By Dr. Meghan van Drimmelen
"If your thyroid isn't functioning properly, neither are you! Here's how to ensure yours is in tip-top shape." ~Dr. Meghan van Drimmelen | Naturopath Victoria BC
Hypothyroidism, or underactive thyroid, affects more women than men, especially over age 60 (1). The thyroid is the master gland of metabolism and energy, and affects almost every cell in the body—so if your thyroid gland isn’t working optimally, neither are you!
What is the thyroid gland?
The thyroid is a butterfly-shaped gland located at the base of the neck. Thyroid hormone production is controlled by a feedback loop from your hypothalamus, pituitary, and thyroid gland.
This feedback system acts like a thermostat: when the body needs more heat, this system will stimulate the thyroid gland to produce and excrete thyroid hormones (T3 and T4). Conversely, when the body has enough thyroid hormone and needs to cool down, it signals the hypothalamus and pituitary to stop further production of thyroid hormone.
What are the symptoms of hypothyroidism?
Have you been feeling fatigued, gaining weight, and dealing with dry skin? An underactive thyroid could be to blame. Other symptoms of hypothyroidism may include:
- poor memory
- cool body temperature
- dry hair, brittle nails, hair loss
- low libido
- muscle aches
- fluid retention
- menstrual irregularities
A naturopath will identify and treat the underlying cause(s) of hypothyroidism, which include:
Hashimoto’s is an autoimmune disorder in which the immune system attacks the thyroid tissue, resulting in decreased production of thyroid hormone. Often Hashimoto’s has a genetic component, and may be triggered by one or more of the following factors:
- chronic stress (2)
- celiac disease and food sensitivities (3)
- digestive issues, such as an imbalance of gut flora (4) and leaky gut (5)
- deficiencies in nutrients, especially vitamin D (6) and selenium (7)
- exposure to toxins such as heavy metals, perhaps through dental amalgam fillings (8)
In addition, excessive iodine intake can make matters worse for Hashimoto’s patients. Although iodine is an essential micronutrient required for thyroid hormone synthesis and function, too much iodine can actually trigger immune reactivity (9).
Adrenal dysfunction occurs when the adrenal glands produce unnaturally high or low levels of cortisol in response to acute and chronic stress. Adrenal insufficiency occurs when the adrenal glands produce low levels of cortisol. This disorder has been associated with mild subclinical hypothyroidism (10). Conversely, high levels of cortisol can impact thyroid function by inhibiting the conversion of free T4, to active thyroid hormone free T3 (11).
This is a relatively rare cause of hypothyroidism in which a benign pituitary tumour suppresses the secretion of thyroid-stimulating hormone (TSH).
Severe iodine deficiency
In areas of the world where there is a severe iodine deficiency, hypothyroidism is seen in 5 to 15 percent of the population. Since the addition of iodine to salt in North America, iodine-deficient hypothyroidism has become less common (12). To a lesser extent, deficiencies in iron (13), selenium (14), zinc (15), and vitamin A (16) have also been linked with impaired thyroid function.
Destruction of the thyroid gland
Certain medications, such as those used to treat hyperthyroidism, may result in a permanently underactive thyroid. Thyroid surgery and radiation treatment may also prevent this gland from functioning properly.
How do naturopathic doctors diagnose hypothyroidism?
The most comprehensive way to diagnose hypothyroidism is through a thorough medical intake, which examines an individual's symptoms, as well as laboratory testing for various thyroid hormones and antibodies. In my practice I recommend a complete thyroid profile blood test that includes:
- TSH (Thyroid Stimulating Hormone)
- fT3 (Free T3)
- fT4 (Free T4)
- TPO (Thyroid Peroxidase Antibodies)
How do naturopathic doctors approach treatment for hyothyroidism?
The most common causes of hypothyroidism I see in my practice are Hashimoto’s thyroiditis, and problems related to adrenal dysfunction. Here’s my general approach to hypothyroid care:
Determine the underlying cause
The first step in treating hypothyroidism is to determine what’s causing your thyroid dysfunction. After appropriate laboratory testing, I will recommend removing all aggravating factors, such as gluten in cases of celiac disease, food sensitivities, or excessive iodine. I may also recommend treating adrenal dysfunction and correct deficiencies in nutrients such as iodine, iron, selenium, zinc, and vitamin A.
