The thyroid gland is one tricky customer. Once disturbed, it’s the devil to restore to its preferred state of hormonal harmony. The thyroid gland is your body’s internal thermostat, responsible for regulating temperature as well as governing metabolism. It does this by determining how quickly or slowly cells use and produce energy, the implication of this means that thyroid hormones affect all bodily functions. Hypothyroidism or low thyroid function is one of the most common hormonal deficiencies, especially for women.
The classic sign of hypothyroidism is a goitre, or a swelling of the thyroid gland, which appears like a bulge or lump in the neck. However, many symptoms of low thyroid activity are less obvious and include one or more of the following: – Puffy face and lips. – Dry skin. – Dry and thickened skin on shins. – Thinning hair. – Thinning of outer third of eyebrows. – Cold hands and feet. – Increased intolerance to cold temperatures. – Constipation. – Hoarseness of voice. – Depressed mood. – Poor concentration. – Fatigue. – Weight gain. – Difficulty in losing weight. – Decreased libido.
What causes it?
- Hashimotos thyroiditis (a common form of hypothyroidism) is an auto-immune condition. Like many auto-immune conditions such as MS, RA, Hashimotos thyroiditis is thought to be hereditary, but its genetic manifestation will only likely appear after it has been triggered by an event such as a period of high stress or infection.
- After childbirth is a common time for this hypothyroidism to appear, called post partum thyroiditis, quite possibly precipitated by the unborn babies extra requirements for iodine, and or the extra stress on mother’s body.
- Inadequate dietary intake of iodine is a major cause of hypothyroidism as the thyroid hormones require the mineral iodine, and if it’s not in the diet, it’s not available for thyroid hormone creation.
- Certain medications including lithium can interact with iodine levels.
- Past exposure to chemicals and pesticides.
- Radiation exposure.
- Stress. All the endocrine (ductless) glands are interconnected. Increased cortisol levels (the adrenal stress hormone) is implicated in lowering thyroid hormone function.
- Chronic infection or inflammation may precipitate hypothyroidism
Hypothyroidism is common in areas where there is little or no iodine in the soil. No iodine in the soil, means no iodine in the food crops grown from this soil. Iodine deficiency is a common nutritional deficiency and acknowledged as a major public health concern. Not only can it cause hypothyroid disease, low iodine levels during pregnancy negatively impacts on the intellectual development of the unborn child. Public health policies in the past have been to ‘iodise’ salt, and more recently iodine has been added to bread (except organic bread). A recent spike in hypothyroid cases may be attributed to two arbitrary causes. Alongside the emergence of the foodie culture, many consumers are opting for fancy pants rock or sea salt in preference to daggy old iodised salt. Additionally, milk has historically been ‘accidental’ source of iodine in the diet. Iodine is not normally found in large amounts in any dairy products. However, in a case of a happy incidental contamination, until recently dairy equipment was sanitised with iodine containing cleaning products, and so tiny amounts of iodine found its way into dairy foods. Dairy equipment is no longer cleaned in this way, meaning dairy foods have returned to their low iodine status.
Testing thyroid levels
The standard blood test for ascertaining thyroid function is to look for levels of TSH (thyroid stimulating hormone released by the pituitary gland) and T4 and T3 (thyroid hormones). T4 is converted to T3 by the loss of an iodine molecule and T3 is the more active form of the hormone. This occurs in the liver, muscles and kidneys and requires the presence of selenium and zinc. If there are low levels of thyroid hormone, the pituitary gland will increase TSH in order to stimulate the thyroid gland into producing more thyroid hormones.
If TSH is high and thyroid hormones are low, the diagnosis of hypothyroidism is made. In this case, thyroid hormones (throxine) will often be prescribed in order to re-establish hormonal order. However, in some cases TSH will be in the normal range, as will T3 and T4. Yet, there are still signs and symptoms of low thyroid hormones (mentioned above.) It is believed that during some illnesses and times of stress, another form of T3 is produced, known as reverse T3 or rT3, along side plain old T3. rT3 is less active than T3. Normal blood tests for thyroid hormones don’t look for the ratio of rT3 to T3 and it will seem that levels are normal, even though there may be symptoms of low thyroid activity. Certain laboratories do perform this test of rT3.
