Low thyroid: is it everybody’s problem?

A partial list of signs and symptoms of low thyroid reads a bit like a “who’s who” of adults who come to see me:

Morning fatigue
Headaches or migraines
Muscle and joint pain
Menstrual disorders
Weight gain
Hair loss
High cholesterol
and so on

In many cases it would seem that just ordering a simple blood test to measure thyroid hormones would solve the riddle, and yet blood tests are often normal – even tests that are sophisticated and expensive!

Some seemingly forward-thinking doctors try to solve the problem by prescribing thyroid medication based on symptoms regardless of test results, but this is probably a bad idea. Excessive thyroid hormones suppress the body’s thyroid function and cause osteoporosis, and people rarely feel better in the long run. A better solution may be found by looking at what happens to thyroid hormones after the thyroid produces them.

The thyroid gland produces mostly T4, an inactive hormone, and much smaller amounts of T3, the active thyroid hormone. As T4 circulates in the blood, it is carried to body tissues where it is gradually converted to T3. For some people, the problem is that their bodies do not convert T4 to T3, not that they don’t produce enough T4.

Since blood tests are just a snapshot, they don’t fully evaluate the conversion of inactive T4 into active T3, a gradual process that occurs throughout the day. Experience has shown that a more sensitive test to evaluate conversion adequacy requires a 24-hour urine collection.

Once it is determined that there is a conversion problem, through testing or a process of elimination, we need to look at factors that could be hindering this conversion. The first of these is a deficiency of the mineral selenium.

I believe that selenium deficiency is widespread, because the soil in which our food is grown is itself depleted of this important mineral, and what little might be in our food is wiped out in refining and processing. Selenium in multivitamins may not be absorbed, considering that minerals compete with one another for absorption and that certain forms of calcium block absorption of other minerals. Further, the form of selenium used for thyroid hormone conversion, selenocysteine, which is found in garlic and broccoli from selenium-rich soil, is rarely included in supplements.

Stress also indirectly suppresses the conversion of T4 to T3 . Stress causes overproduction of the adrenal hormone cortisol, and cortisol blocks the conversion. Therefore, testing adrenal hormone levels makes a lot of sense when there is stress in addition to symptoms of low thyroid. Many herbal extracts, including the Indian herb Ashwagandha can be used to help normalize cortisol levels and can therefore improve thyroid metabolism.

Finally, herbal extracts that support liver function – such as milk thistle – have been found to help thyroid hormone conversion as well, simply because a majority of the T4 our bodies produce is converted to T3 in the liver.

It has been my experience that we need to look at more than blood tests to diagnose low thyroid, and treat stubborn cases with more than just a thyroid supplement.

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