Have you recently been diagnosed with a thyroid condition? Know your basics
Thyroid conditions are on the rise and one of the most common disorders worldwide [1]. In fact, it’s estimated that 1 in 20 people living in the United States (US) alone will suffer with a thyroid condition at some stage in their life [1]. I know, I’ve used statistics from the US to show you just how common thyroid conditions are as Australia’s are somewhat lacking. In this blog I explore some of the most common questions from my clients with newly diagnosed thyroid conditions including what your thyroid is and what it does, what can go wrong, thyroid markers and what they mean, what markers to test, contributing and causative factors of thyroid conditions, and common signs and symptoms.
What is the thyroid and what is its role in the body?
Let’s talk about the boring stuff first so that you understand just how important the thyroid is! Your thyroid is a butterfly-shaped gland that’s located beneath the larynx in the neck. It controls the metabolic rate of all cells and overall development of the human body. Your thyroid produces and secretes the hormones thyroxine (T4) and to a lesser extend triiodothyronine (T3) and is regulated by the hypothalamic-pituitary-thyroid (HPT) axis [2]. It also secretes calcitonin which helps to regulate calcium levels in the body but that’s a discussion for another time.
The HPT axis acts in response to the level of thyroid hormones in the blood. A section of the brain called the hypothalamus secretes thyrotropin-releasing hormone (TRH) which passes a message on to the anterior pituitary gland, located at the front of the brain, to secrete thyroid stimulating hormone (TSH). TSH then acts as a whip to tell our thyroid to make hormones. This cascade of events maintains an optimal level of T4 and T3 in the blood [2].
I like to think of the thyroid gland as the body’s little powerhouse as the hormones that it produces act on numerous tissues all over our body to produce many actions. Your thyroid plays a role in maintaining and supporting your metabolic rate, cholesterol breakdown, digestive secretions, body temperature, bone growth in children, gastrointestinal function, muscle tone and function, the “fight or flight” stress response, appetite regulation and it affects fertility and menstruation [2].
Your thyroid predominantly makes T4 which is inactive and it needs to be converted to T3 in order to carry out the aforementioned actions within the body. This is a process that takes place in the liver (approx. 60%), in the gastrointestinal tract (approx. 20%) and in the peripheral tissues (approx. 20%) [3].
What can go wrong?
Many factors can influence the function of our thyroid gland resulting in hypothyroidism (an underactive thyroid), hyperthyroidism (an overactive thyroid) or autoimmune thyroiditis such as Hashimoto’s or Graves’ disease. Hyperthyroidism and Graves’ disease are less common than hypothyroidism and Hashimoto’s disease.
Hypothyroidism and Hashimoto’s disease
Hypothyroidism and Hashimoto’s disease aren’t the same! Hypothyroidism is diagnosed by having a high TSH, low free T4 and/or low free T3. You may have also heard of subclinical hypothyroidism, which is when you have a high TSH, but your thyroid hormones are still within range [4].
Hashimoto’s disease is an autoimmune disease where the immune system attacks the thyroid and causes damage. It’s diagnosed by having high thyroid peroxidase (TPO) and/or thyroid globulin (Tg) antibodies. Hashimoto’s disease can cause hypothyroidism if left unmanaged. In fact, it’s the most common cause of hypothyroidism and should be identified in order to treat the cause – the immune system.
Many factors can cause and contribute to hypothyroidism and Hashimoto’s disease such as stress, infections, genetic susceptibility, trauma, nutrient deficiencies, sluggish liver and liver disease, ageing, smoking status, use of endocrine disrupting chemicals, poor gut health, compromised eliminatory pathways, food intolerances and allergies, alcohol intake, and certain medications [4, 5, 6].
Hyperthyroidism and Graves’ disease
Hyperthyroidism and Graves’ disease aren’t the same! Hyperthyroidism is diagnosed by having low or undetectable TSH, high free T4 and/or high free T3. Much the same as Hashimoto’s disease, Graves’ disease is an autoimmune disease where the immune system attacks the thyroid gland and causes damage. It’s diagnosed by having TSH receptor antibodies. Graves’ disease is a common cause of hyperthyroidism. And again, it’s important to have your antibodies tested in order to treat the cause. Factors that cause and contribute to hyperthyroidism and Graves’ disease include excess iodine, nutrient deficiencies, stress, trauma, genetic susceptibility, infections, food intolerances and allergies, use of endocrine disrupting chemicals, compromised eliminatory pathways, and poor gut health [5, 6].
