Dr. Laura: Is Your Thyroid Tired ?

Perhaps your thyroid needs a check-up? It does if you feel sluggish, tired, constipated, have difficult concentration, and are a wee bit depressed.

Subclinical hypothyroidism is when a patient with sluggish digestion, cognition, fatigue and weight issues has a high TSH but normal T4. It is important to look at the reasons for the symptoms, which could have multiple causes, before reaching for the thyroid hormone replacement drug.

Don’t let the sunset on your thyroid…

What nutrients help the thyroid?

Nutrition is a factor. Consider levels of zinc, iodine, selenium and iron as they all play a role in thyroid function. B12 is also an important one to look at and easy to run the labs to determine its status.  Also the health of the gut microbiome and liver needs to be healthy as a large amount of the inactive T4 converts to the active T3 thyroid hormone in the liver and the gut. So many people have issues with the balance in their microbiome.  

Does stress play a role?

Another area of thyroid health to consider is the stress axis. This involves the hypothalamus, pituitary and adrenal, or HPA. Chronic long term stress can make it difficult for optimal thyroid function. In addition to mineral level attention, it is highly important to support the adrenals and provide opportunities for stress management.  

Are there natural thyroid medications?

Finally, there are other options to synthetic thyroid. Natural desiccated thyroid (NDT) may be something to consider if diet and lifestyle changes don’t break through the fog. NDT provides both T4 and T3, which is good if there is an issue with conversion.

How can a naturopathic doctor help?

Naturopathic doctors are medical trained and naturally focussed. They can run labs for the nutrient levels, thyroid stimulating hormone (TSH), T4, T3, and any antibodies to help rule out autoimmune thyroid disease. This helps determine what nutrients might be missing and what foods or nutraceutical dose to suggest and for how long. Naturopathic doctors with education in pharmaceuticals are able to prescribe natural desiccated thyroid. They are also very good at stress management and adrenal (HPA-axis) support with both nutrition, lifestyle and stress management programs.

Dr. Laura M. Brown, ND is a board certified naturopathic doctor with advanced training in pharmaceuticals, functional medicine and stress management. She is a Heart Math Certified Practitioner, a graduate of the Kresser Institute’s Adapt Level 1 functional medicine training and is a Certified Gluten Practitioner.

Dr. Laura: How does your thyroid function?

Feeling tired, loosing hair, bring fog, brittle nails, constipated,  periods heavy and cholesterol rising? Perhaps your thyroid is to blame.

What does thyroid hormone do?

Thyroid hormone keeps:

  • our metabolism humming
  • hair and skin smooth and silky
  • muscles and tendons well lubricated
  • mood bright
  • digestion moving along
  • brain firing on al cylinders
  • LDL cholesterol at healthy levels

How do you measure thyroid function?

General practitioners assess Thyroid Stimulating Hormone (TSH), and if it is out of range, T4 and T3 is measured. Sometimes an ultrasound is done to visualize the size and health of the gland, to assess nodules or help diagnose thyroid cancer.  Naturopathic doctors, functional medicine doctors and endocrinologists will be more likely the ones to run a full thyroid panel (freeT4, freeT3, TSH, TPO, Anti-Thyroglobulin and reverse T3).

How does the body naturally balance thyroid hormone?

T3 is the active hormone in the body and is made from T4. Although the T4 is made in the thyroid, conversion to T3 happens mostly in the liver and the gastrointestinal tract.   A normal functioning thyroid gland works with the hypothalamus in the brain using a negative feedback system to indicate when there is enough active thyroid hormone in the system.

How does the medical doctor balance thyroid?

Traditionally synthroid or levothyroxine is prescribed to treat inadequate levels of thyroid hormone and treatment is geared to reach a desired TSH level. Direct T3 therapy (Cytomel) is rarely prescribed due to lack of research and clinical experience. Typically the family doctor will  treat to normalize the TSH, but recent research, and numerous patient complaints may indicate that this is not enough.

More research is required to support T4 and T3 combination therapy, whether it is levothyroxine plus cytomel or natural desiccated thyroid, alone or in combination.

