The Master Switch
An effectively operating thyroid
is crucial for abundant natural energy.
By Beverly Burmeier
In her mid-40s Linda Childers, now 52, began feeling anxious and out of sorts. “I didn’t feel like myself, and I was always tired,” she says. Childers’ symptoms, together with her gender and age, led her doctor to test for thyroid disease.
Childers fit what Alan Christianson, NMD, a natural endocrinology specialist in Scottsdale, Arizona, calls the classic scenario for thyroid problems. “Women have a 25% chance of developing thyroid disease during their lifetimes, and it’s especially prevalent during times of hormone shifts such as pregnancy and perimenopause,” Christianson says. (Perimenopause refers to the time when a woman’s hormone levels begin to fluctuate but before her monthly cycles cease completely.)
Childers, of Martinez, California, was diagnosed with underactive thyroid, which occurs when the thyroid gland can’t make enough of the hormones that the body needs to optimize energy production.
Too Much, Too Little
The thyroid is a butterfly-shaped gland in the front of the neck that is part of the endocrine system. Besides serving as the body’s master energy controller, the thyroid produces hormones that regulate processes including bone repair, and cardiac and muscular activity. Because thyroid hormones affect so many functions, a properly working thyroid is crucial for peak well-being.
Thyroid problems, especially in their earliest stages, can mimic other conditions. That means millions of Americans are living with thyroid disease and may not realize it, explains Christianson, author (with Hy Bender) of The Complete Idiot’s Guide to Thyroid Disease (ALPHA). Besides producing various discomforts a malfunctioning thyroid can, if left untreated, increase heart disease risk. Pregnant women also run a greater risk of developing gestational diabetes as well as complications such as pre-eclampsia and premature labor.
The symptoms that accompany disturbances in thyroid output depend on whether the gland is overactive (hyperthyroidism) or underactive (hypothyroidism, as in Childers’ case). People who have hyperthyroidism may lose weight, muscle mass and their ability to tolerate heat. Other possible symptoms include insomnia, rapid heart rate, diarrhea, hand tremors and nervousness or irritability.
Graves’ disease, an immune system malfunction that results in excessive thyroid hormone production, is the main cause of overactive thyroid.
A variety of symptoms can indicate a sluggish thyroid; among the most noticeable are fatigue and unexplained weight gain. Other symptoms may be more subtle and harder to link definitively to poor thyroid performance. They include dry skin, facial puffiness, brittle nails and hair, joint and muscle pain, depression, slowed heart rate, headaches, hair loss, mental fogginess, sensitivity to cold and irregular or heavy menstrual periods.
The most common cause of hypothyroidism is Hashimoto’s disease, in which inflammation damages the gland. This results in reduced production of thyroid hormones and increased secretion of thyroid-stimulating hormone (TSH), an indication that the pituitary gland at the base of the brain is trying to stimulate the thyroid to make thyroxine (T4); T4 is then converted into the active form of thyroid hormone, triiodothyronine (T3). As a result the thyroid may enlarge to form a goiter, a visible swelling of the neck. Hashimoto’s disease primarily affects middle-aged women but can occur
in both genders at any age and even in children.
Not so commonly, prescription medications such as lithium for bipolar affective disorder and amiodarone for heart arrhythmia have been known to induce hypothyroidism, as can treatment of overactive thyroid with either surgery or radiation. In rare cases hypothyroidism may occur when a malfunctioning pituitary gland fails to release adequate amounts of TSH.
Risks Rise With Age
People are more prone to hypothyroidism after age 40 because the gland starts to perform less efficiently over time. A family history of thyroid disease increases risk, as does having Down’s syndrome or an autoimmune disease such as type 1 diabetes. If symptoms are generalized or vague, the disorder may take years to manifest itself.
According to the American Academy of Clinical Endocrinologists, hypothyroidism affects women more than men because estrogen inhibits the body’s absorption of iodine, a mineral essential to the production of thyroid hormone. What’s more, during pregnancy iodine stores are diverted from the mother to the fetus, which requires iodine for brain development. (Prenatal vitamins account for this by providing extra iodine.)
The standard diagnostic tool for hypothyroidism is a panel of blood tests checking the levels of hormones T3 and T4 (and a related hormone, T2) in the blood. “If any of these is low or lacking, and TSH levels are higher than normal, the diagnosis is hypothyroidism,” says Christianson.
“The test is quite accurate, although the range of normalcy is large and symptoms are very individual,” adds Supneet K. Saluja, MD, endocrinologist at Mercy Medical Center in Baltimore.
Current guidelines suggest a TSH range of 0.4 to 4.0, although Saluja cautions that every person is different and someone may have symptoms even if the blood test doesn’t indicate an abnormality.
Boosting a Sluggish Thyroid
Hypothyroidism is generally treated with supplemental hormones, either synthetic or natural. “When your body can’t synthesize the thyroid hormone on its own, you add what it needs to help the immune system work properly,” Saluja says. “Patients should take this medication on an empty stomach and at a consistent time, either morning or night.” Check with your practitioner about foods or other substances that should be avoided while taking such supplements; although some studies indicate that cruciferous (broccoli family) vegetables may reduce thyroid hormone levels, Christianson says
it’s not necessary to avoid these otherwise healthy veggies. (Cooking crucifers will break down the offending compounds.)
In fact, a healthy diet can help support proper thyroid function. “Eating wholesome foods that strengthen the immune system helps prevent thyroid disease while improving overall health,” says Joy DuBost, PhD, RD, CSSD, spokesperson for the Academy of Nutrition and Dietetics. She recommends a diet with plenty of whole grains, low-fat dairy, fruits and vegetables, and lean protein. DuBost also recommends foods containing healthy fats (including omega-3 fatty acids) and fiber.
Foods, supplements and medications containing high levels of iodine should be avoided as these could actually disrupt thyroid function. On the other hand, Christianson says a high-quality multivitamin containing selenium and magnesium may be helpful; selenium-based proteins help convert T4 into T3. DuBost says tuna, mushrooms, Brazil nuts, crab and lobster provide high amounts of selenium. She also recommends consuming more fatty fish, eggs and low-fat dairy to avoid deficiencies of vitamin D, which has been linked to hypothyroidism. Spending safe time in the sun (about 15 minutes a day without sunblock) helps the body increase vitamin D production.
Take time to savor your meals slowly. Avoid rushing in general as well as in other situations that lead to stress, since over time chronic stress can overwork the thyroid hormones. Try techniques such as deep breathing, meditation or yoga to promote greater relaxation. Don’t forget the physical and mental benefits of exercising on a regular basis—it keeps the immune system strong, aids in weight control and helps lessen feelings of depression or anxiety. (Getting enough sleep also helps rejuvenate the immune system.) For some patients acupuncture or biofeedback may be helpful in restoring balanced thyroid function.
Working with her doctor, Childers changed the type and strength of her medication until she found the TSH level at which she feels best. She takes a magnesium supplement, eats a healthy diet and has periodic blood tests to make sure thyroid hormone levels remain steady. “I believe in being a partner in my health care,” she says—good advice for all thyroid patients.