June is Thyroid awareness month in Canada. The thyroid gland is incredibly important in its contribution to the healthy functioning of our bodies. It is located in the middle of the neck, in front of the trachea. It is often referred to the gland that resembles a “butterfly” shape, given its two lobes. The thyroid gland is a part of the endocrine system (the system regulating hormones) and is responsible for producing thyroid hormone. The thyroid gland plays an incredibly important role in our body’s metabolic activities. Thyroid disease can include but is not limited to: hypothyroidism (underproduction of thyroid hormone), hyperthyroidism (overproduction of thyroid hormone), autoimmune thyroid disease, non-malignant thyroid nodules/growth and thyroid cancer.
There is a common misconception that only women can experience thyroid disorders, but men do, too! As we have discussed in prior hormone-related blogs, the thyroid gland and its hormones plays a crucial role overall hormone regulation and balance. Thyroid hormones can be affected by and can in turn affect cortisol & other hormones.
Thyroid markers are tested in the blood. There are a few markers that should be checked in order to be comprehensive. Today, we will keep it incredibly simple in order to understand the bigger picture, but remember there is always more than meets the eye.
Thyroid Stimulating Hormone (TSH) – this is the marker that is most commonly checked and often, the only marker that is checked. TSH is released from the pituitary gland and stimulates the thyroid to produce thyroid hormones. If low amounts of thyroid hormones are produced, then that signals the brain to release more TSH. This in turn, increases the amount of TSH found in the blood.
High TSH + Low thyroid hormone production = Hypothyroidism
Alternatively,
Low TSH + High thyroid hormone production = Hyperthyroidism
Symptoms of Hypothyroidism include, but are not limited to:
unintentional weight gain
fatigue
hair loss
dry skin
constipation
slowed heart rate
depression
intolerance to cold
Symptoms of Hyperthyroidism include, but are not limited to:
unintentional weight loss
thinner skin
increased perspiration
fast heart rate
anxiety/nervousness
insomnia
Now, there is also more to the equation. T4 and T3 are forms of thyroid hormone and their values also matter! We won’t get into the details in the article, but it is important to check the levels of T3 and T4 to ensure adequate conversion of T4 to T3. When there are issues with activation & conversion of T4 to T3, this in turn may increase the need for TSH release from the brain. We will save this specific conversation for another day.
Often, TSH is the only marker that gets tested. But as you can now see, testing T4 and T3 is also important. In clinical practice, this can provide us with more information to base naturopathic therapeutic strategies. In addition, the reference ranges provided for each of these markers are wide and so, it may make sense to revisit your test results and add in some other thyroid markers if "everything is normal" but you still don't feel like yourself.
Thyroid disease can also be a result of an autoimmune condition. Autoimmune thyroid conditions occur when the immune system attacks the thyroid gland.
Grave’s disease occurs when there is an autoimmune tendency to overproduction of thyroid hormones.
Hashimoto’s thyroiditis occurs when there is an autoimmune tendency to underproduction of thyroid hormones.
Thyroid antibodies can be tested to confirm autoimmune thyroid conditions. These include:
Thyroid Peroxidase Antibody (TPO)
Thyroglobulin Antibody (TGAb)
Thyroglubulin can be used as a marker to test for potential thyroid cancer and if elevated, can guide the health provider to order diagnostic imaging & biopsy to confirm. Often, symptoms of thyroid cancer get missed because the symptoms are similar to non-malignant thyroid conditions. This is why a complete thyroid panel can be beneficial.
So, as you can see, I have merely scratched the surface of thyroid health, but the major take home message is that testing Thyroid Stimulating Hormone (TSH) alone, is not enough. There are also other markers for thyroid health such as Reverse T3 (RT3)
One of the principles of Naturopathic Medicine is “Prevention” and when it comes to thyroid health, it is incredibly important to have appropriate screening.
I hope that you found this super basic article informative!
Cheers!
Dr. Mawji