Anyone with a suspected thyroid issue should know how to test their thyroid properly. Most doctors only check TSH levels and assume your thyroid is fine as long as the TSH (Thyroid Stimulating Hormone) is below about 5 (way too high) these days. But there are much better tests than those on the standard thyroid panel. There are, however, better thyroid tests than those on a standard thyroid panel. You can ask your doctor to order them for you although they will sometimes refuse (if so I can do that for you – see here )
The thyroid gland produces multiple hormones which are master regulators of the body’s metabolism. They govern how fast things get done including growth, bowel motion, and temperature regulation response. Because thyroid hormones can affect so many areas, the list of associated symptoms is very broad. Some common symptoms of poor thyroid function include:
• feeling cold when others are warm, especially cold hands & feet
• a low body temperature (under 36.9 degrees C/98.5 degrees F)
• dry skin
• thinning eyebrows or missing the outer third of the eyebrows
• slow pulse
• high cholesterol
• hair loss especially in patches
• weight gain
• weak or brittle fingernails
• fatigue even with adequate rest (this is also an adrenal issue)
• fibromyalgia, muscle and joint pain
• hoarse voice
• swelling in the neck
TESTING FOR LOW THYROID FUNCTION
If you have several of the above symptoms, or are already on thyroid medication, you should be monitoring the following regularly:
• Free T3
• Free T4
• Total T4 if the country you live in does it
• Reverse T3 (rT3) is also very helpful
• Check antibodies to rule out Hashimoto’s Thyroiditis (auto-immune disorder)
Note: Thyroid tests do not have to be fasting tests
IMPORTANCE OF ‘FREE’ T3 & T4
In addition to TSH and antibody levels, you need FREE T3 and FREE T4. These are different to other tests. “Free” hormone gauges ‘unbound’, readily available thyroid hormone. Basically, a bound hormone is already attached to something such as mercury, estrogen or other toxins as well as to other molecules that have “captured” the hormone. It is now unusable, even though technically still in the bloodstream.
This is very easy to do when you first wake up in the morning. Shake down a mercury thermometer, not a quick-recording digital kind, and place it next to your bed. Immediately upon waking, slip the thermometer into your armpit and leave it for 10 minutes without moving or talking – lie very still, and don’t eat or drink or get up. The basal temperature of a person just barely awake should be around 36.9 degrees C. This is called the Barnes Basal Temperature Test. If your temperature is consistently below this, there may be an issue with thyroid, pituitary or adrenal hormones, or with other toxins such as mercury, viruses or antibodies.
Things are not always what they seem though, the thyroid is complicated. Low thyroid readings might have nothing to do with the thyroid itself. Well that’s confusing! So bear the following in mind when trying to “fix” the thyroid:
1. IF YOU DON’T FIX YOUR ADRENALS, YOUR BODY WILL NOT RESPOND FOR LONG TO THYROID HORMONE. This is why people feel great for a few months on a thyroid prescription, but then their symptoms can return. This is how the body works – taking your foot off the accelerator pedal (the thyroid) because the engine (the adrenals) is worn out. Adding more speed to an exhausted body doesn’t work. Here are some ways to help you remedy this situation:
o Go on a Paleo Diet
o Get more sleep
o Live a less toxic lifestyle (you’ll find how to do this in my book 63 Days to Optimum Health”)
2. If you do take thyroid hormones, opt for bio-identical, natural thyroid hormone if possible (you’ll need to see a doctor for this – and hope he gives it to you if it’s available. In the USA it is under the name of Armour). Synthetic T4 and does not have the other thyroid hormones such as T3 in it. If your body is not converting T4 to the active form, T3, you may need to either get some of that added to your synthetic script – or make sure you have the co-factors and nutritional support to help to convert the T4 to T3.
3. There is a reason for a sluggish thyroid, the most common one being tired adrenals (too much stress, medications, etc); low progesterone (which you can get from my online store – called Renewed Balance) and a big one – lack of sleep.
4. Your thyroid is a fat-burning machine, and if it (and the adrenals) are working as they should, you will lose weight and your cholesterol will drop. Organic coconut oil is an excellent food for the thyroid and is thermogenic. Remember GOOD fats burn fat, especially coconut oil.
IDEAL RANGES (my opinion)
In Clinical Nutrition, we have specific lab ranges that we prefer, and we don’t use the generic lab ranges that come with tests. For example, we like TSH to be between 1 and 2, as opposed to .5 to 5. That range is too big and many people report feeling awful if their TSH moves away from the 1 to 2 range. Ranges I believe should be:
• TSH: 1.5 -2 (NB: when on thyroid medications, TSH can be suppressed)
• Free T4: 1.1
• Free T3: 3.5
• TPO or TgAb Antibodies: within range or negative
Thyroid function is like a relay race, with hormones passing the baton from the hypothalamus in the brain to the pituitary gland, then to the thyroid, liver and finally cells throughout the body. Around 94% of the hormone made in the thyroid gland is T4, the rest is T3 (because it has three iodine molecules). These hormones grab a ride through the bloodstream on thyroid-binding proteins, but they are called ‘free’ when released to the cells for active duty. So T4 must be converted to T3 before the body can use it.
