, she tells the Student (Thyroid) in charge of producing thyroid hormone, via the TSH message (Thyroid Stimulating Hormone). This TSH hormone tells the Thyroid student to make more thyroid hormone.
To summarize: Hypothalamus detects low Thyroid Hormone levels -> Hypothalamus releases TRH to stimulate the Pituitary -> Pituitary release TSH to stimulate the Thyroid Gland -> Thyroid Gland releases Thyroid Hormone. Oh my! Talk about a lot of long-winded communication, and places for thing to go awry!
Thyroid Stimulating Hormone (TSH)
Let's talk about the whole TSH thing (Thyroid Stimulating Hormone) for a sec, which conventional doctors view as the indicator of thyroid status. The TSH is sort of like the thermostat in a house: it tells the heater (Thyroid) how much heat (Thyroid Hormone) to pump out. It does not indicate what the current thyroid status is, as much as what it should be. For example, if a house is cold (like in a hypothyroid state, with too little thyroid hormone), then you'd probably yank up the thermostat (TSH) to tell the heater to generate more heat (thyroid hormone). On the flipside, if the house is too hot, you'd probably turn down the thermostat (TSH) to tell the heater to stop generating so much heat (thyroid hormone).
Of course, if you were to see a picture of a room and just look at the thermostat (TSH), it could be hard to tell what the temperature actually is. If the thermostat is standing in the normal, comfortable range, you might assume everything is working as planned, and the room is, indeed, a comfortable temperature. This is what doctors assume with a "normal" TSH reading. If the thermostat is jacked up to 90, you might assume it must be too cold in the room, and the people are trying to make it warmer. (This is why doctors assume high TSH readings indicate low thyroid hormone levels.) On the flipside, if the thermostat is way down at 60, you might assume it is too hot in the room, and the people are trying to make the room colder. (This is why doctors assume low TSH readings indicate high thyroid hormone levels.)
I bet you can anticipate the problem here: the thermostat (TSH), may or may not actually indicate what the temperature in the room actually is. The thermostat (TSH) may be broken, and not reflect the actual temperature. Or the heater (thyroid gland) may be broken, so no matter how much you change the thermostat (TSH), the room doesn't get comfortable. In other words, TSH basically just tells us what people in the room (like the hypothalamus and pituitary) think or want the temperature to be, not what the temperature actually is.
Thyroid Hormones (T4 & T3)
There are two main, influential thyroid hormones: T4 and T3. T4 is the inactive, storage form. While its great to have optimal levels, T4 does not necessarily indicate the actual amount of thyroid available or being used by the body. T3, on the other hand, is the active form of thyroid hormone, immediately usable. You've also got the Total vs. Free forms of T4 and T3. Ya see, 99% of thyroid hormones in the body are actually attached to carrier proteins called Thyroxine-Binding Globulin (TBG) and are not immediately available to cells. (This ensures the body doesn't run out of thyroid hormone). The unbound Free T4 and Free T3 indicate the thyroid hormones immediately able to be converted (in the case of T4) or utilized (in the case of T3).
Problems can arise, however, if too much or too little thyroid is bound. Too much TGB in the body can bind up too much thyroid hormone, resulting in hypothyroid symptoms. Too little TBG in the bloodstream can leave too much thyroid free, resulting in thyroid resistance at the cellular level, and also hypothyroid symptoms. Factors affecting TGB levels include high estrogen levels (such as from xenoestrogens) and corticosteroids.
While active thyroid hormone (T3) can be generated from the thyroid, it is more often created in a conversion process at each cell, since varying amounts of thyroid hormone are required for various processes. So rather than your whole body being like "I need thyroid hormone please!" it's more like your brain specifically asks for thyroid hormone, or your digestive tract, or your skeletal muscle, or whatever.
Thyroid Hormone Recipe
The thyroid creates thyroid hormone out of tyrosine and iodine. Nutrients needed for the conversion process (in which the deionidase enzyme strips an outside iodine from T4 to turn it into Free T3) include selenium, zinc and iron. T3 also needs cortisol to pass into the cells.
