Supporting Your Thyroid

 

How often do you hear someone say how tired they are? 

Or that no matter what they eat or how much they exercise they can’t seem to lose weight?

It could be their thyroid gland.


The thyroid gland is located in the front of the neck and secretes hormones that regulate growth and development.  These 2 hormones are known as T4 and T3 and factors such as diet and stress can impact their production.

 
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A common diagnosis is that of an underactive thyroid.  An underactive thyroid (also known as hypothyroidism) occurs when the thyroid does not produce enough thyroid hormone to meet demand.  As the levels of thyroid hormone drops the metabolism goes down with it.  It can leave people feeling tired, unable to lose weight, constipated and depressed.  Conversely, an overactive thyroid has the opposite impact and increases the rate of metabolism.  The person may feel restless, have trouble sleeping and find it difficult to maintain weight.


Thyroid Hormones
To understand the thyroid we need to take a step back and look at the bigger picture.  
The thyriod is at the end of a chain known as the HPT axis (this stands for hypothalamus, pituitary, thyroid) which orchestrates the amount of thyroid hormone released from the thyroid gland.
In a situation where your body requires an increase in energy production (eg it's a cold day and you need to burn more energy to heat) the hypothalamus (the master regulator) sends a message to the pituitary (second in command) which then secretes TSH - it is this messenger that tells the thyroid to pump out more T4 and T3 which will travel through the circulation and instruct cells to increase energy production.  The thyroid mostly produces T4 which is the inactive form on the thyroid hormones.  Approximately 7% or what is release is T3, the active form.

T4 will then be converted to T3 which mostly takes place in the liver but also in other areas of the body such as the digestive system and muscle.  T3 is then transported around the body to cells where it has it's influence on energy production.
 

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Hypothyroidism

If you experience the symptoms listed below it would be likely that a test would be carried out to investigate you the function of your thyroid.


The most common symptoms of an underactive thyroid

Fatigue
Depression
Constipation
Hypersensitivity to cold weather

weight gain despite low calorie diet
Dry Skin
elevated cholesterol
SLow wound healing


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While these 6 tests are important and give an insight into the function of the thyroid it don't necessarily give a clear picture of the reason why the thyroid is underperforming.  For example, if the TSH result was above 4mU/mL it would signify that the thyroid needs to be stimulated more and requires a bigger push to produce thyroid hormones.  A sign that it is under functioning but it's doesn't give an indication of why.  This can be due to factors such as nutrient deficiencies, congenital conditions or issues with the pituitary gland.

Pituitary Dysfunction can be caused by:
Infections, poor blood sugar balance, chronic stress.  The factors put stress of the pituitary and it can no longer signal to the thyroid to release thyroid hormones.  Typically TSH and T4 will be low but perhaps not out of the range.

Under-conversion of T4 to T3
Before T3 can be used it has to be converted from T4.  Inflammation and stress impair this conversion.  Often a client will have only had their T4 and TSH tested by their GP which could very well be in the normal range.  The fact that under-conversion may be an issue would make me inclined to test T3 also.

Elevated TBG
TBG (thyroid binding globulin) is a protein that attaches to thyroid hormones and transports then around the body.  When the thyroid hormones are attached or TBG they are inactive and it is only when they are unbound to TBG that they are able to interact with the tissues.  So, if levels of TBG are high then levels of unbound or free thyroid hormone will be low.  This is most commonly a result of increased oestrogen in the body associated with oral contraception or oestrogen replacement therapies.


Further Testing
Further tests are also important as they give a clear insight into the role the immune system may be playing as auto-immune thyroid conditions are common and would involve a different approach.  In the thyroid auto-immune condition known as Hashimoto's the individuals own immune system mistakes their thyroid gland for a invader and begins to attack it and slowly reduces the capacity of the thyroid to release T4 and T3.  In auto-immune cases administering thyroid replacement hormones often helps with normalising the TSH and T4 levels but the person may not feel 100% often as the underlying issue (the immune system imbalance) hasn't been addressed and the thyroid gland is still under attack.  Hashitmoto's is indicated through measuring the levels of the TPO and TG antibodies in the blood.  The levels of which signify the levels of attack the thyroid is under.

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Strategies to health

Selenium
Selenium in a mineral which plays a vital role in converting T4 to T3.  Deficiency in intake of selenium is not thought to be all that common in the western world however those with inflammatory digestive issues which may impact the amount of dietary selenium that is absorbed certainly plays a part.  Selenium also plays a role in the reduction of inflammatory compounds released during the autoimmune attack on the thyroid (in the case of hashimotos).  Understanding the what is occuring with your thyroid through a comprehensive test will determine which approach is the most appropriate.  In some cases supplementing selenium or for more general support simply increasing the levels of selenium rich foods in the diet may have an impact.

Sources of selenium include
brazil nuts, crimini mushrooms, cod, shrimp, tuna, halibut, salmon, scallops, chicken, eggs, shiitake mushrooms, lamb, and turkey.

The Gut
As outlined about, approximately 20% of the conversion of T4 to T3 takes place in the gut which relies on healthy gut bacteria.  Needless to say supporting your gut can contribute to an increased conversion of T4 to T3.  Antibiotics can severely deplete this community of beneficial bacteria as can a diet high in processed foods and a high level of stress.

3 ways to Support your gut

  1. limit processed foods (especially refined carbohydrates)

  2. increase fibre intake (garlic, beans, onion, leeks, jerusalem artichokes)

  3. include probiotic foods daily (sauerkraut, kefir, kvass)

The role of the gut in auto-immune conditions is well documented.  However, this something that requires looking at in depth and I will delve into in a following article.

Adrenal Support
Stress management techniques are a foundational component to any thyroid strategy. 
Similar to the HPT axis the adrenal glands are regulated through the HPA (hypothalamus - pituitary - adrenal) axis.  Stress stimulates the release of inflammatory chemicals which can down regulate the HPT axis and reduce levels of TSH.  This is one way stress can interfere with thyroid hormone production.  

 
 

Supporting the adrenal glands

  • Avoid or at least greatly minimize stimulants

  • Adaptogenic herbs such as Ashwagandha, Siberian Ginseng and Holy Basil leaf

  • Stabilize blood sugar (via a moderate or low-carb diet)

  • Practice stress management and relaxation techniques

  • Have fun, laugh and make pleasure a regular part of your life

  • Avoid dietary causes of inflammation (refined flours and industrial seed oils in particular)

  • Ensure adequate intake of DHA & EPA