Hi Sweet Friends,

I’m usually a chirpy and peppy gal, so when I started feeling sluggish on a regular basis, I put on my detective’s hat and headed to my regular investigative hot spots—the doc’s office and the bookstore. After looking under the hood and between the lines, it turned out that my adrenals (and some plain ole stress) were the major culprits. But through my sleuthing I learned a lot about thyroid health and discovered that it’s a large contributor to many of the chronic physical and mental issues people face today.

OK, let’s get glandular. So many of my readers ask about how to find their way back to wellness, especially when they’re experiencing daily discomforts and they aren’t getting answers at the doctor’s office. Symptoms such as depression, aches and pains, low sex drive, unexplained weight gain, relentless colds, brittle hair and dry skin are very common and could be the result of thyroid problems.

Perhaps you’re just starting to connect the dots when it comes to your health or maybe you’ve been down this road before and still don’t have answers—regardless, please don’t give up! Often, a deeper, more holistic look is needed to find a longterm solution. Hopefully, what you’re about to read will equip you with the knowledge you need to go on that quest with confidence, whether your thyroid gland is the root of your challenges or just something to explore along the way. And because I take your health (and mine) very seriously, this blog was highly researched and vetted by three well-respected RD’s. Dang!

Read on to learn what the butterfly-shaped thyroid gland does, how to figure out whether it’s on the fritz, and, if that’s the case, how to get your thyroid (and your well-being) back on track.

Getting to know your thyroid gland

Your thyroid is two inches long and its “wings” are wrapped around your windpipe (near your Adam’s apple in your neck). It’s an important little bugger that produces several hormones including two that are key in regulating growth and metabolism: T3 (triiodothyronine) and T4 (thyroxine).

T3 and T4 hormones are essential because they:

• Help cells convert calories and oxygen into energy
• Determine growth and development of many tissues in the body, including the brain and skeleton
• Work to increase Basal Metabolic Rate—the amount of energy you burn just sitting still

The pituitary gland produces TSH (Thyroid Stimulating Hormone), which stimulates the production of thyroid hormones T3 and T4. The production of the Ts is dependent on sufficient iodine intake from foods and supplements. The hormones then work to regulate cell growth and development by converting protein, carbs and fat into energy. The catch? Vitamin D must be present for the Ts to do their important work. (We’ll talk more about iodine and vitamin D later!)

When we’re healthy and things are swimming along in our systems, the thyroid gland produces T3 and T4 hormones and does its job quite well. But what about when things get out of whack? In the world of the thyroid, both too much and too little of this typically good thing can cause major problems, which leads us to…

What’s the difference between hypothyroidism and hyperthyroidism?

Hypothyroidism: Underactive Thyroid Disease

Think of it this way: hypo means not enough, and hyper means too much. When your thyroid gland doesn’t make enough of the essential thyroid hormones (either one or both T3 or T4), symptoms of hypothyroidism eventually pop up. Hypothyroidism can be caused by removal of the thyroid gland, a hypothyroid condition present at birth, inflammation of the thyroid gland, radiation exposure, or an autoimmune disease called Hashimoto’s Disease.

You’re more likely to develop hypothyroidism if:

• You’re a woman
• You’re over age 60
• You have a family history of thyroid disease
• You have another autoimmune disease such as type 1 diabetes, rheumatoid arthritis, or lupus
• You’ve been pregnant in the last six months

Symptoms of hypothyroidism include weight gain, difficulty metabolizing carbohydrates and sugars, joint pain, depression, infertility or irregular periods, tightness in the throat, sensitivity to heat and cold, panic attacks, high cholesterol, memory loss, vision problems, dry skin and hair loss.

Diagnosis for hypothyroidism is made by measuring blood levels of thyroid stimulating hormone (TSH). Generally, if the TSH level is above normal, it means hypothyroidism. A low T4 level also indicates hypothyroidism.

