It’s estimated that as many as 59 million Americans have a thyroid problem, but the majority don’t know it yet. The thyroid, a butterfly-shaped gland located in the neck, is the master gland of metabolism. When your thyroid doesn’t function, it can affect every aspect of your health, and in particular, weight, depression and energy levels.
Since undiagnosed thyroid problems can dramatically increase your risk of obesity, heart disease, depression, anxiety, hair loss, sexual dysfunction, infertility and a host of other symptoms and health problems, it’s important that you don’t go undiagnosed.
The thyroid gland is found in the neck below the Adam’s apple located on the front of the windpipe. It mainly controls how quickly and effectively the body uses energy, i.e. the metabolism and is responsible for secreting thyroid hormones into the body. These control the metabolism along with growth, development and the body’s temperature.
There are a range of problems associated with the thyroid and these include:
- Goiter: Thyroid swelling and is often associated with thyroid inflammation known as Hashimoto’s Thyroiditis. Hashimoto’s Thyroiditis is an autoimmune disease that attacks the thyroid gland though it does not destroy the tissue, rather it results in an underproduction of thyroxine, the hormone made in the thyroid that regulates metabolism and controls many bodily functions such as digestion. This disease is more common in women than in men. The cause is not fully understood but a family history of thyroid disorders is common in those with Hashimoto’s Thyroiditis, indicating some kind of genetic link or predisposition.
- Thyroiditis: An inflamed thyroid often caused by a viral infection or that of an autoimmune condition. It can be painful and often there are no symptoms.
- Hyperthyroidism: This is known as excessive thyroid hormone production. This is usually caused by Graves disease or even an overactive thyroid nodule.
- Hypothyroidism: This is caused by low production of thyroid hormones, caused by an autoimmune disease.
- Graves disease: Caused by an overstimulated thyroid, this is an autoimmune condition.
- Thyroid cancer: This is an uncommon form of thyroid cancer, but is mostly curable with radiation, surgery and other forms of hormone treatments.
- Thyroid nodule: These consist of small abnormal lumps or masses in the thyroid gland, they are extremely common and relatively few are cancerous. They usually serete excess hormones and can cause hyperthyroidism.
- Thyroid storm: This is rare and causes thyroid hormone levels to become extremely high, thereby causing severe illness in the body.
Ten Top Signs You have A Thyroid Problem
Muscle and Joint Pains, Carpal Tunnel/Tendonitis Problems
Aches and pains in your muscles and joints, weakness in the arms and a tendency to develop carpal tunnel in the arms/hands, tarsal tunnel in the legs, and plantars fasciitis in the feet can all be symptoms of undiagnosed thyroid problems. (For more information)
Neck Discomfort/Enlargement
A feeling of swelling in the neck, discomfort with turtlenecks or neckties, a hoarse voice or a visibly enlarged thyroid can all be signs of a “goiter” — an enlarged thyroid gland that is a symptom of thyroid disease.
To help find out if your thyroid may be enlarged, try a simple “Thyroid Neck Check” test at home.
Hair/Skin Changes
Hair and skin are particularly vulnerable to thyroid conditions, and in particular, hair loss is frequently associated with thyroid problems. With hypothyroidism, hair frequently becomes brittle, coarse and dry, while breaking off and falling out easily. Skin can become coarse, thick, dry, and scaly. In hypothyroidism, there is also often an unusual loss of hair in the outer edge of the eyebrow. With hyperthyroidism, severe hair loss can also occur, and skin can become fragile and thin.
Bowel Problems
Severe or long-term constipation is frequently associated with hypothyroidism, while diarrhea or irritable bowel syndrome (IBS) is associated with hyperthyroidism
Menstrual Irregularities and Fertility Problems
Heavier, more frequent and more painful periods are frequently associated with hypothyroidism, and shorter, lighter or infrequent menstruation can be associated with hyperthyroidism. Infertility can also be associated with undiagnosed thyroid conditions. (For More Information)
Family History
If you have a family history of thyroid problems, you are at a higher risk of having a thyroid condition yourself. You may not always be aware of thyroid problems in your family, though, because among older people, it is often referred to as “gland trouble” or “goiter.” So pay attention to any discussions of glandular conditions or goiter or weight gain due to “a glandular problem,” as these may be indirect ways of referring to thyroid conditions.
