The thyroid problem
How much do we really know about the thyroid? I imagine that most of people might even be aware that they have one. A majority of people may know it is often linked to problems with weight control, while others may even be able to locate it at the front of the neck. But the fact is, for most of us, until something goes awry, we pay very little attention to this highly important gland and its function within our bodies.
Perhaps, then, we should start by looking at what exactly the thyroid does and why it is so vital to almost all aspects of our health and well-being.
The thyroid gland sits low on the front of your neck and is made up of two lobes which lie on either side of the windpipe. The brain produces thyroid stimulating hormone (TSH) which signals the thyroid gland to produce and secrete two of the major thyroid hormones into the bloodstream, thyroxine (T4) and triiodothyronine (T3).
These hormones regulate the speed at which our cells work. If too much of the thyroid hormones are secreted, then they will work faster; if too little are secreted, then they will perform much slower.
Imbalances of this nature – known as hyperthyroidism when overactive and hypothyroidism when underactive – are increasingly common, and now thought to affect around 1 in 20 people worldwide, most of whom are likely unaware that they have the condition. Many in the medical profession are of the belief the figure is considerably higher, with upwards of 40% of people over 50 having low thyroid hormone.
That last statistic is particularly worrying when you consider that a thyroid imbalance can lead to a whole host of medical complaints, from issues with temperature regulation and weight control, to brittle hair and nails, dry skin, fatigue, insomnia, depression, low libido, anxiety, high cholesterol, neurological conditions, and heart disease.
With that in mind, let’s take a look at what exactly a healthy thyroid reading should be and what we can do if we suspect ours is out of range.
Testing thyroid health
The most common way to test for thyroid function is via a series of blood tests in order to ascertain your TSH, T3 and T4 levels. The TSH and T4 tests generally take place first, and these are used specifically to ascertain the levels of thyroid stimulating hormone in the blood and to determine whether there are any indications of hyperthyroidism or hypothyroidism. Any result between 0.4 and 4.0 milliunits of hormone per litre of blood (mIU/L) for TSH (although a large number of my age management colleagues believe a normal TSH should be less than 0.5 mIU/L) and 9.0 and 25.0 picomoles per litre (pmol/L) for T4 are considered to be within the normal range. If the results of this test suggests an overactive thyroid, a T3 test is then usually administered. The normal range for T3 is anywhere between 3.5 and 7.8 pmol/L.
It is very important to note here, however, that these healthy ranges are very much a guide, not least because blood tests do not always provide the accuracy required for your physician to properly diagnose a thyroid condition, but also because many in the medical profession are at odds as to what actually constitutes a “normal range”.
That’s why many physicians are now also using a Thyroflex as a secondary measure to test thyroid function. The Thyroflex is essentially a reflex hammer connected to a computer, which measures the speed of the neurotransmitters and the reflex speed in order to determine a resting metabolic rate. Your reflex reading will be slow with a low thyroid level, and higher with increased thyroid levels. This is due to thyroid’s effect on nerve conduction and muscle contraction.
We have known for more than 40 years now – ever since American physician Dr. Broda Barnes warned doctors that blood tests for thyroid are not that useful on their own – that we need to look at the complete picture. Besides blood tests, then, this includes the client’s history, a physical examination, and now, today, the Thyroflex as well.
Should you get tested?
As I touched upon earlier, thyroid problems are massively under-diagnosed. One reason for this is that many of the conditions associated with thyroid imbalance are accepted by many as just “part of life”, and so until those symptoms get really bad, there is often no further exploration into the issue. So let’s take a brief look at some of the main conditions for which your thyroid could well be to blame:
- Issues with weight: If you’ve genuinely tried a healthy diet and plenty of exercise but you are just not shifting that excess weight, there is a good chance that an underactive thyroid is slowing your ability to burn fat. On the other hand, if the pounds are dropping off you at an alarming rate, this could be a sign of hyperthyroidism.
