Are you feeling more than just tired? Do you have dry hair skin & nails?  Do you have difficulty putting your thoughts together with your mind feeling “foggy”? Do you seem eat less but gain more weight?  You may be one of the estimated 20 million Americans that have some form of thyroid disease.¹ If you are a woman you or one of the eight women around you will develop a thyroid disorder during her lifetime and as a woman you are five to eight times more likely than men to have thyroid problems.¹

Undiagnosed thyroid imbalances may be one of the most common health conditions that people experience but may not know and have when they walk into their doctor’s office. In fact 60 percent of those with thyroid disease are not even aware of their condition.¹ Thyroid disease can begin at any time and most often slow and steady changes and symptoms occur years before a diagnosis or support is offered. Common times that thyroid conditions develop are times after stress such as having a baby, chronic lack of sleep, perimenopause or menopause. Stress stimulates the adrenal gland to produce your fight or flight hormones epinephrine, norepinephrine and cortisol. With infrequent or shorter periods of stress the body can recover with rest. However long periods of chronic stress will deplete or weaken the adrenals. In order to help the body restore health, the thyroid steps in as the backup organ to support the adrenals. The thyroid thus slows everything down making you feel tired to promote you to rest so that you can heal.  Other causes of thyroid imbalance but not limited to may include nutritional deficiencies, environmental toxins, heavy metals, and genetics.

THYROID HEALTH 101

What Is The Thyroid?

The thyroid is a gland that is found in your neck just below your voice box or Adam’s apple. It produces your thyroid hormones that influence almost every cell in the body. The thyroid hormones are released under the influence of the hypothalamus and the pituitary that are glands that sit in the brain.

What Does The Thyroid Do?

The main function of thyroid glands is to regulate the rate of metabolism in most bodily cells (thus the symptoms can be varied), especially the rates at which they utilize energy and form proteins. Both thyroid and growth hormones need to be present in sufficient quantities for normal growth to occur. The thyroid produces two clinically relevant hormones:

• Thyroxine (T4) – Inactive thyroid hormone
• Triiodothyronine (T3) – Active thyroid hormone, travels through your bloodstream converting oxygen and calories into energy for the body to use.

In addition the thyroid produces:

• Diiodothyronine (T2) and Iodothyronine (T1) – These are both at this time believed to play minor roles in the thyroid and rest of the body, primarily serving as precursors to and byproducts of T4/T3 formation.

When all is optimal, you will make what you need and have the optimal levels of T4, T3, T2 and T1. If your T3 is inadequate, either by reduced production or lack of conversion of T4 to T3, your whole body will be impacted.

A hormone calcitonin is produced from the parathyroid glands that are four tiny glands located behind and at the lower edge of the thyroid or embedded within its substance. Calcitonin is a thyroid hormone, along with parathyroid hormone (PTH) regulate calcium, which can also be low with hypothyroidism.

The thyroid hormones influence the whole body including following:

1. Energy – they increase the mitochondrial (energy producing warehouses) size & number to increase the rate of ATP production.
2. Body Temperature – they increase your body heat by activation of sodium and potassium (via Na, K-ATPase activation) which uses energy and increases the amount of heat produced in the body.
3. Growth – promotes growth and development of the brain of a fetus during pregnancy and for the first years after birth.
4. Metabolism – of carbs (increasing insulin), fats (including reduction of cholesterol and triglycerides (TG) and thus hypothyroid function increases cholesterol & TG as well as causes excess fat to be deposited in the liver) and protein.
5. Weight – varying thyroid hormone levels can cause metabolism to increase 60-100% above normal or decrease 30-50% below normal. Note the thyroid hormones also can increase appetite.
6. Heart Health – increases blood flow (vasodilation) due to increased oxygen use and heart rate.
7. Digestion – increased appetite, digestive juices and motility. Hypothyroid function can lead to constipation while hyperthyroid function can lead to diarrhea.
8. Brain Function
9. Muscular Activity – increased. Hyperthyroid function weakens muscles due to the breakdown of protein. In addition a fine tremor may be present with hyperthyroid states.
10. Sleep – Hyperthyroid activity leads to insomnia even though one is tired as the thyroid hormones are excitatory in nature. Hypothyroid activity leads to excess sleep.
11. Hormones – Hypothyroid function leads to reduced libido, in women frequent & excessive periods, irregular periods or lack of periods (amenorhea). Hyperthyroid function leads to impotence in mean and women often experience reduce or absent periods.
12. Milk Production – in pregnant women, thyroid hormone is also involved in the production of prolactin, a hormone responsible for milk production.

