Town & Country, MO 63017
Phone: 636-227-4949
www.wellnessalternatives-stl.com
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Thyroid HealthThe thyroid is a butterfly-shaped gland located at the base of your neck, just below your Adam's apple. Although it weighs less than an ounce, the thyroid gland has an enormous effect on your health. It's part of your endocrine system, which is made up of several glands and tissues that produce hormones. These chemical messengers coordinate many of your body's activities, from digestion to metabolism to reproduction. Hypothyroidism Hypothyroidism occurs when the thyroid is consistently under active for a variety of reasons. Prescription thyroid hormones rarely address the true cause of poor thyroid function. Many things contribute to hypothyroidism. They include poor liver or gut function, a sluggish pituitary gland, too many thyroid-binding proteins in the bloodstream (as a consequence of excess estrogen), and immune dysfunction. Nutritionally supporting hypothyroidism is important as many functions in the body can become impaired due to faulty thyroid function. The majority of people with hypothyroidism do not need thyroid hormone medication. In fact, medication can make functional hypothyroidism irreversible. Synthroid has been shown to increase natural bone loss and is not recommended if a patient suffers from bone density loss. There are six patterns of functional hypothyroidism, only one of which responds to medication (although medication is rarely necessary). Most of these patterns are related to poor blood sugar control, stress, poor gut health, a sluggish liver, and hormonal imbalances. Only one of these patterns will appear on standard/traditional thyroid blood tests that measure only TSH. Often a person with hypothyroidism has ‘normal’ blood test results. Incomplete or inaccurately interpreted thyroid blood tests allow countless people with hypothyroidism to go undiagnosed. In many clinical cases, by the time your hypothyroid condition ‘shows up’ on a blood test, it may be too late to support it nutritionally. In traditional medicine, abnormal blood test ranges are based on pathological ranges, the stage at which the condition is a disease requiring medical intervention. At Wellness Alternatives, we utilize functional ranges based on what constitutes good health. If ranges are functionally abnormal, it can alert a clinician to the person's risk of developing a disease and in turn support, prevent, and correct potential disorders. Hypothyroidism can be caught in time to be reversed nutritionally through properly interpreting appropriate thyroid blood tests. Thyroid Hormones T4 & T3 – Conversion and Availability The brain secretes thyroid stimulating hormone (TSH), which tells the thyroid gland to make and secrete the thyroid hormones T4 and T3. T4 and T3 are named for the number of iodine molecules of iodine — four and three respectively. The body can only use T3, even though only 7 percent of it is secreted by the thyroid gland. The body must convert T4 to T3 by removing one molecule of iodine with an enzyme called tetraidothyronine 5'deiodinase. This happens in the liver, the gastrointestinal tract, and various other cells in the body, such as muscle, heart, and nerve cells. The liver plays a significant role in T4 conversion. Liver clearance pathways can become impaired and sluggish. (One example of a contributing factor altering liver clearance is estrogen dominance.) An additional twenty percent of T4 is converted to T3 in the intestines, but only in the presence of healthy gut flora. Hashimoto's Hashimoto's disease, an autoimmune disorder that destroys thyroid tissue, is the most common cause of hypothyroidism. Because it is an immune disease, Hashimoto's often goes undiagnosed, and is largely mismanaged by both conventional and alternative health care systems. People with Hashimoto's do not respond well to thyroid replacement hormones, or they experience symptoms of both an under active and over active thyroid. A TPO and TGB serum antibody test helps identify Hashimoto's. A negative test is sometimes false as the immune system fluctuates. If symptoms strongly suggest the disease, repeat tests should be done to confirm the diagnosis. Sometimes it is necessary to challenge the patient with gluten before an antibody test. In known cases of autoimmune thyroid disorders it is recommended that a complete immune and cytokine panel be utilized to measure the effectiveness of case management. Risk factors for developing Hashimoto's include gluten intolerance, insulin resistance, PCOS, estrogen fluctuations, vitamin D deficiency, chronic infection, inflammation, or an immune reaction to heavy metals or environmental pollutants. Because supplementing with iodine will exacerbate Hashimoto's, strictly avoid iodine if you have the disease. Hashimoto's is an immune disease, not a thyroid disease, so the immune system must be supported. If Hashimoto's is being triggered by an undiagnosed, underlying, or active infection, the antigen must be removed. If the autoimmune reaction is due to chronic inflammation the cause must found, removed, the body supported, and normal physiology restored. We don't always know what triggers an autoimmune disease although a compromised immune barrier in the digestive tract is often a factor. When the gut lining loses integrity due to poor diet, infections, blood sugar swings, and adrenal malfunction, the immune system is called into action on a constant basis. This can lead to an immune system imbalance and the development