Your Wellness Options - Thyroid, Hypothyroidism

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LeeAnn Rahn
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What You NEED to Know About Your Thyroid
by LeeAnn Rahn

Do you feel fatigued much of the time? Are you having a difficult time controlling your weight despite honest efforts? Are your hands and feet chilly more often than not? Are you losing your hair? Do you even feel a little depressed at times? Don't worry, you are not alone. Thyroid disease can affect your health in ways you may never have imagined which is one of the reasons it may be frequently overlooked or misdiagnosed.

Women are far more likely to be affected with Thyroid disorders than are men, in fact, seven times more likely. A woman's lifetime chance of being affected by a Thyroid disorder, depending upon the source, is anywhere from 20 percent to 50 percent.[5] If you think that's startling, some suggest the number of Americans suffering from Thyroid disorders is close to 27 million with half still undiagnosed or misdiagnosed.[3, 5] Learning a little bit about how your endocrine system works may positively impact your life.

What is the Thyroid gland and what is its function? The Thyroid gland is a small butterfly shaped gland that wraps around your windpipe. It is located in the front of the neck just behind the Adam's apple area. The role of the Thyroid gland is basically that of a metabolic gatekeeper. The hormones secreted, regulate the rate of function of almost all tissues in the body.

Even though the Thyroid gland is considered the "master gland of metabolism," it should not be singled out from the rest of the endocrine system. Your endocrine system is similar to an assembly line. If any gland in the 'assembly line' does not function properly, the end product may be lacking in quality, quantity, etc. The same holds true for the environment in which the 'assembly line' resides. If it is turbulent, void of nutrition, or full of stress, quality control will again have their hands full.

Though your Thyroid secretes many hormones, the two key hormones produced are Thyroxine (T4) and Triiodothyronine (T3). When your endocrine system is working in tip top form, your Thyroid output will be approximately 80 percent T4 and 20 percent T3. [5]

When your Thyroid gland combines iodine with the amino acid tyrosine, the result is T3, with three iodine molecules, and T4, with four iodine molecules. T3 is more biologically available and much stronger than the largely inactive T4. But remember, we only get a portion of T3 directly from our Thyroid gland. The remainder comes from what is referred to as the "T4 to T3 conversion". [5] This is another point in the process where your overall health can affect your thyroid function because the process to convert T4 to T3 does not occur in the Thyroid. It depends upon other areas of the body such as the liver and the hypothalamus. A sluggish liver may possibly lead to less T3 than is necessary for proper Thyroid function. [5]

I want to take a couple steps back to allow you to see a bigger picture of the process. "The thyroid is part of a huge feedback process. The hypothalamus in the brain releases Thyrotropin-releasing Hormone (TRH). The release of TRH tells the pituitary gland to release Thyroid Stimulating Hormone (TSH). This TSH, circulating in your bloodstream, is what tells the thyroid to make thyroid hormones and release them into your bloodstream." [5]

Thyroid Disorders

Goiter is an extremely enlarged thyroid gland.
Thyroid Cancer - The most common types respond very well to treatment.
Solitary Thyroid Nodules - "Although as many as 50% of the population will have a nodule somewhere in their thyroid, the overwhelming majority of these are benign." [3]
Thyroiditis is an inflammation of the thyroid.
Hyperthyroidism is caused by over activity of the thyroid gland. Generally present symptoms include rapid weight loss, insomnia, anxiety, palpitations, unusual sweating, tremors, diarrhea, and fatigue to name a few. Quite often, treatment for hyperthyroidism will lead to hypothyroidism.
Hypothyroidism, in simplistic terms, is basically the opposite of hyperthyroidism. It is caused by an under active thyroid gland. Of those who suffer from hyperthyroidism and hypothyroidism, the vast majority suffer from hypothyroidism which is much more common than most realize. For this reason, we are going to focus on hypothyroidism for the remainder of the article.

Symptoms of Hypothyroidism will vary greatly from person to person. Some will experience only mild symptoms while others will experience symptoms of greater severity. The following list of symptoms is a long compilation from a variety of sources.

