Dr. Doni Wilson follows up last week’s article on thyroid health with an eight-step approach to improving thyroid function and optimizing the way you feel.
In my last post, I talked about how an under-active thyroid, even if it is within ‘normal lab ranges,’ can affect your health. I also described some of the key signs that may suggest your thyroid is not performing as well as it should. This week I will suggest some things you can do to improve thyroid function.
The first thing you should do is review the options available to you and determine an individual approach that will work for you based on the ladder of intervention below (please note that, for the purposes of an under-active thyroid there is no surgical intervention – unless you have nodules that need to be removed or if surgery caused low thyroid function – so in terms of improving thyroid function, we will only climb as far as medications on the ladder).
I have low thyroid function—as does my mother—so I know, from first-hand experience, that it is not something that should stop you from feeling good. I’m going to share exactly what I’ve done for myself, for my mom, and for patients over the past 14 years of my practice.
Keep in mind that you might only need to use one or two steps from this list or alternatively, you might find you work your way right through the list, adding things as you go, and perhaps eventually needing several forms of support. It is all about determining what your body needs at this point and being aware that what it needs may change over time.
The 8 Steps to a Healthy Thyroid
Step 1: Diet
The first thing we need to know is whether you are eating anything that could be slowing your thyroid function. There are several possible ways that food can affect thyroid function, including by decreasing iodine, which is important for thyroid hormone production, or by triggering an autoimmune thyroid issue (gluten).
Foods containing goitrogens (because they could lead to enlargement of the thyroid gland, referred to as a goiter), contain substances that can slow thyroid function by interfering with iodine. It is important to keep in mind that if you have healthy thyroid function, these foods will not cause an issue, and if you do have a thyroid issue, they could only make your thyroid situation worse if you eat a lot of these foods (with every meal).
Goitrogenic foods include soybeans and soy products, raw cruciferous vegetables (broccoli, cabbage, cauliflower, and turnips) – goitrogenic substances are partially destroyed by cooking – as well as peanuts, flaxseeds, strawberries, pine nuts, pears, peaches, spinach, and sweet potatoes. Again, it is only if you eat too much of these foods (such as if you eat them three times a day every day) that it could inhibit your thyroid hormone production.
Gluten interferes with thyroid function by causing leaky gut and triggering the production of autoimmune antibodies that attack the thyroid and slow thyroid function. The best way to know if thyroid antibodies are an issue is to do a blood test for them. You can find out if gluten and leaky gut are an issue by doing an IgG and IgA food panel (you can order a test kit here).
If these tests give a positive result you can then follow The Hamptons CleanseTM which is a gluten free – as well as dairy, soy, egg and sugar free – program to help you get your foods working for you, instead of against you. I’ve seen patients who got their thyroid back to optimal function simply by changing what they eat.
You may also want to focus on foods to choose to improve thyroid function because they contain nutrients needed for thyroid hormone production. These foods include seaweed, which is high in iodine, as well as foods that are high in zinc (pumpkin seeds, cashews, chicken) and selenium (brazil nuts, sunflower seeds, chicken). Coconut oil is also thought to support thyroid function.
Step 2: Lifestyle and Exercise
It is well documented that exercise increases thyroid function, but it’s important you don’t overdo it. If you feel very tired, you may need to do other things to get yourself feeling better before you are able to do much exercise. Even singing and breathing exercises have been shown to get your thyroid working better. You might consider yoga and/or bodywork therapies as a gentler place to start.
Step 3: Nutrients and other supplements (Clinical Nutrition)
From the start, or if you don’t see enough positive change within 6 to 8 weeks of starting steps 1 and 2, it would be a good idea to request blood tests for the following nutrients, which are important for thyroid hormone production, and address any deficiencies:
- ferritin (iron stores)
If any of these tests indicate that you are deficient in any of these elements, then think about how the deficiency might have developed. For example, leaky gut syndrome can lead to nutrient deficiencies, even without any digestive symptoms.
It is also important to consider whether you may have an MTHFR mutation, which can inhibit your ability to make active folate and active thyroid hormone. Find out more about how to be tested for MTHFR and why it is important to make sure your supplements contain 5MTHF instead of folic acid by clicking here.
Plus, low thyroid function can cause a riboflavin deficiency which further inhibits your ability to activate folate and to make healthy neurotransmitters (messengers in the nervous system).
In general, it is good to start by taking a multivitamin* (such as this example) – that contains the most bio-available forms of B vitamins, including riboflavin (B2), methyl-folate, and methyl-cobalamin (B12), minerals and iodine – as well as a probiotic, which helps with thyroid hormone conversion from T4 to T3.
