EVERYTHING ABOUT

thyroid

Every week I am posting about  everything you need to know about hormones. This weeks topic is about thyroid

Did you know …

  • A butterfly-shaped organ / gland that sits in front of the neck, just behind the Adam’s apple
  • Ensuring that the thyroid gland is healthy and functioning properly is vitally important to the body’s overall well-being.
  • Women are 5 to 10 times more likely to develop a thyroid problem than men.
  • Women over the age of 60 are at a higher risk of developing thyroid problems
  • Up to 60% of people with a thyroid condition are unaware of their condition as symptoms can be misinterpreted and poorly diagnosed
  • A diagnosis is established through blood tests, which unfortunately is not always reliable
  • On a global scale 200 million people have problems with their thyroid glands
  • Over 50% are undiagnosed or misdiagnosed
  • Thyroid problems can be triggered by things as simple as your drinking water or swimming in your pool
  • The Thyroid produces the hormone T4 and small amounts of T3,
  • These hormones control the rate of many activities in your body, such as:

– how fast you burn calories
– how fast your heart beats

  • Affects weight, energy levels, body temperature, skin, hair, and nail growth, bone health, and much more
  • Also affects the menstrual cycle, which can make it more difficult to get and or maintain a pregnancy.
  • Thyroid disease includes thyroid enlargement and thyroid hormone dysfunction
  • Thyroid enlargement – may be benign, resulting in nodules or goitre, or malignant ie. thyroid cancer.
  • Thyroid hormone dysfunction is divided into

– underactive thyroid gland / hypothyroidism
– overactive thyroid gland / hyperthyroidism also called thyrotoxicosis

  • Hypothyroidism usually caused by autoimmune Hashimoto’s is found in about 2% of the UK population and in more than 5% of those over 60
  • Hyperthyroidism is often caused by autoimmune Graves, accounting for 60 to 80% of hyperthyroid cases in the UK
  • The overall prevalence of thyroid dysfunction has increased from 2.3% to 3.8% from 1994-2001
  • Hyperthyroidism increased from 0.86% to 1.26% in females and 0.17% to 0.24% in males
  • Hypothyroidism increased from 3.12% to 5.14% in females and 0.51% to 0.88% in males.

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Intro

The Thyroid Epidemic

Are you converting T4 to T3?

How does good thyroid function feel

Can we rely on TSH measurements to diagnose Thyroid problems?

Know your Thyroid Hormones

  • TRH – Thyroid Releasing Hormone – The Hypothalamus hormone that tells the Pituitary to release TSH
  • TSH – Thyroid Stimulating Hormone – The Pituitary hormone that tells the Thyroid to produce T4 (and T3)
  • T4 – Thyroxine – the less active Thyroid hormone
  • T3 – Tri-iodo-thyronine – the most active Thyroid hormone
  • rT3 – reverseT3 – does the opposite of T3 ie. blocks energy production.

Signs of a Healthy Thyroid

  • Stabile energy all day
  • Uninterrupted 7 – 8 hours of sleep
  • Shiny strong hair
  • Strong nails
  • Clean skin
  • Steady weight
  • 1 – 3 bowel movements per day
  • Stabile good mood
  • Body temp 36.6C – 37.5C
  • Pulse 70 – 85
  • Regular periods and ovulation
  • Strong immune system
  • Strong libido

In short – you’re not aware of your body.

The Thyroid Epidemic

  • On a global scale, a staggering 200 million people have problems with their thyroid glands, with over 50% remaining undiagnosed.
  • Thyroid disease is one of the silent epidemics of our time.
  • 50% of all women and 25% of all men in the US will die with evidence of an inflamed thyroid.

