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August 13, 2017
Many people either know someone with a thyroid problem, or they have a thyroid problem themselves. There are many different types of thyroid problems, as well as underlying causes.
The thyroid controls many functions within the body, with some of its main functions being regulation of metabolism and body temperature.
Let's start with a bit of the basics. The thyroid gland, located at the bottom center of the neck, produces thyroid hormone called Thyroxine, or T4. This is an inactive thyroid hormone that is later converted into active hormone. This production of T4 begins when the thyroid receives signals from the pituitary gland via the hormone TSH (Thyroid Stimulating Hormone). Through a series of steps and processes, T4 is converted into the active thyroid hormone, Triiodothyronine, or T3.
One issue I often see is that many people are walking around with undiagnosed thyroid issues, either because their doctors are not ordering the proper tests, or because they are told that they fall within the lab ranges (instead of optimal ranges, which I will discuss below).
Types of Thyroid Dysfunction
There are many types of thyroid problems, with the most common being hypothyroidism (an underactive thyroid).
Some of the typical symptoms of hypothyroidism include:
-Low body temperature
-Hair loss and/or dry skin
-Intolerance to cold, and/or cold hands and feet
-Brain fog and/or difficulty concentrating
-Constipation and other digestive issues
There are two types of hypothyroidism - output issue and conversion issue. An Output Issue is due to not enough T4 being created / output by the thyroid. This can be caused by a pituitary issue (not enough signaling via TSH to the thyroid), or destruction of the thyroid gland via an autoimmune process, where the body is attacking the thyroid gland (Hashimoto's Disease).
I will go into this in more detail in the future, but in the case of Hashimoto's or other autoimmune diseases, the following should be pursued: analyzing the diet, looking for underlying infections, and looking for heavy metal or other toxicity. It is my opinion that the body does not decide to attack itself for no reason.
A Conversion Issue is due to a problem in the conversion of T4 to T3. The thyroid output (T4) is adequate, but T3 will be lower than optimal, usually along with a high level of Reverse T3, or RT3 (an inactive thyroid hormone, which blocks the T3 receptors).
Causes of a conversion issue can be a sluggish liver (the liver is where most of the T4 to T3 conversion is done), insufficient levels of nutrients that are needed for the conversion, inflammation due to a disease process, toxins or infections, or adrenal dysregulation.
In the case of adrenal dysregulation, the body can down-regulate the thyroid by "putting on the brakes" and shunting T3 to RT3. This is because, at that time, the adrenals cannot handle the higher metabolic state that the thyroid is trying to create, and the body needs to slow down in order to repair and regenerate adrenal levels and reserves. A high cortisol level can also shunt T3 to RT3.
Hyperthyroidism (an overactive thyroid)is less common. Some causes of hyperthyroidism include Graves' Disease (an autoimmune disease), and nodules on the thyroid that release excessive amounts of thyroid hormone.
Some of the common symptoms of hyperthyroidism include:
-A fast resting heart rate
-Anxiety and irritable mood
-Intolerance to warm temperatures and excessive sweating
-Frequent and loose bowel movements
What tests should be run to determine thyroid issues?
Most doctors only test TSH, which is the signaling hormone produced by the pituitary, but is not actually a thyroid hormone. This does not show a good picture of what is actually happening with the thyroid. By only running TSH, they are assuming that everything down-stream is working as it should be, as well as the feedback mechanisms back to the pituitary.
They are assuming that a TSH within the standard lab range means everything is a-ok. It is also assumed that a high TSH means that one is hypothyroid (the pituitary is sending the signal to the thyroid to produce more thyroid hormone, and when adequate levels of thyroid hormone are not detected, the pituitary keeps raising levels of thyroid signaling hormone -- i.e. it "knocks louder" -- in an attempt to get the proper response from the thyroid). On the other hand, when TSH is low, it is assumed that one is hyperthyroid.
The following tests should be run to get a clearer picture of what is going on with the thyroid:
-TSH (Thyroid Signaling Hormone released from the pituitary)
-Free T4 (the inactive thyroid hormone, produced by the thyroid)
-Free T3 (the active thyroid hormone, which is converted from T4)
Note that we want to specify "Free" versus "Total" T3 and T4 when requesting these tests. Total shows total levels of the hormone. However, the free levels show us what is available to be used by the body, as some T4 and T3 is bound up by tissues and is, therefore, not available for immediate use.
The next step in looking at thyroid status is analyzing the test results. Simply being "in range" via the lab ranges is not good enough.
Optimal ranges vary, but one of the main resources I use is Stop the Thyroid Madness. You can find their optimal ranges here.
Causes and Next Steps
Once it is determined there is an issue (output type hypothyroidism, conversion type hypothyroidism, hyperthyroidism, autoimmune thyroid disease), the next steps would be to determine what is causing the issue.
Some of the key areas to explore include:
-Poor diet and gut health. Aim for a "whole foods" diet like our ancestors ate. Read more about my take on that subject here.
-Lack of nutrients (minerals and vitamins) needed for either the production of thyroid hormone (T4), or the conversion of inactive T4 to active T3 hormone. Just a few of the minerals and vitamins needed for healthy thyroid function include selenium, iodine, magnesium, iron, potassium, and B vitamins such as B2 and B12.
Please note that I prefer to get vitamins via a well planned, whole foods diet first, with supplementation when that is not possible or sufficient. Also, please note that iodine can be tricky, especially when it comes to those with autoimmune conditions. It is best to find and work with a knowledgeable practitioner.
-Underlying infections such as Lyme & co-infections, Epstein Barr virus, and H. Pylori, just to name a few of the most common ones. These will be discussed in more detail in future articles.
-Toxins, such as heavy metals (mercury amalgams - metal teeth fillings - is one major issue) and / or chemical exposure. Chemical exposure includes high levels of halides (such as fluoride) in our drinking and bathing water, which block iodine receptors in the body (iodine is a crucial mineral for thyroid hormone creation).
-Mold and / or mycotoxin exposure can also wreak havoc on many parts of the body, including the thyroid.
-Adrenal Dysregulation. See my article on this area here.
When beginning a plan to support the thyroid, it is usually best to also support the adrenals before, or at the same time, if there is an adrenal dysregulation issue present. The reason for this is explained above -- the adrenals need to be able to keep up the metabolic pace of the thyroid. If one is working on ramping up metabolism via thyroid support, and the adrenals are not adequately supported, further dysregulation can occur.
-Liver Sluggishness is a common issue in this day and age. The liver is key in the conversion and production of so many of our hormones (including the conversion of T4 to T3), as well as filtering toxins from the blood. For more on supporting your liver, check out this article - here.
One at-home way to check for possible thyroid and adrenal issues is to track your Daily Average Temperatures, or DAT's. I am a huge fan of tracking daily temperatures. This data can tell you a lot about your body and how it is responding to your support plan.
We are aiming for temps right around perfect -- 98.6 F. Unfortunately, most of us have not been taught that having a low body temperature, in the 96's and 97's, can be just as bad, or worse, than having a fever. A low body temperature is a sign of inadequate metabolism, which can cause a weakened immune system and a body that is vulnerable to pathogens. More info on DAT's can be found here and here.
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