Thyroid Diagnosis and Treatment
Of all the organs in the human body, the thyroid is one of the smallest and, at the same time, one of the most powerful and important. This butterfly-shaped gland nestles in the space between the Adam’s apple (larynx) and windpipe.
Through the hormones it produces, the thyroid regulates almost all of the body’s metabolic processes, including your weight, heart rate, breathing, muscle strength, menstrual cycles, body temperature, and cholesterol levels. It takes iodine (which is found in foods and fortified salt) and converts it into the hormones thyroxine (T4) and triiodothyronine (T3). The thyroid produces about 80 percent T4 and 20 percent T3, but T3 has four times the strength of T4.
The pituitary gland, which lives at the base of the brain, controls the thyroid. When T3 and T4 drop too low, the pituitary releases thyroid stimulating hormone (TSH), which tells the thyroid to produce and secrete more hormones. In contrast, when T3 and T4 levels are too high, the pituitary scales back on TSH, which signals the thyroid to release less hormone.
When T3 and T4 are released into the bloodstream, they impact nearly every cell in your body, managing the speed at which the cells work. As you can imagine, this entire process is a delicate balance. If hormone levels are even slightly too low, the cells work at a slower-than-normal pace (resulting in slowed metabolism). Conversely, excessive hormones cause cells to work a lot faster (resulting in a faster-than-normal metabolism).
Ideally, T3 and T4 stay within normal ranges, and the body’s processes operate at a healthy rate of speed. If not, countless symptoms can develop, ranging from annoying to downright miserable.
An excess of thyroid hormone results in a condition called hyperthyroidism. Symptoms include:
- Heart: high blood pressure, heart palpitations, or rapid pulse
- Emotional: Anxiety, irritability, panic attacks
- Appearance: weight loss, hair loss, protruding eyes, dry and scaly skin
- Energy: increased appetite, weakness, exhaustion, difficulty sleeping
- Discomfort: heat sensitivity, tremors, muscle cramps, migraines
A deficiency in thyroid hormone results in hypothyroidism. Symptoms include:
- Energy: low libido, overwhelming fatigue, low heart rate, loss of appetite
- Emotional: depression, irritability, brain fog
- Appearance: unexplained weight gain, dry skin, hair loss
- Discomfort: temperature sensitivity (usually feeling cold all the time), achy joints, painful muscles
Causes of Thyroid Disorders
By far, the most common cause of hyperthyroidism is an autoimmune condition called Graves’ disease. With Graves’, a malfunction in the body’s immune system causes the release of antibodies that mimic TSH. As a result, the thyroid receives false signals to produce more T3 and T4, to the point that there’s far too much hormone coursing through the body.
Other causes of hyperthyroidism include nodules (usually benign growths on the thyroid that can upset hormone balance); pituitary gland malfunction; or thyroid cancer. (Thankfully, thyroid cancer has an excellent survival rate; nearly 97 percent of those diagnosed with it are alive five years later.)
The most common cause of hypothyroidism is another autoimmune disease called Hashimoto’s thyroiditis. With this condition, the body attacks its own thyroid tissue. This process can take many years, and lifestyle changes can put the autoimmune attack into remission or at least slow it down. But if no action is taken to mitigate this process, the thyroid eventually dies and stops producing hormone.
Other causes of hypothyroidism include removal or irradiation of the thyroid; exposure to excessive amounts of iodine; and certain medications.
There’s another often-overlooked factor when it comes to thyroid issues of all kinds, whether it’s hypothyroidism, Hashimoto’s, hyperthyroidism, or Graves’. It is important to know that both stress and adrenal function play a huge role in your thyroid health.
The adrenal glands are widely known for managing the fight-or-flight response to stress. When you experience stress, your pituitary signals your adrenals to release stress hormones, including cortisol. These hormones redirect your body’s normal functions so that most of your energy can be used to fight off the immediate stressor. This means functions like digestion and thyroid hormone production are put on hold.
Ideally, everything returns to normal quickly. But for those who experience chronic stress, the adrenals work on overdrive for extended periods of time. Eventually, they become less efficient—a state often called adrenal fatigue.
Adrenal fatigue is also marked by decreased function of the pituitary gland. Remember, along with controlling adrenal function, the pituitary regulates the production of thyroid hormone—which is suppressed long term with adrenal fatigue, leading to hypothyroidism.
It also should be noted that chronic stress releases inflammatory compounds called cytokines, which make thyroid receptors in cells less sensitive to T3 and T4. This means that even thyroid medication may prove to be less effective.
Long story short, getting a handle on all stress, big and small, is critically important for thyroid health.
Understanding Your Thyroid Test Results
An under- or overactive thyroid can be managed with medication and lifestyle changes. Not doing so can result in a worsening of either condition. But first, the problem has to be diagnosed, and that’s where medical experts don’t always agree. Not all practitioners interpret test results the same way. So, numbers that one physician believes are normal could be labeled problematic by another.
