Understanding Your Thyroid and How to Get Help
Thyroid hormones are regulator hormones that influence almost ery organ system and cell in your body.
Thyroid hormones influence the body’s:
- Metabolic rate - the rate at which your body uses calories (energy).
- Heart rate and function.
- Body temperature.
- Speed at which food moves through the digestive tract.
- Brain development.
- Muscle growth.
- Skin and bone maintenance.
- Breathing rate.
- Liver Function.
- Reproductive system.
- Eyes.
Understanding Thyroid Health:
Thyroid health is crucial for overall well-being. Unfortunately, thyroid disease can manifest through hundreds of different symptoms.
Hyperthyroidism, also called overactive thyroid, is when the body makes more thyroid hormone than your body needs.
Hypothyroidism, also known as underactive thyroid, is when the body does not make enough thyroid hormone and thyroid function is compr
Both tend to be more common in women over age 60, or in women who have been pregnant within the last 6 months. However, either can happen at any age, and often begins in peri-menopause.
Most Common Symptoms of Hyperthyroidism
- Weight loss despite an increased appetite.
- Rapid or irregular heartbeat.
- Nervousness, irritability, trouble sleeping, fatigue.
- Shaky hands, muscle weakness.
- Sweating or trouble tolerating heat.
- Frequent bowel movements.
- An enlargement in the neck, called a gaiter.
Most Common Symptoms of Hypothyroidism
- Fatigue.
- Depression.
- Brain fog.
- Weight gain.
- Trouble tolerating cold.
- oint and muscle pain.
- Dry skin or dry, thinning hair.
- Heavy or irregular menstrual periods or fertility problems.
- Slowed heart rate.
During perimenopause, hormonal imbalances can make women more susceptible to developing thyroid conditions, including autoimmune disorders. In fact, thyroid disorders affect women five to eight times more often than men, with many first diagnosed during perimenopause. Approximately 1 in 8 women will develop a thyroid disorder during her lifetime. Up to 60 percent of those with thyroid disease are unaware of their condition.
While proper nutrition and supplements can support thyroid health, sometimes medication is necessary to restore proper function.
Many conventional doctors, including endocrinologists, often miss the mark when diagnosing and treating thyroid issues. They tend to focus on TSH (Thyroid Stimulating Hormone), a pituitary hormone, rather than directly on thyroid hormones. This approach often leads to treatment with T4 medications alone.
Although T4 medications work well for many patients, others need additional T3 treatment to achieve optimal results. Unfortunately, many women feel dismissed by doctors who don’t fully address their concerns or symptoms.
The internet adds another layer of confusion with numerous myths about thyroid treatment that aren’t based on science. This misinformation can make it hard for people to know what to believe. As a result, many thyroid patients are left feeling frustrated and unsupported.
This is where a wellness coach with expertise in thyroid care can make a difference. With years of experience and a deep understanding of scientifically-backed information, I can help you navigate the complexities of thyroid health. While I can’t prescribe medication, I can review your lab results, help you understand your levels, and suggest topics to discuss with your doctor.
Is Your Doctor Failing You?
Delayed Treatment: Many doctors wait to begin treatment until your TSH is more than double the upper limit of the normal range (often 4.5), delaying until TSH reaches 10. This can leave patients feeling unwell for longer periods.
Incomplete Hormone Assessment: Some doctors only focus on TSH or the storage hormone FT4, ignoring the active hormone FT3. T4 needs to be converted to T3 for your body to use it. If you have a conversion issue, you may not have enough T3, even if your T4 levels appear normal.
Inappropriate Medication Management: Although most thyroid patients do well on T4 medications, a small percentage do not. Many doctors fail to recognize when medication needs to be adjusted or supplemented with T3. Instead, they might treat persistent symptoms with antidepressants, blood pressure medications, statins, or pain medications, rather than addressing inadequate thyroid hormone levels.
Inadequate Dosing: Some doctors prescribe thyroid hormones based solely on TSH levels, not considering the actual thyroid hormone levels. This can result in patients remaining ill due to insufficient dosing.
