Optimizing Thyroid Function

The Thyroid Foundation of American reports that about 13 million Americans have thyroid disorders, of which midpoint 11 million are women and more than half are undiagnosed 1.

In his book, Thyroid Power, Dr. Richard L. Shamus concurs with the dominant and writes, “ Although notably common, low thyroid is an unsuspected indisposition. Even when suspected, it is frequently undiagnosed. When it is diagnosed, it usually goes untreated. When it is treated, it is infrequently treated optimally” 2. How true are his words. Like many of you, halfway everyone who walks into my office complains of enervate, low energy, depression, weight gain or the inability to lose unwanted weight— all symptoms of suboptimal thyroid function. Many times I have found myself scratching my head and seriously solicitation myself “ what is going on here? ” and “ why is it that midpoint every kind I’ ve observed in seven years of practice has something going on with his or her thyroid function? ”

Thyroid Hormones 101

Thyroid Stimulating Hormone ( TSH ) measurement is the blood test most commonly used by conventional doctors to shelter for thyroid dysfunction. The “ normal” range varies from lab to lab; the most common ranges are 0. 3 to 5. 5 with some labs using the newer values of 0. 3 to 3. 0 avowed by the American Association of Clinical Endocrinologists ( AACE ) in 2002 3. However, if we meeting place only on TSH we may be misplaced vital clues in the patient’ s thyroid hormone function. Unfortunately, too ofttimes, if TSH measures within the “ normal” range, the patient’ s complaints are dismissed and renounced untreated. TSH is a very poor needle of thyroid hormone function and should never be used alone to evaluate or recorder thyroid function. Comprehensive testing that includes free levels of thyroid hormones, free thyroxine ( fT4 ) and free triiodothyronine ( fT3 ) to evaluate visible conversion problems ( T4 into T3 ) should be performed. Anti - thyroperoxidase ( TPO ) antibodies should be measured to rule in / out autoimmune thyroid disease ( i. e., Hashimoto’ s ). Many patients come to me saying that their doctor uttered their thyroid tests were all general; however, upon further scrutiny of their labs and with comprehensive testing I have rarely found this to be the plight.

The first mistake some physicians make upon finding that their considerate is hypothyroid is to nowadays put them on thyroid hormone replacement therapy. Thyroid hormone, be it synthetic Synthroid ( T4 ), or natural porcine USP Armour ( T4, T3 ), will increase the patients’ metabolic standard and some will initially report pleasure better with increases in energy and less prostration. However, in many patients this is generally a transient outgrowth, and the benefits they initially reported may plunge into to weaken. This most likely occurs when doctors only treat the symptoms with medication and do not superscription the underlying cause. I have witnessed time and time again that, when medication for hypothyroidism is the sole therapy, many patients will eventually complain that they no longer feel well. The elderly symptoms of hypothyroidism promote to creep back in and they feel they are back locale they started, or even worse off than before they were prone the medication.

When adrenal function has been weak by chronic stress, poor diet, and environmental toxins, thyroid medication, by accelerating the metabolic standard, may further stress the system, causing the sympathetic to feel even more tiredness and tiredness. I presume true that it is a mistake to prematurely rush in and give thyroid hormone if you find your patients are hypothyroid, as you may cause them to crash and burn. Before treating with thyroid hormone, it is certainly necessary to get a clearer picture of your compassionate and ask yourself how and why your discerning got here in the first place.

Address the Underlying Cause

As with most chronic disease, thyroid dysfunction tends to be multi - factorial; very infrequently is there one single initiating cause. Stress 4, aging 5, cigarette smoking 6, 7, insulin resistance 8, genetics 9. 10, nutritional deficiencies / imbalances 11, 12, 13, 14, extreme dieting and / or starvation 15, iodine ( haphazard and / or deficiency ) 16, goitrogens 17, poor digestion / preoccupation and dybiosis 18 are all contributing factors. Toxins from the environment, such as pesticides, herbicides, PCBs, dioxins and heavy metals such as mercury, are known to disrupt the delicate balance of thyroid hormone 19, 20. Perchlorate 31 and thiocyanates 31, 32 have been shown to block the sodium - iodide symporter ( NIS ) and prevent the uptake of iodine into the thyroid gland 21, 22. Exogenous hormones such as xenoestrogens, birth dominion pills, and hormone replacement therapy have also been shown to interfere with thyroid function 23. Halogens such as bromine, chlorine and fluoride may interfere with the NIS and also prevent iodine uptake into the thyroid gland 24, 27 29, 30. More recently plastics ( i. e., phthalates, bisphenol - A ) have also been in the story and are being occupied in hormone disruption ( xenoestrogens ) and thyroid dysfunction 33, 34, 35.

