ARE YOU SUFFERING WITH A THYROID DISORDER?
If you feel like you're doing all the 'right things' when it comes to health, fitness and body composition, but just aren't making the progress you would like..... then hopefully this article will shed light on a few of your symptoms....
When it comes to conventional medicine and wellness, thyroid health is a complex and often overlooked topic so this article aims to get into the nitty gritty and provide you with a guide to all things thyroid.
We'll be covering:
- The role of the thyroid within the body
- Causes of thyroid dysfunction
- Symptoms of low and high thyroid function
- Testing for thyroid function
- Nutritional and lifestyle hacks to support the thyroid
So let’s get stuck in…
WHAT EXACTLY IS THE THYROID GLAND?
The thyroid gland is a butterfly shaped gland which sits just below the 'adam's apple' (larynx)
This is an endocrine gland (involved in hormonal function) which plays a major role in development, growth and metabolism.
The release of thyroid hormones starts at the hypothalamus which releases TRH (thyrotropin stimulating hormone), this triggers the pituitary to release of TSH (thyroid stimulating hormone - you've probably heard of that one)... which finally triggers the thyroid gland to produce T4 (thyroxine) and T3 (triiodothyronine).
The majority of hormone produced in the thyroid is T4 but this actually needs to be converted to T3 to be used in the body.
This conversion predominantly occurs in the liver (but also some in the heart, muscles, gut and nerves) where about 60% of T4 is converted to T3, 20% (approx) is then converted to T3 in the gut by healthy gut bacteria (always our friend!), the remaining 20% (approx) is converted to REVERSE T3 (an inactive form the body cannot use).
So what does the thyroid actually do?!
The thyroid regulates basal metabolic rate (energy expenditure at rest) and contributes to the regulation of body temperature, heart rate, brain development and growth in children, concentration, breathing, central and peripheral nervous systems, menstrual cycles, cholesterol levels.... etc.... it's pretty damn important!
The thyroid also releases a third hormone called CALCITONIN which helps to regulate levels of calcium and phosphate in the blood and is particularly important for bone health.
Like anything in the body, it's a pretty complex process..... so what might cause your thyroid to mal-function...
WHAT CAUSES YOUR THYROID TO GET OUT OF WHACK?
STRESS - As I've mentioned numerous times, stress has a knock on effect for your entire endocrine system, including forcing your thyroid to take a back seat, with cortisol being associated with raised levels of reverse T3. Stressors can come in many different forms such as financial, work, relationships, over training, bereavement, blood sugar imbalances, chronic calorie deprivation, surgery, illness etc.
CONGESTED LIVER - as explained above the liver plays an important role in the conversion of inactive T4 to active T3, a congested liver hinders this process.
EXCESS OESTROGEN - such as birth control pills, phytoestrogens and exposure to chemicals which mimic oestrogen in the body. Not only will these cause the liver to be further backed up, but it has also been associated with raised levels of TBG (thyroid binding globulin), the protein which binds to thyroid hormone to transport it through the body (when bound the thyroid hormone is inactive).
POOR GUT HEALTH - as mentioned above, healthy gut bacteria is needed to facilitate conversion of T4 to T3. Poor gut health can also cause a cortisol response.
AUTOIMMUNE DISEASE - this is where the immune system attacks the thyroid for example hashimotos (low thyroid) and grave's disease (high thyroid). It can also be coupled with various other autoimmune diseases such as lupus, rheumatoid arthritis, addison's disease etc.
OVERSTIMULATION - causes raised levels of T4 hormone which may result in goitre (swelling of the thyroid). This could be due to an autoimmune response (typically grave’s disease) and/or excess iodine in the diet, thyroid nodules or thyroiditis.
INFLAMMATION - such as parasites, bacterial overgrowth, viral infections, food intolerances, environmental moulds and toxins etc. These can all disrupt the conversion of T4 to T3.
NEUROTRANSMITTER DEFICIENCIES - reduced levels of serotonin and dopamine hinder the communication between brain and thyroid.
ANEMIA - reducing the efficiency of T3 being carried in the blood to your cells.
PREGNANCY - Some women experience 'postpartum thyroiditis' where the thyroid gland becomes inflamed.
So how do we know when it's all going pear shaped? What should we be looking out for?
SYMPTOMS ASSOCIATED WITH LOW THYROID FUNCTION (HYPOTHYROIDISM):
Difficulty losing weight (even in a calorie deficit)
Poor circulation/sensitivity to cold (particularly hands and feet)
Lack of motivation and reduced initiative
Feeling mentally sluggish
Easily fatigued (even on minimal exertion)
Feeling sleepy during the day
Chronic constipation
Excessive hair loss or coarse hair
Loss of lateral third of eyebrow
Morning headaches which wear off during the day
Seasonal sadness
Trouble sleeping
Depressed mood
Joint/muscle pain
Frequent/heavy periods
Raised LDL cholesterol levels
Respiratory symptoms
At the other end of the spectrum, you can also experience….