KEY TO GOOD THYROID FUNCTION
While most of the conversion of this hormone takes place in the liver, not the thyroid, it also takes place in the cells of the heart, muscles, gut and nerves. Interestingly, here’s how T4 is generally converted in a normal body, roughly:
• 60% of T4 becomes ‘usable’ T3
• 20% becomes rT3 (inactive, unusable)
• 20% can be converted to T3 by healthy gut bacteria
You can see the importance of having a healthy liver and gut here!
Your LIVER metabolises hormones, filters toxins and cleans the blood while the by-products from these processes are sent to the gallbladder for final removal. Low thyroid function slows this entire process causing a sluggish, congested liver and gallbladder. You can see how hypothyroidism creates a vicious cycle of hindering liver function slowing conversion of T4 to T3.
The GUT converts around 20% of T4 to T3, but only in the presence of enough healthy gut bacteria. We carry roughly 2kg of healthy bacteria in our colons, with many functions including the ability to convert T4 to T3. Poor diet fosters bad strains of bacteria, crowding out the beneficial bacteria hampering thyroid conversion. You can see here why using antibiotics can significantly affect your flora and affect the thyroid. Dysbiosis (dysregulation of gut bacteria) causes gut inflammation and/or infection, reducing the ability to convert to T3 as well. Inflammation then causes the adrenals to produce more cortisol, further decreasing active T3 and increasing rT3.
FACTORS AFFECTING THE THYROID
One of the worst of all is chronic stress – it can hinder thyroid conversion by:
• Affecting communication between the brain and the endocrine glands
• Increasing thyroid binding protein activity, so that thyroid hormones cannot get into cells to do their job
• Hampering the conversion of T4 to T3
• Hindering detoxification pathways through which ‘used’ thyroid hormones exit the body, making it difficult for the cells to receive thyroid hormone – known as ‘thyroid resistance’
• Causing cells to lose sensitivity to thyroid hormones
• Resulting in excess production of the adrenal hormone cortisol – the body makes plenty of T4, but excess cortisol prevents the body from being able to convert enough T4 to usable T3
Other confounding factors include inflammation from gut infections, chronic viral infections, Lyme disease, food intolerances, exposure to mould and environmental compounds all of which can disrupt the conversion of T4 to T3. Finding the cause of inflammation is key to thyroid support. Inadequate conversion of T4 to T3 often isn’t diagnosed because a low T3 level doesn’t affect TSH levels. That’s why should test for Free T3 and T4 not just TSH. Lastly, anaemia is another confounding factor in thyroid support! Don’t stop eating red meat, eggs and other animal protein or your thyroid may suffer.
THYROID ‘NATURAL’ SUPPORT
You will often hear of how tyrosine and iodine will support your thyroid, but I would like to offer a warning here. They are vital thyroid nutrients but sometimes they can have an adverse effect on the thyroid even though in the beginning you appear to have more energy. Sometimes iodine can trigger an autoimmune condition or exacerbate an existing autoimmune condition like Hashimoto’s, that’s why it is imperative to do this under proper medical supervision.
Tyrosine, while essential (and found in animal protein) can sometimes suppress thyroid activity if supplemented. It can increase the adrenal hormones epinephrine and norepinephrine creating a “wired” feeling which although seems like progress after the fogginess of hypothyroidism, it can suppress TPO activity and ultimately thyroid hormone production – the way caffeine and stimulants do. If you are doing this under the supervision of an expert, no problem.
This is really important to support the thyroid and help to convert the inactive T4 hormone to the active T3 form:
• Fish oil – healthy hormones depend on it and we cannot make the DHA and EPA found in fish oil (it is NOT found nor converted from flaxseed oil).
• Selenium (Brazil nuts, or take a selenium tablet daily) is a major co-factor for conversion to T3 and to reduce rT3.
• Magnesium Citrate – one of the most underestimated nutrients for thyroid health
• B Complex (many B’s are needed as co-factors)
• Zinc (needed for T3 production and reduces antibodies)
• Vitamin A – not beta-carotene (which cannot be converted to vitamin A) – which is only found in animal products or cod liver oil – is critical for thyroid activity. When a thyroid hormone binds to a cell’s receptor site, it sets off a series of biochemical reactions that carry messages to the cell’s nucleus. Vitamin A appears to influence how well the thyroid hormone receptors in the cell’s nucleus function.
• Don’t forget liver and gut function support is also absolutely essential to conversion of T4 to T3 – Milk Thistle Premium is a wonderful liver support herb which makes you feel amazing, and you should be on a really good Probiotic (MaxiBiotic 20 or ProBPlus) too, every single day in my opinion.
Incidentally, one of the main reasons vegetarians and vegans have so many thyroid issues is their inability to get enough of these nutrients from their diets.
You will find all the above nutrients in my online store here