Environmental Effects on the Thyroid Function

Disparate environmental chemicals easily disrupt the delicate balance of the thyroid gland and its function 25. It is the additive effects, or bioaccumulation, of these chemicals over the oldness in our tissues that create hormone disruption and imbalance.

The European Logbook of Endocrinology reported in 2006:

“ Several groups of chemicals have potential for thyroid disruption. There is substantial evidence that polychlorinated biphenyls, dioxins and furans cause hypothyroidism in exposed animals and that environmentally occurring doses affect human thyroid homeostasis. Similarly, flame - retardants reduce over thyroid hormone ( TH ) levels in rodents, but human studies are inestimable. Studies also indicate thyroid - disruptive properties of phthalates, but the end product of certain phthalates seems to be stimulative on TH production, contrary to most other groups of chemicals. Thyroid disruption may be caused by a heterogeneity of mechanisms, as different chemicals interfere with the hypothalamic - pituitary - thyroid pivot at different levels. Mechanisms of reaction may move the sodium - iodide symporter, thyroid peroxidase enzyme, receptors for THs or TSH, transport proteins or cellular uptake mechanisms. The alien metabolism of the THs can be affected through effects on iodothyronine deiodinases or hepatic enzymes. Even small changes in thyroid homeostasis may adversely affect human health, and especially fetal neurological development may be vulnerable” 26.

Every man, woman, and child on planet earth has been found to harbor these toxins in their tissues. Even more disturbing is the gospel that tether blood of newborn babies was found to contain these harmful compounds exposing neonates to their burdened effects even before they are born 27, 28. 29, 30.

Environmental Toxins: Disruption of Thyroid Hormone Consonance

Chemical: Perchlorate ( ClO4 )

Aftermath: Blocks iodine uptake by the NIS; displaces T4 from thyroid - hormone binding

Sources: Contaminated drinking water ( propellant found in hum fuel ), found in milk, human breast milk, vegetables ( contaminated irrigation water )

Chemical: Thiocyanate

Outcome: Blocks iodine uptake by the NIS; displaces T4 from thyroid - hormone binding, sap proteins ( causes transient elevation in free T4 )

Sources: Cigarettes, brassica vegetables ( i., e., broccoli, cauliflower, etc ).

Chemical: Phthalates

Follow up: Thyroid disruptor ( exact mechanism unknown )

Sources: Plastics ( polyvinyl chloride ), children ' s toys, IV tubing, cosmetics, nail polish, perfumes, detergents, solvents.

Chemical: Bisphenol A ( BPA )

Side effect: Binds thyroxine receptor ( rival ); increases fluid thyroxine ( T4 )

Sources: Polycarbonates ( plastics ) #7, water bottles, liners in cans, baby bottles, dental fillings, sealants, electronics, paints, adhesives, varnishes.

Chemical: Mercury

Flak: Blocks conversion of T4 into T3 ( 5’ deiodinase ) inhibits TPO enzyme.

Sources: Thimerosol ( i. e. flu vaccines ), dental amalgams, mercury thermometers, agriculture, medications ( i. e., nasal spray, opthalamic solutions, antibiotics, and the new Compact Cloudless energy - saving light bulbs )

Chemical: Perfluoro - octanoic acid ( PFOA )

Reflex: Possible thyroid disruptor

Sources: Teflon coatings, coating for food packaging, stain - resistant coatings for carpets, fabrics, and garb. Scotchguard, Pierce - Tex, coatings on microwave popcorn bags, fast food containers.

Chemical: Bromide

Event: Displaces iodine; increases plasma TSH. Inhibitory effect on thyroid exercise

Sources: Flame retardants found in plastics, paints, electronic parts and fabrics. Bromated flour, bromated vegetable oils ( i. e., Gatorade®, Powerade®, Squirt®, Fresca®, and MountainDew® ), contaminated drinking water.

Chemical: Fluoride

Reaction: Suppresses thyroid hormone ( mechanism unknown ); increases plasma TSH

Sources: Sodium fluoride in treated drinking water, fluoride toothpaste, fluoride dental treatments, beverages made with fluoridated water ( i. e., soda, juice, tea )

Chemical: Chlorine

Reaction: Inhibits iodide trapping; Decreases extract thyroxine ( T4 )

Sources: Chlorinated tap water, swimming pools, bleach, at ease chemicals

Chemical: Polychlorinated Biphenyls ( PCBs )

Flak: May reduce thyroid hormone levels by decreasing soleness; displacing T4 from binding proteins; may mimic thyroid hormones’ eventuality on expression of genes.

Sources: Persistent, universal environmental contaminants. Banned in 1977; found in aged phosphorescent lighting fixtures, electrical devices; enter the environment through unbarred burning of plastics, paints, etc.

