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Hypothyroidism
By: Colleen Jo Gagliardi, ND
Dear Doctor: My doctor has diagnosed
me with hypothyroidism. What does this mean?
KT, Joliet
Whenever anyone comes into our clinic complaining about
weight gain or inability to lose weight, fatigue, low
energy, depression or feeling cold we always consider
the possibility of low thyroid function, otherwise known
as hypothyroidism. Additional symptoms of
hypothyroidism may include decreased libido,
constipation, dry skin, hair loss, menstrual
difficulties, elevated cholesterol levels, headaches or
joint pains.
The thyroid gland, which is butterfly shaped, is located
on the front of your neck, just below your "Adam's
apple". The thyroid gland, though small in size is
responsible for forming thyroid hormones, which set the
metabolic rate of the body. It is as though the thyroid
gland is the “accelerator” of the body…if it is not
stimulated enough the body's metabolism slows down.
Additionally, thyroid hormones affect brain, muscle,
gastrointestinal and skin function, as well as
interacting with other hormones in the body.
Thyroid function is usually measured through a simple
blood test that measures TSH (thyroid stimulating
hormone). Although there are more sophisticated tests
that can check other aspects of thyroid function, the
first test to start with is TSH. Since thyroid hormones
function on a feedback mechanism, if your thyroid is low
your TSH will be high as it tries to stimulate the
thyroid to put out more thyroid hormone. From a
Naturopathic viewpoint, thyroid hormone is prescribed
based on TSH values and also on clinical symptoms. In
the case where TSH is not optimum (a TSH value of more
than 3 mU/L), this may be treated as a case of
sub-clinical hypothyroidism. This means that TSH lab
values are within normal range, but are not at an
optimum level, and clinical symptoms of hypothyroidism
are present. The American Association of Clinical
Endocrinologists suggest considering patients with TSH
levels between 3.0 and 5.6 as having possible thyroid
underactivity in spite of being within the reference
range of normal. They recommend correlation with
clinical symptoms. Estimates for people who have
sub-clinical hypothyroidism range from 4-17% of women
and 2-8 % of men. The incidence also increases with age
and especially around menopause.
Although nutrient deficiencies and prescription
medications can contribute to hypothyroidism, another
common reason for hypothyroidism is a condition called
Hashimoto’s thyroiditis, where the body’s immune system
attacks components of the thyroid gland, thus impairing
its function.
What can be done? From a naturopathic standpoint,
hypothyroidism may be treated using a combination
approach. Primary to this approach is the use of
medication to supply the body with the thyroid hormones
needed. In our Naturopathic practice, we often use
Armour thyroid or Naturthroid, which is thyroid hormone
derived from animal sources and contains both T4 and T3.
Levoxyl or Synthroid is a synthetic version of thyroid
hormone and contains only T4. There is scientific
evidence to support that using the combination of T4 and
T3 works better for some people than just T4. Patients
who are prescribed thyroid support often respond within
days but could take up to 6 weeks. Responses vary and
often include increased feelings of energy and
well-being. Weight loss may or may not be experienced.
Because dosing is individualized, blood tests may be
needed every 6-8 weeks until the right dose is
established. Then, TSH should be checked yearly to make
sure the dose of thyroid medicine continues to be the
right one for you.
Because symptoms of hypothyroidism are common to many
other conditions, it is important to have a full
evaluation and follow-up to make sure that thyroid is
not the only cause for symptoms that you might be
experiencing. However, just as your car will slow down
if your foot is off the accelerator, so, too, will your
body slow down if your thyroid gland is under
functioning.
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