Research finds TSH monitoring is not enough to determine adequate thyroid functioning and some medical doctors agree a 4:1 ratio of T4:T3 predicts patient satisfaction and better health.

What does the naturopathic doctor do to balance the thyroid?

Naturopathic doctors seek to support the thyroid in making T4 and the body’s ability to convert the T4 to the active form of thyroid known as T3.   A naturopathic doctor offers support to people on pharmaceuticals like synthroid or levothyroxine, and is also able to additionally or solely prescribe advice for nutraceutical  support and natural desiccated thyroid.

A naturopathic doctor will:

  • look at the full thyroid panel
  • adrenal health
  • cholesterol panel
  • sex hormone health
  • the function of the liver
  • health of gastrointestinal tract,
  • nutrient balance of things like selenium, zinc, iron and iodine

How is cholesterol linked to thyroid function?

T3 levels are also inversely linked to LDL Cholesterol. When thyroid levels are low, LDL cellular reception is reduced, leaving more LDL in the blood stream.  Emerging research finds treatment with T4 alone (synthroid, levothyroxine) does not always correct the high levels of cholesterol induced by poor thyroid function. Rising levels of LDL cholesterol in peri-menopausal women with symptoms of fatigue should trigger an investigation into the balance of T4 and T3, not just TSH.

What drives T3 levels down?

  • Body shuttles T3 to reverse T3 in times of starvation and stress
  • Poor feedback function in the hypothalamus
  • Thyroiditis
  • High levels of natural and environmental estrogens
  • Epstein Barr Virus

T3 levels are increasingly challenged as xenoestrogens (environmental contaminants) rise in developed countries.  Peri-menopausal women also experience challenges. This is because estrogen (unopposed by progesterone as ovulation slows down), or estrogen mimickers like xenoestrogens (from plastics, pesticides and insecticides) have the ability to bind up Thyroid Binding Globulin and somehow affect the T4 to T3 conversion ratio. Some research points to Epstein Barr Virus impacting the genome and ultimately the function of the thyroid.

For more help optimizing your thyroid function, book an appointment with Dr. Laura M. Brown, ND.

 

Dr. Laura: Is your thyroid to blame?

One in eight women will develop thyroid disease in her lifetime and 15 Million women have a dysfunction, but don’t even know it. Men can have issues too, although at a less rate than women.

Environmental toxins are largely to blame for the rising rates of thyroid disease. Years ago, it was mostly iodine deficiency and this is why iodine was added to salt. Now we point the finger more often at the rising rates of hormone mimickers in our environment like BPA’s and their alternatives in plastics, cadmium, circadian light disrupters, pesticides, herbicides and more.

Untreated thyroid dysfunction can lead to feelings of:

  • Fatigue and exhaustion
  • Brain fog, difficulty focusing thoughts
  • Unexpected weight gain, and with it increased risk of obesity, diabetes, and heart disease
  • High LDL cholesterol – the thyroid plays an important role in fat metabolism
  • Depression – as many as 15% of women on antidepressants have an undetected thyroid problem as the root cause of their depression –but their problem hasn’t been fully investigated. When I check thyroid I check more than the TSH (thyroid stimulating hormone).  I look sub functioning gland by checkin TSH, T3, T4, thyroid antibodies and look for how well cortisol is clearing on the DUTCH hormone test.
  • Anxiety – often because cortisol is not clearing
  • Increased risk of cardiac arrhythmias and congestive heart failure due to the regulatory control of this hormone has on heart rate and rhythm.

Troubles in the digestive track and liver can lead to poor activation of the T4 to T3 hormones. When I work with patients I am always looking for clues in the skin, stress, and sleep and how well the micro biome functions. A good clue to micro biome function is the Comprehensive Stool Analysis by Doctors Data.

If you suspect you may have a thyroid issue, get it tested!  I’ll look at results from a functional medicine perspective, which mean optimal performance, not disease levels of lab markers.

From the heart and research of Dr. Laura M. Brown, ND.