HypothyroidismI see many women patients who are concerned with symptoms such as depression, mood swings, irregular heartbeat, fuzzy thinking/memory challenges, declining libido and fatigue. Many think that their hormones may have something to do with it and they are often right as these are common symptoms of PMS or hitting menopause.

However, if we dig deeper and I discover rapid weight gain for no reason, cold intolerance or feel the cold more, constipation, and hair loss then it alerts me that a woman might be experiencing low thyroid function (hypothyroidism).

The problem is that hormonal imbalance symptoms and low thyroid function symptoms can be exactly the same AND can trigger each other. And because of this a thyroid problem may not be picked up straight away, putting the issue down to PMS or perimenopause. Although a basic thyroid test may be carried out, it may not pick up the imbalances or be acted upon (especially if in the first instance only TSH is tested and not T3 and T4) until symptoms become more severe

As thyroid problems become more and more common in New Zealand, with a whopping estimated 10% of adults with some degree of underactive thyroid, let’s explore why your thyroid may be causing a whole heap of health issues, including weight gain, how you can detect if you have an underactive thyroid and what you can do about it.

 

What does the thyroid gland do?

thyroidThe thyroid gland is a small butterfly-shaped gland found in the throat. The thyroid produces thyr
oid hormone (TH), an important regulator of the body’s metabolism. Too much TH speeds up the body’s metabolism – increasing heart rate and temperature. Too little TH causes the body to slow down – causing one to feel tired or cold. Abnormal levels of thyroid hormone affect all aspects of physical, mental and emotional wellbeing, and untreated thyroid disorders can be fatal.

New Zealand’s Iodine story

Iodine is an essential ingredient in all thyroid hormones and the thyroid cannot function in an iodine deficient state. The sole function of the thyroid is to make thyroid hormone. And as we have said, this hormone has an effect on nearly all tissues of the body where it increases cellular activity.

New Zealanders have about 50% of the daily requirements for iodine

Like other countries iodine deficiency has led to health problems in New Zealand. In the late 1800’s and early 1900’s goitre was very common and in 1924 Iodine was added to table salt to increase iodine in people diets.

Yet, now iodine deficiency is re-emerging with estimations that most New Zealanders have about 50% of the daily requirements for iodine and a presence of mild iodine deficiency.

It is widely known that iodine deficiency causes goitre and may lead to hypothyroidism but because the thyroid has a major part to play in the body, and the adrenal and thyroid glands interact to regulate weight, energy, blood sugars, neurotransmitters, sex hormones, inflammation and immune function, low iodine leading to thyroid disorders may play a part in  autoimmune disorders. These include Graves and Hashimotos disease.

Hypothyroidism can lead to increased cardiovascular and diabetes risks, fertility and pregnancy issues, neurological risks, mental and emotional problems such as anxiety and depression and an increased risk of Alzheimer’s. The decreased metabolic rate in people with hypothyroidism is associated with weight gain and obesity.

Why are more New Zealanders becoming iodine deficient?

Iodine is naturally found in fish, seaweed, shellfish and to some extent eggs, dairy, meat and iodised salt. But iodine deficiency is on the rise due to the increased consumption of commercially prepared foods, the reduced use of iodised salt and the reduced use of iodine in sanitisers in the dairy industry.

So, what else may cause an underactive thyroid?

One of the most common causes of hypothyroidism is Hashimoto’s disease, an auto-immune disease in which the immune system attacks the thyroid gland, inhibiting its function, reducing its secretion of hormones, and destroying thyroid tissue

Other factors that can inhibit thyroid function include:

  • Iodine deficiency (as discussed above). Other nutritional deficiencies may also be involved, including zinc, selenium, copper, and vitamins A, C, D and E
  • Poor digestive function
  • Poor diet (e.g. excessive consumption of saturated fats)
  • Viral infections
  • Food allergy and/or intolerance
  • Stress
  • Sedentary lifestyle
  • Exposure to radiation from x-rays, especially around the throat area
  • Exposure to toxins (e.g. alcohol, pesticides)
  • Treatment for over-activity of the thyroid gland (hyperthyroidism) and thyroid cancer
  • Some prescribed medicines (e.g. lithium)
  • Pituitary gland or hypothalamus dysfunction, which can interfere with the signals that tell the thyroid to produce T3 and T4

Can anyone get an underactive thyroid?

Many people, mainly women older than age 40, have an under-active thyroid. Many women may become hypothMen can also get hypothyroidism. Because hypothyroidism usually develops slowly, only about half of all cases are diagnosed early.
  NZ’s prevalence is partly due to low selenium levels in the soil.
  About 15% of women aged 35 to 60 are affected to some degree by hypothyroidism.
  15% – 20% of women over the age of 60 are affected by sub-clinical hypothyroidism.
  50% of people who have it are unaware that they have hypothyroidism.

