Thyroid Series Part 1: Your Thyroid 101
This is the first of a series of blog posts about one of my most frequently discussed hormonal health topics with patients – the thyroid. It’s a complicated topic, and I find that it is commonly misunderstood by many patients. Given the thyroid’s important role in every single cell in the human body, it can affect every aspect of our health. Today’s discussion is meant to familiarize you with the thyroid gland and what it does. We’ll pick up next time with a nuanced dive into thyroid testing, and follow that with how natural medicine can be used to support healthy thyroid function.
Your Thyroid 101
The thyroid – a small butterfly-shaped gland that sits at the base of your neck, just above the little hollow between your collarbones, and has a role to play in nearly every aspect of your health. At it’s essence, thyroid hormone is essential for normal growth, development, neural differentiation and metabolic regulation in humans. Although it is small, it’s one of the most frequently discussed hormonal glands in my office. Thyroid hormones can assist on your path toward balanced health, enhance your fertility, and optimize the aging process, or it can just as easily drive you toward dysfunction. Quite literally all cells in the human body sport thyroid hormone receptors: your heart, your muscles, your ovaries, and your skin cells all respond to thyroid hormone.
Here’s a common scenario. A 36-year-old patient comes into my office feeling tired. She’s 15 pounds overweight and no matter how clean she eats or how vigorously she works out, she just can’t shake the extra weight. She is tired easily and feels like she has to nap in the afternoons, even though she’s in the middle of meetings at work. This patient and her partner have been trying to get pregnant for the past 12 months, without any success. She’s noticed diffuse hair loss from her scalp in the past few years, and she only has a bowel movement once every other day. Her GP tested her TSH, which was a little high but considered in the ‘normal’ range. Her doc then prescribed antidepressants, after she complained of fatigue, lack of motivation, and occasional bouts of depression. But before taking them, this patient came to us at Acubalance to see if she could turn things around with natural medicine. She was hopeful as we discussed the ins-and-outs of thyroid testing, and started to have a deeper look at exactly how her body was responding (or not responding) to her thyroid.
Thyroid dysfunction is pretty common, yet it is estimated that about 60% of people who have thyroid dysfunction (like the patient above) aren’t aware of it. Women are more prone to hypothyroidism, and it is more common that the thyroid becomes dysfunctional as we age.
One of the many problems with diagnosis is that the symptoms of inappropriate thyroid hormone levels can involve so many systems of the body. Unlike diagnosing asthma based on respiratory function, if the thyroid is under- or over-producing hormones, the symptom picture is variable and can be vague.
Some of the symptoms people with low thyroid experience are: weight gain, fatigue, low moods, anxiety, infertility, cystic acne, dark circles under the eyes, hair loss, dry skin, constipation, muscle and joint pain/stiffness, brittle fingernails, puffiness in the neck, reduced ability to sweat, high cholesterol, hypoglycemia, headaches heavy and/or irregular menstrual periods, and water retention. You may have one, or several, of these symptoms if you have a low functioning thyroid. It’s not hard to imagine that low thyroid is often misdiagnosed as arthritis, depression, adrenal fatigue, or something else entirely.
Some patients experience symptoms of over-production of thyroid hormone. Although less common, hyperthyroidism often looks like: unexpected weight loss, sudden onset diarrhea, irritability, increased sweating, insomnia, anxiety and panic, hair loss, sensitive to heat, shortness of breath, palpitations, irregular menses, difficulty concentrating, increased metabolism and appetite, and protruding eyes.
Furthering the problem is the fact that the test for thyroid hormone that is most frequently done (TSH) doesn’t tell doctors the whole picture. We’ll discuss this more in future blogs, but for now let’s chat about how the thyroid works.
How Your Thyroid Works
Thyroid hormone production is under the control of the brain. Similar to how the body knows to produce cortisol, estrogen, or testosterone, it all starts in the hypothalamus – a master sensing area of the brain. The hypothalamus takes in information about what is going on in the body, and directs appropriate hormonal responses. When it senses a need for more thyroid hormone, it releases thyrotropin-releasing hormone (TRH) to be sent to the pituitary. The pituitary gland (also in the brain) is stimulated by TRH, and responds by producing thyroid-stimulating hormone (TSH). When things go off without a hitch, your thyroid then produces a pro-hormone called thyroxine (T4), which gets transported to your cells and turned into the active form of thyroid hormone, triiodothyronine (T3). Once the cascade is complete, the cells in the body bind and respond to T3, which is responsible for the following actions:
-regulates your heartbeat
-keeps you warm, regulates your body temperature and sweating reflex
-grows hair and nails
-induces turnover of dying cells into new healthy cells
-reduces the pain sensation
-moves the bowels
-improves your fertility
-makes you feel happy and content
In short, thyroid hormone (T3) makes you feel healthy, vibrant, and makes you fertile.
What this also means is that if you have a problem with making T4, converting it to T3, delivering T3 to the cells, or the cells binding and being able to use it – you don’t feel healthy, vibrant or fertile. There are a lot of things that have to come together in order to get proper thyroid hormone response in your cells – and many ways that this cascade can be blocked.
To start, nutrient deficiencies of iodine and minerals reduce T4 production by the thyroid as it runs out of building blocks. Further deficiencies in vitamin D, B vitamins and minerals like selenium can inhibit T4 to T3 conversion, as can bacteria that live in the intestinal tract, if they’re not the right type. Inflammation and stress block T4 to T3 conversion, and can also result in T4 getting converted to an inactive version of hormone called ‘reverse T3’ (rT3 for short). This ‘evil twin’ of T3 antagonizes T3 activity – it looks like T3 to the cells in the body, but actually lowers thyroid hormone activity instead of increasing it. You need some rT3 to keep T3 in balance (too much T3 isn’t good either), but if you have too much rT3, your cells can suffer for lack of active T3.
The good news is that natural medicine has an incredibly comprehensive toolkit for thyroid dysfunction. Your diet and lifestyle hugely affect your thyroid – either helping or hindering it. Vitamins, minerals, herbal therapy and acupuncture work wonders for regulating thyroid hormone production and cellular response. And I see men and women every day in my practice that experience remarkable improvements in their quality of life, their vitality, and their fertility when we address thyroid appropriately.
If you have concerns with the way that any of the above body systems function, it may be useful to look more deeply at how your thyroid is functioning. But don’t rush off and just get a TSH – that’s not going to tell you the whole picture. The next blog I’ll be releasing will be an in-depth look at thyroid hormone testing, and why you’ll want to do more than just a TSH to know the whole story.
Dr Kali MacIsaac HBSc ND