Dietary Compounds: Disruption of Thyroid Hormone Unification

Compound: Isothiocyanates

Issue: Goitrogenic; interferes with iodine uptake in the thyroid gland; inhibition of thyroid peroxidase ( TPO ) liveliness Produces goiter & hypothyroidism in lab animals.

Sources: Brassica ( cruciferae ): property, broccoli, kale, cauliflower, kohlrabi, turnip, rutabaga, mustard, horseradish and rapeseed. Cassava, sorghum, maize, millet

Compound: Isoflavones

Reaction: Inhibits thyroid peroxidase ( TPO ); goitrogenicInhibits thyroid peroxidase ( TPO ); Inhibits type I deiodinase exertion.

Sources: Soy protein ( i. e., genestin, daidzen ), peas, almighty dollar Flavonoids: Fruits and vegetables ( i. e., quercetin, catechin, rutin ).

Compound: Gluten ( Gliadins )

Backlash: Associated with autoimmune thyroid disease ( i. e., Hashimoto’ s ); may increase anti - thyroperoxidase antibody levels ( anti - TPO ) in gluten - sensitive mortals.

Sources: Wheat, rye, barley, spelt, and non - gluten - free oats,

may be invisible in purified foods as natural flavorings

Compound: Epigenin and luteolin

Fruit: Thyroid disruptors

Sources: Millet

Medications that Disrupt Thyroid Singleness

Drug: Sulfonamides

Outgrowth: Antithyroid exertion, prevents intrathyroidal iodide binding

Sources: Acetazoleamide ( Diamox )

Drug: Sulfonylureas

Spin-off: Inhibits the solidarity of thyroid hormone; goiter ( rats ); inhibit iodide binding, block binding of T4 to the carrier proteins in extract

Sources: Carbutamide, tolbutamide, methahexamide, and maybe

chlorpropamide

Drug: Lithium

Outgrowth: Inhibits thyroid hormone release; and coupling reactions; associated with the development of goiterinhibits thyroglobulin iodination

Sources: Bipolar medication

Drug: Estrogen ( ERT )

Follow through: Increases thyroid binding globulin, possible elevation of TSH

Sources: Hormone replacement, PCBs, ( TBG ), xenoestrogens

Drug: Androgens

Upshot: Decrease thyroid binding globulin

Sources: Testosterone replacement, anabolic steroids, Danazol

I have usually pondered that what we may ruminate dysfunction may not be dysfunction at all, and that the slowing down of the metabolic proportion in hypothyroidism may wholly be an important mechanism that protects the body from undue harm stagy by chronic exposure to harmful substances in our environment. Down - regulation of the hypothalamus - pituitary - thyroid ( HPT ) spindle may be a invidious mechanism to conserve energy in times of stress. Chronic, low - dose exposure to environmental chemicals most certainly must be considered a stressor to all life upon this planet. One just has to glance at the brochure provided big to get an conception of the magnitude of the problem. Based upon this evidence, metabolism most likely slows down to protect the organizing from the toxic effects of its internal and independent environment. It is beautiful to note, that hyperthyroidism repeatedly precedes the hypothyroid state. A common trigger of hyperthyroidism is excessive stress. When you ask a hyperthyroid forgiving what was occurring in his or her life before they were diagnosed with hyperthyroidism, many of them will tell you a terrible event or that a interval of severe stress precipitated their diagnosis. In hyperthyroidism the metabolic scale accelerates and metabolism is upregulated. At this ratio the cells are rapidly metabolizing toxins. I propose it is impartial to cogitate that if the liver ( conjuncture II ) is unable to keep up with detoxifying this large metabolic load, toxic metabolites will build up in the bloodstream and produce to interfere with metabolic functions. For, the metabolic scale slows down in an header to reduce the degree of toxic metabolites that are building up, whence leading to a hypothyroid ( low metabolic ) state in composition to protect itself. Obviously, this rundown is abstract; nevertheless, the body in its own mysterious wisdom ALWAYS strives to do the right thing. Could this so - called disease utterly be the body’ s way of attempting to correct the problem? It is our job, as naturopathic physicians, to spot and remove the barriers to healing.

Uncovering the Underlying Cause

It is most important to not just treat symptoms with thyroid hormone medication and / or supplements without addressing the underlying cause ( s ). It is our job as doctors to distinguish and remove the barriers to healing. Ask yourself, why does your forbearing have thyroid dysfunction in the first place? Evaluate his / her lifestyle; help your forbearing build a solid foundation on which they can trigger to heal. Look at their diet and nutritional stratum and work with them to optimize it; find out if they are getting enough high quality sleep, and if they are not, help them to achieve it. Ask questions to find out how they are coping with the stressors in their lives.

What is upsetting the balance, what are the barriers to healing? Ask yourself not “ are they toxic? ” but “ how toxic are they? ” and develop a comprehensive detoxification plan based on their biochemical individuality.

