Your Thyroid’s Role in Health
The thyroid gland is a small butterfly-shaped gland located at the front of your neck. It works in close coordination with your adrenal glands (two tiny glands on top of each of your kidneys, located in your lower back) to regulate your metabolism, promote a balanced mood and healthy response to stress, and promote high-quality sleep at night. When your thyroid is not producing enough thyroid hormone, you may suffer from a variety of symptoms including fatigue, dry skin, hair loss, low body temperature, weight gain, water retention, constipation, unrefreshing sleep, brain fog, high cholesterol, and an enlarged “puffy” tongue. When your thyroid is producing too much thyroid hormone, you may experience profuse sweating, tremors, low grade fever, heart palpitations, insomnia, voracious appetite, and bulging eyes. Because thyroid hormone is used by every cell of your body, a poorly functioning thyroid can literally affect every other system of your body.
The main hormones produced by the thyroid are thyroxine (T4) and triiodothyronine (T3). These hormones are produced by the thyroid from the amino acid tyrosine and the mineral iodine. Thyroxine is converted into triiodothyronine inside the body’s cells by removing one iodine molecule.The mineral selenium is required for this process. A deficiency of any of these three nutrients can cause a lack of thyroid hormone, simply because the raw ingredients to make it are not available. In the presence of high cortisol (typically caused by chronic stress or exogenous administration of cortisone), T4 is converted to reverse T3 instead of T3. Reverse T3 is an inactive thyroid hormone that puts the brakes on your metabolism and can cause hypothyroid symptoms.
Why So Many Thyroid Patients Remain Undiagnosed
Thyroid problems often start in a person’s teens and early twenties, but can go undiagnosed for decades. Most thyroid problems are caused by an autoimmune disease called Hashimoto’s thyroiditis, which can include symptoms of both hyperthyroidism and hypothyroidism during the early stages. Because women are more likely to get autoimmune diseases than men, they are also more likely to suffer from thyroid disease. The explanation is that women have more delicate hormonal systems that are more easily disrupted by environmental triggers such as stress, pollution, fluoridated water, and poor quality food.
If you go to your doctor complaining of thyroid symptoms, the doctor will test your thyroid stimulating hormone (TSH). TSH is not a thyroid hormone. Instead, it’s a hormone produced by your pituitary gland that signals your thyroid to boost production of thyroid hormone. If your thyroid hormone is low, your pituitary gland in your brain will increase production of TSH to tell your thyroid to produce more thyroid hormone. If thyroid hormone in your body’s cells is adequate, the pituitary gland will produce less TSH. The pituitary gland is often described as your body’s internal thermostat because it produces TSH in this way.
The optimal TSH level for most individuals is between 0.5 – 1.8. This is the range at which most individuals feel healthy and energized. Unfortunately, most doctors use the clinical range, which is 0.5 – 5.0. An individual with a TSH of 5.0 may suffer from severe symptoms of hypothyroidism, but would not be diagnosed because TSH is still within the “clinical range.”
Another problem is that the TSH test is only an indirect measurement of your thyroid function since this hormone is not made by your thyroid at all. It’s highly possible that your thyroid can ignore the signal from TSH, and it’s also possible that the pituitary gland may be ignoring the signal from the hypothalamus to produce TSH. If the pituitary gland is analogous to a thermostat, the hypothalamus is analogous to the person who is adjusting the thermostat.
To understand whether your thyroid is producing the right amount of thyroid hormone, a better strategy is to actually measure your thyroid hormones rather than just the pituitary hormone TSH. This means testing your levels of T4 and T3. During the early stages of Hashimoto’s thyroiditis, TSH will be low, and T4 and T3 will be high. During the later stages of Hashimoto’s thyroiditis, TSH will be normal or high, and T4 and T3 will be low.
Graves’ Disease or Misdiagnosed Early-Stage Hashimoto’s?
Early stage Hashimoto’s thyroiditis is often confused with hyperthyroidism due to Graves’ disease, and the thyroid is either removed or irradiated (killed). Hormone replacement therapy is then required for the rest of the person’s life. This is unfortunate because individuals who are correctly diagnosed with early-stage Hashimoto’s can actually heal their own thyroid by putting the autoimmune process into remission.
Late stage Hashimoto’s thyroiditis is characterized by all the classic signs and symptoms of not enough thyroid hormone: hair falling out, tiredness, unrefreshing sleep, facial puffiness, weight gain, decreased appetite, depressed mood, dry skin, low body temperature, high cholesterol, and brain fog. Since TSH is often in the optimal range in late-stage Hashimoto’s, many individuals go undiagnosed until they finally demand that T4 and T3 be checked. These will be low.
