An A-Z Woman's Guide to Vibrant Health

Thyroid (Hypothyroidism)

Hypothyroidism or low thyroid hormone is a common condition in North America, particularly in Canada and the upper U.S. states where levels of sunlight are low for much of the year, and soil mineral depletion is common. Low thyroid function affects approximately 20-25 percent of the female population and about 10 percent of males. An additional 30 percent of persons over the age of 35 may also have sub-clinical or mild hypothyroidism whereby their thyroid stimulating hormone (TSH) is within normal range, but they have many of the symptoms of low thyroid. The thyroid secretes two hormones - T3 and T4 - that are crucial for controlling our metabolism. Because thyroid hormones affect every cell in the body, a deficiency will result in many symptoms.

The thyroid is a small gland that lies below the Adam's apple in the neck, wrapped around both sides of the trachea. It secretes thyroid hormones that control many metabolic functions in the body. Thyroid hormones stimulate the production of proteins and increase the use of oxygen by cells in the body. Iodine is required by the thyroid to produce thyroid hormones. A careful recycling process occurs in the thyroid to ensure adequate thyroid hormones are available to control the body's metabolic rate. The following hormones and substances directly affect the thyroid or are released by it:
  • Thyrotropin-releasing hormone (TRH) is secreted by the hypothalamus, a brain centre that coordinates the actions of the nervous and endocrine systems. TRH triggers the pituitary to secrete TSH.
  • Thyroid stimulating hormone (TSH) is secreted by the pituitary in response to TRH. TSH stimulates the production of thyroid hormones and the growth of thyroid cells (excess TSH causes thyroid enlargement, or goiter.)
  • Calcitonin is a thyroid hormone involved in the homeostasis of blood calcium levels. It lowers the amount of calcium and phosphate in the blood as needed by inhibiting bone breakdown and accelerating the assimilation of calcium. Thus, the thyroid is involved in bone health and diseases such as osteoporosis.
  • Thyroxin (T4) is the most abundant thyroid hormone and is manufactured in the thyroid gland. It is synthesized from tyrosine and includes four molecules of iodine per molecule of thyroxin hormone.
  • Triiodothyronine (T3) is the most active thyroid hormone, with four to ten times the activity of T4. It includes three molecules of iodine molecule of triiodothyronine hormone. Twenty percent of T3 is produced and secreted by the thyroid gland and the other 80 percent is converted from T4 in the liver and other organs. Many factors contribute to the conversion of T4 to the more active T3, including liver health, low stress levels, the types of foods you consume and more.
At any given time, most T3 and T4 molecules in the body are bound tightly to blood proteins. Only a small amount of each circulates as "free" hormone that is physiologically active. For example, unbound T4 accounts for approximately 0.05 percent of total T4. Unbound hormone levels are seldom measured by medical doctors, yet these levels are most accurate for determining thyroid function.

A delicate balance must be maintained to keep a steady metabolic rate in the body. The hypothalamus and pituitary glands work in concert with the proteins of the body, T4, the liver and other organs to maintain that balance.

When the thyroid produces too much thyroid hormone, hyperthyroidism develops. Autoimmune reactions against the thyroid can cause hyperthyroidism; Graves' disease is one such condition. The immune system malfunctions, causing an increase in thyroid hormone. Goiter, a greatly enlarged thyroid gland, is seen in those with Graves' disease and is due to the excessive secretion of thyroid hormone. Thyroiditis, an inflammation of the thyroid gland, can initially cause hyperthyroidism, but eventually the damage to the thyroid caused by the inflammation causes hypothyroidism or low thyroid function.

Low Thyroid Function, Peri-menopause, Menopause and Weight Gain: Estrogen decides body fat distribution, and, in women, fat is stored on our hips, bottom, abdomen and thighs. Fat cells manufacture and store estrogen. Some researchers believe women get an increase in body fat around menopause to ensure adequate estrogen from fat cells. Others believe that it is low thyroid and exhausted adrenals that promote mid-section fat gain. Considering that excess fat reduces our life expectancy, I tend to believe the latter because the body is generally programmed to ensure our survival.

I mentioned earlier that there could be as high as 30 percent of people over the age of 35 walking around with sub-clinical low thyroid function. We know that low thyroid function promotes many hormonal problems that could be remedied with thyroid-supporting nutrients or medication (thyroid hormones).

