De-mystifying Hypothyroidism: symptoms, testing, and healing solutions
The Thyroid. The little Gland with BIG consequences in the body. The more I learn, study, and see clients the more I am overwhelmed with just how much our thyroid can affect every aspect of our life. And, not to mention, overwhelmed at the sheer magnitude of how many women in America have thyroid problems and have NO IDEA.
Just to give you a picture of what thyroid dysfunction looks like in the United States, let’s run through statistics, shall we?
Nearly 1 in 3 PEOPLE HAVE THYROID DYSFUNCTION, the MAJORITY of which are women, but more than half of them have NO IDEA THEY HAVE IT.
Around 95% of diagnosed Hypothyroid cases are HASHIMOTO'S THYROIDITIS (the autoimmune form of hypothyroidism)….
Women are 5-8x more likely to develop a thyroid condition in their life than their male counterparts
1 in 8 women will develop a thyroid disorder in her life!
Okay. Do you see what I’m talking about now? It is common and rampant among women especially.
You might be wondering: why do women get the short end of the stick here? What is it about us that makes us so much more prone to thyroid dysfunction? Well, I’ve got one simple answer for you:
WE CAN MAKE BABIES.
Yup. That’s why. We bleed every month, we have the capacity to grow tiny humans, and that means we are more sensitive to stress and we’ve got a higher possibility for complicated hormone issues like Estrogen Dominance which can irritate the inflammatory processes in the body, therefore contributing to something like HashimotoThyroiditisits (the autoimmune form of Hypothyroidism).
Also, since we can have babies, we are the human beings that have the opportunity to go through LITERALLY the most stressful event our bodies can complete (multiple times for some women), which is directly followed by YEARS of ongoing stress, lack of sleep and the life changing job that is motherhood. Though having children can be an incredible source of joy, pregnancy and birth can also be a trigger for thyroid conditions and happens in A LOT of women.
BUT WE AREN’T JUST SCREWED FOREVER. Read on to learn what hypothyroidism can look like, the most common causes, EXACTLY what lab tests to request from your doctor, and methods for healing your thyroid naturally.
Think you have hypothyroidism but not sure? I feel you. I put together a list of Hypothyroid symptoms so you can assess for yourself whether you might want to bring these to your doctor:
-fatigue (most prevalent and common)
-brain fog and/or forgetfulness
-insomnia and trouble sleeping
-High Cholesterol (especially that which doesn’t respond to diet changes or stress reduction techniques, or even medication!)
- unexplained weight changes
-mood disturbances like depression and anxiety
-muscle aches or joint pain
-thinning hair or loss of the outer portion of eyebrows
-skin changes like acne or extremely dry skin
-infertility and/or multiple miscarriages
-difficulty swallowing or changes in neck size
-sensitivity to cold
If you’re thinking that’s a lot YOU'RE RIGHT. I told you, the thyroid controls and contributes to SO MANY bodily processes that if your thyroid is off, you feel off!
Autoimmunity & Leaky Gut
Considering 90% of hypothyroid cases are Autoimmune in nature (Hashimoto's Thyroiditis), I would be remiss If I did not mention this. In this instance, our immune system mounts antibodies to destroy the thyroid tissue because it sees it as a foreign invader, a process that causes MASSIVE inflammation elsewhere in the body, ESPECIALLY in the adrenal glands and ovaries.
The irony is, the root cause of this mechanism isn’t in the thyroid but in our GUT. Our gut houses anywhere between 70-80% of our immune system in a sect called GALT (Gut Associated Lymphoid Tissue). Galt can be triggered by infectious agents, food particles, and foreign proteins slipping through our intestinal lining in a condition called LEAKY GUT. This is when the lining of our intestine becomes damaged and allows WAY too many little guys to get through, therefore causing GALT to trigger an inflammatory response.
If this happens chronically, the body will see this as a resounding threat and seek to create ANTIBODIES which set off an autoimmune attack on tissues such as the Thyroid and raise inflammation everywhere.
Basically, having intestinal permeability (aka LEAKY GUT) is NECESSARY for an autoimmune disease to develop. This is why when I get questions about autoimmunity or I see clients with Hasimotos, I immediately ask about their digestion and what they are doing to heal their gut. Poor gut health puts you in way too compromised a position for Autoimmunity and needs to be the cornerstone of any healing protocol. (For more on Gut Healing, go HERE)
Common Causes of Leaky Gut are
-chronic NSAID use
-Chronic stress that’s a big one
-Diets high in processed food/sugar and low in Nutrient Dense fiber
-The Birth Control Pill
-Ignored or undiagnosed food sensitivities (this is also ironic because leaky gut can also CAUSE a whole array of food sensitivities. If you’ve been told you’re sensitive to a whole bunch of foods, chances are your intestinal lining has been compromised and gut healing is necessary)
It is EXTREMELY common for pregnancy to trigger thyroid dysfunction in women. It is so common we now have coined it “Post Partum Thyroiditis”. Why? Well, there are a few factors at play. Most women enter pregnancy to being with at a nutrient depleted level, then go through pregnancy (which demands a CRAP ton of nutrients from our body), then they give birth which is HIGHLY stressful and inflammatory, and then they push out the placenta, at which point their hormone levels COMPLETELY nosedive and their body is in a state of disarray and balance until it can get its bearings.
