With winter approaching, it is the ideal time to reboot your system and commit to glowing health – and thinking about thyroid health is a good place to start. If you often feel you’re dragging yourself through the day or you've been struggling to lose weight for a long while despite eating all the right things, it might be worth considering whether your thyroid is doing the job it should.
The thyroid – a butterfly-shaped gland located in the neck – is the body’s internal motor, effectively setting the speed at which the body works. If it’s not up to scratch, you might experience a whole host of uncomfortable or annoying symptoms (see below).
The hormones it makes affect most cells in the body by increasing the basal metabolic rate, as well as augmenting heat production. That’s why people with an underactive thyroid often struggle to lose weight, feel the cold more easily and have low energy – imagine a record player playing a record at reduced speed.
Do any of these sound familiar?
I feel tired all the time
My hands and feet are always cold
I’m putting on weight for no reason
I can’t seem to lose weight whatever I do
I’m often constipated
My muscles ache
I get muscle cramps more often
I feel irritable
Generally, I’m feeling a bit low
I’m struggling to fall pregnant
My periods are heavier than usual
My hair and skin feel so dry
My sex drive is flagging or non-existent
I’m losing hair at the outer edge of my eyebrow.
If more than a few symptoms resonate with you, visit your GP to discuss symptoms and ask to get your thyroid tested.
GP Testing
One of three things will happen after you have a blood test at the GP. The doctor may tell you your results look normal, in which case no further action will be taken. Or you might be sent for further testing. Make sure that you have tested more than simply TSH and T4. Often these can be normal, however T3 is the active hormone and if levels are low, you will have the symptoms of an under active thyroid. If the result looks a little off, either immediately or in a few months' time, go for a retest.
It’s much more common to have an under active thyroid than an overactive one, and more common still for the under active thyroid to be an autoimmune condition called Hashimoto’s, where the immune system destroys the thyroid gland to the extent that it can no longer function normally. However, even with a diagnosis, many people still experience symptoms in spite of treatment.
What Actually Gets Tested?
In the UK, the first thing doctors test is Thyroid Stimulating Hormone (TSH) levels. TSH is the hormone that tells your body to produce the actual thyroid hormones. If TSH is within range, your GP is unlikely to do any further tests on the assumption that the rest of the thyroid hormone-producing cascade is working correctly.
If TSH is raised, your body is working harder than necessary to produce the right levels of thyroid hormones. At this point, your doctor may repeat the TSH test in a few months in order to compare levels.
Alternatively, they might test your Thyroxine (T4) levels to determine whether or not you’re producing the right levels of this hormone. If this level is below range, you’ll likely be prescribed a synthetic form of thyroxine to supply the body with what it is not making itself. If the levels is above range, which suggests an overactive thyroid, you may be prescribed carbimazole and perhaps a beta-blocker.
Still Feeling Tired and ‘Rubbish’ Despite Treatment?
This a common problem. Initially, you may start to feel better, but many patients report sliding back into their previous pattern of symptoms.
The reasons why you’re not feeling better can be complex.
Supplementing with T4 might not work, as what’s going on in your body might be more complicated and involve several issues.
Some people produce enough TSH and T4, but T4 isn’t actually the hormone that does the work.
Triidothyronine (T3) is the ‘work horse’ that needs to be converted in the liver from T4. Some people, for various reasons, simply don’t convert it very well. Zinc and selenium, for example, are two essential minerals required for the conversion of T4 to T3, and it may simply be a question of a deficiency in one or both.
In other cases, you might produce enough TSH, T4 and T3, but the body negates the effects of the usable T3 by making reverse T3 (rT3) –literally reversing the action of T3.
Everything may ‘look normal’, but if you’re still dragging yourself through the day, you could have sub-clinical thyroid problems. GP ranges are quite broad, so it’s easy to fall outside the limits.
It’s worth knowing that regular GP testing does not cover T3 or rT3, so if you’re still feeling below par, it’s worth getting a full thyroid blood screen done privately. I work with all major private laboratories and can arrange this for you.
Do You Have An Autoimmune Thyroid Problem?
Another vital piece of information, which isn’t often covered by the standard GP test, is for the presence of autoimmune thyroid antibodies (thyroid peroxidase and thyroglobulin). This indicates your immune system is attacking your thyroid.
The autoimmune disease Hashimoto’s Disease (a form of under active thyroid) is incredibly common but unless your GP tests for the antibodies, you won’t know that you have it.
GPs generally don’t test for this as it doesn’t affect their clinical management of you – whatever the diagnosis, you’re still going to be prescribed thyroxine.
However, this test is important to nutritional therapists, as the diagnosis requires an entirely different treatment protocol.
You may have high levels of these antibodies, but no symptoms of an under active (or overactive) thyroid. The autoimmune element always comes first. Hashimoto’s (under active) and Graves’ (overactive) Disease affect the thyroid, but they are actually immune system disorders. According to Dr Alessio Fasano MD who lectures on autoimmunity at Harvard University, for an autoimmune disease to exist there are 3 requirements: a genetic predisposition, a trigger and a 'leaky gut.' Once you have been diagnosed with an autoimmune condition, we will delve deeper into these issues.
Adrenal Stress - The Missing Link In Thyroid Treatment
Thyroid health is closely connected with your adrenals (two walnut-shaped stress glands located on your kidneys). If you have had any significant stress, your adrenal glands may not be performing optimally – and this is very bad news for thyroid health.
Adrenal stress disrupts the complex network of interactions needed to make the right amount of thyroid hormones, suppressing the thyroid function.There are tests available privately for this.
Unfortunately, adrenal problems are not recognised by UK GPs. Addressing adrenal problems is important because the effects of stress affect energy production, fat storage (storing fat around the middle) and female hormone health.
The Importance of Iodine
Did you know that the mineral iodine is essential for the manufacture of thyroid hormones triidothyronine (T3) and thyroxine (T4)? Thyroid hormones contain three or four iodine atoms respectively. If you’re serious about fixing your thyroid for once and for all, you could consider a urine test to determine whether or not you have sufficient levels of iodine.
Ready To Get That Thyroid Back Into Shape?
There are a number of different tests, which we can use to measure your thyroid levels. These include a full blood draw, finger prick blood spot test and a urine test. I take a full medical history and evaluate my clients before deciding on the best option. If you have an under active thyroid and are feeling below par, despite medication, I can help. Medication is just a piece of the puzzle.
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