Furthermore, the B vitamins, as well as vitamins A and D, are necessary for proper energy production and a healthy immune system. As for the cells themselves, they need healthy cell walls which can adequately accept thyroid, while forbidding toxins and other nasties. Healthy cell walls are created from a healthy diet, rich in healthy fats likes like omega 3s, monounsaturated, and saturated fats, and low in unhealthy trans fats and inflammatory omega-6s.
THYROID HORMONE OVERVIEW & OPTIMAL LEVELS
Note: The Optimal Levels are according to Amy Myer's The Thyroid Connection: Why You Feel Tired, Brain-Fogged, and Overweight - and How to Get Your Life Back.
Thyroid Hormone Quick Guide
TSH: Thyroid Stimulating Hormone (TSH) is generated by the pituitary gland, which prompts the thyroid to make more hormone. Conventional wisdom holds that a high TSH = low thyroid levels (since the pituitary is asking for more thyroid hormone), while a low TSH = high thyroid levels (since the pituitary is not asking for more thyroid hormone.)
Clinical TSH levels: .4 - 4.5 mIU/L, Optimal TSH levels: 1.0-2.0 (or lower)
Total T4: T4 is the main thyroid hormone generated by the thyroid gland, which makes around 17 T4 for every 1 T3. T4 is made of thyroglobinin and 4 iodine atoms. Total T4 is the storage form, and includes both bound and free T4.
Bound T4: The form of storage thyroid hormone attached to TBG proteins, and thus not immediately available for conversion into T3.
Free T4 (FT4): The form of storage thyroid hormone which is free, and immediately available to be converted into T3.
Clinical Free T4 Levels: .8-1.8 ng/dL, Optimal Free T4 Levels: > 1.1 ng/dL
T3: T3 is the active form of thyroid hormone, made of thyroglobinin and 3 iodine atoms. The thyroid generates small amounts of T3, while the rest is converted from T4 directly at the cells, by stripping an outside iodine from a T4 hormone. T3 is around 5x more biologically active than T4.
Bound T3: The form of active thyroid hormone attached to TBG proteins, and thus not immediately available for use in the cells.
Free T3 (FT3): The form of active thyroid hormone which is free, and immediately available for use in the cells.
Clinical Free T3 Levels: 2.3-4.2 pg/mL, Optimal T3 Levels: > 3.2 pg/mL
Reverse T3 (RT3): Reverse T3 is an inactive thyroid hormone which prevents free T3 from attaching to cells. (T4 becomes reverse T3 when an inside iodine is stripped away.) Reverse T3 can explain why you may have adequate or even high T3 levels, yet exhibit hypothyroid symptoms. Reverse T3 helps the body retain fat and energy, and is stimulated by heavy metals (arsenic, mercury, lead, cadmium, etc.), over-exercise, starvation diets, low calorie plans, stress of all kinds, and/or too much estrogen.
Optimal Reverse T3: < 10:1 RT3:FT3
TBG: A protein produced in the liver that binds to thyroid hormone so it can move through the bloodstream, resulting in "bound" thyroid. (Free T4 and free T3 are not attached to TBG.)
Thyroid Antibodies (TPO, TGAB): Thyroid Peroxidase Antibodies (TPO) and Thyroglobulin Antibodies (TGAB) indicate biochemicals of the immune system poised to attack the thyroid, often due to autoimmune conditions.
Optimal TGAB <4 IU/mL, or negative ,
The Problems With Standard Tests
There are many reasons doctors can easily misdiagnoses thyroid conditions, telling you everything is "fine" when you just know they are not fine. Here are some examples:
- The doctor may consider the standard, normal ranges as definite indicators of thyroid status. This does not take into account the many other problems which could be going wrong. And shockingly, the standard thyroid level ranges were determined based on patients with thyroid problems, meaning they aren't very good indicators in the first place!
- The doctor may only consider TSH. This may simply indicate what your pituitary thinks should be happening with your thyroid, rather than what is actually happening. Since the TSH functions on a negative feedback loop, it can take a few days for it to accurately adjust to thyroid levels. In other words, it may or may not be indicative of what's going on at the very moment in time with your thyroid.
