The Metabolism Master: Thyroid Hormone

The Metabolism Master:  Thyroid Hormone

Thyroid hormone controls your growth and metabolism.  It provides energy.  If you are low on thyroid you might notice fatigue, sluggishness, intolerance of cold or cold body temperature, thinning hair or dry/brittle hair, dry skin.  You might have uncontrollable weight gain or trouble losing weight.  You might have constipation.  You might be depressed, apathetic, or have “brain fog”.

Your thyroid gland sits in the front part of the neck and makes a thyroid hormone with 4 iodine molecules attached, called T4.  This is not the active thyroid hormone.  Out in the body, in the muscle, liver, kidney and brain, T4 must have one of its iodine molecules removed to form the active thyroid hormone, called T3.  T3 is the form that gets into the body cells to do its work.  

The most common textbook form of low thyroid disease is Hashimoto’s.  In this case your body makes antibodies against your thyroid that turn the thyroid gland off.  We find this most commonly in women, age 30-50, often after pregnancies or around menopause.  In recent years we have learned that this condition, like other autoimmune diseases, might be cured if we can find and remove the “trigger” that upset the immune system’s regulating cells.  Common triggers are delayed food allergies, heavy metal accumulation or chronic infections.

For various reasons some people do not convert their T4 to T3, and as a result are low on thyroid.  So why don’t some people convert T4 to the active T3?  The lack of conversion can be due to aging, stress, prolonged illness, toxic metal exposures, other hormone imbalances, nutrient deficiencies and medications, amongst others.  

Other people have low thyroid due to iodine deficiency.  There is debate as to whether the iodine in our table salt supply is really enough for optimal health.  It is estimated that about 8-9% of Americans are low in iodine.  Worldwide, low iodine is by far the leading cause of low thyroid function.  We recommend simply testing for iodine levels and supplementing higher levels if indicated.  This often will improve thyroid function.

Other hormone imbalances can impair thyroid function.  Estrogen dominance, high testosterone, or high cortisol, can all impair normal thyroid function.  Rather than supplement thyroid hormone it is ideal to “fix” the other hormone problems in these cases.

The standard blood test for diagnosing and monitoring thyroid conditions is thyroid stimulating hormone (TSH) from the pituitary gland.  TSH goes up to promote thyroid hormone production in the thyroid.  So if TSH is high, it suggests low thyroid, and visa-versa.  There is conflicting opinion about how well this test can be trusted.  I recommend patients also get a free T4 and free T3 blood test, as well as two tests for antibodies to the thyroid, TPO and thyroglobulin antibody.

Not every low thyroid condition requires thyroid hormone.  We strive to correct other imbalances that have led to low thyroid production or resistance to thyroid hormone action.  Often Hashimoto’s is curable.  Controlling high stress and the associated high stress hormone, cortisol, will improve thyroid function.  Eliminating sugar and high glycemic foods from the diet will improve all hormone functions.  Eliminating external sources of estrogen-like chemicals (xenoestrogens) will help improve thyroid function.  These are only a few examples…

Most physicians use T4 only thyroid hormone for replacement, such as Levothyroid or brand name Synthroid.  This is just fine as long as people convert the T4 to the active T3.  Some patients do markedly better on forms of thyroid hormone that contain both T4 and T3, such as brand name Armour thyroid.

Aside from feeling poorly, low thyroid will cause a host of diseases to get worse, such as obesity, diabetes or heart disease.  Low thyroid also causes problems with the function of other hormones causing them to work poorly.  For example, women need thyroid hormone to ovulate and make enough progesterone which is required for a normal menstrual cycle or pregnancy.  Men and women need enough thyroid hormone to allow the sex hormones to promote a healthy sex drive.  As you can see, thyroid is a critical player in the symphony of hormones.

If you have symptoms of low thyroid and they don’t seem to relate to anything else, then you are very likely low on thyroid hormone.  Consider other conditions that mimic low thyroid, such as high cortisol or insulin resistance.  But remember, the routine thyroid blood tests might be “normal” but not optimal!

Know the symptoms of low thyroid.  If you are suspicious that you have a problem, ask your physician to check the blood tests suggested above.  This will give you a starting point for treatment.  The blood level may be within the “normal” range, but might need to be adjusted to a higher level to be “normal” for you.
I recommend several books as resources, including “Why Do I Still Have Thyroid Symptoms?  When My Lab Tests are Normal” by Datis Kharrazian, and “Stop the Thyroid Madness” by Janie Bowthorpe.  One of our most popular free seminars at the IMC is “Low Thyroid:  Misunderstood, Misdiagnosed, Missed!”  Catch the next live seminar or pick up the DVD version at the IMC.  
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The next free seminars are “Supplements:  Why you need them and how to choose them”, Monday, April 9th, and “Bioidentical Hormone Replacement for Women”, Monday, April 23rd, both at 6pm, at the IMC.  Seating is limited so RSVP at 245-6911 or online at rsvp@imcwc.com.
 
Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com).  Call (970) 245-6911 for an appointment or more information. 

He is also medical director of Integrative Weight Solutions, a holistic, physician supervised HCG weight loss program that incorporates expert evaluation for hormone and digestive health imbalances, exercise physiology, and behavioral support for a powerful and balanced journey to weight loss.  For more information see www.integrativeweightsolutions.com or call 245-0373 to arrange a free consultation.