As you can look, cleaning up the thyroid patient’ s internal and outward environment becomes a very important matter in section them to improve thyroid function and produce to heal. There are simple things you can teach your tolerant to do, such as avoiding polycarbonate plastics ( i. e., phthalates, Bisphenol - A ), and drinking reverse osmosis filtered water instead of tap water to avoid contaminants such as perchlorates, fluoride, bromide, chlorides and mercury.

Other important steps should bear rating the patient’ s total body anxiety. Look for sources of exposure to heavy metals such as mercury ( i. e., silver amalgams, fish, vaccines ) and exogenous estrogen ( xenoestrogens ) exposure such as hormone replacement therapy, birth bridle pills, excessive exposure to estrogen mimics ( pesticides, plastics, cosmetics, hormones in hideous products, etc ).

Detoxification

This makes detoxification a very important prime mover. However, placing someone on a “ cleanse” or “ water fast” is not necessarily the best step to take. There is make out that when someone loses weight, the toxins that are stored in the body fat ( adipose tissue ) will be released into the bloodstream. The circulating toxins interrupt endocrine function and interfere with thyroid function. Proper and safe methods of detoxification are essential for the sympathetic and should append nutrients ( i. e., glutathione, sulfur amino acids, etc. ) that have been shown to guide predicament I and ceremony II liver detoxification of toxins. Detoxification powders, such as UltraClear or MediClear, may be used and are good for detoxifying most patients. Use of saunas and hydrotherapy may also be appropriate for the understanding to enhance the detoxification process. It is important to evaluate your patients’ needs and create a program just for them.

Diet & Nutrition

Encourage an organic, whole foods diet, rich in constitute foods ( i. e., phytochemicals and minerals ). Optimizing nutrition through diet and nutritional supplements is necessary to residence down the foundation for healing. It has been found that outright foods may interfere with thyroid function - - especially gluten found in wheat, rye and barley.

Goitrogenic properties found in the brassica ( cruciferae ) family of vegetables ( i. e., broccoli, collard greens, mustard greens, arugula, Brussels sprouts and kale ) have been shown to impede thyroid function. Nevertheless, it is not advised to avoid these foods, because they are shown to help the body to detoxify; cleverly do not eat too many in their raw state. Moveable feast has been shown to deactivate the goitrogenic properties associated with this family of vegetables. Isoflavones, found in property, especially soy, have been shown to impede thyroid function. However, studies have found that soy did not cause problems in humans with compelling iodine intake 37, 38.

Vitamin D grade should be evaluated in nation with thyroid dysfunction as it is variegated in piece T3 predicament to nuclear receptors 39. It has been suggested that optimal 25 - hydroxy vitamin D3 levels should be between 50 and 75 ng / ml in the blood 40. Food sources of vitamin D are waste - fired, cold - water fish such as flushed, mackerel, sardines and herring.

Other important nutrients such as selenium 12, zinc 12, 13 and vitamin A 11 are also important for thyroid health.

Sleep, Exercise, and Stress Management

Address sleep quota and quality, amount of exercise ( too little, too much ), and stress levels and coping skills in all thyroid patients. It is amusing to note that the thyroid and adrenal glands cannot function without each other, and to inscription only the thyroid without addressing adrenal health is not good medicine.

Steps to Enter on Optimizing Thyroid Function

• Drink and sodden in rarefied water only ( reverse osmosis )

• Avoid swimming in chlorinated pools, chlorine bleach

• Avoid fluoride toothpaste

• Avoid bromated flours, flame - retardants ( i. e., attire, furniture, electronics, etc )

• Purchase and use environmentally - solicitous cleaning products

• Optimize nutrition

• Avoid pesticides

• Avoid plastics that contain phthalates, and bisphenol - A ( BPA )

• Purchase and eat organic foods whenever possible

• Cook cruciferous vegetables and don’ t eat too many in their raw state

• Avoid gluten ( especially with Hashimoto’ s autoimmune thyroiditis ) and / or gluten sensitivity or Celiac Disease

• Evaluate vitamin D class by 25 - OH vitamin D3 testing

• Evaluate halogens ( iodine, bromide, fluoride ) grade – Doctor’ s Data

• Take up and address adrenal function

• Dream of and inscription sex hormone stratum

• Distinguish and avoid food sensitivities

• Cogitate and superscription inflammation

• Address blood sugar and insulin levels

• Individualized detoxification program

• Comprehensive thyroid panel: TSH, Free T3, Free T4, anti - TPO antibodies

• If indicated, use thyroid medication wisely along with addressing the cause

As you can behold, there is not one simple answer that fully corrects the thyroid epidemic we are seeing in this country. Nevertheless, addressing the underlying causes and removing the barriers to healing provides the best fair shake for healing patients with thyroid disorders.

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