Thyroid dysfunction in 2019

For a long time, high blood pressure has held the notorious title of the "silent killer" because it often can go unnoticed for a long time, and in the meantime wreak havoc on your health. In our modern, stress-filled times, I'd like to add another condition to this dubious silent but harmful list: 

Thyroid dysfunction. 

In this blog post, I'd like to talk a bit about the important role your thyroid plays in your health, why the prevalence of thyroid dysfunction seems to be rising, how to tell if you're living with it, and how you can take your health into your own hands and address the real root cause of your thyroid issues (and why the conventional approach to "treating" it can fall so short).

What Is Your Thyroid?

Your thyroid gland is a butterfly shaped structure in your neck. It's an important part of your endocrine system and produces two essential hormones known as thyroxine (T4) and triiodothyronine (T3). Meanwhile, the thyroid stimulating hormone (TSH) is released by the pituitary gland in your brain; TSH dictates how much T4 and T3 are secreted by your thyroid. 

T3 is actually the only biologically active hormone produced by your thyroid and the one that influences your body; T4 is converted into T3 by your cells and tissues. Together, these hormones contribute to a variety of key functions in your body, including bone and muscle health, cognitive function, heart rate, digestion, and metabolism.

Signs and Symptoms of Thyroid Dysfunction

According to the British Thyroid Foundation, about 1 in 20 people have some kind of thyroid dysfunction (generally, a thyroid that under-produces or overproduces thyroid hormones). The number could even be higher than that, given that thyroid dysfunction often isn't caught on standard thyroid tests, nor does it always present with any symptoms.

When signs and symptoms of thyroid dysfunction do show up, they may include:

•  Weight gain
• Hair loss and dry skin 
• Frequently feeling cold or having poor tolerance to heat
• Muscle pain and stiffness 
• Depression
• Hoarse voice
• Mental fogginess and impaired concentration
• Constipation 
• Infertility 

Causes of Thyroid Dysfunction—And Why Its On the Rise

The most common type of thyroid dysfunction is an autoimmune disorder called Hashimoto's disease. In this case, the thyroid gland produces too little hormones because the body mistakenly attacks and inflames its own thyroid tissues. Among other problems, this can lead to slower metabolism, weight gain, and general sluggishness. 

Another major cause of thyroid dysfunction is postnatal depletion, which occurs in many mothers (often persisting for years following the birth of their children) and comes about due a combination of factors including stress, exhaustion, and nutrient insufficiencies. This helps explain why women are most likely to experience thyroid dysfunction—although men and children can be affected, too. 

In general, a combination of environmental and genetic factors influence who gets thyroid dysfunction and who doesn't. The question on many doctors' and researchers' minds is why there seems to be so many more cases of thyroid dysfunction occurring. Research points to the following causes which are increasingly prevalent in our modern day life:

• Exposure to heavy metals and other toxins 
• Pesticides
• Radiation
• Dietary substances including gluten, sugar, and soy
• Stress

The good news is that many of these contributors to thyroid disorders are preventable—that is, we have it in our power to do something about them!

How to Optimize Your Thyroid Function

The following strategies are some of the most effective things you can do to improve your thyroid function, which (because of how influential your thyroid hormones are in your body) will by default improve your overall health, too. 

Upgrade your diet. 

Getting enough of what you need (and avoiding what you don't need) through your diet is your number one goal for improving your thyroid function! 

Specifically, you want to include foods that are rich in protein and nutrients like magnesium, selenium, zinc, and iodine (meat, shellfish, eggs, nuts, organic leafy greens). A high quality supplement routine can make up for wherever your whole food choices lack (which happens a lot, given modern day food packaging and transporting practices). Keep in mind that TOO much iodine can be harmful in people with autoimmune dysfunction—so get enough to correct deficiencies and consider getting your iodine levels tested. 

At the same time, you want to avoid soy, gluten, and sugar, which are pro-inflammatory, stressful on your body, and linked with thyroid dysfunction. For a lot of people with food sensitivities, going gluten-free isn't enough: they may also need to eliminate or avoid starchy veggies, legumes, and sweeteners. In many cases, going low-carb can be extremely beneficial because it supports better blood sugar control and digestive health, both of which are tied to your immune system (recall that the majority of thyroid dysfunction is due to immune system dysfunction). 

