Hypothyroidism, also known as an underactive thyroid, affects nearly five out of a hundred Americans from the age of 12 and up (1). This condition can affect almost every aspect of health. Let's take a closer look at hypothyroidism, and what you can do to manage this condition.
The thyroid is a small butterfly-shaped gland that wraps around the windpipe. It is a part of your endocrine system and plays an important role in producing and releasing hormones. These hormones include:
Your body requires iodine to produce these hormones. Iodine is available from sources such as food, iodized salt, or supplements. Your thyroid cells use this iodine and combine it with the amino acid tyrosine. The thyroid then converts this into the thyroid hormones called T3 and T4.
Once released by the thyroid, the T3 and T4 travel through the bloodstream. Under normal conditions, 80 percent of thyroid hormones are in the form of T4, and 20 percent are in the form of T3. T3 is biologically more active and is several times stronger than T4. The conversion of T4 to T3 takes place both inside the thyroid as well as in some organs other than the thyroid, including the hypothalamus, a part of your brain.
RT3, as its name suggests, can reverse the effects of T3. However, it is produced in very small amounts in the body. Calcitonin is another hormone your thyroid produces and helps to balance calcium within your blood.
The thyroid, like other hormones, is regulated by an extensive negative feedback system. The system starts in the hypothalamus of the brain, which releases Thyrotropin-Releasing Hormone (TRH). TRH signals the pituitary gland to release Thyroid Stimulating Hormone (TSH). TSH in turn instructs the thyroid gland to make thyroid hormones and release them into the bloodstream. When the level of thyroid hormone in your body is high, a negative feedback system activates to reduce the production of TSH, and vice-versa.
The thyroid gland acts like the body's barometer. Its main function is to help cells convert oxygen and calories into energy. However, some other roles include regulating:
Hypothyroidism, or an underactive thyroid, occurs when your thyroid gland does not produce enough thyroid hormone. Since the thyroid gland is responsible for many important functions, hypothyroidism can result in symptoms related to these functions not being performed.
The signs of hypothyroidism include:
There are a variety of factors that can contribute to thyroid conditions. These include:
You have a higher risk of developing thyroid disease if you have one or more of the following risk factors:
Family history of thyroid problems
Blood tests are performed to determine your thyroid function. These include:
The key tests are TSH, Free T3, Free. T4, and Reverse T3. The lower the amount of thyroid hormone in the body, the more TSH will be produced and secreted by the pituitary to stimulate the thyroid gland to release thyroid hormones. A low TSH signals enough TSH on board, while a high TSH signals a deficiency of TSH in the body.
However, these tests can be difficult to interpret and may not give a full picture.
Normal TSH levels' upper limits for most traditional laboratories are under 4.0 to 4.5. While those who have TSH higher than 4.5 are highly likely to have hypothyroidism, many more with TSH under 4.5 have hypothyroidism and can experience symptoms.
Hypothyroidism can be missed if the focus is only on the traditional reference range. In other words, the traditional normal range is far too insensitive to detect hypothyroidism, especially in the early stages before symptoms have started to occur.
Thyroid Peroxidase Antibodies or Thyroglobulin Antibodies being high can point to Autoimmune Thyroiditis, commonly known as Hashimoto's Disease.
Some doctors believe that you do not need to have an elevated TSH level (higher than 4.5) for hypothyroidism to be determined. Increasingly, innovative doctors are also viewing high-normal or normal TSH levels (by traditional standards) as possible evidence of low-level hypothyroidism, especially if symptoms are present.
The traditional normal laboratory range is relative. Many, especially women, even have symptoms of hypothyroidism when TSH is at the lower end of the normal range, or 2.
TSH alone, however, is not an accurate test of all forms of hypothyroidism. Additional tests like Free T3 (FT3) and Free T4 (FT4) are necessary. Some doctors also test for elevated thyroid antibodies in addition to FT3 and FT4. Many patients, especially women, with elevated antibodies are in the process of developing autoimmune thyroid disease.