It is vital to have optimal thyroid function as poor thyroid function has not only been linked to the symptoms as listed above but also it has been linked to a wide variety of serious health conditions including:  fibromyalgia, irritable bowel syndrome (IBS), infertility, autoimmune diseases and thyroid cancer. ^2,3

I’ve Heard That You Need Iodine For A Healthy Thyroid, Why Is That?

Iodine found in the water and food that you drink and eat. It is a component of your thyroid hormones and is needed to make T4 and T3 along with tyrosine. T4 contains tyrosine and four atoms of iodine while T3 contains three. 93 percent of thyroid hormones secreted are the inactive T4 while 7% is the active T3. The body further converts inactive T4 to active T3 in the liver, kidneys and skeletal muscle under the influence of nutrients including niacin, selenium, zinc and other key minerals. Too much or too little of any of these vital nutrients including iodine can be related to thyroid problems. Iodine deficiency is very common. The World Health Organization (WHO) recommends the following for daily iodine needs: 150 µg/day for adults; 200 µg/day for pregnant/lactating women and 50-250 µg/day for children.^4,5 In Japan where iodine is rich in sea foods the daily dose of iodine obtained from the diet averages around 2000 to 3000 µg/day. Some authorities including Dr. David Brownstein a physician and author of the book “Iodine: Why you need it. Why You Can’t Live Without It” recommends as high as 125,000 µg/day. More than 11 percent of all Americans have moderate to severe iodine deficiencies (less than 50 µg/L)⁶, while 36 percent of reproductive-aged women in the US are considered mildly iodine deficient (<100 µg/L)⁷

It is best to use whole foods rich in iodine for your iodine sources as your first option. For iodine rich foods click here.  It is particularly important to ensure you are getting optimal levels of iodine in your diet as it plays a key role in your baby’s brain and nervous system development. Some research suggests that you can improve your child’s IQ by nearly 1.25 points.⁸

It is important to check with your health care team before adding any supplemental forms of iodine in particular to your routine if you have an autoimmune version of thyroid disease as iodine may potentially aggravate autoimmune thyroid disease.

Aside from dietary deficiencies, toxins can also affect your iodine levels by displacing iodine. Environmental toxins such as bromine (hidden in flours), fluorine (in water) and chlorine (in water) can selectively occupy your iodine receptors (due to them all being related elements (halogens)) which further reduce the available iodine to make your thyroid hormones.

How Are Thyroid Hormones Released?

The Thyroid System (Hypothalamus Pituitary Thyroid (HPT) Axis Figure 1⁹ 

Thyroid hormones are regulated by the hypothalamus, the pituitary which both sit in the brain and the thyroid gland or the HPT Axis (hypothalamic-pituitary-thyroid). The HPT axis is a negative feedback look and a part of the neuroendocrine system responsible for the regulation of metabolism.

When there is a need for more thyroid hormones to be released, the hypothalamus senses lower circulating levels of T3 and T4. The hypothalamus responds by stimulating the release of thyrotropin-releasing hormone (TRH). The TRH stimulates the pituitary to produce thyroid-stimulating hormone (TSH). The TSH, in turn, stimulates the thyroid to produce thyroid hormones until the levels in the blood return to normal. The thyroid hormones then exert a negative feedback loop to “speak to” the hypothalamus as well as the anterior pituitary to turn off the production of more TRH or TSH respectively until more is needed.¹⁰ For example if we are going to make a recipe. We will look at the recipe (hypothalamus) which contains the main directions then we (TRH) will walk to the refrigerator (pituitary) which releases the cauliflower (TSH) to the pot (thyroid). We will then cook it and we will end up with cooked cauliflower (T4). We will then add spices (iodine, selenium, zinc & other key nutrients) and voila end up with cauliflower soup (T3)!.  We then enjoy eating it and the soup itself fills us so we send a negative feedback loop back to the recipe by putting it away until the next time that we need it. (How can you tell that I am a foodie:)

The hypothalamus and pituitary also regulate the adrenal gland with the HPA (hypothalamus – pituitary adrenal gland ) axis for the production of cortisol and the HPG (hypothalamus – pituitary gonadal ) axis for the production of sex hormones.