Stress is one of the biggest drivers of Autoimmunity. And you know what one of the biggest drivers of stress can be? A NEW BABY. A baby that you now have to care for and lose sleep over and produce milk for after just going through the nutrient depleting, inflammatory and stressful process of pregnancy and birth.
If you are not in tip-top shape gut and nutrient wise, it can be the PERFECT trigger for hypothyroidism or Hashimoto's.
Not to mention, this is one of the most underdiagnosed populations. Because when a new mom comes to the doctor complaining of fatigue, weight gain, and low mood, most doctors will say “well yeah, you just had a baby”….. Um no. TEST TEST TEST.
Stress and Trauma
Stress is the NUMBER ONE cause of disease. Chronic low-grade stress from your work or relationship can contribute to and TRIGGER thyroid dysfunction, and so can an acute traumatic event can like Pregnancy or death of a loved one. Stress CANNOT be understated in your thyroid health and needs to the at the top of the priority list in any healing protocol.
Stress can also look like the physical stress of overexercising and undereating. I see WAY too many clients and women around the world who develop hypothyroidism due to years of chronic restriction and dieting. It’s the classic picture of women who think “more is better” and push themselves in the gym every day, restricting their food and going low carb or low fat, only to start GAINING weight. To which they usually think more restriction and extra exercise is the answer, which only makes everything worse. If this sounds familiar, WELCOME TO THE FRIKIN CLUB. That is a thyroid’s worst nightmare. STRESS STRESS and more STRESS.
Nutrient Depleted Diet
Chronically consuming processed/nutritionally depleted foods while also neglecting to include nutrient dense foods leads to nutrient deficiencies that over time can weigh on our body. Two of the most important nutrients for optimal thyroid health are selenium and iodine, and failure to get those in for a long period of time can cause hypothyroid symptoms. More on thyroid-specific nutrients later in the post.
One of the most frustrating things about thyroid dysfunction in the United States is how often it is MISSED or MISDIAGNOSED. Often we are given antidepressants, anti-anxiety meds, cholesterol lowering meds, or even birth control to fix symptoms that are ACTUALLY caused by thyroid dysfunction. Why is it missed? 2 main reasons:
Doctors don’t order the proper tests
It is common for most doctors to JUST look at TSH when examining the thyroid which is a big no-no. Here’s why: the TSH is just 1 piece of a multiple chain process that is involved in our thyroid hormone functioning. TSH stands for Thyroid Stimulating Hormone but there are other pieces of the puzzle that need to be looked at: Free T4, Free T3, Reverse T3, and Thyroid Antibodies are all labs that need to be run in order for your doctor to not only get an accurate picture of your thyroid health, but be able to pinpoint WHERE in the chain something is going wrong.
So, when you go to the doctor, here is what I want you to request: a FULL thyroid cascade with TSH, free T4, Free T3, Reverse T3 (if you can), and the following antibodies: TPO (Thyroid Peroxidase) and Thyroglobulin (TGAb)
2. Your doctor is using the wrong ranges.
Oohh this is the other that gets me fired up. LET ME BE CLEAR, your TSH SHOULD rest in between 1-2.5 (for the majority of you guys, there are always outliers). That is what we see in THRIVING individuals. Unfortunately, a lot of doctors prescribe to the outdated lab ranges that focus on extreme diseased states and don’t get flagged until you hit ABOVE a 4.5. So even if you get all the right lab tests ordered, your doctor could say oh Nothing was flagged you're great! While you sit there with your hair falling out and fatigue so strong you want to take a nap 24/7. YOU ARE NOT CRAZY. This is why I advocate for getting those lab results IN YOUR HANDS. Discuss with your doctor what ranges they use and tell them you want to be notified when they are outside of functional ranges, or just get a copy and see for yourself. If you’ve been told your lab results are normal but you are still exhibiting symptoms, I HIGHLY recommend the book Why do I still have thyroid symptoms when my lab tests are normal?
