How much do you know about that little butterfly-shaped gland in your neck? You probably don’t think much about your thyroid gland, the master gland of your endocrine system, until you start to feel fat, fuzzy, frazzled, and fatigued. Or even worse: your hair starts falling out. Sound like you? I know how you feel, because I struggle with hypothyroidism too.
All About the Thyroid: Hypothyroid
Your thyroid is the powerhouse of your body. Thyroid hormones regulate other hormones including insulin, cortisol, estrogen, progesterone, and testosterone. That’s why healthy thyroid function is so important to overall health and balance.
If your thyroid is underfunctioning, many other body systems suffer. It’s estimated that as many as 25 million Americans have a thyroid disorder, and over half are unaware. Hypothyroidism is more common than hyperthyroid, overactive thyroid, and thyroid disorders affect women far more often than men.
(side note: up to 80-90 percent of hypothyroid cases can be due to an autoimmune disease called Hashimoto’s thyroiditis, an autoimmune condition that is treated differently than hypothyroidism. You’ll need to test for the presence of antibodies to rule that out.)
Symptoms of Hypothyroid
- Weight gain/inability to lose weight
- Brain fog
- Hair loss
- Mood swings, irritability
- Thinning hair/brittle nails
- Dry skin
- Cold hands and feet, morning basal body temperature under 97.6
- Heart palpitations
- Outer 1/3 of eyebrow missing (grows back once thyroid function normalizes)
The human endocrine system really is akin to an orchestra: every piece must work properly for the whole production to function soundly. Your brain signals to your thyroid, ovaries/testes, and adrenals to secrete necessary hormones to manage stress response, reproduction, and metabolic balance. Thyroid hormones impact brain function/cognition, female hormone balance, fertility, GI function, body temperature, cardiovascular function, and lipid/cholesterol metabolism.
Your thyroid produces two major hormones: T4 and T3. Most is in the form of T4, the inactive form. Your liver converts T4 into T3, which is why having a healthy, well functioning liver is important for this process as well. Thyroid hormones work within a feedback loop between the brain and other glands in the endocrine system. Here is a visual that explains these systems and how your thyroid and adrenal glands function within this axis.
Your pituitary makes TRH (thyroid releasing hormone), and your hypothalamus makes TSH, thyroid stimulating hormone. If everything is working properly, you will make what you need and you’ll have the proper amounts of T3 and T4 in your cells. T3 & T4 need to be in good working order for a healthy thyroid.
If your T3 is inadequate, either by insufficient production or not converting properly from T4 (proper nutrient co-factors, like iodine, are needed for this), your whole system suffers. Your pituitary can sense whether or not there is enough thyroid hormone in the bloodstream, and it releases more TSH when it detects insufficient thyroid hormone. That’s why doctors use TSH as a main marker for hypothyroidism on lab work.
The TSH tells your thyroid to release more hormone when T3 & T4 aren’t at proper levels to compensate, so your TSH rises when your thyroid is underactive. A high TSH (over 2.5) means that the pituitary gland is releasing its hormone to overcompensate for abnormal T3 & T4 levels, even though T3 & T4 can appear normal on lab test, a condition called subclinical hypothyroidism.
Adrenals and female hormones impact the thyroid. I always say that nothing in the endocrine system malfunctions in isolation. That means your thyroid doesn’t just suddenly decide to crap out. Imbalances in brain chemistry, adrenal hormones, and sex hormones all contribute to hypothyroidism, as do nutrient deficiencies. That’s why I so often get women in my office who are taking Synthroid or another thyroid hormone replacement and don’t feel any better. Taking thyroid hormone replacement doesn’t address the whole system and fix the underlying cause.
What causes hypothyroid?
- poor diet (high in processed foods, low in nutrients/minerals, sugar, nicotine, drugs)
- stress, poor adrenal function
- estrogen dominance
- environmental toxins
- liver congestion
- heavy metal toxicity/mercury
- radiation damages the thyroid
- poor lifestyle habits: not sleeping enough, lack of exercise
- nutrient deficiencies, especially zinc, iodine, selenium, vitamin A
- birth control pills
Conditions that Result from Hypothyroid
- High cholesterol
- Irregular & often heavy menstrual cycles
- Low libido
- Fluid retention/puffy eyelids
- Skin conditions such as acne and eczema
- Memory/cognition problems
- Hormonal imbalance & infertility
- Heart disease
- Chronic fatigue & fibromyalgia
- PMS & menopausal symptoms
- Irritable bowel syndrome
How to Detect Hypothyroid
Take a look at your most recent labwork and check your TSH. Normal TSH is between 1 and 1.8 mIU/L or so. This is the therapeutic range, but the reference range for TSH on a lab test is very wide, from 0.5 up to 4.5 typically. This is also why it’s always critical to ask to see your lab results and take action if your numbers are high or low normal. I cannot tell you how many times I’ve asked to see my clients’ labwork when I’ve suspected a thyroid issue, and they say, “My doctor said everything was normal.” 9 times out of 10, it is NOT. ALWAYS ask to see your labs, especially if you have symptoms. Your doctor is only concerned if the levels are already flagged as out of range, and by then, there’s already a serious imbalance.