Hypothyroid treatment includes taking a synthetic hormone replacement (identical to T4). To determine the dosage, blood levels of TSH are tested regularly. Keep in mind that although adequate iodine intake is necessary for a healthy thyroid, excess amounts may cause or worsen hypothyroidism. See my section on holistic approaches for ways you can be proactive about your thyroid health.

Hyperthyroidism: Overactive Thyroid Disease

You can think about hyperthyroidism as your lovely butterfly gland going on a nectar bender. When the thyroid gland makes more thyroid hormone than you need, many bodily functions speed up—including metabolism.

You’re more likely to develop hyperthyroidism if:

• You’re a woman
• You’re over age 60
• You have a family history of thyroid disease
• You have type 1 diabetes
• You’ve been pregnant in the last six months
• You have a vitamin B12 deficiency

Symptoms of hyperthyroidism include: insomnia, nervousness, weight loss, mood swings and irritability, rapid and irregular heartbeat, heat intolerance and the development of a goiter (an enlarged, swollen thyroid gland). Hyperthyroidism can be caused by Graves’ disease, thyroid nodules (lumps in the thyroid), inflammation of the thyroid, consuming too much iodine, or taking too much synthetic thyroid hormone to treat hypothyroidism.

Diagnosis for hyperthyroidism is made after your doc does a few blood tests. The following factors point to a batty butterfly:

• TSH levels are very low
• T3 and T4 levels are high
• Radioactive Iodine Uptake is abnormal

Radioactive Iodine Uptake (RAI-U) testing is just what it sounds like: the test shows how much radioactive iodine your thyroid can absorb four to six hours and then 24 hours after consuming a dose of iodine (tasty, no?). This is important because it helps determine what exactly is sending your thyroid into overdrive. Health professionals will also feel for an enlarged thyroid, listen for heart palpitations, and measure for weight loss as they diagnose hyperthyroidism.

Treatment of hyperthyroidism is trickier and more individualized depending on the cause of the hyperthyroidism and the severity of it. Treatment often includes radioiodine therapy, surgery, and/or medication to ease the many health challenges that arise from an overactive thyroid. Although there may not be holistic treatments for hyperthyroidism, there are still many diet and lifestyle upgrades you can make to improve your overall thyroid gland health. More on that soon!

Additional information on diagnosing hypothyroidism and hyperthyroidism

I was pretty confused about diagnosing these issues until I read Frank Lipman MD’s take on thyroid health in his book, Revive. Dr. Lipman suggests three approaches to checking thyroid function: your symptoms, underarm temperature and blood test results. To avoid being misdiagnosed or having a thyroid problem overlooked, make sure you’re working with an open-minded practitioner who is looking at all three of these factors.

Also, ask your doctor about the blood tests he or she is requesting (you have the right to know!). Dr. Lipman suggests the following tests for a full thyroid panel:

• Thyroid-stimulating hormone (TSH)
• Free T4 (free thyroxine)
• Free T3 (free triiodothyronine)
• Reverse T3
• Antithyroglobulin antibodies (anti-TG)
• Antithyroid peroxidase antibodies (anti-TPO)

Holistic Approaches to Improving Your Thyroid Health

As I mentioned earlier, holistic approaches to treating hypothyroid and hyperthyroid issues are few and far between, but there are some proactive things you can do to boost your overall thyroid health:

• De-stress through meditation, yoga, chamomile tea, more sleep, and/or exercise. Under times of stress, the hormone cortisol suppresses TSH production. Managing stress is one of the best ways to ensure your thyroid gland doesn’t slow down.
• Exercise! Low-intensity and regular aerobic exercise can stimulate the production of thyroid hormones.
• Eat organic to reduce exposure to environmental toxins. Some recent research suggests that pesticides and polychlorinated biphenyls (PCBs) lower T3 hormone.
• Get sweaty. Saunas (I adore my far infrared Sunlighten Sauna) or steam baths may help to detox pesticides or PCBs from your system.
• Get your nutrients. Selenium, iodine, and vitamins A, C, D, and E are all important for thyroid hormone production. Vitamin D is essential for thyroid hormone’s efficacy in your body’s cells. If your diet is lacking in any of these nutrients, consider supplements.
• Go easy on gluten. Like other foods that can cause inflammation, gluten is a sticky subject (one on which I’ll do a whole, separate post soon!). People who have celiac disease might find that gluten aggravates autoimmune thyroid issues, so it’s best to steer clear.

