Hypothyroidism (underactive thyroid)

What is hypothyroidism?

Symptoms of hypothyroidism

Causes of hypothyroidism

Prevention / remedies / cures / treatment for hypothyroidism

References

What is hypothyroidism?

Hypothyroidism (underactive thyroid, sluggish thyroid) is a common endocrine disorder in which the thyroid gland does not produce enough thyroid hormones. The opposite of hypothyroidism is hyperthyroidism (overactive thyroid).

The thyroid gland, located at the base of the throat, has an influence on almost every metabolic process, helping cells get the energy and nutrients they need. An underactive thyroid causes a slow metabolism (a slow pace of all of the processes in the body).

The thyroid cannot function properly without sufficient iodine, zinc, selenium and the amino acid tyrosine. The thyroid gland is the biggest repository of iodine in the body.

Sometimes, a person's thyroid function can swing between too high and too low. For example, Hashimoto's thyroiditis often results in hypothyroidism with bouts of hyperthyroidism.

Most people are iodine-deficient, and therefore it is likely that most people have a thyroid that is functioning less than optimally. However, symptoms of hypothyroidism are usually slow to appear, and sometimes non-existent (see below). In Western countries, between 4.3% and 8.5% of the population is identified as having subclinical hypothyroidism. Around one in ten of them have serious hypothyroidism. (2)

Women are about seven times more likely than men to have hypothyroidism. Most cases occur in women over 60 years of age, but it can affect all age groups. About 2% of children have subclinical hypothyroidism, and they often return to normal thyroid function.

Test for thyroid function

A laboratory can test for levels of thyroxine and thyroid stimulating hormone (TSH). TSH is produced by the brain to tell the thyroid to produce more thyroxine. Many doctors say a level of TSH below 5 5 mIU/L is normal, but the American Association of Clinical Endocrinologists now considers more than 3 to be abnormal. Some practitioners even consider above 2.5 to be unhealthy.

Symptoms of hypothyroidism

People with hypothyroidism often have no or only mild symptoms, and they may develop slowly. Only some of the symptoms may be present.

• Goitre (swollen thyroid causing a bulge in the throat).
• Fatigue, low energy.
• Cold hands and feet, poor ability to tolerate the cold.
• Cool, dry, coarse skin.
• Puffy face and skin around the eyes.
• Hair is thin and dry, hair loss.
• Weight gain.
• Muscle weakness.
• Poor memory and concentration.
• Constipation.
• Heavy periods, later becoming unusually light periods.
• Hoarse voice.
• Short of breath.
• High blood triglycerides, increased risk of coronary heart disease.
• Slow pulse.
• Swelling of the limbs (oedema).
• Poor cholesterol metabolism with increased risk of gallstones.
• Poor reflexes.
• Poor hearing.
• In children, slow or delayed growth and intellectual development. In severe cases it is called cretinism.

Causes of hypothyroidism

• Iodine deficiency. This is the most common cause of hypothyroidism worldwide. Iodine deficiency may be caused by, and is often related to fluorides in drinking water, diet and the environment. Fluoridated drinking water is the main source of fluorides which cause hypothyroidism (5) and numerous other serious diseases.
• Insufficient bile and bile salts. Bile stimulates the thyroid gland, and a healthy thyroid stimulates the production of bile by the liver, in a beneficial circle. Bile is stored in the gallbladder.
• Insufficient saturated fats in the diet. Being on a low-fat, low-cholesterol diet.
• Gluten in the diet. (3, 4) Many people have an inflammatory reaction to gluten, especially wheat gluten. If the reaction is both systemic (circulating throughout the body) and sustained, the antibodies can eventually attack your own cells and organs (known as celiac disease). Usually the thyroid is one of the first organs affected.
• Hashimoto's thyroiditis. This is the most common cause of hypothyroidism in those few countries where there is sufficient iodine in the diet. It is also the most common autoimmune condition affecting the thyroid.
• Estrogen dominance.
• Giving birth. About 5% of women develop postpartum thyroiditis which can occur up to nine months after delivery. There is usually a short period of hyperthyroidism followed by a longer period of hypothyroidism, ongoing in 20-40% of cases. (1)
• Autoimmune thyroiditis is associated with other immune-mediated diseases such as diabetes mellitus type 1, pernicious anaemia, celiac disease, rheumatoid arthritis, myasthenia gravis and systemic lupus erythematosus.
• Pharmaceutical medications such as lithium-based mood stabilisers, interferon alpha, tyrosine kinase inhibitors such as sunitinib, and amiodarone.
• Viral infection.
• Previous thyroid surgery.
• Previous treatment with radioactive iodine.
• Injury to the hypothalamus or the anterior pituitary gland.
• Lack of a proper functioning thyroid at birth, genetic causes.