Thyroid testing usually begins with a blood test for thyroid-stimulating hormone (TSH). Results ranging between 0.5 and 5 mIU/L (milli-international units per liter) are often considered normal. But the American Association of Clinical Endocrinologists, experts who specialize in thyroid and related issues, consider 0.3 to 3 as a more accurate benchmark because less serious imbalances are included in that range.
If your results are in the low-normal range, you should also have a blood test that checks free triiodothyronine (T3) and thyroxine (T4) or thyroid-releasing hormone (TRH). If your hormone levels are normal but you are still experiencing symptoms of either hypo- or hyperthyroidism, get your thyroid antibodies checked. The presence of these antibodies would confirm either Hashimoto’s or Graves’ disease.
You can also check your thyroid function in the comfort of your own home with a simple test. Purchase a basal body thermometer (these are glass, not digital, and are available at most drug stores). As soon as you awaken in the morning, place the thermometer under your arm for 10 minutes, and be as still as possible. Record your temperature, repeat the process on two or three more consecutive mornings, and average the results. If your average score is below 97.6°F, you may have an underactive thyroid.
Be aware that self-testing is not 100 percent accurate, so don’t panic if your score looks as though you may have a problem. Talk with your physician about additional testing.
Treating the Thyroid
Thyroid treatment is not a do-it-yourself project. You will want to work closely with your physician to monitor your thyroid hormone status. Medication is available for both under- and overactive thyroids.
But treatment doesn’t end there. Making dietary and other lifestyle changes is just as important in supporting healthy thyroid (and adrenal) function.
When it comes to diet, you want to be aware of one category of foods—goitrogenic foods. Cruciferous vegetables such as broccoli and kale have the potential to suppress thyroid activity if eaten in excess and especially when eaten raw.
This may be beneficial for symptoms of an overactive thyroid. But for hypothyroid patients, they can be problematic, so eat them cooked and in moderation. Other goitrogenic foods to avoid include peanuts, flax seed, strawberries, pears, peaches, spinach, bamboo shoots, and sweet potatoes.
Lastly, nutritional deficiencies play a big role in thyroid function (and dysfunction). Some of the top deficiencies in this area include iodine, vitamin D, omega-3 fats, selenium, zinc, and the B vitamins. With that said, here are the supplements you should consider taking if you have a thyroid issue:
- Kelp is an iodine-rich sea vegetable that’s rich in B vitamins and essential minerals, including iodine, iron, potassium, magnesium, and calcium. Look for a product that contains 150 mcg of iodine, and take no more than one daily.
- Fish oil is rich in omega-3 essential fatty acids (EFAs), which are vital for good health. They are involved in producing new cells and repairing damaged ones. They also support health of the cardiovascular system, brain, skin, and joints, and reduce systemic inflammation, which is common with autoimmune conditions like Hashimoto’s. Take 2,000 to 3,000 mg in divided doses.
- Vitamin D3 is necessary to produce and use thyroid hormones. Before supplementing, ask your doctor to check your levels. Optimal blood levels are between 50-80 ng/mL. If your levels are below that, supplement with D3, up to 5,000 IU per day.
- Selenium is converted in the body to the antioxidant glutathione, which helps to protect the thyroid from inflammation. Studies have shown that selenium can also reduce levels of thyroid antibodies that lead to autoimmunity.1 The recommended daily dose is 200 mcg per day.
- L-tyrosine plays an important role in metabolism, as well as overall mood improvement. This amino acid combines with iodine to produce thyroid hormones, so if too little is available in the body, the result could be an underactive thyroid. Take 500 mg twice daily on an empty stomach.
- Zinc is required for the synthesis of thyroid hormones. Specifically, this mineral allows the T3 receptors in your cells to bind to T3 so that the cells can absorb it. Conversely, thyroid hormones are essential for the absorption of zinc, so hypothyroidism can result if you’re deficient in zinc.2Take 30 mg per day.
- Vitamin B complex: To treat deficiencies in the Bs take a product 100 mg each of the most important Bs (thiamin or B1, riboflavin or B2, pantothenic acid or B5, and pyridoxine or B6) and lesser amounts of the others. It should be taken two or three times daily for maximum effectiveness.
If any of the symptoms I mentioned feel like they’re happening to you, or you’re just concerned about the possibility of thyroid disease, see your doctor. If you are diagnosed, combining proper medication with lifestyle changes that support good health overall, can ease (and even eliminate) symptoms, so that you can enjoy a healthy thyroid once again.
- Negro R. Selenium and thyroid autoimmunity. Biologics. 2008 Jun;2(2):265-73. Last accessed April 30, 2019.
- Ambooken B, et al. Zinc deficiency associated with hypothyroidism. Int J Trichology. 2013 Jan-Mar;5(1):40-2. Last accessed April 30, 2019.