Even with normal TSH levels, the majority of symptomatic women with elevated antibodies, low FT3, and low FT4 require thyroid hormone replacement to feel well.
The thyroid gland produces four thyroid hormones called T1, T2, T3, and T4. The number indicates the number of iodine molecules attached to the molecule. As discussed above, T4 is a hormone precursor converted into T3, the form that performs most thyroid functions in the body. However, many individuals cannot convert the T4 to T3, and this can cause hypothyroidism.
Free T3 and Free T4 are the only accurate measurement of the body's active thyroid hormone levels. This is the free hormone that exerts an effect on the cells.
If you ask for these tests and your doctor is uncertain about the results, consider visiting a reputable holistic physician or alternative physician for further interpretation and support.
Secondary hypothyroidism is caused by organ malfunctions in parts of the body other than the thyroid gland. One cause of secondary hypothyroidism is Adrenal Fatigue Syndrome (AFS). This is the non-Addison's form of adrenal dysfunction, where the body's stress response cannot keep up with life's chronic stressors.
When stressed, your adrenal glands produce stress hormones, such as cortisol, to help your body respond to this stress. In addition, your body is also supported by the NeuroEndoMetabolic (NEM) Stress Response System. This system has six circuits of related organs that help to support your body during stress. When stress becomes chronic, your adrenal glands can deplete, and imbalances occur in the NEM system. This then results in AFS.
Symptoms of AFS will depend on where in the NEM system there is an imbalance. The one circuit that can be affected by AFS is the Hormone circuit. This consists of the adrenal glands, thyroid glands, and reproductive organs.
When the adrenals are exhausted, the ability of the adrenals to handle the stress associated with normal bodily function and energy requirements is often compromised. To survive, the adrenals force a down-regulation of energy production, slowing your metabolism to conserve energy.
This causes the thyroid to reduce the production of T3 and T4. The down-regulation leads to an increase in thyroid-binding globulin (TBG). As a result of increased TBG, more thyroid hormones are bound on a relative basis, and less is released to the cells. If measured, this leads to reduced free T4 and free T3 levels in the blood (while total T3 and T4 may be normal).
High cortisol, associated with stress, can also inhibit the conversion of T4 into T3, which may affect their entry into cells. In this down-regulation process to enhance survival, the body also shunts some available T4 to produce the inactive reverse T3 (RT3). RT3 acts as a braking system and opposes the function of T3. This reduction in T3, combined with an increase in RT3, may persist even after the stress passes and cortisol levels have returned to normal. Furthermore, RT3 itself may also inhibit the conversion of T4 to T3. This may perpetuate the production of the inactive RT3. If the proportion of RT3 dominates, it will antagonize T3, possibly leading to a state called RT3 dominance. This results in hypothyroidism symptoms despite sufficient circulating levels of T4 and T3. Reverse T3 can be measured and should generally be under 15. Anything higher can mean something is putting the brake on the thyroid; usually, it is the adrenals.
T3 is necessary for the production of progesterone as well. Without adequate T3, progesterone levels can start to decline, resulting in imbalances within the reproductive hormones. This can also then further affect the thyroid hormones. This relationship between the adrenals, thyroid, and reproductive organs is known as the ovarian adrenal thyroid (OAT) axis.
Traditional thyroid medications tend to increase metabolic function. Raising the basal metabolic rate is akin to putting all body systems into overdrive. However, this is not a good idea at a time when a body with adrenal fatigue is trying to rest by down-regulation through the many mechanisms described above.
The body's survival mechanism is designed to achieve a reduction and not increased level of T4 and T3. What the body wants (to slow down) and what the medications are designed to do (to speed up) are opposed.
Thyroid medication administered under such circumstances in those with adrenal fatigue may temporarily relieve symptoms and a slight boost in energy. But this is often short-lived. Ultimately, fatigue returns as thyroid medication worsens pre-existing adrenal weakness and can cause an adrenal crisis. The overall fatigue level continues to increase beyond what the medication is trying to combat. It can become necessary to increase medication dosage or switch to more powerful thyroid medication to manage the worsening fatigue.
