Thyroid Health: Causes of Damage, Symptoms and Natural SolutionsDr. Zoltan P. Rona, MD, M.Sc. March 1, 2010
Part One: The Underactive Thyroid
The thyroid is a butterfly shaped gland situated in the neck and wrapped around the windpipe just below the Adam’s apple. It controls metabolism and virtually every aspect of health including weight, mood, energy and circulation. Damage to the thyroid can lead to underactivity (hypothyroidism), overactivity (hyperthyroidism), thyroid inflammation (thyroiditis) and thyroid cancer.
The thyroid uses iodine and the amino acid tyrosine to manufacture the thyroid hormones T3 (triiodotyrosine) and T4 (thyroxine). About 80% of the hormones made are T4, while 20% is T3. It is T3 that is the more biologically active form of thyroid hormone. In order to have adequate amounts of T3 there has to be some conversion of T4 into T3. This is something that can occur both inside and outside of the thyroid.
The thyroid is controlled by a rather complex feedback mechanism. When the hypothalamus in the brain senses there is an inadequate amount of thyroid hormones present, it releases a hormone known as TRH (Thyrotropin-releasing hormone), which in turn tells the pituitary gland to release a Thyroid Stimulating Hormone (TSH), which then stimulates the thyroid gland to synthesize and release more thyroid hormone (T3 and T4) into the circulation. Thus, the level of TSH goes higher in order to help the thyroid manufacture more of the hormones.
CAUSES OF THYROID GLAND DAMAGE
1) Radiation exposure – The thyroid is quite vulnerable to radiation. You do not have to be a victim of a nuclear meltdown to get thyroid damage; CT scans, x-rays and nuclear medical tests are more common ways of damaging the thyroid. One especially unfortunate decision in the 1950s compelled dermatologists to treat acne in teenagers with x-rays. As a direct result of this, thousands of patients developed thyroid damage leading to various cancers. Let’s also not forget the numerous types of radiation therapies for different types of cancer.
2) Overconsumption of soy – Despite a great deal of evidence that soy products are a health benefit in terms of cancer prevention, too much consumption can tip the balance in favour of boosting estrogen function. High estrogen activity weakens the thyroid. The advice here would be to restrict soy to one serving a day or less and stay with fermented organic soy products only (miso and tempeh).
3) High doses of lithium – In high doses (1,200 mg daily), lithium can cause hypothyroidism. Lithium, however, has also been shown to be an effective natural treatment for an overactive thyroid.
4) Amiodarone – This is a drug often prescribed for abnormal heart rhythms. Unfortunately, it can damage the thyroid.
5) Iodine deficiency or iodine excess – Iodine deficiency is probably one of the most common nutritional deficiencies. Too much or too little iodine can damage the thyroid. In 1990, the World Health Organization estimated that 28.9% of the population was iodine deficient. Severe deficiency of iodine produces a large lump in the neck known as a goiter. It can also produce mental retardation, impaired mental function and hypothyroidism. Excessive iodine has been documented to result in thyroiditis, goiter, hypothyroidism, hyperthyroidism and acne. Intakes of 1,000 mg/day are probably safe for the majority of the population. Even those who use large amounts of kelp or dulse will very rarely develop a problem with excess iodine. There are however, some very sensitive individuals who will develop adverse skin and thyroid reactions to even a few mgs of iodine. Fortunately, this is very rare.
6) Thyroid toxic foods – The overconsumption of uncooked “goitrogenic” foods can weaken thyroid function. These include broccoli, Brussels sprouts, rutabaga, turnips, cauliflower, kohlrabi, radishes, cabbage, kale and millet. These foods, very much like soy products, are non-toxic to the thyroid in moderate amounts. It’s only when one consumes these raw foods in large quantities that thyroid function is weakened. This, in itself, is an aspect of biochemical individuality. If these foods are cooked, they lose their toxic influence on the thyroid.
7) Other thyroid toxins – Tobacco smoke, perchlorate, fluoride, fungal (candida) infestations, toxic heavy metals such as mercury and lead, and a high sugar intake have been reported to damage the thyroid. Once again, this may be true for only some people and is not a generalized phenomenon.
8) Stress – This is a frequently overlooked cause of thyroid damage, but is certainly one of the causes of sub-optimal thyroid function.
It is conservatively estimated that at least 60 million people in North America have some form of thyroid dysfunction. At least 10% of these people go undiagnosed. There remains a great deal of disagreement about making the diagnosis of thyroid disease between glandular specialists (endocrinologists) and natural health care practitioners.
Conventional endocrinologists are a rather dogmatic bunch when it comes to thyroid health. Most follow strict guidelines in making a diagnosis of hypothyroidism (underactive thyroid), and tend to dismiss symptoms that suggest the disease may be present when lab tests are not abnormal enough for them to treat the disorder. They are also quite adamant about the prescription of synthetic chemicals to correct the condition and are generally of the belief that natural solutions are useless or potentially dangerous.
