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What Causes Hypothyroidism?

-9 Things Your Doctor Might Not Know About Your Thyroid

-And Why Even A Clean Thyroid Test May Not Indicate Your Thyroid Is Healthy

May 10th, 2012


Your butterfly-shaped thyroid gland weighs less than an ounce but plays numerous vital roles in your body, from controlling energy production to body temperature to moods and emotions.

Think of your thyroid as a thermostat that's incredibly sensitive to the slightest changes in your body. A healthy thyroid can adjust for those changes. If you're diagnosed with hypothyroidism, however, or worse still have thyroid symptoms but your tests come back normal, you know all too well how an out-of-whack thyroid can create weight gain and numerous other problems.

According to the American Association of Clinical Endocrinologists, more than 27 million Americans suffer from thyroid dysfunction. Unfortunately, half of them go undiagnosed. If you have thyroid issues, or suspect you do even if your numbers appear normal, consider these nine issues your doctor might not be telling you or even know about.

1. Doctors look at pathological, not functional, averages. Doctors use a normal range of numbers to evaluate thyroid tests. These ranges reflect the averages of everyone who had lab blood work analyzed over the last year, many of whom had thyroid disease or potential thyroid disease. In other words, these averages don't consider healthy people, and if you have a thyroid imbalance, you might fall outside this pathological range.

2. Conventional doctors don't always run the full spectrum of thyroid tests. Most doctors only run thyroid-stimulating hormone (TSH) and T4 (the inactive form of thyroid) tests, and prescribe thyroid meds on these tests alone. But to get a full picture, you also need to measure free T3 (the active form of the hormone) and thyroid antibodies. Measuring TSH alone doesn't reveal pituitary function, whether thyroid hormones are working normally throughout your body, or whether an autoimmune disorder underlies hypothyroidism.

3. Your doctor might not consider autoimmune disease. Hashimoto's is an often-overlooked autoimmune disease where your body attacks and destroys its own thyroid gland. "The cause of hypothyroidism in the US is autoimmune in nearly all cases," says Dr. Alan Christianson, author of The Complete Idiot's Guide to Thyroid Disease. However, "autoimmune causes do not show up for the first several years of disease." That's because a person with Hashimoto's can have normal TSH levels.

4. Gluten can potentially worsen Hashimoto's. The protein gluten in wheat resembles your thyroid gland. So when immune antibodies tag gluten for removal, they also trigger antibody production against your thyroid. Even the tiniest bit of gluten can trigger an immune response, which can last up to six months. "Celiac disease and Hashimoto's are both autoimmune diseases," says Dr. Christianson, "and patients with one autoimmune disease are more likely to have others." A study in the World Journal of Gastroenterology, for instance, found people with Hashimoto's disease also tested positive for Celiac. Researchers suggested when a person tests positive for one, doctors test for both diseases. However, Dr. Christianson notes that gluten does not trigger Hashimoto's.

5. You need a healthy gut to make adequate thyroid hormone. 20 percent of your healthy thyroid hormone activity depends on healthy gut flora, which converts T4 to its active form, T3. Bad diets, stress, and dysbiosis (too much bad bacteria) can all inhibit converting T4 to its active form, T3. Fermented foods and probiotics help you balance friendly flora to make optimal thyroid hormones.

Related PEERtrainer Article:The Diet Protocol For Gut Health

6. Fish oil can boost thyroid function. A study in the Journal of Nutritional Biochemistry showed that omega 3s could increase thyroid hormone signaling within your liver. Thyroid hormones regulate metabolic rate, which explains why people with hypothyroidism often struggle to lose weight. In other words, T4 and especially T3 determine how effectively your liver metabolizes food. Fish oil can boost thyroid hormones to make you a better fat burner.

