Author's Perspective: When I was running one of the diabetic support groups for the American Diabetes Association, I met quite a few diabetics who were having problems with an underactive thyroid.
At that time, I didn't really understand the connection between the thyroid and diabetes and why it appeared that so many people with diabetes were having problems with their thyroid.
After doing some research, I discovered that thyroid disorders are very common, affecting at least 30 million Americans.
Thyroid disorders are second only to diabetes as the most common condition to affect the endocrine system — a group of glands that secrete hormones that help regulate growth, reproduction, and nutrient use by cells. As a result, it is common for an individual to be affected by both thyroid disease and diabetes.
Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes.
In addition, untreated thyroid disorder can increase the risk of certain diabetic complications and can aggravate many diabetes symptoms. Consequently, periodic screening for thyroid disorder should be considered for all people with diabetes.
Unfortunately, most of the medical approaches and even the alternative approaches to treating thyroid problems are haphazard at best.
Because so many of my clients came to me for help, I designed a structured 10-step autoimmune diseaseswellness program and customizable nutritional program to improve the health of the thyroid along with treating several other common autoimmune diseases.
Then, I documented the program and my findings along with my research in the DTD How to treat Autoimmune Diseases Naturally book.
The thyroid is a butterfly-shaped gland located in the neck, just below the Adam’s apple and above the collarbone. The thyroid produces two hormones, thyroxine (T4) and triiodothyronine (T3), which enter the bloodstream and affect the metabolism of the heart, liver, muscles, and other organs.
The thyroid gland operates as part of a feedback mechanism involving the hypothalamus, an area of the brain, and the pituitary gland, which is located within the brain.
First, the hypothalamus sends a signal to the pituitary through a hormone called TRH (thyrotropin-releasing hormone). When the pituitary gland receives this signal, it releases TSH (thyroid-stimulating hormone) to the thyroid gland.
Upon receiving TSH, the thyroid responds by producing and releasing the two thyroid hormones (T3 and T4). The pituitary gland “monitors” the level of thyroid hormone in the blood and increases or decreases the amount of TSH released, which in turns regulates the amount of thyroid hormone produced.
So, in a disease like hypothyroidism, when there is too little T3 and T4 produced by an underactive thyroid, the pituitary produces more TSH, which tells the thyroid to produce more T3 and T4.
And, in a disease like hyperthyroidism, when there is too much T3 and T4 produced by a hyperactive thyroid, the pituitary produces less TSH, which tells the thyroid to produce less T3 and T4.
Function of the Thyroid
Thyroid hormone regulates the way the body uses energy. It works by attaching to specific proteins called receptors that are present in cells throughout the human body. Therefore, thyroid hormone exerts wide-ranging effects in regulating the function of virtually every organ.
Consequently, any changes in the blood level of thyroid hormone can affect many body systems and cause a wide range of symptoms.
The extent to which each organ is affected varies widely between individuals, which is why thyroid dysfunction causes very different symptoms in different people.
In general, the severity of symptoms of abnormal thyroid function depends on the severity of the actual condition, the length of time it has been present, and the person’s age.
The hypothalamus (located in the brain) sends signals to the pituitary gland, located beneath it, to create hormones that stimulate other organs. One of these is Thyroid Stimulating Hormone, more commonly known as TSH. TSH tells your thyroid to produce thyroid hormones such as thyroxine, also known as T4.
The “T” stands for tyrosine, which is the amino acid that 4 iodine atoms are attached to. A healthy person produces, on average, around 100 mcg T4 and 6 mcg T3 daily.
T3 or triiodothyronine, which is tyrosine with 3 iodine atoms attached, is the biologically active thyroid hormone that raises metabolism when it fits into a T3 receptor site in a cell. This is analogous to a key fitting into a lock. Without sufficient T3, the body doesn’t function well, and in extreme cases, lack of T3 causes a condition called myxedema coma.
In a healthy person, T3 converts from T4 by an enzyme that strips one iodine atom off a T4 molecule, resulting in a T3 molecule. A different enzyme will convert a T4 molecule into a reverse T3 (rT3) molecule, by removing an iodine atom from a different position.
Both T4 and rT3 do not directly increase metabolism, though they do have other essential functions. A healthy body has T4, T3 and rT3 in the correct proportions, with T4 being the dominant hormone.
The hypothalamus and pituitary work off feedback loops, similar to a thermostat in a house. If you turn the heat on in a cold house, a thermostat will sense the air temperature, and when the temperature drops below a certain level, the heat will turn on, warming the house until the temperature reaches the desired level.
Then the system automatically shuts off, until the temperature again drops below the set level. The heater only turns on when the thermostat indicates it’s too cold.
This is a simple feedback loop, and similar to how the TSH works. TSH (from the pituitary) will rise when the body senses that thyroid levels are too low. A high TSH is a signal to make more thyroid hormone.
Severely hypothyroid patients have reported TSH levels in the 100s, while a healthy TSH is closer to 1.0. A very low TSH (near zero) may indicate hyperthyroidism or too much thyroid hormone in the body, but many people on replacement thyroid medications have a suppressed TSH with normal T4 and T3 levels.
In the same way that thermostats can break and become unreliable, so can a damaged hypothalamus or pituitary result in insufficient TSH signals. The TSH will not be a reliable gauge of thyroid levels.
A car accident or a hit to the head from a sports injury can damage either the hypothalamus or pituitary, resulting in what is called tertiary or secondary hypothyroidism. Severe blood loss from an accident or childbirth can also damage the pituitary, again resulting in a broken feedback TSH signal.
For this and multiple other reasons explained in another section, TSH is not a reliable indicator of thyroid levels.
To review: Thyroid hormone is produced in the thyroid gland in the neck, acting on the TSH signal produced by the pituitary gland in the brain.
In a similar manner, cortisol is a hormone produced in the adrenal gland located above the kidneys, in response to an ACTH signal produced by the pituitary gland in the brain. ACTH stands for Adrenocorticotrophic Hormone.
Thyroid and cortisol work together in a healthy person, so lack of either hormone creates health problems. Normally, thyroid and cortisol will rise and fall in tandem, so as thyroid levels fall, so do cortisol levels. Likewise, raising thyroid levels slowly can raise cortisol levels.
Interestingly, if someone suspects they have low cortisol or adrenal fatigue, a lab test to determine cortisol levels is run first. ACTH, the pituitary hormone, would only be tested later to determine if a deficiency in ACTH is the cause of the abnormal cortisol result.
This is in direct contrast to thyroid testing, where the pituitary hormone TSH is tested first, and actual thyroid hormones (T3 and T4) may not even be checked.
As stated earlier, a normal TSH does not necessarily mean that thyroid levels are healthy. This is the major flaw with current thyroid treatment:
TSH is a pituitary hormone, not a thyroid hormone, that does not fit into a T3 receptor site, and therefore excessive or deficient TSH levels cannot cause one to be hyper or hypothyroid. Only excessive or deficient T3 (and T4) levels can cause hyper or hypothyroidism. Someone can be severely hypothyroid with a normal TSH.
For more information about thyroid testing, refer to the "What Your Doctor May Not Know" section below.
Medical Diagnosis & Testing: Hypothyroidism
Having your doctor perform a complete thyroid panel is the best way to understand your thyroid health. Even if you’ve had lab testing completed in the last year, you may need to retest if you are now having symptoms.
Some doctors will only order the TSH test, so make sure that your doctor includes the following tests, which are usually part of a complete thyroid panel:
- Total T4
- Total T3
- Free T4
- Free T3
- Reverse T3
Once you have your blood work, your doctor can evaluate your thyroid health and understand if your thyroid is the cause of your symptoms.
If your doctor is not able or willing to order these tests, you should find a practitioner who will. This is an absolutely essential step to understanding how to heal your thyroid.
Getting a proper medical diagnosis is important, because an improper diagnosis will lead to more problems, frustration, anxiety, etc.
FYI: Here is some general information about possible scenarios and interpretations of test results. But, keep in mind that this information is general and not patient-specific.
The pituitary gland, located in the head, responds to a thyroid deficiency by secreting more TSH. Thus, in more mild cases of primary hypothyroidism, T4 and T3 levels are normal, but the TSH from the pituitary gland is high.
In more severe cases, T4 and T3 levels drop. Although the normal range for TSH is often between 0.5 and 5 mU/mL, values at the high end of the normal range may be abnormal. T3 is the more bioactive hormone compared to T4, but T4 is more stable in the circulation.
A better approach to diagnosing hypothyroidism is to start with a careful history and physical and a complete thyroid hormone panel test that includes Blood TSH, free T4, free T3 and anti-TPO antibodies.
In general, patients with an enlarged thyroid and/or a positive anti-TPO antibody test and a TSH greater than 4.0 mU/mL should be considered to have primary hypothyroidism.
In general, patients without an enlarged thyroid and without a positive anti-TPO antibody test but with a TSH greater than 7.5 mU/mL should also be considered to have primary hypothyroidism.
Patients with a free T4 of less than 0.9 mg/dL and a TSH less than 1.0 mU/mL are likely to have central hypothyroidism. Patients with symptoms of hypothyroidism but who do not meet these criteria should be watched and retested in 6 months.
Additional Medical Tests: Your Gut!
Your gut and thyroid are intimately connected. To heal your thyroid you must heal your gut.
