Understanding Thyroid Health
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The thyroid gland, located at the base of the neck, is a butterfly shaped gland that produces thyroid hormone. Thyroid hormone is critically important to cell metabolism and energy production throughout the body, and effects function of many other hormones.
Symptoms of low thyroid function (hypothyroidism) include fatigue, muscle aches and pains (fibromyalgia), sleep disturbances, cold hands and feet, night sweats, dry skin, brittle nails, hair loss, weight gain, depression, and high cholesterol.
Symptoms of overactive thyroid function (hyperthyroidism) include anxiety, racing heart (palpitations), sleep disturbances, jitteriness, weight loss, heat intolerance, osteoporosis and bulging eyes.
The thyroid gland produces different types of thyroid hormone: large amounts of T4( somewhat active), a little T3(highly active) and reverse T3 (rT3- inactive). T3 is the most active form utilized by our cells for metabolism, it must be converted from the less active form T4, usually in the liver and kidneys.
Like all the other hormones in the body, function of thyroid hormone is influenced by many different factors including adrenal hormones (adrenaline and cortisol), imbalance of estrogen and progesterone, lack of nutrients (particularly iodine and selenium), auto-immune inflammation, toxicity (particularly heavy metals such as mercury and chlorine), food intolerances (especially gluten), gut health and many medications including synthetic hormones.
Traditional thyroid testing using TSH (thyroid stimulating hormone- an indirect measure of function) often misses subtle thyroid dysfunction. The range of "normal" for most blood work labs is 0.3-4.5., whereas optimal levels may be closer to 0.5-2.
Thyroid testing should include measuring antibodies against thyroid hormone function including anti-thyroglobulin antibody (anti-TG Ab) and thyroid peroxidase anti-body (TPO Ab). These may reflect ongoing autoimmune disruption of thyroid function. Additional testing may include measuring "free" blood levels of T4 and T3, as well as reverse T3.
Measuring basal body temperature first thing in the morning may also be a good indicator of poor thyroid function. Body temperatures consistently below 98.0 are a good indicator of poor thyroid function, even when blood work is "normal".
Help for Thyroid Function
My approach to improving thyroid function begins with a quality multivitamin with minerals (Shaklee Vitalizer strips) with the possible addition of extra iodine and selenium and anti-inflammatory herbs. Treating estrogen dominance with natural progesterone as well as improving liver detoxification of estrogens is very useful. Identifying food intolerances, improving gut health and treating inflammation through an elimination diet is important.
One of the most important aspects of optimizing thyroid hormone function is treating adrenal fatigue. Both inadequate amounts of cortisol as well as excessive amounts of cortisol and adrenaline, interfere with thyroid function.
Traditional treatment of hypothyroidism is with pure T4 (Synthroid or Levothyroxine) which may miss underlying causes and may not be as effective if there is a problem converting T4 into the active T3 form. I often use Armour thyroid for replacement, if indicated, because it contains T3 as well as T4, or I may have thyroid hormone compounded with specific ratios of T3 to T4.
As is the case with all hormones, it is the balance between them that is critical to optimizing well-being. See the Big Picture of Hormone Balance for further suggestions as well as the suggested reading list.
As you can see, many symptoms including chronic fatigue and fibromyalgia, may be related to abnormal thyroid hormone function. The diagnosis and treatment of thyroid related conditions requires and integrative, functional medicine, holistic approach that is not “alternative” — it's biochemistry!"
2006 - 2009, Margaret Christensen, M.D.