It’s only understandable that thyroid function should be my number one health topic. In 2007, I was diagnosed with Medullary Thyroid Cancer which resulted in a total thyroidectomy and parathyroid transplant. I was put on T-4 medication (Levoxyl) for the last 8 years, and only in the last few months, was able to convince my endocrinologist to supplement me with synthetic T-3 medication. How I was able to maintain a normal family life since the removal of my thyroid glands still marvels me. I knew I had to do my part to stay healthy, hence the quest for feeding my body right. What I did fail to do was to find the right doctors or convince my current ones to do their part.
As I dig deeper in my quest for wellness, I realized so many others suffer the same problem I have. The majority of doctors still follow extreme compliance to outdated standards and treat thyroid dysfunction the same way they did 50 years ago, despite of new research and findings. More often than not, doctors don’t have the time or impetus to do their own research, especially when it questions and contradicts what they learned in medical school. Those of you who suffer from thyroid cancer, hypothyroidism, Grave’s disease or Hatshimoto’s disease may very well know what I am talking about. Not only is it exhausting to navigate through our current healthcare idiosyncrasy, it’s next to impossible to find the right doctor in your area to listen and appropriately treat your illness, and not think that you are either out of your mind and crazy or that you are over-exaggerating your symptoms. Even if you find a doctor who’s willing to work with you, when it comes to your health, your number one advocate is still you. I hope to share my experiences and knowledge of what I’ve learned on thyroid to help you in your journey to optimal health. Prior to my diagnosis, I did not even know what a thyroid gland is or its functions. For most of us, we might not give it a second thought unless something goes wrong, so was in my case.
What is Thyroid?
The thyroid gland is part of the endocrine system which influences the function of many of our body’s most important organs, including the heart, brain, liver, kidneys and skin. It is one of the most important, and often mismanaged, glands we have. This butterfly-shaped gland, which is located at the front of the neck , just above the collarbone, secretes thyroid hormones into the blood, which are then carried to every tissue in the body. Thyroid hormone controls our metabolic processes including how we use energy and how we metabolize food. Thyroid hormone also controls functions that affect our breathing, heart rate, digestion, body temperature, muscle control, brain development and bone maintenance. Since it affects every system of the body, thyroid hormone dysfunction causes a global decline in cellular function and therefore disrupts every part of our bodies.
Unlike men, women’s hormones can shift out of balance during childbearing and menopause, putting us at a risk of five to eight times more likely than men to have thyroid disease.
- According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime.
- An estimated 27 million Americans have a thyroid disorder.
- 60 % are silent sufferers who are undiagnosed, according to The American Association of Clinical Endocrinologists
- One woman in eight will develop a thyroid disorder during her lifetime.
- Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility.
- Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.
Different Types of Thyroid Disease?
Thyroid disease consists of:
- Cancer: ( Papillary carcinoma, Follicular carcinoma, Hürthle cell carcinoma, Medullary thyroid carcinoma and Anaplastic carcinoma)
- Hypothyroidism occurs when the patient’s thyroid gland does not make enough of the thyroid hormones. Several conditions can cause hypothyroidism, including radiation treatment to the neck, surgical removal of the thyroid gland and Hashimoto’s disease. Hashimoto’s disease is the most common cause of hypothyroidism in the US. The disease occurs when the body’s immune system mistakenly attacks and slowly destroys the thyroid gland and its ability to produce hormones.
- Hyperthyroidism is a thyroid disease in which the patient’s thyroid gland produces too much of the thyroid hormones. A number of conditions, including toxic adenoma, Plummer’s disease (toxic multinodular goiter) and thyroiditis, can cause hyperthyroidism but the most common cause is Grave’s disease. Grave’s disease is an autoimmune disorder in which antibodies produced by the immune system stimulate the thyroid gland to produce too much T-4.
- Thyroiditis is a thyroid disease in which the patient has an inflammation of the thyroid gland. Thyroiditis can cause hypothyroidism, hyperthyroidism or both.
- Goiter is a condition in which the thyroid gland is enlarged to an abnormal size. The presence of a goiter does not necessarily mean that the thyroid gland is malfunctioning.
- Thyroid Nodule refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Most thyroid nodules are benign (noncancerous), but a small proportion of thyroid nodules do contain thyroid cancer
It is beyond the scope of this post to talk about the details of thyroid physiology. Here are some basic understandings.
- The hypothalamus in the brain releases thyrotropin releasing hormone (TRH).
- TRH signals the pituitary gland to produce thyroid stimulating hormones (TSH).
- TSH regulates thyroid hormone production. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary decreases TSH production.
- Over 90% of the hormones produced by the gland is in the form or T-4 (thyroxine) and about 7% is in the form of T-3 (triiodothyronine).
- T-4 is the inactive form of hormone and must be converted to T-3, the free form of which will be carried into the cells of the body to exert its metabolic effect.
