Understanding Thyroid Disorders: A Natural Approach NICOLE DERSE, CNC CENTER FOR OPTIMAL HEALTH Personalized Medicine People are different and that’s why in our clinic we treat the person and not the diagnosis. This is a major distinction between the approach of conventional, allopathic medicine versus what I do, which is called Functional Medicine. Thyroid The thyroid gland is a soft smooth fleshy gland which sits below the larynx (voice box). Secretes T4: Prohormone T3: Active Calcitonin: regulates calcium How does the Thyroid Work? What does your Thyroid Do? Regulates Metabolism & Regulates Temperature Thyroid hormones stimulate diverse metabolic activities in most tissues, leading to an increase in basal metabolic rate and, therefore, controls body temperature Actions of Thyroid Carbohydrate metabolism: Thyroid hormones stimulate almost all aspects of carbohydrate metabolism, including enhancement of insulin-dependent entry of blood sugar into cells and increased syntheses and breakdown to generate free glucose. Actions of Thyroid Lipid metabolism Plasma concentrations of cholesterol and triglycerides are inversely correlated with thyroid hormone levels – one diagnostic indication of hypothyroidism is increased blood cholesterol concentration. Actions of Thyroid Growth: The growth promoting effect of thyroid hormones is Intimately intertwined with that of growth hormone. Hormones of the Thyroid Gland The thyroid gland produces the hormone called Thyroxine (T4) – this contains 4 molecules of iodine T4 is converted into the much more active form of thyroid hormone called Triiodothyronine (T3) – this contains 3 molecules of iodine T4 is converted into T3 in the liver, muscle, kidney and to a lesser degree in all other body tissues Data Over 30 million women and 15 million men suffer from thyroid disorders. Thyroid problems affect as many as 60 million Americans -- the majority are women in middle age and beyond. The majority are also UNDIAGNOSED. Why are we suffering from such an epidemic of hormonal problems? Common Thyroid Disorders Hypothyroidism (underactive) Hyperthyroidism (overactive) Thyroiditis (inflammation of thyroid tissue) Goiter (enlargement of thyroid gland) Thyroid nodules (lumps within the thyroid) Thyroid cancer (malignant growth in the thyroid) Hypothyroidism Underactive = inadequate thyroid hormone Causes include: Auto-immune disease (Hashimoto's thyroiditis) Poor nutrition Environmental toxins – pesticides, petrochemicals, fluoride, bromide, heavy metals Radiation Hereditary factors Stress Aging Symptoms of Hypothyroidism Weight gain Low body temperature Constipation Hair loss Dry flaky skin Fluid retention Slow reflexes Fatigue Muscle weakness Symptoms of Hypothyroidism Rapid aging Slowness of thought Depression Increased sensitivity to the cold Loss of interest in sex Puffiness around the eyes Heavy or irregular menstrual periods Infertility Severe Hypothyroidism Myxedema is a sign of severe hypothyroidism Hyperthyroidism Over production of thyroid hormone Causes include: Stress & lack of rest Autoimmune disease Hot nodule Over dose of thyroid hormone Amiodarone (heart medication) Iodine toxicity (rare) Symptoms of Hyperthyroidism Rapid heart beat Shortness of breath Increased appetite Weight loss Intolerance of heat Irregularity of menstrual cycle Irritability Anxiety Insomnia Symptoms of Hyperthyroidism Tremor Malaise Muscle weakness Diarrhea Infertility Exophthalmos – eye disease – not always Goiter = Enlarged thyroid Causes include: •Iodine deficiency •Selenium deficiency •Auto-immune inflammation •Nodules within the thyroid •Tumours – benign & malignant •Physiological – During pregnancy & puberty Goiters can compress the trachea or esophagus causing difficulty breathing or swallowing Thyroid Nodules (lumps) Single nodules Multiple nodules Hot nodules (functioning) Cold nodules (nonfunctioning) Often no symptoms Traditional Testing Traditional medical model uses only