Possible Causes

Iodine deficiency
– is the biggest cause in under developed countries, but can also affects developed countries. Iodine deficiency causes a goitre, an enlarged Thyroid which is visible. Possible causes of iodine deficiency:

Anti-nutrients / goitrogens
in cruciferous veggies (broccoli, cauliflower, cabbage family, etc.) block the absorption of iodine into the Thyroid

Soy
– high soy consumption and or use of isoflavone supplements can reduce the absorption of Thyroid medication

Fluoride
an enzyme poison which can block the use of iodine is found in water, toothpaste, tea (more than any other plant), sodas, pesticides, and some medications. The body can only eliminate 50% of its total fluoride intake, so it can accumulate I the body

Chlorine and Dioxin
– displace iodine, found in water, swimming pools, bleached paper, tampons, pads and diapers

Perchlorate
– in some drinking water can contain this chemical which prevent iodine getting into the Thyroid

  • Iodine excess – can cause chronic autoimmune thyroiditis. Be aware iodine supplementation should be implemented to prevent and treat iodine-deficiency disorders, but needs to be maintained at safe levels.
  • Autoimmune disease is the biggest cause in developed countries where the immune system attacks own tissue
  1. Graves – An overactive thyroid
  2. Hashimoto’s – An underactive thyroid
  • Poor / reduced conversion of T4 to T3 due to

Poor liver and or kidney function
– produces approx. 80% of circulating T3

Nutrient deficiency
– in Zinc, Copper, Selenium, Vit A, Vit D, Iron

Exposure to heavy / toxic metals
– such as mercury, lead, cadmium, chlorine, fluoride, etc.

Increased conversion to the hormone rT3
– instead of T3, due to stress, depression, Insulin resistance/diabetes, inflammation, increased energy needs such as excessive training, etc

Chronic Inflammation
– maybe due to a bacterial or viral infection. Maybe there is no pain or swelling and therefore no awareness of the inflammation

Chronic stress
– especially emotional stress

  • Thyroid Lumps / nodes / tumours – which can be benign or cancerous
  • Smoking – has a negative impact on thyroid function and can cause a 3 to 5 fold increase in the risk of all types of thyroid disease.
  • Pesticides – are coming under considerable criticism for their adverse chronic effects on the thyroid.
  • Genetics / Family history – is a warning signal, also a family history of depression, autoimmune disease, chronic fatigue or weight issues can increase the risk for thyroid problems.
  • Radiation and X-Rays – are known to cause damage to the thyroid
  • Some medications, such as:

Amiodarone
– an antiarrhythmic agent used for various types of cardiac dysrhythmias, limits the conversion of T4 to T3 causing hypothyroidism

Lithium
– can cause hypothyroidism

Interferons
– can cause hypothyroidism and hyperthyroidism

Tyrosine Kinase Inhibitors
– can cause hypothyroidism and transient hyperthyroidism

Alemtuzumab
– can cause hyperthyroidism Graves

Iodine-containing medications and agents 
– can cause hypothyroidism and hyperthyroidism

  • Stress – is a factor in almost every kind of disease and can affect the thyroid.
  • Pregnancy – It is estimated that between 5-10% of all pregnancies will result in PPT /Postpartum Thyroiditis. 5 to 10% of women develop mild to moderate hyperthyroidism within several months of giving birth, which lasts for approx. 1 – 2 months. Often followed by several months of hypothyroidism, but most women will eventually recover normal thyroid function. This condition may occur again with subsequent pregnancies.
  • Peri-Menopause – hormonal changes during this period of a woman’s life can wreak havoc on her thyroid, maybe due to Estrogen Dominance / Low Progesterone
  • Neck injuries – such as whip lash.

Thyroid Regulation vis the HPT axis

  • All starts in the brain and is regulated via a negative feedback loop called the HPT / Hypothalamus, Pituitary, Thyroid Axis
  • Hypothalamus gives message to the Pituitary via the hormone called TRH – Thyroid Releasing Hormone
  • Pituitary gives a message to the Thyroid vi the hormone called TSH – Thyroid Stimulating Hormone
  • Thyroid produces T4 Thyroxine (and a small amount of T3 Tri-iodo-thyronine)
  • T4 (and T3) circulates in the bloodstream to target tissues such as your liver, kidney, muscles, heart tissue, brain cells, skin cells, bone cells etc.
  • Inside the calls of the target tissue T4 is either activated or deactivated based on the demand of each tissue.

