What role does the thyroid play in our body?

The thyroid is integral to the body’s health as it affects nearly every cell in the body. Its influence can be seen in how the body relays information, triggers activity, and regulates various substances. More specifically, the thyroid gland produces hormones that monitor the body's metabolic rate which in turn helps control the heart, various muscles, digestive function, brain development, and bone maintenance. Thus, the thyroid plays a crucial role in overseeing many aspects of wellness.

What are the symptoms of thyroid dysfunction?

A malfunctioning thyroid often results in a cascade of symptoms that can appear nearly anywhere in the body. This is because the interconnectivity of the body means that the areas directly affected by poor thyroid function can reverberate and damage other, seemingly unrelated areas.

It is estimated that thyroid disease affects over 20 million Americans with a large percentage of this group being hypothyroid (where the thyroid is sluggish and does not produce enough thyroid hormone). Common symptoms of hypothyroidism include:

• Fatigue
• Unexplained weight gain
• Constipation
• Dry skin and hair
• Hair loss
• Muscle aches and weakness
• Heavy or irregular menstrual periods
• Depression
• Cold intolerance

Hyperthyroidism is another common thyroid disorder where the thyroid is overactive and produces too many hormones. Symptoms that vary greatly from hypothyroidism include:

• Heart palpitations, rapid heartbeat
• Anxiety
• Nervousness
• Weight loss
• Heat intolerance
• Muscle weakness
• Sleep problems

Hashimoto’s Thyroiditis is thought to be the most common cause of hypothyroidism but usually goes undetected. About one out of every thousand people will be diagnosed with this autoimmune condition, but it is much more common. Of this group, women are significantly more likely to have Hashimoto’s, and it is most common between the ages of 45 and 65. Studies show, however, that most cases of Hashimoto’s cannot be detected by blood work—only the worst of the worst test positive. Symptoms often alternate between hypothyroid and hyperthyroid symptoms and can include:

• Fatigue
• Anxiety
• PMS
• Goiters or swelling of the thyroid
• Puffy face
• Brittle nails
• Enlargement of the tongue

What causes thyroid problems?

Thyroid problems such as hypothyroidism may develop from a singular trigger, but it is far more likely that there are multiple contributing factors. Some of the most common causes of hypothyroidism include nutritional imbalances (specifically iodine deficiency), exposure to environmental toxins, pituitary malfunction, congenital predisposition, inhibited hormone signaling or transport, and various medications such as antidepressants.

Perhaps the greatest contributor to thyroid disease, including hypothyroidism, is a chronic illness. Conditions such as diabetes, insulin resistance, depression, and Fibromyalgia can disrupt many factors relating to thyroid activity. One of the most common causes of hypothyroidism is a chronic autoimmune condition known as Hashimoto’s thyroiditis. The disorder encourages the body’s own immune system to attack the thyroid gland, resulting in a serious decline in thyroid function. Another condition linked to Hashimoto’s is Epstein-Barr Virus or EBV, which is a herpes virus (Herpes 4) that has been linked to Hashimoto’s disease and many other autoimmune diseases.

What are the main differences between hypothyroidism & hyperthyroidism?

The main difference between hypothyroidism and hyperthyroidism relates to the way in which hormone levels are affected. Hypothyroidism leads to a decrease in hormones while hyperthyroidism leads to an increase in hormone production. In the United States, there are 20 million diagnosed cases of thyroid disease with a large percentage of this group being hypothyroid.

How does the thyroid relate to our gut, metabolism, and weight?

As previously mentioned, thyroid hormones facilitate communication between the brain and the gut. When thyroid function is reduced, this communication is limited and can result in digestive issues such as constipation, malabsorption, and dysbiosis, or an imbalance of beneficial bacteria. Moreover, a thyroid hormone deficit can limit muscle and nerve action that facilitates movement in the esophagus, slowing digestion. Furthermore, low thyroid levels are associated with reduced levels of gastrin. Low gastrin levels may cause heartburn, ulcers, reflux, bloating, and inflammation.

As for the metabolism, poor thyroid function often means a reduction in metabolic activity, which contributes to weight gain, an inability to lose weight, and fatigue (in the case of hypothyroidism). Hypothyroidism also inhibits the body’s ability to use fatty acids, meaning that fat cannot be effectively broken down and dispersed as fuel for other cells.

What test(s) should we take to check on our thyroid health?

When testing thyroid function, many doctors only test the levels of Thyroid-Stimulating Hormone (TSH). Although TSH is considered the “gold standard” test by many endocrinologists, they do not even agree on the cutoff points for the reference range for this test.

Some endocrinologists consider any number within the reference range (it’s around .40 to 4.0 at many US labs) “normal,” and others feel that TSH must be as high as 10 for a diagnosis of hypothyroidism.

Therefore, the TSH test is not only limited due to the lack of consensus as to what the actual results mean, but also due to the fact that it does not even test Free T4, and Free T3 — the actual circulating thyroid hormones — or antibodies that detect autoimmune thyroid disease. This means you could have sub-normal levels of T4 and T3, and/or antibodies that show that your thyroid gland is in self-destruct mode, but if your TSH is within the reference range, the endocrinologist may say it’s “normal.”

