Where to Start with Thyroid Imbalance

The thyroid gland is one of the smallest glands in the body, but it has some of the most powerful influences on the way a person feels. Conventional medicine relies heavily on the use of labs to diagnose and manage thyroid problems. But more and more people are turning to naturopathic medicine to help manage the symptoms that exist, even when their lab results look normal. An overactive thyroid is considered hyperthyroid, and often shows up on blood work with a low thyroid-stimulating hormone (TSH). Traditionally, hyperthyroid individuals experience weight loss, increased sweating, heart palpitations, fatigue, nervousness, anxiety, and insomnia.

An underactive thyroid is considered hypothyroid, and often shows up on blood work with a high TSH. The most common symptoms associated with hypothryoidism are weight gain, decreased appetite, hair loss, muscle weakness, body pains, and fatigue. In my experience, few people ever fall into just one of these categories. I have seen people with normal bloodwork and all the symptoms of hyperthyroidism, and people with high TSH and no symptoms at all! But the complexity of the human body is so great that the thyroid rarely ever acts alone. What I mean by this is that when one organ is under stress, the body will take resources from other organs to compensate and meet the overall demands. Very rarely is the thyroid the first place to start when determining a treatment plan. By the time the thyroid is affected, many other body systems have been overwhelmed, and we must back-track to find our root cause.

Adrenals Are Taxed—Stress affects us all, and even when we don’t feel emotionally stressed, our bodies may experience it on a deeper level. Cortisol is our major stress hormone, released from our adrenal glands. It is meant to help sharpen our focus, mobilize our fuel sources, and prepare our bodies to run away from a dangerous situation if needed. The high demand for cortisol puts a lot of pressure on the adrenal to use up its stores and eventually, the body has to turn to other systems to prevent depletion. The thyroid often gets caught-up in this process, giving nutrients where needed to keep the body going during prolonged stress.

Progesterone Deficiency—Progesterone is an important female hormone that exists along the cortisol-producing pathway. When the body can’t meet the demand for producing cortisol, it begins to draw from this female hormone and offsets the balance required to keep the hormone cycle maintained. The deficient progesterone cannot offset the higher levels of estrogen, and this stimulates to liver to produce a protein called “thyroid-binding globulin.” Just like a set of dominoes, the effects continue downstream. If we bind up all our thyroid hormone, we will not have enough free hormone to carry out all the important functions of the gland.[1]

Low Iron—Women are at greater risk of iron deficiency, because of the menstrual cycle, and are generally poor consumers of bioavailable sources of iron from red meat. Iron is an important ingredient in thyroid hormone synthesis, and without it, we reduce the activity of an important enzyme called “thyroid peroxidase.”[2] Needless to say, an iron-deficient individual will have reduced thyroid function, but if only thyroid levels are tested in bloodwork, the iron deficiency can be completely missed.

Once all these other root-cause issues have been addressed, if the thyroid is still not functioning optimally, then it is safe to consider treating the thyroid directly. Thyroid hormone is produced from the thyroid gland in response to TSH, which is released from the anterior pituitary in the brain. This signal from the brain stimulates the thyroid gland to produce the less active T4 (thyroxine), which in turn will convert to the active T3 (triiodothyronine). Multiple nutrients and vitamins are important in the production of T4 and in the conversion of T4 to T3. If any of these nutrients are deficient, it can cause a backlog in the entire system.

Consider these nutrients like a ticket to travel through a toll booth on a highway. If the toll booth runs out of tickets to give, then cars will be backed up on the highway and nobody will reach their destination. But as soon as you can refill the stock of tickets, cars can move through and the regular flow of traffic will resume. Without the right nutrients, the thyroid cannot do its job and the process comes to a standstill. Identifying the deficiency can be a simple fix to a huge problem, so consider fortifying the diet with these nutrients:

Selenium—As mentioned before, thyroid hormone exists in the body as less active T4, which then converts to the more active form T3 to regulate the metabolism. This conversion from T4 to T3 requires selenium and a variety of other nutrients to ease the process.[2] This means that without adequate selenium, we are stuck with a whole bunch of less active T4 and no stimulation of metabolism.

Vitamin B12—An important B vitamin for mental and neurological health, B12 is also important in helping to make thyroid-stimulating hormone (TSH). It is also an important factor in the production of red blood cells, which means that if you are B12 deficient, your low energy might be a combination of low thyroid and low red blood-cell production.

Zinc—We all know zinc to be an important player in the immune battle, and immediately pop a lozenge when we start to feel sick. But zinc is also a key ingredient to making TSH, and without it, we’d be left with thyroid imbalance.

Magnesium—Magnesium is an integral part of almost every energy reaction in the body, and it improves muscle function, sleep, anxiety… and so much more. Part of the reason everyone feels better when they take magnesium could be because of its role in producing TSH, which, as we know, is important in signalling thyroid hormone production.

Iodine—The less active form of thyroid hormone T4 requires four molecules of iodine. You guessed it: Without iodine, the thyroid is not able to produce thyroid hormone. Thanks to the addition of iodized salt in North America, goiters are less of a concern, but it just goes to show how important iodine is. Before you overindulge on the seaweed, however, it is equally important to note that high iodine intakes can also be harmful to the thyroid gland.

Vitamin C—Easily obtained from the diet, vitamin C plays a large role in our skin, hair, nails, teeth, and immune system. But many are not aware that vitamin C is also important in the formation of T4 and thyroid function.

Vitamin D—It is often considered a steroid hormone because of its properties and ability to enter all cells of the body. When active T3 is released into the body, it requires vitamin D to help it enter the cell and fulfill its action. A vitamin D deficiency would then result in a whole bunch of active T3 floating around the body with nowhere to go!

As you can see, there are many nutrients involved in thyroid function, and many ways that deficiencies can affect thyroid function. However, a discussion on thyroid would not be complete without considering the autoimmune forms of thyroid disease. Autoimmune conditions are those in which the immune system no longer recognizes a certain body organ or tissue and has been activated to attack and destroy it. “Hashimoto’s thyroiditis” is the term for autoimmune hypothyroidism, and “Graves’ disease” that for autoimmune hyperthyroidism. In these conditions, the immune system attacks the thyroid gland and causes a similar symptom picture as if the thyroid were the main issue. Treatment for autoimmune conditions requires a different approach, targeting the immune system instead of the thyroid itself. Focusing on diet and the digestive tract can significantly reduce inflammation in the body, which allows the immune system to calm down and the thyroid to resume its function. Often, there are underlying viral infections or bacterial dysbiosis that aggravate the immune system and lead to overactivity.[3] Identifying and treating these concerns can help manage autoimmune conditions and help to normalize bloodwork. For your best results, consult your health-care provider to find out exactly how much of these nutrients you need to take and the best way to maintain your thyroid at its optimal function.