How Can I Be Properly Diagnosed If I Think I May Have A Thyroid Imbalance?

• Step 1: Signs & Symptoms: play a large role in determining if your thyroid is playing a key role in how you feel. To take a detailed look take the Ienergy Questionnaire-Thyroid (IE-QT) click here.
• Step 2: Basal Body Temperature (BBT) : because the thyroid plays a key role in your basal body temperature (temperature at rest) its measurement can reflect overall thyroid function. To take the Thyroid Test That You Can Do In Your Own Home click here
• Step 3: Lab Tests: proper lab testing that includes a full thyroid panel and potentially an iodine challenge test is important to establishing a proper diagnosis, your baseline, your optimal thyroid hormone levels and tracking your treatment plan.

It also is important to note that your thyroid health is usually assesses by using only one marker the TSH. The new upper level of “normal” was reduced to 3.0 by the American Endocrinology Association in 2011, although many labs are still using the range of 0.35-5 mIU/L. as “normal”.  The latest research suggests that the TSH should be even lower for optimal thyroid function. Turkish researchers, reporting in the International Journal of Clinical Practice reported that a value of 2.0 for optimal heart markers and the HUNT study of 25,000 healthy Norwegians found that their prospects were substantially affected by thyroid function. Those with a TSH level of 1.5 to 2.4 were 41% more likely to die over the next 8 years than those with TSH below 1.5; those with TSH 2.5-3.4 were 69% more likely to die. ¹¹ This suggests that optimal levels of TSH sit below 1.5 mIU/L. More research is ongoing and what I have found in clinical practice is that each person has their optimal levels which can be determined by looking at how they are feeling and their lab work.  For more on Optimal TSH Levels click here (coming soon!)

What Are The Thyroid Imbalances?

There are two main types of thyroid disorders. Hyperthyroidism or Hypothyroidism (which is the most common). Other thyroid conditions exist that are primarily variations of the two including Goitre which is a swelling of the thyroid gland usually due to lack of iodine. It may or may not be associated with an overproduction of thyroid hormones.  Functional thyroid disorders are when one has symptoms of a thyroid imbalance but yet their labs are not diagnostic of a thyroid disease. It is noted that there is variability in what constitutes a normal range of thyroid hormones in lab medicine. If you feel like you may have a thyroid imbalance consult a health care practitioner who has a focus in hormone health.

Hyperthyroidism:

Hyperthyroidism is over activity of the thyroid gland with too much thyroid hormones being released. The thyroid may increase 2-3 X its normal size (goiter). Types of hyperthyroidism include:

• Grave’s Disease – the most common type of hyperthyroidism according to the American Thyroid Association. It is an autoimmune thyroid condition in which “thyroid stimulating antibody” (TSH like effect) stimulates the thyroid cells to produce excess thyroid hormones. Grave’s Disease affects up to 2 percent of the female population and is 10 X more common in women versus men.
• Tumor Induced Hyperthyroidism – may develop in thyroid tissue and secrete large quantities of thyroid hormone.

Hyperthyroid Symptoms:

• Bulging Eyes (Exopthalmosis)
• Diarrhea
• Fatigue with Insomnia
• Increased Sweating
• Intolerance to Heat
• Mild to Extreme Weight Loss
• Muscle Weakness
• Nervous or Anxious
• Racing Heart
• Thin Brittle Hair
• Tremor of Hands

Common Conventional Medical Treatments: Surgical removal of most of the thyroid gland; Destroying a portion of the thyroid with radioactive iodine and or thyroid drugs that prevent the thyroid from using iodine i.e. methimazole (Tapazole). Natural treatment options are available.

For Natural Support Options Click Here (coming soon!)

Hypothyroidism:

Hypothyroidism is due to an under activity of the thyroid gland and low levels of thyroid hormones (T3 and or T4). Types of Hypothyroidism include:

Type I Hypothyroidism: Low Thyroid Hormones: The thyroid doesn’t produce sufficient amounts of thyroid hormone to maintain “normal” blood levels of thyroid hormones, which in turn will maintain “normal” levels of thyroid stimulating hormone (TSH). Type I Hypothyroidism is easy to detect on tests as a person’s symptoms and blood work are consistent. Iodine deficiency is often related. The most common cause of hypothyroidism worldwide is lack of iodine in the diet.

