Hypothyroidsm & Hyperthyroidism
What is a thyroid gland?
The thyroid is a small, butterfly shaped gland in the front of the neck, just below the thyroid cartilage or Adam’s apple. Thyroid hormone is initiated by Thyroid Stimulating Hormone (TSH) from the pituitary gland, to request the production of the two principal thyroid hormones; the active hormone triiodothyronine (T3) and the inactive hormone thyroxine (T4), which is converted to T3. Iodine is needed for the production of both hormones. The primary function of thyroid hormone is to regulate metabolism and the rate of how the body converts nutrients into energy.
Diagnosing hypothyroidism & hyperthyroidism
Diagnosing a thyroid disorder can take years with standard testing of a TSH level. For many, the signaling hormone alone does not provide adequate information about the available or free thyroid hormone on a tissue level. Thyroid hormones that are free are available for use by your cells, while total levels are bound to proteins. Measuring the available free forms of T4 and T3 provide more reliable information of a thyroid disorder than total readings. Another thyroid hormone known as Reverse T3, is produced in higher amounts with chronic stress. Reverse T3 can block the utilization of T3 hormone. This defense mechanism will slow metabolism to conserve energy under duress. On a tissue level, hypothyroidism can be present with a normal TSH, Free T4 and Free T3. In the event of Iodine deficiency, the thyroid gland will enlarge to absorb more iodine needed for thyroid hormone production. Iodine deficiency is a common cause of an enlarged thyroid gland, also known as a Goiter.
What are the symptoms of hypothyroidism & hyperthyroidism?
Hypothyroidism can present with various symptoms. Most commonly seen in our office is low energy, sleep difficulties, inability to lose weight, brain fog, brittle hair and nails, cold hands and feet, depression, anxiety, menstrual changes, infertility and generalized pain.
Some of the symptoms can overlap with hyperthyroidism which occurs when thyroid levels are too high. The most common cause seen in our office is from an autoimmune condition known as Grave's disease. Symptoms of elevated thyroid hormone include Goiter, increased heart rate, anxiety, hand tremors, sleep difficulties, weight loss, diarrhea and menstrual changes with infertility. It is normal for thyroid levels to slightly rise during pregnancy which is critical in the development of a baby’s brain and nervous system.
How to treat hypothyroidism & hyperthyroidism
Consideration of all aspects of thyroid function including environmental burden, micronutrient deficiencies, food intolerances specifically gluten, Celiac disease and lifestyle factors such as stress and sleep are important in the treatment of thyroid disorders. The most common treatment of Hypothyroidism is with the use of a synthetic hormone known as Levothyroxine or Thyroxine (T4). The brand name is Synthroid. The concept of replacing T4 only, is with the assumption the body will make what it needs to with T4. Unfortunately, most patients require the active form of thyroid hormone known as Triiodothyronine or T3. Some patients with Hypothyroidism respond well to a desiccated porcine thyroid, known as Armour thyroid which is derived from glandular extracts with combination of T4 and T3 in a 4:1 ratio. Depending upon the need of the individual, compounded T4 and T3 is another option that can personalize their thyroid treatment. Patients diagnosed with Hyperthyroidism associated with Grave’s disease are commonly given an antithyroid medication known as Methimazole which blocks the production of thyroid hormone. In some cases, patients are given radioactive iodine to kill active thyroid cells thus decreasing the production of thyroid hormone. If symptoms become unmanageable, surgical removal of the thyroid gland, known as thyroidectomy may be suggested. Available treatment services include:
