A Hypothyroid diagnosis or under active thyroid symptoms are very common. What I typically see is that after receiving limited thyroid diagnostic testing (TSH, T4, sometimes T3), individuals receive one of three options:
- T4 replacement (Levothyroxine or Synthroid)
- T3 replacement (Cytomel or a compounded time-release product)
- Desiccated Natural Thyroid, basically a glandular extract (Armour, Nature-throid or Westhroid)
T4 or T3 replacement is essentially treating a lab result. Something is lacking so you supply the insufficient item without asking “why” it’s lacking in the first place. This approach may offer initial success, but the body adapts, symptoms come back, dosages increase. This may repeat itself before you are switched prescriptions and the cycle repeats.
The second option is a glandular. “Like treats like,” so why not supply actual Thyroid gland to supply the nutrients the Thyroid requires, then wait for it to begin functioning properly. This may or may not work. Be aware that pork thyroid is often used, in case you are sensitive to pork or have anti-pork consumption beliefs.
A glandular on its own is not the best option, so the pharmaceutical industry combines the glandular with low dose T4 (80%) and T3 (20%).
What can possibly be missed with the above approach? A lot…. First, lets look at HPTA or Hypothalamus Pituitary Thyroid Axis communication pathway:
- The Hypothalamus communicates with the Pituitary via TRH (Thyroid Releasing Hormone)
- The Pituitary communicates with the Thyroid via TSH (Thyroid Stimulating Hormone)
- TSH in the Thyroid produces Thyroglobulin
- TSH also stimulates TPO (Thyroid Peroxidase) activity
- TPO is an enzyme which causes iodine to bind with TGB (Thyroglobulin) to create T4 and T3
Of the Thyroid hormone produced, about 90% is the inactive form T4 and 10% the active form T3. T4 has to be converted to T3 via enzymatic chemical reactions to remove one iodine molecule to become active.
So where does this T4 to T3 conversion take place? In a healthy functional individual:
- 60% is converted in the liver
- 20% is converted in the gut (digestive tract)
- 20% is converted to Reverse T3
Much of what is taking place in Thyroid hormone conversion is directed and executed outside the Thyroid gland itself.
What about Iodine for healthy Thyroid function? Iodine is required for many metabolic functions in the body. Iodine deficiency is a rather unlikely cause of thyroid problems in the developed western world. Not saying it can’t contribute.
There is a potential for problems due to iodine. Iodine stimulates the production of TPO. Hashimoto’s is an autoimmune disease where the immune system producers antibodies that specifically attack TPO. An increase in TPO can initiate an auto-immune flareup. This does not mean you should remove all iodine intake, would think twice about taking an iodine supplement or high iodine containing foods.
It is very important to rule out or confirm Hashimoto’s. If there is an auto-immune condition present, the treatment should be very different than a standard hypothyroid therapy. Check your paperwork and see if they tested for TPO and TGB Antibodies.
Healing opportunities: A major consideration is that Thyroid problems are often secondary to other health issues or dysfunction. The following are very common:
1. Adrenal Dysfunction: The Hypothalmus also stimulates the pituitary to communicate via ACTH (Adrenocorticotropic hormone) with the Adrenal Cortex to produce Cortisol (Adrenal Glands), a primary stress hormones.
When the body’s stress defenses are compromised or one is in a chronic state of Fight, Flight or Freeze Stress Response there is a disruption in cortisol regulation. This can inhibit the TSH messaging within the HPTA compromising the conversion of T4 to T3.
In simple terms, if one is under a lot of stress, chronic or acute there is a risk that the Adrenals can “burn out”. To prevent this, the body purposely slows down your metabolism by slowing down Thyroid function to give the Adrenals a break. Allowing the adrenals to rest and heal can naturally resolve common Thyroid symptoms.
2. Liver Congestion: The liver has over 500 distinct metabolic functions in your body including. If it is mal-nourished, over worked or exposed to elevated levels of toxins, chemicals, metals or other foreign substances it often gets congested. Think of a vacuum cleaner with a full bag or canister. It works, but not very well. There is nothing technically “wrong” with the liver. It is not diseased, there is no significant increase in liver enzymes. It just needs a rest, some support and a good cleaning
Considering the liver is involved in roughly 60% of the conversion process. A healthy functioning liver is vital to good health.
3. Gut / Digestive Tract: The 20% or so of conversion within your gut relies on a healthy balance of gut flora or bacteria. Any dysbiosis, pathogenic infection/infestation, increase in mucosal permeability (leaky gut) or other gut related malady can interfere in the conversion process.
4. Selenium / Zinc Deficiency: A deficiency in these two minerals can hinder conversion. Before looking up the best sources, realize that a deficiency can be related to a poor diet, poor digestion or poor absorption (leaky gut) or even exposure to toxins and heavy metals. If any of these issues exist, a supplement may have no positive impact.
5. Methylation Issues: An MTHFR gene defect can alter specific enzymes required to convert T4 to T3. Gene testing is becoming a fad as individuals look to their genes to explain why they have a diagnosis or condition. What is important to realize is that having a defect does not mean you will have or develop a condition. It just means that if the wrong variables come into play there is an increased risk because of a genetic predisposition. You can have a conversion problem without the MTHFR defect.
You should now see that there are at least 5 healing opportunities presented that can be investigated to explain why you have a thyroid condition or why your current maintenance plan is not effective. Also consider that you can have thyroid symptoms while having normal thyroid test results because the symptoms are due to an unrelated dysfunction.
Where do you start? First, get a comprehensive thyroid assessment which should include testing of TSH, Total T4, Total T3, free T4, free T3, T3 Uptake, and TGB and TPO antibodies to rule out or confirm Hashimoto’s.
Functional labs plus a functional, not diagnostic, interpretation will offer great insight into how well the Thyroid and related processes are working or not working. This information plus the DRESS for Health Success® Lifestyle Grounding Program that I coach will offer healing opportunities that work on the root of the problem and not just the symptoms.