You would’ve noticed that hyperthyroidism and Graves’ disease share some overlapping causative and contributing factors as hypothyroidism and Hashimoto’s disease. This is due to the impact that these factors have on our immune system and overall health.
Is there anything that I should know when it comes to testing?
One thing that I can’t stress enough when it comes to testing your thyroid function is how important it is to ask for a full thyroid panel, including antibodies. If you follow me on social media, you’ll see me post about this all the time! More often than not, you’ll only receive a full thyroid panel if there’s a family history of thyroid disease (if you’re lucky) or if your TSH doesn’t come back “within range”. As discussed above, TSH is produced by the anterior pituitary gland and doesn’t actually tell us anything about how our thyroid is functioning, the levels of hormones in the blood or if the condition is autoimmune in nature. A full thyroid panel includes:
Thyroid stimulating hormone (TSH)
Free T4
Free T3
Reverse T3
Thyroid peroxidase antibodies (TPOAb)
Thyroglobulin antibodies (TgAb)
TSH receptor antibodies (TRAb)
Always do your blood tests whilst fasting, first thing in the morning, avoid strenuous activity, and go to the same laboratory for an accurate baseline and consistency. This is important when we compare your results in the future. If you’re taking a biotin supplement, it’s important that you stop taking it before testing as it’ll compromise your test results.
What are the signs and symptoms?
Signs and symptoms can vary greatly between individuals and what you’re experiencing, the next person may not. Afterall, no two individuals are the same [5, 7].
Common signs and symptoms of hypothyroidism and Hashimoto’s disease:
Depression
Fatigue
Brain fog
Bloating
Brittle nails
Constipation
Cold intolerance
Heavy periods
Hair loss or thinning
Dry skin
Weight gain
Fluid retention
Muscle aches and stiffness
Hoarseness of the voice
High cholesterol
Enlarged thyroid gland (goitre)
Common signs and symptoms of hyperthyroidism and Graves’ disease:
Irritability
Muscle atrophy
Heat intolerance
Increased sweating
Diarrhoea
Difficulty swallowing
Insomnia
Irregular periods
Increased appetite
Weight loss
Heart palpitations and anxiety
High blood pressure
Sleep disturbances
Bulging eyes (exophthalmos)
I hope that you’ve found this information helpful as you navigate your way through a newly diagnosed thyroid condition. As the causative and contributing factors vary greatly between individuals, it’s best to speak to your natural health practitioner to discover yours and receive expert individualised advice and treatment.
Yours in health and happiness,
Ebony x
References:
[1] Maniakas, A., Davies, L., & Zafereo, M. E. (2018). Thyroid disease around the world. Otolaryngologic Clinics of North America, 51(3), 631-642. https://doi.org/10.1016/j.otc.2018.01.014
[2] Shahid, M. A., Ashraf, M. A., & Sharma, S. (2021). Physiology, thyroid hormone. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500006/
[3] Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? Nutrients, 12(6), 1769. https://doi.org/10.3390/nu12061769
[4] Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. Lancet (London, England), 390(10101), 1550–1562. https://doi.org/10.1016/S0140-6736(17)30703-1
[5] Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018). Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology, 14, 301-316. https://doi.org/10.1038/nrendo.2018.18
[6] Jung, S., Kang, J., Roberts, A., Nishimi, K., Chen, Q., Sumner, J., ... Koenen, K. (2019). Posttraumatic stress disorder and incidence of thyroid dysfunction in women. Psychological Medicine, 49(15), 2551-2560. https://doi.org/10.1017/S0033291718003495
[7] Doubleday, A. R., & Sippel, R. S. (2020). Hyperthyroidism. Gland surgery, 9(1), 124–135. https://doi.org/10.21037/gs.2019.11.01
