If you often feel you’re dragging yourself through the day or you've been struggling to lose weight for a long while despite eating all the right things, it might be worth considering whether your thyroid is doing the job it should.
The thyroid – a butterfly-shaped gland located in the neck – is the body’s internal motor, effectively setting the speed at which the body works. If it’s not up to scratch, you might experience a whole host of uncomfortable or annoying symptoms (see below).
The hormones it makes affect most cells in the body by increasing the basal metabolic rate, as well as augmenting heat production. That’s why people with an underactive thyroid often struggle to lose weight, feel the cold more easily and have low energy – imagine a record player playing a record at reduced speed.
Do any of these sound familiar?
· I feel tired all the time
· My hands and feet are always cold
· I’m putting on weight for no reason
· I can’t seem to lose weight whatever I do
· I’m often constipated
· My muscles ache
· I get muscle cramps more often
· I feel irritable
· Generally, I’m feeling a bit low
· I’m struggling to fall pregnant
· My periods are heavier than usual
· My hair and skin feel so dry or you are losing hair
· My sex drive is flagging or non-existent
· I’m losing hair at the outer edge of my eyebrow.
· Raised cholesterol
If more than a few symptoms resonate with you, visit your GP to discuss symptoms and ask to get your thyroid tested as they could be a sign of an under active thyroid.
Testing
After a blood test at the doctor may tell you your results look normal, in which case no further action will be taken. Or you might be sent for further testing, if the result looks a little off, either immediately or for a retest in a few months’ time.
It’s much more common to have an underactive thyroid than an overactive one, and more common still for the underactive thyroid to be an autoimmune condition called Hashimoto’s, where the immune system destroys the thyroid gland to the extent that it can no longer function normally. However, even with a diagnosis, many people still experience symptoms in spite of treatment.
What actually gets tested?
In the UK, the first thing they will test is Thyroid Stimulating Hormone (TSH) levels. TSH is the hormone that tells your body to produce the actual thyroid hormones. If TSH is within range, your doctor may or may not do any further tests on the assumption that the rest of the thyroid hormone-producing cascade is working correctly.
If TSH is raised, your body is working harder than necessary to produce the right levels of thyroid hormones. At this point, they may repeat the TSH test in a few months in order to compare levels.
Alternatively, they might test your Thyroxine (T4) levels to determine whether or not you’re producing the right levels of this hormone. If this level is below range, or above range, you may be prescribed medication to support this. If you are struggling to fall pregnant or have absent/irregular periods they may also test your prolactin levels. High levels can be linked with hypothyroidism.
Still feeling tired and ‘rubbish’ despite treatment?
This a common problem. Initially, you may start to feel better, but many patients report sliding back into their previous pattern of symptoms.
The reasons why you’re not feeling better can be complex.
Supplementing with T4 might not work, as what’s going on in your body might be more complicated and involve several issues.
Some people produce enough TSH and T4, but T4 isn’t actually the hormone that does the work.
Triidothyronine (T3) is the ‘work horse’ that needs to be converted in the liver from T4. Some people, for various reasons, simply don’t convert it very well.
In other cases, you might produce enough TSH, T4 and T3, but the body negates the effects of the usable T3 by making reverse T3 (rT3) –literally reversing the action of T3.
Everything may ‘look normal’, but if you’re still dragging yourself through the day, you could have sub-clinical thyroid problems.
It’s worth knowing that regular testing does not always cover T3 or rT3, so if you’re still feeling below par, it’s worth getting a full thyroid blood screen done privately. I work with all major private laboratories and can arrange this for you.
Do you have an autoimmune thyroid problem?
Another vital piece of information is to test, for the presence of autoimmune thyroid antibodies (thyroid peroxidase and thyroglobulin). This indicates your immune system is attacking your thyroid.
The autoimmune disease Hashimoto’s Disease (a form of underactive thyroid) is incredibly common but unless you test for the antibodies, you won’t know that you have it. However, this test is important to nutritional therapists, as the diagnosis requires an entirely different treatment protocol.
You may have high levels of these antibodies, but no symptoms of an underactive (or overactive) thyroid. The autoimmune element always comes first. Hashimoto’s (underactive) and Graves’ (overactive) Disease affect the thyroid, but they are actually immune system disorders.
Adrenal stress - the missing link in thyroid treatment
Thyroid health is closely connected with your adrenals (two walnut-shaped stress glands located on your kidneys). If you have had any significant stress, your adrenal glands may not be performing optimally – and this is very bad news for thyroid health. Adrenal stress disrupts the complex network of interactions needed to make the right amount of thyroid hormones, suppressing the thyroid function.There are tests available privately for this. Addressing adrenal problems is important because the effects of stress affect energy production, fat storage (storing fat around the middle) and female hormone health.
Impact of oestrogen and progesterone on your thyroid
To little oestrogen may result in you lacking thyroid tissue and a lack of the hormone precursor thyroglobulin however to much of a good thing can potentially enlarge your thyroid gland. Oestrogen also raises the amount of protein which transports thyroid hormones in your blood, to much of this results in too little unbound thyroid hormones free to enter cells where it is needed.