Boost the body’s defences
I will also recommend taking steps to optimize immune and digestive function, specifically in cases of Hashimoto's thyroiditis. Supplements often recommended are probiotics, omega-3 fatty acids, L-glutamine and vitamin D.
Some studies also support the use of herbs to help boost thyroid function. Herbs that are often used in naturopathic practice include ashwagandha, coleus, guggul (17), bladderwrack (18), and curcumin (19).
In addition, I may use thyroid hormone supplements to normalize thyroid functioning. Hormone treatment options include natural desiccated thyroid, which is made from animal thyroid, T4 and/or T3.
Before beginning any treatment for hypothyroidism, be sure to check with your naturopath for specific recommendations!
Hypo versus hyper
With hypothyroidism, the body doesn’t make enough thyroid hormone to maintain normal metabolism, and the body becomes sluggish. Conversely, in hyperthyroidism, the body makes too much thyroid hormone and the metabolism becomes overactive. This results in a wide range of health concerns including anxiety, feelings of heat, weight loss, and heart palpitations and flutters.
1) Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6):988–1028.
2) Mizokami T., etal (2004). Stress and thyroid autoimmunity. Thyroid. Dec;14(12):1047-55.
3) Chin Lye Ch’ng etal (2007). Celiac Disease and Autoimmune Thyroid Disease. Clin Med Res. October; 5(3): 184–192.
4) Chervonsky AV (2013). Microbiota and autoimmunity. Cold Spring Harb Perspect Biol. Mar 1;5(3):a007294.
5) Mu Q etal (2017). Leaky Gut as a Danger Signal for Autoimmune Diseases. Front Immunol. May 23;8:598.
6) Bozkurt NC etal (2013). The association between severity of vitamin D deficiency and Hashimoto's thyroiditis. Endocr Pract. May-Jun;19(3):479-84.
7) Drutel A, etal (2013). Selenium and the thyroid gland: more good news for clinicians. Clin Endocrinol (Oxf). Feb;78(2):155-64.
8) Sterzl I etal (2006). Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis. Neuro Endocrinol Lett. Dec;27 Suppl 1:25-30.
9) Latrofa F, etal (2013). Iodine contributes to thyroid autoimmunity in humans by unmasking a cryptic epitope on thyroglobulin. J Clin Endocrinol Metab. Nov;98(11):E1768-74.
10) Abdullatif HD & Ashraf AP (2006). Reversible subclinical hypothyroidism in the presence of adrenal insufficiency. Endocr Pract. Sep-Oct;12(5):572.
13) Sonja Y. etal (2002). Iron Deficiency Anemia Reduces Thyroid Peroxidase Activity in Rats. The Journal of Nutrition. July 1, vol. 132, no. 7, 1951-1955.
14) Drutel A, etal (2013). Selenium and the thyroid gland: more good news for clinicians. Clin Endocrinol (Oxf). Feb;78(2):155-64.
15) S. Nishiyama, Y. etal (1994). Zinc supplementation alters thyroid hormone metabolism in disabled patients with zinc deficiency. Journal of the American College of Nutrition. Vol 13, Issue 1 62-67.
16) Morley JE (1981). The interrelationship of thyroid hormones with vitamin A and zinc nutritional status in patients with chronic hepatic and gastrointestinal disorders. Am J Clin Nutr. Aug;34(8):1489-95.
17) E. Yarnell & K. Abascal (2006). Botanical Medicine for Thyroid Regulation. Alternative and Complementary Therapies, 12(3): 107-112. doi:10.1089/act.2006.12.107.
18) Promoting Healthy Thyroid Function with Iodine, Bladderwrack, Guggal, and Iris (2013). AARM Reference Review.
19) Srivastava RM, etal (2011). Immunomodulatory and therapeutic activity of curcumin. Int Immunopharmocol, Mar;11(3):331-41.