The thyroid is an endocrine (hormone secreting) gland that is located below your Adam’s apple. It is often referred to as the body’s “thermostat,” because thyroid hormones regulate our temperature and the metabolism in every cell of our body – including our heart and brain.
Thyroid conditions are most common in women ages 20-60 years old. Hypothyroidism is the most common type of thyroid disorder and up to 90% of hypothyroidism is not a thyroid problem at all – it is an autoimmune problem that causes inflammation and destruction of the thyroid tissue, which leads to thyroid dysfunction.
What is hypothyroidism?
Hypothyroidism is a term used to describe an underactive thyroid that is not producing enough thyroid hormone. The most common cause of hypothyroidism in the United States is an autoimmune condition called Hashimoto’s Thyroiditis.
What is hyperthyroidism?
Hyperthyroidism is a term used to describe an overactive thyroid that is producing too much thyroid hormone. The most common cause of hyperthyroidism in the United States is an autoimmune condition called Graves’ Disease.
What symptoms are related to thyroid disorders?
- Weight Gain
- Feeling Cold
- Cold Intolerance
- Slow Heartbeat
- Brain Fog
- Thinning of outer 1/3 of the eyebrows
- Dry Skin
- Hair Loss
- Brittle Nails
- Muscle Cramps
- Stiffness & Joint Pain
- Heavy Menstrual Periods
- Enlarged Thyroid (Goiter)
- Weight Loss
- Increased Appetite
- Frequent Bowel Movements
- Heat Intolerance
- Rapid Heartbeat
- Hair Loss
- Warm, Moist Palms
- Soft Nails
- Eye Bulging
- Scanty Menstrual Periods
- Enlarged Thyroid (Goiter)
How do I know if I have a thyroid condition?
Because the thyroid controls the mitochondria and the rate of metabolism in all cells, thyroid function has a wide range of effects on the body. Overlooked thyroid conditions are commonly misdiagnosed as:
- Hyperlipidemia or High Cholesterol
- Irritable Bowel Syndrome (IBS)
- Postpartum Depression
If hypothyroidism is diagnosed, the conventional standard of care typically provides T4 hormone replacement only and does not test for or address autoimmunity, even though Hashimoto’s Thyroiditis is the most common cause of hypothyroidism and the most common autoimmune condition.
Conversely, if hyperthyroidism is diagnosed, conventional care will typically test for autoimmunity (Graves’ Disease) to differentiate from other forms of hyperthyroidism such as toxic multinodular goiter and toxic adenoma. However, if Graves’ Disease is diagnosed, the autoimmune cause of the disease is ignored and thyroid hormone suppressing pharmaceuticals or radioactive iodine thyroid ablation is recommended.
What do I do if I suspect I have a thyroid condition?
1. Get The Right Testing
The first step is to work with a practitioner who will look at the whole picture – that includes a full workup of thyroid function and root causes such as autoimmunity and nutrient deficiencies that disturb thyroid function.
A comprehensive thyroid panel should include the following blood tests:
- Thyroid Stimulating Hormone (TSH)
- Free T3
- Free T4
- Reverse T3
- Anti-TG (Thyroglobulin)
- Anti-TPO (Thyroperoxidase)
- Cortisol (AM) *Must be drawn between 7-9am.
If there are hyperthyroid symptoms, Thyroid Stimulating Immunoglobulin (TSI) should be added to this panel to test for Graves’ Disease.
In addition to assessing thyroid function, markers for inflammation and nutrient deficiencies should also be tested. Iron, zinc, and selenium are all important nutrients necessary for the conversion of active thyroid hormone (T3).
Iron and zinc levels can both be tested by blood. The preferred test for iron status is ferritin (the storage form of iron). This is especially important for menstruating women due to a higher likelihood of iron deficiency.
2. Find The Root Cause
Root cause(s) of thyroid dysfunction are unique to the individual and uncovering them will depend on the your test results, medical history, other health concerns you are experiencing, and physical exam. Even though autoimmunity is the most common reason for hypothyroidism, it does not mean it is the cause for everyone.
The second most likely cause of hypothyroidism are nutrient deficiencies and non-autoimmune inflammation. These conditions can be addressed by healing leaky gut (intestinal permeability), adrenal stress, hormone imbalances, and replacing deficient nutrients such as iron, zinc, and selenium.
3. Optimize Thyroid & Mitochondrial Function
In some cases, thyroid hormone replacement is necessary. The most commonly prescribed thyroid hormone is the T4 medication Levothyroxine (In fact, it is the #1 most prescribed medication in the United States as of this writing in 2017). Although this approach works for some, for many it produces normal TSH lab results without resolving hypothyroid symptoms.
This is because T4 is the inactive form of thyroid hormone and many people have a problem converting the inactive T4 to the active form T3. This can be due to the nutrient deficiencies, inflammation, and high cortisol.
Thyroid hormone replacement should be individualized and options such as WP Thyroid, Armour, and compounded thyroid medications should be explored with a root cause physician.
In other cases, thyroid hormone replacement is unnecessary and the thyroid hormones can be normalized by addressing root causes and supporting thyroid function with adaptogenic botanical medicines such as Withania somnifera (Ashwagandha) and targeted nutrient therapy.
In addition, nutrients needed for mitochondrial function such as B vitamins, CoQ10, alpha lipoic acid, and L-carnitine should be assessed and used therapeutically as needed for cellular energy production.
Dr. DeFrancesco partners with patients seeking a smarter & sustainable approach to health by doing the detective work to uncover root cause(s) and design a personalized and comprehensive plan that includes nutrition, lifestyle, functional medicine, and root cause therapies.
This approach benefits people who are seeking help with chronic inflammatory conditions, autoimmunity, thyroid conditions, digestive problems, brain health, and health optimization.