Have you been putting on weight for no apparent reason? Are you constipated and feeling constantly tired? Do you suffer from “brain fog”, poor memory and concentration or depression? Is your hair falling out or do you feel the cold (especially hands and feet) even on warmer days?
If you are suffering from all or some of the above symptoms, you could have a thyroid imbalance called hypothyroidism.
The thyroid is a small butterfly shaped gland located just under the larynx (voice box) in the front of the throat. It produces hormones that regulate your metabolism – the rate at which your heart, muscles, brain, liver and many other parts of your body work. These hormones, T4 (Thyroxine) and T3 (Triiodothyronine) need to be in balance. If your thyroid is not producing enough of these hormones, your metabolism will slow down, leading to the above symptoms. If your thyroid is producing too many of these hormones, your metabolism speeds up, leading to weight loss, racing and irregular heart, diarrhoea, increased appetite, insomnia and many other symptoms.
The thyroid doesn’t actually make the decision as to how much T4 or T3 is produced. That decision is made by the pituitary gland, located in the brain. The pituitary gland releases a hormone called TSH (Thyroid Stimulating Hormone), which as the name suggests, stimulates the thyroid to produce the hormones T4 and T3.
This article will focus on the symptoms, causes, tests and possible treatments for hypothyroidism, a common disorder. Hypothyroidism can be clinical (when the symptoms are present and the test results actually show a decrease in the hormones) and subclinical (when the symptoms are present, although maybe not as severe, but the test results do not, according to western medicine, show a decrease in the hormone levels significant enough to diagnose). Many people suffer from subclinical hypothyroidism and unfortunately the medical profession does not recognise this as a condition. It is not until it has become so severe that the test results show hormone levels out of the “accepted” range that it is regarded as a “condition”.
Symptoms of hypothyroidism – some or all of below:
- Weight gain
- Chronic constipation
- Feeling cold (especially hands and feet) even on warmer days
- Numbness and tingling (especially in hands and face)
- Low basal temperature
- Fatigue, exhaustion and low energy
- Slow reflexes
- Slow, weak pulse (under 60 beats per minute)
- Brain fog, poor memory and concentration, indecisiveness
- Muscle weakness
- Pain and stiffness in muscles and joints
- Severe PMS, depression, mood swings
- Dry, coarse skin
- Cracking skin on heels, elbows, knee caps
- Lump in throat or goitre
- Brittle hair and nails, hair loss
- Fluid retention (swelling of face and feet)
Possible causes of hypothyroidism:
- Prolonged and high levels of stress
- Blood sugar imbalances
- Insulin resistance
- Elevated copper levels in blood
- Insufficient levels of selenium, zinc and iodine
- Autoimmune disease (Hashimoto’s)
- Certain medications
- Physical damage to thyroid gland
- Gut dysbiosis – where there is an imbalance of good and bad gut bacteria.
Tests to help diagnose hypothyroidism:
If someone thinks they might be suffering from Hypothyroidism going by the above symptoms, the tests that need to be done will measure the amount of TSH (Thyroid stimulating hormone) that the Pituitary gland is producing, together with the amount of T4 and T3 that the thyroid gland is producing.
And herein lies the problem! Most Doctors will only test for TSH, the hormone produced by the pituitary gland. If you can imagine the analogy of a jockey riding a horse and using a whip to stimulate the horse to go faster, the pituitary gland is that jockey. It releases TSH (the whip) to stimulate the thyroid gland (the horse) to go faster and produce its hormone (T4) which is then converted to T3, the form that is available to the body. Although it is commonly thought amongst Doctors that if the level of TSH is within the “normal range”, then all is well with the thyroid, this couldn’t be farther from the truth.
Firstly, the ranges that pathology labs class as “normal” are too wide. There is actually only a very narrow range of “normal” with TSH and even a small variation can lead to thyroid problems.
Secondly, even if the TSH is normal, there can still be problems within the thyroid that lead to hypothyroidism.
The solution to this problem is simple. The tests done need to include TSH, T4 and T3. A TSH test on its own is useless, unless it is obviously well outside of the “normal” range.
Tests to help discover the possible causes of hypothyroidism:
Because the problem of hypothyroidism is often a complicated one, there are various tests that can be done to try and pinpoint the cause. The most obvious ones are testing for levels of Zinc, Iodine, Selenium and Copper and testing for antibodies in case it is the autoimmune disease Hashimoto’s. The other areas that need to be assessed are insulin resistance and whether there has been a prolonged period of high stress. Because there are so many potential causes of hypothyroidism, it is essential to consult either an integrative Doctor or a Naturopath, both of whom are trained to find the causes of disease.
Treatment options for hypothyroidism:
Once your TSH, T4 and T3 have been tested, there are 2 options. Go onto medication (the synthetic thyroid hormone levothyroxine) or find the cause of your hypothyroidism. By going onto medication, you are not treating the cause of your thyroid problem, so you will pretty much always have to take the medication. Like all medications, there is always the problem of side effects, some of which can include extreme fatigue, chest pain, fast or irregular heartbeat, increased blood pressure, nausea, irritability and many more.
By finding the cause of the hypothyroidism, you can then take the appropriate action and resolve the problem. Sometimes the problem can be as simple as not enough iodine, selenium or zinc in your diet. Other times it could be reducing your stress or fixing any gut problems (20% of the conversion of T4 to T3 is done by the good bacteria in your gut). Or if your copper level is high, it can often be reduced by taking Zinc. But there are other causes such as autoimmune disease or gut problems that can be much more complicated and need an experienced practitioner.
This article was designed to inform and educate with regards to thyroid. It is not in any way intended to encourage self diagnosis or treatment. The thyroid gland is an extremely complicated gland and any problems require the skill of a qualified and experienced practitioner.
By Andrea Southern Naturopath, Nutritionist, Herbalist at Stafford and The Gap in Brisbane. For an appointment phone 0412 791 705