Misinterpreting T3 Medications: Doctors may not understand that T3-containing medications naturally suppress TSH. They might mistake a low or suppressed TSH as a sign of hyperthyroidism, even if FT3 and FT4 levels are within the normal range.
Ignoring Autoimmune Factors: Many doctors do not test for thyroid antibodies, despite most thyroid conditions being autoimmune. Detecting and addressing high antibody levels can help manage the disease and slow its progression.
Overlooking Pituitary Issues: Some doctors underestimate the prevalence of pituitary signaling issues. If you’ve had a concussion or serious illness, your pituitary might not be signaling enough TSH to your thyroid. This can lead to low levels of FT4 and FT3, despite normal TSH levels. If your doctor only tests TSH, they may overlook this problem, keeping you inadvertently ill.
Finding your Optimal Thyroid Treatment
Optimizing thyroid health during perimenopause and menopause is essential because hormonal fluctuations during these periods can significantly impact thyroid function. Proper thyroid management can help alleviate overlapping symptoms such as fatigue, weight gain, and mood swings, ensuring a smoother transition during these life stages.
Understanding Medication Types
When it comes to thyroid medication, it’s important to know your options
- T4 Only: T4 is the most commonly prescribed thyroid hormone to promote hormone balance and thyroid function. While most people do well on it, T4 must be converted to the active T3 hormonen your body to be effective. If your body struggles with this conversion, you may not experience the full benefits of the medication and your thyroid health may be compromised.Examples: Synthroid, Levothyroxine, Eltroxin.
- T3 Only: For those who cannot convert T4 to T3 or need an additional T3 boost, T3-only medication is an option. T3 is fast-acting and requires multiple doses throughout the day to maintain stable levels and avoid peaks and valleys. Examples: Cytomel
- Natural Desiccated Thyroid (NDT): NDT is derived from animal thyroid glands and contains both T4 and T3, along with other thyroid hormones. This option can be beneficial for individuals who prefer a more natural approach or who do not respond well to synthetic hormones. Examples: Armour Thyroid, Nature-Throid, WP Thyroid.
- Slow-Release T3: This compounded form of T3 is designed to release slowly in the body throughout the day, providing a more stable level of the hormone and reducing the need for multiple doses. Examples: Compounded slow-release
- Combination Therapy (T4/T3): For individuals who have difficulty converting T4 to T3, adding T3 directly to the regimen can be beneficial. This combination ensures that you receive the active hormone directly.
Dosing Thyroid Medications
Proper dosing of thyroid medications is key to achieving optimal thyroid health and avoiding side effects:
- T4 : Typically dosed once a day. This may be first thing in the morning or at bedtime.
- T3 : Requires multiple doses throughout the day (every 4-8 hours) due to its rapid action. Many people on T3 take a dose at bedtime since a healthy thyroid makes the majority of its hormone in the early morning hours. This mimics this and often can help with sleep.
- Natural Desiccated Thyroid (NDT): Dosing can vary from once to multiple times a day - twice a day is often recommended to maintain stable hormone levels.
- Slow-Release T3: Generally dosed once or twice a day, providing a more consistent hormone release throughout the day.
Timing and Absorption of Thyroid Medication
The timing and the way you take your thyroid medication can significantly impact its effectiveness and your thyroid health.
- T4 and NDT Medications: These should be taken on an empty stomach, at least 60 minutes before eating food or drinking coffee, to ensure proper absorption. Additionally, take the medication two hours away from other medications and four hours away from mineral supplements and proton pump inhibitors (PPIs).
- T3 Medications: These should be taken at least 30 minutes away from food. If you want to lower the peak effect of the medication and mimic a slow-release T3, taking it with food can help.
Testing your Thyroid
Regular testing is essential to manage your thyroid health effectively: To receive optimal thyroid treatment you need to have a full thyroid panel done which assesses much more than just TSH.