Progesterone and your thyroid hormones are very interlinked you need good levels of thyroid hormones to support your ovaries to make progesterone. This hormone decreases the amount of protein carriers mentioned above therefore leaving more unbound thyroid hormones circulating to do their job.
So, you can see it is all a balance of your thyroid and sex hormones working in harmony together. It is key to think about this when looking at your dose on HRT as some people increase their oestrogen rapidly which as you can see may impact their thyroid making them feel symptoms and instead of looking at their thyroid, they may increase their oestrogen further to help with symptoms and the cycle continues.
The importance of iodine
Did you know that the mineral iodine is essential for the manufacture of thyroid hormones triidothyronine (T3) and thyroxine (T4)? Thyroid hormones contain three or four iodine atoms respectively. If you’re serious about fixing your thyroid for once and for all, you could consider a urine test to determine whether or not you have sufficient levels of iodine. Do not just take iodine as it can make the situation worse if you have Hasimoto’s for example.
A guide to nutrition and how to support your thyroid
Iodine is not the only nutrient the thyroid needs to make thyroid hormones. Selenium and zinc are also required. Both activate thyroid hormones, and zinc is also necessary to produce TSH. In developed countries, zinc is abundant in food, but selenium deficiency is common as our soils are depleted of this trace element. If selenium is missing, the thyroid hormone triiodothyronine (T3) cannot be activated. The trace element also has an anti-inflammatory effect on Hashimoto's disease.
Needless to say, I recommend a real food diet to start with – as always. This will give your body what it needs and avoid what it doesn’t. It is always advisable to go for minimally-processed foods.
Protein - at every meal - helps to keep you fuller for longer. Good protein sources are dairy products (if tolerated), fish, meat, pulses and mushrooms.
Vegetables - prepared with high-quality oils, supplemented by low-sugar fruit (such as berries).
Fish - Sea fish such as haddock, plaice, pollock and cod are excellent sources of iodine and omega-3s. Seafood and seaweed also contain the trace element. Doesn’t that sound like sushi makes excellent thyroid food?
Meat - selenium is found in reasonable amounts in pork and offal (liver and kidney).
Eggs – a great source of protein that comes with selenium and iodine, especially in the yolk.
Gluten-free grains and seeds - rice, buckwheat, quinoa – but not millet (see below), chia and flaxseed
Nuts – are good sources of all trace elements. Brazil nuts supply the most selenium; cashews contain iodine.
Other selenium-rich foods are salmon, mushrooms, and wheatgrass powder.
Omega-3 fatty acids – apart from fish, you can get some from high-quality linseed or hemp oil. Note, however, that omega-3s from plant sources alone are not enough. If you do not eat fish, consider supplementing with algae oil, which contains the long-chain omega-3s that you need.
Phytonutrients from colourful vegetables and spices such as dark cocoa, cinnamon, ginger, pepper, turmeric have an anti-inflammatory effect.
Prebiotics (dietary fibre) and probiotics strengthen the intestinal flora. Think sauerkraut, yoghurt, miso, tempeh. An intact intestinal flora may also make losing weight easier.
Drinks: preferably water, coffee (max. 3 cups), herbal tea (fennel, chamomile, dandelion, yarrow, sage) and vegetable juices.
Foods the thyroid is not keen on
Sugar and refined starches – have a pro-inflammatory effect and only serve to fuel the fire. Starch turns into sugar in the digestive process, so its impact is the same. Avoid sugar, sweets, cakes, biscuits, chocolate, ice cream and the like.
Some foods can promote the formation of a goitre. These “goitrogenic” foods interfere with iodine metabolism and thus thyroid hormone production. They include uncooked cabbage and other cruciferous vegetables like broccoli and cauliflower, mustard, radishes, and horseradish as well as soya foods[i], millet[ii]. To render the goitrogens in the veg harmless, you can cook them. Limit your intake of raw cabbage (think coleslaw), but don’t worry about sauerkraut and kimchi. Here, the fermentation has made the cabbage safe. It's the same with soya: fermented soya products such as fermented tofu, tempeh, natto or tamari no longer exert a goitrogenic effect.
What about dairy?
Milk and yoghurt are decent sources of selenium and iodine. Cheese provides iodine, too. However, dairy also contains a protein called casein that causes problems in many people. I recommend getting tested. If casein affects your thyroid health, you may feel much better without dairy. Note that sensitivity to dairy is not the same as lactose intolerance. Lactose is a sugar contained in milk. Antibodies are formed only as a reaction to proteins – in this case, casein. So, purchasing lactose-free milk is not going to help!
Ready to get that thyroid back into shape?
There are a number of different tests, which we can use to measure your thyroid levels. These include a full blood draw, finger prick blood spot test and a urine test. I take a full medical history and evaluate my clients before deciding on the best option. If you have an underactive thyroid and are feeling below par, despite medication, I can help. Medication is just a piece of the puzzle. Why not contact me here
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