Type II Hypothyroidism: Thyroid Hormone Resistance: In this type the thyroid produces “normal” amounts of thyroid hormones, but the cells are unable to recognize or utilize the hormone properly. Some experts refer to this as thyroid hormone resistance (which can be thought of similar to insulin resistance). This type of hypothyroidism is difficult to assess as the symptoms of thyroid imbalance are most often present but blood work appears “normal”. Type II hypothyroidism is diagnosed by signs & symptoms, low basal body temperature (BBT) (less than 36.6˚C (97.8˚F)) with normal BBT being (36.6˚C-36.8 ˚C (97.8˚F-98.2 ˚F))

Type III Hypothyroidism: Autoimmune: In this type of hypothyroid there is an autoimmune thyroid disease. Causes of autoimmunity may include exposure to toxic environmental factors i.e. bromine (found in flours used to make breads, muffins and baked items) leading to inflammation. The most common type III Hypothyroidism is Hashimoto’s Thyroiditis, although there are several other forms.

• Hashimoto’s Thyroiditis: Regionally the America Thyroid Association notes that the most common cause of hypothyroidism is Hashimoti’s thyroiditis an autoimmune condition that attacks the thyroid gland. It results in an accumulation of white blood cells (WBCs) and inflammation in the thyroid gland which leads to destruction of the thyroid cells. As the thyroid hormone production decreases, TSH increases leading to goiter. Hashimoto’s is 1/182 people and it is five times more common in women vs men.

Type IV Hypothyroidism: Selenium Deficiency: Severe selenium deficiency (SSD) is very rare and thus so is type IV hypothyroidism. There may however be many cases where mild to moderate selenium deficiency is present. Selenium is needed to convert T4 to T3 and thus lower levels of T3 are commonly seen.

Type V Hypothyroidism: Wilson’s Temperature Syndrome: This was first described in 1992 by Dr. Denis Wilson and may not be widely recognized or accepted as a formal type of hypothyroidism. He associated signs and symptoms of hypothyroidism with lower BBT, an evaluation of reverse T3 (rT3), a thyroid-blocking hormone of the active thyroid hormone T3. It is theorized that people with Wilson’s syndrome have a reduced ability of converting T4 into the active T3 forming rT3 instead. This is often missed in blood tests as blood tests often only screen TSH initially and then often the blood tests only reveal levels of thyroid hormones in the blood stream versus what is available in the tissues. Thus one may have normal blood work but below activity in the tissues. Often they are treated with just T4 (i.e. synthroid  or levothyroxine) which does not solve the imbalance and people may often not feel any better. Symptoms of Wilson’s syndrome may include: acid indigestion, arthritis, cold hands/feet (Raynaud’s), fatigue, food intolerances, hives, insomnia & narcolepsy, itchiness, allergies, muscular/joint aches, carpal tunnel, constipation/IBS, headaches, irregular periods, heat/cold intolerance, panic attacks, bad breath, infertility, irritability, low BO, unhealthy nails, psoriasis and or tinnitus!  For more on Wilson’s Syndrome click here (coming soon!)

Note: It is possible for people to have more than one type of hypothyroidism i.e. Type I & Ii where a person may have low levels of thyroid hormone and thyroid hormone resistance.

Severe Hypothryoidism

• Myxedmea: Develops in those with almost a total lack of thyroid function and develops as an adult. It occurs when the thyroid gland wastes away. Common symptoms include mental and physical sluggishness, dry hair and skin, bagginess under the eyes, arteriosclerosis and swelling in the face.
• Creatism: Is when the thyroid gland is an extreme form of hypothyroidism beginning in utero, usually from lack of iodine by the mother before and during pregnancy. It is characterized by failure to thrive, grow and developmental delays.

Hypothyroidism Symptoms:

• Chronic Infections
• Cold intolerance & Cold extremeties
• Concentration & memory poor
• Constipation
• Dry hair, skin & nails
• Excess Sleep (12-14 hrs/day)
• Fatigue
• Hair loss or thinning (all over & outer edges of eyebrows)
• High cholesterol
• Hoarse voice
• Lack of alterness
• Muscle weakness and discomfort
• Muscular weakness
• Puffy face & lips
• Sleep apnea
• Slow movements, speech & heart rate
• Weight gain all over & difficulties losing

Common Conventional Medical Treatments: Include thyroid medications to replace the missing thyroid hormones i.e synthroid or levothyroxine which is a synthetic replacement of T4 or cytomel which is T3. For Natural Hypothyroid Treatment click here (coming soon!)

