Thyroid Health : Hypo vs Hyper
If you are a woman over the age of 35, you are likely aware of your thyroid but we often don’t really know what this critical organ does or how it effects are health at different stages of life. The Thyroid is a butterfly shaped gland found in front of the throat, and it’s main job is to produce thyroid hormones. These hormones are most well known for their role in regulating our metabolism which can affect our energy, body weight, and body temperature. But these hormones are also partly responsible for heart and digestive function, muscle control, bone maintenance, fertility, and even brain development. (1)
In order to maintain a healthy body, especially a well functioning metabolism which helps us to convert food into energy among other critical functions that keep us alive, it is important that the thyroid is functioning properly and secreting the right amount of thyroid hormones. Now the thyroid doesn’t work alone, it is part of the endocrine system and it counts on other glands including the hypothalamus to secrete thyrotropin-releasing hormone (TRH) which then stimulates the pituitary gland to produce thyroid stimulating hormone (TSH) which as its name suggests stimulates the thyroid. This teamwork creates a very important feedback loop in the endocrine system known as the hypothalamic–pituitary–thyroid axis. (1)
The thyroid itself then produces two critical hormones called thyroxine (T4) and triiodothyronine (T3). Thyroxine (T4) is the is the inactive form of thyroid hormone that must be converted to T3 in the liver and kidneys. Triiodothyronine (T3) is the active form of thyroid hormone which can be secreted directly into the bloodstream by the thyroid gland, but this only makes up about 20%. The rest must be converted from T4 to T3, making the conversion process crucial for a maintaining a healthy amount of active thyroid hormone the body can use. (3)
So are you confused yet? As with many of the functions in the body, the work of the thyroid is complicated and it doesn't take much for things to go out of balance. When the thyroid is not working properly you can end up with too much or too little thyroid hormone which can both lead to symptoms that need to be addressed.
First we will look at the condition known as hypothyroidism, or too little thyroid hormone functioning properly in the body. Hypothyroidism affects almost all cells and bodily functions and they symptoms can range from subtle to severe so you should always consult your doctor if suspect your thyroid is sluggish. According to the Mayo Clinic, signs and symptoms of hypothyroidism include:
Increased sensitivity to cold
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Slowed heart rate
What causes hypothyroidism?
Hypothyroidism can occur due to dysfunction in any of the glands that are part of the hypothalamic–pituitary–thyroid axis. If any part of the complicated feedback loop is not working properly, the thyroid could not be producing enough thyroid hormone. Also, T3 and T4 are formed from the combination of the amino acid tyrosine and iodine. If the body is deficient in either of these elements it can not make enough thyroid hormone. So nutrition is critical in making sure the thyroid is functioning properly.
The most common cause of low thyroid hormones is the disorder known as Hashimoto’s Autoimmune Thyroiditis. An autoimmune disorder is complicated, but it can be most easily understood as an hyperactive immune state which caused the bodies immune system to attack healthy tissues or organs in the body by mistake. In the case of Hashimoto’s the immune system attacks the thyroid gland. Hashimoto’s is often marked by the presence of autoantibodies and it’s common to be found in people with other autoimmune disorders.
How do you detect Hypothyroidism
Hashimoto’s disease can often undetected due to the fact that it is often asymptomatic, but when symptoms do appear they can generally appear as a goiter, or enlargement of the thyroid gland which can be felt on the throat.
For those who might have a non autoimmune hypothyroid condition, they are often misdiagnosed by doctors who only go by test results which often have a much broader “normal” range then what is really healthy for thyroid function. Your doctor will most commonly test your TSH ( Thyroid Stimulating Hormone) and your Free T4, and if this falls into the normal range they will not treat you for low thyroid. The problem is that many people fall into what is called the subclinical, which means the test numbers might look normal but the thyroid is not functioning properly. It is important to catch these problems early so that you have a better chance of getting things back on track. Some professionals, such as Dr. Sara Gottfried, M.D., feel that symptomatology is just as important as test results, and she also uses a much smaller range for testing thyroid hormones. This allows for better results for patients who are struggling with fatigue, weight gain or other common symptoms of under-active thyroid gland.
Diet Recommendations for Hypothyroidism
Avoid foods that you might be allergic or sensitive too ( especially gluten)
Eat foods high in iodine such as fish and sea vegetables ( but don’t over do it)
Avoid Goitrogens which disrupt the body's iodine intake, such as raw kale, broccoli, soy and cabbage.
Eat plenty of fresh fruits and vegetables high in vitamins, minerals and antioxidants
What if you have too much Thyroid Hormone?
On the other end of the spectrum is Hyperthyroidism, where the body actually creates too much thyroid hormone in the form of T4 and/or T3. The most common form of hyperthyroidism is also an autoimmune disorder known as Graves Disease which accounts for around 85% of cases. Hyperthyroidism is more common among women and often begins between age 20-40.
One thing I found very interesting, is that hyperthyroidism can often be triggered by an extremely stressful or traumatic experience. According to the Clinical Book of Natural Medicine, the most common precipitating event was “actual or threatened separation from a person on whom the patient is emotionally dependent. We often don’t connect our emotional stress to our physical body, but this shows the interconnectedness of our mind and body.
Common signs and symptoms of hyperthyroidism include:
unexplained weight loss
hair thinning or loss
more bowel movements than normal
flushed, itchy skin
Non Painful goiter for Graves’ Disease
Hyperthyroid can be extremely dangerous and needs to be treated by a medical professional, but there are some things you can do to support your healing process naturally. The main goal for a natural treatment of Graves’ disease and Hyperthyroidism is to reduce symptoms by trying to re-balance normal thyroid hormone levels. A health diet can help to support balance in the body and therapies such as hydrotherapy and acupuncture have also been found to be helpful.
A few recommendations for hyperthyroidism
Eat a balanced whole foods diet
Plan small frequent meals
Avoid supplements iodine, caffeine and stimulants
If you are experiencing symptoms that might lead you to believe your thyroid hormone it is important that you consult your doctor for help and determine the underlying cause of your condition. While minor cases of hypothyroidism might be manageable with changes to diet and a more natural approach, more severe cases will need a medical approach.
References and Recommended Readings:
Therapeutic Nutrition by Dr. Ed Bauman, M.Ed, Ph. D and Jodi Friedlander, N.C.