Your gut is a major site of thyroid hormone conversion — meaning it activates your thyroid hormone to increase your energy, mood, metabolism and so much more.
And your gut is where your immune system lives!
Since the majority of thyroid disease is due to immune dysfunction and 60-80% of your immune system is in your gut, then it makes sense that you would need to heal your gut to balance the immune system and heal your thyroid.
Some of the tests that may be necessary to understand the health of your gut include:
- Intestinal permeability (evaluate Leaky Gut)
- Food sensitivity testing
- Comprehensive Stool Analysis
- Parasitology (Stool Ova & Parasite Test)
- H. pylori breath test
- Lactulose breath test (evaluate SIBO)
Please Note: According to some of the latest research, hypothyroidism is being over-diagnosed (misdiagnosed), leading to people taking unnecessary drugs that acerbate the problem! Instead, educate yourself about the thyroid and get additional testing (beyond the TSH, free T3, free T4 tests), including TPO and anti-thyroglobulin antibodies. Plus, look for other health issues such as celiac disease, low vitamin D levels, heavy metal toxicity, autoimmunity, etc.
Note: For more information about medical diagnosis, TSH testing, etc., refer to the Death to Diabetes Blog at: http://deathtodiabetes.blogspot.com/2016/05/thyroid-disease-and-diabetes.html
Why So Much Confusion With Thyroid Testing?
If you are frustrated with trying to figure out what is going on with your thyroid, you're not alone. Thyroid misdiagnosis is one of the top misdiagnoses made by doctors.
Whether it's the family doctor, endocrinologist, naturopathic doctor, functional medicine doctor, chiropractor, or an herbalist, you may not be getting the right information about your thyroid.
Here are some of the medical diagnosis scenarios major myths and misunderstandings concerning why so many people struggle with thyroid problems after a medical diagnosis and drug treatment:
Scenario #1. Your Levels Are Normal: First, what does "normal" mean? A decade ago, the medical community went by the standard that .5 to 5.0 on the Thyroid Stimulating Hormone (TSH) blood test was the normal range.
If your TSH was below .5, you were hyperthyroid/overactive. If your TSH was above 5.0, you were hypothyroid/underactive. In 2002, both the American Association of Clinical Endocrinologists and The National Academy of Clinical Biochemistry's "Laboratory Medicine Practice Guidelines," recommended that the normal range be revised to .3 to 3.0.
Then, several years later, they abandoned these recommendations. You may have a TSH level in the "normal" reference range, but if you are in the higher end of the range, some physicians do not believe that it necessarily normal or healthy for you. When a doctor tells you your levels are "normal," ask what "normal range" he/she is actually using to make that determination.
Scenario #2. It's your thyroid -- take this. Many times, doctors jump to the solution without understanding the problem. It's not their fault -- they have been trained to focus on drugs (or surgery) as the solution to your health problems.
Unfortunately, we assume that our doctor knows what he/she is doing when they prescribe a specific medication. It isn't until we start to have more problems with our thyroid or some other part of the body that we realize that they may not know what they're doing.
This is why it's so important for you to understand as much as you can about your thyroid and the other parts of your body. As you can see from the diagram (below), the thyroid has major effects on other body systems and other body systems have major effects on the thyroid.
Systems and organs of the body that are affected by the thyroid include the following:
- Adrenal Glands
- Blood Glucose
- Cardiovascular System (Circulatory)
- Digestive System
- Gall Bladder
- Nervous System
- Red Blood Cells (Anemia)
- Reproductive System
- Skeletal System
Major Organs & Systems Affected by the Thyroid Gland
The thyroid gland is interconnected with blood glucose control, metabolism, weight control, small intestine function, and other systems in the body.
In other words, diabetes (blood glucose regulation), thyroid problems, inflammation, and autoimmunity are interconnected. Why is this important?
Because if you try to diagnose and "fix" a thyroid problem by taking a thyroid drug, the drug does not address the interdependencies that may be affecting the thyroid, e.g. leaky gut, chronic inflammation, autoimmune dysfunction, etc.
Similarly, if you have a blood glucose regulation problem, taking insulin to lower your blood glucose, does not address other factors that may be driving your blood glucose levels, e.g. leaky gut, chronic inflammation, thyroid dysfunction, autoimmune dysfunction, etc.
This is just one of the many reasons why a thorough set of blood tests and hormone testing is critical to help deteminre a proper diagnosis.
Note: If you want to know how each of these organs and systems are affected by the thyroid, refer to the Death to Diabetes Blog post, Organs and Systems Affected by the Thyroid.
Given the many systems and parts of the body that are affected by your thyroid, that means there is a very good reason why you are experiencing the symptoms that you have. There are very clear reasons why your body is experiencing what it is going through.
The goal of this information is to help you to understand how all this works in simple layman terms, so that you can discover how to get control of your health without having to rely on a lot of drugs.
Note: For more details, get the author's DTD Autoimmune Diseases & Natural Treatment Strategies ebook, which includes nutritional, herbal and lifestyle strategies for optimizing the health of your thyroid and rebalancing your immune system.
Scenario #3. The Only Treatment for Hypothyroidism Is Synthroid. Perhaps one of the most common fallacies doctors regularly repeat is that Synthroid is the only treatment for hypothyroidism. In many cases, this drug works initially so most patients believe that the drug has fixed the problem.
Unfortunately, within a year or more, the patient begins to have more problems and usually the symptoms return with additional symptoms.
At this point, the doctor usually increases the dosage or adds an additional medication. And, if you're diabetic, you find that you can no longer control your blood sugar! But, your doctor will blame that on your diabetes, not your thyroid! So, now you have two major problems and you're taking even more drugs ...
Actually, Synthroid is a brand name for the drug "levothyroxine" — a synthetic form of the thyroid hormone thyroxine, also known as T4.
Synthroid happens to be the top-selling brand-name levothyroxine drug, primarily due to its marketing. Synthroid, however, is almost always the most expensive levothyroxine. Other brands, considered equally effective by many practitioners, and almost always less expensive, include Levoxyl and Unithroid. Some patients find that they respond best to a one brand—not necessarily Synthroid—due to the way that brand dissolves and is absorbed, or the fillers and dyes used by the different manufacturers.
In addition to the levothyroxine drugs, there is also liothyronine—the generic name for the T3 hormone. The brand name is Cytomel. Adding T3 to levothyroxine has been found to help some thyroid patients relieve symptoms more effectively than levothyroxine (T4) alone.
Finally, there is the category of prescription drugs known as natural desiccated thyroid. Don't mistake these with over-the-counter glandular thyroid supplements—they are not the same. Prescription natural desiccated thyroid—the primary brand being Armour Thyroid, but also available are Nature-throid, Thyroid WP, and a generic made by Acella—is made from the dried thyroid gland of pigs. It includes natural T4 and T3, plus other less-understood thyroid hormones including T2, T1. Some practitioners, and in particular holistic, integrative and natural health experts, find that natural thyroid is optimal for some patients.
Scenario #4. If You Have a Thyroid Problem, Take Iodine or Kelp. Natural health practitioners who don't truly understand thyroid function are often quick to tell you that "thyroid problems mean you need iodine" or iodine-containing herbs or supplements, such as kelp, bladderwrack and bugleweed.
If you are truly iodine deficient, iodine may be able to help your thyroid. Studies have shown that iodine deficiency is actually on the rise in the U.S., and about 12% of the U.S. population is currently iodine deficient, up from less than 3 percent in the early 1970s. So, for some people, iodine deficiency may be a factor in their thyroid problem.
But for some people, iodine or iodine-containing products may worsen autoimmune thyroid problems such as Hashimoto's and Graves' disease, and cause enlargement of the thyroid (goiter). Before you start iodine, consider having urinary iodine measured to see if you have an actual deficiency, and pay close attention to any symptoms that develop after you start to take iodine.
Scenario #5. You Have Graves' Disease/Hyperthyroidism and Need Radioactive Iodine (RAI) Treatment. When it comes to autoimmune thyroid disease, Hashimoto's disease, which usually results in hypothyroidism, is the far more common than Graves' disease, which causes hyperthyroidism. At some stages of Hashimoto's disease, however, and in particular, often during the early stages, the thyroid that is in the process of autoimmune failure may actually spurt into action and become temporarily overactive, making a person hyperthyroid. Sometimes, it's the temporary hyperthyroidism symptoms—anxiety, heart palpitations, fast pulse, weight loss, diarrhea, insomnia—that first bring a Hashimoto's patient to the doctor.
Unfortunately, some doctors order a TSH test, see the low TSH that is characteristic of hyperthyroidism, and recommend radioactive iodine treatment—a usually permanent treatment that disables your thyroid, and makes you hypothyroid for life!
The problem is that in these cases, it's not Graves' disease, and the hyperthyroidism is just temporary, a condition known as "Hashitoxicosis." In this case, you may have a temporary period of hyperthyroidism, but actually be on your way to becoming hypothyroid. In some cases, unless the hyperthyroidism is life-threatening and uncontrollable using drugs, the expensive radiation treatment is needless.
If you are told that you have Graves' disease or hyperthyroidism, and are rushed to have RAI, insist on blood tests for antibodies that confirm Graves' disease, as well as imaging tests.
You want your physician to demonstrate that you do indeed have Graves'/hyperthyroidism, and are not just experiencing temporary Hashitoxicosis.