- Taking supplemental T3 can suppress TSH levels. This means you may begin taking thyroid hormone, and still need more for optimal function. But since the T3 suppresses your TSH, the doctor may refuse to raise your dose, leaving you stagnant in hypothyroid symptoms.
- If the doctor only tests total T4 and total T3, it will not indicate the amount of free T4 and free T3. Total T4 and T3 may tell you how much thyroid hormone exists in you, but it does not necessarily indicate the amount of thyroid hormone available for use. You may have normal total T4 and/or total T3, but if too much or too little of either of those is free, you will likely have thyroid symptoms.
- Free T3 and free T4 easily fluctuate in response to stress, meaning your blood levels at any one time can be transient and not indicative of typical levels.
- The doctor may not consider factors which may be inhibiting T3, such as Reverse T3 or too much/too little Thyroid Binding Globulin (TBG).
- The doctor may not consider thyroid resistance: even if your lab tests are "normal," your cells might not be receiving adequate thyroid.
- The doctor may not test for antibodies: even if your thyroid is "ok" right now, you might be on the path towards an autoimmune thyroid condition. These are preventable, so taking action early is key!
- The doctor may not consider necessary nutrients of thyroid function: tyrosine, iodine, selenium, zinc, iron, vitamin A, vitamin D, B vitamins, and essential Fatty acids
- The doctor may not consider sex and stress hormones, and their influence on the thyroid.
Hypothyroidism occurs when, for one reason or another, too little thyroid hormone is received by cells. Common symptoms of hypothyroidism include things you'd expect from a slowed down, frozen system: fatigue, coldness, constipation, hair loss, dry skin, and weight gain, among others.
Hypothyroidism can be due to a multitude of factors, such as:
- Hashimoto's: an autoimmune condition in which the immune system attacks the thyroid
- Too little TSH released by the pituitary, leading to underproduction of thyroid hormone. (Note: A low TSH reading in a properly functioning pituitary, however, is conventionally accepted as indicative of hyperthyroid, since it signifies the body is sensing high thyroid levels and not asking for more hormone. See "TSH" above.)
- The thyroid is simply generating too little T4 or T3
- iodine deficiency
- too much Reverse T3 generation, blocking the effects of T3
- too much TBG (binding protein) in the bloodstream, resulting in too much "locked up" thyroid hormone, or too little TBG, resulting in too much thyroid hormone which itself results in thyroid resistance (see below)
- thyroid resistance: an inability for the cells themselves to receive the thyroid hormone
Hyperthyroidism occurs when too much thyroid is produced and received by cell. Common symptoms of hyperthyroidism include things you'd expect from a ramped up system: anxiety, insomnia, irritability, raging appetite, sweating, restlessness, arrhythmia, irritability, muscle weakness, and weight loss, among others. Left untreated, hyperthyroidism is considered more dangerous than hypothyroidism.
Hyperthyroidism can be due to a multitude of factors, such as:
- Graves Disease: an autoimmune condition in which antibodies stimulate the thyroid, leading to an overproduction of thyroid hormone
- Too much TSH released by the pituitary, leading to overproduction of thyroid hormone. (Note: A high TSH reading in a properly functioning pituitary, however, is conventionally accepted as indicative of hyp0thyroid, since it signifies the body is sensing low thyroid levels and asking for more hormone. See "TSH" above.)
- too little TBG (binding protein) in the bloodstream, resulting in too much free thyroid hormone
- the thyroid simply releasing too much T4 or T3
Thyroid problems are often autoimmune in nature. Autoimmune disorders occur from a confused immune system, and are responsible for many of the degenerative diseases prevalent in today's society. Ya see, the immune system is an awesome, active system in charge of keeping out invaders (like viruses, bacteria, and pathogens) detrimental to our health, and attacking them when they do sneak their way in. Autoimmune conditions occur when a ramped up immune system begins confusing invader proteins with its own proteins, and begins attacking itself in the process. Talk auto literally shooting yourself in the foot!