Key factors that may impact your thyroid health

Iodine

The cells in the thyroid are the only ones in the body that can absorb iodine. Iodine is necessary for the production of both T3 and T4 hormones and is found in almost every living plant. Since we know how important these hormones are to our health, it’s essential to make sure you’re eating enough iodine-rich foods. The best sources of iodine include seaweed (such as the nori wrapped around a veggie California roll) and kelp. Many people use iodized salt or supplements as their main source of iodine.

How much iodine do you need? Recommended intakes are 150 micrograms daily for adults, 220 micrograms per day for pregnant women, and 290 micrograms per day for lactating women. One-quarter teaspoon of iodized sea salt (which doctors recommend in place of table salt) contains about 95 micrograms of iodine, and one six-inch by six-inch sheet of nori contains about 58 micrograms of iodine. If your iodine intake is low, you may experience fuzzy thinking, fatigue, depression, high cholesterol, weight gain or develop a goiter.

Goitrogens

The cancer-fighting isothiocyanates in cruciferous veggies (kale, broccoli, cabbage, Brussels sprouts, cauliflower, kohlrabi, mustard greens, rutabaga and turnips), and the isoflavones in soy products are goitrogens: substances that may interfere with the production of thyroid hormone. In folks who don’t have thyroid challenges, eating goitrogens is A-OK, since cruciferous veggies can be very beneficial to the immune system and in fighting off cancer. In moderation, the same goes for soy foods (in whole or minimally processed, organic and GMO-free forms), especially when it comes to heart health and cancer prevention and survival.

But if your thyroid is underactive you should be very mindful of your cruciferous vegetable and soy food consumption. Some endocrinologists recommend that people with underactive thyroid disease avoid eating these foods completely. However, cooking seems to deactivate about one-third of the goitrogenic compounds, so you may be able to continue including them in your diet just by reducing your consumption of raw or juiced goitrogenic foods. For example, Jennifer Reilly, RD generally advises her clients to avoid excessive amounts of these foods by limiting raw cruciferous veggies like kale in juices and smoothies, rather than cutting them out altogether. And when it comes to eating soy foods, always check with your doc since soy could interfere with synthetic hormone medications.

Other researchers have found that only in the case of iodine deficiency are goitrogenic foods problematic for hypothyroidism, and as long as iodine intake is sufficient, the goitrogenic foods have little or no negative effect on hypothyroidism. This group of researchers recommends simply increasing iodine intake along with goitrogenic foods to maintain a healthy balance for a healthy thyroid. So, salt those Brussels sprouts and make sure you are working with your doctor to adjust your diet if you’re dealing with underactive thyroid issues.

Vitamin D

Vitamin D is a hormone, and aside from boosting the immune system and assisting with bone health and calcium absorption, it is also essential in the last metabolic step. During the final moments of the metabolic process, thyroid hormones are responsible for getting energy and oxygen into the body’s cells. (Pretty important!)

But without sufficient vitamin D, thyroid hormones won’t work properly. This is why vitamin D deficiency has been associated with autoimmune thyroid diseases such as Hashimoto’s and Graves’, and it is even thought that vitamin D deficiency may trigger thyroid disease. Luckily, getting adequate vitamin D is as easy as working 20 minutes of daytime sun into your life three times per week (and if that isn’t enough to boost your levels, supplements are available). You can make sure that you have adequate vitamin D levels with a simple blood test. Pro tip: your levels can change year-to-year, so keep current! Getting too much vitamin D can be toxic for your body, so don’t go on supplementation autopilot.

I know this is a lot of information. So if this post resonated with you and you don’t know where to start, just remember to take one step at a time.

Your turn: If you’ve experienced thyroid health issues, please share what has helped you along the way!

Peace & butterflies,