Your thyroid is a butterfly-shaped gland that sits at the front part of your neck. You may not give much thought to this 2-inch organ when all is well. However, thyroid dysfunction can cause a host of problems.
Take a look at these common questions to understand the basics of thyroid function, symptoms that might indicate a problem, and what can be done about thyroid issues. Plus, discover 5 ways to support your thyroid.
What does your thyroid do?
Every cell in your body relies on your thyroid. The thyroid regulates the body’s metabolism and energy production. A decrease or increase in the hormones released by the thyroid can be noticed throughout the body. Changes in thyroid hormone levels can alter energy levels, body temperature, heart rate, and cholesterol, just to name a few.
What happens when your thyroid isn’t working properly?
Too much or too little thyroid hormone causes problems. Healthy thyroid function is needed for both physical and emotional health.
An excess of hormone is called hyperthyroidism, the most common condition of which is Graves’ disease. Managing hyperthyroidism could include
radioactive iodine treatments, radiations for the neck, and certain medications.
A deficiency in thyroid hormone is called hypothyroidism. It’s an underactive, a low thyroid state. Hypothyroidism is by far the most common than hyperthyroidism and occurs more in women than in men.
How do thyroid hormones work?
There are two types of thyroid hormones:
T3 (triiodothyronine)–active form
T4 (thyroxine)–inactive, storage form
T3, the active form of thyroid hormone, must be converted from the inactive form of T4. When you consume foods containing iodine, your body uses this mineral to make thyroid hormones. T4 contains four iodine items, and T3 contains three.
Your brain, thyroid and body work together to ensure ideal hormone levels are maintained in the body.
You can think of your thyroid as a furnace. Your brain then is the thermostat and your thyroid hormones are the heat.
Step 1: The brain sends messages to release thyroid hormones
First, an area in your brain called the hypothalamus releases thyrotropin-releasing hormone (TRH). Next, TRH travels to your pituitary gland. Then, the pituitary gland releases another hormone called thyroid-stimulating hormone (TSH). After that, TSH travels to the thyroid which releases thyroid hormones, mostly inactive T4.
Step 2: Inactive thyroid hormone must be converted to the active form
Since T4 is the inactive hormone that doesn’t cause any metabolic effects in the body, the next step is converting T4 into T3. T4 travels through your blood with proteins (like thyroid-binding globulin, TBG) to circulate and be converted in the body.
Most thyroid hormone conversion (about 60 percent) happens in your liver and gut (20 percent). Other locations of thyroid conversion include your muscles, heart, and other tissues.
How does T4 switch to T3? The deiodinase enzyme changes your inactive thyroid hormone to the active kind. This extremely important enzyme relies on the mineral selenium in order to work properly. Many of the problems patients have with underactive thyroid symptoms come from poor conversion of T4 to T3. Weight issues, poor diet, medication drugs and vitamin deficiencies can affect the body’s ability to convert these hormones properly, resulting in thyroid disorders.
What causes hypothyroidism?
The biggest cause of hypothyroidism worldwide is iodine deficiency. In the United States, our biggest cause is an autoimmune condition called Hashimoto’s disease. Unfortunately, it is probably very under-diagnosed since not enough physicians are utilizing appropriate testing.
What can prevent conversion to the active thyroid hormone T3?
Here are some of the factors that block the changing of T4 to T3:
- Excess estrogen: may be from extra body weight, years of oral contraceptives or hormone disruptors in plastics from Bisphenol A (BPA) and phthalates
- Chronic infections: including Lyme and Epstein Barr
- Environmental exposures: pesticides and herbicides such as glyphosate, heavy metals like lead, household products like nonstick pans containing perfluorooctanoic acid (PFOA) or fire retardants, and mold and mycotoxins from the air in water-damaged buildings
- Yeast overgrowth: 20 percent of thyroid hormone conversion occurs in the GI tract, so yeast overgrowth can hinder ideal amounts of the active hormone
- Chronic illness: high cortisol can block thyroid hormone conversion
What are the best tests for hypothyroidism and Hashimoto’s?
At Schoenwalder Health and Wellness, we look at a patient’s symptoms while also utilizing functional laboratory testing and ranges. What you say about how you feel is just as important as a test.
Many physicians are focusing only on thyroid stimulating hormone (TSH), and are neglecting to look at other vital markers. Although some physicians consider the TSH testing the gold standard for thyroid care, it is possible to have a normal TSH and still have thyroid problems.
