Subclinical Hypothyroidism: Overlooked and Under Diagnosed
Randi Meares Brodmann, N.D. (Integrative Wellness Services for Women)
We live in a world of “subclinical” disease. Many experience symptoms of malaise and illness but don’t actually present with irrefutable evidence they are sick. This is what is known as subclinical. I have found many women who experience symptoms of hypothyroidism, or low-functioning thyroid – fatigue, feeling cold, low heart rate, weight gain – however the disease doesn’t register when medically tested. In other words, they fall under the category of “subclinical hypothyroidism” but blood tests come back negative, indicating a healthy functioning thyroid. What constitutes hypothyroidism and what natural approaches can we apply to help alleviate symptoms and boost thyroid vitality?
Hypothyroidism is most common in women and people over age 50. It affects women 6x as often as it does men. It is a condition that is caused by an underproduction of thyroid hormone and it is believed that it affects roughly 13 million people in the U.S. An under-producing thyroid can be the trigger to many illnesses and disease, as the thyroid gland is intrinsically linked to the immune system and can be affected by everything from an inadequate diet to pesticide residues in fruits and vegetables. In essence, the thyroid can be implicated in just about any condition, as this small, butterfly-shaped organ directly affects our metabolism in every cell in the body and is linked to many organ system dysfunctions.
The thyroid only releases about 1 teaspoon of hormone a year yet underproduction can cause fatigue, weight gain, low tolerance to cold, loss of appetite, recurrent infections, muscle weakness and cramps, constipation, a slowed heart rate, depression, and dry and scaly skin. The most common symptoms people complain about are fatigue and the inability to tolerate cold. In women, painful periods, problems with fertility, and discharge from the breasts can commonly occur. Hormonal imbalances may also occur where an excess of estrogen over progesterone predominates. Typically a women’s ratio of progesterone is about 10:1 to estrogen. Too much estrogen has been shown to inhibit thyroid production. Progesterone, on the other hand, promotes it.
Allopathic treatment of hypothyroidism is to prescribe drugs. Those can include synthroid, armorthyroid (natural form of thyroid), or levothyroxin. All three are highly effective at eliminating symptoms, however, treatment is ongoing for the course of a patient’s lifetime. But are eliminating symptoms enough? Dr. Mark Lader, co-author of, The Encyclopedia of Women’s Health: Herbal and NutritionalHealth, believes nutritional deficiencies and stress are two major factors to hypothyroidism. He argues iodine deficiencies as the main precipitating factor falls short due to the fact that common table salt, a mainstay in most people’s diets, has been supplemented with iodine and deficiencies these days are rare.
The standardized self-test for detecting underactive thyroid is to keep a thermometer handy next to your bed and before rising, first thing in the morning, place the thermometer under your arm for 15 minutes. Do not move as you are doing this, as movement can alter the reading. Do this for at least 5 days and keep a record of your readings. A temperature of 97.6 F or lower may indicate an underactive thyroid, or subclinical or borderline condition, especially if the readings are consistent. If you suspect hypothyroidism, the first step is to have hormone levels in the blood tested, as a small drop in thyroid-stimulating hormone should register. If blood tests come back normal but you still exhibit the aforementioned symptoms, you may have a subclinical condition, which occurs when TSH levels in the blood are elevated, but T4 and T3 levels are normal. Since the thyroid can be adversely affected by poor diet and other factors, let’s look at some of the alternative nutritional and natural approaches that may help reverse bothersome symptoms.
ü Stress, especially distress, is widely accepted as having a deleterious effect on thyroid functioning, and is a deterrent to maintaining a healthy thyroid. Stressful events on an ongoing basis precipitate many vital nutrients from our body, as well as have an adverse affect on immune system functioning. When stress engages the adrenal glands on an ongoing basis, it creates a situation where copious amounts of cortisol are secreted into the bloodstream. High levels of cortisol secretion over long periods of time repress our immune system by rendering disease-fighting leukocytes less effective, muting their ability to detect and kill off viruses and even cancer. This alteration in immune function slows thyroid functioning by decreasing levels of active T3, causing hypothyroid symptoms. Because a low-functioning thyroid is inextricably linked to adverse immune function, finding ways to cope with stress is paramount. Exercise, deep breathing, meditation, and long nature walks are some suggestions to control stress levels.
ü Selenium, glutathione and zinc are some of the nutrients required for the conversion of T4 to T3, the thyroid hormone form that is effective in tissues. Although the mechanism linking selenium and hypothyroidism is unclear, it is clear that many hypothyroid patients are low in this mineral. According to the Web Site, mindbodygreen.com, glutathione is a critical component because of its powerful antioxidant capacity with the ability to modulate and regulate the immune system. It also dampens autoimmune flare-ups, and protects and heals the thyroid.
ü High blood sugar from over-consumption of carbohydrates can also be a factor as high blood sugar elevates cortisol production causing blood sugar swings that can increase the body’s thyroid production.
ü Some additional culprits Dr. Lader implicates in low-functioning thyroid:
1 – Suboptimal intake of calories in women;
2 – Diets high in caffeine;
3 – Food allergies and sensitivities;
4 – Inmbalances in intestinal microflora, as the gut is the place where many problems can start and it is where thyroid hormones are broken down for absorption. More on this a little later;
5 – An abused, overworked, stressed liver, where enzymes that break down and help detoxify toxins also break down thyroid chemicals;
6 – And lastly, certain medications, like antidepressants, affect thyroid function.