Cholesterol Issues
High cholesterol, especially when it is not responsive to diet, exercise or cholesterol-lowering medication, can be a sign of undiagnosed hypothyroidism. Unusually low cholesterol levels may be a sign of hyperthyroidism. (For More Information).
Depression and Anxiety
Depression or anxiety – including sudden onset of panic disorder – can be symptoms of thyroid disease. Hypothyroidism is most typically associated with depression, while hyperthyroidism is more commonly associated with anxiety or panic attacks. Depression that does not respond to antidepressants may also be a sign of an undiagnosed thyroid disorder. (For More Information)
Weight Changes
You may be on a low-fat, low-calorie diet with a rigorous exercise program, but are failing to lose or gain any weight. Or you may have joined a diet program or support group, such as Weight Watchers, and you are the only one who isn’t losing any weight. Difficulty losing weight can be a sign of hypothyroidism. You may be losing weight while eating the same amount of food as usual – or even losing while eating more than normal. Unexplained weight changes and issues can be signs of both hypothyroidism or hyperthyroidism. (For More Information)
Fatigue
Feeling exhausted when you wake up, feeling as if 8 or 10 hours of sleep a night is insufficient or being unable to function all day without a nap can all be signs of thyroid problems. (With hyperthyroidism, you may also have nighttime insomnia that leaves you exhausted during the day.) (For More Information)
There is also a relationship between an increased incidence of sleep apnea (brief periods when you stop breathing while sleeping) and hypothyroidism. Frequent apnea can also cause unrelieved exhaustion. Apnea is often also seen in conjunction with snoring. For more information on apnea and other sleep disorders , and how they can be treated, see What is Sleep Apnea? .
The Most Important Nutrients for Thyroid Problems
Be sure to take a strong multivitamin with minerals along with a couple of grams of Vitamin C each day. This has to be high-quality, such as can be purchased from reputable health food stores.
The first, of course, is iodine, which – as we have described in our book Thyroid Power: 10 Steps to Total Health, is very much a double-edged sword for thyroid sufferers. You absolutely need it, but not too much of it. The latest study, to look at this more carefully, was a 1999 report in Nutritional Review, by Lee, Bradley, Dwyer. These researchers tell us that the size of the population with iodine deficiency is now close to 10% of men, and 20% of women. However, the other 80-90% do not need extra iodine, and for many of this majority, additional iodine can become a thyroid problem.
What to do? If you are a person who never consumes fast food, avoids salt like the plague, doesn’t eat much seafood, and feels that sea vegetables are for fish, and especially if you live more than 100 miles from any coast, then you might well consider supplementation with iodine, the key mineral in thyroid hormone production.
If you are not in this category, you would probably do well to not take extra iodine, as you’re likely to be getting more than enough from other sources, such as iodized salt and the natural sources of fish and sea vegetables.
This iodine dilemma is the major nutritional problem facing everyone. World wise, iodine deficiency diseases account for incalculable suffering in the form of goiter, miscarriage, infertility, and terrible sickness affecting over one billion people on the planet. This is a significant percentage of the human race. However, in the US, the problem has been thought eliminated by the widespread distribution of iodine, first in bread dough, and in salt. Recently however, there has been resurgence of iodine deficiency, even in our country. It is a problem for specific people.
Researchers are presently working to develop a reliable and effective test for iodine, but at this point, we are not convinced that the available tests are up for the task. In light of all this, some thyroid specialists are suggesting that you hedge your bets and simply ingest each day an amount of iodine that will help if you are too low, but won’t hurt if you are already sufficient. This amount appears to be about 100 mcg (micro-grams) per day. However, if you find that you feel sick after eating iodized foods, you may want to avoid this nutrient.
