An estimated 20 million Americans have some form of thyroid disease, and up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime.
Levothyroxine, a synthetic form of thyroid hormone, is the fourth highest-selling drug in the United States, and 13 of the top 50 selling drugs are either directly or indirectly related to hypothyroidism. The number of people suffering from thyroid disorders continues to rise each year.
Hypothyroidism is one of the most common thyroid disorders. One recent analysis suggested that up to one in 10 Women over age 60 has clinical or subclinical hypothyroidism.
Hypothyroidism is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other unpleasant symptoms. In fact, every cell in the body has receptors for thyroid
These hormones are responsible for the most basic aspects of our body’s function, impacting all major systems. Thyroid hormone directly acts on the brain, the GI tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gallbladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism, and body temperature regulation. The thyroid can be compared to the central gear in a sophisticated engine: if that gear breaks, the entire engine goes down with it.
Though not as common as hypothyroidism, hyperthyroidism is often a more serious condition, because it is associated with an increased risk of heart attack, stroke, and death. Symptoms of hyperthyroidism include palpitations, rapid heartbeat, excessive sweating, weight loss, diarrhea, anxiety, feeling warm even when others are not, increased appetite, and insomnia.
Conventional Medical Approach to Thyroid Disorders
In medicine, the key to choosing the best treatment is an accurate diagnosis. If the diagnosis isn’t correct, the treatment will be ineffective-or even cause harm. Unfortunately, misdiagnosis is common in the management of hypothyroidism. If a person visits a doctor with hypothyroid symptoms, she will simply be given replacement hormones without any further induiry into the cause of her condition.
Even worse, if she has hypothyroid symptoms but her lab tests are normal, she’ll be told that she’s “fine.” If the patient insists that she’s not, she might be sent home with an antidepressant, but no further clue about the cause of her symptoms.
The problem with this approach is that thyroid physiology is complex. The production, conversion, and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms but may not show up on standard lab tests. It’s incorrect and even negligent to assume that all cases of hypothyroidism share the same cause and require the same treatment. Yet that’s exactly what the standard of care for hypothyroidism delivers.
Conventional medicine is almost exclusively oriented toward “disease management”: using drugs or surgery to suppress symptoms. In functional medicine, we focus on addressing the underlying cause of disease so that patients can get well and stay well without un necessary drugs or surgery.
Although a prescription for thyroid hormone replacement is sometimes necessary, the first step should always be to determine why the thyroid is malfunctioning in the first place. Sometimes addressing the underlying cause of the thyroid problem is enough to resolve it without resorting to thyroid hormone replacement.
Underlying Causes of Thyroid Disorders
The two major causes of thyroid disorders are nutrient deficiency (primarily iodine, zinc, and/or selenium) and autoimmune disease. Iodine is a crucial nutrient for thyroid function. Thyroid hormone is rich in iodine, and deficiency of iodine can cause both hypothyroidism and goiter (a swelling of the thyroid gland).
Zinc is required for the synthesis of thyroid hormone, and deficiency of zinc has been shown to result in hypothyroidism. Selenium, a Cofactor for iodothyronine deiodinase, is required to convert T4 (the inactive form of thyroid hormone) into T3 (the active form of thyroid hormone). Selenium deficiency exacerbates conditions caused by inadequate iodine intake.
The most common autoimmune cause of thyroid problems is Hashimoto’s disease. In Hashimoto’s disease, the body attacks the thyroid gland, progressively destroying its capacity to produce thyroid hormone and resulting in hypothyroidism.
Some studies suggest that up to 90 percent of people with hypothyroidism have Hashimoto’s disease. Graves’ disease is another autoimmune disease that affects the thyroid gland, but it causes the thyroid to become enlarged and overactive, which results in hyperthyroid symptoms.
Here’s the key thing to understand: if autoimmunity is causing thyroid problems, balancing and regulating the immune system-and thus slowing or stopping its attack against the thyroid gland should be a primary goal of treatment. Replacement thyroid hormone may still be necessary; the destruction of thyroid tissue in Hashimoto’s disease is irreversible, so if it isn’t caught early on, replacement hormone will often be required to normalize thyroid function. But addressing the immune imbalance is critical to stopping further destruction of thyroid tissue, and in cases where Hashimoto’s is caught early enough, it may prevent hypothyroidism from developing in the first place.
Likewise, if iodine and/or selenium deficiency is driving your patient’s thyroid problem, then restoring healthy iodine and selenium levels is the most logical first step to take. Again, this may not eliminate the need for replacement thyroid hormone, but it can often significantly reduce the dose that’s reduired to normalize thyroid function.
If you or a loved one is suffering from Thyroid disorders, please give us a call at (203) 813‐3363. We can help!