of an autoimmune disease, such as Hashimoto's. Gluten is a common trigger for Hashimoto's. Numerous studies have shown a link between gluten intolerance and Hashimoto's. Premium testing for gluten intolerance is available through Wellness Alternatives . We utilize EntroLab’s Sensitivity Stool and Gene Panel Complete or Metametrix’s GI Effects Stool Panel. Both utilize DNA analysis testing which is extremely accurate, without false negatives, and provides comprehensive information to aid our doctors in determining a correct course of action for each individual. The issue of the autoimmune attack is not addressed by traditional medicine. Traditional thyroid management means having a normalized TSH from thyroid hormone replacement. In a sense the patient is having their TSH level controlled, but not the underlying mechanism for their thyroid loss. In most of these cases, since their autoimmune response is ignored, over time they lose more thyroid cells. Requirements for thyroid hormone replacement continue to rise. Even more importantly, most individuals with Hashimoto’s continue to develop signs and symptoms of hypothyroidism despite the fact that their TSH is managed with replacement drugs. (These may be weight gain, hair loss, fatigue, constipation, and depression – just to mention a few.) Additional reading: Why Do I Still Have Thyroid Symptoms? A revolutionary breakthrough in understanding Hashimoto’s disease and hypothyroidism by Datis Kharrazian, DHSc, DC, MS. Associated Factors Iodine and Tyrosine Iodine and tyrosine are not always appropriate for people with thyroid conditions. Iodine intake, as it relates to thyroid hormones, is a double-edged sword. Iodine is needed for T4 production. If a practitioner looks at a textbook concerning thyroid hormone metabolism, iodine seems a logical choice for low thyroid. However, in the United States we have iodized salt and now health stores are stocking iodized sea salt. This means that anytime a person eats salt they are getting iodine, especially those people eating an unhealthy diet of processed food. Excess iodine intake will first result in a Wolff-Chaikoff effect which is reversible if iodine intake is removed. However, many healthcare practitioners and health food stores recommend continued iodine supplementation. This may then cause Iodine-induced hyperthyroidism, or Jod-Basedow phenomenon. Tyrosine supplementation in many cases will actually suppress thyroid function. Again, if one looks at the textbooks, tyrosine may sound beneficial. However, no studies have show tyrosine supplements have the ability to increase thyroid hormones. Anemia is Key Anemia is a deal breaker when managing hypothyroidism or Hashimoto's, and should always be addressed first. Anemia is commonly and incorrectly thought of as low iron. If treatment of anemia is with iron supplementation, it will often result in increased and chronic inflammation and tissue damage. Just as in treatment of thyroid, anemia often goes undiagnosed, and is largely mismanaged by both conventional and alternative health care systems. Anemia simply put is “a condition of low oxygen.” There are fourteen different types of anemia. Incomplete or inaccurately interpreted blood tests allow countless people with functional anemia to go undiagnosed. Anemia can be reversed nutritionally once proper lab interpretation has been made and the type of anemia identified . New blood cells have the potential to become compromised in different ways with states of low thyroid activity. Decreased absorption of vitamin B12 and folic acid from low stomach acid is induced by hypothyroidism. This creates a vicious cycle where the anemia, due to low HCL (see Digestive Disorders page), must be corrected before the hypothyroidism will be corrected. To distinguish a B12 anemia due to malabsorption or inadequate diet from autoimmune anemia, an Intrinsic Factor Autoantibody test (IF Ab) should be done. The simple fact is: if a patient is anemic, they will not be able to deliver oxygen to the cellular level and their body will not be able to repair. Dysglycemia – Reactive Hypoglycemia/Insulin Resistance Insulin Resistance, Polycystic Ovary Syndrome (PCOS), Syndrome X and Metabolic Syndrome all have the same symptoms as low thyroid. Supporting hypothyroidism is futile unless complete lab testing is done to determine if your blood sugar is too low or too high. This is called dysglycemia, a stepping-stone to diabetes. Diabetes is becoming so prevalent that authorities predict it will bankrupt our healthcare system. There are several key factors involved in blood sugar disorders. Anemia, food sensitivities, and elevated cholesterol/triglycerides all have a direct impact on blood sugar. It is not possible to improve thyroid issues if the patient is anemic, or has adrenal/blood sugar issues. When an individual loses the ability to transport glucose into their cells, the body will resort to fat production and subsequently cholesterol and triglyceride levels will increase. Adrenals Adrenal dysfunction is extremely common in the U.S. Thyroid health is very dependent upon adrenal health. To support the thyroid you must support the adrenals. Adrenal dysfunction is always secondary to other stressors. To support the adrenals you must address what is causing chronic adrenal stress. Causes of Adrenal Stress:
