Although the thyroid is a relatively small gland, it is one of the most important endocrine glands responsible for controlling the metabolic activities in our body.
According to the American Thyroid Association, around 12% of US adults will develop thyroid disease in their lifetime.
Here, in this article, we will discuss hypothyroidism in detail. We will take a closer look and tell you about the symptoms, causes, complications, diagnosis, and treatment to help you better understand the condition.Â
What is Hypothyroidism?
The thyroid is known as the Master Metabolic Control Center of your body. The thyroid gland works together with the pituitary gland to control all the cells in the body, from nerves to skin cells. Sometimes the thyroid gland is unable to produce enough thyroid hormone required by our body to work efficiently.Â
There are many underlying causes of hypothyroidism, where our gland is unable to produce sufficient levels of thyroid hormones. However, some people with risk factors are more prone than others:
- Thyroid diseases are 5-8 times more common among women as compared to males.
- Hypothyroid mothers also have a higher risk of birthing babies with development disorders.
- Women are at even higher risk of developing thyroid diseases after pregnancy and menopause.
I have listed some of the most common reasons that can lead to hypothyroidism below:
- Autoimmune diseases like Hashimoto’s and atrophic thyroiditis are the leading causes for the increasing rate of hypothyroidism cases. In these diseases, our immune system attacks thyroid gland cells and the related enzymes required for hormone synthesis.
- Hashimoto’s disease is more common in women as compared to men.
- People with nodules or thyroid cancer have under-functioning to get their glands surgically removed. As a result, they have to live with hypothyroidism for the rest of their life.
- Radiation treatment is also one of the most common causes of hypothyroidism. Patients with Graves disease, goiter, lymphoma, or any cancer of the head and neck must undergo radiation. That results in thyroid dysfunction in many cases.
- Drugs like lithium, amiodarone, interleukin-2, and interferon-alpha can cause hypothyroidism.
- Any damage to the pituitary gland from radiation, trauma, tumor, or surgery can also lead to secondary hypothyroidism.
- Congenital hypothyroidism is a rare but serious condition, can occur where babies are born without a thyroid or with dysfunctional enzymes. About 1 in 4000 babies in the United States are born with that.
- Iodine deficiency is a leading cause of hypothyroidism in developing countries. Moreover, an excess of iodine can also trigger hypothyroidism symptoms in patients.
- Ingestion of bromine, fluorine and chlorine compounds that damage the gland. However, there is little talk about the latter, so their damaging effects are underestimated by many.
- Estrogens inhibit the activity of thyroid hormones, so overweight estrogen sooner or later also affects thyroid function.
- inflammation
- hormonal disorder
- nutrient deficiency
- drastic dieting
- alcohol consumption
Types of Hypothyroidism According to the Cause
There are four types of hypothyroidism conditions: primary, secondary, tertiary, and central hypothyroidism.
Thyroid hormones exert their action at cellular level. This requires attachment of Free T4 at thyroid receptors to promote synthesis of certain proteins that in turn control various biological activities.
 However, in some cases, thyroid hormone receptors are resistant. In other words, no matter how much Free T4 is available in the serum, no amount of T4 can enter the tissues.
The resultant effect is secondary hypothyroidism that is characterized by normal or nearly normal thyroid functions tests but a multitude of abnormalities such as:
- Growth retardation
- Intellectual disability
- Dysmorphic facies
If the thyroid gland is intact but its regulation of hypothalamic disease is inadequate then we are talking about tertiary hypothyroidism.
Central hypothyroidism refers to thyroid hormone deficiency due to a disorder of the pituitary, hypothalamus, or hypothalamic-pituitary portal circulation, resulting in diminished thyroid-stimulating hormone (TSH), thyrotropin-releasing hormone (TRH), or both.
What is Subclinical Hypothyroidism?
Subclinical hypothyroidism is an early and mild stage of hypothyroidism. In this case, our body does not produce enough hormones to support our metabolic functions.
However, the thyroid hormone T3 and T4 levels are still within the laboratory range. Instead, only the TSH levels are mildly elevated.
Let’s see the symptoms of hypothyroidism.
It is estimated that 20 million Americans are currently living with thyroid-related disorders. Unfortunately, most cases of thyroid disorders remain undiagnosed as symptoms may be mild or non-specific.
However, the first thing you need to do is to recognize your symptoms to understand the causes of your disease, and start a holistic plan of action to get your thyroid healthy again.