A Full Thyroid Panel includes:
- TSH
- free thyroxine (fT4)
- free triiodothyronine (fT3)
- anti-thyroid perioxidase (TPOGb)
- anti-thyroglobulin (TgAb)
- RT3
Testing Tips: Always test early in the morning while fasting. For accurate results, labs should be drawn 12-16 hours after your last dose of T3 or NDT, and 24 hours after T4.
Impact of Other Medications: Some medications, like Metformin, can falsely decrease TSH
Impact of Other Supplements: Avoid biotin for at least three days before the test, as it can falsely lower TSH and inflate FT3 and FT4 levels, making it look like your results are better than they are.
Factors Influencing Thyroid Medication Efficacy
Many factors can affect how well thyroid medication works for you, including:
1. Genetic predisposition
2. Overall health and well-being
3. Lifestyle habits (diet, exercise, sleep)
4. Gut health Liver health
5. Autoimmune conditions
6. Vitamin and mineral deficiencies
7. Hormonal imbalances
8. Chronic or acute illnesses
9. Pregnancy
10. Stress levels
11. Pituitary signaling issues
Addressing these variables can help optimize your treatment plan.
Navigating thyroid health can be challenging, especially when faced with incomplete diagnoses, improper treatments, and conflicting information. If any of this sounds familiar to you, and you’re struggling with symptoms that aren’t being addressed, it’s time to seek guidance. As a wellness coach with expertise in thyroid health, I can help you make sense of your lab results, understand your symptoms, and suggest effective strategies to discuss with your healthcare provider. Book a free discovery coaching session with me, and together we will help you get your life back on track.
Nourishing Your Thyroid
Managing hypothyroidism can be challenging, but the right diet can significantly support your thyroid health and overall well-being. Whether you’re managing your thyroid with medication or aiming to boost thyroid function naturally through diet, these tips can help you feel your best.
Vital Nutrients for Thyroid Health
Iodine:
Iodine is crucial for producing thyroid hormones. While deficiency is rare in many parts of the world, it’s still essential to get enough without overdoing it. Great sources include:
- cod, haddock, and oysters
- Yogurt and cow’s milk
- Eggs
- Seaweed (in moderation)
Iron:
Iron helps transport oxygen in your body and supports thyroid hormone production. People with hypothyroidism often need to keep an eye on their iron intake. You can boost your iron levels with:
- Red meat and poultry
- Fish and shellfish
- Beans, peas, and lentils
- Nuts and seeds
- Fortified cereals
Selenium:
Your thyroid has the highest selenium content of any organ in your body. Selenium helps in hormone metabolism and maintaining thyroid health. Find it in:
- Brazil nuts
- Tuna and halibut
- Sardines and shrimp
- Beef, turkey, and chicken
- Lentils and beans
Zinc:
Zinc plays a role in regulating thyroid hormones. Common sources include:
- Beef and poultry
- Oysters
- Pumpkin, sesame, and hemp seeds
- Lentils
- Fortified cereals
Magnesium:
Magnesium aids in iodine absorption, critical for thyroid hormone production. Get magnesium from:
- Pumpkin seeds
- Almonds, cashews, and Brazil nuts
- Chia seeds and spinach
- Legumes like black beans and lentils
- Whole grains such as buckwheat and quinoa
Nutritional Tips for Hypothyroidism and Menopause
For women experiencing menopause and dealing with hypothyroidism, proper nutrition can be a game-changer to creating hormone balance. Here’s how to balance your diet:
Hydration is Key:
Stay hydrated to support metabolic processes and energy levels. Aim for at least 8 cups of water a day.
Balanced Meals:
Focus on a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. This balanced approach ensures you get a wide range of nutrients.
Protein Power:
Protein is essential, especially during menopause, to maintain muscle mass and support metabolism. Include sources like lean meats, fish, beans, and dairy (If not sensitive). Always aim to consume .8 grams of protein per pound of body weight.
Fiber-Rich Foods:
Incorporate fiber to aid digestion and help regulate blood sugar levels. Good options include whole grains, fruits, vegetables, and legumes. Always aim to consume between 25 and 40 grams of fiber a day.
