Thyroid Function less than optimum in 80% of people screened
The American Thyroid Association estimates that 20 million Americans have some form of thyroid disease, and up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime. As of 2014, levothyroxine, a synthetic form of thyroid hormone, was the highest-selling drug in the United States. Most individuals who take thyroid hormone will never get off the medication.
What’s so important about the thyroid, anyway?
Every cell in the body has receptors for thyroid hormone. It is responsible for the most basic aspects of our body’s function, impacting all major systems. Thyroid hormone directly acts on the brain, the GI tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gallbladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism, and body temperature regulation.
The conventional medical approach to thyroid disorders
Unfortunately, misdiagnosis is common in the management of thyroid disorders. If a person visits a doctor with hypothyroid symptoms, she will simply be given replacement hormones without any further inquiry into the cause of her condition. Even worse, if she has hypothyroid symptoms but her lab tests are normal, she’ll be told that she’s “fine.” If the patient insists that she’s not “fine,” she might be sent home with an antidepressant, but with no further clue about the cause of her symptoms.
The problem with this approach is that thyroid physiology is complex. The production, conversion, and uptake of thyroid hormone in the body involve several steps. A malfunction in any of these steps can cause hypothyroid symptoms but may not show up on standard lab tests. It is incorrect to assume that all cases of hypothyroidism share the same cause and require the same treatment, yet that is exactly what the standard of care for hypothyroidism delivers.
TSH test is one of the most important test, but the range is very wide, from 0.5 – 5.5 mIU/L and the figure lump-sum 95% of the population. Studies showed that 90% screening for thyroid showed normal thyroid function but 80% of those so called normal range require thyroid supplementation. Clinical assessment and trial of treatment and treating underlying cause is the better approach besides relying only on bio-chemistry figure. It is critical to get better profile by testing a combination of thyroid markers, including TSH, T3, T4, free T3, free T4, and thyroid antibodies.
The underlying causes of thyroid disorders
The two major causes of thyroid disorders are nutrient deficiency and autoimmune disease.
Iodine is a crucial nutrient for thyroid function. Thyroid hormone is rich in iodine, and deficiency of iodine can cause both hypothyroidism and goiter (a swelling of the thyroid gland). Zinc is required for the synthesis of thyroid hormone, and deficiency of zinc has been shown to result in hypothyroidism. Selenium, a cofactor for iodothyronine deiodinase, is required to convert T4 (the inactive form of thyroid hormone) into T3 (the active form of thyroid hormone). Selenium deficiency exacerbates conditions caused by inadequate iodine intake.
The most common autoimmune cause of thyroid problems is Hashimoto’s disease. In Hashimoto’s disease, the body attacks the thyroid gland, progressively destroying its capacity to produce thyroid hormone and resulting in hypothyroidism. Some studies suggest that up to 90 percent of people with hypothyroidism have Hashimoto’s disease. Graves’ disease is another autoimmune disease that affects the thyroid gland, but it causes the thyroid to become enlarged and overactive, which results in hyperthyroid symptoms.
You can figure out if your patient’s thyroid issues are due to an autoimmune process by testing for thyroid antibodies (thyroglobulin and thyroid peroxidase antibodies). While not all people with Hashimoto’s have hypothyroid symptoms, thyroid antibodies have been found to be a marker for future thyroid disease. It’s important to note that up to 30 percent of patients with Hashimoto’s do not test positive for thyroglobulin or thyroid peroxidase antibodies)
Strategies for improving thyroid function
With all of this in mind, let’s look at dietary, lifestyle, and supplement strategies for addressing nutrient deficiency and autoimmunity, the two primary causes of thyroid disorders.
- Iodine and selenium: most optimal to get from food, but in cases of significant deficiency, supplementation may be necessary
- Vitamin D: supplementation is required when sun exposure is not sufficient to achieve adequate levels