Most sub-clinical cases of hypothyroidism go undiagnosed. When blood levels of thyroid hormones are found to be normal, the patient is deemed to be “euthyroid”, or having a normal functioning thyroid (inspite of having signs & symptoms). Hypothyroidism is believed to be more prevalent than once thought, with up to 1 in 10 of the population is believed to be affected by some degree of hypothyroidism.

So, how do you know if you have Hypothyroidism?

At first, you may have few noticeable symptoms, or you may just feel tired and sluggish. The signs and symptoms of hypothyroidism vary widely, depending on the severity of the hormone deficiency.

Do you suffer from any of the following? Rate each of the symptoms below from a scale of 0-3 (o-none, 1-mild, 2-moderate, 3-severe)

 Symptom 0-none 1-mild 2- moderate 3-severe Total
Tiredness and sluggishness
Skin is dry, cold, rough and scaly.
Sleep more than usual
Weaker Muscles
Constant feeling of cold
Frequent muscle cramps
Poorer memory
More depressed
Slower thinking
Gritty, burning, itchy, blurry eyes or puffy eyelids.
Cholesterol elevated: unexplained high or resistant levels.
Hoarser or deeper voice
Constipation
Coarser hair/hair loss
Muscle/joint pain
Low sex drive/impotence
Puffy hands and feet
Unsteady gait
Gain weight easily
Eyebrows thinning, losing outer 1/3 of eyebrow.
Menses more irregular or heavy
Difficulty sweating
TOTAL SCORE

If your score is over 8 then you may have hypothyroidism

How is Hypothyroidism diagnosed?

The most common traditional way to diagnose hypothyroidism is with a TSH that is elevated beyond the normal reference range. The big myth that persists regarding thyroid diagnosis is that an elevated TSH level is required before a diagnosis of hypothyroidism can be made. There is no question that this will diagnose hypothyroidism, but it is far too insensitive a measure, and the vast majority of patients who have hypothyroidism, particularly those patients who are classified as sub-clinical, will be missed. If you suspect that your thyroid is imbalanced then persist and see what you can do to make a diagnosis.

What you can do?

  1. Measure your temperature
    There is one simple thing almost anyone can do at home to uncover an under- functional thyroid: take your own temperature. Because thyroid hormone is so vital to cellular metabolism, reduced thyroid function manifests as a drop in body temperature to below the normal level of 36.7 C (98.6F). Use a digital thermometer, and measure your temperature before you get out of bed, every morning for a whole month. The normal temperature on rising will be between 36.4 Centigrade to 36.9 Centigrade. If your temperature is 36.1 Centigrade or less for 3 to 5 consecutive days, one could conclude that the thyroid function is fairly compromised. You may have hypothyroidism. However, it could also indicate adrenal fatigue or exhaustion. Head for your Naturopath or nutritionally oriented GP.

    So even if you have had a blood test and were told you did not have a low thyroid reading, you might go back and look at the results again. You may find that your blood levels of thyroid hormones are actually low normal. Many people who are within the so-called “normal” range but below the midpoint could benefit tremendously from thyroid treatment.

  1. Hair analysis
    Hair analysis is an excellent way to determine your level of iodine, selenium, zinc, which are critical in thyroid hormone metabolism. Hair is also a good screening tool for the presence of heavy metals such as lead, mercury, arsenic or cadmium, all which may bind with selenium, reducing the amount available to convert T4 (the inactive hormone) to T3 (the active form), remembering that selenium is already in short supply due to deficiencies in the average NZ diet. Many people present to their doctors and naturopaths with frank mineral deficiencies, a simple test such as a hair analysis can help pinpoint the problem.

 

How is a Hypothyroid treated?

Medical treatments include medication, surgery and radioactive iodine. Although some people go into remission (euthyroid) where thyroid levels are stable, a significant proportion of people with thyroid disorders are on medication for life.  Levothyroxine (also known as thyroxine) is widely used in New Zealand with approximately 70,000 patients prescribed it. Whole thyroid is another more natural option.

Natural Thyroid Management
Iodine: It is estimated the thyroid gland must capture approximately 60 mcg iodide daily to ensure an adequate supply for thyroid hormone synthesis. Ensure you eat sea minerals or have seafood in your diet. Kelp is a good source of iodine. If you take a look at the MOH (NZ Ministry of Health) website you will even find references to the government’s concerns that our children are not getting sufficient iodine in their daily NZ diet. The answer? Supplement. Give your children a good children’s multi vitamin & mineral daily. Ensure they have sufficient iodine in their diet, give them sea salt (with iodine) and not ‘table salt’ which has been iodine enriched.