In most cases, the process begins with overactivity, which later turns into underfunction. Abnormal “twisting or unscrewing” of the energy center can produce a number of symptoms:
- Puffy face
- Hoarse voice
- Cold intolerance
- Elevated cholesterol levels
- Muscle weakness
- Dry skin
- Brittle and thin hair
- Joint stiffness and pain
- Muscle stiffness and aches
- Irregular menstruation
- Slow heart rate
- Enlarged gland or goiter
- Impaired memory
- Poor metabolism
- Generalized swelling
The following section delves deep into the diagnoses, different hormonal tests, and treatments of hypothyroidism.Â
Diagnosis and Treatment Options for Hypothyroidism
While the cause of hypothyroidism varies from person to person, almost all of them present with similar symptoms which helps doctors to make a plan for the diagnosis and treatment.
What will Happen when you get the Diagnosis?
Your doctor can diagnose your underlying hypothyroidism with a medical evaluation and take a complete panel of blood tests to confirm their diagnosis.
He or she will record your complete medical history and perform a physical exam to evaluate all the signs and symptoms. They look for dry skin, slow heart rate, reflexes, body temperature, and any swelling along your neck.Â
Moreover, your healthcare professional will question you about any symptoms you might have experienced due to hypothyroidism.Â
You should make sure to inform them about any family history of thyroid dysfunction, prior radiation, or any medications you take.Â
Lastly, it is crucial to mention that many thyroid dysfunctions result from nodules and thyroid cancers too. Your doctor can ask you to get an ultrasound or CT scan to look for any abnormality in your gland.
Why Checking for Thyroid is Important
Despite being a small organ, the thyroid is of immense use to the human body due to its ability to secrete some essential hormones, namely T3 and T4.Â
It is precisely why any thyroid malfunction can result in mild to severe physical and even emotional disorders. As a result, it is of the utmost importance that thyroid checks are done regularly to discover any problems with the thyroid as early as possible.Â
Why are T3, Free T3, T4, Free T4, RT3 tests so Important in the Diagnosis, Evaluation, and Treatment of Thyroid Disease?
Assessment of thyroid functions is often tricky simply because so many medications, physiological alterations or diseases can alter the serum levels of these hormones.
Therefore, it is recommended to assess the entire thyroid profile while making treatment or dosing decisions.
The Tests you need to ask for
TSH- This is the initial test to evaluate thyroid function, where high and low levels indicate hypothyroidism and hyperthyroidism, respectively.
Total T4– The test gives both free T4 and bound T4 levels in your blood.Â
Free T4– Free T4 levels together with your TSH give very accurate results on your thyroid health.
Total T3– This is the total amount of T3, free and bound, present in your blood, and is useful for diagnosing and assessing the severity of hyperthyroidism.
Free T3– The test measures the free T3 levels in your blood, which is the active form of thyroid hormone.
RT3– It’s the inactive portion of the T4. Explaining in a different way we can say that T4 is divided into two parts: The T3 and the other one called RT3 that blocks the function of the T3 as a mechanism of regulation and prevention of thyroid overactivity.Â
Why do Traditional Healthcare Practitioners Request only TSH and T4 to Evaluate the Thyroid?
Doctors assume that our systems properly convert T4 to active T3 based on TSH and T4 tests alone. Too high or too low a TSH is indeed an indication of a thyroid problem. But there is a problem with that if TSH and T4 values show well even if the patient is experiencing symptoms of thyroid disease.
Thyroid hormones (T and T4) are extremely potent and thus most of the T4 circulating in the blood is bound to proteins – also known as Thyroid Binding Globulin or TBG (and hence is inactive).Â
Only a small fraction of thyroid hormone circulating in the blood is in unbound form (or free form). It is important to mention that only free thyroid hormone can enter in the tissues and exert action.Â
T4 or thyroxine levels are mainly designed to calculate FREE and BOUND T4 levels. More than 95% of T4 is bound to proteins, limiting its tissue update and bioavailability. On the other hand, FREE T4 can be readily absorbed by tissues to exert a variety of metabolic functions.
Why is TSH not the Right test to Determine the Health of your Thyroid?
This means that the serum levels of Thyroid hormones must always be maintained under recommended limits. This is achieved by a tight feedback regulation system between Thyroid Stimulating Hormone (TSH) and Thyroid Hormones (T3 and T4).
There are Limitations to TSH Measurement
Why Should Traditional Doctors Order: Total T4, Free T4, Total T3, Free T3, and Reverse T3?