Moreover, it is far too uncommon for endocrinologists to screen for a patient’s levels of Reverse T3 (RT3). As the mirror image of T3, RT3 is responsible for keeping active thyroid hormone levels balanced and an important of overall thyroid function. However, with stress, dieting, inflammation, and/or chronic illness over conversion of T4 to RT3 can result in severe symptoms of hypothyroidism. Thus, if you would like to check on your thyroid health, it is best to have a full panel screening of your thyroid hormones.

How can we best support our thyroid?

Millions of Americans suffer from some form of a thyroid disorder, many of them may not even know it. While the most common causes of thyroid problems are autoimmune conditions, there are steps you can take to support your thyroid and its various functions:

• Make sure you are getting enough iron, zinc, selenium, vitamin E, B vitamins, and iodine as low levels of these nutrients can potentially lead to thyroid issues. (Note to be particularly careful with your intake of iodine as high levels of iodine can also result in thyroid dysfunction).
• Find ways to properly manage your stress as high-stress levels lead to the release of cortisol, the stress hormone, which can suppress the release of thyroid hormones.
• Avoid fluoride toxins as fluoride disrupts thyroid hormones and can impact the overall function of the thyroid.
• Avoid heavy metal toxins because they have been linked to thyroid disease and thyroid cancer.
• Eat a thyroid-supporting diet (avoid caffeine, alcohol, and gluten).

Is there a thyroid-supporting diet?

For people with thyroid disease, there are some important things to know about foods and drinks, and their interaction with the body and medications. Below are some general tips thyroid patients should keep in mind:

Beneficial Foods and Beverages:

• Eggs: Eggs are an excellent source of iodine and selenium, which are critical building blocks for thyroid hormones. Eating one large egg fulfills 16 percent of the daily requirement for iodine and 20 percent for selenium.
• High fiber foods: Many thyroid patients struggle with constipation, and extra weight. One of the key tactics that can help is increasing fiber intake, particularly from foods. However, if you switch to a high-fiber diet, you should get your thyroid rechecked in eight to twelve weeks to see if you need a dosage readjustment, as fiber can affect the absorption of medication.
• Coconut oil: Can raise basal body temperatures while increasing metabolism. This is good news for people who suffer from low thyroid function. This saturated, healthy fat is a thyroid-friendly option to replace other fats and oils in your diet.
• Water: One of the most powerful things thyroid patients can do to help their health and metabolism is to stay hydrated. Water helps your metabolism function more efficiently and can help reduce your appetite, get rid of water retention and bloating, improve your digestion and elimination, and combat constipation. Some experts even say that we should drink one ounce of water per pound of scale weight.

Foods and Beverages to Avoid:

• Goitrogens: Substances that occur naturally in certain foods, can cause the thyroid gland to enlarge, which is called a goiter. Goitrogenic foods can also function like an anti-thyroid drug and actually slow down the thyroid and make it under-active. The main goitrogenic foods are cruciferous vegetables like broccoli, cauliflower, kale, and cabbage, among others, as well as soy foods.
• Coffee: It is recommended not to drink coffee until an hour after you have taken the thyroid hormone replacement medication; otherwise, the coffee can affect absorption, and make your thyroid medication less effective.
• Celiac, gluten, and wheat: A subset of autoimmune thyroid patients have dietary-triggered autoimmunity, due to celiac disease, or a wheat/gluten intolerance. For these patients, going on a gluten-free diet may eliminate antibodies, and cause the remission of their autoimmune thyroid disease.
• Alcohol: Wine, beer, and liquor contain phytoestrogens, which increase estrogen levels in the body. Elevated estrogen levels or estrogen dominance suppresses thyroid hormone production.

What toxins play a role in harming the thyroid?

Heavy Metals

• Commonly found in toiletries like deodorant, over-the-counter medications, food additives, cookware, and more aluminum oxidizes the thyroid, inhibits iodide uptake, limits thyroid hormone production, and can mislead the immune system to attack the thyroid, as seen in autoimmune disease.
• Cadmium is present in batteries, pigments, plastics, sewage, and phosphate-based fertilizers. This heavy metal can trigger thyroid enlargement, reduce thyroglobulin secretion, and can induce thyroid cancer.
• Lead, commonly known for its toxicity, remains high in today's environment due to its use in the paint used in old housing, some metal jewelry, and some children’s toys. Lead exposure in work environments alone has been linked to reduced thyroid function.
• Mercury, found in seafood and pollution produced by coal-burning power plants, lowers iodide uptake in the thyroid and prevents thyroid hormone production.

Household Toxins:

Polybrominated diphenyl ethers (PBDEs), more commonly referred to as flame retardants can be found in many areas of the modern-day home such as furniture, carpet padding, clothing made of synthetic materials, and the screens of electronic devices. PBDEs imitate thyroid hormone structure and block T4 from being transported in the blood.

Bisphenol A (BPA) and phthalates, ingredients used to make plastic for water bottles, children’s toys, and food storage containers, imitate the structures of other hormones found naturally in the body and disrupt the entire endocrine system along with the thyroid. BPA can change the structure of the thyroid gland and inhibits T3 from binding to its receptors.

Getting Your Thyroid Under Control

Thyroid disorders are common but often misdiagnosed. Approximately 20 million Americans suffer from some form of a thyroid disorder, according to the American Thyroid Association. However, up to 60% are unaware they have a thyroid issue or have been misdiagnosed with another condition.

At Holtorf Medical Group, our doctors are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your autoimmune thyroid disease, optimize your health, and improve your quality of life. If you think you are suffering from thyroid dysfunction, contact us today to see how we can help you!