6. Basal Body Temperature Can Diagnose Hypothyroidism
Here is a situation where a clinical sign—low body temperature, has been turned into a "one size fits all" diagnostic tool that simply doesn't work.
It's medically known that thyroid hormones have a direct effect on the basal, or resting, metabolic rate. And while hypothermia, or lowered body temperature, is a known and medically accepted symptom of hypothyroidism, some practitioners believe that body temperature is an infallible diagnostic tool.
The late Broda Barnes, M.D. made the public more widely aware of the use of axillary (underarm) basal body temperature (BBT) as a symptom and diagnostic tool for hypothyroidism. It is a diagnostic and monitoring method still used by some complementary and alternative practitioners.
To measure your BBT, use a special BBT thermometer. As soon as you awake, with minimal movement, put the thermometer in your armpit, next to the skin, and leave it for ten minutes. Record the readings for three to five consecutive days. Women who still have their menstrual period should not test on the first five days of their period but can begin on day five. Men, and girls and women who are not menstruating can test any time of the month.
If the average BBT is below 97.6 Fahrenheit, some complementary practitioners would consider a diagnosis of an underfunctioning thyroid or insufficient thyroid hormone replacement. An average BBT between 97.8 and 98.2 is considered normal. Temperatures from 97.6 to 98.0 degrees Fahrenheit are considered evidence of possible hypothyroidism, and temperatures less than 97.6 degrees can be even more indicative of hypothyroidism. Some practitioners, however, consider any temperature under 98 degrees to be indicative of hypothyroidism.
Use of basal body temperature is controversial, however, and even those practitioners who use the test caution that it should be part of an overall approach, and not solely relied upon.
While more research needs to be done, it is generally accepted that diet plays a major role in thyroid health.
Iodine deficiencies, vegetable oil, gluten and soy consumption, and fluoride exposure are all causes of the hypothyroidism epidemic.
But, as depicted in the following diagram, there are many other factors besides diet that can lead to hypothyroidism and other thyroid-related diseases.
Hypothyroidism generally strikes women, causing fatigue, weight gain, and cancers amongst many other problems. Therefore, we recommend topical applications of iodine (if iodine-deficinet), because there is no known toxicity when it is absorbed through the skin into the blood. No person anywhere understands why, but it is a verifiable fact that low to moderate amounts of iodine are harmless when absorbed transdermally.
Organic iodine is found in some foods naturally, including eggs, sea salt, cheese, asparagus, garlic, beans, spinach, and beef. As is usual with all of the critical minerals, iodine is found in higher amounts in organic foods, and there is no comparison between organic iodine and the chemically synthesized versions of iodine found in retailer products and or those so often sold by quacks. The difference is a glaring example of the difference between God-made and man-made foods.
For decades we have known that low iodine intake leads to low thyroid function and eventually to goiter. Iodized salt was intended to solve this problem, but it has not been the answer.
There are a number of foods known as goitrogens that block iodine. Two goitrogens are quite prevalent in the American diet — peanuts/ peanut butter and soybeans used most often in prepared foods as textured vegetable protein (a refined soy food) and soybean oil.
The rise of industrialization, corporate farming, and mass production of food has drastically changed our food supply from what our ancestors ate. Many studies show the detrimental effects of refined sugars and grains on our health. These foods are very taxing on the thyroid gland, and we consume them in large quantities.
Recent studies indicate that our over-consumption of processed soy foods have contributed to the increase in thyroid problems and other hormone-related issues, especially in women. All soy foods (except fermented foods) should be avoided.
Environmental factors such as chemical pollutants, pesticides, mercury, and fluoride are also tough on the thyroid. A growing body of evidence suggests that fluoride, which is prevalent in toothpaste and water treatment, may inhibit the functioning of the thyroid gland.
Additionally, mercury may diminish thyroid function because it displaces the trace mineral selenium, and selenium is involved in the conversion of thyroid hormones T4 to T3.
In addition, many vegetable oils and canola oil can negatively affect thyroid health. We cook with them almost every day and they are plentiful in commercially prepared foods.
It is possible that these oils are among the worst offenders when it comes to the thyroid. The most common source of these vegetable oils used in commercially prepared foods is the soybean.
Traditionally, polyunsaturated oils such as soybean oil have been used for livestock feed because they cause the animals to gain weight. These oils are made up of what is known as long chain fatty acids—the kind of fatty acids that promote weight gain.
The fattening effect of polyunsaturated oils (primarily soy and corn) is due to the presence of linoleic and linolenic acids, long-chain fatty acids, which have an anti-thyroid effect.
In the 1940s, the fat from pigs (lard) was highly desirable, as were most saturated fats. Chemical toxins were used to suppress the thyroid function of pigs, to make them get fatter while consuming less food.
When that was found to be carcinogenic, it was then found that corn and soy beans had the same anti-thyroid effect, causing the animals to be fattened at low cost. The animals' fat becomes chemically similar to the fats in their food, causing it to be equally toxic, and equally fattening.
Today, saturated fats are fed to pigs to keep them lean, while most people buy polyunsaturated soy and corn oils in the grocery stores as their primary cooking oil! So we have a population now characterized by lean pigs and obese people ...
Hypothyroidism, Insulin Resistance and Inflammation
Another cause of weight gain that is often associated with hypothyroidism is insulin resistance. Insulin resistance prevents the body from using its own insulin efficiently. Those who are insulin resistant become immune to the insulin's effect on cells. This means that more insulin is being produced with fewer results. This causes the pancreas to work overtime and the body ends up storing more fat.
Insulin resistance also prevents the body from using this fat as energy stores. Because of this, the insulin responds to things such as carbohydrates and causes a person afflicted with the condition to gain weight, or not be able to lose weight. Hypothyroidism, which will already cause everything in the body to slow down, can often lead to, or cause, insulin resistance.
Another major factor that affects thyroid function is chronic inflammation. The biggest source of this chronic inflammation is gluten, the protein found in wheat, barely, rye, spelt, and oats. Gluten is a very common allergen that affects about 10 to 20 percent of the population. This reaction occurs mostly because of a damaged (leaky) gut, poor diet, and stress.
These three conditions make weight gain inevitable. Also, insulin resistance and chronic inflammation are key drivers of Type 2 diabetes. So, if you're a Type 2 diabetic, you are almost guaranteed to gain a lot of weight under these conditions.
The best way to address this from a dietary perspective is to adopt a plant-based diet of low-carbs (vegetables, lentils), plant oils (ev olive oil, coconut oil), and lean protein (free-range chicken fish, nuts & seeds).
In addition, you should avoid all grains and wheat products; and, eat only gluten-free foods.
This combined with regular exercise is the best way to treat hypothyroidism and insulin resistance.
For some of you with Type 2 diabetes, you're probably already aware that diabetes affects your diabetes and blood glucose levels. But, you may not be aware that diabetes can affect your thyroid.
Recent studies and statistics indicate an increase in thyroid disorders in people with diabetes; and, an increase in blood glucose problems in people with thyroid disorders.
Consequently, as a diabetic, another benefit of keeping your blood glucose in the normal range is to having a healthy thyroid. Otherwise, high blood glucose levels can cause damage to the thyroid gland, especially if you have an autoimmune thyroid disease. As the thyroid gland is destroyed, thyroid hormone production decreases.
Consistently low blood glucose levels (i.e. hypoglycemia) can indirectly affect the thyroid. When your blood glucose levels drop below normal, your adrenal glands release cortisol to tell your liver to release stored glycogen, bringing your blood glucose levels back to normal.
Unfortunately for hypoglycemics, repeated releases of cortisol caused by too many episodes of low blood glucose suppresses pituitary function. And, without proper pituitary function, your thyroid can’t function properly.
In addition, high blood glucose levels and low blood glucose levels can weaken and inflame the gut, lungs and brain; exhaust the adrenal glands; disrupt detoxification pathways; and, impair metabolism. Each of these effects significantly weakens thyroid function. So, as long as you have blood glucose control problems, whatever you do to fix your thyroid isn’t going to work -- unless you follow an effective diabetes nutritional program, such as the Death to Diabetes Nutritional Program.
On the other hand, if you're not diabetic, but, you have low thyroid function, this can affect your blood glucose levels. Low thyroid function can affect you by:
- Slowing the rate of glucose uptake by cells;
- Decreasing the rate of glucose absorption in the gut;
- Decreasing insulin sensitivity to elevated blood glucose; and,
- Slowing the clearance of insulin from the blood.
So, when you’re hypothyroid, your cells aren’t very sensitive to glucose and you’ll have the symptoms of hypoglycemia (e.g. fatigue, headache, hunger, irritability, etc.). And since your cells aren’t getting the glucose they need, as mentioned earlier, your adrenals will release cortisol to increase the amount of glucose. And, this causes a chronic stress response that suppresses pituitary function andthyroid function.
When the thyroid gland is attacked by the immune system, it can manifest into one of the following autoimmune disorders or diseases:
- Hashimoto's Thyroiditis
- Grave's Disease
Hypothyroidism is a relatively common disorder that affects women more often then men. The incidence of hypothyroidism increases with age.
Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. If your pituitary gland makes too much TSH causing your thyroid to make too little triiodothyronine (T3) and thyroxine (T4), this is defined as hypothyroidism.
