Thyroid Disorders: Are You Hypothyroid?
Oct 01, 2012 02:31PM
By Dr. Tracie Leonhardt, DO
Most of us are familiar with the common symptoms of thyroid disease — fatigue, hair loss, dry skin and weight gain, to name a few. But did you know that the thyroid is responsible for the speed of every cell and function in the body, not just our metabolism? This means the speed of the brain (thought processes), the speed of the heart (slow or fast heart rate), the speed of the gastrointestinal system (constipation), the speed of the liver (elevated cholesterol and poor detoxification), and even our skin cell regeneration (dry skin and poor scarring). Since thyroid hormone affects every cell in the body, it also has symptoms that relate to almost every part in the body. Listed below are some other symptoms of hypothyroidism you might not have known:
Acne, Anxiety, Carpal tunnel syndrome, Cold hands and feet
Constipation, Decreased memory, Depression
Drooping eyelids, Easy bruising, Elevated cholesterol
Enlarged tongue, Fibrocystic breast disease, Heart disease
Increased appetite, Infertility, Insulin resistance
Joint pain, Loss of lateral 1/3 eyebrow, Low body temperature
Migraines, Morning stiffness, Muscle cramps and pain
Painful periods, Panic attacks, PMS
Puffy face, Ringing in the ears, Slow heart rate
Slow speech, Swollen hands and eyelids
The thyroid gland is one of the largest endocrine organs, butterfly-shaped and located in the neck just below the Adam’s apple. It secretes a hormone called thyroxine or T4 that is made up of the amino acid tyrosine and four molecules of iodine — hence T4. The thyroid gland is a very sensitive, dynamic organ and its function can be altered or complicated by many factors, including nutritional deficiencies, environmental toxicities, infectious causes, and autoimmune and stress.
Since the thyroid is so sensitive to changes and we have changed many things over the past 30 years, including our testing, we are seeing a significant increase in the rate of hypothyroidism. We have fluoride in our toothpaste and water. Our food supply has increased bromide added. Our bread products used to contain iodine, but now they substitute bromide instead. Bromide and fluoride both compete with iodine in the thyroid which can lead to dysfunction. We have a lot of women on birth control for years without replacing the deficits that these drugs cause, reducing tyrosine, magnesium, and B vitamins — all necessary for proper thyroid function. The decrease in omega 3 fatty acids in the diet will reduce the T4-T3 conversion rate. A lot of our patients are reducing their salt intake and table salt is one of our main sources of iodine. Many women are iron deficient and the thyroid needs iron in every step of its production and activation. One of the significant changes in recent years is the increase in stress levels of most patients. When we are heavily stressed out, our bodies produce increased amounts of cortisol which will eventually send a feedback to the thyroid to slow down. The increased weight in our society also contributes to lower thyroid levels as increased adipose or fat cells will send a signal to the thyroid to slow down. These are just a few examples of the possible explanations for the increased impact of thyroid disease in our society. Additionally, since thyroid is a hormone — like most hormones, it will decline with age.
How do you know if you are hypothyroid? The most common test used to check thyroid function is called TSH, which stands for thyroid stimulating hormone. This test checks for the level of hormone that is released by another gland called the pituitary. The pituitary is located in the brain and is the center of control for many hormones: the body uses it as the control center that tells you whether you need more or less of a given hormone. TSH is the hormone that tells your thyroid whether to produce more or less T4. Therefore, when we measure TSH, we are not measuring your actual thyroid hormone, but only whether our brain thinks we are making enough thyroid hormone. The total T4 level measures all of the T4 hormone, but only the free hormone not bound by any other protein is available to the body for use. T4 is the hormone produced by the thyroid but is not activated until the body takes one of the iodine molecules off and turns it into T3. T3 is also released from the thyroid gland but about 80 percent is derived in the peripheral tissues by the conversion of T4 to T3. T3 is the active form of thyroid hormone. This step can be altered and T4 can be converted to a different hormone called reverse T3 — this is the mirror image of T3, but when attached to the receptor on the cell it is inactive and does not work. This is why you can have normal thyroid numbers but still have significant hypothyroid symptoms due to the fact that the hormone attached to the receptor is not able to work correctly. Excessive stress, obesity, steroids and other medications will increase the ratio of reverse T3 in the system thereby increasing the inactive form.
The thyroid requires certain nutrients to work effectively. Some of the most important ones include iodine, tyrosine, iron, selenium, magnesium, B vitamins and zinc. Deficiencies in any of these nutrients can affect thyroid production or activation. It is important to look at every aspect of the thyroid in order to determine if a patient has an underactive thyroid. Some questions I ask when evaluating a patient for hypothyroid are: Are they symptomatic? Are they producing enough hormones and, if not, why? Are they lacking key ingredients to make thyroid hormone? Are they nutritionally deficient and not converting their hormone correctly? Are they producing antibodies to their thyroid? Are they on medications that interfere with thyroid function? For effective evaluation and treatment, there’s much more involved than simply measuring TSH.
To learn more about thyroid hormone and its functions, attend Dr. Leonhardt’s seminar, Thursday, October 18, 6:30 p.m., at Peaks of Health Metabolic Medical Center, 7600 Bryan Dairy Road, Suite D, Largo. RSVP at PeaksOfHealth.com or call 727-826-0838.
Brownstein, David. Overcoming Thyroid Disorders. Medical Alternative Press
Haugen, Bryan MD. Drugs that suppress TSH or cause central hypothyroidism. Best Practice & Research Clinical Endocrinology & Metabolism. 23 (2009) 793-800
Lord, Richard. Brailly J Alexander. Laboratory Evaluations for the Integrative and Functional Medicine 2nd Ed. 2008
Melmed, William. Textbook of Endocrinology 12thEd Chapter 11
Rosenthal, M Sara. The Hypothyroid Sourcebook. McGraw Hill 2002
Starr, Mark. Type 2 Hypothyroidism: The Epidemic. March 2005
Wheatland, R. Should the TSH test be utilized in the diagnostic confirmation of suspected hypothyroidism? Med Hypotheses. Nov 1, 2010; 75(5): 458-63
Zimmerman, Michael B., Kohrle, Josef. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: Biochemistry and Relevance to Public Health.Thyroid volume 12, Nov 10, 2002