- T-4 and T-3 are bound to a protein called TBG (thyroid binding globulin) to transport them to the cells in the body.
- Along the way, T-4 is converted to T-3 in many tissues but primarily in the kidney and liver.
- About 20% of T-4 is converted to T-3 in the GI tract, in the forms of T3 sulfate (T3S) and triidothyroacetic acid (T3AC).
For optimal conversion of the T-3 hormone, among other factors, the kidney, liver and the gut must remain healthy.
What Causes Thyroid Disease?
For my condition, it is not clear what causes Medullary Thyroid cancer. According to the American Cancer Society, thyroid cancer is linked with a number of inherited conditions, but the exact cause of most thyroid cancers is not yet known. One known risk factor for thyroid cancer is exposure to radiation, especially during childhood years. According to Dr. James Yang, MD MPH, a board certified Internist and specialist in Integrative and Functional Medicine at George Washington University, there are many important factors that lead to thyroid disease.
- Nutrition: Specific nutrients such as selinium, iodine, iron, antioxidants, Vitamin D, and magnesium play a vital role in thyroid function.
- Hormone Dysfunction: The role of other hormones such as cortisol, insulin, DHEA and sex hormones (estrogen, progesterone and testosterone) have significant effect on both thyroid metabolism and immune regulation.
- Liver Dysfunction: Since the body relies heavily on the liver to convert T-4 to T-3, it’s easy to understand why dysfunction in the liver can cause thyroid problems.
- Toxins: Toxins such as pesticides, BPA, phthalates and triclosan disrupt the endocrine system. Heavy metals such as mercury, lead and aluminum can all trigger antibodies, which in turn lead to autoimmune thyroid conditions such as the Grave’s and Hashimoto’s disease.
- Gut Dysfunction: Poor gut health can suppress thyroid function and trigger Hashimoto’s disease.
- Immune Dysfunction and Chronic Inflammation: Both Hatshimoto’s and Grave’s diseases are diseases of the immune system where antibodies attack and destroy the thyroid.
- Infections: Thyroiditis can be caused by an infection, such as a virus or bacteria, which works in the same way as antibodies to cause inflammation in the gland.
How Do You Know If You Have Thyroid Problem?
When it comes to thyroid cancer, signs are often overlooked. For me, there were no symptoms, and if there were, they were ignored with the demand of my newborn and the stress of moving to a different state. The yearly physical checkup was what saved me as my internist found a lump in my neck. This is the number one sign that you may have thyroid cancer. Other signs are swelling or pain in the front of the neck, hoarseness in your voice or trouble breathing or swallowing. Make sure your seek treatments immediately.
The most common thyroid disorder is hypothyroidism, especially in women over 50. If you find that you have trouble loosing weight, feeling tired all the time, depressed for absolutely no reason, having brain fog, losing your hair and having trouble sleeping, these are some of the signs that you may have hypothyroid. On the other hand, if you keep loosing weight despite a healthy appetite, have heart palpitations, high blood pressure, nervousness, and expressive perspiration, it may be a sign of hyperthyroidism or Grave’s disease.
How To Get Help
You are your own advocate when it comes to your health, especially thyroid health. If you suspect that you have a thyroid disorder, see your doctor and ask for a complete thyroid panel test which should include TSH, Free T-3, Fee T-4 and reverse T3. Some doctors may be resistant to a thyroid diagnosis and treatment and most doctors don’t treat the whole person, but only to the lab test, which could present a problem since doctors don’t agree on what a normal lab test should be and what should be tested. Keep searching for a doctor who takes your symptoms seriously and is willing to work with you.
The best thing to do to advocate for the right treatment is to arm yourself with as much information as possible when visiting a doctor. Most of the time, knowing what to ask is already half way to finding the right answer. Below are some of the resources I find most helpful.
- Chris Kresser’s Report on Thyroid Disorders
- Book by Dr. Datis Kharrazian: Why Do I Still Have Thyroid Symptoms? when My Lab Tests Are Normal: a Revolutionary Breakthrough in Understanding Hashimoto’s Disease and Hypothyroidism
- Book by Izabella Wentz PharmD: Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause
- https://www.nahypothyroidism.org/ – “The National Academy of Hypothyroidism is a group of thyroidologists, headed by Kent Holtorf, M.D., who are dedicated to the promotion of scientifically sound and medically validated concepts and information pertaining to the diagnosis and treatment of hypothyroidism.” . There are many interesting blogs on this website that you will find helpful.
It’s easier said than done as I know this too well. Your doctor may have the best intention but since the right diagnosis and the right treatment are often overlooked, the process may be long and tedious. The best thing you can do meanwhile is to avoid toxins, relieve stress and feed your body with the nutrition it needs so that your liver, kidney and gut are in optimal health. These are factors that have a huge effect on your thyroid functions.