This is the good stuff. Alright, I’m going to break this down by Meds, Nutrition, and Lifestyle changes. As I always say, ALL medicine is medicine. And I want to respect your choice to engage with or not engage with prescription medications. It can be a lifesaver for some or a really bad choice for others. Everyone is different, and I just want to make sure you are EDUCATED so you can make informed decisions about what’s right for you with whatever doctor you have that you trust. However, whether you take meds or not, you NEED to still be working on the other two components I have listed to ensure optimal thyroid health.
OKAY. LET'S GO.
So, if your doc calls the right testing and uses the right ranges (some doctors do some don’t, it isn’t necessarily a ‘western v eastern’ type of thing.) and you’ve been identified as having a thyroid issue, there are MULTIPLE courses for treatment.
Here are the most common medication options and some info about each so you can decide with your doctor which would be the best choice for YOU:
This is what I went on personally. The 2 most common brands are NaturThroid and Armour Thyroid. They are desiccated pork thyroid glandular and basically give a BOOST to the entire Thyroid chain as a whole. I find this to be more beneficial for patients that don’t have a SPECIFIC issue in the conversion chain ( ex: like a normal TSH but abnormal T3 kind of patient) but instead have a stressed thyroid OVERALL. Because it is a glandular you can't isolate the amount of T4 or TSH which is why some doctors don’t like to prescribe it. There are mixed reviews with Hashimoto’s patients on Glandulars. For some, the glandular tissue can still trigger an autoimmune attack which is why it won't work for everyone.
It is preferred by many because it is the more natural option but, AGAIN, that doesn’t mean it will be the best choice FOR YOU.
Synthetic T4 (Synthroid)
This is the most commonly prescribed med and is often the preferred choice for those with Hashimoto's. It is a synthetic version of T4 only and can be easily controlled. If your thyroid issue, however, is in the conversion of T4 to active T3 (which is often a liver or nutrient issue more than anything else), than this medication won’t do much for you.
This is the synthetic form of the ACTIVE thyroid hormone we can use so it has the greatest metabolic effect in the body. The flipside of that is it is REALLY easy to overdose and can be too strong for many, especially those with Hashimotos whose symptoms flip from hypo to hyperthyroid, in which case this medication would be a very bad idea. It is not very popular for this specific reason.
Here are the nutrients/foods that are critical for optimal thyroid function and should be a focus for you if you are looking to heal.
LEAFY GREENS: foods like organic chard and spinach are wonderful for the thyroid because they are rich in chlorophyll and insoluble fiber, both of which are critical for detoxification. Since the thyroid is so easily affected by toxins, we want to make sure foods that support detox are a focus of our eating plan. (read more about ways to boost detoxification HERE)
Selenium-rich foods (necessary for conversion of T4 to T3): brazil nuts, sardines, organ meats, sunflower seeds, crimini mushrooms
Organ Meats: Don’t scrunch your nose!! They are some of the most nutrient-dense foods ON THE PLANET, and contain high amounts of Vitamin A which are critical for detoxification! Make sure they are grass-fed and organically sourced.
Bone Broth: like I said before, gut healing needs to be at the cornerstone of your healing protocol. And you can’t spell Gut Healing without BONE BROTH (well....not in my book). It is the best food to help rebuild the gut lining! For more on gut healing, I have a post dedicated entirely to it HERE.
Iodine: this is a tricky mineral to nail because it is critical for thyroid health but only a little is needed. Most Americans are not deficient because our table salt is supplemented with it. However, if you avoid fortified foods, make sure to include some seaweed or seafood a few times a week. NOTE though, that intake of iodine IN THE PRESENCES OF A SELENIUM DEFICIENCY can make autoimmune thyroid symptoms worse…It’s all about balance here folks. Eat your sardines and munch on your brazil nuts! IMPORTANT: iodine can be a trigger for autoimmunity so if you have Hashimoto's Thyroiditis, make sure to consult your doctor on how much iodine to be eating.
Vitamin C rich foods like berries and citrus fruits: Vitamin C is not only a critical vitamin for the immune system, but is major for supporting the adrenals. And if you have a thyroid problem then most likely you have an adrenal problem, so show them some love.
Vitamin D: Low vitamin D levels have been associated with many autoimmune diseases, specifically in the thyroid. Vitamin D levels can get put on most average metabolic panels and will give you insight into whether you need to supplement or schedule more vacation time (kidding…. But also not. GET YOUR SUN TIME GUYS). If you have an autoimmune disease than your ability to synthesize Vitamin D is actually lower than the average person, so you want to maximize the easiest and most bioavailable ways to get it like through direct sunlight (our skin has the most efficient synthesis capabilities for Vitamin D). Vitamin D rich foods include fatty, cold water fish.