SYMPTOMS ASSOCIATED WITH HIGH THYROID FUNCTION (HYPERTHYROIDISM):
Unexplained weight loss (obviously this has many potential causes)
Difficulty gaining weight, even with a healthy appetite
Inward trembling
Hyperactivity
Nervousness, irritability and generally feeling emotional
Flushing and sweating easily
Intolerance to high temperatures (no these last two are not just menopausal symptoms)
Struggling to work under pressure
Fast resting heart rate
Missed/light periods
Abnormally low LDL cholesterol levels
More frequent stools/diarrhoea
** It's worth noting that you may have a mixture of symptoms (hypo and hyper) partly due to wider influences other than the thyroid, it isn't black and white and still well worth looking into. I'd advise not ignoring these symptoms as 'the norm' or just putting it down to 'hormonal changes' or 'burning the candle at both ends' etc.
WHICH TESTS DO I NEED TO GET A COMPREHENSIVE OVERVIEW OF MY THYROID HEALTH?
Unfortunately if you go to the doctor with concerns about your thyroid and related symptoms, they are likely to run just a TSH level (remember this hormone is produced by the pituitary to signal to the thyroid to release T3 and T4).
However, this is often not reflective of what is actually going on, just because the pituitary is sending signals to the thyroid, doesn’t mean that the thyroid is actually responding efficiently.
Your TSH could be ‘normal’ and let’s be honest you still feel like a sack of shit due to poor conversion or T4 to T3, raised thyroid antibodies, increased levels of reverse T3….. suddenly TSH doesn’t seem so indicative of your overall thyroid health anymore!
So what tests should we be doing?
Any comprehensive thyroid test should include TSH, free T3, free T4, reverse T3 and thyroid antibodies.
In the UK, medichecks do tests which include both ANTIBODIES and REVERSE T3, along with the other tests listed above.
You should consult your health care professional regarding any abnormal results.
NUTRITION AND LIFESTYLE HACKS TO SUPPORT THE THYROID:
Obviously your doctor may recommend medication to treat thyroid disorders and therefore you need to consult them before making any additional changes to your nutrition and lifestyle. However, under the guidance of a healthcare professional, there are plenty of optimal supporting nutrients and practices you can put into place to help optimise the health of your thyroid.. Here’s some examples:
SELENIUM - particularly beneficial for low T3 as it supports the conversion of T4 to T3. Food sources include brazil nuts, fish, meat, eggs, brown rice, mushrooms, sunflower seeds etc
IODINE - Iodine is the main building block of T3 & T4, and is particularly beneficial in the case of low T4. We have to obtain this trace mineral from food, good sources include seaweed, prawns and cod. Please note that iodine is also detrimental if taken in excess (associated with triggering or exacerbating autoimmune thyroid disorders) so I would avoid supplementation and stick to food sources. The RDA for iodine is 150mcg/day.
TYROSINE - Also combined with iodine to make thyroid hormone, so again particularly beneficial in the case of low T4. Food sources include: fish, meat, dairy, almonds, pumpkin seeds, sesame seeds etc.
AVOID GOITROGENS - such as raw cruciferous veg and soy. These inhibit iodine uptake to the thyroid.
REDUCE EXCESS OESTROGEN LEVELS - from food sources (such as excess nuts, seeds and legumes), chemicals which mimic oestrogens, contraceptive pills etc. Magnesium is particularly beneficial for supporting detox of oestrogen, as are cruciferous vegetables.
SUPPORT DETOXIFICATION IN THE LIVER - to support conversion of T4 to T3 without the hinderance of a backed up liver. Milk thistle and molybdenum are particularly beneficial for liver health. Reducing your exposure to other toxins such as mould will also help to reduce the burden on the liver.
ADRENAL SUPPORT - yup you guessed it reducing stress through mindfulness, meditation, float tanks, breath work, gratitude journals etc will have a positive impact on thyroid function, particularly in the case of raised reverse T3.
GUT HEALTH - addressing food intolerances, parasites and bacterial/yeast overgrowths as well as poor digestion, leaky gut, imbalances of bacteria etc. Remembering that healthy bacteria are needed for conversion of T4 to T3, you could gradually introduce some prebiotic (eg raw garlic and onion) and probiotic foods (eg sauerkraut, kimchi, kefir etc)
OTHER KEY NUTRIENTS - for optimal thyroid function include: vitamin A, zinc, copper, magnesium, niacin (vitamin B3), riboflavin (vitamin B2), antioxidants and essential fatty acids.
Aaaaaaaand…… that’s all I’ve got for now, that was far more than I was intending to write!
I really hope you have enjoyed nerding out on the intricacies of thyroid health with me.
Like anything in health and nutrition, our knowledge of the thyroid is ever evolving, so if you are suffering with thyroid dysfunction, keep yourself informed!
Any questions, please shoot me an email on harri@boldhealth.co.uk
Coach Harri
Nutritional Therapy Practitioner
The content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding your health.