Updated: Apr 26, 2019
Feeling tired for seemingly no reason at all…trouble losing weight…dry skin…hair falling out…constipation. These are the classic symptoms of an under-active thyroid—also called hypothyroidism.
What is the thyroid?
The thyroid is a butterfly-shaped gland located just below the surface of the skin in the front of the neck. If you place your fingers on the front of your neck, you can feel the thyroid move up and down each time you swallow.
The thyroid is responsible for making thyroid hormone, in the form of thyroxine (T4) and triiodothyronine (T3). All of the hormones involved in producing thyroid hormone are shown in the image. The hypothalamus (a master gland within the brain) produces TRH (thyrotropin-releasing hormone), which triggers the pituitary to produce TSH, which triggers the thyroid to produce T4, which circulates throughout the body and is converted to T3 in the liver, gut, skeletal muscle, brain, and thyroid gland itself.
What does thyroid hormone do?
Thyroid hormone, above all, regulates metabolism. Thyroid hormone increases the rate at which you burn food for energy. That is why two of the most common symptoms of an underactive thyroid are fatigue and weight gain.
What causes hypothyroidism?
There are many possible causes of hypothyroidism. The most common cause is an autoimmune disease called Hashimoto’s thyroiditis. In Hashimoto’s, the body creates antibodies that attack the thyroid, damaging its ability to produce adequate T4 and T3. Other causes of hypothyroidism include nutrient deficiencies, systemic inflammation because of food reactions, lifestyle habits like under-eating and over-exercising, or exposure to toxins like heavy metals.
How do I know if I have hypothyroidism?
If you go to your doctor for annual physical exams, one of the routine screening tests is a blood test for TSH. Elevated TSH is the first clue to your doctor that you have an underactive thyroid. Your may also evaluate levels of T4 and T3. It is important to know if your body is effectively converting thyroid hormone into T3, which is about 5 times as active as T4. Further checking antibody levels to determine if you have autoimmune Hashimoto’s thyroiditis may be appropriate.
What is the holistic treatment for hypothyroidism?
Once you are diagnosed with hypothyroidism, the standard treatment is a prescription for thyroid hormone replacement. Your blood levels of TSH will be monitored to determine the right dosage over time.
From a holistic perspective, there are many more treatments we can use in addition to thyroid hormone replacement. Depending on the underlying cause, we would consider some of the following therapies:
- Iodine. Iodine is a mineral that is required for the production of thyroid hormone. Iodine is considered an essential nutrient, meaning that your body cannot make it and you must get it from food. Iodine deficiency was common until the routine fortification of table salt with iodine (iodized salt). In recent years, however, many health conscious individuals have either decreased their intake of salt or switched to various forms of sea salt. Sea salt is packed with minerals, but it is not fortified with iodine and does not supply an adequate amount to prevent deficiency. Besides iodized salt, other foods that are high in iodine include saltwater fish, shellfish, and seaweed.
- Selenium. Selenium is required for the conversion of T4 to the more active T3. Just like iodine, selenium is an essential mineral that must be provided by the diet. Studies have shown that selenium supplementation improves thyroid function and reduces antibody production in patients with Hashimoto’s thyroiditis.[1] One of the best food sources of selenium is Brazil nuts, which pack a dose of about 200mg of selenium in just 3 nuts.
- Vitamin A. Vitamin A has a synergistic relationship with the thyroid: vitamin A regulates thyroid hormone metabolism, and thyroid hormone is required for the synthesis of vitamin A from beta carotene in foods like carrots and sweet potatoes. Vitamin A deficiency is common in people with an underactive thyroid, and supplementation has been shown to improve thyroid function.[2]
- Gluten-Free Diet. People who have the most severe reaction to gluten (celiac disease) also have a greater risk for Hashimoto’s thyroiditis and other autoimmune conditions.[3] Less severe forms of gluten sensitivity can also create inflammation in the body. More inflammation means worse control over autoimmune disease—a big problem for patients with Hashimoto’s thyroiditis.
- Leaky Gut Protocol. Disruption in the healthy barrier of the intestines results in larger food particles and toxins passing into the body’s circulation, leaky gut syndrome. This aggravates the immune system, causes inflammation, and worsens autoimmune diseases like Hashimoto’s. You can read more about the link between leaky gut and autoimmune disease here.
- Avoidance of Toxic Exposures. The thyroid gland is particularly susceptible to damage from environmental toxins like plastics, heavy metals, and even chlorine in tap water and showers. You can read more about the link between hypothyroid and endocrine disruptors like plastics here.
Every person is unique. If you are concerned about symptoms of hypothyroidism, work with a functional medicine provider to determine the underlying cause of your symptoms. Create a plan that might include prescription thyroid hormone, nutritional supplements, and dietary changes.
References
[1] Turker O, Kumanlioglu K, Karapolat I, Dogan I. Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses. J Endocrinol. 2006;190(1):151-156.
[2] Farhangi MA, Keshavarz SA, Eshraghian M, Ostadrahimi A, Saboor-Yaraghi AA. The effect of vitamin A supplementation on thyroid function in premenopausal women. J Am Coll Nutr. 2012;31(4):268-274.
[3] Diamanti A, Capriati T, Bizzarri C, et al. Autoimmune diseases and celiac disease which came first: genotype or gluten. Expert Rev Clin Immunol. 2016;12(1):67-77