The thyroid gland sits in the middle of your neck wrapped around your windpipe like a small scarf in the shape of a butterfly. The wings sit on the sides of your neck and are called right and left lobes and the body sits in the middle right in front of your windpipe and below your Adam's apple and is called the isthmus.
The thyroid is a very important gland because the hormones it produces directly affect your weight, how you perceive heat and cold, your metabolic rate, energy level, ability to think clearly, quality and depth of sleep and even sexual interest. Thyroid hormones perpetually interact either to enhance or counteract the effects of every other hormone in your body. If your thyroid is not well balanced the rest of your body won't be either and you will never feel quite right, no matter how many hormones and supplements or medications you take.
Interesting about thyroid is its episodic ups and downs in the medical and public awareness. For many years thyroid was almost entirely a forgotten hormone while over the past decade it has made a strong and serious comeback.
As we focus a bit more on the thyroid it is important to understand that never will there be one hormone, one pill, one thing responsible for or able to cure all our problems. Thus the more you know and the more you do to integrate all the pieces of your life, the more likely you are to feel great and find balance and permanent wellness.
The more familiar you are with the thyroid and its function, the better prepared you become to take responsibility for creating a great hormone balance to keep you well at all ages.
-The thyroid makes two principal hormones: T3 and T4.
-The active hormone is T3 but both hormones are important in their action of maintaining metabolic balance in your body.
-Low thyroid is called hypothyroidism
-Over production of thyroid is called hyperthyroidism.
Diagnosing Thyroid Issues
The gold standard blood test used to diagnose low thyroid function is the TSH.
TSH reflects the amount of pituitary hormone called TSH (thyroid stimulating hormone) released into the blood stream by the pituitary gland when the pituitary does not register enough T3 and T4 circulating in your blood stream.
TSH is a poor test to hang your diagnosis on. The reference range used by conventional laboratories is very broad and misses a large portion of the population who truly suffers with low thyroid function but whose test results fail to fall outside the range. Conventional physicians who only look at the blood tests and don't' listen to the patient will often make mistakes and under diagnose people suffering with classic cases of low thyroid. Clinically, low thyroid is a constellation of the following symptoms:
- cold intolerance- always feeling cold
- inability to loose weight
- unexplainable weight gain in the face of great diets and exercise regimens
- foggy thinking
- heavy menstrual bleeding
Doctors must evolve beyond relying on the blood test results to make the correct diagnosis and actually listen to the patient.
Of note is the fact that since we are unique individuals, what is normal TSH to one of us, may be quite high or low to another and we have no way of telling what is fact until we work with the whole patient in context.
This "new medicine" type of approach actually decreases the incidence of overlooked or ignored thyroid problems in this particular case.
Fact is that thyroid is a key ingredient to hormone balance and that besides using bioidentical estradiol, progesterone, testosterone and supplements, diet and exercise, thyroid function must be addressed and treated as part of the whole picture from the very start if success is to be achieved.
- Thyroid is rarely high as we get older. High thyroid or hyperthyroidism is essentially a disease of the young. It is usually caused by autoimmune or viral causes. People who suffer with hyperthyroidism are usually hot, skinny, hyper, have lots of palpitations and their periods all but disappear. Grave's disease an extreme yet common version of hyperthyroidism causes eyes to bulge. The treatment is symptomatic for the palpitations (beta blocker) and hyperactivity and moves on to PTU- a chemotherapeutic agent and radioactive iodine which is contraindicated and dangerous to pregnant women. The goal is to stop the thyroid from overproducing thyroid hormones.
- Thyroid cancer is a rare disease and may be caused by low thyroid that is not addressed, radiation exposure or other unknown causes including viral.
- Thyroid nodules often appear from an over strained thyroid that is unable to produce the amount of hormones the body needs. Treatment with thyroid medication often makes the nodules disappear or decrease in size.
- Thyroid goiter is an extreme and rare form of thyroid growth that creates a neck bulge and is most commonly caused by either too much thyroid as found in hyperthyroidism or not enough Iodine in the water or salt.
- Low thyroid is what we know as hypothyroidism and is the most common type of thyroid problem. It is caused by a progressive slowing down and decrease in production of thyroid hormones. Aging, diet, stress, toxic exposure, radiation, Hashimoto's thyroiditis (a common diagnosis of low thyroid where non specific blood tests show an autoimmune marker (your own body turns against your thyroid)).
- We are taught to believe that once you take thyroid medication you always have to take thyroid medication. That is not necessarily so. Everyone is different and times of higher stress demand more hormonal support including thyroid, while other times don't. So when you take thyroid medication, you don't need to think of it is a life sentence. However, if it works and you feel better, you may want to choose to continue the medication.
- Symptoms of low thyroid; weight gain, sluggish thinking, loss of energy and vitality, always feeling cold, heavy periods and sleep disorders sound a lot like estrogen and progesterone deficiency. This is a crucial point. It is of utmost importance that you realize that ALL hormones work together and affect one another. You cannot only treat one type of hormone imbalance and think you will get better.
- Your thyroid is affected by all the other supplements, vitamins and medications you take including birth control pills, antidepressants and hormones even bioidentical hormones.
Treatments for Low Thyroid
The treatments for low thyroid include a variety of medications that are only available by prescription only. There are no thyroid medications that are available at the health food store or at your nutritionist's office.
The following is a list of the thyroid medications available and it is all bioidentical regardless of whether you get it from the pharmacy or the compounder:
- Cytomel- T3,
- Armour Thyroid - T3 andT4,
- Synthroid -T4,
- Levoxyl, Levothyroxine- T4,
- Compounded T3 and T4 in cream, drops and troches form.
While diagnosing low thyroid is not difficult if you have an open mind and the understanding, you can practically do it yourself, the proper treatment is not so simple and the outcome is based on how good you are at explaining how you feel and how experienced your doctor is at listening to you and integrating the proper treatment options for you.
My recommendations on treating thyroid problems
Once you figured out your thyroid is probably sluggish and may be causing you some of the problems that just don't go away with the other treatments you are undertaking, do not take thyroid supplements. The only way to help a low functioning thyroid is with thyroid medication and it is all prescription medication.
The supplements I work with are designed to support your thyroid function by improving energy production at the cellular level, boost your immune system, decrease inflammation which often causes the thyroid to slow down, and support hormone balance. But the supplements alone are not enough for a truly sluggish thyroid.
You need the proper thyroid hormone medication and you must find a doctor to help you who is open and knowledgeable and willing to work with as many options as there are to find the proper combination of thyroid hormones that provide you the best balance. Treatment must be tailored to your individual needs. What the right medication for you is depends on your needs and you must work together with the doctor as partners to get you to the best thyroid hormone balance possible.
Finally, because the thyroid is not the only hormone that makes or breaks your wellbeing, keep in mind the thyroid is an important yet still just one piece of the puzzle that is your health.
You need to address your other hormones with the use of bioidentical hormones, your diet needs to become a hormone friendly diet and your exercise regimen must help you get more energized and not more drained.
The stress in your life should have increasingly positive effects and the negative effects should diminish as you age.
And keep in mind that the only thing you can be sure of is that your body will keep changing. So become aware and flexible. When your body changes and the need for thyroid preparations and doses change, make sure your doctor knows you need to change the thyroid regimen you're on.