-When your thyroid doesn’t function properly, it can impact every aspect of your health, energy and mental wellbeing. The symptoms of thyroid dysfunction are often subtle and easily misdiagnosed.
The thyroid gland produces the hormones -triiodothyronine (T3) and thyroxine (T4). These hormones fuel metabolism and help the body use energy and burn calories. The thyroid hormones work in concert with other hormones, including estrogen and cortisone. In this way thyroid dysfunction can cause havoc by influencing other hormonal pathways in the body.
What do the thyroid hormones do?
T3 is the active thyroid hormone, stimulating energy production and oxygen consumption in almost every cell. T3 stimulate the livers output of glucose and the uptake of circulating glucose by cells for energy. T3 also stimulate the livers use of fatty acids, cholesterol and triglycerides. In the gut thyroid hormones increase the absorption of carbohydrates and the excretion of cholesterol. Therefore low thyroid function will lead to weight gain, and increased triglyceride levels and high cholesterol.
Hypothyroidism (underactive thyroid)
An underactive thyroid or hypothyroidism is a very common disease in Australians, particularly women. Hypothyroidism describes a condition where the thyroid gland produces less thyroid hormones than are required for normal body function. When the thyroid is underactive a blood test for thyroid function will show high levels of TSH production by the pituitary. This occurs as a response to low circulating levels of T4.
Hypothyroidism can result from a number of factors including; autoimmune disease (Hashimoto’s); nutrient deficiencies (most commonly iodine); genetic factors; excessive production of the hormones oestrogen or cortisol; as a side effect of drugs and environmental pollutants; or as a result of burnout after Thyroiditis.
Persistently high levels of TSH cause enlargement of the thyroid gland, often called a “goiter”. A goiter is often visible as swelling around the neck and can cause difficulty swallowing, a persistent hacking cough or a choking sensation.
The symptoms of Hypothyroidism often vary in severity. They may include thin brittle nails and hair, fatigue, memory loss, difficulty concentrating, constipation, weight gain, an irregular menstrual cycle, infertility, depression, a low basal temperature, puffy eyes and difficulty swallowing and a course voice.
Having an underactive thyroid has devastating results on the developing brain of a fetus. Hypothyroidism often resulting from a lack of iodine intake prior to conception and during pregnancy and can result in first trimester miscarriage or developmental delays in the child.
Hyperthyroidism (overactive thyroid)
Hyperthyroidism is most often caused by Grave’s disease in younger women and multi-nodular Goiter in older people. In both conditions the thyroid gland becomes enlarged and produces too much thyroid hormone (T3) resulting in weight loss, heart palpitations, nervousness, anxiety, tremor, an irregular menstrual cycle and heat intolerance. Often an overactive thyroid can become underactive after thyroid burnout.
After giving birth, a woman’s thyroid can swell and become larger or inflamed. This can cause changing levels of thyroid hormone in the body. Sometimes high levels can be followed by low levels of thyroid hormone. After 6 months or less, this condition usually goes away with no permanent damage to the thyroid.
While common, thyroid disorders after pregnancy are often hard to detect since some of the symptoms, such as having trouble sleeping, fatigue, depression, or weight change are viewed as normal when a woman has a new baby.
Diagnosing thyroid dysfunction
To diagnose Thyroid disease, a blood test is required for Thyroid Stimulating Hormone (TSH). The range considered normal for TSH (Thyroid Stimulating Hormone) is between 0.5-5 mIU/L. However, some consider that the range for a normal functioning thyroid is between 1-2 mIU/L. It is important to insist on tests for T3, rT3, Free T4, as well as Thyroid Antibodies and Thyroid Stimulating Antibodies. These tests are often overlooked and diagnosis of thyroid dysfunction delayed.
Iodine deficiency and thyroid function
The trace element Iodine is essential for the formation of thyroid hormones. The most natural source of iodine is from seafood and seaweed. A person only requires a total of one teaspoon of iodine for their entire lifetime, however because it cannot be stored in the body for long periods of time, tiny amounts are required regularly.