Although doctors generally recommend synthetic thyroxine (T4) for hypothyroid, it is important to remember that you do have options, you can take charge of your health and what you take, and do not necessarily have to stay on prescribed thyroxine for life. Natural treatment options are now available for the natural hormone management of thyroid conditions.

This is one condition I would not give advice regarding what to take, without consulting with the patient on an individual basis. I would never recommend self-medication when it comes to the thyroid, it is always best to consult your health-care professional. You nutritionally-oriented Doctor or Naturopath can best help you with your natural treatment of hypothyroidism. Contact me to find out more.

Nutritional & Herbal Support

Our aim is to treat the cause as well as the symptoms. These may be prescribed

  • Iodine is the key nutrient for thyroid function, and is involved in the manufacture of T3 and T4. Kelp is a natural source of iodine
  • A special healthy thyroid function support nutrient formula including vitamins A, D and E, and the minerals selenium, copper and zinc, as well as tyrosine which are involved in the production and utilisation of thyroid hormones.
  • Omega-3 fatty acids from fish oil, salmon oil or flax seed oil help to maintain the integrity and fluidity of cell membranes, including those in the thyroid gland
  • Herbal formulas. Often we need to treat thyroid imbalance causes first, including infections ans stress. Herbal formulas prepeared specifically for you by a qualified herbal practitioner are amazing

Diet & Lifestyle

  • Underactivity of the thyroid is a complex condition, but often responds well to natural therapies. In many cases we will recommend you stick to a low glycaemic index (GI) diet that includes slow-burning carbohydrates (such as oats and legumes) to help you manage your weight, energy and blood sugar levels. At the same time, you will be advised to avoid high GI carbohydrates such as sugars, wheat products (e.g. bread), and potatoes, which are metabolised quickly, leading to energy slumps and blood sugar fluctuations
  • Consider allergy or intolerance testing.
  • Include plenty of fresh fruit and vegetables in your diet. Choose organic where possible to avoid exposure to pesticides and other toxins, which may be implicated in thyroid problems by interfering with the body’s detoxification mechanisms and/or triggering auto-immune problems
  • Eating seafood, seaweed and small quantities of iodised salt will help to ensure you obtain iodine in your diet. Other important foods to include in your diet include Brazil nuts (an excellent source of selenium), sesame seeds and tahini (which provide zinc, copper, tyrosine and vitamin E) and other nuts and seeds, including pumpkin seeds and cashews
  • GoitrogensSome foods contain compounds called goitrogens, which bind to iodine and interfere with the production of thyroid hormones. These foods include broccoli, cauliflower, turnips, cabbage, mustard greens, spinach, radish, Brussels sprouts, kohlrabi, and horseradish. It is advisable to avoid eating these foods raw, however small quantities of cooked goitrogen-containing foods should not pose a significant problem, as the goitrogens are inactivated by heat
  • Limit your consumption of apples, walnuts and almonds too, as these contain thiocyanates, which impair iodine concentration
  • Regular exercise and activity are important for energy levels, and can also help to improve stress levels, low moods and depression and weight. Exercise stimulates thyroid hormone secretion, increases tissue sensitivity to thyroid hormone, and prevents decline in metabolic rate in response to weight loss diets. Even a brisk 30-minute walk has health benefits, but other options include swimming and going to the gym. Yoga may have particularly beneficial effects via increased circulation and stimulation of the thyroid gland, and due to its stress-reducing actions
  • Stress may contribute to suboptimal thyroid function. Learn and practice meditation or relaxation techniques in order to improve your ability to cope with stress
  • Don’t smoke – it decreases the secretion of thyroid hormones as well as their actions in the body. Alcohol and recreational drugs should also be avoided

What now?
Contact Sheena Hendon and depending on the severity of symptoms and further discussion we will be able to suggest next steps – from further tests to prescribing supportive nutrients for a healthy thyroid gland. Remember it may not be enough to just take iodine supplements as we may need to work on adrenal stress, immunity and other health issues.

References:

Drutel, A., Archambeaud, F., & Caron, P. (2013). Selenium and the thyroid gland: more good news for clinicians. Clinical endocrinology, 78(2), 155-164.
The many benefits of natural thyroid. Life Enhancement. February 2001.
Bunevicius, R., et al. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. New England Journal of Medicine. 340(6):424-429, 1999.
“Hypothyroidism: The Unsuspected Illness”, 1976, Dr Broda Barnes, PhD.
Gartner, R., et al. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. Journal of Clinical Endocrinology & Metabolism. 87(4):1687-1688, 2002.
Ristić-Medić, D., Novaković, R., Glibetić, M., & Gurinović, M. (2013). EURRECA—Estimating Iodine Requirements for Deriving Dietary Reference Values. Critical reviews in food science and nutrition, 53(10), 1051-1063.

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