TSH to assess thyroid. The medical model that relies upon medications to replace T4 or T3 hormone was developed in the 1950′s. New Research The good news is that there has been a lot of research in the last 10 years that uncovers the mechanisms that cause thyroid symptoms even when your TSH is normal. Poor Converters Nutrient Deficiencies - Chromium - Copper - Iodine - Iron - Selenium - Zinc - Vitamin A - Vitamin B2 - Vitamin B6 - Vitamin B12 Medications - Beta Blockers - Birth Control Pills - Estrogen - Iodinated Contrast Agents - Lithium - Phenytoin - Steroids - Theophylline Causes of Poor Conversion Diet - Cruciferous Vegetables - Soy Other - Aging - Alcohol - Lipoic Acid - Diabetes - Fluoride - Lead - Mercury - Obesity - Pesticides - Radiation - Stress - Surgery Complete Thyroid Testing Thyroid Stimulating Hormone (TSH) Free T3 Free T4 Reverse T3 Thyroid antibody levels -TPO -Anti-TG Thyroid antibodies are like missiles. They travel through the blood & find the thyroid gland and attack its cells Other Thyroid Tests Urinary Challenge iodine test Basal body temperature Ultrasound of thyroid Nuclear scan of thyroid Needle biopsy of nodule Assessing Body Temperature Men should take their basal body temperature for four consecutive days Women should take their basal body temperature for first 10 days of your menstrual cycle; this avoids confusion with the normal spike in body temperature which occurs after healthy ovulation Basal Body Temperature If your temperature is below 36.0º C or 96.8º F, your thyroid gland function is less than desirable; this should be confirmed with a blood test Gluten Sensitivity If you have hypothyroidism you should NOT be eating gluten. Over 90% of people with hypothyroidism is the US have Hashimoto’s Thyroid and almost everyone with Hashimoto’s is gluten sensitive. Gluten is a protein found in wheat, rye, and barley. Subsequently, gluten can be found in many everyday foods like cereal, bread, bagels, and muffins. Gluten can also be found in less suspecting foods like soy sauce, pickles, canned baked beans, licorice, hot dogs, salad dressing, boxed soups, pudding, and beer. Iodine 70 – 80% of the iodine in your body is stored in your thyroid gland Required for healthy thyroid tissue Required for production of thyroid hormones Required for healthy breast tissue Reduces thyroid & breast cancer Iodine deficiency is common worldwide Japanese Studies Food rich in nutrients needed for thyroid hormone manufacture and conversion Iodine: Sea vegetables (kelp, dulse, hijiki, nori, arame, wakame, kombu), clams, shrimp, haddock, oysters, salmon, sardines, eggs ZINC • Fresh oysters • Ginger root • Lamb chops • Pecans • Split peas • Brazil nuts • Rye • Oats • Almonds • Walnuts • Sardines Vitamin E Wheat germ oil Sunflower seeds, almonds Peanut oil Olive oil Wheat germ Peanuts Liver, red chili peppers, greens (collard, Vitamin A turnip, kale, Swiss chard, beet greens) apricots, winter squash, cantaloupe, papaya, nectarines, peaches, cod liver oil. Plants containing carotenoids, which have precursor for Vitamin A; alpha-carotene and beta-carotene). Yellow and orange vegetables contain significant quantities of carotenoids. Green vegetables also contain carotenoids. Vitamin B2 (riboflavin): Brewer’s B Vitamins yeast, organ meats, almonds, wheat germ, wild rice, mushrooms, egg yolks Vitamin B3: (niacin): Brewer’s yeast, rice bran, wheat bran, peanuts with skin, liver, light meat of turkey and chicken Vitamin B6: (pyridoxine): Brewer’s yeast, sunflowers seeds, wheat germ, tuna, liver, soybeans, walnuts, salmon, trout, lentils, lima beans, navy beans, garbanzos, pinto beans, brown rice, bananas Vitamin C Red chili peppers Guavas Red sweet peppers, Parsley Greens (collard, turnip, mustard, kale) Strawberries Papaya (organic) Citrus fruits (oranges, lemons, grapefruit) Selenium Brazil nuts. One Brazil nuts provides approximately 139mcg; 200mcg/day is the recommended dosage. Excess selenium