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Hypothyroidism and Natural Thyroid Health
What are Hypothyroidism and Thyroid Disorders?

The thyroid gland is an endocrine organ that is butterfly-shaped and sits low on the front of the neck, below the larynx and laryngeal prominence, or 'Adam's apple', along the front and anterior of the trachea.  The thyroid has two side lobes, connected by a bridge, or 'isthmus', in the middle.  When the thyroid is its normal size, you can't feel it. 

thyroid image entire.jpg

 **image credits

The thyroid tissue itself is surrounded by two fibrous capsules and consists of a lot of small individual lobules that are enclosed in thin layers of connective tissue. These lobules contain a great number of small sacs, or 'follicles', which store secreted hormone products called 'thyroid hormones' in the form of little droplets. 

thyroid gland cells image.jpg

  ***image credits

The thyroid hormones include:

  • Triiodothyronine, also known as 'T3'

  • Tetraiodothyronine, also called 'thyroxine' or 'T4'

  • Calcitonin, which is involved in calcium and bone metabolism

T3 and T4 are considered the main thyroid hormones with T4 being made in higher quantities.  These hormones ultimately act throughout the body, influencing metabolism, growth and development, heart rate, body temperature and much more. During infancy and childhood, adequate thyroid hormone is crucial for brain development.

Iodine is one of the main building blocks of both T3 and T4 hormones. Our bodies can’t produce this trace element, so we need to get enough of it in our diet. Iodine, like other nutrients important to the thyroid, is absorbed into our bloodstream from food in our bowel. It is then carried to the thyroid gland, where it is eventually used to make thyroid hormones.  The conversion of inactive T4 into the metabolically active T3 occurs in the thyroid itself but also largely in the brain, liver, intestines, kidneys, central nervous system, pituitary, and skeletal muscle. (2, 3, 4)  The health and well-being of these some of these other tissues has been shown to heavily influence the proper functioning of the thyroid and its hormones; for example, intestinal inflammation and overgrowth of unfavorable bacteria has been found in multiple autoimmune thyroid conditions and even thyroid carcinoma while beneficial probiotics showed beneficial effects on thyroid hormones and thyroid function in general. (4)

The control and balance of the thyroid hormones is an intricate process.  Normal thyroid function is maintained by endocrine interactions between the hypothalamus, anterior pituitary and thyroid gland.  Sometimes our bodies need more thyroid hormones, and sometimes they need less, so to make the exact right amount of hormones, the thyroid gland gets instructions from those other two organs, with direct instruction from the anterior pituitary gland. The anterior part of  the pituitary gland secretes a hormone called Thyroid Stimulating Hormone (TSH) which signals the thyroid gland whether to release more or less hormones into the bloodstream. Also, a certain amount of thyroid hormones are attached to transport proteins in the blood. If the body needs more hormones, T3 and T4 can be released from the proteins in the blood and do their job.

Thyroid Disorders

thyroid glowing yellow.jpg

Why use integrative medicine
to treat Hypothyroidism and Thyroid Disorders?

Hypothyroidism and Hashimoto's disease, among other thyroid conditions, are complex conditions with numerous possible etiologies and causes, many of which are often not pursued by conventional medicine.  Though there may be a genetic predisposition toward thyroid issues, other concerns can converge to make thyroid disorders express and manifest.  Yet most conventional doctor's recommendations do not going beyond thyroid replacement medications and a single test marker; there is often no attempt to move beyond symptom management.

However, people deserve more than lifelong medication recommendations!

Naturopathic Approach to Hypothyroidism and Thyroid Disorders Possible Etiologies and Causes

Possible considerations to the development of thyroid problems include:

  • Genetics

  • Over-consumption of isoflavone-intensive soy products such as soy protein or powder because isoflavones act as potential anti-thyroid agents, and are capable of suppressing thyroid function, and causing or worsening hypothyroidism.

  • Adrenal insufficiency, commonly known as 'adrenal fatigue', and caused by chronic stress and/or Hypothalamic-Pituitary-Adrenal axis ('HPA axis') Dysfunction

  • Estrogen Dominance and/or Polycystic Ovary Syndrome ('PCOS') (11)

  • Improper usage of Iodine

  • Infections

  • Nutrient Deficiencies

  • Gut Disorders or Liver problems

  • Some anti-thyroid drugs, such as lithium (12)

  • A history of radiation treatment to the head and neck areas

  • Over-consumption of uncooked goitrogenic foods, such as broccoli, turnips, radish, cauliflower, and Brussels sprouts are all substances that suppress the function of the thyroid gland

  • Immunologic responses to foods including food allergies, sensitivities or auto-immune responses like Hashimoto's-disease-induced-by-gluten (13)

  • Radioactive iodine treatment for hyperthyroidism/Graves' Disease.

  • Post-surgical removal of all or part of the thyroid due to nodules or cancer.