As you can see, the minerals may be more important for thyroid production than the vitamins, because the next two items on the list are the minerals selenium and zinc. Selenium is crucial in both the production of T-4 thyroid hormone (thyroxine) in the thyroid gland, as well as in the conversion of T-4 to T-3 thyroid hormone, the active form (thyronine). Zinc is needed both before and after these production and conversion processes. Zinc is necessary for the TRH hypothalamus hormone to stimulate the pituitary gland, which signals the thyroid gland to produce thyroid hormone.
Moreover, zinc is needed at the intracellular level to help the thyroid nuclear receptors attach and drive the reading of the DNA genetic code. Keep in mind that the main function of thyroid hormone is to help put the genetic code into action.
Regarding selenium, we suggest 200 mcg (micro-grams) per day. This is, again, more than is contained in the common multiple mineral products. For zinc, we believe you can take at least 10 mg per day; please keep in mind that when taking 10-25 mg. of zinc, you need to balance that with one mg copper for the zinc-copper ration so useful for thyroid patients. Therefore a good product would contain 1-2 mg of copper in addition to the zinc.
In addition to these minerals, vitamin D is necessary for thyroid hormone production in the pituitary gland, and possibly in the early stages of T-3 (thyronine) binding to its receptor. Vitamin E is part of the necessary supporting apparatus that enables the deiodinase enzyme to convert T-4 (inactive thyroid hormone) into T-3 (the active type).
It now appears that the amount of vitamin D people need has been grossly under-estimated, nor is it as toxic as first was thought. We recommend at least 800 IU of Vitamin D daily.
The amount of vitamin E needed has likewise been undersold; we recommend 400-800 IU daily. This turns out to be more than is provided in most multiple vitamins, yet it allows for excellent antioxidant protection as well as helping menopausal women avoid hot flashes without resorting to estrogen.
There you have it – the 5 most essential nutrients for feeding the thyroid gland. Keep in mind, however, that these researchers based their studies, for the most part, on fairly healthy individuals. If you have had a thyroid problem of some duration, or if you have some other illness, in addition to your thyroid problem, then other recommendations apply to you. These include:
- full-symphony antioxidant, not just the C and E, but especially 5000 – 10,000 IU of Vitamin A, which is usually present in most multiple products. The other antioxidants, such as lipoic acid, pygnogenol, etc. are often omitted in a multiple vitamin with minerals, but are indeed present in an antioxidant combo. We suggest, for people in this category, very strong anti-oxidant supplementation.
- Moreover, to have your thyroid get to where it needs to go, you are likely to need high doses of the essential fatty acids (EFA) in a 2:1 mix of Omega 3 and Omega 6. This can best be obtained in a separate gel capsule or as refrigerated liquids from the health food store.
- Finally, long-time sufferers would do well to take extra amino acids. Recall that thyroid hormone is basically the amino acid tyrosine with some iodine attached. Amino acid metabolism is crucial for thyroid function, but it is not just tyrosine that is needed. In fact, far better if full-symphony, free-form amino acids, a couple of grams per day.
It may sound complicated to meet all of the Shames’ recommendations regarding supplements, but it’s actually not, because I’ve worked it all out for you! (Note: These are my own recommendations regarding what I take. The Shames did not specify any brands.)
Are You Being Treated by the Right Doctor?
Endocrinologists are physicians whose specialization is in diseases of the endocrine system, including diabetes, infertility, polycystic ovary syndrome (PCOs), and thyroid disease.
Endocrinologists are, however, in extremely short supply in the US and worldwide, and many of them focus their practice primarily on diabetes diagnosis and treatment. For suspected or confirmed thyroid cancer, Graves’ disease, nodules, and goiter, it’s important to see an endocrinologist who specializes in thyroid issues.