Common symptoms of hypothyroidism include:
- Dry, cold skin
- Feeling cold
- Hair loss
- High cholesterol
- Joint pain
- Menstrual irregularities
- Slow reaction time
- Weight gain
The pituitary gland at the base of the brain controls hormone production in your body. It makes thyroid-stimulating hormone, or TSH, which tells the thyroid gland how much T4 and T3 to produce.
The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. If your TSH levels are abnormally high, it could mean you have an underactive thyroid, or hypothyroidism.
This may seem confusing, but, TSH levels go in the opposite direction of your thyroid hormone. If you’re making too little thyroid hormone, your TSH will go up. If you’re making too much thyroid hormone, your TSH will go down.
Since the main purpose of thyroid hormone is to "run the body's metabolism," it is understandable that people with this condition will have symptoms associated with a slow metabolism.
There are two fairly common causes of hypothyroidism. The first is a result of previous (or currently ongoing) inflammation of the thyroid gland, which leaves a large percentage of the cells of the thyroid damaged (or dead) and incapable of producing sufficient hormone.
The most common cause of thyroid gland failure is called Hashimoto's Thyroiditis (or autoimmune thyroiditis), a form of thyroid inflammation caused by your own immune system.
The second major cause is due to "medical treatments" where the treatment warrants surgical removal of a portion or all of the thyroid gland. If the total mass of thyroid producing cells left within the body are not enough to meet the needs of the body, the patient will develop hypothyroidism.
Hashimoto's Thyroiditis is not only the most common form of thyroiditis (inflammation of the thyroid gland) but also the most common thyroid disorder in America.
The disease, which is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis, affects more than 14 million people in the United States alone.
Hashimoto's thyroiditis causes immune cells to mistakenly attack healthy thyroid tissue, causing inflammation of the thyroid. If Hashimoto's thyroiditis attacks your thyroid to the point that the gland can no longer produce enough thyroid hormones for your body to function properly, then you will develop hypothyroidism.
But hypothyroidism isn't the only complication associated with Hashimoto's thyroiditis. In some people, the disorder causes the thyroid to become so inflamed and enlarged that a goiter develops.
For people who develop symptoms of Hashimoto's thyroiditis, such as hypothyroidism or goiter, a sound nutritional program should be considered before using thyroid hormone/drug therapy.
Hyperthyroidism is a condition in which the thyroid gland is overactive and makes excessive amounts of thyroid hormone. If your pituitary gland makes too little TSH causing your thyroid to make too much triiodothyronine (T3) and thyroxine (T4), this is defined as hyperthyroidism.
Common symptoms of hyperthyroidism include:
- Appetite change (decrease or increase)
- Blood sugar increases possibly
- Diarrhea, frequent bowel movements
- Fatigue, muscle weakness
- Fertility problems
- Hair thinning, brittle
- Heart palpitations
- Heat intolerance
- Increased sweating
- Itching and hives
- Light menstrual periods—perhaps even missed periods
- Mental disturbances
- Muscle weakness
- Nervousness, anxiety and irritability
- Paralysis -- sudden
- Shortness of breath
- Skin thinning
- Tremor — usually a fine trembling in your hands and fingers
- Vision changes
- Weight loss or weight gain
Older adults are more likely to have either no signs or symptoms or subtle ones, such as an increased heart rate, heat intolerance and a tendency to become tired during ordinary activities. Medications called beta blockers, which are used to treat high blood pressure and other conditions, can mask many of the signs of hyperthyroidism.
The most common cause of hyperthyroidism is the autoimmune disorder Graves’ disease, where the body makes antibodies that cause the thyroid gland to make too much thyroid hormone.
Hyperthyroidism may also be caused by a toxic nodular or multinodular goiter, which are lumps or nodules in the thyroid gland that cause the thyroid to produce excessive amounts of thyroid hormones.
In addition, inflammation of the thyroid gland—called thyroiditis—resulting from a virus or a problem with the immune system may temporarily cause symptoms of hyperthyroidism.
Furthermore, some people who consume too much iodine (either from foods or supplements) or who take medications containing iodine (such as amiodarone) may cause the thyroid gland to overproduce thyroid hormones.
Graves' disease causes the thyroid gland to produce too much thyroid hormone, which is called hyperthyroidism. Graves’ disease runs in families and is more commonly found in women.
In Graves’ disease, your immune system creates antibodies called thyroid-stimulating immunoglobulins (TSIs) that cause the thyroid to grow and make more thyroid hormone than your body needs.
The TSIs bind to thyroid cell receptors, which are normally “docking stations” for thyroid-stimulating hormone (TSH—the hormone responsible for telling the thyroid to produce hormones). The TSIs then stimulate the thyroid into growing and producing too much thyroid hormone, leading to hyperthyroidism.
Sometimes an uncommon problem called Graves' ophthalmopathy may affect your eyes, especially if you smoke. In this disorder, your eyeballs protrude beyond their normal protective orbits when the tissues and muscles behind your eyes swell. This pushes the eyeballs forward so far that they actually bulge out of their orbits. This can cause the front surface of your eyeballs to become very dry. Eye problems often improve without treatment.
Signs and symptoms of Graves' ophthalmopathy include:
- Protruding eyeballs
- Red or swollen eyes
- Excessive tearing or discomfort in one or both eyes
- Light sensitivity, blurry or double vision, inflammation, or reduced eye movement
More specifically, if there is an injury to the organ, neutrophils are the first immune cells to arrive at the site as part of the inflammation response, which is the first phase of the healing process. The neutrophils destroy (eat) the bacteria to prevent infection. If there are local macrophages, they also eat the bacteria.
In order to acquire additional help during the inflammation phase, the macrophages send out signals (cytokines) to recruit more macrophages and other immune cells such as basophils and eosinophils, depending on the specific disease pathology.
The macrophages also recruit immune cells from the adaptive immune system via the dendritic cells by acting as an antigen-presenting cell (APC). That is, the macrophage, after eating the bacteria, present a piece of the bacteria to the dendritic cell, which activates the T cells.
The T cells proliferate into the T Helper cells, such as Th1, Th2 and Th17 to participate in the attack. And, some of the T Helper cells may recruit the B cells to produce antibodies.
The dendritic cell may also activate the killer T cell (Tc or CTL), which can destroy infected cells within the organ or tissue to prevent the infection from spreading or getting worse.
If for some reason, the organ or tissue is not repaired, over a period of years, the inflammation can become chronic. This ramps up the immune response, especially from the T cells.
If this cointinues for a period of years, this can create an imbalance between the Th1 and Th2 cells, leading to an autoimmune disease.
More specifically, if the immune cells such as Th1 and Th17 infiltrate the thyroid gland and kill thyroid cells, this can cause the thyroid to produce less thyroid hormone and more TSH from the pituitary. And, this can, eventually, lead to an autoimmune disorder such as hypothyroidism or an autoimmune disease such as Hashimoto's Thyroiditis.
In a different scenario, the Th2 cells trigger the B immune cells to produce antibodies that bind to thyroid cells and cause the thyroid gland to grow and produce too much thyroid hormone and less TSH from the pituitary. In that scenario, it can lead to an autoimmune disorder such as hyperthyroidism or an autoimmune disease such as Graves' Disease.
In addition, based on recent studies, thyroid dysfunction can affect the small intestine by causing the tight junctions to spread open. This, in turn, can lead to problems with the small intestine, known as leaky gut syndrome. And, as the leaky gut syndrome gets worse, this, in turn, can have a negative effect on the thyroid, creating a vicious cycle!
However, the good news is that various super foods, antioxidants, anti-inflammatories, vitamins, andminerals along with Treg cells can suppress autoimmunity and help to modulate the immune response to stop the progression of the disorder or the disease.
On the other hand, trigger foods (or "dead" foods), toxins, and stress can fuel the progression of the disease and make matters worse by increasing the severity of the symptoms and the progression of the disorder or the disease.
Thyroid Autoimmune Diseases Pathogenesis: Cell Level Diagram
Why is this important? Because if you know from your thyroid blood testing whether you are Th1 or Th2 dominant, you can modify and customize your nutritional program accordingly.
For more details about proper nutrition, refer to the DTD AIP & Autoimmune Diseases Nutritional Program web page.
Are you tired of being tired? Whatever you call it—exhaustion, weakness, lethargy, or feeling run down, sluggish, or overtired — fatigue is a common symptom of thyroid problems.
We're not talking about normal fatigue after a late night. This is debilitating fatigue. You may find yourself needing a nap in the afternoon just to survive until dinnertime. Or you sleep ten to twelve hours a night and still wake up exhausted.
Or you are less able to exercise, and your endurance is low, because of weakness or lethargy. Or you just walk around tired and brain-fogged out on the same amount of sleep that used to leave you feeling refreshed.
There are a number of important factors to know about the connections between fatigue and thyroid conditions, and how to improve your energy and fighting fatigue.
Hypothyroidism/Hyperthyroidism: Fatigue is a very common symptom of hypothyroidism (an underactive or low thyroid) and hyperthyroidism (an overactive or high thyroid) in many patients. In some cases, fatigue in hyperthyroidism may result from insomnia, anxiety, or disrupted sleep patterns.
When the treatment for hypo/hyperthyroidism is optimized, many patients report that their fatigue is lessened or even fully resolved.