Healthy Fats:
Omega-3 fatty acids, found in fish, flaxseeds, and walnuts, support heart health and reduce inflammation.
Calcium and Vitamin D:
These are crucial for bone health, particularly during menopause. Dairy products (if not sensitive), leafy greens, and fortified foods are excellent sources.
Boosting Your Thyroid Naturally
If you’re trying to boost your thyroid function without medication, focusing on your diet can be a natural and effective approach. Incorporating the essential nutrients mentioned above can support your thyroid and overall health.
Foods to Watch:
Certain foods might interact with thyroid function or your medication, so be mindful of:
Soy:
Soy can interfere with thyroid medication absorption. It’s best to have a gap between consuming soy products and taking your medication.
Cruciferous Vegetables::
Veggies like kale, collard greens, and Brussels sprouts contain glucosinolates. While they have cancer-fighting properties, large amounts might affect thyroid function. Moderate consumption is generally safe.
Millet:
Millet contains compounds that might suppress thyroid function if eaten in large amounts. If it’s a staple in your diet, consider diversifying your grains.
Alcohol:
Moderation is key, as excessive alcohol can interfere with thyroid function.
Medication and Diet
When taking levothyroxine (T4) or natural desiccated thyroid (NDT) for hypothyroidism, consider:
- Taking it one hour before eating for best absorption.
- Avoiding certain foods like soy, fiber-rich foods, and coffee within an hour of taking your medication.
- Watching for interactions with supplements such as calcium, iron, and vitamin C.
- Avoiding mineral supplements for at least 4 hours after taking T4 containing medication.
For those taking Liothyronine (T3) medication:
- Avoid food for at least 30 minutes around taking it, as it can decrease the peak and efficacy of the medication.
Avoid Drastic Dieting
While managing weight gain can be particularly frustrating for those with hypothyroidism, it’s Important not to resort to drastic dieting. Severe calorie restriction can lower thyroid hormone levels, further complicating weight management and thyroid function. Instead, focus on a balanced, nutrient-rich diet that supports your thyroid and overall health.
Eat Regular Meals:
Skipping meals can lead to metabolic slowdown. Aim for regular, balanced meals to keep your metabolism steady.
Include Complex Carbohydrates:
Carbohydrates are vital for thyroid function. Eating too low a carbohydrate diet can decrease thyroid levels. Including complex carbs in your diet is essential to support your thyroid and overall health. Here are some excellent sources of complex carbohydrates:
Whole Grains: Brown rice, quinoa, oats, barley, and whole wheat products (gluten free for those with Hashimotos Autoimmune Disease.
Legumes: Beans, lentils, chickpeas, and peas.
Starchy Vegetables: Sweet potatoes, squash, carrots, and beets.
Fruits: Apples, berries, oranges, pears, and bananas.
Incorporating these complex carbohydrates into your meals can help maintain your thyroid function while providing steady energy levels and essential nutrients.
Embrace a Healthy Lifestyle
Combining proper nutrition with a holistic approach to wellness can make a significant difference. Join a wellness challenge, such as a hydration or fiber focus challenge, to kickstart healthier habits. Or explore the guides available here that are designed to help you navigate menopause and thyroid health with ease.
By focusing on a balanced diet and incorporating the essential nutrients you need, you can support your thyroid function and overall health. Always consult with a healthcare professional before making significant changes to your diet or starting new supplements.
With the right tools, tips, and techniques at your fingertips, you can enhance your well-being and take control of your health journey. Embrace the opportunity to improve your mid-life wellness with resources designed to support you.
Thyroid Wellness Journeys: Illustrative Case Studies
The following two case studies illustrate common scenarios that mid-life women may experience who are experiencing impaired thyroid function and hormone balance. These examples are crafted to help you understand potential outcomes and see yourself in similar situations. While the individuals in these case studies are not real, the challenges and solutions presented are based on typical experiences, offering valuable insights into managing similar health issues.
