The CDC says that thyroid dysfunction affects 7.35% of the population. As these figures are based on outdated TSH/T4 testing, the prevalence is likely to be severely underestimated. Dr David Brownstein, an American doctor who specialises in iodine status and thyroid function, believes this figure to be 40 percent. Either way, a lot of people are suffering from low thyroid function and that includes many people that I see.
Standard treatment for hyperthyroid is to damage the gland with radiaoctive iodine until the remaining tissue can only produce a small amount of thyroid hormones, then prescribe thyroxine when the output wains. Standard treatment for hypothyroid is to prescribe thyroxine until the TSH levels drop to below 3. I have previously described here why these steps rarely bring about improvement, essentially because the gland was already capable of producing hormones, thus the provision of more in a tablet does noting to address the cause of the imbalance. It didn’t work in the 1960s and it doesn’t work now.
I have seen countless individuals with thyroid dysfunction and these can be grouped into three categories: undiscovered, untreated and poorly treated. The former group may be those that have suffered with low thyroid symptoms for years, but have not been granted thyroid tests by their doctor because they have low body weight or do not experience constipation. The second group are those that are aware of low thyroid symptoms and have measured a consistently low temperature, but are told by their doctor that their blood tests do not support a diagnosis of hypothyroid. The latter are those that have been measured as low thyroid, and have mindlessly been given thyroxine.
The problem is that, apart from primary and unexplained thyroid failure (rare), the provision of thyroxine does nothing to address the issue. And it consigns the patient to a lifetime on thyroid drugs, a lifetime of continued visits to the doctors to pick up prescriptions and a lifetime of not feeling right. The only things that change are the blood tests and the profit sheet of the companies that make the drugs. This is not acceptable.
Luckily, there is another way. A way that reliably achieves success and improvements in symptoms, well-being, metabolic function and weight loss. This involves assessing for the root cause. And these causes are invariably factors other than the thyroid itself. The most common are:
no two ways about it, autoimmunity is the number one reason for low-thyroid function. Autoimmunity occurs when the immune system begins to attack it’s own cells. While this can take a number of routes (for example, lupus and rheumatoid arthritis are common autoimmune conditions), the thyroid is perhaps the most common target when this imbalance becomes a problem. Autoimmunity at the thyroid gland can cause hyperfunction (known as Grave’s Disease) or hypofunction (known as Hashimoto’s). There can be several triggers of these autoimmune conditions, with the most common being poor digestive function, issues with gluten, poor adrenal function, stress, Vitamin D deficiency and chronic infections. That’s a lot of people at risk of autoimmunity; the main surprise is that there is not more incidences. Although 15 percent of autoimmune individuals will show a false negative, you can test yourself for this imbalance with blood tests for anti-TPO and anti-TG antibodies. If you have confirmed low thyroid function and your doctor has not ordered tests for these antibodies, he/she is an idiot.
- iodine deficiency
there is a big crossover between iodine deficiency and autoimmunity. Autoimmunity against TPO enzymes occur once these proteins have been damaged due to excessive oxidation. Iodine is one of the most important nutrients to control the rate of oxidation at the thyroid gland; iodo-lactones, compounds which see iodine join together with fatty acids, regulate this process effectively and can positively influence a Hashimoto’s attack that is already in place. They can also reduce the likelihood of one developing in the first place. However, iodo-lactones can only be formed when iodine is provided in sufficient amounts, eg 12.5mg per day. That’s 98x the RDA for this halogen element. I have previously heard from other practitioners that iodine can induce autoimmune reactions at the thyroid. This does not occur when selenium is also provided, as I discuss here.
- systemic inflammation
if you are suffering from an ‘itis’ of any kind, then you are suffering from inflammation. Arthritis, bronchitis, inflammation at the intestines; all are signs of inflammatory conditions. So too are rashes, headaches and sinus problems. Whenever inflammation exists, the immune system releases a host of chemical messengers called cytokines. These hormone-like signallers travel through the bloodstream to alert other cells in the immune system that an incident is occurring and prime the system for an appropriate response. However, they also have an impact at various sites that regulate hormonal balance. Cytokines can reduce the function of the paraventricular nuclei (PVN), part of the hypothalamus that regulates the amount of TSH released.
- nutritional deficiency
If you are low on either zinc, iron or especially selenium, this can have effects on the conversion of T4 to T3. This is important because, although T4 can be found in much higher concentrations in the bloodstream, it is T3 that has the most potent effects at the cellular level. Anything that compromises this conversion will result in low thyroid function and providing more thyroxine (T4) will not correct the problem. If you have low Vitamin D levels, then this can reduce the verve of your entire hormonal cascade through reduced levels of dopamine (vitamin D is required for the enzyme that produces dopamine, tyrosine hydroxylase). Even more important is Vitamin D’s effect on the immune system; when levels become low, the risk of autoimmunity increases significantly.
- adrenal dysfunction
as the two energy-producing glands in the body, the thyroid and the adrenals have an intimate connection. To avoid overcooking the system, evolution has equipped all of us with a system that balances out the actions of these glands. When adrenal activation increases, so to does adrenaline. Adrenaline increases the production of reverse T3 (rT3), an inactive hormone that competes with active T3 at receptors. This means that the thyroid has less impact while the adrenals are oversecreting. Problems occur when the adrenal function drops, as this pushes the adrenaline ever higher; it then becomes inevitable that the thyroid ‘sensibly’ downregulates it’s action. Low cortisol levels can also impact autoimmunity, as this steroid hormone represents the body’s major anti-inflammatory chemical. If autoimmunity already exists, dropping cortisol levels means that the brakes are removed. The process can now go into overdrive.
Now the above factors are more starting points than a definitive treatment plan, but it does begin to show the number and complexity of factors that can contribute to low thyroid function. In the last seven years, I have not found a single case of hypothyroidism that was not explained by other factors. That is to say, I have never come across a case of ‘primary’ thyroid dysfunction. Every time low thyroid function presents, the gland is always a victim of imbalances elsewhere rather than the cause of them.
This is why I never test for thyroid function on the first consultation. In any chronically-ill person, it’s very likely that they will be experiencing thyroid issues (this could be disturbances at the thyroid itself, but just as likely to be issues in conversion between T4 and T3, or cellular response to circulating thyroid hormones). The same applies to obese individuals that have tried unsuccessfully to lose weight. In these circumstances, there are many metabolic imbalances that are having an impact on their well-being and aims. If I were to order a test upon the first visit, it would generally show an imbalance but this is hardly useful as, two thirds of the time, this is simply a secondary imbalance.
This is also why, on many occasions, the thyroid symptoms disappear too quickly to even order a thyroid test; of course, this remains a race that I am happy to lose. Naturally, there are plenty of follow-ups I do where symptoms linger, body temperature remains low and bodyfat doesn’t budge. Digestion, hormonal production and mental faculties are also effected, showing the huge range of problems people experience when the thyroid is suffering. When these symptoms remain, a full thyroid workup – and that means a lot more than just TSH and T4 – can be suitable to determine whereabouts the imbalance is occurring. In almost all cases, the results show that the thyroid gland is a victim of imbalances in the body, rather than the root cause.
With so many things that can affect the organ, it becomes clear as to why so many people report the symptoms of low thyroid function. Current medical thinking is that providing thyroid hormones is a legitimate way to manage the problem; the dismal response shown by most tells us all we need to know. Whatever your symptoms, you need to find the cause; and if that is low thyroid function, then you need to find the cause of that, too!