However, laboratory results often do not fully reflect the complex function of hormones. And the values they get that day may change the next day or in a week.
What Factors Influence TBG Serum levels, and how do these changes Manifest Themselves?
Thyroid-Binding Globulin (TBG), as described previously, are transport proteins that are responsible for binding to thyroid hormones, and carry thyroid hormone (particularly T4) in the bloodstream to the appropriate tissues.Â
A number of non-thyroid factors can alter the serum T4 levels by altering the serum levels of TBG:Â
- If you’re taking any drugs (such as contraceptive pills),
- if you have certain infections (Hepatitis C infection or liver disease),
- if you are pregnant,Â
- if exposed to environmental toxins (xenoestrogens),
the serum levels of TBG changes, thereby altering the levels of FREE and BOUND T4 in the absence of a thyroid disorder.
What Should be the Optimal Range you Should have to Feel Well?
- Hormone Tests Normal Range
- Thyroxine T4 5.0 to 12.0μg/dL.
- Triiodothyronine T3 80-220 ng/dL.
- Thyroid Stimulating Hormone 0.5 to 5.0 mIU/L.
– The normal range is different in some physiological/ pathological conditions: so the reference range listed above is ideal for normal healthy adults. But if you are suffering from pituitary disease or thyroid cancer, the normal range when you should feel normal will be different. Even in some physiological conditions such as pregnancy or old age, the optimal effective range of thyroid hormones differs from the reference range listed above.
– Normal range of thyroid hormones is relatively wide. In other words, theoretically, 0.5 mIU/L and 5.0 mIU/L are both normal, but you may not feel optimal at 0.5 mIU/L. Change to 1.5 mIU/L  I think 0.5 is too low and most likely you are going to the side of hyperthyroidism if you are not on thyroid medication.Â
– The optimal range of TSH for most people can be from 0.5 to 1 mIU/L(without any thyroid medication), but you need to check their FT4, FT3, and RT3 to see if they are optimal ranges (we need to talk about the TSH with and without medication). Â
Please watch this video of Dr. Child by clicking here.
All such blood tests are quite essential to detect any thyroid condition in its early stage. Consequently, you can control your thyroid illness by taking the proper treatment seriously and starting early to prevent further damage to the thyroid.
Treatment
There is no complete cure for hypothyroidism, but do not despair.
Along with this, you will have to get a blood test in 2-3 weeks at the beginning of the treatment and later every 4-6 weeks to adjust the medication. In the future, you can wait six months before consulting your doctor again if you don’t experiment with any recurrent or new symptoms of hypothyroidism.
Apart from thyroid function tests, holistic doctors check other health areas of your body. This includes checking for any possible vitamin deficiency and levels of iodine, selenium, and zinc levels in your body.Â
In the case of any deficiency, they will recommend supplements to correct the levels. It is worth mentioning, the goiter caused by iodine deficiency. is an abnormal enlargement of your thyroid gland.Â
However, goiter is usually a painless condition; it sometimes causes swelling in the neck, which can result in discomfort, difficulty breathing, hoarseness, and difficulty swallowing.
Moreover, your doctor will also investigate if any food allergies exacerbate your thyroid disease. Since chronic inflammation damages your gland, they will advise you to avoid any food triggers in case of any allergies.
As you can see, many professionals deal with hypothyroidism patients, prescribing individualized treatment for everyone and sooner or later. Still, everyone will find a proven treatment for them, you too.
Additionally, holistic doctors understand the effect of chemicals in the environment on thyroid health too. Therefore, they will inquire about any dental amalgams, filtered water, and your everyday products.Â
Unfortunately, all such substances are high in heavy metals like mercury and lead, and you might be advised to switch to alternate options.
Furthermore, holistic doctors will keep a keen eye on your RT3 through regular blood testing. As mentioned above, this inactive hormone can reduce free T3 levels and exacerbate hypothyroid symptoms like weight gain.Â
Hypothyroidism is also responsible for high cholesterol levels. You must go for regular lipid profile tests and visit a cardiologist for a heart check-up to prevent any heart disease.
Typically, your cholesterol levels decrease when you treat your thyroid disease. If your cholesterol is not improving, make sure to get your liver tested and visit a doctor for further investigations.
How to Keep Your Thyroid Healthy?
If you do not treat hypothyroidism properly, it can cause multiple health problems in the future:
You can develop myxedema, a rare but life-threatening condition, from long-standing, untreated hypothyroidism.