Unfortunately, autoimmune conditions are all the more common today. For starters, the slew of dietary and environmental toxins keeps our immune systems on constant alert. Rather than simply dealing with occasional, obvious #problems, our immune systems are now taxed with constantly facing potential invaders in the form of chemicals and processed products, leading to a tendency to over, rather than under, react. Furthermore, the presence of the gluten protein rampant in today's food supply injures the stomach lining to enter the bloodstream, and also resemble body proteins. This can cause the body to begin attacking itself. Yep: Eating gluten just may lead to your thyroid problem!
Autoimmune thyroid conditions can be indicated by levels of thyroid antibodies in the bloodstream, such as Thyroglobulin Antibodies (standard ranges <4 IU/mL or negative) or Thyroid Peroxidase Antibodies (standard ranges < 9 IU/mL or negative). That said, antibodies may or may not be indicative of the actual functioning state of the thyroid.
While the overwhelming prevalence of autoimmune thyroid conditions may be disheartening, take heart! Autoimmune conditions are in your control! Following an autoimmune, thyroid-supporting diet can effectively calm your immune system, and prevent or even reverse autoimmune thyroid conditions.
A multitude of environmental, genetic, and lifestyle factors can stress the body and put you on the path to thyroid problems.
Environmental/ Lifestyle Influences
- Mold: Mycotoxins from mold can disrupt immune function and lead to autoimmune and non-autoimmune thyroid problems.
- SNPS: Single nucleotide polymorphism are genetic mutations which affect the body's ability to deal with toxins and to absorb vitamins. Examples include the MTHFR and GSTM1 mutations.
- Leaky Gut
- Systemic Gut Infections, Lingering Infections: Chronic infections tax the immune system, reap chronic stress, and encourage autoimmune disorders via molecular mimicry (resembling the body's proteins), bystander activation (a virus lurks in the thyroid, which gets attacked by the immune system in the process ), or cryptic antigens (the pathogen "hijacks" the thyroids DNA).
- Stress: Stress can suppress the immune system, decrease thyroid function and T4-T3 conversion, increase reverse T3, and encourage excess estrogen.
- Estrogen Overload: Excess estrogen increases TBG, leading to more bound thyroid hormone and less free thyroid hormone.
- SIBO: Small intestinal bacteria overgrowth is linked to thyroid problems: half of people with thyroid problems also have SIBO. Addressing my thyroid issues essentially "cured" my SIBO! See Breaking Free From SIBO: My IBS Story And “Cure” for more on that!
- Bacteria Infections (like H Pylori) and Parasites
- Environmental Toxins: Mercury fillings, nonstick pans, BPA, plastic containers, teflon, cleaning products, cosmetics, shampoos, soaps, deodorant, shower water, etc. overload detox pathways in the body. Consider switching out your cosmetics and household products, embracing glass, using water filters and air purifiers, and purchasing organic food.
- Mercury: Toxic mercury is found in vaccines, fillings, pesticides, cosmetics, seafood, and even water. Mercury is similar to iodine, so the thyroid may absorb mercury, blocking iodine and encouraging autoimmune disease, like Hashimoto's.
- Perchlorate: Perchlorate is common in the water supply and irrigated fruits and vegetables. Similar to iodine, perchlorate competes with iodine at the thyroid receptors and decreases thyroid function.
- Halogens: Bromine, chlorine, and fluorine are frequent in food, water, and conventional products. They are similar to iodine, and attach to the receptors for it. Fluoride has been added to our water, even though it is an endocrine disruptor - affecting thyroid, sex, and stress hormones. Chlorine is also added to water supply, even though it is a disinfectant. Bromine is a flame retardant and sanitizer, found in plastics, pesticides, and processed food.
Stress and the thyroid are intimately connected. The hypothalamus and pituitary gland which regulate the thyroid fall along the HPA axis, which stands for hypothalamus, pituitary, and adrenal. Yep, those adrenals are what regulate your stress response.
Any challenge to the body is a sort of "stress," including physical, mental, and emotional taxations. When the hypothalamus senses a stressful situation, it tells the adrenals to release stress hormones, which support the body to deal with the challenge. These stress hormones include neurotransmitters such as epinephrine, norepinephrine, dopamine, and cortisol. Chronic high cortisol levels may be particularly problematic for the thyroid, since high cortisol levels can slow thyroid production. Stress hormones can also hinder enzymes which convert T4 to T3, may encourage more reverse T3, may instigate inflammatory cytokines which desensitize cells to thyroid hormone, and may increase excess estrogen and consequently TBG, which binds to thyroid hormones, making them less available for the body. In other words, chronic stress can lead to down-regulation of thyroid performance.