Fatigue, exhaustion, frequent napping, weakness
Always cold, especially feet and hands
Weight gain or inability to lose weight despite honest efforts
Depression
Constipation
Muscle aches, muscle cramps
Joint pain
Thin, brittle nails
Eczema
Psoriasis
Difficulty concentrating, memory problems,
Irritability
Decreased libido(men & women), erectile dysfunction in men
Abnormal/increased menstrual periods
Breast milk formation
Tendonitis in arms or legs
Carpal Tunnel Syndrome

Heart palpitations
Dry, pale, coarse, or flaky skin
Puffy face and eyes, and sometimes hands and feet
Hair loss
Dry, coarse, brittle hair
Thinning of eyebrows
High cholesterol levels (diet and medication do not seem to help)
Infertility or miscarriages (unexplained)
Allergies more severe
Abdominal bloating
Chronic yeast infections: "Whether or not Candida can cause hypothyroidism - as Dr. Crook claims - or whether thyroid disease can allow Candida to flourish is not clear. But there are anecdotal claims of a definite relationship." [6]
Anemia
Swelling in your neck
Chronic Fatigue Syndrome
Fibromyalgia

[1,4, 5, 6, 7, 8, 9, 10, 11,12, 13, 16]

Some of the Causes of Hypothyroidism are tied to cell damage within the thyroid.

Inflammation of the thyroid gland - the most common is Hashimoto's Thyroiditis where the body creates antibodies to attack the thyroid.
Exposure to radiation, especially in the nasal and neck areas.
Treatment for hyperthyroidism, nodules, and goiter may damage the thyroid gland as well.

Other causes include:

Improperly functioning or damage to other glands and organs that work hand in hand with the thyroid such as the liver, pituitary, and hypothalamus.
Birth defects
Surgical removal of the thyroid gland
Family history of thyroid disorders
Use of Lithium
Dietary iodine deficiency or over consumption
Over consumption of soy products
Poor nutrition

Now that we have noted the common causes, let's look at some of the risk factors.

Women over 50 or men over 60 years of age
Near menopause or menopausal *
Female gender
Pregnancy (during or after) *
Thyroid or immune system disorders are present in your family tree
Obesity
Thyroid damage due to surgery or neck X-rays
Smoking
Exposure to drugs such as Lithium or chemicals such as fluoride and ammonium perchlorate (both can be found in water).
Diagnosed with Chronic Fatigue Syndrome, Fibromyalgia, or Carpal Tunnel
Stress

*Studies suggest fluctuating hormones may play a role in hypothyroidism risk. [5, 11]

All right, let's say your are cold almost all of the time, even when everyone else is comfortable, your hair is dry, coarse, and falling out, and you are always exhausted. Let's also throw in the fact that your uncle has insulin dependent diabetes and your mother has rheumatoid arthritis (both immune system disorders). This clearly points to hypothyroidism, correct? Absolutely not. Yes, it is possible you have an under active thyroid but it is also possible you are just dealing with symptoms of another ailment. Your symptoms may come from something as simple as basic aging or working too many hours. It could also be caused by cortisol (excess hormone is produced in response to stress), by stress on your adrenal gland, or insulin resistance. [1] This is why it is very important to be tested.

Thyroid Testing has come under fire as well as some of the doctors analyzing the results. Many experts now days do not believe the standard TSH and T4 testing adequately predict hypothyroidism. "Remember that these levels can vary considerably from individual to individual and what is 'normal' for one person is not necessarily normal for another. Doctors must be sensitive to the correlation between symptoms and TSH and T4 levels in the individual. Because the 'normal' range varies from person to person, some people may have hypothyroidism or hyperthyroidism (and their symptoms), while blood tests show that their TSH and T4 levels are normal." [12] Unless you seek out (or get a referral) to a doctor who specializes in thyroid or endocrine disorders or one with a good understanding of and positive track record in diagnosing hypothyroidism you may just be sent home with a prescription for more sleep, more exercise, or pills for depression. Some may get the PMS or menopause brush off.

The two most common Thyroid screening tests are the TSH and T4**.

TSH is a measurement of Thyroid Stimulating Hormone coming from the Pituitary gland

'Normal' range: 0.5 to 5.0 or 0.3 to 3.0 depending upon the laboratory

T4 is a measurement of Total Thyroxine

'Normal' range: 4.5 to 12.5

Other tests that may and should be run include**:

Total T3

'Normal' range: 80 to 220

Free T4

'Normal' range: 0.7 to 2.0

Free T3

'Normal' range: 2.3 to 4.2

** All test ranges are approximate and may vary depending upon the laboratory used.
[14]

If all of the above tests results come back 'normal' but you have symptoms and believe you may have a thyroid problem, please request the following tests.

Antibodies test - If your antibodies are elevated, your may be in the process of developing an auto immune thyroid disorder.
Comprehensive Thyroid Assessment also called a Great Smokies Diagnostic. You may actually want to request this test up front.

Do It Yourself Testing is a great place to start but please seek medical attention should you need it. Self testing is by no means a substitute for detailed medical testing.