Essential Fatty acids: These are major for decreasing inflammation. Not only does high inflammation levels suppress our ability to convert T4 to T3, but it can also decrease thyroid receptor function. Make sure you are getting those Omega 3 sources in or taking a Cod liver oil supplement like I am and get that extra punch of thyroid loving Vitamin A!
Zinc: critical for immune function and work together with copper and selenium to convert T4 to T3--> Oysters and grass-fed red meat are great sources, or you can supplement!
Iron: for many, iron deficiency and thyroid dysfunction commonly occur together. Since iron contributes to proper production of thyroid hormone, a lack of it can negatively impact thyroid function. It is also really important for proper immune function. I recommend getting your sources from bio available heme iron animal sources like red meat and chicken liver. It’s commonly said that spinach and broccoli are great sources of iron, but the sad news is that your body is not NEARLY as primed to process this non heme form ( You can add lemon juice -vitamin C- to help increase absorption and make sure you eliminate phytic acid foods like legumes that block absorption of it)
AVOID: Though I am not one to willy-nilly prescribe elimination, in healing protocols it is often necessary. For starters, Gluten and Dairy should be completely avoided for patients with thyroid dysfunction. For my AUTOIMMUNE friends with Hashimoto's Thyroiditis, I recommend something like the AIP protocol for help in gut healing. Also, GOITROGENS (ie. Cruciferous veggies) can aggravate thyroid conditions in the face of an iodine deficiency. Most of us don’t have to worry about that though, and can simply cook them and keep it to a couple servings a day to avoid any thyroid agitation. Cook al your veggies and don't overdo it and you should be fine.
If you take ONE THING away from this post, over all my scientific or nutritional recommendations, let it be this: You WILL NOT heal thyroid dysfunction without making serious changes in your life to lower mental and emotional stress. Stress is the BIGGEST predictor of thyroid disease, whether it be emotional, mental, or physical. The thyroid is a powerful gland BECAUSE it is so sensitive to changes in the body. It is ravaged by stress and is one of the first components of our bodies to crumble in high-stress times, next only to the adrenals.
There are many women who have what’s called “subclinical” hypothyroidism. Their antibodies aren’t elevated and their TSH is SLIGHTLY elevated above what it should be. This is seen usually in the midst of high stress. The thyroid temporarily can be suppressed by high-stress times without actually spiraling into a full-fledged disease. Therefore, If you get your labs done and nothing is majorly concerning but you are still experiencing symptoms, I urge you to address where your stress levels are at. Focus on your emotional health, eat nutrient dense foods, take it easy on the exercise, and sleep a lot. Those are the foundations I used myself to heal my thyroid. Simple but effective.
A NOTE ON LOW CARB DIETS
Okay, I’m just going to put this out there because I’ve seen this phenomenon happen in too many women not to mention it. I am not a big fan of low carb diets in the face of thyroid dysfunction at all, and AS A MATTER OF FACT, I have seen MULTIPLE women trigger their hypothyroidism by going Keto, myself included. Now, THIS IS NOT A BLANKET STATEMENT, as everyone is different. However, I have noticed a common pattern in many that I think is worth bringing up: They start doing low carb or Keto and feel GREAT. They love that they are shedding weight and they have mental clarity like never before and YAY. Then, a few months go by and their sleep starts to get a little messed up. And their hair starts falling out. And the weight that used to fall off is now creeping back. They have no idea what's going on and think the answer is to low carb HARDER...
Guess what...It's not.
Here’s why: Your liver REQUIRES glucose for the conversion of T4 to T3. And though TECHNICALLY speaking your body can produce its own, that is still a stressful process for your body to go through under anything less than vacation-like circumstances.
Not many people thrive off of a Ketogenic diet LONG TERM (there are definitely some...just not a lot), and for the MAJORITY of the women I have worked with, witnessed, and talked to, a lot of us don’t fall in that category. This is ESPECIALLY true of any of you that have struggled with food restriction or having a stressful relationship with food. Cutting out macronutrients can literally be traumatic for a body that is already coping with the mental stress of food restriction in general and can really back fire.
So, if you are currently low carbing it and experiencing any thyroid like symptoms, it might be as easy as upping your carbs and working on stress reduction and BOOM, your thyroid is back in business.
Okay, YOU MADE IT. I know that was a lot of info and man I feel like I could’ve gone on FOREVER. We’ll be talking about the thyroid in more posts to come, because there is so much to dig in here, but I hope this gave you a good amount of info to sit on and take to your doctor. And DON’T FORGET, if you need help looking over lab results, want to pick my brain, or want me to guide you in your personalized thyroid healing plan, don’t hesitate to reach out;)