– If you are exercising and using your muscles then your body may activate more thyroid hormone in your muscles but deactivate it in your intestinal tract (you don’t need to digest food while exercising!).

– If you are thinking really hard or studying for a test your body may activate more thyroid hormone in your brain and inactivate some in your muscles.

  • Deiodinase enzymes are responsible for controlling the activation and deactivation of thyroid hormones – see more in the article thyroid regulation and the deiodinase enzymes in this blog 

The Feedback Loop

  • Blood levels of T4 and T3 feedback up to your hypothalamus / Pituitary where they influence how much TRH or TSH is being released

Examples

Low T4 and T3 blood levels

  • The Pituitary sends more TSH to the Thyroid
  • Blood TSH levels will be high or higher – closer to or above 4 IU/L

High T4 and / or T3 blood levels

  • The Pituitary sends less TSH to the Thyroid
  • Blood TSH levels will be low – closer to or below 0.3 IU/L

In short

  • Low TSH – can indicate hyperthyroidism – overactive
  • High TSH – can indicate hypothyroidism – underactive
  • BUT this is not always the case

Standard Blood Levels

  • TSH – 0,3 – 4,0 IU/L
  • Free T4 – 12,0 – 21,0 pmol/L
  • Free T3 – 3,9 – 6,8 pmol/L

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Regulating Thyroid Hormones and The Deiodinase Enzymes

NB! – complex but very important as this may be the missing link and future focus for optimal Thyroid treatment

  • The enzymes Deiodinase 1, 2 and 3 convert T4 and T3, to various forms of thyroid hormone
  • All the enzymes require selenium
  • Deionization means iodine is removed
  • There are 3 different types of deiodinizing enzymes

D1 – activates T4 to T3 in the Thyroid, liver and kidney

D2 – activates T4 to T3 in the Pituitary, heart, muscle

D3 – deactivates T4 to rT3 and T3 to T2 in all cells apart from the Pituitary

Deiodinase D1

  • Removes iodine from the inner and outer ring of the Thyroid molecule and therefore activates and deactivates
  • Activates T4 to T3
  • Deactivates to rT3 and or T3 to T2
  • Women have less D1 than men
  • The Pituitary has less D1 than the rest of the body
  • Found in the cell membrane
  • The majority of T3 in the bloodstream is derived from DI activity
  • Converts approx. 30-50% T4 to T3
  • High levels can be responsible for high T3 seen in hyperthyroidism
  • It’s production is down regulated by

– hysical and psychological stress

– Depression

– Insulin resistance / diabetes

– Obesity / wight gain

– Extreme diets / low calorie

– Autoimmune problems

– Fibromyalgia

– Inflammation

– Environmental toxins such as petrochemicals PBA etc.

  • A decrease in this enzyme can result in lower than normal free T3, T3 and T4 levels in the blood.

 Deiodinase D2

  • Removes iodine from the outer ring of the Thyroid molecule
  • The main thyroid activating enzyme in the Pituitary (and body)
  • Found inside the cell
  • Responsible for intracellular levels
  • Is 1000 times more effective than D1
  • Converts 80 – 90% T4 – T3
  • Is upregulated in response to cold exposure
  • Is downregulated in the body BUT upregulated in the Pituitary in response to

– Physical and psychological stress

– Inflammation

– Depression

– Insulin resistance

– Obesity

– Extreme dieting

– Autoimmune

– Fibromyalgia

– Pain

– Etc.

  • Is upregulated in those with hypothyroidism
  • Is downregulated in those with hyperthyroidism
  • Test yours – BUY HERE

Deiodinase D3

  • Removes iodine from the inner ring of the Thyroid molecule
  • Found mainly in the brain (neurons), skin, and endothelial cells, gestating uterus and placenta
  • In the embryo the enzyme is most abundant protecting foetal tissues from exposure to surplus Thyroid gland during development
  • D3 is not found in the Pituitary
  • Competes with and supresses D1
  • Deactivates T4 to rT3 and T3 to T2 inside the cells and in the blood
  • Also blocks the absorption of T4 and T3 into the cells
  • Is downregulated in those with hypothyroidism
  • Is upregulated in those with hyperthyroidism
  • Upregulated by