- Mood swings: If you are regularly experiencing low moods and can’t quite put your finger on why, an underactive thyroid is quite often the answer. Equally, many people who experience regular irritability and anxiety – again for no obvious reason – often find that it is an overproduction of hormones in the thyroid that is causing the issue.
- Problems regulating temperature: The thyroid is essentially the body’s thermostat. So if you find yourself constantly cold when others are fine, or if you are overheating in the middle of winter, don’t just put it down to being ‘one of those people‘. It could well be your thyroid.
- Irregular sleep patterns: Again this is something that many of us simply get used to. We make excuses: ‘Of course I’m tired, I’ve had a busy week’, or ‘I’m just not a morning person, so I struggle to get up first thing’. You may be right on both counts, but once again an over- or under-active thyroid could well be the culprit.
Dealing with a thyroid complaint
The good news if you suffer, or suspect you suffer, from either an over- or under-active thyroid is that there are several options available to help manage your symptoms. There are both medicinal and lifestyle treatments available, both of which can restore your hormone levels to their proper balance.
For the treatment of hyperthyroidism, the hormone levels in your body can be controlled by taking anti-thyroid medication (with results usually taking between six and eight weeks to show). In more extreme cases a course of radioactive iodide treatment may be prescribed, or even surgery. Your physician will decide on the best approach for you based on the severity of your symptoms.
Surgery is usually considered a last resort, whereas radioactive treatment is regularly prescribed for the more extreme cases. This involves swallowing a capsule of liquid iodine in an amount large enough to damage the cells of the thyroid gland, thus limiting their ability to produce hormones.
As for hypothyroidism, the only real option is thyroid replacement, as no surgery or pharmaceutical has as of yet been shown to be effective in increasing the production of thyroid hormone once it has slowed down. When this is the case, a synthetic thyroid hormone such as Synthroid or levothyroxine is usually prescribed.
But we have to caution on synthetic for the following reason: Many physicians (and therefore their clients) are unaware that a normal thyroid gland puts out 80% T4 and 20% T3. The smaller fraction (T3) is the real “active” form of the hormone. As many people age or develop chronic disease, they are in fact unable to convert T4 to T3 (iodine is very important for this conversion). Unfortunately, the synthetic thyroid sold in pharmacies only contain T4 and this cannot convert to T3, which is why I prefer the compounded thyroid.
As for more natural solutions, because thyroid complications are often caused by deficiencies in vital minerals (such as selenium, zinc, and copper) and nutrients, topping these up with supplements can be a great way to manage symptoms. The mineral of choice is iodine, which is essential in the formation of thyroid hormones and can help to regulate the chemical balance in the thyroid. In a similar vein, topping up on your B vitamins can also pay off as they – specifically B2 and B3 – help to utilise iodine at a cellular level, which is important for optimal thyroid health.
Striking the right balance
If you are to take one thing away from this article, let it be that the importance of thyroid health should never be underestimated. To stress again, the thyroid is essentially the engine room of the body, responsible for regulating energy levels, mood, temperature, rate of metabolism, sleep patterns and a litany of other vital functions.
What’s more, an undiagnosed thyroid issue can drastically increase the risk of a number of health complaints we see so much of here in the UAE – in particular obesity and cardiovascular disease – as well as sexual dysfunction, infertility, and depression.
Whatever you do, don’t leave it to guesswork. Don’t just assume you’re tired for no reason and don’t just write your bad mood off as one of those days. Get to your physician, explain your symptoms and take a step towards taking control of your health with a proper diagnosis.
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The opinions in the column are by Dr Graham Simpson, and are not necessarily those held by Esquire or Hearst International. Dr Simpson is Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai. He graduated from the University of the Witwatersrand Medical School in Johannesburg, South Africa, and is board certified in Internal Medicine and Emergency Medicine. As a founding member of the American Holistic Medical Association (AHMA) Dr Simpson is also a licensed homeopath.