Prevention / remedies / cures / treatment for hypothyroidism

• Iodine. Dulse, kelp, nori, shellfish and ocean fish (especially fish heads) are all high in iodine.
• Thyroxine. Boost your body's own production of thyroxine with iodine (see above) and tyrosine. Tyrosine-rich foods include seaweeds, turkey, salmon and other fish, eggs, chicken, red meats and pork, lima or butter beans, avocados, mushrooms, sesame seeds, almonds, bananas and pumpkin seeds.
• Sufficient saturated fats are essential, and also Omega-3s.
• Treat adrenal exhaustion. High levels of cortisol hinder thyroid function.
• Gluten-free diet. Gluten is strongly associated with many autoimmune diseases. Eliminating gluten from your diet is beneficial, even if it turns out that gluten is not the main culprit. People with thyroid problems have a higher rates of coeliac disease.
• Take a gluten-free diet further by going grain-free.
• Identify and treat allergies or intolerances.
• GABA.
• Goitrogens. Try to avoid foods that are high in goitrogens, which are substances that lower thyroid function, preventing the thyroid from producing thyroid hormone properly. Goitrogenic foods anti-thyroid properties are strongest when eaten raw. Cooking destroys most of the goitrogens, but anyone with hypothyroidism should eat these foods sparingly, if at all.
  Avoid:
  Soy products (anything made from soy, especially if they are not well fermented).
  Vegetables in the brassica family: broccoli, Brussels sprouts, cabbage, cauliflower.
  Kale, mustard, turnips and spinach. Millet.
  Almonds, pine nuts, peanuts.
  Peach, pear, strawberry.
• Exercise. Sufficient regular and enjoyable exercise. If you have an underactive thyroid exercise may be the last thing you feel like doing, but daily exercise really does help to boost thyroid function.
• Ensure you are not deficient in zinc and selenium. The best food sources of selenium are kidneys, shellfish, fish, egg yolks or eating one Brazil nut per day.
• Try to avoid caffeine, alcohol and dairy foods.
• Avoid farmed fish and fish from polluted waters.
• See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Stagnaro-Green A. Approach to the patient with postpartum thyroiditis. (February 2012). The Journal of Clinical endocrinology and Metabolism (Review) 97 (2): 334-42. doi:10.1210/jc.2011-2576. PMID 22312089.

2. Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, Pessah-Pollack R, Singer PA, Woeber KA. Clinical Practice Guidelines for Hypothyroidism in Adults. American Association of Clinical Endocrinologists and the American Thyroid Association Taskforce on Hypothyroidism in Adults. (December 2012). Thyroid 22 (12): 1200-1235. doi:10.1089/thy.2012.0205. PMID 22954017.

3. Ch'ng CL et al. Celiac disease and autoimmune thyroid disease. Clinical Medicine & Research 2007 October; 5(3): 184-192.

4. Naiyer AJ et al. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid 2008 Nov;18(11):1171-8.

5. Peckham S, Lowery D, Spencer S. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. J Epidemiol Community Health, 2015;0:1-6. doi:10.1136/jech-2014-204971.