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 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 up to 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.

What is the Thyroid?

The thyroid is a butterfly-shaped gland located in the neck, just below the Adam’s apple and above the collarbone. It 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.

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.

As a result, it is difficult to correctly diagnose thyroid disorder based only on symptoms. Fortunately, precise measurement of thyroid function is now possible with the TSH blood test, a test that directly measures the amount of TSH produced by the pituitary gland.

TSH Testing

A test for thyroid-stimulating hormone (TSH) is done to determine whether the thyroid gland is functioning properly. High levels of the hormone indicate an underactive thyroid.

An underactive thyroid gland (hypothyroidism), due to high TSH levels, can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods.

An overactive thyroid (hyperthyroidism), due to low TSH levels, can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.

Note 1: TSH levels can help determine whether hypothyroidism is due to a damaged thyroid gland or some other cause (such as a problem with the pituitary gland or the hypothalamus).

Note 2: The basic problem that traditional medicine has with diagnosing hypothyroidism is the so called "normal range" of TSH may be far too high: Many patients with TSH levels greater than 1.5 (not 4.5) have classic symptoms and signs of hypothyroidism.

The alternative to monitor thyroid disease is to use the Free T3 and Free T4 and TSH levels and interpret them with new reference ranges.

If one measures the Free T3 and Free T4 levels the only accurate measure of the actual active thyroid hormone levels in the blood, as well as the TSH, one will find out how often a low normal TSH does NOT exclude hypothyroidism.

It is relatively common to find the Free T4 and Free T3 hormone levels below normal when TSH is in its normal range, even in the low end of its normal range. When patients with these lab values are treated, one typically finds tremendous improvement in the patient, and a reduction of the classic hypothyroid symptoms.

Normal Results
Adults: 0.4–4.5 mIU/L
Note: The normal ranges for the results of this test may vary from laboratory to laboratory.

High TSH Values

  • High thyroid-stimulating hormone (TSH) test result often indicates an underactive thyroid gland caused by failure of the thyroid gland (primary hypothyroidism). Hashimoto's thyroiditis is the most common cause of primary hypothyroidism.
  • On rare occasions, a high TSH value can occur from a pituitary gland tumor that is producing excess amounts of TSH. In this case, the person usually has symptoms of hyperthyroidism such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods. Other thyroid hormone test results will likely be high as well.
  • A high TSH value can also occur in people who have an underactive thyroid gland and are receiving too little thyroid hormone medication.

Low TSH Values

  • Low thyroid-stimulating hormone (TSH) value can indicate an overactive thyroid gland (hyperthyroidism). Causes of hyperthyroidism include Graves' disease, a type of goiter (multinodular goiter), or a noncancerous (benign) tumor called a toxic nodule.
  • A low TSH value can also indicate damage to the pituitary gland that prevents it from producing TSH (secondary hypothyroidism). In this case, the person usually has symptoms of hypothyroidism such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods.
  • A low TSH value can occur in people who have an underactive thyroid gland and are receiving too much thyroid hormone medication.

What Affects the TSH Test

Factors that can interfere with your test and the accuracy of the results include:

  • Medications, such as corticosteroids, levodopa, aspirin, heparin, dopamine, lithium (such as Carbolith, Duralith, Lithane), methimazole (Tapazole), and propylthiouracil.
  • Recent X-rays with iodine dye or tests using radioactive materials.
  • Severe stress or long-term (chronic) illness.
  • The first trimester of pregnancy.

Hypothyroidism Diagnosis

Hypothyroidism is a relatively common disorder. It affects more women then men. Symptoms of hypothyroidism include fatigue, gradual weight gain, constipation, muscle aches, joint pain, feeling cold, menstrual irregularities, weakness, hair loss, dry, cold skin and slow reaction time. Many patients will have a goiter (enlarged thyroid).

The incidence of hypothyroidism increases with increasing age. In other words, the older we get, the more likely a thyroid deficiency will show up. The most common cause of primary hypothyroidism (hypothyroidism originating in the thyroid gland itself), is Hashimoto’s Thyroiditis.