  • Environmental contaminants including mercury and bisphenol A (14) 

  • Inadequate phase 2 liver detoxification mechanisms,

  • Gastrointestinal sources of inflammation

  • Exposure to external radiation such as occurred after the Chernobyl nuclear plant explosion.

  • and more. 

Remember, interventions don't have to be just prescription medications; naturopathic physicians treat with compounds found naturally occurring in the body, including amino acids, neurotransmitters, vitamins and minerals.

Naturopathic Approach to Hypothyroidism and Thyroid Disorders Thyroid Tests

Beyond broader consideration for what precipitated the hypothyroidism or other thyroid condition, naturopathic physicians are more likely to order comprehensive testing above and beyond just the TSH, as is typical of most medical doctors.  Multiple laboratory values should be ordered to determine overall thyroid function.  For example, we have had patients whose previous doctors had only ordered TSH without T4 and T3, and they therefore missed the hormone conversion issue as the cause for hypothyroidism.  We have also had hypothyroidism patients that did not even know they had an auto-immune condition because other providers had neglected to order auto-immune antibody testing, despite years of annual case management.   

  • Thyroid stimulating hormone (TSH): Secreted by the anterior pituitary gland, TSH regulates thyroid hormone release.  The test is thought to be more sensitive and accurate than testing the T4 and T3 hormones themselves, "... because it can be elevated even with small decreases in thyroid function". (15)  Hence many clinicians' reasoning to order TSH and no other laboratory values.  A blood test with high TSH indicates a high need for the thyroid gland's production of hormones, as is seen in hypothyroidism and Hashimoto's disease, when the gland is underactive.  Meanwhile, a low TSH suggests the excess and abundance of thyroid hormones, as seen in hyperthyroidism and Graves' disease.

  • T4 (Tetraiodothyronine)(thyroxine): The primary form of thyroid hormone made by the gland, it is inactive and can be checked with a blood test. It may be 'free' or 'bound', which means it is adhered to a protein and unable to enter tissues to be metabolically active. 

  • T3 (Triiodothyronine): This active form of thyroid hormone is made by the gland in lesser amounts and T4 is converted into T3 for use in the body.  T3 may be 'free' or 'bound', which means it is adhered to a protein and unable to enter tissues to be metabolically active.

  • Anti-TPO antibodies: In autoimmune thyroid disease, proteins mistakenly attack the thyroid peroxidase (TPO) enzyme, which is used by the thyroid to make thyroid hormones.  This is common in Hashimoto's disease but may also occur in Graves' disease or even other auto-immune conditions like lupus. (16)

  • Anti-TG antibodies: Anti-thyroglobulin (TG) antibodies can be a sign of thyroid gland damage caused by the immune system. They may be measured if thyroiditis is suspected and like anti-TPO antibodies, they may be found in patients with Hashimoto's disease, Graves' disease or lupus. (16)

  • Reverse triiodothyronine (RT3): This metabolically inactive form of T3 can be problematic if it fills a substantial number of binding sites, leaving the active and proper form of T3 itself unable to bind to receptors and do its job.  Once the binding site receptors are filled, the body signals that it has adequate T3, not recognizing that it instead got the inert and largely unhelpful RT3.  Such a situation could lead to hypothyroidism.

  • Thyroglobulin: Thyroglobulin is a protein secreted by the thyroid that can be used as a marker of thyroid cancer. It is often measured during follow-ups in patients who have received treatment for such cancers, with the goal being cessation of all thyroid production capacity.  That's because the goal of treatment is to get rid of all thyroid tissue – both healthy cells and cancer cells. So, if treatment is successful, there should be little or no thyroglobulin in the blood. However, if thyroglobulin levels remain the same or increase, more cancer treatment may be needed, as high levels likely indicate recurrence of the cancer. 

  • Thyroid ultrasound: A thyroid ultrasound is a non-invasive imaging test to get information about the thyroid gland. During this procedure, a probe is placed on the skin of the neck, and reflected sound waves can detect abnormal areas of thyroid tissue.  It can be used to help identify nodules, understand what characteristics are present in thyroid tissue, and more.

  • Thyroid biopsy: During a thyroid biopsy, a small amount of thyroid tissue is removed, usually to look for thyroid cancer. Thyroid biopsies are typically done with a needle. 

  • Thyroid scan (thyroid scintigraphy): A thyroid scan uses a small amount of radioactive iodine, given by mouth, to get images of the thyroid gland and understand how it is functioning. The radioactive iodine is concentrated within the thyroid gland. 

