A Holistic Approach Thyroid Health
To wrap up this blog series, this week we will discuss a holistic approach to thyroid health, which I consider to be one of the most important topics when thinking about the thyroid. As I have mentioned, in the conventional setting, once you are diagnosed with a thyroid disorder you are put on synthetic thyroid hormone replacement and that is the end of it. There is no mention of anything you can do to support your thyroid, and I went along with this for a little while with my own thyroid disease but then I started wondering and digging to see if there is more you can do to help your thyroid and it turns out, there is! Today we’ll be discussing how select nutrients play a role in thyroid health as well as how nutrition, stress and toxin exposure can impact thyroid function. Let’s dive in!
Nutrient status and thyroid health
The thyroid gland is an amazing part of the body. It is responsible for aiding in so many different functions and without certain nutrients, it will not function properly. In order to produce T4, the thyroid gland needs adequate amounts of amino acids, minerals and vitamins including: tyrosine, iodine, iron, zinc, magnesium, selenium, vitamins A, E, B2/3/6, C and D. The conversion from T4 to T3 requires selenium and zinc and in order for T3 to be utilized efficiently in our body tissues we need vitamin A and zinc.
When I see a patient who has symptoms that could potentially be thyroid disease, not only am I checking the full thyroid panel we discussed a couple of weeks ago (find that HERE), I am often checking nutrient status such as an iron panel with ferritin, magnesium, zinc, vitamin D, and B vitamins. If someone has thyroid disease, we may check even more of these including selenium, iodine and vitamin A.
There are also amazing micronutrient panels from Genova Diagnostics, Metabolomix and Nutraeval that I would LOVE to see on every patient but does come with an out of pocket cost. These tests look at an extensive list of vitamin and minerals in addition to amino acids and oxidative stress markers. They are truly the cadillac of tests when trying to sort through nutrition deficiencies and potential causes of thyroid, or any chronic disease. That being said, standard nutrient markers through LabCorp can also be really insightful with less of a price tag.
Nutrition Basics for Thyroid Health
For most patients, I don’t recommend a fancy in depth dietary protocol. I will often recommend starting with a few weeks of an elimination diet which is going to help reduce inflammation and also identify any foods which may be causing symptoms. In general, I recommend following a diet that is:
- Sustainable and well rounded
- Has adequate protein (Higher protein intake has been linked to a reduced likelihood of elevated thyroid antibodies)
- Low in potential foods that may cause reactions (more on this below)
- High in prebiotic and probiotic foods
- High in phytonutrients (Eat the Rainbow!!)
- High in Omega 3s
- Low in saturated and trans fats
- Adequate caloric intake (low calorie intake is a stress on the body!)
Many patients find benefit with following the Autoimmune Protocol Diet, which is an elimination type diet, if they have Hashimoto’s or other autoimmune conditions, as it thought to reduce inflammation. Following a gluten free diet has been shown to improve subclinical hypothyroidism in one small study. For patients with Hashimoto’s the thought is that eating gluten can worsen this autoimmune state because the protein structure of gluten is similar to the structure of the thyroid. With this mimicry, it is thought that the immune system may mistake and attack the thyroid gland. This is debated but what I find is that people, myself included, often feel better when eliminating or reducing gluten because it naturally reduces the amount of processed food intake which is inherently less inflammatory.
Stress and the Thyroid
When thinking about a holistic approach to thyroid health, we cannot avoid talking about how stress plays a role. Stress can impact thyroid function in many ways. It can also play a role in the development of autoimmunity. In the body, there is what we call the “hormonal hierarchy” which goes as follows -1. The Adrenals →2. The Thyroid → 3. The Sex Hormones. If there is adrenal dysfunction, we are going to see dysfunction of the thyroid and the sex hormones. Stress impacts production of T4 as well as the conversion from T4 to T3. In fact, if chronic stress is left unchecked, T4 will convert to Reverse T3 which as discussed in the thyroid lab blog post, is essentially like putting on the brakes. It is important in our go-go-go, on all the time society that we live in, to focus on mindfulness and stress reduction techniques to get out of that fight or flight state by focusing on: restful sleep, purposeful movement and exercise, social engagement, as well as mindfulness techniques. Whenever I talk about mindfulness, patients always assume I mean sitting quietly and meditating in silence and honestly this can be a really challenging thing for some patients, at first. Mindfulness can also look like doing yoga, journaling, prayer, practicing gratitude and simply taking a few deep breaths. Just start somewhere!
Toxin Exposure and the Thyroid
There are at least 150 industrial chemicals that have been shown to reduce TSH and/or T4. Toxins are everywhere and while we cannot avoid all of them, there are certain things we can do to minimize exposure (more on Detox HERE), especially when it comes to a holistic approach to thyroid health. Endocrine disrupting chemicals that can alter thyroid function include: fluoride, PCBs, BPA, triclosan, mercury, perchlorates, dioxins, cadmium, lead, food dyes, and the list goes on. A big one that has been somewhat controversial, but has some solid literature to back it up is fluoride and its impact on the thyroid. There are several studies that have shown that fluoride exposure is associated with increasing TSH levels, even at standard drinking water concentrations. Further, a clear association has been found between fluoride levels in drinking water and variations in hypothyroidism. This is one reason we got an AquaTru reverse osmosis water filter. While we cannot totally eliminate toxins, we can try our best avoid the ones that are in our control (more on that HERE).
Integrative Thyroid Care
A holistic approach to thyroid health would not be complete without mentioning that many patients still need thyroid hormone replacement even if they are working on all of the lifestyle approaches. Some patients, if caught early enough, can actually reverse their disease and get off of medications entirely but if the thyroid disease has been going on long enough and there has been enough destruction to the thyroid gland, medication will likely be needed, and that is okay! The goal is to improve symptoms and FEEL BETTER. That said, the standard leveothyroxine may NOT be all you need. There are other formulations that may work better for each individual including synthetic T4 and T4 and T3 medications (generic vs. brand name is another story), compounded T4 and T3 medications, natural desiccated thyroid medications. It is not, and should never be in medicine, a one size fits all approach. If you are still not feeling great on one medication, you may need to try something else or add T3 and you need a provider who is going to work through this with you and who takes a holistic approach to thyroid health.
If you are looking for someone to work with on thyroid health or health in general, I have a few new patient slots open for August so book a free 15 minute consultation now!