In the case of hypothyroidism during AFS, the focus needs to be on supporting the adrenal glands first. This will often lead to spontaneous resolution of hypothyroidism symptoms. The faster the adrenal glands recover from AFS, the faster the symptoms of hypothyroidism resolve.
Those on thyroid replacement will find that less medication is needed as adrenal function normalizes. As adrenal health improves, the need for down-regulation subsides, and thyroid function suppression is lifted, leading to the normalization of thyroid function.
For those pursuing thyroid recovery through adrenal fortification first, the body regains energy without increasing thyroid medication, even after years of relying on such replacement. Eventually, thyroid replacement may not be necessary and can be tapered off totally over time as adrenal function normalizes. However, this should only be done with the support of your doctor. There are also more natural types of glandulars and medications like NP thyroid or Armour Thyroid that can be utilized before jumping into levothyroxine or liothyronine.
However, it is important not to abruptly discontinue any thyroid medications and other natural compounds that may have stimulatory effects, such as herbs and glandulars, without professional guidance. Abrupt termination may result in serious withdrawal symptoms. In rare cases, an adrenal crisis may occur.
However, laboratory tests of thyroid function during this adrenal-focused thyroid recovery strategy will continue to show low thyroid function for some time due to a lagging effect. TSH may continue to be high and out of the normal range, while free T3 and free T4 remain low. This lagging effect can last for months. However, as the adrenals recover, symptoms will reduce.
Traditionally, hypothyroidism is relieved through the use of conventional medication such as synthetic T4. However, some natural remedies in supplements may also assist here.
One of these supplements is Thyro-Blast by Dr. Lam. As the name suggests, Thyro-Blast helps to promote thyroid health. However, it also helps support the adrenal glands with vitamins B6, 9, and 12, iodine, zinc, selenium, copper, L-tyrosine, guggul, and ashwagandha.
The vitamins and minerals in this supplement all play a critical role in promoting thyroid health.
The amino acid in this supplement, L-tyrosine, works to help increase the TSH that your body produces, helping to increase the production of thyroid hormones (2).Hypothyroidism is a condition that can go undetected due to the traditional laboratory tests being out of date and insensitive. Due to this, properly identifying the condition requires a careful history and physical examination, accompanied by laboratory studies such as TSH, Free T3, Free T4, and reverse T3. Not only can this help to determine whether or not you have hypothyroidism, but it can also help to determine whether it is primary hypothyroidism or secondary hypothyroidism caused by AFS. If it is related to AFS, it is also important to address your adrenal health.
If you are currently experiencing symptoms of an underactive thyroid and would like holistic guidance on recovery, you can call us directly at +1 (626) 571-1234 for a free initial call.
Support Your Thyroid Functioning
National Institute of Diabetes and Digestive and Kidney Diseases. "Hypothyroidism (Underactive Thyroid)." 16 Nov. 2022, www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism.
Panda, Sasmita, and Anand Kar. "Guggulu (Commiphora Mukul) Potentially Ameliorates Hypothyroidism in Female Mice." Phytotherapy Research, vol. 19, no. 1 Jan. 2005, pp. 78–80. https://doi.org/10.1002/ptr.1602.
Wang, Zhihua, et al. "L-tyrosine Improves Neuroendocrine Function in a Mouse Model of Chronic Stress." PubMed, vol. 7, no. 18 June 2012, pp. 1413–19. https://doi.org/10.3969/j.issn.1673-5374.2012.18.008.
Wiciński, Michał, et al. "Can Ashwagandha Benefit the Endocrine System?—A Review." International Journal of Molecular Sciences, vol. 24, no. 22, Nov. 2023, p. 16513. https://doi.org/10.3390/ijms242216513.
Whilst hypothyroidism can be a result of AFS, you can also experience AFS as a result of hypothyroidism. This is because of the ovarian-adrenal-thyroid axis. Low thyroid levels can cause imbalances within the reproductive hormones, which can affect cortisol levels. This increases the chance of AFS occurring. And addressing adrenal health is important to managing thyroid health.
