By Carol Chuang 
According to the American Association of Clinical Endocrinologists,
- 27 million Americans have underactive or overactive thyroid glands, and over half are unaware of it.
- More than 8 out of 10 people with thyroid disease are women.
- Eighty percent of the people diagnosed with thyroid disease have hypothyroidism, an underactive thyroid.
Do you have a low thyroid? If you answer “yes” to most of these questions, it may indicate that you do.
- Are you depressed, lethargic, chronically fatigued, and easily chilled?
- Do you gain weight easily or have difficulty losing weight?
- Do you have dry skin, hair loss, eczema, or adult acne?
- Do you have constipation?
- Do you have PMS or menstrual abnormalities? Is your libido low?
- Are your legs and feet swollen and your nails brittle?
- Do you have cold hands and feet?
- Do you often get colds and flu?
What Is Hypothyroidism?
The thyroid is a small, butterfly-shaped gland located in the lower part of your neck. It produces hormones that influence essentially every organ, tissue, and cell in the body. It is the master regulator of your metabolism.
The thyroid has the only cells in the body capable of absorbing iodine. The iodine is combined with the amino acid tyrosine to produce T4 (thyroxin) which is then converted to T3 (triiodothyronine). T3 is the biologically more active hormone and is also several times stronger than T4.
Hypothyroidism occurs when the thyroid gland fails to produce enough hormones, resulting in a slowdown of metabolism. Hypothyroidism may be caused by:
- Overconsumption of raw goitrogenic foods, such as brussels sprouts, broccoli, rutabaga, turnips, kohlrabi, radishes, cauliflower, cabbage, kale, and millet.
- Overconsumption of iodine-rich supplements such as kelp and bladderwrack or shortage of iodine in the diet.
- Hashimoto’s thyroiditis, the most common form of hypothyroidism.
- Surgical treatments for thyroid cancer, goiter, or nodules.
- After effect of radioactive iodine treatment for Graves’ disease (the most common form of hyperthyroidism).
- Imbalance of female hormones may trigger a thyroid problem. Estrogen inhibits thyroid hormone activity, while progesterone and testosterone support the thyroid. Hypothyroidism occurs predominantly in women around the time of menopause when estrogen is high relative to progesterone.
Some people have a higher risk of developing hypothyroidism. Factors include:
- Having a family member with a thyroid, pituitary, or endocrine disease
- Having a family member with an autoimmune disease
- Having Chronic Fatigue Syndrome Having Fibromyalgia Having been treated with lithium
- Having just given birth to a baby
- Being female
- Approaching or have attained menopause
- Smoking
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, which is an autoimmune disease.
In Hashimoto’s, antibodies react against proteins in the thyroid gland, gradually destroying the gland itself making the gland unable to produce the thyroid hormones the body needs. In the beginning, there can be periods where the thyroid sputters back to life, even causing temporary hyperthyroidism, then a return to hypothyroidism. This cycling back and forth is rather characteristic of Hashimoto’s.
Symptoms Of Hypothyroidism
Symptoms usually go with a slowdown of metabolism and may include:
- Lethargy and fatigue
- Forgetfulness
- Mood swings
- Depression
- Low libido
- Heavy menses
- Constipation
- Dry, coarse hair
- Dry, coarse skin
- Eczema or adult acne
- Weight gain or increased difficulty losing weight
- Hoarse voice
- Cold hands and feet
- Muscle cramps or frequent muscle aches
- Vulnerability to infections
How Hypothyroidism Is Diagnosed
There are a number of blood tests to detect the function of the thyroid gland. The one that your doctor is most likely to check annually is the TSH. If a thyroid problem is suspected, subsequent tests like the free T3, free T4, and thyroid antibodies will be needed.
TSH Thyroid stimulating hormone is secreted by the pituitary gland. Since the pituitary controls the release of thyroid hormones, the level of TSH indicates how hard the pituitary has to work to get the thyroid to produce whatever levels of thyroid hormones are present in the blood. A high TSH may indicate low thyroid levels.
Free T3 and Free T4 These tests are used to determine the level of thyroid hormones in the body. Free means it is biologically active and unbound to protein. Low free T3 and T4 will indicate low thyroid hormones.
Thyroid antibodies Autoimmune thyroid diseases, such as Hashimoto’s thyroiditis, occur when the thyroid gland is attacked by the body’s own immune system. If this is suspected, blood tests for thyroid antibodies will validate the diagnosis.
The medical definition of hypothyroidism is TSH higher than the normal range and T3 and T4 below the normal range.
Note: It is possible that some people may have normal lab results, yet experience hypothyroid symptoms. This is because the reference range of 0.45-4.50 uIU/ml for TSH is fairly wide and a given person may require higher or lower levels to feel well and function optimally. If you are in this early stage of hypothyroidism and remain untreated, you can experience the symptoms of the disease for months to years before it progresses to full-blown hypothyroidism.
Treatment For Hypothyroidism
The treatment for hypothyroidism is usually with synthetic thyroid hormone medications containing:
- T4 (generic name: levothyroxine) or
- T3 (liothyronine) or
- A combination of T4 and T3 (liotrix)
Different brands of medication may have different fillers, dyes, and potential allergens. If you have a bad reaction to a certain brand, ask your doctor to switch to another one.
An alternative is to use desiccated natural hormones derived from the thyroid gland of pigs, such as Armour Thyroid or Nature-Throid, which contain both T4 and T3. These can be prescribed by your doctor.
Lifestyle Approach
- Stress exacerbates all thyroid problems, particularly those with an autoimmune component, like Hashimoto’s. Stress reduction improves the entire hormonal system, including the thyroid gland. There are many types of mind-body approaches to relaxation, such as meditation, guided imagery, yoga, etc. Find something that you enjoy doing.
- You must exercise and it is not optional. Aerobic exercise helps burn calories and weight-bearing exercise helps build muscles, which is critical to raising metabolism.
Diet Appraoch
- If you are around menopause and a saliva hormone test confirms that you have high estrogen relative to progesterone, using progesterone supplementation can help balance the female hormones.
- If your hypothyroid condition is not autoimmune in nature, it is helpful to consume more iodine-rich foods or use iodine-rich supplements, such as kelp and bladderwrack.
- If you have an autoimmune thyroid disease, avoid iodine-rich supplements such as kelp and bladderwrack, as they can aggravate the symptoms. However, many people with autoimmune thyroid disease find that they can still eat some iodine-rich foods such as seafood and seaweed without any adverse symptoms.
- Selenium can help rebuild the immune system and reduce thyroid antibodies. Brazil nuts have a very high amount of selenium, so just eating a few everyday will be sufficient.
- Avoid consuming soybean-related foods such as tofu, soy milk, soy protein, and soy supplements. The isoflavone in soy suppresses the thyroid.
- Avoid consuming raw goitrogenic foods, such as broccoli, brussels sprouts, cabbage, cauliflower, kale, kohlrabi, radishes, rutabaga, turnips, pinenuts, walnuts, millet, peaches, spinach, and strawberries. Goitrogens tend to decrease thyroid function, but cooking usually deactivates most of the goitrogens.
- Avoid sugar, artificial sweeteners, refined carbohydrates, and stimulants including caffeine and nicotine.
- Eat more fiber and make sure you have enough protein in your diet.
- Drink plenty of clean filtered water, half your weight (lbs) in ounces per day. If you weigh 128 lbs, drink 64 ounces (or 8 cups) of water a day.