Testing for antibodies is critical to diagnose the autoimmune condition Hashimoto’s. And unfortunately most physicians are not checking these important indicators. It’s possible to have a normal TSH and normal T3 while still having antibodies. You need to be assessing for all of it.
There are normal ranges and optimal ranges. Traditional medicine relies on laboratory normal ranges of TSH alone when diagnosing thyroid disorders. We treats patients based off of symptoms and aim for optimal levels on thyroid labs.
Our thyroid lab testing can include the following:
- TSH < 2 Free T4 >1
- Free T3 >3
- Reverse T3 <20
- Thyroid peroxidase antibodies (TPOAb)
- Thyroglobulin antibodies (TgAb)
We may also include testing for:
What are the treatments for hypothyroidism?
The most widely prescribed medication for hypothyroidism is levothyroxine (Synthroid). However, this is just a T4 medication.
Natural Desiccated Thyroid Hormone
Schoenwalder Health and Wellness uses Nature Throid, a natural desiccated thyroid medication, that has a combination of both T3 and T4. Since the body metabolizes T3 quickly, we recommend taking a divided dose, twice a day, in order to support stable energy all day long. (Note, once-a-day dosing is okay for those taking a sustained release compounded T3 support.)
A separate T3 medication can be prescribed, along with Nature Throid, if a patient needs additional T3 support. Other medications can be used if a patients cannot tolerate Nature Throid.
Low Dose Naltrexone
For those with Hashimoto’s, low dose naltrexone (LDN) can be prescribed in addition to their thyroid hormone medication. LDN can support the immune system and lower antibodies.
When should I take my thyroid medication?
Here are some ways to get the most benefit from your thyroid medication:
- Take your morning thyroid dose immediately after waking, on an empty stomach.
- Take your thyroid dose away from any other medications or supplements.
- Wait an hour before eating or drinking anything besides water
- Avoid food an hour before and an hour after taking your afternoon dose. A 3:00 p.m. time works well for many people.
Is medication the only treatment for thyroid disorders?
In addition to medication, we may support thyroid function by incorporating specific nutrients and lifestyle changes. Nutrients such as selenium, zinc, iodine, B vitamins, Vitamin D, Omega 3’s or others may be recommended. It’s important to work with your Schoenwalder Health and Wellness provider to know if any of these are right for you.
A low inflammatory diet plays a significant role in managing Hashimoto’s and lowering antibodies.
How can I support my thyroid health?
Even if you don’t have a thyroid disorder, you can benefit from these health-promoting tips.
Five Ways to Support Your Thyroid
- Upgrade your water bottle. Plastic water bottles contain hormone-disruptors that are toxic to your thyroid. Instead, opt for reusable ones made of stainless steel or glass.
- Make sleep a priority. Aim for at least 8 hours a night. This will support your adrenals which work hand-in-hand with your thyroid.
- Get the right nutrients. Eat a low inflammatory diet. Choose nutrient-rich fresh produce over packaged, processed foods. Avoid any food intolerances. Talk to your SHW provider to see if supplementing with key thyroid-supporting nutrients is right for you.
- Keep your gut healthy. If intestinal permeability is an issue, take steps to fix it. A leaky gut can cause Hashimoto’s. Since 20 percent of thyroid hormone conversion occurs in the GI tract, it’s important to address bacterial issues such as H. pylori, Candida, yeast. Improving your diet can improve gut health.
- Relax. Managing stress is important for thyroid function since an excess in the stress hormone cortisol can prevent conversion of T4 to T3. Try yoga, stretching or even just listening to soothing music. Sauna use may reduce stress as well as increase the amount of active thyroid hormone in your body by decreasing the burden from environmental toxins such as pesticides. The Detox Chamber in our office offers detox assistance and mitochondrial support, as well. Other stress-reducing interventions such as mindfulness-based practices can help, too.
Next Steps for Thyroid Support
Ready for more help in supporting your thyroid? Contact us so we can begin to craft your individualized treatment plan.
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https://www.ncbi.nlm.nih.gov/pubmed/12762077 PCB’s/plastics & thyroid conversion
https://www.nejm.org/doi/full/10.1056/NEJM198001033020105 fire retardants & thyroid conversion
https://www.ncbi.nlm.nih.gov/pubmed/19625957 endocrine disruption & thyroid hormones
https://link.springer.com/article/10.2478/s11536-009-0092-8 lead & thyroid
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654247/ thyroid & mycotoxins