– Fasting

– Carbohydrate deprivation

– Surgery

– Myocardial infarction

– Sepsis

– Critical illness

– Oxidative stress

– Chronic stress

– Depression

– Inflammation

– Diabetes

– Etc

More information – READ HERE

The Dilemma

  • Blood levels of T3 are maintained by the HPT / hypothalamic–pituitary–thyroid axis
  • Blood levels of T3 often reflect and are regulated by intracellular Pituitary levels of T3 but don’t necessarily reflect the intracellular T3 levels of the rest of body
  • The intracellular T3 in the Pituitary is maintained by enzyme D2 activity, which reacts differently / oppositely to the body’s intracellular D2 when exposed to the same physiological conditions
  • TSH is regulated by intra-pituitary T3 levels, which often don’t correlate with T3 levels in the rest of the body
  • Because of this many are not receiving appropriate treatments  

Test your ability to make D2 

Read this article for more information

Why T4 might not convert to T3

Are you taking Thyroid medication for low Thyroid function but still don’t feel right?

Maybe you have difficulties converting T4 to T3.

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 Possible causes

  • Imbalance in the Deiodinase enzymes
  • Poor liver function

Nutrient deficiency

– Zinc
– Copper
– Selenium
– Vit A
– Vit D
– Iron

Toxic metals such as

– Mercury
– Lead
– Cadmium
– Fluoride
– Chlorine

Increased conversion to the hormone rT3 due to

– Oxidative stress
– Chronic stress
– Depression
– Insulin resistance/diabetes
– Inflammation

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Home tests for Thyroid Function

Axillary (armpit) Temperature

  • Measure your morning temperature in your armpit
  • Use a digital thermometer as soon as your wake
  • Put it in your armpit for 10 minutes
  • Repeat 6 days in a row
  • If you have a menstrual cycle, do it on day 2 – 10 of a 28-day-cycle, otherwise take it whenever you like
  • Normal functioning Thyroid: 36.5C – 36.7C
  • Hypo: constantly under 36.5C
  • Hyper: constantly over 36.7C

Pulse test

  • Take your pulse for 5 minutes whilst in a rested state
  • Hypo – constantly under 65 beats per minute
  • Hyper – constantly over 85 beats per minute
  • Remember that your pulse is easily affected by other factors, such as your level of training, mental and emotional state, foods, etc., and therefore maybe less reliable

Iodine skin test

  • Paint a 2cm square of iodine on your skin on the front side of you elbow or back of knees.
  • Should be able to see the orange square for at least 24 hours
  • If it disappears before 24hrs you probably need to top up on iodine
  • Iodine is found mainly in animal protein foods and sea vegetables, and to a lesser extent in fortified foods like breads, cereals, and milk.

Hypothyroidism 101

Low functioning Thyroid – low T4 and / or T3

 Possible Symptoms

  • TATT – tired all the time syndrome
  • Increased weight
  • Inability to lose weight no matter what
  • Hair loss / thinning hair
  • Poor digestion
  • Constipation
  • Heavy menstrual bleeds
  • Spontaneous abortions
  • Brain fog
  • Insomnia
  • Difficulties concentrating
  • Poor memory
  • Anxiety
  • Depression
  • Cold extremities hands, feet, buttocks,
  • Muscle and joint pain
  • Reoccurring infections
  • Slow heart beat and pulse
  • Low temperature – constantly under 36.5 degrees
  • High cholesterol and triglycerides levels

Possible Causes

  • Iodine deficiency
  • Genetics – family members with Hashimoto’s or other autoimmune diseases
  • Hashimoto’s – autoimmune
  • Autoimmune thyroiditis most often a goitre (enlargement of the thyroid).
  • Radioactive iodine treatment for hyperthyroidism
  • Removal of the Thyroid gland
  • Toxic metals
  • Radioactive radiation such as X-rays
  • Estrogen dominance
  • Chronic stress
  • Chronic inflammation
  • Neck injuries – think whip lash
  • Central or Pituitary hypothyroidism –a tumour in the pituitary –
  • Congenital hypothyroidism
  • Certain Medication
  • Postpartum thyroiditis

