The Functional Medicine Approach to Hypothyroidism
Thyroid disease is a subject that hits close to home for me. I was diagnosed with Grave’s disease while I was in medical school.
Conventional medicine gave me three options: take a medication known as propylthiouracil (PTU), which has really awful side effects; use radioactive iodine to ablate (blow up) my thyroid; or have my thyroid surgically removed.
I eventually made the decision to have my thyroid ablated, a decision I regret to this day. I have since made it my mission to help those facing thyroid disease and other chronic illnesses reverse their thyroid disease and return to optimal health using functional medicine principles.
More than 12% of the U.S. population will develop a thyroid condition in their lifetime. An estimated 20 million Americans have some form of thyroid disease, and up to 60% of those people don’t even know they have one. What’s even more alarming is that women are 5 to 8 times more likely than men to develop thyroid disease.
While those statistics can seem frightening, it doesn’t have to be this way. I’ll explain what can go wrong with your thyroid — specifically Hashimoto’s and hypothyroidism — a few of the root causes of thyroid disease, the importance of thorough testing, and how a functional medicine approach can help reverse your symptoms.
How Your Thyroid Works
To understand what can go wrong with your thyroid, it’s important to first know how the thyroid functions. Think of your thyroid gland as your body’s power generator. It sends energy to every cell in your body through the hormones it produces. These hormones determine the energy level and reproduction of each cell, keeping your organs powered up and managing your overall metabolism. This process of creating, regulating, and delivering these hormones begins in your brain.
Your hypothalamus, which is responsible for managing hunger, thirst, sleep, hormones, and body temperature, among other important functions, monitors the level of thyroid hormone present in your bloodstream. If it determines energy levels are low, it sends out Thyroid Releasing Hormone (TRH) to your pituitary gland. Your pituitary gland, a pea-sized gland at the base of your brain, releases Thyroid Stimulating Hormone (TSH) directly to the thyroid.
Your thyroid is then prompted to produce thyroid hormone using an amino acid called tyrosine and iodine. It converts tyrosine into thyroglobulin and attaches between one and four iodine atoms, creating T1, T2, T3, and T4 respectively.
The primary output of your thyroid is T4, thyroglobulin plus four iodine atoms—a storage form of the hormone. It is circulated throughout the bloodstream and stored in tissues so it’s available when needed. A much smaller percentage of the hormones produced is T3, the active form of thyroid hormone. T2 and T1 make up an even smaller percentage, and although we now know T2 is involved in metabolism rate, researchers are still unsure of what role these two hormones play.
When each local area of your body determines that it needs active T3, it converts the storage T4 to active T3 using an enzyme called deiodinase. This enzyme strips one of the outside iodine atoms off of the T4, turning it into Free T3 (FT3). Your body also uses a portion of the T4 to create Reverse T3 (RT3). This is done by stripping away one of the inside iodine atoms, creating another inactive form of thyroid hormone that can attach to Free T3 receptors.
The T3 enters cell membranes with the help of cortisol and regulates how much energy your mitochondria produce. Your mitochondria are the “power plants” of your cells and there are trillions of them in your body. Free T3 acts as a gas pedal for the mitochondria, revving up power production. Reverse T3 acts as a brake pedal, slowing down the power.
These micro-level reactions are a part of your endocrine system and work to control important metabolic factors such as heart rate, fatigue, weight regulation, brain function, and more. When your thyroid isn’t functioning properly it can affect any or all of these separate systems, creating a wide array of symptoms that might seem unrelated yet can all be traced back to your thyroid.
What Can Go Wrong With Your Thyroid
The most common form of thyroid disease is hypothyroidism, which is when your thyroid is underactive and does not produce enough thyroid hormone.
This can happen because your pituitary gland is malfunctioning and not sending enough Thyroid Stimulating Hormone (TSH) to your thyroid, or your TSH levels are normal, but your thyroid isn’t producing enough T4 and T3 to adequately fuel your cells. I’ll explain how you can read your thyroid test results and what tests are done to check thyroid function later. Before that, though, let’s go over the signs of hypothyroidism.
Symptoms of Hypothyroidism
The underproduction of thyroid hormones leads to a decrease in the metabolic rate, which leads to a myriad of symptoms such as:
- Brain fog
- Weight gain or inability to lose weight
- Cold hands or feet
- Hair loss
- Poor concentration
- Low libido
- Decreased heart rate
- Decreased body temperature
One of the most common causes of hypothyroidism is Hashimoto’s Thyroiditis, an autoimmune disease where your immune system attacks your thyroid. Actually, most patients’ thyroid disease is triggered by an autoimmune condition. Autoimmune disease occurs when the immune system mistakenly attacks your own cells.
Many doctors who suspect a patient has something wrong with their thyroid only check their thyroid hormone levels, which indicate if the patient has hypo- or hyperthyroidism. They will likely not determine if it is caused by an autoimmune disease.
To get a complete picture of a patient’s thyroid health and medical needs, I recommend a doctor order all six tests listed below. It’s important that the results are read for optimal levels, not “normal” levels.
- TSH Levels: This test is based on the activity of the pituitary gland. A high TSH level indicates hypothyroidism whereas a low TSH level indicates hyperthyroidism. The optimal levels of TSH should be 1-2 UIU/ML or lower.
- Free T4 (FT4): FT4 refers to the unbound T4 – i.e. the one found in the bloodstream. High FT4 levels indicate hyperthyroidism whereas low FT4 levels indicate hypothyroidism. Optimal FT4 levels should be values greater than 1.1 NG/DL.