When the thyroid gland has become damaged and fails to produce adequate amounts of thyroid hormone, the TSH levels will remain high. If the TSH blood test is above 2.0, there is a strong chance your thyroid is underactive. The normal range for the TSH is 0.4 to 2.0 but this is an area of controversy, with the conventional medical forces saying that the upper limit should be 5.0.
There are a large number of symptoms that could make you think you have an underactive thyroid. You do not have to have all these symptoms to be diagnosed as being hypothyroid, but the majority will have several of these symptoms if their thyroid is not in optimal health. Combined with a high TSH, a trial therapy for hypothyroidism is warranted.
1) Fatigue – If you feel exhausted and weak despite getting eight to 10 hours of sleep, you may have an underactive thyroid.
2) Weight gain – If you have been on a low calorie diet, exercise daily and have eliminated all possible food allergies yet you are still not losing weight, chances are high that your thyroid function needs help. There may also be swelling in the eyes, face, arms or legs.
3) Low body temperatures – If your body temperatures on average are below 97.4F, chances are you are lacking an adequate supply of thyroid hormone. People who have hypothyroidism often feel cold in normal temperature rooms. They also do not tolerate cold temperatures (cold intolerance) as well as their friends with normally functioning thyroids.
4) Depression and Anxiety – When depression, anxiety, irritability, short-term memory loss, panic attacks and insomnia are present with no apparent cause, there is a strong chance that hypothyroidism could be involved. This is not to say that all mental health issues are related to low thyroid activity, but it is a commonly overlooked reason for sub-optimal mental function. The common practice is to drug these symptoms with anti-depressants. Unfortunately, this does not correct the thyroid deficiency.
5) High cholesterol – When a high blood level of cholesterol does not respond to diet, exercise or cholesterol lowering supplements, hypothyroidism may well be the cause. A high cholesterol reading combined with fatigue and obesity is almost always due to an underactive thyroid. Even in the face of normal blood levels of TSH, a trial therapy to reverse low thyroid function should be attempted.
6) Infertility and Menstrual Abnormalities – Infertility is quite a common symptom of hypothyroidism. In my practice I have seen at least a dozen cases of successful pregnancies after treatment was started with natural thyroid hormone. In the majority of cases, the TSH was normal and the patient was assumed to have normal thyroid function. Quite commonly, a low libido and menstrual difficulties (pain, excessive bleeding and cramping) are associated with a previously unsuspected case of hypothyroidism.
7) Constipation – If you drink plenty of water and consume lots of fibre and still need to resort to laxatives to have regular bowel movements, consider a low thyroid condition as a potential cause.
8) Hair Loss – This is a common symptom of hypothyroidism and is particularly distressing to women who reach the menopausal years. Hair can become brittle, coarse and dry, breaking or falling out easily. Although hair loss is often blamed on low estrogen levels, a more common finding is hypothyroidism. Look for an unusual loss of hair in the outer edge of the eyebrows. This is a common manifestation of hypothyroidism.
9) Dry skin – Fragile and thin skin that does not respond well to moisturizers or vitamin E creams is not necessarily a sign of normal aging, but may be an indicator that your thyroid is not functioning well. Cold hands and feet are sometimes also connected to a low thyroid.
10) Carpal Tunnel Problems – This is a painful wrist condition that is under-recognized as being associated with a low thyroid condition. Hypothyroidism could also be the unexpected cause of chronic tendonitis and joint pain virtually anywhere in the body. Muscle cramps and frequent muscle aches and pains are not always a sign of exotic problems such as Fibromyalgia, but could simply be due to a low thyroid.
11) Neck swelling or discomfort – The thyroid gland will enlarge itself in a futile effort to make more thyroid hormone. As a result of this gland enlargement (known as a goiter), one can have a sensation that there is swelling in the neck and develop some pain or hoarseness due to this.
12) Family history – It is quite common to see a low thyroid condition in family members of those who suffer from hypothyroidism. Although it is not a given, there is a strong chance you will develop the condition if your mother or father was diagnosed with a low thyroid.
There are various levels of treatment for an underactive thyroid gland. It all depends on severity of symptoms, the blood levels of TSH, T3, T4 and the thyroid antibodies. Body temperatures are also a crucial factor in the treatment protocol. Sorting all this out is a fairly complex issue and is best dealt with the help of a natural health care professional.
For Mild Cases
These are cases where the TSH is greater than 2.0, underarm body temperatures are on average below 97.4F and where there are one or more of the signs and symptoms of an underactive thyroid present (such as fatigue, weight gain, high cholesterol, etc.). In these cases, a combination of the following supplements will often help return the thyroid function to a more optimal level:
L-Tyrosine: 3,000 mg daily. The body will use this amino acid to manufacture more thyroid hormone. Often, this amino acid is used as treatment for fatigue or mild depression.
Zinc citrate or picolinate: 50 mg daily. Zinc and copper are both needed in the control of thyroid hormone production.
Copper citrate: 4 mg daily. The ideal zinc to copper ratio in the body is approximately 8:1 (zinc:copper).