Step 4: Herbs
Once you have addressed diet, lifestyle and nutrition, if you are still not feeling your best, then you might consider adding herbs to your routine. There are many herbs that support thyroid function, including Ashwaganda, Guggul, Nettle leaf, Bladderwrack and Blue Iris root. There are formulas available that contain the nutrients that are important for thyroid function as well as the herbs that support it. You can click here and here to see a couple of good examples. This approach gives your thyroid what it needs to work better by itself rather than simply replacing your thyroid function as you would if you simply take thyroid hormone (see steps 7 and 8 below).
Step 5: Homeopathy
In addition to nutrients and herbs, or for those people who are sensitive to other approaches, homeopathic remedies can be a gentle support. These are remedies that support thyroid function using minute doses of herbs or other substances in pill or liquid form. A practitioner with training in homeopathy (like me) can help you determine the right remedy for you.
Step 6: Adrenal gland optimization
Right through this process, from beginning to end, it is important to assess adrenal function and to determine whether optimization is needed. The thyroid and adrenal glands are so interdependent that under-functioning in one can cause lower function in the other. It is only when we ensure that both are working well that you can optimize your energy, mood, weight, hair, and more. This may involve checking your cortisol levels (the hormone made by the adrenal glands) and taking herbs and/or nutrients to support adrenal function. You can read more about this here.
Step 7: Natural Hormones
Glandular thyroid (or natural thyroid hormone) is a treatment that replaces both thyroid hormones (T3 and T4). This can be a very helpful approach if/when you find that your thyroid is simply doing all that it can. In essence, the medication will make up for your reduced thyroid function by boosting the amount of thyroid hormone available in your system. Unfortunately, there is no test that can tell us exactly how much additional hormone you need; the only way to know is to try it, notice the effects and adjust the dose until your blood-work and the way you feel indicate that your thyroid function is closer to optimal.
There is a prescription form of glandular thyroid (called Armour), as well as over the counter forms, and these have varying degrees of effectiveness. Some, like Armour, are made from thyroid hormones taken from pigs while others come from cattle. Different people will respond differently to these glandular thyroid replacements, especially because many of them contain other ingredients (such as lactose) that may trigger a negative response. The only way to know which is going to work best for your body is to try them out.
Note: If you have thyroid antibodies, it is also possible that your immune system could react to the glandular thyroid and make you feel worse. The best thing to do is work with a practitioner who can help fine tune the dose for you.
Step 8: Medication (Synthetic Thyroid Hormone)
Many of you may have started at step 8. Others may never reach step 8 at all. Those who have not found adequate resolution by applying steps 1 through 7 may find that synthetic thyroid hormone is the best solution for them, perhaps in addition to diet changes, exercise, nutrients, herbs, and adrenal optimization.
The most common prescription form of thyroid hormone replacement is levothyroxine, or Synthroid. It contains T4, so as you read in last week’s article, your body still needs to convert it to T3 in order to benefit from it. If you have a nutrient deficiency, it is still important to take the nutrients in order to get the most out of the T4.
There is also prescription T3 available. The dosing with T3 can be difficult because it needs to be taken at exactly the same time of day, every day, but it can make a world of difference if your body is struggling to convert T4 to T3.
I offer support for determining what you need to do to improve your thyroid function and to address the underlying cause. If you would like to discuss how I can help you please click here to make an appointment.
I also carry thyroid supportive products (nutrients, herbs, and homeopathic remedies) that I have vetted for quality and effectiveness in my office and store.
Prescription thyroid hormone can be prescribed by a naturopathic physician (ND) in certain states that license NDs to prescribe (AZ, CA, HI, ID, KS, ME, MT, NH, OR, WA, VT). If you live in another state, then I’m happy to help you find a practitioner who can prescribe appropriate thyroid support for you, if that is what you need.
Unlike many prescription medications, support for your thyroid (including thyroid hormone when needed) will help and won’t cause other negative effects as long as the dosage is correct and the underlying issues are also addressed. That is why it is important to work with a practitioner, and monitor your symptoms and blood levels as described in Part 1 of this article to ensure you are reaching the optimal range for you. If your thyroid function is too high it can cause anxiety, sleep issues, weight loss and bone loss – so we don’t want that either!
Be sure to carefully walk through this ladder of intervention and tailor it for you. Sometimes, even when you know your thyroid needs help, you might not be able to jump right in to increase thyroid function because the rest of your body is not ready for it. Everything is inter-related so we need to consider what needs to be resolved first, then come to the thyroid when you’re ready. And sometimes, while addressing other issues, the digestion and adrenals for example, the thyroid issue resolves itself.
What do you think about addressing thyroid function with these eight steps, versus jumping right in at number eight? What have you found works well for you?
Thank you for your interest and input.
30th May 2014
*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.