Have you been struggling with weight loss or been feeling sluggish and tired most of the day and concerned about your thyroid? Click here to read up on the symptoms of thyroid disorders to see if they sound like you and if so, what tests you can ask your doctor for next time.

IF you have been diagnosed with a thyroid disorder and curious to know some potential causes behind your thyroid imbalance, keep reading below.

The four major contributors that can lead to abnormal thyroid hormones are: Nutrient deficienciesAdrenal dysfunctionAutoimmune; and, Cancer.  While allopathic medicine can help increase or decrease your T4 and/or T3 levels through medication, there is not much in allopathic medicine currently for lowering thyroid antibodies or addressing suboptimal adrenals if it isn’t overt Cushing’s syndrome (most common cause is iatrogenic – caused by too many corticosteroid medications) or Addison’s disease (rare).  MDs may recommend vitamins or minerals if they suspect your low thyroid hormone levels are due to an iodine or iron deficiency.

Iodized Salt

Causes: Nutrient Deficiencies

Thyroid hormones contain iodine and in developing countries, where iodine deficiency is common, this is a leading cause for hypothyroidism. With the advent of iodized table salt in North America, it reduced the incidence of hypothyroidism, however, with the exposure to heavy metals and other environmental pollutants, this can decrease the ability of iodine to accumulate in the thyroid gland and form thyroid hormone.  Other nutrients like tyrosine (amino acid), zinc, copper, iron, vitamin E, vitamin B2, vitamin A, and selenium are necessary for forming T3 and T4 thyroid hormone.

Should everyone just take iodine, tyrosine, and iron then? Not necessarily.  Caution is necessary if you have an autoimmune thyroid condition such as Hashimoto’s as iodine may induce hypothyroidism (1). Too much iron in the body can be oxidative and create free radicals.  Seeing a licensed healthcare provider can help you determine if optimizing nutrients is necessary and if functional testing for environmental pollutants and heavy metals (mercury, cadmium, lead, etc) should be considered.

Causes: Adrenal Dysregulation

This is a complex topic and there are additional blog posts discussing cortisol and the adrenals. Your adrenal cortex produces the following hormones: cortisol, mineralocorticoids, DHEA, androgens (testosterone, etc), estrogen and progesterone.  The adrenals also release epinephrine a.k.a adrenaline – the "flight or fright" neurotransmitter released in times of stress, anxiety, and scary situations.

During times of stress, these adrenals are in overdrive overproducing cortisol which can affect levels of the other adrenal hormones.  Cortisol can decrease the conversion of T4 to T3 and lower TSH production from your pituitary.  This can be why you may find you have low thyroid symptoms but your TSH keeps coming back normal and your doctor refuses to test T4 and T3.  Cortisol can also affect peripheral tissue activity of T3.  If you are stressed and on Synthroid but not feeling the best, this may be the reason why since Synthroid (T4) still has to be converted to T3, the active thyroid hormone.

Too much estrogen or estrogen dominance (imbalanced estrogen-progesterone ratio) can also lower the free thyroid hormones (T4 and T3) because estrogen increases thyroid binding protein in the blood which binds T4 and T3 rendering them unavailable.

Thyroid and adrenal connection

Causes: Autoimmune

This is the hardest type of thyroid disorder to treat because it involves an inflammatory state and a hyperactive immune system that produces antibodies against certain enzymes or other thyroid proteins affecting the production of thyroid hormones.  The two autoimmune thyroid disorders are Hashimoto’s Disease ‘Hashi’s’ and Grave’s disease.  The latter is associated with hyperthyroidism.  In Hashimoto’s, one may start out in a hyperthyroid state and eventually end up in a hypothyroid state as the thyroid gland is damaged by the autoantibodies (2). MDs will treat these conditions the same way they treat general hypothyroidism or hyperthyroidism.

Naturopathic medicine aims at getting to the root cause and working with you to lower inflammation; Slowing down, regulating, and re-balancing the immune system; lower antibodies; and increase/decrease thyroid hormones if needed naturally. This could involve addressing your digestive health and other hormonal imbalances simultaneously as well.

Food sensitivities can be a key area to investigate for any autoimmune condition, not just Hashimoto's or Grave's disease.

Infections and postpartum can also trigger thyroiditis (inflammation of the thyroid) which can result in hypo- or hyperthyroidism. In some people, these states can also lead to an increase in thyroid antibodies. Sometimes this can be a long-term change but other times it is transient and the thyroid can return to a euthyroid (normal) state within 6-12 months postpartum.

Causes: Cancer

Yes, unfortunately, another factor to rule out if you have thyroid dysfunction is thyroid cancer. This is more common in females and most common in the 15-49 years range.  Exposure to ionizing radiation, a family history of thyroid cancer, having a personal history of other thyroid disorders, obesity and tall height are risk factors (3).  If you notice swelling on your neck in the thyroid region and your doctor assesses an enlarged thyroid or firmness over the thyroid during a physical exam, he or she will refer you to get an ultrasound.  If nodules are found, you may be referred for a biopsy to rule out a malignant vs benign nodule.  Benign nodules can be associated with autoimmune thyroid conditions and are monitored to ensure they do not become malignant.

Naturopathic Treatment Options

There are many therapeutic options for supporting your thyroid health. In order to figure out the best supplement or treatment for you, an initial visit is important. This is where we will sit down and perform a thorough review of your health concern(s) and a head-to-toe review of symptoms which will help identify if it is a nutritional deficiency issue, an adrenal or other hormonal issue, or an autoimmune thyroid disorder contributing to your suboptimal thyroid function and then initiate the appropriate treatment recommendations. Complete thyroid blood tests can also be ordered for an additional fee if your medical doctor has not run any. Over the course of your treatment, we can determine if additional functional testing options may be of benefit.

Some Tips to Implement At Home Can Be: 

  1. Steam or cook your cruciferous vegetables - broccoli, cauliflower, cabbage, brussel sprouts - as this reduces some of the goitrogens that interfere with thyroid hormone production
  2. Eat brazil nuts if you are not sensitive or allergic to them - these contain selenium which supports thyroid function
  3. Find ways to reduce stress - meditation, music, dancing, being creative, exercise, etc - as this keeps your cortisol levels down
Brazil nuts
References:
  1. Chung HR MD. Iodine and thyroid function.  Ann Pediatr Endocrinol Metab. 2014 Mar;19(1):8-12.
  2. Ferry R, Jr. MD. Hashimoto's Thyroiditis Symptoms, Diet, and Treatment.  Retrieved on November 24 2018 from https://www.medicinenet.com/hashimotos_thyroiditis/article.htm#what_are_the_signs_and_symptoms_of_hashimotos_thyroiditis
  3. Canadian Cancer Society (2018). Thyroid Cancer.  Retrieved on November 23 2018 from http://www.cancer.ca/en/cancer-information/cancer-type/thyroid/thyroid-cancer/?region=on
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