Consider taking steps in your life to reduce stress. This may include things such as yoga, meditation, acupuncture, massage, belly breathing, laughing with friends, dancing, turning off electronics at night, ensuring adequate sleep, and following a healthy diet.
With all that said, I encourage you not to stress about stress. Or even worse, stress about stressing about stress (which I totally do.) Perception and stress are vitality connected, and perceiving stress as "bad" can turn it chronic, rather than acute. I recommend checking out Kelly McGonigal's The Upside of Stress for more on stress perception!
EVALUATING YOUR THYROID
Signs and symptoms of thyroid disorders may be enough to indicate issues with your thyroid. If you're constantly cold, sluggish, and gaining weight, there's a good chance you may be hypothyroid. If you're constantly wired, restless, and sweating, and losing weight, there's a good chance you may be hyperthyroid. As you begin addressing your thyroid issues, you should find your symptoms diminish. Keep in mind that finding your optimum thyroid dose (if you choose to go that route) is a process, and symptoms can fluctuate between hypo and hyper ones.
Monitoring your basal body temperature is a nice way to get a picture of your basal thyroid status, as well as monitor for changes when you begin addressing your thyroid through diet and/or supplemental thyroid hormone. Take your temperature consistently at the same times each day, preferable once you wake up (before moving), and again later in the day. The important thing is to determine your own "normal" body temperature fluctuations, so you can ascertain how it changes when you begin healing your thyroid.
Of course, blood tests are the primary indictor of thyroid status, though they can still be confusing and even misleading. A single blood test at any given time is like a quick and temporary look at the thyroid hormone levels at that transient moment, which may or may not be indicative of the thyroid's overall state. Your thyroid levels can be easily influenced by everything from your current stress level, to the breakfast you had that morning. As discussed, blood tests can only provide hints of what may be happening, rather than providing the whole picture. I recommend getting regular tests and looking for trends and changes over time, rather than viewing any one test as the ultimate "truth."
TREATING THE THYROID
The Place For Medication?
In general, I hold an extremely cautious view of prescriptions, and believe most diseases can be addressed via dietary and lifestyle changes. Most medications simply mask symptoms, rather than address the cause. Prescriptions often cause more problems than they solve, perpetuating and even accelerating the root disease. The pharmaceutical industry is one which thrives on disease: pills are often not the answer, and often are the problem.
That said, thyroid hormone is pivotal for the functioning of the body. Without it, we cannot live. If you've had your thyroid ablated for Graves' disease, you must take thyroid hormone. Just as the body cannot grow a new foot, it cannot grow a new thyroid. In this case, supplementing with thyroid hormone is the equivalent of wearing a prosthetic.
For an over-performing thyroid not yet terminated (hooray!), you may choose to take medication to slow thyroid production. However, these medications often have negative side effects. Alternatively, you may be able to calm your thyroid with natural supplements and lifestyle changes, discussed in a bit.
For an under-performing thyroid, while you can quite likely heal your thyroid via supportive lifestyle changes (yey!), it can often be hard to climb back up to health when you're starting off with low thyroid. It's sort of like going to get a new car: you'll get to the car dealership a lot faster if someone loans you a car to get there in the first place. Supplementing with thyroid hormone while making adequate lifestyle changes may provide the ultimate boost you need to regain your health. Once everything begins returning to normal, (which can happen rather quickly once you get adequate thyroid hormone fueling everything), you may find you can eventually lower your thyroid dose, or even titrate off completely.
Of course, if you only take supplemental thyroid medication, without addressing the root cause of the problem (be it an autoimmune condition, nutrient deficiency, etc.), you will be unlikely to make lasting forward progress. You can put on a bandaid everyday, but the wound won't go away if you keep pricking yourself every morning. Healing on a foundational level is key. Think: Not pricking yourself and wearing a bandaid!