Also, choose filtered and/or spring water whenever possible. Ammonium perchlorate and chlorine in tap water has been associated with abnormal thyroid function and disrupted iodine uptake, respectively. 

Manage your stress.

We all know by now that chronic stress has an inflammatory effect on your body, which can exacerbate autoimmune dysfunction and thyroid inflammation. So it makes sense that managing your stress more effectively can help you boost thyroid function.

Learn about stress coping skills and stress-busting techniques, and use whatever works best for you as part of a regular practice—including but not limited to acupuncture, exercise, breathing exercises, meditation, yoga, journaling, and even cognitive behavioral therapy. 

Consult with a functional medicine doctor.

Did you realize that many standard medical tests performed during routine wellness check ups don't thoroughly evaluate your thyroid health? This is a problem. To paraphrase a quote from famed business author Peter Drucker, you can't manage what you can't measure—and if you're not screening for thyroid issues when they're still early on and relatively minor, you're likely not going to be able to prevent them from getting bigger and more problematic.

By the way, this is essentially how we devolve down the path from preventive healthcare to reactive healthcare—the latter almost always being more expensive, stressful, and harmful. Sub-optimal. 

If you can find a good functional medicine doctor in your area and are curious about taking a closer look "under the hood" of your own body, so to say, I highly recommend scheduling a consultation with him or her.  Do some research or try the "Find a Practitioner" feature on the Institute for Functional Medicine website, which you can check out here. 

You can also ask your primary care doctor to run additional thyroid function tests for you (if they're able to). Realize, however, that the standard tests for thyroid function, which generally includes TSH (from the pituitary gland) and maybe T4 (which, if you remember, is converted into T3 before it actually can have any effect on your body), really can't give you the full picture of what's going on with your thyroid.

That is, a "normal" TSH test result can generally rule out major issues such as hypothyroidism and hyperthyroidism, but it's not necessarily enough to safely say that your thyroid is functioning optimally, nor is it enough to rule out certain other types of dysfunction, especially if your dysfunction is "sub-clinical" (e.g., not "bad" enough to meet the somewhat arbitrary medical definition of dysfunction but still not optimal).

My functional medicine doc recommends additional tests including total T4 and T3, free T4 and free T3, and thyroid antibodies. These tests are better able to tease out subtleties with your thyroid function, because they assess for different thyroid hormones which serve different roles in the body. I recommend looking at these especially if you have signs and symptoms of thyroid dysfunction or are at an increased risk for dysfunction (postpartum, highly stressed, poor diet, etc.). This way, you can get a better idea of how your thyroids are doing and then problem solve through specific and individualized methods to maximize it.

A Note on Medications

The standard treatment for thyroid dysfunction is medication, specifically hormone replacement therapy. My beef with this approach (which is shared by many other holistic-oriented practitioners) is that like many conventional drugs it takes a band-aid approach. Meds may treat and manage symptoms, but they don't resolve the underlying issues causing the symptoms in the first place (whereas lifestyle, diet, and stress management behaviors can and do).

Plus, many medications fail to fully resolve symptoms and may come with their own laundry list of problems. 

I'm not your doctor, so I'll never tell you to stop taking medications. But I do encourage you to speak with your doctor more intimately about thyroid health and realize that not only are there things YOU can do to improve it, but that these things ideally should be considered your first line of defense.

Conclusion

Estimates suggest that anywhere from 20 to 27 million Americans are living with some type of thyroid disorder, and many of these people or even more are undiagnosed. 

Whether you believe you have symptom of thyroid dysfunction or not, I think it's a good idea to hedge your bets and start making the necessary (and actually pretty simple) lifestyle changes necessary to support a healthier thyroid. Doing so could make drastic improvements in your weight, energy, mood, and brain power. 

Sources: 

https://chriskresser.com/why-changing-your-diet-is-always-the-first-step-in-treating-hashimotos/

http://drknews.com/changing-your-diet-is-the-first-step-in-addressing-hashimotos/

https://www.thyroid.org/thyroid-function-tests/

http://www.btf-thyroid.org/information/your-thyroid-gland

http://www.lifeworkswellnesscenter.com/thyroid-disease-treatment/thyroid-disease-why-this-epidemic.html

https://chriskresser.com/thyroid-disorders/