If you or your loved ones have been newly diagnosed with hyper- or hypothyroidism, your first question may be how to treat the thyroid disease. This guide will explore the basics of thyroid disease, why it happens, and how to fix it.
Here's what we will cover:
- What is the thyroid gland?
- What is hypothyroidism?
- What is hyperthyroidism?
- What are the root causes of thyroid disease?
- How is thyroid disease diagnosed?
- What is the treatment of thyroid disease?
What is the thyroid gland?
The thyroid gland is a butterfly-shaped gland present in the front of the neck. Its primary function is to produce two hormones - triiodothyronine (T3) and thyroxine (T4). These hormones have multiple functions in the body.
One of the most significant functions is regulating the body's metabolic rate. They play a massive role in your energy levels, stamina, body temperature, and heart rate. This is why if you have been feeling tired or lethargic, your doctor may advise getting your thyroid function checked.
There are two main conditions of thyroid dysfunction - hypothyroidism and hyperthyroidism.
What is hypothyroidism?
Hypothyroidism is a condition in which the body cannot produce adequate quantities of thyroid hormones. Often, despite continued stimulation, the T3 and T4 levels remain persistently low.
The most common cause of hypothyroidism is an autoimmune condition called Hashimoto's thyroiditis. In this condition, the body produces antibodies that attack the thyroid tissue and affect its ability to synthesize thyroid hormones. Anti-thyroperoxidase (TPO) and antithyroglobulin antibodies are checked to diagnose Hashimoto's thyroiditis.
Other causes include:
- Iodine deficiency.
- Late stages of thyroiditis (inflammation of the thyroid gland).
- Post-surgical removal of the thyroid or radioactive iodine therapy.
Symptoms of hypothyroidism
The most common symptoms associated with hypothyroidism are:
- Weight gain
- Dry skin
- Hoarseness of voice
- Sensitivity to cold temperatures
- Joint pain or stiffness
- Muscle ache or muscle weakness
- Raised serum cholesterol levels
- Puffiness of the face
- Hair fall
- Mood changes and depression
- Slowed heart rate
What is hyperthyroidism?
Hyperthyroidism is a condition in which the body produces excessive quantities of the hormones T3 and T4.
One of the most common causes of hyperthyroidism is Grave's disease. This is an autoimmune condition in which the body produces antibodies that continuously stimulate the thyroid gland to produce hormones.
It can also occur in the presence of thyroid nodules that produce hormones or inflammation of the thyroid gland (thyroiditis). Overdosing on thyroid medication or iodine tablets can also result in hyperthyroidism.
Symptoms of hyperthyroidism – H3 The most common symptoms of hyperthyroidism are:
- Unintentional weight loss (even if appetite is increased)
- Raised heart rate
- Palpitations or irregular heart rhythm
- Increased sensitivity to heat
- Menstrual irregularities
- Increased frequency of bowel movements
- Thin, brittle hair
Root causes of thyroid disease
Now that we have understood the technical terms, let's explore why these changes occur. Despite years of research, doctors have been unable to pinpoint the exact reason for autoimmune disease. What could be the reason for your body attacking its own tissues?
That is what we explore in functional medicine. Multiple triggers can result in the production of these antibodies. Avoiding these triggers can reduce inflammation in the body. This means functional medicine aims to slow down the continued damage to the thyroid tissue over time.
Exposure to environmental toxins
Numerous triggers can increase the production of antibodies. These antibodies are responsible for autoimmunity that affects thyroid hormone production. Some examples of such toxins include:
- Heavy metals such as mercury and lead
- Repeated antibiotic use
- Certain medications such as lithium
- Parasitic or fungal infections
Blood sugar imbalance and insulin resistance
Patients often suffer from multiple chronic metabolic conditions at once, all of which affect their health. Thyroid disease can also be associated with high insulin levels. Insulin is a hormone responsible for controlling sugar levels in the body. Patients with insulin resistance have high blood sugar levels even with enough insulin. This is because the body is not responding to the insulin produced.
