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This issue's topic:

Thyroid Disease

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Thyroid Disease: Hypothyroidism

by Dr. Tina Marcantel

The thyroid gland is located just below the Adam's Apple in the neck. It measures about two inches across and resembles a bow tie. Normally this gland cannot be palpated but if it becomes enlarged it can easily be felt.

The function of this gland is to secrete thyroid hormones that control the body's metabolic rate. As with most of our bodies' systems, when it is functioning properly we are not even aware of it. When problems develop with the thyroid gland, it can manifest with many different signs and symptoms.

Thyroid disease can fall into several categories:

*Hypothyroidism: may take the form of Hashimoto's thyroiditis, subacute granulomatous thyroiditis, and silent lymphocytic thyroiditis.

*Hyperthyroidism: may take the form of Graves' disease, toxic nodular goiter, or secondary hyperthyroidism.

*Thyroid cancer

In this article I'll deal specifically with hypothyroidism and I'll cover hyperthyroidism and thyroid cancer in later articles. I should point out that although Graves' disease starts out with the thyroid gland overproducing hormones (hyperthyroidism), the subsequent damage to the gland can lead to underactivity and the patient will need thyroid hormone replacement therapy, which is a typical treatment for hypothyroidism.

Some signs and symptoms of low thyroid production (hypothyroidism) are dry skin and hair, hair loss, fatigue, depression, weight gain, constipation, and hypersensitivity to cold.

Hashimoto's thyroiditis  This is the most common type of thyroiditis covering approximately 80% of patients. It is an autoimmune thyroiditis in which the body turns against itself, creating antibodies that attack the thyroid gland. Most people with Hashimoto's develop hypothyroidism and must take thyroid hormone replacement therapy. Inflammation of the gland will initially cause the gland to go through a phase of hyperthyroidism that will eventually damage the gland and lead to a state of low hormone production. In a patient with Hashimoto's, the doctor will feel a painless enlargement of the thyroid gland.

Subacute granulomatous thyroiditis  This disease often follows a virus or sore throat and low grade fever. The thyroid gland is tender and there is pain when the patient swallows or turns her head. Usually it can go away by itself within a few months. Inflammation causes the gland to release increased amounts of thyroid hormones which is then followed by hypothyroidism.

Silent lymphacytic thyroiditis  This occurs mostly in women after childbirth. The thyroid is enlarged and non-tender. The patient may eventually recover but hypothyroidism can be permanent.

Testing

Testing for thyroid disease can include blood tests to measure the amount of thyroid hormones T3 and T4 and pituitary response to thyroid hormone TSH.

A TPO test can measure thyroid antibodies to determine autoimmune problems like Hashimoto's disease.

Salivary testing can be done to measure a patient's cortisol levels to rule out adrenal fatigue. It is necessary to correct adrenal fatigue and support the adrenal glands in order for thyroid treatment to be effective.

Blood testing for ferritin, vitamin D, and iodine

Low ferritin can contribute to a decrease in the transport of thyroid hormone (T3) to the nucleus of the cell.

Vitamin D level is an effective immune modulator when there are elevated autoimmune thyroid antibodies.

Iodine: The thyroid gland needs a small amount of iodine to synthesize thyroid hormones. A large amount of iodine can decrease the amount of hormone the gland produces.

Treatment options

Supplements of zinc and selenium are needed to produce thyroid hormones. Supplements of vitamin D and iron may be used as needed according to blood test results.

Thyroid hormone supplementation may also be recommended according to test results.

Prescription medications may be synthetic, bio-identical (made at a compounding pharmacy), or tablets made from animal (pig) thyroid gland. I prefer to use bio-identical hormones because they can be tailored to the individual's needs. I have some patients who do not get the desired results from synthetic T4 alone because their bodies are unable to convert T4 to T3, which is the active hormone. For instance, Synthroid has only T4.

I avoid using animal thyroid (Armour Thyroid) if the patient has autoimmune diseases such as Hashimoto's, rheumatoid arthritis, etc., because it can add to the inflammatory process if the patient's antibodies react to the animal thyroid.

Some final considerations

Prescribed thyroid medication action can be altered by certain drugs, so it's very important to inform your healthcare professional of all medications and nutritional supplements you may be taking. Also, the absorption rate of these thyroid meds can be decreased if there is inflammation in the gastrointestinal tract or a parasitic infection is present.

To read this article on our website, click here

For titles and summaries of more articles by Dr. Marcantel, click here

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Dr. Tina Marcantel

5416 East Southern Avenue #110

Mesa, AZ 85206

480-985-0000

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