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Abby Kurth, MPH, MS, CCN, Clinical Nutritionist + Wellness Coach,

The thyroid is a tiny little gland that has us by the throat – literally and figuratively.  This gland, located on the front part of the throat, impacts every cell in the body to regulate metabolism, and so impacts our energy and wellbeing every day.  Many people I work with don’t realize they have thyroid issues, while others are taking medication, but getting no or short term results.  Clearly, successful therapy is going to require finding the real reason behind poor thyroid function.

Primary hypothyroidism comes about when the thyroid produces less hormone due to aging, stress, thyroid gland destruction from autoimmune assault, or nutritional deficiency.  The nutrients iodine and tyrosine are required to make thyroid hormone.

When Functional Hypothyroidism is the issue, the good news is that the thyroid can make enough of the hormone T4.  The bad news is that the body cannot convert the T4 to the T3 hormone that is active in the body.  This is the person for whom basic thyroid tests may be normal, but they have all the symptoms of hypothyroidism.   Liver health and having enough of the nutrients selenium and zinc, which help the conversion is important.  It is also imperative to have normal levels of the adrenal hormone cortisol, which can become too high during stress or too low after a period of chronic stress.  There are proteins that may bind the thyroid hormone and they are increased if estrogen is too high or as a result of some medications.  Thyroid medication is one that can stimulate more binding protein and this is why some people may feel better the first month on thyroid medication, but the results don’t last.

The third scenario for our thyroid is Functional Hypometabolism.  This is where the hormone levels are adequate, but not getting into our cells .  Cells have receptor sites on their surface that allow hormones to enter and then the hormone is transported to the part of the cell where it is utilized.  High cortisol from stress can again inhibit these activities, and so adrenal gland support is often indicated when trying to help the thyroid.  Nutrient deficiencies of iron and vitamin D affect the receptors, as do autoimmune antibodies. 

If we aren’t always getting the right answer to what is happening with the thyroid, we may not be asking the right question.  A usual test of thyroid function is the TSH (Thyroid Stimulating Hormone), a hormone secreted by the pituitary gland to stimulate thyroid production.  Unfortunately this may not tell the whole story of poor thyroid conversion or cell receptivity.  Complete testing of the thyroid would include TSH, free T4 (hormone not bound to proteins), free T3,  as well as Anti-Thyroid Peroxidase (the enzyme that helps thyroid conversion), and Anti-TG Antibodies to look for autoimmune issues impacting the thyroid.