Temperature: For this test you will be taking your basal body temperature three to five days in a row with an 'old fashioned' thermometer.

Place a thermometer, shaken down below 95 degrees, by your bedside. Shaking it down when you wake up will be too much activity and will cause an inaccurate basal body temperature reading.
When you wake up in the morning, place the thermometer in your armpit with no clothing between the thermometer and your skin for 10 to 15 minutes. Lay still and relax.
Record your temperature
At the end of the three or five days, average the temperature readings by adding all of the temperatures together and then divide by the total number of days you took your temperature.

Please note: Women should avoid the first week of their menstrual cycle(during menstruation) and a few days mid cycle while they are ovulating.

Results: Your average temperature should be above 97.5 degrees (defined range varies from 97.4 to 97.6 depending upon the expert). If your temperature is lower, you may be suffering from hypothyroidism or subclinical hypothyroidism.

Iodine Test: This test seems to have a wider range of result definitions and even some who say the test really is not applicable due to the evaporation factor of iodine. I will let you decide for yourself.

Do not perform this test more than once in a 24 hour period.

For this test you will need to purchase a small bottle of Tincture of Iodine, 2% solution. It comes in a very small bottle and costs $1 to $2 at a discount store.
Draw a 2" circle on the soft skin on your stomach, near your belly button or on your inner thigh.
Check every 1/2 hour or so and record how long it takes the iodine stain to completely disappear.
Results: The jury seems to be out on exactly how long the iodine should take to disappear. Some say in no less than 24 hours others say less. One source says if it is absorbed in less than 4 hours you may have an iodine deficiency at the very least.

When you do the self tests above, you need to consider the 'big picture'. Look at how many symptoms you have, how long you have had them, and how severe they are. Assess your risk factors, and review your diet. Women require more iodine than men and may need double or triple the amount when under stress. Unfortunately, the foods we eat contain less and less iodine as the years progress. "For example, back in 1940, the typical American diet contained about 800 micrograms of iodine. By 1995, that amount plunged to just 135 micrograms. That's an 83% decline." [15]

Multiple treatment options exist for hypothyroidism though many doctors may only inform you of one. 'Take one pill a day and your problem is solved!' Sounds great but, how can a 'one size fits all' program properly treat a disorder whose afflicted have such a wide range of symptoms and test results. Earlier you read how even those with normal test readings can have hypothyroidism. Basically the point I want to make is to ensure you have a good understanding of hypothyroidism, its symptoms, and some of the treatment options available before you speak to your doctor. When you do speak to your doctor, do not be afraid to discuss your options. If you would like to begin with a nutritional or herbal option first, make it known. Please always be up-front and frank with your doctor though.

Treatment Options

Synthetic T4 - The most popular treatment method is synthetic T4 (Levothyroid, Levoxyl, Synthroid). Unfortunately, it is not quite as simple as many doctors would have you believe. Prescribing the proper dosage levels can be quite tricky sometimes. Luckily for some, the synthetic T4 works perfectly fine. Others find minimal relief of symptoms and sometimes feel a little like guinea pigs. If you choose the synthetic T4 treatment option, please make sure you are working with a practitioner or endocrinologist with a proven track record of success.
T3 - Some people with hypothyroidism are not in need of additional T4. Their bodies struggle with the "T4 to T3 conversion" process. Few doctors will prescribe T3 to their patients. Many doctors do not believe in using T3 because it is much more difficult to pinpoint the correct dosage than with T4.
Armour Thyroid - Prior to the 1970's, desiccated pig thyroid (Armour Thyroid) was the treatment of choice because it provided both T3 and T4. Once the synthetic T4 was made available, doctors abandoned the natural form and jumped on the 'lab created' bandwagon believing it had to be a better product. Armour Thyroid is still available today and apparently provides good results for many.
Nutrition - According to many alternative health practitioners, poor nutrition may actually be the leading cause of today's widespread thyroid problems. It is a known fact that the foods we eat no longer contain anywhere near the amount of nutrients they did in the past. Alternative health practitioners believe proper nutrition, which in today's environment requires supplementation, may reverse hypothyroid symptoms or at least stop further progression of the disorder. Supplements such as Progressive Health's Thyax may be taken to support healthy thyroid activity. Supplements of any kind should never be substituted for healthy eating habits though. If you would like to increase your daily iodine intake, try adding the following to your diet: the herb kelp, sea vegetables, sea food and fish, eggs, dairy products, onions, radishes, and watercress. Foods you may want to remove from your diet, at least temporarily, include cabbage, peanuts, Brussels sprouts, cauliflower, broccoli, turnips, kale, and soy flour. These foods contain very important components for immune system health but they also suppress thyroid function.
Reduce Soy Consumption - You may want to reduce soy consumption to a minimum until more is learned about soy isoflavones and their possible connection to worsening thyroid problems.
Stress Reduction - Chronic stress plays a very serious role in hypothyroidism. Continued stress invokes additional cortisol production which then causes the body to create more RT3 (Reverse T3, which is inactive) instead of active T3 in efforts to conserve energy for stress. Unfortunately, the non-functional RT3 looks just like active T3 in blood tests. You can treat a stress induced T3 deficit with T3 but it is best to directly treat the stress and excess cortisol production. If you suffer from chronic stress, you need to implement a stress management plan. In addition, unresolved emotional issues, nutrition, as well as a dose of self care all need to be addressed. Herbal products, such as Himalayan Goji Juice, may aid in your stress reduction efforts.
Acupuncture and Reflexology - both practices involve stimulating anatomic reflex points in the body to treat ailments.
Homeopathic Remedies, Chinese Medicine, and Herbs - Many people respond very well with these types of treatments.
Avoid Fluoride, Chlorine, and Ammonium Perchlorate - Make sure your water is purified.
Stop Smoking - Smoking can worsen hypothyroid symptoms and can even damage the thyroid gland. [1, 7, 12, 15, 17]