Synthetic Vs. Natural
While I doubt any one type of thyroid medicine is "right" for everyone, I do believe natural, desiccated thyroid hormone ("NDT") is likely often the way to go. Unlike the common forms of synthetic thyroid which contain only lab-generated T4, natural thyroid is developed from pig (and sometimes cow) thyroid glands. It contains the full range of both T4 and T3 in ratios natural to the body, and also contains trace amounts of T1 and T2. As for the whole "Paleo" thing, it is argued that hunter gathers, in consuming the entire animal nose to tail, including hormone-rich organs and glands, would have "eaten" thyroid via diet. And in his 1939 book, Nutrition and Physical Degeneration, Weston A Price notes the dietary intake of presumed thyroid hormone in native African tribes:
Among the Indians in the moose country near the Arctic circle a larger percentage of the children were born in June than in any other month. This was accomplished, I was told, by both parents eating liberally of the thyroid glands of the male moose as they came down from the high mountain areas for the mating season, at which time the large protuberances carrying the thyroids under the throat were greatly enlarged.
Hypothyroidism can be treated with supplemental thyroid hormone in the various forms:
- Synthetic T4: Levothyroxine is the generic form of synthetic T4, and is available under the band names Levothroid, Levoxyl, Synthroid, Tirosint, Unithroid. It is also the most prescribed drug in the US. Since it contains only T4, it can take over a week for the body to being converting the storage form of T4 to the active T3. While this may work for some people, it will likely be ineffective for those with problems converting T4 to T3 in the first place. Many forms of levothyroxine also contain added fillers, including lactose, corn, and/or dyes. Tirosint may be the most "pure" form, continuing only levothyroxine, gelatin, glycerin, and water.
- Synthetic T3: Liothyronine (brand name Cytomel) is a synthetic form of T3, and is very fast acting.
- Natural Desiccated Thyroid (NDT): Natural desiccated thyroid is derived from porcine (and occasionally bovine) thyroid gland. Brand names include Armour, Nature-Throid, Wp-Thyroid, NP Thyroid and the over the counter Nutri-Meds. NDT contains the full range of T1, T2, T3 and T4 hormones. T3 is notably fast acting, and can thus provide an instant boost of energy, though too much may cause a person to swing the other way towards hyperthyroid symptoms. Some of the brands do contain lactose or dextrose. WP-Thyroid (which I personally use) is the most pure, containing only thyroid, inulin, and MCT.
- Natural Compound: Alternatively, you can get thyroid hormone specifically compounded in specific T4:T3 ratios for your own personal constitution.
Hyperthyroid can be treated with the various medications and treatments:
- Methimazole: With the brand name Tapazole, this medication stops the thyroid from producing hormone. However, its side effects include hair loss, dry skin, sleep problems, and loss of sex drive.
- Beta Blockers: Beta Blockers can inhibit T4 conversion into T3 by slowing the heart.
- Iodine Ablation: The most permanent ,conventional "fix" for hyperthyroid involves destroying the thyroid gland with radioactive iodine.
Herbs And Supplements
For hypothyroidism, various adaptogens can be used to boost thyroid function, including ashwagandha, ginseng, rhodiola, maca root, and tulsi.
For hyperthyroidism, herbs which suppress thyroid function include bugleweed (decreases T4), lemon balm (blocks thyroid receptors), motherwort (natural beta blocker), and blue vervain (calming, sedative properties). Eating the indigestible glucomannan fiber (found, for example, in Shirataki noodles), may also bind to excess thyroid in the body.
HEALING THYROID WITH DIET
Thankfully, thyroid problems can often be adequately addressed via dietary and lifestyle interventions which support the thyroid and restore normal function. Since diet can heal and support the thyroid on a foundational level, a general thyroid-supportive diet can reverse both hypothyroidism and hyperthyroidism. To do this, it is important to stop eating foods which hurt thyroid function, while getting a great amount of foods which support a healthy thyroid:
Foods To AVOID!