- Free T3 (FT3): High FT3 indicates hyperthyroidism whereas low FT3 indicates hypothyroidism. Optimal levels are values greater than 3.2 PG/ML.
- Reverse T3 (RT3): High RT3 levels indicate that there’s a high conversion of T4 to RT3 instead of FT3. This is an indicator of hypothyroidism. The optimal level compares the ratio of RT3 to FT3 and that value should be less than 10:1.
- Antibodies test (TPO – TgAb levels): Since the most common forms of thyroid disease are autoimmune diseases, detection of thyroid antibodies is essential to get an accurate result. There are two antibodies of concern: TPOAb and TgAb. TPOAb refers to the thyroid peroxidase antibodies that target the enzyme that mediates the iodination of thyroglobulin. TgAb refers to the antibodies that attack thyroglobulin. Optimal levels for both antibodies should either be negative or values lower than 4 IU/ML.
How to Prevent or Reverse Thyroid Disease
Managing your thyroid levels through thyroid medication is only part of the process. The real work comes in identifying the underlying factors that caused your thyroid disease and making healthy lifestyle changes to remove them. I call this The Myers Way®.
This proven approach is a lifestyle that relieves and reverses your symptoms of thyroid disease, helps you get off your harsh medication, and enables you to live a healthy, energetic, and pain-free life.
This approach rests on four pillars, each of which has been tested through extensive research and has seen amazing results with thousands of patients over my own years of practice as a physician and while empowering the world to achieve optimal health through Amy Myers MD®.
Pillar I: Heal Your Gut
Your gut is the foundation of your whole body’s health because 80% of your immune system is located there. Without a healthy gut, you can’t have a healthy immune system. Without a healthy immune system, you’re open to infections, inflammation, and autoimmune disease. I use the 4R approach to healing your gut:
- Remove the bad — get rid of things that negatively affect the environment of the GI tract such as inflammatory and toxic foods, and intestinal infections such as Candida overgrowth and Small Intestinal Bacterial Overgrowth (SIBO).
- Restore what’s missing — adding digestive enzymes to your daily regimen will help support optimal digestion and nutrient absorption, as well as assist your body’s intestinal repair and inflammation responses.
- Reinoculate with healthy bacteria — restore beneficial bacteria with probiotics to re-establish a healthy balance of good bacteria to heal your gut.
- Repair the gut — provide nutrients necessary to help the gut repair itself. Drinking bone broth or collagen will help heal your gut, as will supplementing with omega-3s, zinc, and herbs such as slippery elm and aloe vera.
Pillar II: Get Rid of Gluten, Grains, and Legumes
Leaky gut puts you on the autoimmune spectrum, which is why healing your gut is the first pillar of The Myers Way®. Once you’ve healed your gut, it’s time to make lifestyle and diet changes to put you on the path towards optimal health. One of the best ways to do that is through diet and eliminating foods that are causing inflammation and damage to your intestinal tract: gluten, grains, and legumes.
Pillar III: Tame the Toxins
Pillar III addresses and reduces your exposure to toxins, a poison or any substance that’s dangerous to the human body. That includes heavy metals such as lead, mercury, and cadmium, industrial chemicals and pollutants, and pesticides.
Unfortunately, toxins are also in common products such as home cleaning products, body products, even makeup. Every day, we are exposed to thousands of toxins through the air we breathe, the water we drink, the food we eat, and the products we put on our bodies.
Each exposure to toxins adds to your body’s toxic burden. Think of your body like a cup, and toxins like drops of water: if your cup is already full because you have leaky gut, a poor diet, infection, and stress, those small, cumulative toxic exposures cause that cup to overflow.
The best thing you can do to lighten your toxic burden is to prevent the toxins from getting into your system by drinking clean water, buying clean food and body products, and filtering your air.
Pillar IV: Heal Your Infections and Relieve Your Stress
When a patient isn’t getting better on the first few pillars of The Myers Way®, I always consider the possibility that an underlying infection could be at the source. Once you have a virus, the inflammatory immune response damages tissue, which then causes more inflammation and a stronger response from the immune system. Autoimmune disease develops from that chronic state of inflammation.
The relationship between stress and infections is complex. Your immune system responds to stress by producing inflammation, which is ordinarily a good thing as it produces cortisol to gear your body up for a challenge. However, when you have constant stressors in your life, your immune system never really gets to turn off. Your inflammatory immune response is activated for too long and eventually goes rogue, attacking your own bodily tissues. Pretty soon, your stress hormones try to suppress the response but go overboard, leaving you with a weakened immune system.
Addressing your infections and relieving your stress are necessary steps to get your immune system back to proper functioning. Adopting daily stress-relieving strategies such as exercise, dance, and meditation, will help give your immune system a boost.
To support optimal thyroid function while following The Myers Way®, I recommend adding The Myers Way® Multivitamin to your supplement regimen. This specially-formulated multivitamin is jam-packed with micronutrients in the forms your body wants and the amounts your thyroid needs. With optimal levels of thyroid-supporting minerals such as zinc, selenium, and iodine, alongside antioxidants including vitamins C and E and other free radical scavengers, no other multivitamin on the market does more to support your thyroid!
To get the additional benefit of supporting your thyroid health and immune system function, I designed my Hashimoto’s Support Plus Kit that includes The Myers Way® Multivitamin, along with Adrenal Support and ZenAdapt to facilitate optimal cortisol levels and a balanced stress response.
I personally lived with thyroid issues. I’ve spent my career perfecting the art of supporting thyroid health for myself and anyone who wants to achieve optimal health. I hope this information empowers you to take back your health!
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