Since hypothyroidism elevates blood cholesterol and LDL levels, it can lead to heart diseases. Left untreated, it can even lead to heart failure.
You can develop a goiter or an enlarged thyroid gland due to constant stimulation of the TSH to produce more hormones. The enlarged gland can affect your breathing and swallowing.Â
Over the long term, hypothyroidism can damage the peripheral nerves, causing pain, numbness, or tingling in the extremities.Â
Even if you take lifelong medications to manage hypothyroidism, you may have to face complications. There may also be long-term side effects of the drugs.Â
Hypothyroidism and Regular Life
There is no doubt that your everyday life is greatly affected by hypothyroidism. Since it is a lifelong disease, you need to change your lifestyle to cope with the symptoms to carry out your daily activities.
Fortunately, there are many treatments available to help regulate the hormone levels in your body. They help to keep your symptoms down, prevent flare-ups, and allow you to work normally.
So how do you Cope with a Thyroid Disorder?
According to a study in the JAMA, there was a 3% increase in advanced thyroid disease every year from 1974 to 2013.Â
Although hypothyroidism is increasing globally, you can manage its symptoms with appropriate medications without fillers, changes in your diet, supplementation of important nutrients for your thyroid, elimination of chemicals and heavy metals, utilization of tools to manage emotions and stress, and a great holistic doctor that listens to your symptoms and concerns.Â
- Since stress worsens hypothyroidism, learn how to manage your triggering factors for the future
- Practice meditation to relax your body and relieve stress.
- Exchange your tap water for filtered water to remove any metals or chemicals.
- Exercise regularly to keep your weight at a healthy level, reduce fatigue, and strengthen your muscles. Also, start a weight training program to help to keep your muscle mass and bone density as you age.
- Learn to control the triggers of your symptoms, including stress, dietary, and environmental factors.
- Although you are taking medications to replace the low thyroid levels in your body, it is also essential to supplement your diet with healthy foods.
Some of the foods beneficial for people with hypothyroidism are as follows:
– It should include a variety of organic fruits and vegetables, organic chicken, grass-fed meats (beef and lamb), and wild seafood in a well-balanced diet (Salmon, halibut and Cod from Alaska).
– Avoid trans fats and corn syrups in your diet, and choose gluten-free grains to minimize inflammation.
– Stay hydrated by drinking filtered water and decaffeinated beverages.
– To maintain a healthy gut, use probiotics and prebiotics.
– To correct any deficiency, take vitamins, minerals, and supplements.
Consume a nutritious, well-balanced diet.
Conclusion
- TSH doesn’t reflect thyroid health 100 percent of the time; it is critical to properly understand the best range of all blood test results to properly regulate or eradicate hypothyroidism or hyperthyroidism symptoms properly.
- I hope you found out everything you wanted to know about thyroid dysfunction. You must have figured out the causes of your thyroid disease, and you already know which type it belongs to.
- You’ve got a clearer picture of what’s waiting for you during an examination, so you don’t have to be so scared in the doctor’s office anymore. You know that holistic methods can be used to improve your health, but at the same time, a thorough blood test is essential before starting treatment.
- The tests you need to ask for are TSH, T4, Free T4, T3, Free T3 and RT3 to detect any abnormalities and also the importance of knowing your antibody test numbers to rule out any autoimmune diseases.
- And while your treatment is in progress, you can do a lot about how to cope with hypothyroidism in your daily life like changes in your diet, supplementation of important nutrients for your thyroid, or elimination of chemicals and heavy metals, utilization of tools to manage emotions and stress, and a great holistic doctor that lists your symptoms and concerns.
- Although medications replace the low thyroid levels in your body, it is also essential to supplement your diet with healthy foods.
References
thyroid.org
PubMed
uclahealth.org
Mayo Clinic
The content on mythyroidrelief.com, such as text, videos, graphics or images, and other materials, are for educational and informational purposes only. It is not intended to be a substitute for professional medical and nutritional advice, diagnosis or treatment. It should not be used as a substitute for medical consultation. The knowledge provided in this blog comes from the author's own experiences and research. Consult your doctor before making any decisions about your medical care.
An interesting discussion is definitely worth comment. There’s no doubt that that you need to publish more about this topic, it may not be a taboo subject but typically folks don’t speak about such topics. To the next! Cheers!!
Hi Everette,
Thank you for your comment! I appreciate your interest in this topic and your encouragement to explore it further. I’ll consider writing more about it in upcoming posts. Stay tuned!