It’s also useful to test for anti-thyroid peroxidase antibodies (TPO). Thyroid peroxidase is an enzyme needed to convert T4 into T3 in the body’s cells. Anti-TPO antibodies provide evidence that thyroid tissue destruction is occurring. This is an indicator of hypothyroidism caused by an autoimmune disease, rather than hypothyroidism that is secondary to a problem with the pituitary gland, hypothalamus, or chronic illness.
The Gut-Autoimmune Connection
If your blood test comes back positive for anti-thyroid antibodies, this means you have an autoimmune disease. Even if you remove your thyroid gland, you still have an autoimmune disease. The latest science on autoimmune disease strongly suggests that autoimmune processes begin with having intestinal hyperpermeability (leaky gut).Therefore, in order to put the autoimmune disease into remission and prevent an autoimmune attack on other tissues of your body, you must heal your gut! If you ignore this, the autoimmune disease will eventually attack another part of your body.
A leaky gut can be caused by a variety of factors, including: non-steroidal anti-inflammatories (NSAIDS) such as Aspirin, Aleve, Ibuprofen, and Naproxen; antibiotics; pesticides; proton pump inhibitors such as Prilosec and Nexium; chronic stress; nutritional deficiencies; gastrointestinal infections and parasites; chronic viral infections; food sensitivities; and gluten.
How to Heal Your Gut
Healing the gut is a four-step process that can take up to a year for more advanced cases of autoimmune disease. The approach is as follows:
- Remove – The first step is to do the appropriate functional medicine lab testing to identify overgrowth of pathogenic bacteria, chronic viral infections, fungal infections, parasites, and accumulation of environmental toxins. Depending on the particular pathogens or toxicities that are identified (if any), the appropriate supplements or medications are used to remove them. Removal also refers to the substances that are known to cause leaky gut (NSAIDS, PPIs, gluten, antibiotics, etc.). Foods that contain antibiotic residue, such as meat from confined animal feeding operations (CAFOs), must also be removed from the diet.
- The second step is to replace digestive enzymes such as hydrochloric acid, lipase, protease, and saccharidase. Failure to produce enough digestive enzymes can contribute to small intestinal bacterial overgrowth (SIBO), which can produce symptoms such as acid reflux, heartburn, and GI distress. Additionally, lack of stomach acid can allow parasites to live inside the gut and also increase your chances of contracting pathogenic bacteria associated with the “stomach flu.”
- The third step is to reinocculate the gut with beneficial bacteria. This involves including prebiotic foods (such as chicory, Jerusalem artichoke, and garlic) and probiotic foods (such as fermented veggies, kefir, and kombucha) in the diet. Probiotic supplements containing at least 8 different strains of bacteria is also an important element of this step. It’s extremely important to not include prebiotic and probiotic foods (as well as supplements) before steps 1 and 2 or you could potentially worsen your condition.
- Finally, the fourth step is to regenerate the intestinal mucosa. This is often referred to as “healing and sealing” the gut. This is the fun part where you get to incorporate colostrum ice cream, vitamin C gelatin gummies, butter cookies, Wild Alaskan Salmon, and bone broth into your diet. There are also supplements that can assist the process, such as proline-rich polypeptides, lactoferrin, and phosphatidylcholine.
Get More Support
It’s tough to go at it alone when you’re struggling with your health, and dysfunctional medicine isn’t providing the answers and protocols you need to get better. Join my Telemedicine Annual Membership to have access to me for help and guidance throughout the year.
An autoimmune process in your body that robs you of your energy and disrupts your ability to focus can be extremely frustrating, especially if your lab tests all come back “normal.” There are many reasons why thyroid disorders often go undiagnosed for years or even decades, but I think one of the big reasons is the McDonaldization of healthcare. The doctor usually has 5 minutes or less to hear your case, and on a hectic day he might actually be looking at another patient’s medical chart during his visit with you. (This has happened to me before, and I bet it has happened to you!)
What I offer through Annual Membership is more of a concierge service. You are a name, not a number. We will investigate every aspect of your health that you are comfortable with disclosing in order to find the root cause of your condition. Then during the treatment protocol, I will hold your hand every step of the way to make sure you feel supported. All Annual Members have access to my personal cell phone number for help and support any time they feel lost in the process. You health information is also kept completely confidential, meaning your health information is never shared with third parties. All consultations can be done through phone or Skype, so you do not even have to be in the USA to be able to work with me. For more information, or to get started working with me, please click here.