What Causes Thyroid Imbalance?

Hyperthyroidism is usually related to:

1. Autoimmune (Grave’s Disease): As with most autoimmune disorders, researchers are unsure what the exact cause is, including Grave’s Disease. What we do know is that the antibodies called thyroid-stimulating immunoglobulins (TSIs) cause your thyroid gland to produce more thyroid hormone than what your body needs. TSIs attach to the thyroid receptors for TSH but in Grave’s disease the TSIs “trick” the thyroid gland into over-producing thyroid hormone. Other potential causes include: your genetics and sex as women are more likely to be affected.
2. Tumor: A tumor can increase the size of the thyroid and the production of thyroid hormones.

Hypothyroidism has many potential causes which include the following:

1. Dietary Deficiency of Iodine: lack of foods rich in iodine. The amounts in iodized salt may be just enough to prevent goiter but not optimal.
2. Nutrient Deficiencies: Nutrient deficiencies, such as iodine, selenium, calcium, niacin and iron can impair thyroid function.
3. Environmental Toxins: Halides such as chlorine found in drinking water, fluorine also found in drinking water and bromine found in flours used to make breads, muffins and baked items are in the same family as iodine and can displace iodine in your thyroid gland. In addition petroleum & its byproducts; pesticides, herbicides & fungicides; organic solvents including benzene, toluene, trichloroethylene & dichloromethane; and numerous other synthetic chemicals. These fat-soluble toxins are absorbed by fat cells and thus women whose bodies on average contain a higher percentage of body fat than men’s have proportionately more toxins in their systems. This is consistent with the higher rates of hypothyroidism shown in women, as to whether this is coincidence or fact remains to be clarified scientifically.
4. Heavy Metals: Heavy metal toxicity from metals such as aluminum, arsenic, barium, cadmium, lead, mercury and other toxic metals increase the conversion of T3 to reverse T3 and thus reduced levels of active T3 thyroid hormone are available. Detoxification and chelation programs are effective to chelated and eliminate these heavy metals from the body.
5. Defective Thyroid Receptors: May prevent a sufficient supply of thyroid hormones that are circulating in your blood to reach their destinations such as the mitochondria (energy producing cells) or nucleus of the cell where they are needed to activate genes and stimulate protein synthesis.

For More On Thyroid Health:

• Ienergy Questionnaire-Thyroid (IE-Q)
• Optimal TSH Levels vs Normal Levels
• Thyroid Test That You Can Do In Your Own Home
• Thyroid Lab Tests
• Top Food Rich In Iodine
• 5 Foods for Hyperthyroidism
• Pregnancy & Your Thyroid
• How Does Stress Affect Your Thyroid
• What is Goiter?
• Natural Treatment For Hyperthyroid
• Natural Treatment For Hypothyroid
• Do You Have All The Symptoms of Hypothyroid But Your Tests Are Normal? (Subclinical Hypothyroidism)
• Functionally Low Thyroid

References

1. The American Thyroid Association, http://www.thyroid.org/media-main/about-hypothyroidism/, Retrieved Oct. 23, 2016
2. com April 18, 2014
3. Reuters April 21, 2015
4. World Health Organization/UNICEF/International Council for the Control of Iodine Deficiency Disorders. Recommended iodine levels in salt and guidelines for monitoring their adequacy and effectiveness. (WHO/ NUT/96.13). Geneva: WHO, 1996.
5. World Health Organization/UNICEF/International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers. (WHO/NHD/01.1). Geneva: WHO, 2001. 3. UNICEF. The state of the world’s children
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7. com May 26, 2014
8. Prevent Disease August 10, 2015
9. Hill RN, Crisp TM, Hurley PM, Rosenthal SL, Singh DV (August 1998). “Risk assessment of thyroid follicular cell tumors“. Health Perspect. 106 (8): 447–57. PMID 9681971. PMC: 1533213.
10. Dietrich JW, Landgrafe, G, Fotiadou, EH (2012).“TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis”. Journal of Thyroid Research. 2012: 1–29.doi:1155/2012/351864. PMC 3544290. PMID 23365787.
11. Asvold BO et al. Thyrotropin levels and risk of fatal coronary heart disease: the HUNT study. Arch Intern Med. 2008 Apr 28;168(8):855-60. http://pmid.us/18443261.