Do you have low thyroid?

© 2014 Dr. Sharon Norling

If you have fatigue, weight gain, constipation, fuzzy thinking, low blood pressure, fluid retention, depression, body pain, memory loss, weakness, dry hair, dry pale skin, hair loss, cold intolerance, rheumatoid-like pain and swelling in joints, muscle aches and cramps, irritability, memory loss, abnormal menstrual cycles, decreased libido or slow reflexes, you may have low thyroid function.

Additional symptoms can be elevated cholesterol (generally seen as LDL cholesterol increases), fibromyalgia and easy bruising. I can personally attest to the relationship of low thyroid and high cholesterol. I was diagnosed with high cholesterol with no apparent reason or risk factors. My thyroid levels were borderline low and my doctor didn’t think it was necessary to treat the lower thyroid function because my numbers, although low, were in the reference range “box.” When I persisted and was placed on thyroid medication, my cholesterol dropped 50 points without any other changes.

According to American Association of Clinical Endocrinologist (AACE) President Richard A. Dickey, MD, “Patients who have been diagnosed with high cholesterol should ask their physician about having their thyroid checked. If they have an underlying thyroid condition in addition to their high cholesterol, the cholesterol problem will be difficult to control until normal levels of thyroid hormone are restored.”

Fewer than half of the adults diagnosed with high cholesterol know if they have ever been tested for thyroid disease, despite the well-documented connection between the two conditions. The National Institutes of Health (NIH) and the Food and Drug Administration (FDA) both recommend thyroid testing in patients with high cholesterol levels. The prescribing information for the popular cholesterol-lowering drugs also recommends that patients be tested for thyroid disease before beginning cholesterol-lowering drug therapy.

These are signs and symptoms of low thyroid function. Maybe you have had your thyroid tested and it is “normal.” Many times hypothyroidism (low thyroid function) is misdiagnosed. Let’s look further.

In healthy people, the thyroid makes just the right amounts of two hormones, T4 and T3, which have important actions throughout the body. These hormones regulate many aspects of our metabolism, eventually affecting how many calories we burn, how warm we feel, and how much we weigh. In short, the thyroid “runs” our metabolism. These hormones also have direct effects on most organs, including the heart which beats faster and harder under the influence of thyroid hormones. Optimal thyroid function affects every cell in our body. On a cellular level, there can be no optimal nutrition absorption, detoxification of wastes or stimulation of oxygen consumption without adequate thyroid balance. T3, the active thyroid hormone, is created from T4 in the liver so a healthy liver is important.

The first step is knowing your exact TSH level, and other key thyroid levels such as free T4 and free T3. Keep in mind that a doctor telling you your TSH is “fine” is not enough, because if your doctor is using the old standard normal range of 0.5 to 5.0, you could have a TSH of 4 and be told that you are “normal” but, in fact, your thyroid is not functioning adequately. Many doctors today are following the new, recommended TSH range of 0.3 to 3.0. Free T4 and free T3 should be in the mid range of the reference levels instead of the low end for optimal thyroid function. Thyroid auto anti-antibodies (antibodies directed against the thyroid gland) are important to measure and evaluate in order to balance the person.

More than five million Americans have this common medical condition. In fact, as many as 10 percent of women may have some degree of thyroid hormone deficiency.

Causes

Psychosocial, chemical and physical stressors lower levels of T3, the active thyroid hormone.

You may have heard that foods in the Brassica family such as cabbage, brussels sprouts, broccoli, and cauliflower affect thyroid function. These studies have been done in animals and at higher amounts than we get in a normal diet. Human studies provide no clear evidence that normal intake of these foods induces thyroid abnormalities.

In the United States, the most common cause of hypothyroidism is Hashimoto’s thyroiditis, a condition that causes the bodies defenses ― the immune system ― to produce antibodies that over time destroy thyroid tissue. As a result, the thyroid gland cannot make enough thyroid hormone. Researchers studying Hashimoto’s thyroiditis have found that treatment with the thyroid hormone replacement drug levothyroxine (LT4) can reduce the incidence of Hashimoto’s thyroiditis, as well as help alleviate the symptoms of the disease even if the patient’s thyroid function is normal at the time (Endocrine Journal, 2005).