During the peri-menopausal years (the 10 to 15 years before menopause) and menopause (menopause means one year with no periods), it is common for women to suffer a multitude of hormonal complaints. Hot flashes, night sweats and sleep disturbances are common complaints during this time in a woman's life. Most would think these symptoms are associated with a decline in estrogen, but they are also hallmark symptoms of low thyroid, especially night sweats and insomnia. Most menopausal women are given hormone replacement therapy with estrogen for these symptoms. Peri-menopausal women may be put on the birth control pill. The problem with these treatments is that estrogen further shuts down the thyroid: high estrogen levels interfere with the thyroid hormones, particularly the utilization of T3, the most biologically active thyroid hormone. I have to reiterate that too much estrogen, either from hormone replacement therapy, your own estrogen, or the environment, causes a host of problems and also impairs thyroid function.

Many women have experienced a 10 to 15 pound weight gain and increased blood pressure when they started taking synthetic estrogen at menopause. This happens because estrogen is an antagonist to thyroid hormone and the metabolic rate slows down. As this happens, many women develop difficulties with fat metabolism, because one of the functions of the thyroid hormones is to stimulate fat cells to burn fat. Weight control problems result.

In addition, serum cholesterol or triglyceride levels may increase. Thyroid activity can also be inhibited by high levels of androgens (male sex hormones) circulating in the blood. Depression and fatigue are the most common thyroid symptoms in menopausal women.

Many people suffer with mild or sub-clinical low thyroid function - their thyroid stimulating hormone (TSH, the hormone that stimulates your thyroid to make thyroid hormones) is greater than 2.0 IU/ml but less than the 5.5 IU/ml level indicative of hypothyroidism. As such they contend with the many symptoms of low thyroid function but are not being treated with medication. If you are trying to lose weight and have followed a healthy eating plan and exercised and still cannot lose a pound, you may have subclinical low thyroid function.

Many people's TSH falls within the conventional parameters for normal (0.5 to 5.5), but most people with levels greater than 2.0-3.0 have symptoms of low thyroid function. Enlightened doctors refer to such people as having sub-clinical, or functional, low thyroid function.

If a diagnosis of low thyroid is based solely on a TSH reading, without taking other symptoms into account, it may take 10 years before thyroid hormone levels drop low enough to trigger a mainstream diagnosis of low thyroid function. In the meantime, the person with low thyroid function symptoms will go through much unnecessary suffering. Make sure you go for your thyroid test first thing in the morning for more accurate results.

Low Thyroid Function and Hormonal Problems: It is common for the thyroid to be functionally, or even clinically, out of balance in women who experience hormone-related problems such as premenstrual syndrome (PMS), infertility, ovarian cysts, fibroids, endometriosis, fibrocystic breasts, dysmenorrhea (menstrual pain), metrorrhagia (heavy bleeding) or menopausal symptoms. Back in the days before fertility drugs, when a woman could not get pregnant or had recurring miscarriages, doctors prescribed thyroid hormone with some success. Women who suffer post-partum depression could also benefit from thyroid hormone as childbearing can often exhaust the adrenals and promote low thyroid.

Symptoms
The symptoms of hypothyroidism are varied. Hypothyroidism causes the body's metabolic rate to slow dramatically, and early symptoms are often misdiagnosed as depression. Slowed heart rate, hoarse voice, slowed speech, swollen and puffy face, drooping eyelids, intolerance to cold, constipation and weight gain are hallmark symptoms. The hair often becomes sparse, coarse and dry, and there is a loss of eyebrow hair. The skin will become dry, scaly, thick and bumpy and may have raised, thickened areas on the shins. Carpal tunnel syndrome, muscle weakness, confusion, depression, dementia, heart disease with high cholesterol and triglyceride levels, hormone disruptions, shortness of breath and extreme fatigue may also be present. Women with hypothyroidism may also experience heavy menstrual bleeding, infertility and, when they do become pregnant, they are at increased risk of miscarriages, premature deliveries and stillbirths.

Have your thyroid function checked by your doctor, but don't be surprised if the results come back normal even though you have a large number of the symptoms above. Many people have sub-clinical low thyroid and yet are diagnosed with normal thyroid based on the current tests. The Barnes basal temperature test can better help determine thyroid function. This simple temperature test can determine if you have low thyroid. Men and nonmenstruating women can take the test on any day, but women who are menstruating should take the test on the second, third or fourth day of their period. (See Thyroid Basal Temperature Home Test in Appendix C)

Those women with low thyroid are at serious health risk for many other conditions including osteoporosis, breast cancer, heart disease, hormone problems, severe hot flashes and more. As well, nutritional therapies do not work as well in those with an under-active thyroid.