Hashimoto's is an autoimmune condition. The body's own antibodies attack the thyroid gland and destroy it, leading to hypothyroidism. Hashimoto’s Thyroiditis may be a manifestation of multiple autoimmune syndromes and may occur in families. Hypothyroidism can also be due to a pituitary problem (central hypothyroidism).

Diagnosing all types of hypothyroidism is important, because treatment with thyroid hormone will improve symptoms in patients with hypothyroidism, but is unlikely to help those who do not have hypothyroidism. In primary hypothyroidism, the thyroid gland is less able to produce the thyroid hormones, T4 and T3.

The pituitary gland, located in the head, responds to this deficiency by secreting more TSH. Thus, in more mild cases of primary hypothyroidism, T4 and T3 levels are normal, but the TSH 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. Then an endocrinologist should perform a hands-on thyroid examination to determine if the patient has a goiter. Blood TSH, free T4, free T3 and anti-TPO antibodies should be tested.

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.

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.

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, get additional testing (beyond the TSH, free T3, free T4 tests), including TPO and anti-thyroglobulin antibodies. Plus, look for other things such as celiac disease, low vitamin D levels, heavy metal toxicity, etc . 

What is Causing This Epidemic of Hypothyroidism?

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.

Hypothyroidism generally strikes women, causing fatigue, weight gain, and cancers amongst many other problems. Therefore, we recommend topical applications of iodine, 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.

Alternative Health Strategies for the Thyroid

The following section will discuss several alternative (non-drug) strategies to support a healthy thyroid, including: proper nutrition, detox, stress, sleep, and cardiovascular support.

Nutritional Strategy for Thyroid

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.

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/medication, 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.

Management of Thyroid Dysfunction

Hypothyroidism should be treated with thyroid hormone therapy. L-thyroxine is the most widely used thyroid hormone replacement. Natural thyroid extracts such as desiccated thyroid should no longer be used.

The usual full replacement dose is 1.6 µg L-thyroxine per kg of body weight. Often, patients with mild thyroid failure require less than a full replacement dose initially. The dose can be adjusted by measuring TSH every 2­3 months.

Once the TSH is normalized and the patient is established on a stable dose of L-thyroxine, TSH monitoring can be done annually. With progression to complete thyroid failure, there is usually a need to increase the thyroxine dose with time. In diabetic patients with underlying coronary artery disease, L-thyroxine therapy may exacerbate angina by increasing myocardial contractility and heart rate.

Therefore, it is best to start with a low dose, such as 25 µg daily, and increase slowly by monthly increments of 25 µg while monitoring the patient's clinical status and serum TSH levels.

Treatment of subclinical hypothyroidism should be considered if 1) patients have elevated serum LDL cholesterol that is worsened by the hypothyroidism, or 2) they have detectable serum anti-TPO antibodies, because the progression to frank hypothyroidism is high in this group, or 3) they are symptomatic.

Because hyperthyroidism can cause serious adverse effects on glycemic control and possibly worsen pre-existing coronary artery disease, it is desirable to consider definitive treatment with radioactive iodine therapy whenever possible. There is no contraindication to the use of antithyroid medications in diabetic patients, but the long-term remission rate of Graves' disease is <40%. Patients with toxic multi-nodular goiters or an autonomously functioning thyroid nodule should be definitively treated by radioactive iodine or surgery.


Thyroid dysfunction is common in diabetic patients and can produce significant metabolic disturbances. Therefore, regular screening for thyroid abnormalities in all diabetic patients will allow early treatment of subclinical thyroid dysfunction. A sensitive serum TSH assay is the screening test of choice.

In type 1 diabetic patients, it is helpful to determine whether anti-TPO antibodies are present. If these are present, then annual TSH screening is warranted. Otherwise, a TSH assay should be done every 2­3 years. In type 2 diabetic patients, a TSH assay should be done at diagnosis and then repeated at least every 5 years.

Note: For more information about thyroid disease and how to optimize the health of your thyroid gland, get the How to Treat Autoimmune Diseases, PCOS & Thyroid Issues Naturally ebook. Also, refer to the Death to Diabetes Blog.

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