Other less common causes of hypothyroidism include:

  • Thyroid surgery
  • Radioactive iodine therapy
  • External beam radiation, which is used to treat some cancers, such as Hodgkin’s lymphoma
  • Infections
  • Medicines: Lithium carbonate is one of the most common medicines
  • Disorders of the pituitary gland or the hypothalamus
  • Congenital hypothyroidism
  • Pregnancy: About 2 percent of pregnant women in the United States get hypothyroidism.

Iodine is an essential element that enables the thyroid gland to produce thyroid hormones. The body does not make iodine, so it is an essential part of your diet.

Selenium is a component of the enzyme that helps convert T4 to T3, so deficiencies of selenium may impair thyroid function and promote hypothyroidism. According to the New England Journal, “selenium deficiency can result in thyroid injury and decreased extrathyroidal triiodothyronine production” (reduced T3 production).

Cures

Once placed on thyroid medication, an important step is to determine if you are on the right drug for you. The majority of thyroid patients start out with levothyroxine, a synthetic T4 drug, usually the Synthroid brand. But if you are not feeling well on Synthroid, or another brand you are taking, you may want to ask your doctor about trying a different brand. The brands all have different fillers and binding ingredients and some are more easily dissolved or absorbed than others, so some people find they do better on one brand versus another.

Common natural brand names include Armour Thyroid and Nature-Throid. These are FDA-regulated, prescription drugs — not to be confused with over-the-counter, non-prescription thyroid glandulars available at the vitamin store. Armour Thyroid is a type of hormone that differs from other replacement therapy in that it provides both of the key thyroid hormones levothyroxine (T4) and L-triiodothyronine (T3).

For some people, even if the TSH level is normal, one may be functionally hypothyroid due to the body’s inability to convert circulating T4 thyroid hormone into the active T3 hormone at the cellular level.

Patients may find that adding T3, in the form of Cytomel or via a compounded, time-released T3, to their levothyroxine (T4), resolves symptoms. Others seem to feel best on the natural desiccated T4/T3 drug Armour Thyroid, which has been available by prescription for more than 100 years.

Can you head down to the local health food store, pick up some supplements, make a few dietary changes and fix your thyroid problem yourself? Probably not. Your thyroid hormonal balance is complex. Thyroid hormone is related to and interacts with many other hormones and neurotransmitters. High levels of cortisol and inflammatory markers have been associated with decreased thyroid function.

High levels of cortisol (which can also be caused by high stress levels, low testosterone, etc.) can directly lead to suppression of pituitary TSH secretion, and impair conversion of T4 to T3, and can impair serotonin function. Thyroid function and serotonin activity are highly linked. In hypothyroidism, serotonin production is reduced. Adequate serotonin production is necessary to maintain thyroid hormone levels. Both need to be addressed in order to optimize function.

Treating thyroid alone without balancing other hormones often results in less than optimal results. Appropriate treatment can prevent the condition from progressing and causing more weight gain and atherosclerosis along the way. Untreated or undertreated hypothyroidism can cause infertility, endanger pregnancy, or cause other hormonal problems, such as erratic menstrual cycles or difficult menopause.

Nutrients required for T4 manufacture include:

  • Iodine
  • Zinc
  • Vitamins A, E, B2, B3, B6, and C
  • Nutrients required to convert T4 to the more active T3 are zinc and selenium.

1. If you have symptoms suggestive of hypothyroidism, see a doctor who can perform a comprehensive assessment and order appropriate labs to evaluate your thyroid hormones.

2. Find a doctor who provides you with options to give you the best thyroid balance.

3. Eat healthy foods that support thyroid health.

4. Decrease your stress. Cortisol will be lower and your thyroid health better!

5. Enjoy life! It supports serotonin, the happy calming hormone which supports thyroid!

Written BY: Dr. Sharon Norling, MBA