Most middle aged woman and even younger females need to hear this! Let's talk about thyroid health!!
Something I feel we are failing miserably at is thyroid health. We 1) Do not check the right labs, 2) normal parameters are way too lenient 3) we prescribe a synthetic T4 hormone only medication 4) We do not find out the root cause of the dysfunction. 5) We rarely check or track antibodies to diagnose Hashimoto. Hypothyroidism or Hashimoto and Graves disease are not YOUR diagnosis! Why you have these, is the diagnosis and it is likely reversible! It could be a simple zinc or Iodine deficiency as to why you are not making enough thyroid hormone. It could be a heavy metal or chemical toxicity causing an autoimmune attack on the thyroid as seen in Hashimoto and Graves. If thyroid function is low, even just slightly, it will 1) impair your ability to lose weight, even causing weight gain, sometimes substantial, 2) increase LDL cholesterol and triglycerides, and thereby 3) increase cardiovascular risk. It can also cause/worsen low energy, cold hands and feet, constipation, thinning hair, and other abnormal phenomena.
Iodine is crucial for health; without iodine, thyroid hormone levels decline, you gain weight, develop cold hands and feet, feel tired yet can't sleep, are constipated, retain water and gain weight, develop heart failure and can eventually die. Iodine is critical for thyroid health, as it is required for the thyroid gland to manufacture thyroid hormones, T3 and T4. Iodine is also important for breast health (reducing fibrocystic breast disease, a potential precursor to breast cancer) and oral health (as salivary glands concentrate iodine for antibacterial effects).
Problem is that unless you live in a coastal environment, the food you consume likely lacks iodine if it is sourced inland. So people in the midwest have a high incidence of iodine deficiency. This was prevalent up until the first half of the 20th century when goiters (enlarged thyroid glands due to iodine deficiency) were everywhere, affecting 25% of the population. This is why the FDA passed a regulation in 1924 that encouraged that iodine be added to table salt, a time in which there was no TV, radio, internet, and much of the U.S. was illiterate and/or rural. Early 20th century Americans were therefore encouraged to use more salt to “Keep your family goiter free!” (This was the actual motto on the Morton’s iodized salt container.)
Excessive salt use with conventional table salt~only Sodium Chloride lacked the potassium and other minerals that should be in salt~ ie sea salt (Celtic is best) led to problems with sodium in some populations. The FDA responded by urging Americans to cut their salt consumption. People listened . . . and iodine deficiency reappeared, showing up as the symptoms listed above, the symptoms of underactive thyroid, or hypothyroidism.
Iodine deficiency is readily reversed by supplementing an inexpensive iodine supplement in capsule, tablet, or liquid form. This should be monitored by a practitioner that can identify symptoms of hyperthyroidism and if you have Hashimotos there are other considerations as well.
Along with iodine deficiency that impairs thyroid function, we have all been exposed to a wide range of organochemicals which are what we call Endocrine disruptors such as perchlorates residues from synthetic fertilizers in your produce, polyfluorooctanoic acid from non-stick cookware (which can persist for 10 years or more in your body or in groundwater), and many others. This can result in hypothyroidism. While approximately 20% of people will experience partial or total restoration of thyroid function with just iodine supplementation, the other 80% with hypothyroidism will require prescription thyroid hormone replacement. Most people do best with restoration of both T4 and T3 thyroid hormones, not just T4 (Synthroid or levothyroxine). It means taking levothyroxine (T4) with liothyronine (T3) or a combination tablet containing both, such as Armour thyroid or Naturethroid. The hard part is trying to find a practitioner to 1) perform a full thyroid assessment, then 2) address all aspects of thyroid health, including Free T3 and Free T4 which can detect a conversion issue from T4 to T3 which is the more bioavailable thyroid hormone. Also checking a Reverse T3 is important as this can be a preservation mechanism the thyroid uses to indicate early hypothyroidism or stress on the thyroid. Reverse T3 can elevate 5 years before the TSH increases. Elevated Reverse T3 can point to HPA axis compromise or Hypothalmus~Pituitary~Adrenal axis, which is usually caused by stress on the adrenal glands. Thyroid peroxidase antibodies are the antibodies seen in Hashimoto's and can present 10 years before a TSH increases.
If you are dealing with hypothyroidism and are on Levothyroxine without notable improvements in symptoms or worsening of symptoms ask your provider to draw a Free T3, Free T4, thyroid antibodies and Reverse T3 in addition to TSH. They will then be able to identify if your condition is Hashimoto's or if you have a conversion issues and be able to treat the low T3 and T4 with a compound thyroid medication. Also we are failing at our normal levels! The lab normals identified by most lab companies are way to high. They are averages of those who get labs draw, which are basically unwell individuals. TSH should be 1-2 or 2.5 if you are over the age of 65. More important than a number are the symptoms! If your "number are fine" but you dont feel fine there is an issues. If they are unable/unwilling to do this, find a practitioner who will! Give me a call at 618-789-7848 or email me with any questions! Laura Burton NP-C, CFMP