Autoimmune Thyroid Disease: Even when thyroid function tests show that the thyroid is "normal" and hormone levels fall within the reference range, the presence of elevated thyroid antibodies, which can indicate autoimmune Hashimoto's disease or Graves' disease, may cause fatigue as a symptom in some patients.
T3 and Natural Thyroid: Some thyroid patients on thyroid hormone replacement have reported an improvement in their fatigue levels when switching from a T4 only treatment (i.e., levothyroxine), to a T4/T3 treatment--for example, the addition of synthetic T3--or use of a natural desiccated thyroid drug.
However, because of the long-term effects, try to avoid these drugs if possible.
Type 2 Diabetes: Healthy thyroid function depends on keeping your blood glucose in the normal range and keeping your blood glucose in the normal range depends on healthy thyroid function.
If you are diabetic, then, you can be tired because your cells can't pull in glucose from your bloodstream because of insulin resistance.
Studies have shown that the repeated insulin surges common in insulin resistance increase the inflammation of the thyroid gland, and as the thyroid gland becomes hypo, thyroid hormone production falls. Low blood glucose is just as dangerous as high, so it is important to keep your blood glucose in balance.
Together, hyperglycemia and hypoglycemia (referred to as dysglycemia) weakens and inflames the gut, lungs, and brain. It imbalances hormone levels, exhausts the adrenal glands, disrupts detoxification pathways, and impairs overall metabolism.
Each of these effects significantly weaken the thyroid function. As long as you have any blood glucose imbalance, whatever you do to fix your thyroid isn’t going to work and you are still going to have fatigue.
Follow a plant-based nutritional program such as the Death to Diabetes Nutritional Program (for Type 2 Diabetics), which will reduce and get rid of the insulin resistance.
Gluten Sensitivity: Some thyroid patients -- including those who do not have celiac disease or gluten intolerance -- have reported a reduction in fatigue when they switch to a gluten-free diet. A gluten-free diet is a diet free of wheat and gluten products. Others have reported similar effects by eliminating sugar, dairy, or other inflammatory and allergenic foods from the diet.
Adrenal Fatigue: The body relies on the adrenal glands located on top of each kidney to manage stressful situations. If our bodies are working picture perfect, our adrenal glands release, in perfect balance and harmony, the stress hormones cortisol, adrenaline, and DHEA, in order to help us cope with the day-to-day stresses and demands of life. They also have plenty of sleep time to recover, rejuvenate, and replenish themselves in order to come to our aid when called upon. Given our busy stressful lives it’s not surprising that many of us suffer from issues of adrenal dysfunction.
Our adrenal glands can become so overwhelmed and exhausted that they are unable to meet the body’s demand for adrenaline, cortisol, and DHEA. Instead of being in adaption phase where we are able to adapt to everything, we are in a low phase where we cannot adapt at all.
If you believe that you are suffering from adrenal fatigue, speak to your doctor about an adrenal function saliva test.
Ashwagandha and Rhodiola Rosea are adaptogen herbs that support adrenal function. They are awesome helpers when it comes to boosting your energy. Rhodiola Rosea is an adaptogen herb with tremendous energy enhancing and brain boosting power (it also helps burn fat!).
By combining these two adaptogenic champions together you can help balance stress hormones, boost energy, and even burn fat.
Adaptogenic herbs are great because they work with your body to bring you back into balance whether your levels are high or low. Be sure to ask your doctor about adding herbs in particular if you are on medications or if you are pregnant or nursing. Not all herbs are right for every person. We’re all different in terms of how our bodies react to various supplements so be sure to always start slow and watch your body.
Iron Deficiency: is the most common nutritional deficiency in the United States and women are among those at greatest risk. If you notice low energy levels, weight gain, or even a lower body temperature, talk to your doctor about iron testing.
You may experience fatigue if you are low in iron, in particular, the stored form of iron known as ferritin. It's worth having ferritin levels checked by your doctor, and if they are not optimal, talk to your doctor about supplementing with iron, or adding more iron to your diet through foods.
Note 1: While most of the attention is on iron deficiency, there is a concern as well for iron overload. Most women only need 8 milligrams per day, so try adding a serving of lentils, spinach, red meat, liver, nuts, chicken or chickpeas to your diet. More isn’t necessarily better. If you have to supplement, try a wholefood-based supplement such as Ferrofood from Standard Process or Carlson Labs Buffalo Liver.
Note 2: An excess of iron, in particular, a hereditary condition known as hemochromatosis, can also be associated with fatigue.
Vitamin B12 Deficiency: This vitamin is an “energy nutrient” that our body needs to carry out essential functions. Autoimmune diseases such as Hashimoto’s have been associated with a B12 deficiency. If you’re feeling weak and easily tired, you could have a Vitamin B12 deficiency. This vitamin is what your body requires for energy production, blood formation, and DNA synthesis.
Gastrointestinal absorption depends on many co-factors, so it is quite possible to take adequate amounts of B12 in the diet yet have a B12 deficiency from not absorbing. Remember you are not what you eat. You are what you absorb.
If you have insufficient B12 levels in your blood, your health will become vulnerable and defenseless against disease. Daily life gets harder for you to endure as you experience debilitating symptoms such as muscle weakness, fatigue, tingling in your arms or legs, mental fogginess, memory problems, mood swings, and feelings of apathy and lack of motivation.
What’s more unfortunate is that you may already have B12 deficiency without you knowing about it! Symptoms of this condition may only manifest after a number of years as influenced by your diet and your body’s absorption of B12. Look for a sublingual methylcobalamin B12.
Vitamin A Deficiency: This vitamin deficiency is usually overlooked or the assumption is that you will get your vitamin A from the carotenoids in the vegetables. But, as we age and especially if we have a disease, it becomes very difficult for the body to convert the Vitamin A from the carotenoids into the true form of Vitamin A.
But, don't take Vitamin A supplements! -- most of them, if not all of them, are synthetic! Instead, get your true Vitamin A from organ meats and/or unprocessed cod liver oil.
Vitamin D Deficiency: This vitamin is unlike any other vitamin because it is a “pre-hormone” produced in the skin with sunlight exposure. The sun is the main source of Vitamin D3, a type of vitamin D that increases levels of “feel-good” chemicals in the brain called dopamine and serotonin.
Deficient levels of either of these neurochemicals can be an underlying cause of fatigue and depression. A deficiency in Vitamin D has now been linked to numerous health problems including hypothyroidism, depression, and even cancer.
In fact, a recent study conducted by Boston University researchers revealed Vitamin D affects genes that have a wide variety of biologic functions of more than 160 pathways linked to autoimmune disorders and cardiovascular disease.
So, make sure that you have your Vitamin D tested. In addition, eat foods such as wild salmon, mackerel, eggs yolks, and beef liver. If necessary, add a wholefood vitamin D3 supplement such as Standard Process Cataplex D or take unprocessed cod liver oil. If possible, get 15-30 minutes of sunshine on your skin every day.
Exposure to Household Chemicals (i.e. Xenoestrogens): Xenoestrogens are invisible but they are big endocrine disruptors (hormone imbalancers). They can steal your natural hormone balance, cause fatigue, and in addition have reproductive (weight gain, estrogen dominance, cancers, PMS, PCOS, hypothyroid) and developmental consequences.
Experts say that in a typical day, we are exposed to more than 700 xenoestrogens in chemically made toothpaste, deodorant, sunscreen, food preservatives, the lining of cans that hold food, and many kinds of plastic.
Xenoestrogens are foreign estrogen which pass into our cells from plastic water bottles, pesticides, herbicides, fungicides, plastics, fuels, car exhausts, dry cleaning chemicals, industrial waste, meat from animals (which have been fattened with estrogenic hormonal drugs), and countless other household cleaning and personal products which many of us use every day, probably even the hair product or makeup you have on right now.
Try to cut these out as best you can. Always remember we absorb 60% of what we apply to our skin. If you wouldn’t eat it – don’t put it on your skin. Buy food and cosmetic items that are natural, BPA and phthalate free for you and your family.
Unrefreshing Sleep: Some people experience fatigue due to what's known as unrefreshing sleep. This means you've had enough sleep -- usually seven or more hours -- but you wake up and still feel tired, because the sleep was of poor quality, interrupted, or did not reach restorative levels. Unrefreshing sleep may be associated with poor glucose control, adrenal dysfunction, chronic fatigue syndrome and fibromyalgia.
Sleep Apnea: Thyroid patients are at greater risk of sleep apnea, where breathing stops for short periods during sleep. Sleep apnea can contribute greatly to fatigue, due to reduced oxygen intake. Thyroid patients experiencing fatigue should talk to a physician about having a sleep study or evaluation done to determine if sleep abnormalities -- including apnea -- may be contributing to the fatigue.
Chronic Fatigue Syndrome and Fibromyalgia: If you have long-term, debilitating fatigue, and the fatigue is accompanied by other symptoms such as enlarged lymph nodes, a chronic sore throat, and/or body/muscle aches pains, you may have other conditions such as Chronic Fatigue Syndrome and/or fibromyalgia. these conditions are more common in thyroid patients than in the general population.
Exercise: If you are fatigued try yoga, qigong, and/or tai chi because they are not stressful on the body and they do not break down tissue.
