Author: Malaina Morales, AP
What is Hypothyroidism?
Hypothyroidism is a condition in which the thyroid gland is unable to make sufficient amounts of hormones (T3, T4) that play a significant role in regulating your metabolic rate. Symptoms of hypothyroidism include:
The Production of Thyroid Hormone
First, the hypothalamus produces thyroid-releasing hormone (TRH) which triggers the release of thyroid-stimulating hormone (TSH) by the pituitary gland. TSH directly stimulates the thyroid gland to produce thyroid hormones. With the help of nutrients such as amino acids, iodine, selenium, and zinc, the thyroid gland synthesizes T3 and T4 and sends them into circulation. Thyroid hormone levels are controlled via a biofeedback loop. When thyroid hormone levels in the blood are insufficient, the pituitary gland releases more TSH. When blood levels are too high, the pituitary gland releases less TSH. In hypothyroidism, TSH will increase in order to promote hormone production. In subclinical hypothyroidism, thyroid hormone levels are normal but TSH is elevated. This is a sign that full-blown hypothyroidism may develop in the future.
The thyroid gland produces three hormones: T3, T4, and calcitonin. While calcitonin is involved mainly in calcium and bone metabolism, T3 and T4 are involved in regulation of the basal metabolic rate and are the two main hormones that are given to hypothyroid patients in the form of medications such as Levothyroxine (synthetic T4) or natural dessicated pig thyroid (T3 and T4). T3 is the bioactive form of thyroid hormone while T4 is a prohormone that must be converted in the peripheral cells in order to be used. This conversion takes place with the aid of deiodinase enzymes (D1, D2, and D3). The conversion of T4 to T3 is largely dependent on trace minerals such as iodine, selenium, zinc, and iron.1
Once T4 is in circulation, it is converted to active T3 or to reverse T3 based on cellular demand. Stressors such as prolonged fasting, long-term calorie restriction, severe illness, or chronic inflammation can all cause your body to convert more T4 into reverse T3, which is biologically inactive.2
Blood Tests for Examining Thyroid Function
Your doctor may only be testing your TSH levels, but that may only be one piece of the puzzle. Taking a closer look may be necessary for those who are suffering with symptoms but left without an answer. Even those with TSH within the normal range may be experiencing symptoms. The normal range for TSH is defined as 0.5 - 5 mIU/L, however expert clinical thyroidologists have not been able to reach consensus over these limits.3 In addition, individuals may be experiencing undetected issues with T4 to T3 conversion, high reverse T3, or autoimmunity - none of which are addressed by testing TSH and/or free T4 only.
Steps to Improve Thyroid Function
1. Optimize Nutritional Status
There are several nutrients that are essential for proper synthesis and conversion of thyroid hormone. Ensure that you are obtaining adequate amounts of the following nutrients:
You can easily meet your nutritional requirements by incorporating more nutritional powerhouses such as seafood, organ meats, eggs, and beef. If you prefer to supplement, work with a healthcare professional to determine the safe upper limits of intake, as oversupplementation can be harmful.
2. Address Autoimmune Disease if Present (Hashimoto's)
If you have high TPO antibodies along with low levels of thyroid hormone, you may have an autoimmune disease called Hashimoto's. In this case, your thyroid is being attacked by your immune system, leading to an underactive thyroid gland. Diet is an important focus for autoimmune patients. Removing foods that trigger autoimmune flare-ups and adding foods that provide essential nutrients are key. Optimizing selenium intake is especially important for autoimmune thyroid dysfunction.4
Leaky Gut may be implicated in autoimmune disease. It is a condition marked by hyperpermeability of the small intestine and cell destruction inside the gut lining. When undigested food or proteins pass through large gaps in the gut wall, an immune response may be triggered. Lectins are proteins found mainly in plant foods that are highly resistant to human digestion and are known to cause damage to the gut lining. One example of a lectin is gluten, the protein found in wheat. High amounts of lectins can be found in grains, soy, legumes, nightshades, nuts, and seeds. Lectins are also present in eggs and dairy products, so eliminating these may be necessary for some.
Some dietary protocols that may help Hashimoto's include:
These dietary strategies aimed at managing autoimmune diseases are slightly different but are unified by a common theme: removal of plant proteins, focus on nutrient-dense animal foods, and restoration of the gut lining. To simplify: focus on meat, seafood, organ meats, and fresh vegetables and fruits. It may be useful to avoid gluten, dairy, grains, sugar, legumes, nuts, seeds, and cruciferous vegetables (cruciferous vegetables and legumes such as soy contain antinutrients known as goitrogens, which inhibit the uptake of iodine into the thyroid and can worsen an underactive thyroid).5
3. Manage Stress
High levels of stress can put the brakes on your T3 levels by converting it into Reverse T3, rendering it inactive. Managing stress involves prioritizing quality sleep and making a conscious effort to maintain healthy perspectives on life. Avoiding physical stressors such as prolonged fasting, calorie restriction, and excessive exercise is important for patients with hypothyroidism, as these are stressors that can increase Reverse T3 and also down-regulate thyroid hormone synthesis. Another stressor is chronic inflammation, which can be addressed through dietary changes aimed at removing or cutting down on inflammatory foods such as vegetable oils and sugar.
4. Supplement with Natural Dessicated Thyroid
If you are taking Levothyroxine (synthetic T4) and aren't experiencing significant relief, you may have issues with the conversion of T4 to T3. To remedy this issue, speak with your doctor about taking Dessicated Pig Thyroid (such as Armour Thyroid or Nature-Throid). These medications provide both T4 and T3, which can help to bypass conversion issues. These medications are only obtainable by prescription.
If you are struggling with hypothyroidism, diet and nutrition are very important for managing your condition. It is crucial to include key nutrients that are essential for proper thyroid function while also avoiding foods that are inflammatory or may lead to autoimmune flareups. In addition, stress management, proper sleep, and sun exposure may also be beneficial. If you are taking thyroid medications but continue to suffer with symptoms, it is recommended that you speak to your doctor about trying Natural Dessicated Thyroid in addition to implementing the strategies outlined above. It is also recommended that you consult your doctor before trying new dietary regimens or changing your medications.