7. Soy can inhibit thyroid function. Soy elevates TSH, and when patients remove soy from their diets, TSH numbers often fall into the normal range. Soy can also disrupt conversion of inactive T4 to active T3. A study in the Journal of Clinical Endocrinology and Metabolism, for instance, showed that while soy offered other potential benefits, people with subclinical hypothyroidism who consumed 16 mg of soy phytoestrogens increased their risk of overt hypothyroidism threefold. The isoflavones in soy also closely resemble estradiol (E2), the form of estrogen linked to thyroid cancer.

8. Iodine could be harmful, not helpful. Think of one nutrient that benefits your thyroid, and you'll probably name iodine. Your enzyme thyroxine peroxidase (TPO) requires iodine to make thyroid hormones. But if you have Hashimoto's, iodine-rich foods and supplements can exacerbate problems. Iodine stimulates production of TPO, which dramatically increases your body's production of TPO antibodies that can lead to an autoimmune flare-up. A study in the Yonsei Medical Journal found 78% of people with Hashimoto's regained normal thyroid function simply by restricting iodine intake.

9. Stress can create hypothyroidism. Chronic elevated levels of your stress hormone cortisol inhibit T4's conversion to its active form, T3. "During stress, cortisol levels abruptly fluctuate," says Dr. Christianson. "In the acute state, this can cause immune fluctuations giving rise to a latent autoimmune response. In the chronic state, this can suppress the cells' individual ability to respond to thyroid hormones."

Gut inflammation also raises cortisol and reduces gut flora, therefore limiting conversion of T4 to T3. Stress also makes you more vulnerable to autoimmune diseases like Hashimoto's. A study in the journal Thyroid, for instance, found stress is an environmental factor for thyroid autoimmunity. Sugar can also stress your thyroid. That's because high blood sugar stresses your adrenals, which inhibits your pituitary gland and ultimately affects your thyroid.

Related PEERtrainer Article: How To Reduce Gut Inflammation

Related PEERtrainer Article: A Story Of A Woman Who Cured Hashimoto's Disease

Related PEERtrainer Article: How To Lose Weight (The PEERtrainer Formula

Related PEERtrainer Article: How To Do Low Carb The Right Way

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Q"I've had my thyroid removed and still have all the same symptoms as when I was hypothyroid. My thyroid tests are normal but I'm always tired and can't lose weight."

A: (From Dr. Christianson) "Thyroidectomy is still rather common. It can be total or partial. In all cases of total Thyroidectomy and most cases of partial, the patient is unable to make enough thyroid hormone to satisfy their body's needs and are put on thyroid replacement.

Based on a large survey of several thousand patients, roughly half of those on thyroid replacement still have persistent symptoms such as fatigue and weight gain.

The simplest answer is that the guidelines by which doctors choose thyroid replacement medicines and their dosages, is due for an overhaul. Many important variables, including the patients' symptoms, are not taken into account."

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Hadithi M, et al. Coeliac disease in Dutch patients with Hashimoto's thyroiditis and vice versa. World J Gastroenterol. 2007 Mar 21;13(11):1715-22.

Kumar A, et al. Estradiol-induced proliferation of papillary and follicular thyroid cancer cells is mediated by estrogen receptors alpha and beta. Int J Oncol. 2010 May;36(5):1067-80.

Mizokami T, et al. Stress and thyroid autoimmunity. Thyroid. 2004 Dec;14(12):1047-55.

Sathyapalan T, et al. The effect of soy phytoestrogen supplementation on thyroid status and cardiovascular risk markers in patients with subclinical hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol Metab. 2011 May;96(5):1442-9

Souza LL, et al. Effects of dietary fish oil on thyroid hormone signaling in the liver. J Nutr Biochem. 2010 Oct;21(10):935-40.

Yoon SJ, et al. The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis. Yonsei Med J. 2003 Apr 30;44(2):227-35

Kharrazian, D. (2010). Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal, A Revolutionary Breakthrough In Understanding Hashimoto's Disease and Hypothyroidism. New York, NY: Morgan James Publishing.

Stockigt, JR and Baverman LE. (1997). Update on the Sick Euthyroid Syndrome. Diseases of the Thyroid. Totowa, NJ: Humana Press.

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