can interfere with enzyme systems and can be toxic in amounts greater than 900mcg/day The amino acid tyrosine combines Tyrosine with iodine to make the hormone thyroxine (T4). These foods include meat, fish, turkey and chicken breast, low fat milk and yogurt, almonds, avocado, bananas, lima beans, pumpkin seeds, sesame seeds, lentils. Sunlight While not a food, it is important to get a daily dose of safe sun. Light stimulates the pineal gland, which in turn positively affects the thyroid as well as all the other endocrine glands. Exercise Exercise stimulates the thyroid gland secretion, increases tissue sensitivity to thyroid hormone, and is well known in its stress relieving effects. Foods to Avoid Certain foods are detrimental for hypothyroidism because they can inhibit the production of thyroid hormones. Soy Soy products. Isoflavones are hormone-like substances found in soy products. High consumption of soy products have been found to suppress thyroid function in some people and can even cause or worsen hypothyroidism. Cruciferous Vegetables Broccoli, cauliflower, Brussels sprouts, cabbage, mustard, rutabagas, kohlrabi, and turnips. Isothiocyanates are the category of substances in cruciferous vegetables that have been associated with decreased thyroid function.. Cooking these vegetables does make the isothiocyanates less available. Only restrict this group if you have been actually diagnosed with hypothyroidism or have strong symptoms. Progesterone Low progesterone goes hand in hand with low thyroid, so avoid foods that promote estrogen dominance. This includes any animal product that has not been produced organically (chicken, eggs, dairy, beef, lamb, pork, etc.). All of these foods are available organic. Xenobiotics Exposure to toxic levels of heavy metal can interfere with thyroid function. Lead and mercury can invade the thyroid gland and disrupt the production of thyroid hormones. Consider testing heavy metals in your system. Xenobiotics In agricultural areas, the likelihood of pesticide contamination in the water is higher. Tap water may be contaminated with minute amounts of insecticides, weed killers, and artificial fertilizer. Pesticides have been shown to interfere with thyroid function and to increase cancer risk. Use distilled water or a high quality reverse osmosis filtration system. Xenobiotics Hormones and antibiotic residues in meat and dairy products, food-borne bacteria, chemicals in cleaning products, food additives, cosmetics, and the metabolic by-products of unfriendly gut bacteria can denature thyroid hormones and impair the activity of the liver and kidneys. Eat only organic animal products and consider taking a probiotic (beneficial bacteria) to keep pathogenic bacteria in the gut in check. Other Treatment for Thyroid Problems If on synthetic T4 medicines and not feeling better Try switching to dessicated Thyroid (Armour) Bowel and liver detox plan Gluten free diet if thyroid antibodies present A reduction of dairy products may be required if thyroid nodules contain a mucus secretion called colloid Suggested Approaches for Autoimmune Thyroid Conditions - Use enough thyroid hormones to keep TSH between 0 and 1 - Selenium 200-800 mcg daily - Gluten-free diet for at least 60 days - Rectify any iodine deficiency - Remove aspartame, trans fats, and processed whole foods from diet - Magnesium - Treat any underlying infections - Correct any hormone imbalances, especially DHEA insufficiency and adrenal dysfunction - Restore proper gut function - Avoid thyroid glandulars If you have or suspect you have a thyroid problem Assess your stress Stress management techniques Check Adrenal Status via Adrenal Stress Test Get Tested Complete Thyroid Profile Iodine Testing Gluten Sensitivity test Toxicity Testing Nutritional Testing: Amino Acids: Tyrosine Fatty Acids: Omega 3’s Vitamins: D, A, B Vitamins Minerals: Selenium, Zinc www. 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