This is a special guest blog by Dr. Hillary Webster, ND. Dr. Hillary is a naturopathic doctor who practices in Toronto with a focus on Women’s Hormonal Health. She helps burned-out and exhausted women uncover and repair their hormone and nutrient imbalances to get their world-conquering energy back. In this article, Dr. Hillary is going to explain some of the inner workings of thyroid health beyond environmental medicine and what to do when your green home detox isn’t quite enough.
When necessary isn’t sufficient: Thyroid health.
So you’ve done a home detox and you’re still exhausted. Your hair is falling out in clumps and you’re not…ahem…eliminating regularly. Your skin and hair are dry as a bone and you’re cold all the time and it feels as if your body is desperately clinging to stubborn weight, or you’re gaining weight for no reason. You might also be depressed – depression is a huge signal to get your hormones checked.
All of these symptoms are indicative of low thyroid function. While detoxification is a crucial part of thyroid health, sometimes you need a little more help to get things back into balance. Here’s why: in addition to just feeling like garbage all the time, even minimally low thyroid function is associated with increased risk of cardiovascular disease (1). Underfunctioning thyroid is also a huge impairment to fertility and can increase the rate of adverse pregnancy outcomes (2).
However, one of the biggest problems I see in my practice is that under-functioning thyroid often goes undetected. Typically, you only get one measly blood test that comes up normal and you’re left wondering why you still feel so lousy. I’ve ordered plenty of thyroid testing lately and found that there are many variations of low thyroid function that isn’t detected by one blood test.
A note on normal vs optimal
As a naturopathic doctor, I look at your labs with a different reference range in mind. I am not simply looking for your bloodwork to be within the range values provided by the lab, because those ranges are sometimes enormous and inaccurate and unsuitable for you. Ever wonder how these normal ranges were determined? They were found by testing people without any overt disease and taking the average of those values. Just because you’re in the reference range does not mean you’re healthy. Although you may not have an overt disease, things may not be functioning as well as they should. I find this a lot in my clinical practice.
The Thyroid Panel
In my office, I want to see all of your thyroid hormones because it gives me a clearer picture of how your thyroid is functioning. Here are the tests I run:
TSH – This is the signal from the brain that tells your thyroid to produce the hormone. The higher it gets, the lower your thyroid function, because your brain is pumping out more TSH to try to give your thyroid a boost.
T4 – The amount of actual thyroid hormone secreted by your thyroid gland. In a lot of women, this values dips toward the low end of the range even if your TSH is normal.
T3 – The ACTIVE thyroid hormone that binds thyroid receptors all over your body. This value is pretty darn important. Many women who come into my office have normal TSH and T4, but they’re poor converters to T3 for many reasons.
Antibodies – if your immune system is attacking your thyroid, it’s going to make antibodies against it. Autoimmunity is a major contributor to thyroid disease, and there is a complex environmental component to this issue. A well-rounded treatment plan addresses the underlying immune system issue.
Reverse T3 – In times of extreme stress, your T3 can be converted to reverse T3, which blocks thyroid receptors and induces thyroid resistance.
Reasons for Low Thyroid
Genetics – sometimes it’s just hereditary and you need to be medicated for life (and so you can get your active lifestyle back).
Autoimmunity – as explained above, if your immune system attacks your thyroid, it can turn overactive or underactive, and a full naturopathic treatment plan can address the root cause of this issue.
Poor nutrient status – you need many different nutrients for proper thyroid hormone conversion including, but not limited to, Vitamin A, D, B Vitamins, Iron, Selenium, Zinc, Iodine, etc. Stress, diet changes, and toxic environments can deplete these nutrients and slow your thyroid.
Stress – blocks thyroid production at both the level of your brain and your thyroid. In my practice, we always treat your stress while we treat your thyroid.
Sex hormone imbalances – high levels of unbalanced estrogen are implicated in thyroid cancer (3) and elevated estrogen levels, such as during hormone replacement therapy, can block thyroid hormone function (4).
What to do?
So, with all this new shiny knowledge, it can feel a little overwhelming. Here are some first steps to figure out if your thyroid needs more care beyond the first and crucial step of detoxing your home.
Test – the full panel. See what’s really going on. Are you making enough T4 and it’s simply converting poorly? Do you make antibodies against your own thyroid? Missing some key nutrients? Testing provides answers for accurate treatment.
Eat a nutrient-dense diet. Did you know you can get your daily dose of selenium from 3 brazil nuts? Orange veggies provide vitamin A, iron from red meats and spinach, you get the idea. A nutritionist or naturopathic doctor can help you with diet if it gets overwhelming.
De-stress. Like it’s your part-time job. Yoga, improv class, swimming, painting. Doesn’t matter. Stress is toxic to our bodies in the amounts we suffer from every day, and it harms your thyroid. There are herbs we also use in my practice for thyroid health as well, but they should be selected with the help of a professional.
Test and balance your sex hormones. All of your hormones talk to each other, after all, and they can interfere with the proper function of the whole hormone system if they’re out of whack. A full hormone workup includes sex and thyroid hormones and should be interpreted by someone who is well-versed in the subtleties of hormone balance.
What if I need medication?
If your doctor, nurse practitioner or naturopathic doctor tests your thyroid and determines you need some replacement, you have options. Typically, your family doctor or specialist will prescribe T4 medicine, but as we’ve discussed above, many people have trouble converting T4 into active T3. There are ways around this problem with different medications and nutrient/herbal supplementation.
We took a deep dive into thyroid beyond toxicity in this blog, and I hope it was educational. If you suspect your thyroid needs a closer look, or you’re still feeling exhausted after removing toxins from your home and body, please seek the help of a functional medicine doctor, naturopathic doctor, or nurse practitioner for proper testing and treatment.
(1) Suh S, Kim DK. Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinol Metab (Seoul). 2015;30(3):246-51.]
(2) Maraka S, Singh Ospina NM, Mastorakos G, O’Keeffe DT. Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How?. J Endocr Soc. 2018;2(6):533-546. Published 2018 May 3. doi:10.1210/js.2018-00090
(3) Zahid M, Goldner W, Beseler CL, Rogan EG, Cavalieri EL. Unbalanced estrogen metabolism in thyroid cancer. Int J Cancer. 2013;133(11):2642-9.
(4) Mazer NA. Interaction of estrogen therapy and thyroid hormone replacement in postmenopausal women. Thyroid. 2004;14 Suppl 1:S27-34. Review. PubMed PMID: 15142374.