Sometimes it seems as women our lives revolve around our hormones. We have to deal with the ups and down of hormone imbalance, menstruation and then menopause — how unfair is that? Who’s calling the shots around here? With its small butterfly shape, the thyroid might seem like a cute little harmless gland, but it’s the one making the decisions on your metabolic hormones and it’s time to start paying attention to it.
Located in the front of your neck just below the larynx (Adam’s apple), this little gland plays a role in nearly every body system, including the heart, nervous system, bone maintenance, GI health and metabolism. It is responsible for the production of three important hormones that influence your metabolism: thyroxine (T4), triiodothyronine (T3) and calcitonin.
The core thyroid hormones are T4 and T3, and proper balance between the two is essential. They dictate your basal metabolic rate, which is the rate at which your body uses energy for its most basic functions, like breathing and maintaining its core temperature. The most abundant hormone released from the thyroid gland is T4 and then about a third of that is converted to T3 every single day. Calcitonin, as the name suggests, is an important player in calcium and bone metabolism, a status we as women cannot ignore. Especially as we age, a combination of a thyroid disorder plus falling levels of estrogen from menopause are a brittle bones disaster waiting to happen.
THE ROLE OF THE PITUITARY GLAND
Everyone knows that partnership is essential to success. Just think of where your partner would be without you! This is why the thyroid gland works closely with the pituitary gland, a tiny pea-sized organ located at the base of the brain, to make balance happen in your body. Think of the pituitary gland as the thyroid gland’s personal assistant, always giving feedback on the status of thyroid hormones in the body. When thyroid hormones are low, the pituitary gland releases thyroid stimulating hormone (TSH) to signal the thyroid to make and release more hormones (T4, T3). The partnership continues, with the pituitary gland being regulated by the hypothalamus, a small region of the brain that plays a crucial role in many important functions. The hypothalamus signals the pituitary gland with a hormone called TSH Releasing Hormones (TRH). These three glands work together to find a hormone equilibrium in your body.
Equilibrium is an important aspect of every part of our lives, and the thyroid is no exception. When the balance of hormones is off, it can cause a cascading effect, throwing off many of our body systems.
Thyroid dysfunction is very common and an estimated 20 million Americans have some form of it. Undiagnosed thyroid disease can increase your risk of heart disease, weight changes, osteoporosis, and can also affect fertility.
There are two scenarios for thyroid hormone imbalance: hypothyroidism and hyperthyroidism. Let’s take a closer look at each.
Hyperthyroidism is when the thyroid is overactive making and releasing an overabundance of thyroid hormones. Too much thyroid hormone is not a good thing. The side effects include:
Graves Disease. Hyperthyroidism is less common than hypothyroidism and affects around 1.2% of Americans. Graves’ disease is the most common cause of hyperthyroidism, contributing to around 50% to 80% of all hyperthyroid cases. It is an autoimmune disease, which means that the body attacks its own cells and tissues because they are accidentally seen as foreign invaders. In the case of Graves’ disease, there is an overproduction of TSH receptor antibodies. These antibodies stimulate the release of thyroid hormones along with the growth of the thyroid gland.
Around 30% of people with Graves’ disease have an eye condition called Graves’ ophthalmopathy, which causes their eyes to protrude or “bulge.” This is caused by inflammation that affects the muscles and other tissues around the eyes.
Risk factors for Graves’ disease include:
There are three main treatment options for an overactive thyroid, which include:
Untreated hyperthyroidism can be dangerous. Complications can include:
Heart problems. Untreated hyperthyroidism can lead to dangerous heart rhythm disorders and heart failure.
Thyroid storm. If hyperthyroidism is severe and left untreated, you are at risk for a complication called thyroid storm, which is not common but can happen and often results in death. Symptoms include confusion and high temperature (often over 40 °C/104 °F), and is usually triggered by an infection or other illness.
Brittle bones. Untreated hyperthyroidism can also lead to osteoporosis, since the thyroid gland is responsible for making calcitonin, a hormone involved in bone growth and maintenance.
HYPOTHYROIDISM (UNDERACTIVE THYROID)
Hypothyroidism is when the thyroid is underactive, not making and releasing enough thyroid hormones. The lack of thyroid hormones slows down metabolism which can lead to a myriad of symptoms including:
As if we didn’t have enough going on after having a baby, postpartum thyroiditis is a common cause of hypothyroidism. It is observed in the first year following childbirth. Fortunately, about 70% of women with postpartum thyroiditis are back to balanced thyroid function within a year of childbirth.
Hashimoto’s thyroiditis. The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto’s thyroiditis, in which the immune system mistakenly attacks thyroid cells, producing inflammation in the thyroid gland and slowing down production of thyroid hormones. It most commonly affects middle-aged women but can also occur in younger women, men of all ages, and children.
You should not be able to see your thyroid or feel it. If you do see a lump in your neck around the area where your thyroid gland is located, you could have a goiter. Enlargement of the thyroid gland is referred to as a goiter and can be another indication of a thyroid disorder. Growth of the thyroid can result in a hormone imbalance. Sometimes the whole thyroid may grow while other times singular nodules can become enlarged, causing them to either make too much or too little thyroid hormones.
Nodules that make more hormones than needed are called “hot” nodules, while those that don’t make enough are called “cold” nodules. Usually a change in the size of the thyroid is benign but should be checked by a doctor to rule out cancer.
GENETICS AND NUTRITION
Genetics play a big role in your risk for thyroid dysfunction, and research suggests that up to 67% of circulating thyroid hormone is genetically determined. People with Hashimoto’s thyroiditis often have family members who have thyroid disease or other autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis.