Now what do I do? My advise is to take a look at your 'big picture'. What symptoms do you have and to what degree of severity? What risk factors do you have? What were the results of your self tests? Depending upon your answers, you may only choose to improve your nutrition. (Make sure you get enough iodine, the amino acid tyrosine, zinc, selenium, and folic acid in your diet or via supplements.) Some of you may choose to see your doctor to have additional tests run. Then, others of you, may have perfectly operating endocrine systems and may not need to currently implement any changes. What ever you decide, even if you do absolutely nothing but read this article, I hope it makes a lasting impression and you think about your thyroid health the next time you send your daughter to get your sweater because you're cold.

Herbs and More:
Short Briefs
by LeeAnn Rahn

acidophilus: Not all bacteria are "bad". Lactobacillus acidophilus and other members of the Lactobacillus family are considered "good" bacteria and are very beneficial to your health. Many potentially harmful organisms live in and invade your body constantly. The natural antibiotic effects received from acidophilus aid in the maintenance of your digestive tract health. Another function acidophilus aids is the manufacture of 'B' vitamins. Acidophilus is generally taken to treat and prevent digestive disorders , vaginal infections, and other illnesses. It also may ease irritable bowel syndrome, help control diarrhea (if due to antibiotic use), reduce flatulence, relieve infections associated with Candida, relieve urinary tract infections, and help bad breath. Our diets can greatly affect the level of good bacterial in our gut. Diets rich in antibiotic and steroid fed red meat and over consumption of sugar can both destroy the necessary and beneficial bacteria. We also destroy beneficial bacteria every day with the over use of anti-bacterial soaps and hand sanitizers. Remember, some bacteria are good for us.

aloe vera: Aloe vera gel is historically recognized as a topical remedy for first degree burns, sunburns, cuts, scrapes, insect bites, and other minor skin irritations. It is also used to lessen the pain associated with shingles and reduce the symptoms of psoriasis. Juice, made from the aloe vera gel, can be taken internally. The stomach, small intestine, and colon benefit from anti-inflammatory fatty acids contained in the aloe vera as well as its alkalizing and soothing qualities. Currently, a compound of aloe vera is being researched for its ability to strengthen the immune system.

Occasionally, some who use aloe vera gel may develop a mild allergic reaction and may experience itching or a rash. Topical application is very safe though and reactions are rare. A component of the aloe vera plant is used and marketed as a potent laxative. Caution should be taken when using the aloe laxative especially if you are on digitalis heart medication or corticosteroids and it should never be taken by the elderly, children, or by anyone who is pregnant. Aside from improper processing (small amounts of laxative compound being included in aloe vera juice), a small percentage of people, especially IBS sufferers, may find aloe vera juice disruptive to their digestive tracts.

bilberry: During World War II, the Bilberry became known for its ability to help night vision. Since then, we have learned Bilberries are powerful antioxidants. Bilberries protect all cells in the body against free radical damage but seem to be especially effective in protecting the eyes. The retina's ability to quickly adjust to both light and dark is positively affected by the Bilberry plant. This is one reason Bilberry has become a popular alternative for vision disorders such as light sensitivity, night blindness, cataracts, and macular degeneration. Previous to World War II, the Bilberry's astringent compounds, called tannins, were used to help relieve sore throats, diarrhea, kidney stones, and urinary tract infections. By the way, Bilberry fruit is also great as a pie filling.