Of course, you have probably been told that exercise gives you energy, however, with hypothyroidism you may find that exercise exhausts you. This is because most cardio and weight training exercise is catabolic by nature, meaning that the stress of it causes your body to break down its own tissue.
Anabolic is the opposite of catabolic -- it helps energy, healing and growth. After catabolic exercise your body’s natural repair processes start up and your body recovers from the stress with the goal of rebuilding itself stronger than before. But when you are hypothyroid, your body cannot properly recover from stressful exercise. We are all different in terms of what degree of physical activity our bodies find ‘exhausting’ so listen to your body.
A lot of people with thyroid problems suffer with insomnia, weight gain/loss, fatigue, exercise intolerance, blood sugar instability, and/or food cravings.
While the underlying cause is complex, the problem can be solved without the need for any medications -- as long as you're willing to make the necessary nutritional and lifestyle changes.
In healthy people, the liver stores adequate amounts of glucose in the form of glycogen in the liver, muscles, and brain. These stores are used (between meals and when you're sleeping) to prevent your blood sugar from going to low and to support cellular metabolism, thyroid function, and keep your stress hormones under control.
However, people with hypothyroidism lose the ability to store and produce glycogen efficiently, which can lead to hypoglycemia.
The main reason for this is that glycogen storage and release are regulated by active T3 thyroid hormone. When you become hypothyroid, your T3 is low or when your liver can't use T3, it can directly affect your glycogen in 3 ways:
- Your liver can't store or release glycogen
- Your body can't regulate your blood glucose
- Your brain, muscles and organs become easily fatigued.
To compensate for the lack of glycogen, your pituitary gland sends a signal to the adrenal glands to produce stress hormones (cortisol and adrenaline). Adrenaline stimulates the liver to release stored glycogen to prevent a drop in your blood glucose.
These constant surges of adrenaline deplete your liver glycogen and puts an extra demand on the liver, making it difficult to regulate your blood glucose.
Then, cortisol takes over and breaks down healthy muscle tissue in order to convert protein (from the muscles) into glucose to feed your cells.
Consequently, if you don't eat enough carbohydrates, your body will start to break down muscle tissue in order to survive. But, if you eat too many carbohydrates, then, your blood glucose make spike (especially if you're diabetic).
To make matters worse, this may cause hormonal cravings for sugar and other overly-processed foods.
In addition, during exercise, you become very fatigued because all of this affects your cardiovascular, musculoskeletal, neuromuscular, and cellular metabolic systems.
Another problem that can occur is insomnia. When you go to sleep, your blood glucose tends to drop at night. When this happens, your body produces adrenaline to stimulate your liver to release glycogen. If adrenaline levels continue to increase, cortisol will increase usually around 1:00 AM to 2:00 AM, which causes some people to wake up and are unable to go back to sleep.
Given these types of problems, it becomes critical to find a functional medicine doctor, who can help you. Unfortunately, your doctor will only prescribe medications, which will only make the problem worse!
It is also very important to follow a structured nutritional program that will help to modulate and rebalance your immune system.
More specifically, the key to a healthy and effective immune system is the balance and coordination of the T-helper (Th) cells, specifically the Th1 and Th2 cells, along with the Th17 and Treg cells during an immune response.
As explained in the DTD How to Treat Autoimmune Diseases Naturally ebook, you should use the 10-step DTD Autoimmune Diseases Wellness Program as your base program to get started with improving the health of your thyroid.
Then, use the following DTD AIP & Autoimmune Diseases Nutritional Program; which identifies the 4 key components of our customizable nutritional program:
(1) The super foods that you should eat.
(2) The "trigger" foods ("dead" foods) that you should avoid.
(3) The key nutritional supplements that you require.
(4) The super food immune modulators and Th1/Th2 compounds to help customize the program to your specific needs and to rebalance your immune system.
These four key components of this nutritional program will help to address the root causes of your autoimmune disease and the biological processes that fuel this disease, e.g. inflammation, oxidation, toxicity, dysregulation, hormonal imbalance.
Then, based on your specific pathology, test results, other health issues, specific food sensitivities, etc., use the disease-specific information in the DTD Autoimmune Diseases book to customize our program to address your specific needs and treatment strategies.
Key Point: The reason why our program is customizable is because everyone reacts differently to various foods and supplements. This is also why we recommend that you keep a food journal.
The following section below will discuss several alternative (non-drug) strategies (based on the book) to support a healthy thyroid, including: proper nutrition, detox, stress, sleep, and cardiovascular support.
Key nutritional strategies include a periodic detox and an organic plant-based diet, with minimum processed food and no tap water (because of the chlorine and fluoride). This is necessary to prevent any major nutrient deficiencies that may trigger diseases such as heart disease, diabetes, and cancer.
Without proper nutrition, your thyroid lacks nutrients to make basic thyroid hormone, known as T4 (thyroxin), or you may lack key nutrients that help convert T4 to the biologically active T3. Your thyroid can be inflamed or stressed, which gets in the way of making T4 at an optimal rate.
And your liver can be inflamed or stressed, which gets in the way of converting T4 to T3 at an optimal rate. Cells around your body require basic nutrition to carry out the metabolic instructions that T3 is giving them; otherwise it is no different than not having enough T3.
Any or all of these simple-case thyroid problems can be addressed with nutrition. Optimal nutrition with plant-based foods (i.e. vegetables, beans, nuts, seeds) can enhance the formation of thyroid hormone in the thyroid gland, enhance the activation of T4 to the biologically active T3, and enhance the nutritional ability of cells to utilize thyroid hormone.
Use raw juicing to help nourish and protect the thyroid and balance the endocrine system. Drink a glass 30 minutes before meals.
In addition, it is critical to avoid fried foods, fast foods, soy foods, and most processed foods, especially the hybridized and genetically modified grains and vegetable oils, including canola oil.
It may be necessary to go through a detox to help remove the accumulated toxins and poisons in your tissues and cells.
Also, tap water should be avoided because it contains fluoride and chlorine, two harmful chemicals that can contribute to an under-active thyroid.
Once you've implemented a plant-based diet and eliminated gluten-based foods, some wholefood-based dietary supplements may help to fill some specific needs. But, always try to obtain these nutrients from your food first.
For more details about the foods on this slide, refer to the Death to Diabetes Blog.
Nutritional Supplementation Strategy for Thyroid
Since a selenium deficiency can reduce the activity of the thyroid hormones, selenium is needed by your liver to convert T4 to T3. Selenium-rich foods include Brazil nuts, seafood (oysters), tuna, sunflower seeds, mushrooms, free range beef, lamb, chicken and turkey.
Manganese is also needed to boost specific antioxidant enzymes inside your thyroid gland and in your liver, so that both organs can function in a less stressed and inflamed manner.
Tyrosine is is an amino acid that is needed to boost dopamine and nerve related thyroid formation, as well as providing the core molecule of thyroid hormone (T4 is one molecule of tyrosine surrounded by four molecules of iodine). And so the use of tyrosine as a dietary supplement increases production of thyroid hormones.
It appears that a water-soluble and biologically active form of iodine called Iosol Iodine has proven to be very effective. It is one of the most popular supplements to help individuals warm up. Iodine is needed for thyroid hormone formation.
Note: Unlike potassium iodide which can clog the thyroid gland due to its poor solubility, Iosol readily washes away if it is not needed. There used to be plenty of iodine in vegetables and fruits but the soil is very iodine depleted in most areas today.
Kelp is rich in iodine. Other foods that contain iodine are organic yogurt, free range eggs, fish and other seafood, radish, and parsley.
Thyroid glandular supplements have been used for some thyroid treatments. Usually it is only sold through your practitioner or by prescription (like Armour) but there are some over-the-counter thyroid glandular supplements available.
Seaweed (i.e. bladderwrack) is a rich source of iodine. Traditionally it has been used for weight loss and hypothyroidism. The low incidence of goiter in maritime people has been attributed to the iodine in bladderwrack. It also contains the minerals potassium, magnesium, calcium, iron, zinc, etc. Bladderwrack is thought to stimulate the thyroid gland increasing metabolism.
Note: Be careful -- some seaweed is known to loaded with heavy metals and other pollutants from the ocean floor.
Extra virgin coconut oil helps to promote your metabolism by providing thyroid support. It acts in tandem with the thyroid to produce an effect greater than the sum of their individual effects. Moreover, it is a highly recommended source of fats, as it improves sensitivity of tissues to thyroid hormones.
The fusion of the two work to the benefit of the body and help in maintaining optimum metabolic rate. To explain it in simple words, coconut oil serves as high octane fuel for the internal combustion engine in the car. An efficient fuel (coconut oil) makes the car (thyroid) perform better and last longer. Coconut oil is also considered to be the best cooking oil, as it does not add to your weight.
More importantly, you should avoid all of the vegetable oils that we use to cook food and those used in commercially-prepared and processed foods.
These polyunsaturated vegetable oils (including canola oil) have a negative affect on the thyroid and may, in fact, be the worst villain in the spread of thyroid diseases.
Alfalfa and wheat sprouts help to nourish the pituitary gland (especially if developing white skin blotches). Ginseng and Gotu Kola also help to nourish the pituitary.