But for diagnosing and treating Hashimoto’s disease, or diagnosing and managing sex hormone, thyroid, or adrenal imbalances, an endocrinologist may not be the best choice. Many patients find they are better served by an integrative physician (a physician who combines conventional as well as holistic medicine). Other physicians that specialize in managing hormone imbalances can include primary care doctors, GPs, internists, gynecologists, osteopathic physicians, naturopathic physicians, and nurse practitioners who specialize in women’s health issues.
Are Your Adrenals Imbalanced?
Did you start on thyroid treatment, feel better, and then a few weeks later, find that you’ve regressed or even crashed, symptom-wise? Do you find that you can’t tolerate even small increases in thyroid medication without feeling jittery and anxious? You may have some sort of imbalance in your adrenal glands – that glands that produce stress hormones and help the body manage stress. Imbalances or insufficiency in the adrenals can cause a backslide in thyroid symptoms after you’ve started treatment, or make you intolerant to thyroid medication.
Integrative physicians typically recommend that you have adrenals tested with the 24-hour saliva cortisol/DHEA test, and imbalances can sometimes be corrected with supplements along with nutritional and lifestyle changes.
Are Your Ferritin and Vitamin D Levels Too Low?
Ferritin – the stored form of iron — is crucial to proper thyroid function. On a reference range of 20 to 100, many integrative doctors recommend that ferritin levels be at least 50 for proper hormonal function. If you are experiencing hair loss, the recommendation is that the level be at least 80. You can have a blood test for ferritin performed, and discuss iron supplementation with your physician if necessary. Remember, though, that if you supplement with iron, you should take it at least three to four hours apart from your thyroid hormone replacement medication.
Vitamin D is now known to be more than just a vitamin, it’s a prohormone. And it has an important role in immune health, and weight loss. On a reference range of 20-100, many integrative doctors recommend that Vitamin D levels be at least 50 or higher.
Am You Getting Enough Sleep?
You may find, even with optimal thyroid treatment, that you still feel fatigued. The most common cause is the most obvious one – lack of sufficient, good quality sleep. If you are experiencing fatigue, make sure you work with your practitioner, and practice good sleep hygiene, to get at least seven to eight hours of sleep per night.
This is even more essential if you are trying to lose weight, or are have been diagnosed with adrenal imbalances.
In addition to getting more sleep, here are some other fatigue-fighting secrets.
Should You Change Your Diet?
Some thyroid patients find it difficult to stay regulated on their dosage of thyroid hormone replacement medication. Others can’t lose weight. Some people have joint and muscle aches and pains that continue despite treatment. And still others experience constant bloating and skin irritations. Even if your treatment is optimized, if you continue to have these kinds of symptoms, your diet may be to blame.
Goitrogens are naturally-occurring substances found in various foods, and they have the ability to cause a goiter — an enlargement of the thyroid gland.
In addition to promoting goiter formation, goitrogenic foods can act like antithyroid drugs, slowing down the thyroid, and ultimately causing hypothyroidism, an underactive thyroid.
Goitrogens are able to disrupt normal thyroid function by inhibiting the body’s ability to use iodine, block the process by which iodine becomes the thyroid hormones thyroxine (T4) and triiodothyronine (T3), inhibit the actual secretion of thyroid hormone, and disrupt the peripheral conversion of T4 to T3.
The key goitrogen-rich foods are the vegetables in the cruciferous category. In addition, there are a number of other foods that contain significant amounts of goitrogens.
Interestingly, some people appear to carry a genetic predisposition to avoid goitrogenic foods.
Some of the more common and potent goitrogens include the following vegetables, fruits and other foods:
- African cassava
- Babassu (a palm-tree coconut fruit found in Brazil and Africa)
- Bok choy
- Broccoli
- Chinese Broccol
- Broccolini
- Brussels sprouts
- Cabbage
- Cauliflower
- Collards
- Kale
- Kohlrabi
- Mustard greens
- Rutabaga
- Turnip
- Daikon
- Red radish
- Watercress
Dr. Richard Shames
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Tags: adrenals, cruciferous vegetables, diet, fatigue, hair loss, thyroid disease, thyroid gland, thyroid problems, Vitamin D
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