Thyroid hormone is shared by both men and women. However, women are more likely than men to have thyroid conditions, especially after pregnancy and menopause. The thyroid is a small gland, shaped like a butterfly, located in the lower part of your neck. The function of a gland is to secrete hormones. The main hormones released by the thyroid are triiodothyronine, abbreviated as T3, and thyroxine, abbreviated as T4.
These thyroid hormones deliver energy to cells of the body. When the thyroid gland is underactive, improperly formed at birth, surgically removed all or in part, or becomes incapable of producing enough thyroid hormone, a person is said to be hypothyroid (too little=hypothyroid). A hypothyroid patient will have a high level of TSH, thyroid stimulating hormone, as it is attempting to stimulate the thyroid gland, but it is not responding. This lack of response makes the body make more TSH, hence the rising TSH when the gland is NOT working. One of the most common causes of hypothyroidism is the autoimmune disease called Hashimoto’s disease. With this condition, antibodies gradually target the thyroid and destroy its ability to produce thyroid hormone.
Symptoms of hypothyroidism usually go along with a slowdown in metabolism, and can include fatigue, weight gain, constipation, dry skin, depression, hair loss, irregular periods, sleep disturbance, infertility, hoarse voice, light sensitivity…among others.
When the thyroid gland becomes overactive and produces too much thyroid hormone, a person is said to be hyperthyroid (too much=hyperthyroid). The most common cause of hyperthyroidism is the autoimmune condition known as Graves’ disease, where antibodies target the gland and cause it to speed up hormone production.
Symptoms of hyperthyroidism usually go along with a speed up in metabolism, and can include rapid heartbeat, weight loss, diarrhea, moist skin, and anxiety/nervousness. With hyperthyroidism, patients should seek treatment with an endocrinologist.
To test your thyroid, we can perform simple blood tests to measure your TSH (thyroid stimulating hormone), Free T3, Free T4 and thyroid antibodies to evaluate for Hashimoto’s hypothyroid. The TSH level is evaluating the stimulation to the thyroid gland. If the thyroid gland does not respond to the stimulating hormone (TSH), the body responds by making more TSH, if the thyroid still does not wake up, still more TSH is made; therefore, HIGH TSH levels mean LOW functioning thyroid (hypothyroid). The current TSH range used by most labs is .5 to 5.5, although most people do not feel good unless their TSH levels are around 1-2.
Looking at the whole picture – TSH, Free T3, Free T4, thyroid antibodies, cortisol, hormone levels, plus your symptoms, will help us determine if you need thyroid replacement.
Some patients can have functional hypothyroid, meaning the blood tests appear to show normal function of the thyroid, but the patients have all the classic symptoms of hypothyroid. Sometimes, adding the vitamins that are crucial for thyroid function, such as iron, iodine, selenium, zinc, copper, manganese, vitamin C and B vitamins, will help the thyroid function better. And sometimes these patients will respond to low dose thyroid hormone replacement.
Good supplements that can help your thyroid perform are iodine, iron, selenium, zinc, copper, manganese, vitamin C and B vitamins. It is important to know your cortisol function when determining if you have suffered hypothyroidism for a long time and not been treated. The cortisol response becomes tired over time, trying to compensate for a poor functioning thyroid. Even when your thyroid condition is treated, if you adrenals are still tired, you may not feel better. It is very important to have your cortisol tested, preferably in the saliva, before starting any thyroid treatment.
Try to control stress, which in turn will control your cortisol level. Easy to say, but hard to do. Sleep, adequate diet and water intake, and vitamins go a long way to helping cortisol and thyroid hormones.
Finding the right dosage of thyroid hormone to alleviate your symptoms takes time. At Comprehensive Women’s Healthcare, we can replace thyroid hormone by giving you synthetic T4, in such preparations as Synthroid® or Levoxyl®, or by using Armour thyroid®, which has a ratio of T4 and T3 in it. In the body, T4 must be converted to T3, and some patients lack this conversion response; therefore, some patients respond better to a combination of T4/T3 than T4 alone.
No matter which combination of medications we use, when using thyroid hormone we “start low and go slow”. We do this to decrease side effects from adjusting your medications too quickly. It just takes time for your thyroid to respond to newly added medications.
Take the low thyroid quiz to help identify symptoms.