Selenium: 200 mcg daily is required to help convert T4 (inactive) to T3 (active) thyroid hormone. Selenium is also important to prevent the formation of abnormal antibodies that can attack the thyroid leading to disease.
Vitamin D: 10,000 IU daily. Vitamin D deficiency has been linked to both hypothyroidism and hyperthyroidism. Blood levels of 25-hydroxy vitamin D should be tested prior to supplementation.
Iodine as potassium iodide: 10 mg daily. Iodine is part of active thyroid hormone. The use of iodine is often strongly criticized by endocrinologists as potentially dangerous. Studies, however, have proven that most people can easily tolerate doses as high as 1,000 mgs a day without any harm.
Homeopathic thyroid: 5 to 10 drops twice daily. There are reports that homeopathic thyroid is effective at reversing many of the signs and symptoms of an underactive thyroid. It may be a worthwhile product to try for those homeopathically inclined.
If six weeks or more of this supplement regime fails to do much for any of the signs and symptoms, a trial therapy with natural desiccated thyroid (30 mg twice daily) is recommended. Lab tests and symptoms should be monitored and dosages adjusted accordingly. I must point out that this is a type of treatment that is vehemently opposed by conventional endocrinologists who insist that desiccated thyroid is unacceptable. Endocrinologists believe that synthetic thyroid hormone (Synthroid, Eltroxin, L-throxine) is the correct treatment. Unfortunately, while synthetic thyroid hormone may return blood levels of T3 and T4 to normal, it does not always help the hypothyroid symptoms as well as desiccated thyroid helps. This remains an area of great debate between natural health care practitioners and endocrinologists.
In mild cases, the use of homeopathy or the supplementation of the amino acid L-Tyrosine, zinc, copper, selenium and iodine combined with a sugar-free, caffeine-free diet can be used. Dosages of these nutrients depend on various biochemical tests. For some cases, this may not be effective and actual thyroid hormone may be required.
The preferred thyroid hormone treatment is desiccated thyroid, which seems to be effective for at least 80% of the cases. For some, this will not work and their thyroid can only be regulated by a pure T4 prescription (L-thyroxine). See a natural health care practitioner to get personalized therapy.
For Moderate to Severe Cases
These are cases where natural thyroid boosting supplements have been tried for at least six weeks and no benefits have been seen. Usually the TSH is above 5.0 and there may even be a swelling in the thyroid gland area. In such cases, one could certainly use desiccated thyroid starting at 30 mgs twice daily and monitor the hormone blood levels. In cases that are poorly controlled by the natural thyroid extract, the use of synthetic thyroid hormone may be needed. In my experience, this may only be true for about 10% of individuals diagnosed with hypothyroidism.
Many people have also read about the Wilson’s Syndrome protocol for an underactive thyroid. To call Wilson Syndrome’s therapy controversial would be an understatement. This treatment is so complex that a book and therapeutic manual have been written to help patients do the therapy correctly. It involves the scrupulous monitoring of body temperatures several times daily and the use of time released capsules of T3 (active thyroid hormone). Basically, one uses increasing doses of T3 to raise the body temperatures and adjusts dosages accordingly. For more information on this protocol see www.wilsonssyndrome.com.
Moderate or severe cases of hypothyroidism are best treated by a family physician. It’s usually a good idea to have an ultrasound done in order to rule out more serious thyroid conditions such as thyroid cancer. Most family doctors will refer their more difficult cases to an endocrinologist for further assessment and treatment.
· Barnes, Broda O. Hypothyroidism, The Unsuspected Illness. Harper and Rowe, 1976.
· Stephen Langer, M.D. and James Scheer. Solved: The Riddle of Illness by Keats Publishing, USA 2000.
· Ridha Arem, M.D. The Thyroid Solution, Ballantine Books, USA 1999.
· Iham Amir Al-Juboori , Rafi Al-Rawi, Hussein Kadhem A-Hakeim. Estimation of Serum Copper, Manganese, Selenium, and Zinc in Hypothyroidism Patients. IUFS J Biol 2009, 68(2): 121-126
· Thyroid gland photograph. www.fotosearch.com/photos-images/thyroid.html
· Mary Shomon. What is the optimal TSH for Thyroid Patients? http://thyroid.about.com/od/gettestedanddiagnosed/a/optimaltsh.htm
· The Iodine Deficiency Disorders. http://www.thyroidmanager.org/Chapter20/index.html
· Vitamin D Deficiency and Thyroid Disease. http://www.goodhormonehealth.com/VitaminD.pdf
Dr. Zoltan P. Rona practises Complementary Medicine in Toronto and is the medical editor of The Encyclopedia of Natural Healing. He has also published several Canadian best-selling books, including Vitamin D, The Sunshine Vitamin. Visit his website at: http://www.highlevelwellness.ca For appointments, call (905) 764-8700; Office: 390 Steeles Ave. W. Unit 19, Thornhill, ON