A wholefood multivitamin can be helpful if it contains all the co-enzyme B vitamins and mineral transporters. Avoid the cheap cyanide-producing form of B12 known as cyanocobalamin. Cyanide metabolites are very hard on the thyroid -- only cheap vitamin companies put this low grade B12 in their products. Vitamin B12 and folic acid are especially important for the enzymes that make thyroid hormone. A lack of B12 is commonly found in those struggling with thyroid function (along with poor mood).
A variety of other nutrients, if lacking, can impede healthy thyroid function, including quercetin, Vitamin D, iron, selenium, and zinc. Ensure you are not lacking in these, as anyone of them can be responsible for the symptoms of a sluggish thyroid.
Quercetin is a bioflavonoid common in the plant kingdom, a potent polyphenol antioxidant and immune system modulator found in onions. It has a stabilizing affect on the immune system, helping various types of immune cells maintain their composure under stress. It has a modulating effect on immune system signals, helping to calm down inappropriate excess. This helps the tissues and cells in your thyroid gland better tolerate common irritants such as pollution and stress.
Researchers recently demonstrated that a lack of Vitamin D was associated with lower levels of T4 and that irritation of the thyroid gland was more pronounced if vitamin D is lacking. It should be noted that cold weather itself is a temperature stress that makes your thyroid work harder, and the lack of sun in winter months makes it more likely you could be deficient. Most people need 2000 IU of Vitamin D per day in the winter months for a variety of health needs, which includes thyroid support. Unprocessed cod liver oil is an excellent source of Vitamin D.
When thyroid instructions reach the DNA of your cells it tells them how to set the metabolic pace of the cells activities, in turn setting into motion a number of different genes that carry out these instructions. It has now been discovered that iron is required for up to 80 of these vital gene signals, otherwise thyroid instructions don't get implemented.
A lack of iron also impedes proper oxygenation of blood. A lack of iron can cause fatigue, especially muscle weakness, which can readily be confused with thyroid-related fatigue. Vegetarians, menstruating women, and heavy exercisers are most at risk for a lack of iron. Clams, oysters, beef liver, grains, pumpkin seeds, lentils, spinach, and blackstrap molasses are good sources of iron.
Selenium is essential for the production of thyroid hormone. Cells within your thyroid gland, called thyrocytes produce a protein called thyroglobulin. It is thyroglobulin's job to connect iodine and tyrosine to form basic thyroid hormone (thyroxine or T4).
To fight oxidation, your thyrocytes make an antioxidant enzyme called glutathione peroxidase, which requires selenium. Thus, if selenium is low then this antioxidant enzyme is not made at optimal levels and the thyroid is damaged in proportion to the level of selenium deficiency.
So, include selenium-rich foods in your diet. Great sources of selenium include: Brazil nuts, crimini mushrooms, cod, shrimp, tuna, halibut, salmon, scallops, chicken, eggs, shiitake mushrooms, lamb, and turkey. Brazil nuts are particularly rich in selenium -- it only takes two or three per day to improve your selenium status and boost immune function.
Zinc is another cofactor mineral that needs to be adequate for thyroid hormone to perform at an optimal pace. A lack of zinc is known to reduce the activity of TRH (thyroid releasing hormone in the hypothalamus), in turn tending to depress thyroid hormone levels.
Zinc participates in the conversion of T4 to T3, and zinc is needed to bind active thyroid hormone to the DNA of cells. Zinc is needed for immunity, sex drive, and maintaining leptin status while on a diet. It is lost in sweat and by stress. Beef, nuts, whole grains, legumes, and yeast are good sources of zinc.
Note: A number of homeopathic treatments for the pituitary gland are available these days. Much like the homeopathic tinnitus treatment remedies for ringing ears, the homeopathic treatment modes for pituitary gland disorders are basically derived from a wide array of natural ingredients and substances like herbs, animal extracts, plants and vegetables, which are taken in quite extremely minute doses.
The homeopathic treatment therapies are usually chosen based on the patient’s symptoms, which also include the person’s physical, mental and emotional states, as well as their family history. Such treatment course is aimed to properly stimulate the body's own immune system, as well as lead to a long-term cure rather than simply offer temporary relief.
If necessary, work with a naturopathic doctor and consider taking a low dose of a natural thyroid replacement such as Armour Thyroid for a few months (read below for more details).
Other Lifestyle Changes to Help Your Thyroid
Besides eating healthier, here are some additional things to consider doing to help with thyroid issues:
Detox on a periodic basis can help remove the excess toxins, heavy metals and chemicals that have accumulated in the cells and tissues; and,may have caused damage to the thyroid.
Exercise can boost energy, decrease stress, and help you maintain a healthy weight -- all important benefits, especially if you have hypothyroidism.
Work in the 4 types of exercises: aerobic, strengthening, flexibility, and balancing. Exercises to try: Walking, light weight lifting, yoga, and standing on one leg. Of course, talk to your doctor before trying a new exercise program.
Stress can be very detrimental to your thyroid. To combat stress, pencil in a weekly massage or schedule a daily 5-minute session of deep breathing or meditation.
Make sure that you're getting enough sleep especially if you feel tired throughout the day. Establishing a sleep schedule and sticking to it helps. Go to bed and wake up at the same time every day—including weekends. In general, the sweet spot for sleep is between 7 and 9 hours.
Note: If you have issues with your thyroid, get the How to Treat Autoimmune Diseases, PCOS & Thyroid Issues Naturally ebook. This ebook explains how to optimize the health of your thyroid gland.
Note: Refer to the Nutritional Supplements ebook for more details about wholefood-based supplements.
Toxins that Affect the Thyroid
One of the key factors that helps induce weight gain and reduces the ease with which you can lose weight is the issue of environmental chemicals, chemicals in food and water, and toxins from low grade infections (like Candida or bacterial overgrowth).
This issue is always made worse if your internal plumbing systems aren't up to the challenge (constipation, irritable bowel, liver issues, lymph stagnation, chemical sensitivity, fibromyalgia, etc.)
Some chemicals like perchlorate, chlorine, and fluoride can directly bind to your thyroid gland and reduce iodine uptake. Many other chemicals, especially the fat-soluble ones, can bind to thyroid cell membranes and participate in thyroid inflammation and thyroid autoantibody production.
Fat-soluble chemicals can readily cross your blood brain barrier and interfere with how your brain senses any hormone level, including thyroid. Endotoxins from infections (lipopolysaccharides or LPS) directly interact in the Thyroid Releasing Hormone (TRH) region of your hypothalamus gland and intentionally turn down TRH production interfering with thyroid hormone production. Endotoxins also make you hungry by elevating your stomachs hunger signal, ghrelin.
Your liver, which is your main detoxification organ, is particularly sensitive to toxic excess. Because T4 is converted to T3 on cell membranes of your liver, fat-soluble toxins readily interfere with thyroid hormone activation by your liver. Liver detox may be needed to help your liver specifically clear toxins more efficiently while simultaneously protecting liver cells. Refer to the Cleanse/Detox ebook for more details.
If you are trying to lose weight, you must keep your detox systems working well as toxins will be released from stored fat as weight is lost. This toxins can crash your thyroid long before you get to your goal weight, if you don't take care to ensure they are smoothly flowing out of your body.
Soluble fiber (in vegetables) is needed to bind onto these toxins as they are excreted in your bile. Such fiber also helps regularity and reduces cravings for food.
Other supplements that are helpful for those in a toxic rut include chlorella (a great binder of fat-soluble toxic waste), and herbal tinctures for congested lymph (excess mucous, shoulder stiffness, etc.).
Stress and the Thyroid
There is an intimate interaction between stress hormones and thyroid function. The more stress you are under, the worse your thyroid functions. Any approach to correcting poor thyroid function must address the effects of chronic stress and provide support to the adrenal glands.
Your stress management system is rooted in the function of your adrenal glands, which operate in an interdependent fashion with your overall thyroid system. Many books on adrenals list all the symptoms of low thyroid as adrenal problems and vice versa. There are differences.
Morning energy, stress tolerance, and aerobic fitness are primarily adrenal issues. Thyroid issues are more about afternoon energy level, being too cold, and feeling mentally sluggish or heavy headed (adrenals issues go more with brain fog).
Thyroid sets your basic supply of energy for your body to use. Not having enough automatically stresses your adrenals if there is an increased demand for needed energy.
Conversely, tired adrenals make it so your body gets too inflamed from even normal activities forcing your thyroid to go slower than it would like so that you don't overheat and burn up. Ongoing stress can wreak havoc with these problems.
If you are someone who struggles with a long list of adrenal and thyroid symptoms then you have to nurse both systems back on at the same time. A good way to do this is to use basic thyroid support along with basic adrenal support.
In order to get these systems back into good condition you must find an amount of exercise you can do on a consistent basis and then gradually increase the amount.
When you can get a refreshing response to aerobic type exercise that is done at least three times a week, then both your adrenal and thyroid system will be working better. Don't push too hard with exercise, be consistent and gradually improve what you can do.
Key nutrients for stress management can be added to a thyroid support program, enabling you to have better stress tolerance, i.e. B-Complex vitamins, phosphatidyl serine (PS), quercetin and Vitamin C.
Sleep and the Thyroid
When stress is either extremely intense or has been going on too long, then the relaxed reserves in your nervous system tend to deplete. This gives your brain a wired feeling, meaning you are likely to be more anxious or irritable during the day and have poorer quality sleep at night.