How can we move toward a healthy thyroid? Where can we look to correct nutritional deficiencies and support healthy thyroid function? The following ideas may help.
ü A natural way to ensure you get iodine in your diet is to take a kelp supplement. Kelp is seaweed naturally rich in iodine. This is especially helpful if you are on an extremely low-salt diet. Take up to 3,000 mg. daily.
ü B-vitamins are essential to immune function and therefore healthy thyroid function. They are crucial in fighting stress. Take a 100 B-complex vitamin for several weeks following up by a lower full spectrum B supplement. It’s not healthy to stay on a high B supplement for long periods of time.
ü Essential fatty acids support thyroid function and flaxseed can be a tremendous addition to your diet. Take 2,400-5,000 mg. spread throughout the day.
ü Foods to eat in moderation or completely omit are: Broccoli, Brussels sprouts, cauliflower and cabbage, because of their thyroid-blocking actions. Holistic nutritionist and author, Phyllis A. Balch, CNC, also recommends cutting out kale, mustard greens, peaches, pears, radishes, spinach and turnips.
ü Vitamin C is vital to immune function. Take a supplement with bioflavanoids and in a food-based medium. Take 1,000-2,000 mg. daily. More than this becomes contraindicated for arthritic and other health conditions.
ü Move to eliminate gluten from the diet. According to some researchers the molecular makeup of gluten is similar to that of thyroid tissue.
ü Cut out all foods that have an inflammatory effect on the body. Inflammatory-inducing foods cause stress on the body asking it to work harder to fight the inflammation. When your body and your liver don’t have to work so hard it frees up the immune and endocrine systems to perform more efficiently. The health of the liver can’t be overstressed. This organ has its hands full with detoxifying chemicals from our food and the environment. An overworked liver can actually work against someone with thyroid problems because the liver becomes overtaxed and enzymes working overtime can actually precipitate thyroid hormone elimination. This is another reason why a healthful diet is so important. Foods to cut out that inhibit vitality are: Caffeine, sugar, trans and saturated fats, high sodium processed foods, and foods that contain added synthetic chemicals for freshness, color and consistency.
ü Maintaining a healthy gut with healthy intestinal microflora can make a huge difference in overall vitality and thyroid function. Our bodies detoxify and eliminate thyroid hormones through the gut. This is where enzymes break apart thyroid hormones enabling them to be absorbed into the bloodstream. Individuals with inadequate or poor diets, and those with intestinal problems that lead to imbalances in microflora, impair their body’s ability to absorb active thyroid hormone. A probiotic is extremely helpful, as is a diet rich in dark greens that supply plenty of digestive-friendly vitamin K. Look for greens that aren’t on the contraindicated food list. Adding digestive enzymes may also be beneficial in aiding thyroid hormone absorption.
Nutritional supplementation can be a tricky business, let alone knowing how to supplement when working with a complex health condition. I can’t stress enough the importance that a supplementation program be highly individualized, as everyone’s chemistry is different, and everyone’s reaction to nutritional supplementation can vary. It may be necessary to be evaluated by a qualified professional.
With any disease there is always room to find the positive aspects and opportunities for lifestyle improvements. People suffering from hypothyroidism and subclinical hypothyroid symptoms can view this chapter of their life as one that opens doors to enhancing well-being. An evaluation of an individual’s stress levels and exposure to environmental toxins should be addressed when instituting changes for moving a patient toward better wellness, as these two aspects are important keys moving forward in a healthily, constructive and positive way.
The following resources were used in compiling this issue:
Balch, Phyllis, A. and Balch, James R.; Prescription for Nutritional Healing, 3rd ed. New York: Penguin Putnam, Inc., 2000.
Null, Gary, Ph.D.; Get Healthy Now! A complete guide to prevention, treatment and healthy living. New York: Seven Stories Press, 2001.
Web Sites by article title:
“Alternative Thyroid Treatments, Hypothyroid Diets, & Natural Hypothyroid Therapies.” Dr. Podell. Podell, Dr. <http://www.drpodell.org/alternative_thyroid_treatments. shtml.>
“Alternative Treatment for Hypothyroidism – Help for low thyroid and hypothyroidism.” Womentowomen. Pick, Marcelle, OB-GYN-NP. <http://www.womentowomen.com/hypothyroidism/alternativetreatments.aspx>
“Can Hypothyroidism Be Treated Naturally?” About, 9 Nov 2006. <http://thyroid.about.com/b/2006/11/09/can-your-hypothyroidism-be-treated-naturally.html>
“Hypothyroidism.” MedicinePlus. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001393/>
“Hypothyroidism.” Wikipedia. <http://en.wikipedia.org/wiki/Hypothyroidism>
“Hypothyroidism: Diet & Exercise.” Livestrong.
“13 Ways to Treat Hypothyroidism Naturally.” Mindbodygreen, Grunewald, Jill.
“Thyroid Disease: A natural/herbal perspective.” About. Shomon, Mary. 12 Aug 2009. <http://thyroid.about.com/cs/expertinterviews/a/shasta.html>
Randi Meares Brodmann, ND, MFA, CNC
Board Certified HHP – AADP
Integrative Wellness Services for Women
Holistic Health – Nutrition – Women’s Wellness