Elevated cortisol associated with chronic adrenal stress leads to hypothyroidism in a number of ways, both directly and indirectly. To determine cortisol levels, the doctors at Wellness Alternatives use an Adrenal Stress Index. The adrenal salivary index (ASI) test gives the clearest picture of adrenal status. One ASI test is useless, but follow-up tests determine progress. There are seven stages to adrenal dysfunction. New research shows they do not necessarily happen sequentially. Digestion/Microbial Ecology Hippocrates said, "All disease begins in the gut." This is still true today, including people with hypothyroidism and Hashimoto's. To support functional hypothyroidism or an autoimmune thyroid condition, you must address your digestive health. At Wellness Alternatives we use the “4R” program: Remove, Repair, Replace, and Restore. The remove phase includes finding what foods are irritants and we begin with the elimination/provocation diet. If you simply eliminate the foods from your diet without repairing the digestive chemistry and restoring microbial ecology, you will become sensitized to whatever food you now commonly eat, defeating the purpose of the allergic food elimination. After you have diligently worked at restoring gut integrity, yon may be able to eat the foods you formerly eliminated. The exception is gluten in those with Hashimoto's. The doctors at Wellness Alternatives understand that balancing blood sugar and eliminating food sensitivities is dependent upon proper digestive chemistry and luminal feedback regulation. Twenty percent of T4 is converted to T3 in the intestines, but only in the presence of healthy gut flora. In a healthy body, gut flora is controlled by stomach acid, enzymes and pH. Any alteration in any of these components will allow microbes which should be beneficial to become destructive. A variety of nutritional compounds greatly speed along gut repair, and specific digestive aids are recommended before meals. Wellness Alternatives can order any necessary tests, saving you time, money, and speeding progress. Do a thyroid test after your gut-health program. You may be surprised to find your functional hypothyroidism is no longer an issue, and your autoimmune thyroid condition successfully controlled. Hormone Replacement Therapy The use of exogenous hormones — hormone creams, hormone pills, and oral contraceptives — in the long run cause problems of hormone deficiency. Why? By overwhelming the body with excess hormones, they shut down communication between the hormone glands and the brain. The cells become resistant to hormones in an attempt at self-preservation and eventually the glands atrophy. Toxicity of synthetic hormones doesn't show up on blood tests of hormones. As a result, when a person complains of symptoms related to hormone deficiency, many doctors simply prescribe more hormones, which compounds the problem. Excess hormones accumulate in body fat, bog down liver function, and suppress pituitary function. If the damage is not too extensive, it is possible to clear out excess hormones and restore pituitary health with a hormone detox. If permanent damage to the hormone feedback loop is done, judicious use of exogenous hormones may be warranted. In addition, hypothyroidism shifts the estrogen ratio in such a way to increase the risk of estrogen-related cancer. Fluctuations of estrogens tend to be a trigger for Hashimoto’s in combination with other factors such as cytokine dominance and genetic susceptibility. In addition to potentially contributing to Hashimoto’s, once Hashimoto’s has begun, estrogen fluctuations appear to trigger autoimmune responses. High levels of estrogen exposure from hormone replacement such as oral contraceptives, hormone replacement therapy or putrefaction dysbiosis suppress thyroid hormone utilization. Elevations of estrogen increase thyroid hormone binding and therefore the free T3, T4 and T3 Uptake (availability) are reduced, making a person feel low thyroid. Don't Forget About the Brain The brain is saturated with thyroid receptors. Healthy thyroid function is integral to healthy brain function. Brain health and sufficiency of the neurotransmitter serotonin and dopamine are important for thyroid function. Dopamine has many functions in the brain, including important roles in behavior and cognition, motor activity, motivation and reward, sleep, mood, attention, and learning. Decreased dopamine levels may promote exaggerated TSH output and alter normal Hypothalamus-Pituitary coordination. Most often in our clinical setting, poor blood sugar control is the greatest factor involved with neurotransmitter deficiencies. A critical look at dysglycemia (insulin resistance, reactive hypoglycemia, and hypoglycemia) should be considered. Dysglycemia is the most common clinical cause for serotonin defects. The typical symptom of a hypoglycemic is fatigue, sugar-cravings, and irritability between meals that are normalized after a meal. For insulin resistance, the typical symptoms are fatigue and sugar-cravings after meals. In Summary Twenty-two patterns of metabolic thyroid disorders have been identified that often still evidence normal blood test results. You cannot assess the thyroid without clinical consideration of the immune system, hormones, gastrointestinal function, anemia, dysglycemia, nutrition, and brain function. The doctors at Wellness Alternatives understand supporting thyroid disorders and are experienced in addressing these issues. Would you like more information? Please contact us at 636-227-4949. Additional reading: Why Do I Still Have Thyroid Symptoms? A revolutionary breakthrough in understanding Hashimoto’s disease and hypothyroidism by Datis Kharrazian, DHSc, DC, MS. References:
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