One low-tech method for ascertaining whether your might have low thyroid hormone levels is to chart your basal or resting body temperature. As mentioned previously, the thyroid gland is the body’s thermostat, regulating temperature. Known as the Barnes Basal Temperature Test, you simply record your temperature for 5 days in a row, and take an average of the readings. If you record an average temperature under 36.6 degrees Celsius it may be an indication your thyroid hormone levels are low and to seek advice from your health practitioner.
- Leave a thermometer next to your bed.
- First thing in the morning, as soon as you wake and before you get out of bed place a thermometer under one armpit.
- Leave it there for a full 10 minutes.
- Record your results for 5 days in a row. Then take an average. (Divide the sum of five readings by five). - For women, start on day 2 of your menstrual cycle (second day of period).
- An average reading of below 36.6 C may indicate low thyroid hormone levels
Behind the scenes
The thyroid gland is an endocrine or ductless gland, meaning it secretes its gear inside the body (for example, adrenal glands) compared to exocrine glands, which excretes outside the body (for example, sweat glands). The endocrine glands, which include pituitary, pancreas, ovaries, testes, thyroid and adrenal glands are intimately connected. When something goes awry with one gland, this will impact on all the others. The treatment implication is two fold. Firstly, tread carefully and slowly. Making small changes is the best way to treat this little gland. And secondly, by supporting other endocrine glands, this will have a positive impact on the others. In the case of the thyroid gland there is a special relationship with the adrenal glands, the glands that deal with stress. It is not uncommon, after a period of stress, and increased production of the stress hormones, adrenaline and cortisol, the thyroid gland can ‘act up’. By addressing the initial cause, and pacifying the adrenal glands, this is likely to calm the thyroid gland and reverse symptoms.
What to do?
As the thyroid is so sensitive, and has the potential to swing from an underactive to overactive state, it is wise to seek advice from your health practitioner before embarking on any course of treatment.
- Increase food that is high in iodine, including shellfish, marine fish, seaweed, egg yolk, iodised salt (unless you have high blood pressure, when increasing salt is not advised).
- There appears to be a connection between thyroiditis and gluten intolerance. It is worthwhile going gluten free for a month to see if this helps with your symptoms.
- Goitrogens (named after the symptom of goitre) are substances that prevent iodine from being utilised by the thyroid gland. Goitrogens are found in the Brassica family including broccoli, Brussels sprouts, kale, cauliflower, turnips, radishes, horseradish mustard greens and rutabaga. Also found in soybeans, cassava root, peanuts, pine nuts and millet. Goitrogens are only active in food eaten in the uncooked or raw state and cooking inactivates goitrogens.
- Increase foods containing zinc, selenium and vitamin A to improve conversion from T4 to active T3. (See Appendix XX for list of these foods.)
- Herbs that increase thyroid activity include bladderwrack, withania and coleus.
- Take a supplement that includes iodine, selenium, vitamin A and zinc.
- Stress is often the trigger to unbalance thyroid function. The anti stress, adaptogen herbs are useful in long term balancing of the endocrine glands, including the thyroid. Rehmannia, Withania, Rhodiola, licorice.
- A and B Complex will help you cope with stressful times.
- To check whether your thyroid function may be low, chart your basal temperature. (See breakout box above.)
- Stress needs to be kept under control. Take regular exercise and incorporate stress-relieving activities such as meditation, knitting, Tai chi or playing or listening to music.
At a glance
- Thyroid hormones need iodine, eat iodine rich foods including shellfish, marine fish, seaweed, egg yolk and iodised salt.
- Trial a gluten free month. Evidence suggests a connection between gluten intolerance and thyroiditis.
- Boil your vegies, at least the ones containing goitrogens. Goitrogens prevent iodine from being used by the thyroid gland to create thyroid hormones. Goitrogens are found in the following foods broccoli, Brussels sprouts, kale, cauliflower, turnips, radishes, horseradish, mustard greens and rutabaga. Also found in soybeans, cassava root, peanuts, pine nuts and millet. As cooking inactivates goitrogens, so avoid eating any of these foods in their raw or undercooked state.
- Several herbal remedies assist the thyroid gland to produce thyroid hormones, these include bladderwrack, withania and coleus.
- Take a supplement that contains iodine, selenium, vitamin A and zinc.
- Chart your basal temperature to assess whether you might have low thyroid levels.
- Music, meditation, exercise, whatever it takes for you to lower your stress levels. Stress is the great thyroid unbalancer.