A deficiency in Iodine (generally less than 50micrograms each day) causes the thyroid gland to produce more TSH in an attempt to increase the glands uptake of iodine. This leads to changes to the structure of thyroid cells resulting in swelling of the gland.
Australian’s have a long history of iodine deficient disorders (IDD’s). Australian farming practices starting in the early part of the 20th century and still in use today leach iodine from the soil. In the 1950’s the incidence of IDD’s was reduced by farmers using Iodine to sanitize milking equipment. In the 1960’s a national scheme to reduce IDD’s introduced fortification of salt and bread to ensure Australians had an adequate intake of iodine.
Today farmers use chlorine to clean milking equipment and most people eat less salt or salt that has not been iodized. This has lead to a spike in the numbers of iodine deficient disorders in the past five years, especially in children and pregnant women. It is estimated that more than 70% of pregnant women in Australia are mildly-severely iodine deficient. The Australian Food Standards of Australia and New Zealand have made it compulsory for commercial manufacturers to add iodized salt to bread in an attempt to reduce Iodine Deficient Disorders. Screening for iodine deficiency in pregnant women is current not standard practice, nor is it covered by medicare.
A child with an IDD may have poor control of body movement, hearing problems and an IQ 10-15 points below normal, as well as a greater incidence of ADHD (Attention Deficit Hyperactivity Disorder). The extreme form of this is called Cretinism. Iodine Deficiency is the single most common cause of mental retardation and brain damage in the world today. It is therefore imperative to check thyroid function and urinary iodine levels prior to conceiving. Iron is also important for thyroid function during pregnancy.
Testing for iodine
The standard for testing Iodine is a one off urinary analysis. The limitations of this test are that it does not detect mild to moderate deficiencies. However, it is less time consuming and accepted as the general standard by GPs and endocrinologists. Also available is a 24 hour iodine loading test. In this test the patient consumes 50mg of iodide and the amount of iodine excreted is measured over a 24 hour period. The more iodine excreted in urine, the less iodine a person needs in their diet or through supplementation.
Natural support for an underactive thyroid gland
- Vitamins A, B complex, C, E, magnesium and manganese are nutrients are all vital for thyroid gland function.
- Iodine is necessary for the formation of thyroid hormones; prior to taking any supplement containing iodine it is important to have thyroid function tested, as well as urinary iodine.
- L-tyrosine (together with iodine) produces thyroid hormones; a deficiency of tyrosine can lead to hypothyroidism and low adrenal function.
- Zinc is essential for successful conversion of T4 to active T3 and is found to be deficient in hypothyroid patients; conversely, a zinc deficiency causes hypothyroidism.
- Iron status is important for proper thyroid function; low iron and people with anaemia often also have a low TSH levels.
- Bladderwrack is seaweed with high amounts of iodine which stimulates production of thyroid hormones; however, should only be taken when prescribed by a qualified naturopath.
- Bacopa is a herb that stimulates thyroid gland function and is also used for memory and concentration problems.
- In patients with Hashimoto’s disease, Selenium combined with thyroxine therapy can reduced antithyroid antibodies and has a beneficial result on bone.
Natural support for an overactive thyroid gland
- Vitamin C and Vitamin E are anti-inflammatory and can reduce inflammation associated with Hashimoto’s Thyroiditis.
- Vitamin E and Curcumin (a compound from turmeric) alleviate induced hyperthyroidism in animal studies.
- L-Carnitine has been found to reverse the symptoms of hyperthyroidism at a dose of 2-4 grams.
- Some studies suggest that Selenium (200mcg/day) therapy may alleviate the course of Grave’s disease and can reduce thyroid inflammation associated with thyroiditis.
- Lipoic acid is useful for conversion of T4 to the inactive Tr3 and can reduce thyroid function.
- Glucomannan decreases levels of circulating thyroid hormone.
It is important that any treatment, supplements and medication of a thyroid disorder is managed by a GP and endocrinologist in combination with naturopathic care.