Gluten and dairy are two of the most common groups of products to which people are intolerant. What exactly does that mean? If you repeatedly eat a food you are intolerant to, it will weaken your intestinal barrier.
Certain foods that should be avoided can now pass through your gut and into your bloodstream. These act as foreign particles and stimulate autoimmunity.
Your large intestine has millions of healthy bacteria that are absolutely vital to digest food and prevent infections. These bacteria are one of the key defenses of the body. However, bacterial overgrowth in the small intestine (another part of the gut) can be dangerous.
There can be several reasons for this changed gut bacterial growth pattern. These include:
- Repeated antibiotic use
- Chronic constipation or diarrhea
- Low stomach acid levels
- Poor diet
Hypothalamic–Pituitary–Adrenal (HPA) Axis Dysfunction and Stress
You may have heard every second person tell you that a stress-free life is essential to treating thyroid disease. But how exactly is stress related to the thyroid gland?
Research shows that the release of stress hormones affects the release of T3 and T4. This is because of the effects of corticosterone (the stress hormone) on the release of TSH, which regulates T3 and T4 levels. Stress has also been linked to weight gain and other thyroid symptoms.
Most of the population today is deficient in some or the other nutrient. This could be linked to poor quality of food, wrong food choices, etc. The most common deficiencies include iron, vitamin D, and vitamin B12. Patients may also need micronutrient supplements such as zinc.
Investigations to diagnose thyroid disease
- Complete blood count (CBC) with ESR
- Cardiometabolic: Fasting glucose and hemoglobin A1c, Fasting Insulin, Lipid Profile, and Homocysteine
- Nutrition Profile: Vitamin D, Iron panel with ferritin, Vitamin B12, Magnesium
- Inflammation markers: hs-CRP, CRP
- Liver Function Test
- Thyroid Function
- Thyroid-stimulating hormone (TSH)
- Total T3 and Total T4
- Free T3 and T4
- Anti-TPO antibodies and antithyroglobulin antibodies
This panel of investigations helps assess the status of thyroid function and the overall metabolic health of the body. Thyroid disease can coexist with other chronic conditions, including diabetes, lipid disturbances, etc.
When treatment is started, all of these reports are considered to give optimal doses of medications. The reports are also used for monitoring the progress and response to treatment.
Treatment of thyroid disease
Treatment of hypothyroidism
- Thyroid medication: These are thyroxine supplements that are given in different dosages as per your current health status, symptoms, disease duration, etc.
- Nutritional supplements: Often, our regular diet lacks several nutrients necessary for optimal thyroid function. By taking supplements, we can support our bodies.
Treatment of hyperthyroidism
- Antithyroid medication - Doctors often prescribe tablets such as methimazole that reduce thyroid hormone production. Hence, they control the symptoms of hyperthyroidism.
- Radioactive iodine - The body uses iodine to produce thyroid hormones. Taking radioiodine can selectively destroy the thyroid tissue that is producing excess hormones.
- Surgical management - In some cases, it may be required to surgically remove a part of the thyroid gland to reduce the release of T3 and T4.
The role of functional medicine in thyroid treatment
Conventional thyroid treatment is centered around checking hormone levels and taking tablets. As a result, several hypothyroid persons continue to experience symptoms despite a high dose of medication.
Functional medicine offers a different approach to thyroid treatment. It mainly focuses on finding the root cause of thyroid disease and addressing it. This cause could be related to gut health, antibiotic use, or environmental factors.
By taking the time to understand the root cause of disease, we aim to treat the whole body, not just symptoms. Every person has a unique medical history. In this history lies the answer to what is causing your thyroid dysfunction.
In a practical sense, this can include changes in your diet, a routine focused on rest and stress reduction, and appropriate physical activity. These might sound simple, but if followed consistently can cause a dramatic improvement in your health.
The bottom line
Thyroid treatment is a multi-step process. The treatment starts with understanding the cause of the disease and formulating a plan. Functional medicine doctors are trained to do precisely this.