This has a major bearing on how your subconscious brain (hypothalamus gland) processes thyroid-related information, directly interfering with the normal production of TRH (thyroid releasing hormone), which in turn regulates your pituitary gland (TSH), and those overall regulation of your thyroid system.
This will leave you with a mixture of hyper and hypo symptoms, and unless you cool this off these symptoms, including the lack of quality sleep, remain problematic and induce ongoing thyroid wear and tear.
This combination of symptoms causes you to be tired, irritable/anxious, and hungry during the day and you typically eat more because it brings temporary relief to these feelings. At night, your subconscious brain is set to hyper-vigilant, left over circuitry from evolution so that you do not miss a hunting opportunity.
In this inappropriate metabolic pattern thyroid hormone levels are set very slow by your subconscious brain (TRH-related control) so that your body can conserve energy during this misperceived famine. The only way out of this is to relax and un-inflame your system so that it can calm down.
On an exercise basis this is stretching, walking, prayer/meditation, stress management, etc. towards the goal of you feeling calmer and more in control of your life.
You are not just trying to knock yourself out at bed. You are trying to get a smoother energy production during the day and replenish depleted relaxed reserves. If this problem is locked in, then relaxing lifestyle adjustments are also mandatory. It can take a month or two to unwind a wound up system and thyroid wont work right until you do.
Refer to Chapter 13 of Death to Diabetes or the Stress Reduction ebook for more details about stress, sleep, and relaxation.
Cardiovascular Health and the Thyroid
Thyroid hormone controls the rate that oxygen is used at the cellular level to make energy. Your circulatory system is how oxygen is transported to cells. Thus, there is tremendous overlap between a healthy thyroid and cardiovascular system, and conversely, between a stressed thyroid and cardiovascular system.
Indicators of good health include a sense of feeling well oxygenated, reflected in very easy breathing and a head that feels quite awake. Numerous studies in the past year show the extreme importance of maintaining optimal thyroid function so as to support cardiovascular well being with the use of oxygen being a common theme.
Additionally, stressed nerves directly irritate both systems, pushing them in the wrong direction (felt as a lack of stress tolerance, irritation, anxiety, racing heart, trouble sleeping, etc.)
Therefore, a relaxed and smooth feeling in your body, accompanied by easy breathing and an awake head, along with plenty of oxygen during exercise, are all signs of a good foundation of oxygen that enhances both thyroid and cardiovascular health.
High quality iron is vital for the transport of oxygen in your blood. Proper function of your hemoglobin also requires Vitamin E. The other best nutrient that supports oxygen status is CoQ10 (cellular and heart support). Refer to Chapter 15 of the Death to Diabetes book or the How to Prevent a Heart Attack ebook for more details.
Thyroid Connection to Diabetes
Researchers have now found that even subtle changes in thyroid function increase the risk for metabolic syndrome and diabetes.
The link between overt hypothyroidism and an increased risk of heart disease has already been established.
But research published in the February 2007 issue of the Journal of Clinical Endocrinology and Metabolism found a connection between thyroid function and metabolic syndrome in people who have normal thyroid stimulating hormone (TSH) levels.
What the researchers found was that in those with normal TSH levels, the thyroid hormone level known as free T4 was important. Free T4 levels that were slightly low, but still within the normal range, significantly increased the risk of many risk factors for metabolic syndrome.
Lower levels of another thyroid hormone, free T3, were linked to risk factors including higher total cholesterol, LDL cholesterol, and triglycerides.
The researchers concluded that for people who have normal TSH levels, even slight changes in free T4 and free T3 levels can have an effect on the risk of metabolic syndrome and heart disease.
The researchers recommend that a study be done to determine whether early treatment of thyroid dysfunction might reduce the risk.
What Does This Means for You?
If future research does find that early treatment helps, free T4 and free T3, and not just TSH, will become key measurements in thyroid diagnosis and treatment decisions.
This research also suggests that if you are being treated for hypothyroidism, you should be monitored for signs of metabolic syndrome. If you are hypothyroid, you'll want to make every effort to reduce your metabolic syndrome risk factors.
Addressing the risk factors can be complex, but generally, involves a combination of any or all of the following approaches:
- Overall efforts to lose weight, including diet and exercise
- Specialized dietary changes to combat insulin resistance and improve cholesterol levels.
- Exercise regularly
- Diet changes to lower triglycerides, raise HDL, lower blood pressure, lower/manage blood sugar.
Note: Hypothyroidism can be treated before it develops into diabetes. One of the biggest treatments is simply changing lifestyle and habits. Eating a low carbohydrate, low-fat plant-based diet that is also high in plant protein can greatly help with the treatment of hypothyroidism.
Thyroid Disease and Diabetes
Thyroid disease is common in the general population, and the prevalence increases with age. The assessment of thyroid function by modern assays is both reliable and inexpensive. Screening for thyroid dysfunction is indicated in certain high-risk groups, such as neonates and the elderly.
Hypothyroidism is by far the most common thyroid disorder in the adult population and is more common in older women. It is usually autoimmune in origin, presenting as either primary atrophic hypothyroidism or Hashimoto's thyroiditis. Thyroid failure secondary to radioactive iodine therapy or thyroid surgery is also common. Rarely, pituitary or hypothalamic disorders can result in secondary hypothyroidism.
Approximately 4 million people in the United States are hypothyroid and receive thyroxine replacement therapy. By contrast, hyperthyroidism is much less common, with a female-to-male ratio of 9:1. Graves' disease is the most common cause and affects primarily young adults. Toxic multi-nodular goiters tend to affect the older age-groups.
Hypothyroidism, because it slows down the body’s processes, also affects insulin production. When a condition such as hypothyroidism is involved, the pancreas slows down its ability to turn blood sugar into energy. This is a complication that leads to diabetes.
Diabetic patients have a higher prevalence of thyroid disorders compared with the normal population. Because patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and thyroid disorders are more common in females, it is not surprising that up to 30% of female type 1 diabetic patients have thyroid disease.
The rate of postpartum thyroiditis in diabetic patients is three times that in normal women. A number of reports have also indicated a higher than normal prevalence of thyroid disorders in type 2 diabetic patients, with hypothyroidism being the most common disorder.
How Thyroid Dysfunction May Affect Diabetic Patients
The presence of thyroid dysfunction may affect diabetes control. Hyperthyroidism is typically associated with worsening glycemic control and increased insulin requirements. There is underlying increased hepatic gluconeogenesis, rapid gastrointestinal glucose absorption, and probably increased insulin resistance. Indeed, thyrotoxicosis may unmask latent diabetes.
In practice, there are several implications for patients with both diabetes and hyperthyroidism. First, in hyperthyroid patients, the diagnosis of glucose intolerance needs to be considered cautiously, since the hyperglycemia may improve with treatment of thyrotoxicosis.
Second, underlying hyperthyroidism should be considered in diabetic patients with unexplained worsening hyperglycemia.
Third, in diabetic patients with hyperthyroidism, physicians need to anticipate possible deterioration in glycemic control and adjust treatment accordingly. Restoration of euthyroidism will lower blood glucose level.
Although wide-ranging changes in carbohydrate metabolism are seen in hypothyroidism, clinical manifestation of these abnormalities is seldom conspicuous.
However, the reduced rate of insulin degradation may lower the exogenous insulin requirement. The presence of hypoglycemia is uncommon in isolated thyroid hormone deficiency and should raise the possibility of hypopituitarism in a hypothyroid patient.
More importantly, hypothyroidism is accompanied by a variety of abnormalities in plasma lipid metabolism, including elevated triglyceride and low-density lipoprotein (LDL) cholesterol concentrations.
Even subclinical hypothyroidism can exacerbate the coexisting dyslipidemia commonly found in type 2 diabetes and further increase the risk of cardiovascular diseases. Adequate thyroxine replacement will reverse the lipid abnormalities.
In young women with type 1 diabetes, there is a high incidence of autoimmune thyroid disorders. Transient thyroid dysfunction is common in the postpartum period and warrants routine screening with serum thyroid-stimulating hormone (TSH) 68 weeks after delivery.
Glucose control may fluctuate during the transient hyperthyroidism followed by hypothyroidism typical of the postpartum thyroiditis. It is important to monitor thyroid function tests in these women since approximately 30% will not recover from the hypothyroid phase and will require thyroxine replacement. Recurrent thyroiditis with subsequent pregnancies is common.
Medical Treatment: Management of Thyroid Dysfunction
Medical science and your doctor will tell you that hypothyroidism should be treated with thyroid hormone therapy, using l-thyroxine, which is the most widely used thyroid hormone replacement drug.
Hormone/drug therapy may work initially, but, long-term, problems with your thyroid tend to get worse! Why? Because the drug only addresses the symptom of your problem -- not the root cause that causing your thyroid to malfunction.
Because hyperthyroidism can cause serious adverse effects on glycemic control and possibly worsen pre-existing coronary artery disease, it is desirable to consider alternative non-drug treatment before the drugs make matters worse.
However, before you consider any alternative strategy, you need to educate yourself about the thyroid so that you select a safe and effective strategy. Just because it's an alternative strategy doesn't mean that it's safe and effective!
For more information about autoimmune thyroid diseases and how to optimize the health of your thyroid gland, get the author's How to Treat Autoimmune Diseases, PCOS & Thyroid Issues Naturally ebook.
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