kelp: Many varieties of Kelp exist within our oceans and sea beds. Depending upon the species cultivated, Kelp, also knows as seaweed, or sea vegetables, is commonly used as fertilizer, for its salty taste in cooking applications, as a food, or for medicinal purposes. Kelp has a high nutrient content and some species may contain close to 30 minerals. Of these minerals, Kelp is best known for its rich iodine content and other trace minerals necessary for our endocrine system especially healthy thyroid function. Through its association with the thyroid, kelp may help the body burn fat more efficiently, boost stamina, and aid in the lowering of cholesterol levels in the blood. Kelp also contains antioxidant vitamins, protein, and alginic acid. The effects of radiation on the body may be lessened by alginic acid.

Though Kelp has also been used for years as a treatment for liver function, arthritis pain, immune system function, and energy, it lacks the scientific studies to substantiate these claims.

Always take Kelp at the recommended dosage levels or those recommended by your physician. High doses of iodine over a period of time may cause an enlarged thyroid in a very small percentage of people who are sensitive to iodine. Do not take Kelp if you are pregnant or nursing without first discussing it with your doctor.

Newsletter references:

1. "Hypothyroidism in Perimenopause and Menopause ", Marcy Holmes, www.womentowomen.com
2. "Puberty & Thyroid", PFPC, 2000, www.bruha.com/science/html/puberty.html
3. "Your Thyroid", www.endocrineweb.com/thyroid.html
4. "Hypothyroidism, Too Little Thyroid Hormone", November 2003, www.endocrineweb.com/hypo1.html
5. "Basic Information on Hypothyroidism, Hyperhtyroidism, Nodules, Cancer", Mary Shomon, http://thyroid.about.com/cs/basics_starthere/a/thyroid101.htm
6. "Candidiasis (Yeast Overgrowth) and Thyroid Disease", PFPC, Mary Shomon, http://thyroid.about.com/cs/relatedconditions/a/candida.htm
7. "Thyroid Disease 101: Basie Information on Hypothyroidism, Hyperthyroidism, Nodules, Goiter, and Thyroid Cancer Part 4: When Symptoms Won't o Away, Preventing Thyroid Disease", Mary J. Shomon, http://thyroid.about.com/cs/basicinformation/1/aathyroid101_d.htm
8. "Thyroid Disease 101: Basic Information on Hypothyroisism, Hyperthyroidism, Nodules, Goiter, and Thyroid Cancer Part 2: Hypothyroidism", Mary J Shomon, http://thyroid.about.com/cs/basicinformation/1/aathyroid101_b.htm
9. "The High Cholesterol Thyroid Connection, Undiagnosed Thyroid Disease May Be the Reason for Your High Cholesterol", Mary Shomon, http://thyroid.about.com/cs/symptomsproblems/a/cholesterol.htm
10. "The High Cholesterol Thyroid Connection, Undiagnosed Thyroid Disease May Be the Reason for Your High Cholesterol, About Cholesterol", Mary Shomon, http://thyroid.about.com/cs/symptomsproblems/a/cholesterol_2.htm
11. "Thyroid Disorders & Treatmenst, Overview", AllThyroid.org, www.tsh.org/disorders/index.html
12. "Do At Home Thyroid Test", www.healthynewage.com/339161.html
13. "Hypothyroidism, Overview", A.D.A.M., Inc., http://health.yahoo.com/health/ency/adam/000353/overview
14. "How to Tell If You are Hypothyroid", http://thyroid.about.com/library/howto/hthypothyroidism.htm
15. "How to Self-Test for an Iodine Deficiency", Alternative Medicine Angel, http://substance.altmedangel.com/iodine.htm
16. "Thyroid Self-Testing by Basal Temperature", originated by Dr. Broda Barnes, www.alternate-health.com/thyroid.html
17. "Thyroid Handout/Self Test", June 2000, Georgiana Duncan, www.nspforum.com/faq/bbs.cgi?read=588
18. "Thyroid", www.health911.com/remedies/rem_thyr.htm
19. "Hypothyroidism", www.royalrife.com/hypothyroid/html
20. "Thyroid Hormones, Symptoms, and Treatment of Hypothyroidism", September 2004, Alisa Cornille and Paul Hueseman, Association of Women for the Advancement of Research and Education, www.project-aware.org/Spotlight/thyroid.html