According to webmd, approximately 25 million Americans have low thyroid function with about half being undiagnosed. The most common cause of hypothyroidism, low thyroid function, is related to an autoimmune disorder called hashimoto’s thyroiditis. In this disorder, the body’s immune system views the thyroid as a “foreign invader” and “attacks” the thyroid gland. Whatever the cause, the result is less available thyroid hormone in circulation.
Due to the fact that thyroid hormones play a role in energy production, heart health, hormonal balance, mood balance, brain function, and skin health, hypothyroidism can cause an array of symptoms, including:
- mood imbalances and depression
- constipation and digestive issues
- fatigue
- changes in weight
- low libido
- dry, flaky skin
- “brain fog” or memory problems
- hormonal issues, such as hot flashes
- cold extremities
- high cholesterol (cholesterol is the precursor for hormone production)
The most common treatment for hypothyroid is a drug which provides the inactive form of thyroid hormone, T4. Examples of this drug include synthroid or levoxyl. In order to convert this T4 to it’s active component, T3, the body must have enough vital nutrients and minerals. Therefore, these drugs provide the body with its precursor thyroid hormone; but will not necessarily eliminate the symptoms of hypothyroid if the body isn’t producing its active hormone. (Lab values can be “normal” if only measuring one marker, TSH, because, hormone production is related to a feedback system. They body uses measurement of T4 to turn down the pituitary’s signal for thyroid hormone production (TSH)).
For this reason, someone being treated for low thyroid function can get very frustrated if they have normal lab markers yet still experience the symptoms of hypothyroidism. In 2003, The American Association of Clinical Endocrinologist (AACE) Thyroid Task Force realized this when they revised current ranges of TSH (thyroid stimulating hormone from the pituitary) from 0.5-5.0 mIU/dl to 0.3-3.0mIU/dl. According to AACE, patients with hypothyroid may have normal TSH levels if there condition is chronic. Therefore, any level above a 2.0 mIu/dl can be a flag for further thyroid evaluation.
As an integrative practitioner, if a client is experiencing the above symptoms, yet has “normal” lab values, it’s time for me to put on my detective hat. Usually, this means requesting additional blood work. This additional testing would aid me to look for the cause of the issue, including:
* autoimmunity
* hormonal imbalances and blood sugar handling problems (insulin and hormones affects the binding of thyroid hormone to a protein, affecting availability)
* liver function (conversion of T4 to T3 occurs in the liver) and digestive health (also helps with thyroid utilization)
* heavy metal toxicity (this will affect nutrient use)
* stress (stress hormones decrease active thyroid conversion)
* nutrient availability
(Some chronic cases could be aided with additional functional medicine tests, integrative tests measuring health status and cellular functional.
As you can see, low thyroid has many causes; therefore, in my practice not everyone is treated the same with the same label. For example, hypothyroidism related to an autoimmune condition would be addressed quite differently than one due to a nutrient deficiency or liver issue. Furthermore, my job would also be in providing overall support for the body as it heals to boost feelings of overall vitality and mood. For more information on thyroid and mood imbalance, see my website.
Reference:
AACE. Thyroid Awareness Month 2003: An explanation on the changing of TSH Levels. http://www.aace.com/public/awareness/tam/2003/explanation.php. Updated September 2005. Accessed January 4, 2010.
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