NB! – more details in the article The Thyroid Epidemic in this blog

Possible Solutions

Medical

  • Lifelong hormone replacement therapy – thyroxine / T4
  • Some may need T3 replacement

Natural Remedies

The goal of natural remedies or alternative medicine is to fix the root cause of the thyroid problem, such as

  • poor diet – gluten, sugar
  • stress
  • inflammation
  • oxidative stress
  • missing nutrients

– selenium
– zinc
– iron
– Vit A
– Vit D

Hyperthyroidism 101

Overactive Thyroid aka too much T4 and / or T3

Is dangerous and needs to be dealt with asap which often involves medication and or surgery.

Possible Symptoms

  • HATT syndrome, high all the time syndrome, feel like you’re in fast lane all the time
  • Sudden weight loss
  • Constantly eating but still losing weight
  • Fast heart beat and pulse
  • Irregular, pounding heart beat
  • Increased appetite
  • Nervous, anxious and or irritable
  • Shaking hands and fingers
  • Sudden protruding / bulging eyes
  • Sweating more than usual
  • Changes in menstrual cycle, bleeding less and less often / cycle hopping
  • Increases sensitivity to heat
  • Frequent bowel movements
  • Enlarged Thyroid gland / struma
  • Difficulties relaxing
  • Insomnia
  • Thin skin, possible bone and muscle loss
  • High temperature – constantly over 37.5

 Possible Causes

  • Autoimmune – Graves is the most common cause.
  • Food allergies
  • Toxic metals
  • Toxic nodes called Plummer’s syndrome
  • Thyroiditis – chronic inflammation

 Possible Solutions

  • Radioactive iodine which ’kills’ the Thyroid followed by lifelong hormone replacement therapy of T4 aka Thyroxine and T3 if necessary
  • Anti-thyroid medication, such as

– Carbimazol
– Thiamazol
– Propylithiouracil

  • Beta blockers, if there are unpleasant symptoms such as pounding pulse and heartbeats until metabolism decreases
  • Surgically removing the Thyroid gland
  • Bulging eyes can be a problem for some people which, depending on the severity can be treated with eye drops, medication or operations.

Thyroid and Goitrogens

  • Are anti-nutrients found in certain plant foods, such as:

– Brussels sprouts
– Broccoli
– Cabbage
– Cauliflower
– Kale
– Soy beans – edamame
– Tofu
– Tempeh
– Sweet potatoes
– Cassava
– Peaches
– Strawberries
– Nuts and seeds
– Millet

  • Consuming foods with goitrogens affects triiodothyronine (T3) and thyroxine (T4) levels and cause hypothyroidism, which is increasing daily worldwide
  • Interfere with iodine absorption and uptake into the Thyroid gland
  • Also interfere with the uptake/absorption of flavonoids and minerals such as iron and zinc both of which are necessary for the conversion of T4 to T3 and therefore optimal Thyroid function.

Thyroid and Calcium  

Together with the Parathyroid glands – the 4 small glands on the back of the Thyroid they maintain

  • Blood pH levels at 7.4
  • Bone calcium levels – thus maintaining bone strength
  • Optimal nervous system function – calcium creates muscle contractions

The Hormones

Calcitonin

  • Produced by the Thyroid sinks blood calcium
  • Decreases bone breakdown
  • Increases bone building
  • Decreases calcium reuptake in the kidneys – you pee out more

Parathyroid (PTH)

  • Produced in the Parathyroids increases blood calcium levels
  • Increases bone breakdown
  • Decreases bone building
  • Increases calcium absorption in the gut by increasing Vit D production
  • Increases reuptake in the kidneys – you pee out less.

Men and Thyroid

Even though men suffer much less than women, low thyroid function can be the cause of the following symptoms

  • Hair loss
  • Low sex drive
  • Low sperm count
  • Delayed ejaculation
  • Erectile dysfunction
  • Loss of muscle mass
  • Lower testosterone levels
  • Man boobs.

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