Causes
Hashimoto's thyroiditis is the most common cause of hypothyroidism. The autoimmune process attacks the thyroid, and eventually the thyroid cannot produce enough thyroid hormone. The treatment of hyperthyroidism, using radioactive iodine and surgery, is the second most common cause of hypothyroidism.

Decades ago, iodine was added to salt to make iodized salt to treat goiter and subsequent thyroid problems, but many people are no longer eating salt and, as a result, we are seeing an increase in hypothyroidism. As well, stress, anemia, estrogen replacement, birth control pills and other medications that block iodine uptake are associated with an increase in hypothyroidism.

Those living in the northern hemisphere are not getting enough sunshine to produce vitamin D, a cofactor in thyroid hormone production; as a result they are more prone to hypothyroidism. Trace minerals are also required to make thyroid hormone, and deficiencies promote hypothyroidism.

PRESCRIPTION FOR WOMEN'S HEALTH

You should not stop your thyroid medication it is essential for providing adequate thyroid hormone. If you are on medication but still have the symptoms of low thyroid function, add the following nutrients for better conversion of T4 to the more active T3. Recommendations below are designed to support thyroid function.

Nutrients
Dosage
Action
Multivitamins with minerals; (contains no iron)
MULTISMART
As directed. For complete formula recommendations see Appendix A
For optimal nutrient status. Required for thyroid, metabolism and for proper immune function
THYROSMART
Take two capsules at breakfast containing:

Potassium Iodide
100 mcg

Ensure your total daily iodine from all sources does not exceed 300-400 mcg.



Iodine's only role in the body is to make thyroid hormones. Too little causes impaired thyroid function; too much iodine interferes with the thyroid's ability to make thyroid hormones. Important for fertility, fibrocystic breasts, breast cancer prevention, and to destroy H. pylori in the gut and more
Tyrosine
(amino acid) 500 mg
A key component in the function of the thyroid gland
Senoril Ashwagandha 125 mg
Increases T4 thyroid hormone. Acts directly on the thyroid gland.
Commiphora mukul extract
(Gugguls)120 mg
Enhances the conversion of T4 to the more active T3. Works synergistically with Ashwagandha directly on the thyroid gland
Pantothenic acid 100 mg
Supports adrenal glands; increases energy; helps you handle stress better. Added benefit: works to combat cellulite.
Copper 500 mcg
Support for the thyroid gland
Manganese 500 mcg
Support for the times thyroid gland
Protein powder
2 scoops, 30 g daily
Contains amino acids, including tyrosine which binds with iodine to make thyroid hormones

HEALTH TIPS TO ENHANCE HEALING
  • Ensure you get adequate sunshine. The thyroid gland requires vitamin D to function properly. Those living in the northern hemisphere have higher rates of low thyroid. Take THYROSMART to support thyroid health.
  • Reduce your consumption of foods (called goitrogens) that impede the absorption of iodine, if you have hypothyroidism. These foods include soy, turnips, cabbage, mustard greens, peanuts, pine nuts and millet. You would have to eat these foods every day to impede thyroid hormone, but just as a precaution be aware of their effects.
  • Avoid fluoride toothpaste and fluoridated water as they compete with iodine for absorption.
  • Detoxification and elimination of waste is very important. Eat liver-friendly foods such as kale, carrots, beets, artichokes, lemons, onions, garlic, leeks.
  • Stress reduction is essential. See Adrenal Exhaustion. The adrenals and the thyroid are linked. If the adrenals are exhausted, low thyroid hormones will result. If you have low thyroid function, it promotes stress on the adrenals.
  • If you are having fertility problems, ensure your doctor does sensitive thyroid tests to rule out sub-clinical low thyroid function. A fertility clinic in Toronto found that 25 percent of its patients had low thyroid function that was not detected on the standard TSH test. See Thyroid Tests in Appendix C.
  • Severe hypothyroidism, confirmed by a thyroid stimulating hormone (TSH) test, requires the use of thyroid medication. Most medical doctors prefer the synthetic thyroid hormone T4, but some physicians and patients prefer desiccated natural thyroid obtained from the glands of animals (mainly pigs). Desiccated thyroid also contains the more active T3. When initially prescribed it may be difficult for some people to get the correct dose of desiccated thyroid medicine unless your doctor is willing to monitor your TSH, T3 and T4 adequately. (It should be taken under the guidance of your physician). This is a problem in Canada where medical doctors are not as familiar with natural hormones and where the medical system will only pay for certain diagnostic tests and only so many per year. Desiccated thyroid is available through compounding pharmacies in Canada.