Most people think of their thyroid only when it does not do its job, but all of us can work on optimizing our thyroid function. The thyroid is a butterfly-shaped gland that sits at the base of the neck, just below the knobby "Adam’s apple" that juts out. It is in charge of producing thyroid hormone, which has a role in the metabolism of every cell in the body. The thyroid therefore has influence on our growth and development, digestion, reproduction, heart health, brain health, and much more.
Hypothyroidism is a condition when they thyroid does not produce enough thyroid hormone, and is the most common thyroid disease. Women are much more likely to develop this condition than men, and it is more common in pregnant women and the elderly. Because the thyroid gland affects so many different parts of the body, there can be many different symptoms when it is not working as it should. But in general, with an underactive thyroid, all of your body's metabolism slows down. The gut slows down causing constipation. Your metabolism slows down, causing weight gain and fatigue. You may have trouble with your memory, or have a depressed mood. Your heart rate slows down, and you may have a low body temperature. Your skin becomes dry, and your hair thins. You may get an enlarged thyroid (called a goiter), with swelling or fullness in your neck.
Hyperthyroidism is the opposite, when the thyroid produces too much thyroid hormone. In this case the body's metabolism goes into overdrive, leading to unintended weight loss, fast heart rate, agitation or anxiety, diarrhea, tremor, flushing, and more. With either hypo- or hyper-thyroidism, all of these symptoms could be the result of other causes, but with any of these we start thinking about your thyroid.
Why does the thyroid stop working well? The most common cause worldwide is iodine deficiency, as iodine is the building block for thyroid hormone. In the United States and other developed countries with iodized salt, this is less an issue. Here, it is more common to have the body's immune system attack the thyroid. This is called Hashimoto's disease, an autoimmune hypothyroidism, or Graves disease, an autoimmune hyperthyroidism.
How is a thyroid disorder diagnosed? Your primary care provider can talk to you about your symptoms and concerns, and from there will order blood tests. These tests measure the current functioning level of your thyroid. For those with low thyroid, the first step is to replace the hormone levels with synthetic thyroid hormone. For those with high thyroid, we treat with medicines that block overproduction of the hormone, and many times surgery or radiation to remove all or part of the thyroid.
Sometimes people have all the symptoms of hypothyroidism but their blood tests are normal; there has been some debate in recent years over this situation. There is now a category called subclinical hypothyroidism, a diagnosis made when a patient has normal blood tests yet seems to have a thyroid gland that is not functioning correctly. For these individuals, as well as for all of us whether we have a thyroid imbalance or not, it is important to support our general thyroid health. We can look at the minerals the thyroid gland needs to work well, and try to make sure we have enough in our diet.
As mentioned above, iodine is an essential building block for thyroid hormone. Iodized salt, seafood, and sea vegetables (or seaweed) are the main source of iodine in our diet. The Recommended Daily Allowance (or RDA) is 150 micrograms daily, which is about ½ teaspoon of iodized salt a day. You do not need to add more salt to your diet to get enough-- most adults eat more than enough salt every day. But you might consider switching back to iodized salt if you use some of the fancier new sea salts, or experiment with adding seaweed to your diet. Many types are available; kombu may be purchased in dried strips, which is easy to add to soups, bean, and noodle dishes. Wakame and dulse are also edible types of seaweed that can be flavorful additions. Some adults add an iodine supplement to their daily regimen, but talk to your doctor first as too much iodine can be a problem too.
There are other minerals the thyroid needs to function well. Selenium helps your thyroid convert to active hormone. If you enjoy nuts, eating 2 brazil nuts a day is a great way to get in more selenium, or there are over-the- counter supplements which should be no more than 50 to 100 mcg daily. Vitamin A, iron, and zinc are all nutrients that support your thyroid, but the emphasis should be more on eating a well-rounded diet that gets adequate amounts of these in rather than taking more supplements. Eating at least 5 colorful fruits and vegetables a day along with regular servings of whole grains and beans should ensure you are getting enough.
Ironically, if you do have thyroid disease, there are a few vegetables that interfere with thyroid function. These are the green leafy vegetables in the brassica family that are so good for your health in others ways: Brussels sprouts, broccoli, cabbage, cauliflower, and others. These vegetables can inhibit production of thyroid hormone, but usually only when deficient in iodine. Cooking these vegetables, rather than eating them raw, can also lessen this effect. Rather than avoiding them entirely, start by making sure you have enough iodine in your diet, and then cooking them when you do eat them.
If you take a thyroid hormone replacement, it is important to take it on an empty stomach. A recent study showed it may be more effective to take in the evening rather than the morning; most important is taking the medicine either 30 minutes prior to meals, or 2 hours after to ensure it is fully absorbed.
If you have any symptoms that sound similar to low or high thyroid function, or any questions about the above information, make an appointment with your provider at Tecumseh Family Health to discuss further. Reflect on the amazing function of this gland, and enjoy your health!