  • and more

thyroid tests.jpg
thyroid hand bursting thru yellow.jpg

Support for patients with Hypothyroidism and Thyroid Disorders 

Evidenced-based herbal medicine

Different botanical medicines have been used for centuries, and in some cases millennia, to help aid thyroid conditions.  Some herbal treatments, including Lycopus (bugleweed) and Melissa officinalis (lemon balm), have been used for treating hyperthyroidism. (17)  An even wider variety of botanical medicines have been used to support different aspects of hypothyroidism, including Withania somnifera (ashwagandha),(18) Coleus forskohlii (coleus), and Bacopa monniere (bacopa) (19) with some very impressive results.  When selecting herbal medicines, it is important to identify as fully as possible the underlying cause for the imbalance, as this will lead to different choices for treatments.  If the goal is to increase conversion of T4 to T3 hormones, we would choose adaptogenic herbs.  If the goal is to decrease inflammation or auto-immune driven reactions, then we would select anti-inflammatory or immunomodulating options.  Thus a good treatment should be quite individualized.

Advanced specialty and nutrient deficiency testing

Multiple minerals have been shown to increase the risk of hypothyroidism if they are low. (20)  On the topic of minerals and thyroid, specifically iodine is of course of keen interest, as levels being either too low or too high could be problematic. (21)   Beyond minerals, other nutrients to consider regarding thyroid include some vitamins and amino acids.  When it comes to testing minerals, local laboratories can be helpful and offer some degree of functional testing assessment; however, they often do not have advanced methods for testing vitamins and amino acids, if any at all.  So other options for testing may be preferable in some cases and these collection methods can include nutrients being tested in multiple ways including blood, urine, or hair.  More testing options to consider when gaining insight into thyroid health may include assessments for other endocrine organs such as the adrenal glands, which can comprise of several timed salivary samples easily collected at home or even environmental pollutant testing, as described below.

Exploring endocrine disruptors, environmental contaminants, and how we detoxify them

 A wide variety of compounds can have effects on the endocrine system including man-made chemicals, heavy metals, infectious disease and inflammatory foods, to name a few. In many cases it is advisable to seek beyond the snapshot of inflammatory activity and consider what may be provoking the imbalance from a more fundamental level.  Environmental pollutants like the organopesticides including DDT, (22, 23) and  industrial chemicals such as poly-halogenated hydrocarbons, which include polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and dioxins (PCDDs), have been shown to impair thyroid hormone levels. (24, 25)  Other chemicals such as perfluoroalkyl and polyfluoroalkyl substances (PFAS), (26, 27) phthalates, and perchlorate are among others have been shown to be associated with reduced thyroid hormone levels or impaired thyroid hormone action and may also confer an increased risk of autoimmune thyroid disease. (28) Thus testing for environmental contaminants may reveal possible contributing to factors to thyroid dysregulation and disease, and this is often available using just a simple urine test! If possible causative agents can be identified, these become substantial ways to try to make progress.


Effective use of vitamins, minerals and nutritional supplements for thyroid health

Another way to improve outcomes for those with hypothyroidism or other thyroid disorders is to include daily additional nutritional supplementation.  Attempting to restore balance to our bodies in the least invasive manner possible is part of the philosophic approach of naturopathic physicians.  Thus we often seek to use the body's constituents to see if better health can be achieved, especially in light of findings from advanced nutritional testing.  These may include vitamins, minerals, amino acids, fatty acids, supplemental hormones and more.

Don't get stuck not trying acupuncture

"According to the World Health Organization (WHO), acupuncture can be used to treat thyroid diseases ... and ... can reduce symptoms and improve relevant biomarkers of thyroid disease patients". (29)  Years of research has shown improvements for both hyperthyroidism patients as well as hypothyroidism patients, while the mechanisms by which acupuncture supports immunity and modulates auto-immunity has been elucidated. (30-32)

Dietary trigger and sensitivity evaluations

What we eat can have tremendous repercussions on our 

health!  Autoimmune disorders such as Graves' disease and Hashimoto's disease  can be influenced by aberrant reactions to foods by way of food additives, processing, allergies and sensitivities.  Disruptions in gut health can open the door for some of these problems to develop and worsen.  This is because there is tremendous interplay between the digestive and immunologic systems.  'Allergies' are technically  also different from 'sensitivities', as they involve different types of antibody production, IgE and IgG respectively.  Comprehensive dietary analysis will likely test for not just one but both types of reactions to see which may be contributing to neurotransmitter dysregulation.  Furthermore, when it comes to thyroid topic, the dietary consumption of dietary goitrogens and soy-based isoflavone foods needs to also be reviewed. 

So if you are seeking guidance, support or treatment, consider contacting our clinic at the number above.












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  34. ***image credits [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the thyroid gland work? 2010 Nov 17 [Updated 2018 Apr 19].  Available from: 

The content and any recommendations in this article are for informational purposes only. They are not intended to replace the advice of the reader's own licensed healthcare professional or physician and are not intended to be taken as direct diagnostic or treatment directives. Any treatments described in this article may have known and unknown side effects and/or health hazards. Each reader is solely responsible for his or her own healthcare choices and decisions. The author advises the reader to discuss these ideas with a licensed naturopathic physician.

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