- Grains: Grains are inflammatory to the digestive tract and encourage leaky gut and systemic inflammation, all which then require more thyroid hormone. They also feed unfriendly bacteria and contain sticky, protein-binding lectins which encourage autoimmune disease. Phytic acid in grains can also bind to minerals, inhibiting their absorption. Grains also contain saponins which can leak into the bloodstream and affect red blood cells.
- Gluten: Gluten is a particular protein found not only in grains, but also abundant in processed foods. This stuff is seriously everywhere! Gluten tears apart the gut by creating holes in the intestinal wall and encouraging leaky gut via zonulin. Gluten can also trigger an autoimmune thyroid condition via molecular mimicry: since the gluten protein somewhat resembles the thyroid proteins, the body may attack the gluten and form antibodies to the thyroid in the process.
- Dairy: Dairy is inflammatory and often full of antibiotics and growth hormones. The casein protein found in dairy products can encourage molecular mimicry and lead to autoimmune thyroid conditions.
- Legumes: These can be inflammatory and hard to digest, encouraging autoimmune conditions. If you do eat them, make sure they are sprouted and cooked thoroughly, organic, and non-GMO.
- Nightshades: Potatoes, tomatoes, eggplants, and peppers contain compounds which can instigate inflammatory responses in some individuals.
- Processed Foods: Ingesting the many toxins and chemicals in processed foods yields inflammation and digestive distress in the body, taxing the thyroid. They also can fire up and confuse the immune system, leading to autoimmune thyroid conditions.
- Refined Sugar: Refined sugar is insulin spiking and inflammatory.
- GMOS: GMO food contains very high contents of their natural protective mechanisms (like lectins) which wreak havoc on the gut.
- Goitrogens: If you are hypothyroid, you should avoid vegetables which contain goitrogens - natural plant chemicals which hinder thyroid function. These include: bok choy, broccoli, brussels sprouts, cabbage, cauliflower, kale, radishes, rutabagas, spinach (lower), soy, and turnips. Cooking and fermenting goitrogenic vegetables can potentially decrease the goitrogen activity, so consider eating small amounts of well-cooked, nutritious green veggie goitrogens if you desire.
- Chlorides, Bromides, Fluorides: Found in tap water, processed foods, household products, and toothpastes, these halogens are in the same family as iodine. They can attach to the iodine receptors in the thyroid, blocking the iodine needed for necessary thyroid function and generating T3 and T4. Use filtered water, natural toothpastes, and avoid processed foods to minimize your exposure.
- Personal Food Sensitivities: Avoid foods which you personally react to, as these can instigate inflammation and tax the digestive system and thyroid. Not sure what you're reacting to? Consider an elimination diet of autoimmune Paleo foods, and check out my Food Sensitivity Guide for identifying various food compounds which may pose problems for you personally, such as amines, histamines, salicylates, oxalates, glutamates, sulfites, and thiols.
- Soy: Soy can encourage estrogen dominance and consequential high levels of TBG, which binds to thyroid hormone, making it less available.
Foods To ENJOY!
- Grass fed, pastured chicken, beef, wild game: Animal proteins are wonderful for supporting thyroid hormone production and building strong, healthy bodies. They can provide essentially every necessary nutrient (with perhaps the exception of Vitamin D), including tyrosine, b vitamins, zinc, and iron.
- Wild Caught Seafood: Wild caught seafood is rich in Omega 3s necessary for healthy cell membranes, as well as Vitamin D and iodine. Choose fish lower in heavy metals, such as Salmon, Flounder, Mahi Mahi, and Cod. See the Environmental Working Group or the EDF Seafood Selector for current fish status.
- Green Leafy Veggies: Veggies are great sources of thyroid-supportive vitamins and minerals. Think: lettuce, asparagus, celery, cucumber, spinach, squash, etc. Be wary of goitrogen and nightshade veggies, as discussed above.
- Low Glycemic Fruits: Choose antioxidant and vitamin C rich fruit with low GIs, so as to not spike blood sugar and insulin levels, which taxes the body and thyroid. We're talking things like berries (blueberries, strawberries, blackberries, etc.), kiwis, and green apples.