Subclinical hypothyroidism means your TSH is within “normal” range on a lab test, but outside of the therapeutic range I mentioned. You still may have symptoms and may be feeling frustrated, but your doctor will tell you nothing’s wrong, or even worse, recommend anti-depressants (I hear that one all the time from my clients. It’s heartbreaking). These cases often aren’t even addressed in conventional medicine but are typically easy to correct with diet, supplemental, and overall endocrine support BEFORE it turns into a full blown problem. This is how preventive healthcare works.
Get Lab Work
I recommend running a full thyroid panel so you can get a clear picture about all your thyroid hormones and antibodies. Ask for TSH, free T3, free T4, and TPO antibodies at a minimum. If your doctor balks, you can order testing yourself and complete it at home via EverlyWell (click here to get the kit which checks all thyroid hormones and antibodies). Also check iron and ferritin as well; low levels contribute to hypothyroidism.
Ideal thyroid ranges are as follows:
- TSH 1-2 UIU/ML or lower
- Free T4 >1.1 NG/DL
- Free T3 > 3.2 PG/ML
- Reverse T3 less than a 10:1 ratio RT3:FT3
- TPO < 4 IU/ML or negative
How can you tell if you have hypothyroidism without lab testing?
- elevated cholesterol levels and/or elevated LDL
- low basal body temperature: less than 97.6 degrees, taken first thing in the AM before even getting out of bed & averaged over a minimum of 3 days. Use a BBT thermometer to assess this.
- other symptoms mentioned above
I didn’t know I had hypothyroidism when my labs showed it (my TSH was over 7.0 when I was first diagnosed!), but I did notice dizzy spells, brittle hair, and inability to lose weight initially.
How to Treat Hypothyroid
If you have the above symptoms or out of range TSH, get a full thyroid panel, and once you determine your levels, you’ll want to address diet & take appropriate supplemental action. For a TSH higher than 3.0, you may need thyroid hormone replacement, and there are several different options for this. Your practitioner can determine what is best for you. I no longer recommend NatureThroid, WP thyroid, nor natural thyroid alternatives due to inconsistencies from batch to batch.
Diet for Hypothyroid
- Unless you have Hashimoto’s autoimmune thyroiditis, which can be detected via thyroid antibody testing, iodine supplementation is recommended. Iodine is essential for the formation of thyroid hormones, and deficiency can be the cause of hypothyroidism. However, if you have Hashimoto’s, iodine can make your condition worse, which is why it’s critical to consult with a professional. Typically balancing selenium and iodine combats this problem. Also include iodine rich foods like sea veggies, especially kelp. I do not recommend iodized salt, which is chemically processed. Use natural sea salt.
- AVOID GLUTEN. The molecular structure of gliadin, the protein portion of gluten, closely resembles that of the thyroid gland. Gluten triggers an inflammatory response in the gut, breaching the protective barrier. The proteins enter the bloodstream, and the immune system tags it for destruction. These antibodies to gliadin also cause the body to attack thyroid tissue. Gluten can aggravate hypothyroidism. If you have Hashimoto’s, you must avoid gluten strictly.
- Stay away from too many raw cruciferous veggies, which block thyroid hormone production. Cooking or lightly steaming will deactivate this effect. Don’t add raw kale to your daily morning smoothie.
- AVOID SOY, which can damage the thyroid and contribute to estrogen dominance.
- Focus on organic proteins & plenty of veggies of all kinds
- Get the co-factors needed for thyroid hormone production: vitamin A, zinc, tyrosine, and selenium. Just five Brazil nuts contain all the selenium you need for a day.
- Use coconut oil, which boosts thyroid function
- Avoid processed foods & too much booze
- Get plenty of veggies of all types so you’ll get the antioxidants and minerals you need for thyroid hormone production. Root vegetables are especially good sources of minerals.
- Liver is an excellent thyroid superfood. Read about additional thyroid superfoods here, and my top 5 thyroid rockstars here.
- You may need a thyroid support complex to optimize nutrient levels. This complex has all the co-factors you need for healthy thyroid function.
- Address adrenal function/mitochondrial function, which is intimately tied to thyroid function
- Get enough sleep, 8 -9 hours
- Exercise! It doesn’t have to be much in the beginning, whatever works for you. Start out with a 20 minute walk, and add some yoga or pilates into your routine.
- Eat in regular intervals for stable blood sugar.
- Gut health is so important to healthy thyroid function, so address leaky gut and probiotic levels.
- Do a liver detox twice yearly to encourage proper T4->T3 conversion and to support healthy female hormone levels.
Do You Want to Learn Even More about How to Overcome Hypothyroid?
Check out my fabulous little resource guide, 3 Steps to Heal Your Thyroid. It’s only $9.99 and you can download it with a couple clicks to gain immediate access to all this wonderful information.
This e-book goes in depth about testing for overcoming hypothyroid:
- how to order your own labwork (with a 10% discount!) to test your thyroid hormones
- my 3-step plan for healing hypothyroid
- detailed supplement protocol, including my 5 thyroid rockstars
- plenty of diet recs
- my favorite thyroid-healing recipes to help get you started.
- And it’s only 25 pages!
Please note: this is an ebook, which means you will not receive a hard copy. You will receive an email with directions on how to immediately access the book via download. Please do not download to your phone. Files are best downloaded to your laptop or desktop.
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.