Just as it is with all disease, nutrition is another key component of thyroid function. These two variables work together to either increase or decrease your risk of thyroid disease.
Legumes, soy and some cruciferous and root vegetables have naturally occurring elements called goitrogens. This means they release a bioactive compound called goitrin, which can reduce T4 absorption and perpetuate autoimmune thyroid disease. Consuming high amounts of goitrogens may have an impact on your thyroid by interfering with iodine uptake in the thyroid gland. Cruciferous vegetables, like broccoli, cauliflower and cabbage, lose their goitrogenic effect through cooking, so it’s best to steam, cook, or ferment them before eating them.
Dietary iodine balance is incredibly important to thyroid health. A deficiency or overabundance can both lead to thyroiditis in people with genetic susceptibility. Iodine is an essential building block in the production of T4 and T3. As our bodies cannot produce iodine, it needs to come from your diet. For proper production of T4 and T3, your body needs about 100 micrograms of iodide every day. Most Western diets are abundant in iodine due to iodized salt. Other sources of iodine include seafood, dairy products, and products made from grains.
Dietary fat influences the release of TSH from the pituitary gland. Optimal communication between the thyroid and pituitary gland is important for healthy hormone balance. Animal studies have shown protective effects on the thyroid from a diet higher in unsaturated fats and negative effects on the thyroid from a diet high in saturated fats. Further, omega 6 fatty acids may have a stimulating effect on thyroid function. A few wonderful sources of essential fatty acids include dark leafy greens, chia seeds and fatty fish such as salmon and albacore tuna.
Vitamins B12 and D:
Vitamins B12 and D both have a strong tie to Hashimoto’s thyroiditis and Graves’ disease, while also affect bone health. The sun is your best source of vitamin D and it is suggested that around 15 minutes per day of sun exposure (without sunscreen) provides most people with an adequate amount of vitamin D production. Vitamin D can also be incorporated into your diet, although it can be hard to get enough that way. Some good dietary sources of vitamin D include fatty fish, dairy, eggs and mushrooms.
Vitamin B12 was found to be low in around 40% of people with a low functioning thyroid. Vitamin B12 is a common deficiency in the United States and research suggests that around 39% of Americans have B12 levels in the “low normal” range. The most abundant source of B12 comes from shellfish, organ meat, and dairy, but can also be found in fortified cereals. Vitamin B12 is available as a supplement.
Recent research has recognized selenium as an essential element in healthy thyroid function. Almost all the selenium in the body is contained in the thyroid and a deficiency can stimulate the development of autoimmune thyroid disease. Selenium supplementation in this type of thyroid dysfunction has shown promise as a treatment for thyroid disorders. Some foods naturally rich in selenium include pasture-raised eggs, brazil nuts, and shellfish. You can also take a selenium supplement.
Inflammation and oxidative stress work hand-in-hand to negatively impact health. An imbalance in thyroid hormones has been shown to increase oxidative stress, which leads to a decrease in antioxidants, which protect against tissue damage in the body. Reduced glutathione, also called GSH, the “master antioxidant” naturally found in the body, is a cofactor for antioxidant enzymes that help convert T4 to T3. Also involved in the process is Vitamin E, a strong antioxidant. Oxidative stress and inflammation have both been shown to be precursors to chronic disease. Foods naturally rich in glutathione and vitamin E include nuts and seeds, leafy greens, and olive oil. You can also take a glutathione or vitamin E supplement.
Zinc and Copper:
Zinc is another mineral that is needed to convert T4 to T3. It is also needed to trigger a response from your hypothalamus to moderate thyroid hormone levels and keep them in balance. Good sources of zinc include beef and shellfish. You can also take a zinc supplement. However, since zinc can lower levels of copper, another important mineral in your body, it’s important to make sure you are getting enough copper when taking a zinc supplement. High-quality zinc supplements specially formulated for those with a thyroid disorder contain an optimal ratio of zinc and copper.
Iron is needed to convert T4 into the more powerful thyroid hormone T3. It also helps convert iodide to iodine, which is needed for a functioning thyroid. Many women are deficient in iron, especially if they are menstruating every month. Good sources of iron are beef and chicken, dark leafy greens, and beans and lentils. You can also take an iron supplement, but it should be combined with vitamin C to help absorption. You should take it with food because it can cause an upset stomach when taken alone.
DIAGNOSIS OF THYROID IMBALANCE
While turning to WebMD may be tempting, remember that a doctor is your best bet for an accurate diagnosis. Blood tests are a doctor’s most reliable diagnosis tool for thyroid disorder. The thyroid function marker your doctor will check first is TSH, the messenger from the pituitary gland to the thyroid to indicate more thyroid hormones are needed. The pituitary gland cranks up the release of TSH when thyroid hormones are low, so an elevated TSH can be a sign of hypothyroidism. A low TSH suggests hyperthyroidism. If TSH is high or low, your doctor will check the other thyroid hormones, T3 and T4. There are other tests that can be done as well, such as thyroid peroxidase (TPO) antibodies, which may suggest that the cause of the thyroid disease is an autoimmune disorder such as Hashimoto’s or Graves’ disease.
Your thyroid may be small, but it carries a heavy responsibility for your overall health. Thyroid disease presents in a multitude of ways, with some very serious side effects. Now that you have a better understanding of the function of your thyroid and how your diet and genetics can affect its function, you are better equipped to maintain and build healthy thyroid function. It is important to listen to the messages your body is sending and seek help when you need it. A healthy balanced diet and open communication with your doctor will help keep you on the right track for optimal thyroid health.
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