- Healthy Fats: Healthy monounsaturated, omega 3 polyunsaturated, and stable saturated fats are great for building healthy cell membranes, supporting energy production, and fueling the metabolism and thyroid. Choose cold-pressed coconut, olive, and avocado oils, grass-fed rendered fats, and potentially pastured organic grass-fed butter, if it does not cause you problems. (Ghee may be a safer alternative). Of course, you can also choose fatty pastured, organic meats and fatty fish to get your fat intake.
- Paleo Superfoods: Grass-fed, organic bone broth and marrow, collagen, cod liver oil, raw unpasteurized fermented foods, etc.
Nutrients Necessary For A Healthy Thyroid
While all of the following nutrients can be supplemented, I like using food first, to maximize bioavailability and minimize toxicity risks.
- Iodine: Iodine is a key building block of thyroid hormone, found in seaweed and fish. Curious about table salt? Iodized salt actually contains iodide, which the body converts into iodine. However, the conversion process generates the problematic and autoimmune-sparking oxidant hydrogen peroxide. (Selenium can neutralize this hydrogen peroxide.) I recommend forgoing conventional, idolized salt (and using Himalayan or sea salt instead), and getting iodine from food.
- Tyrosine: Tyrosine is a key building block of thyroid, found in red meat chicken, fish, and seaweed.
- Selenium: Selenium is needed for the T4-T3 conversion, and can also help prevent autoimmune thyroid condition by reducing TPO antibodies. Selenium is found in red meat, liver, chicken, turkey, fish, and shellfish. While selenium is notably high in Brazil nuts, the amount in each varies, and may be too high in some cases. Nuts can also cause autoimmune problems for some, so proceed with caution
- Zinc: Zinc is needed for the T4-T3 conversion and helps the hypothalamus properly mitigate thyroid production. Zinc is found in red meat, liver, pork, chicken, spinach, and seafood.
- Iron: Iron is needed for the T4 to T3 conversion, and also for converting iodide into iodine. It is found in beef, beef liver, pork, poultry, seafood, and dark leafy veggies.
- Omega 3s: Omega 3s are necessary for healthy cell membranes, so T3 can enter cells. Omega 3s are found in fatty fish, cod liver oil, nuts and seeds. However, nuts and seeds can cause autoimmune conditions for some. Furthermore, some genetic SNPs affect the body's ability to synthesize the vital EPA from the plant form of Omega-3s (ALA). These people need to get Omega 3s from animal protein sources specifically.
- Vitamin D3: Vitamin D3 (which is actually a hormone) is necessary for immune function and assists T3 in entering cells. Our bodies synthesize vitamin D from sunlight, and it is also found in fatty fish, cod liver oil, and raw pastured egg yolks.
- B Vitamins: B vitamins are vital for energy production and a healthy immune system. They're found in green vegetables, meat (particularly red), liver, and shellfish. Note: Those with the MTHFR-related SNPs may have difficulty converting and maintaining adequate amounts of folate (B9) and other B vitamins. For those with a mutation, folic acid will be actually toxic, as those with the variant cannot convert it. For this case, consider avoiding all processed and fortified foods, which often contain folic acid, and supplementing with methylated forms of B vitamins, such as Methylcobalamin (Methylated B12) and Methylfolate (methylated folate.) For more on this, see my post MTHFR Mutations: Do you have this hidden kryptonite
- Vitamin A: Vitamin A assists T3 in entering cells and supports healthy immune function. Vitamin A is found in carrots, sweet potato, squash, mangos, apricots, liver, cod liver oil, kale, and raw pastured egg yolks. Note: Those with mutations (SNPs) in the BCMO1 gene may struggle with converting plant-based vitamin A into its useable form, and should assure adequate vitamin A from animal products.
- Vitamin C: Vitamin C is needed for T4 production, and also serves as an antioxidant for healthy liver function (necessary for T3 production.)
The thyroid is a big deal. Like really. I became passionate about the thyroid after recently discovering hypothyroidism was connected to some of my digestive issues. Addressing my thyroid has been, quite truly, life changing. It can be tricky to pinpoint the cause of thyroid issues, as well as proper thyroid hormone dosages, but I encourage you to invest the time and effort, and keep at it! You can heal your thyroid, and perhaps a lot of other conditions along the way. True life vitality is waiting!
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