Meet Emily:
Emily is a 47-year-old woman going through perimenopause. She has been experiencing symptoms like fatigue, weight gain, mood swings, and irregular periods. Recently, she noticed her symptoms were becoming more pronounced, including heart palpitations, hair loss, and cold intolerance.
Initial Diagnosis:
Emily visited her primary care physician, who conducted a standard TSH test. Her TSH level was slightly elevated, but within the normal range. The doctor reassured her that her symptoms were likely due to perimenopause and recommended lifestyle changes and possibly hormone replacement therapy (HRT).
Persistent Symptoms:
Despite following the doctor’s advice, Emily’s symptoms persisted and worsened. Together, we reviewed her symptoms and lab results and decided that she would discuss a comprehensive thyroid panel, including FT4, FT3, and thyroid antibodies, with her doctor.
New Findings:
The detailed thyroid panel revealed that while Emily’s TSH and FT4 levels were within the normal range, her FT3 levels were low, and she had elevated thyroid antibodies, indicating Hashimoto’s thyroiditis, an autoimmune thyroid condition. Additionally, her FT3/FT4 ratio indicated that she was not converting T4 to T3 as well as she should.
Personalized Plan:
Based on these findings, we decided that she would discuss the possibility of adding Natural Desiccated Thyroid (NDT) medication with her doctor. Additionally, we considered an Autoimmune Protocol (AIP) diet to help reduce inflammation and support her immune system. To manage stress, which can exacerbate autoimmune conditions, we also discussed incorporating yoga and meditation into her routine. I suggested that she consider supplements such as selenium, myo-inositol, vitamin D3, magnesium, B1, B12, probiotics, betaine with pepsin. A low ferritin level indicated she should also consider an iron supplement.
Outcome:
With the new medication regimen, dietary changes, and stress management techniques, Emily began to notice significant improvements in her energy levels, mood, and overall well-being. Regular follow-ups ensured she stayed on track and made necessary adjustments.
Meet Karen:
Karen is a 60-year-old woman who has been post-menopausal for 6 years. She has struggled with weight gain, depression, dry skin, and joint pain, attributing these issues to aging. Recently, her symptoms have intensified, making daily activities more challenging.
Initial Diagnosis:
Karen’s primary care physician performed a routine check-up, including a TSH test. Her TSH levels were slightly above normal, and she was diagnosed with hypothyroidism. The doctor prescribed T4 medication, which Karen started taking.
Persistent Symptoms:
Despite taking the medication as prescribed, Karen’s symptoms showed little improvement. She continued to feel fatigued and mentally foggy, and her joint pain persisted. We reviewed her symptoms and medical history and decided that she would discuss a comprehensive thyroid panel, including FT4, FT3, reverse T3, and thyroid antibodies, with her doctor. We also discussed the potential impact of post-menopausal hormone changes on her thyroid health.
New Findings:
The comprehensive thyroid panel revealed that while Karen’s TSH and FT4 were within the normal range due to the T4 medication, her FT3 levels were low, and she had a high reverse T3 (RT3), indicating underlying chronic inflammation. Additionally, her FT3/FT4 ratio was low, indicating that she needed additional T3 to augment the T4.
Personalized Plan:
We decided that she would discuss adding T3 medication with her doctor to improve her FT3 levels. We also considered lifestyle changes, including a nutrient-dense diet, light exercise with a focus on strength training, and stress reduction techniques, to support her thyroid and overall health. We suggested that she consider supplements such as turmeric, quercetin, and glutathione to aid liver detoxification, as well as N-acetylcysteine (NAC) to reduce overall inflammation and lower RT3. Additionally, beginning hormone therapy was recommended to help manage her post-menopausal symptoms and improve overall well-being.
Outcome:
After incorporating T3 medication, hormone therapy, and making lifestyle changes, Karen experienced noticeable improvements in her energy, mood, and joint pain. Regular check-ins helped her fine-tune her regimen and maintain her progress.
These case studies highlight the importance of a comprehensive approach to thyroid health, especially for women in different stages of menopause. By understanding their unique needs and working with knowledgeable professionals, women like Emily and Karen can achieve better health and well-being.