Is a sluggish thyroid making you sick, fat and tired?

(originally published in InnerSelf Newspaper)

 As women age the incidence a “sluggish” or non-optimal thyroid function is prevalent quite despite what is termed a “normal” thyroid hormone test.  The most common screening test for hypothyroidism is the TSH or thyroid-stimulating hormone.  Often in women in their 30’s and beyond the TSH starts to creep up – an indication of sluggish response by the thyroid.  Even though the range of normal TSH goes up to 4, many women have signs of poor thyroid function or cellular response to thyroid hormones when the TSH level in the blood passes 2.  When one examines sequential TSH results over a few months or years one frequently sees this gradual creeping up of the TSH.  If clinical hypothyroidism is suspected additional tests such as Total T4, Free T4 and Free T3 may be ordered by your doctor or naturopath.  These assist in determining if there is adequate conversion of T4 (from the thyroid) into T3 (the form that acts at a cellular level).  Additional tests that may be useful include testing for thyroid antibodies if autoimmune causes are suspected (Hashimoto’s thyroiditis) and reverse T3 (a form of T3 that is “reversed” in its molecular structure and does not work well).  If clinical hypothyroidism is detected then hormone replacement therapy is instituted by your doctor.

 So what if all the tests are “normal” but your TSH is creeping up and/or you are feeling unwell?  You may be feeling tired and depressed and you may be gaining weight, can’t concentrate and really feel the cold.  Other symptoms associated with a sluggish thyroid include constipation, muscle cramps, joint pain, dry skin, hair loss, fluid retention and menstrual irregularities.  Also associated are increases in your total cholesterol and LDL – increasing your chance of heart disease.  Obviously these symptoms can be associated with other hormone imbalances such as adrenal fatigue and peri-menopausal estrogen dominance (discussed in previous articles in Inner Self). Due to the increased incidence of “sluggish thyroid” in the middle years often there are several hormone imbalances combining to paint the picture. So if  you don’t have “clinical hypothyroidism” as diagnosed by the blood tests but believe you may have a “sluggish” thyroid what can you do?

 Hypothyroidism and/or “sluggish thyroid” are commonly associated with autoimmunity and can also be influenced by nutritional deficiencies.  Factors that contribute to immune overactivity include food intolerances, gut dysbiosis, poor digestion and heavy metal toxicity.  Gluten sensitivity for example has been associated with Hashimoto’s disease.  Maximising digestive function is essential as is treating “dysbiosis” or an overgrowth of noxious bugs in the gut – the cell walls of these bugs are toxic and can put the immune system into “high gear” leading to autoimmunity.  Heavy metal toxicity such as mercury and lead may also contribute.

Deficiencies of iodine, selenium and zinc directly impact thyroid production and activity.  Digestion and production of vital stomach acid is impacted by zinc deficiency. The amino acid tyrosine is required for synthesis of thyroid hormones and if your protein intake, digestion or assimilation is inadequate you may have a deficiency. It is recommended you have a Hair Mineral Analysis through your naturopath to assess both your nutritional and heavy metal status.  Specialised amino acid testing is also available.

 On the herbal medicine front there are several herbs that stimulate and balance the production of thyroid hormones.  Iris versicolor, Commiphora mukul, and Fucus vesiculosis are three medicinal herbs that help to correct “sluggish” thyroid activity.  It is also useful to balance adrenal hormones and numerous herbs can be utilised including Withania somnifera, Rehmannia glutinosa and many others. Depending on the situation and particularly if you are in peri-menopause or menopause it is important to also balance the sex hormone contributions to symptoms. Herbs can also be used to treat other contributing factors as mentioned above include auto-immunity, digestion and dysbiosis.  A qualified medical herbalist is recommended as this is a specialised field and herbal medicines are just that – medicines with both cautions and contraindications.

 On the dietary front increasing foods high in selenium, zinc, iodine and tyrosine is helpful.  Such foods include: brazil nuts, cashews, almonds, chicken, eggs, fish, garlic mackerel, oysters, tuna, broccoli, baked beans, sunflower seeds and pumpkin seeds. It is often important to treat with “therapeutic” dosages of these nutrients to achieve optimal results.  Naturopathic advice is recommended. It is also important to note that a very high consumption of cruciferous vegetables such as broccoli and cauliflower can have an anti-thyroid effect and although they are marvellous for health it is best to be moderate in your intake if your thyroid is sluggish.

 The single most important lifestyle factor to improve thyroid function is exercise.  Aerobic exercise stimulates the enzyme required to convert T4 into its more active form T3.  A minimum of three weekly sessions per week is recommended.  Yoga is also particularly helpful for balancing our hormonal systems.  Asanas (poses) which “invert” the body such as the shoulder stand are wonderful for “toning” up the thyroid.  Seeking the advice of a qualified yoga therapist is recommended.