All about the Thyroid

What is the thyroid gland and what does it do?

Thyroid is a highly vascularised butterfly-shaped gland that is located around your throat - below the voice box and straddling the windpipe. Although quite small, it is a major regulator of metabolism, heart rate and body temperature, as well as being involved in the regulation of specific genes. It not only increases uptake of glucose & amino acids but also increases cellular energy and function.

Which hormones does the thyroid gland produce and how?

Under the influence of thyroid stimulating hormone (TSH) from the brain, the thyroid produces two hormones: Thyroxine (tetraiodothyronine) or T4 (it contains 4 iodine atoms) and triiodothyronine or T3 (it contains 3 iodine atoms). T3 and T4 hormones are then released from thyroid gland into the blood stream.
T3: is the most active of the thyroid hormones. T4 gets converted into T3 via the removal of one of the iodine atoms, which occurs in tissues such as liver, kidneys & muscle.

What can go wrong with the thyroid gland?

Generally the thyroid gland produces the required hormones needed for the body to stay in balance and work in harmony. However, inflammation of the thyroid gland (thyroiditis) and deficiency in the production of iodine (it is used by the thyroid gland to make hormones) will lead to reduction in the amount of thyroid hormones being produced. Hence, people with chronic inflammation in the thyroid gland and long term iodine deficiency will suffer from thyroid abnormalities in their life time.

What are the thyroid disorders and their associated symptoms?

There are a number of disorders that are directly linked with the production of thyroid hormones. These disorders include the following:

Hypothyroidism (underactive thyroid gland):

The most common pathological hormone deficiency arising more often in women than men; the incidence increases with age.

Signs and symptoms:

• Fatigue, depression, memory deficit, headaches
• Weight gain, fluid retention
• Cramps, myalgia, arthralgia, muscular weakness
• Iron deficiency anemia, shortness of breath
• Anorexia or reduced appetite, constipation, bloating
• Puffy eyes, goiter (enlarged gland), sore throat, hearing impairment
• Low libido, infertility, impotence, menstrual irregularities
• Dry skin, brittle nails or coarse hair & skin

Hyperthyroidism (overactive thyroid gland):

Higher incidence is found in women (30-60 years of age) than men.

• Fatigue
• Fine hair, sweating, tremor, heat intolerance
• Palpitation
• Hyper-defecation
• Protruding eye
• Easy bruising, irregular menstrual periods
• Anxiety, insomnia

Why do many people with mild hypothyroidism go undetected?

This is because the most common test for thyroid function is based on levels of thyroid stimulating hormone (TSH) in the blood. In fact, TSH in isolation does not provide sufficient evidence with respect to thyroid health. A thorough investigation of the thyroid gland is required to identify thyroid issues. In reality, other parameters such as FT3 (free T3), FT4 (free T4), thyroid antibodies (TPO, Tgb, TSHR) and urinary iodine test are also critical to be examined.

So yes - even if your TSH blood test appears to be normal, you may still have an undetected, underlying thyroid condition which may explain some of the symptoms you are experiencing. 

What are the long term implications of untreated thyroid disorders?

• Cardiovascular diseases
• Elevated triglycerides and lipids
• Metabolic syndrome and insulin resistance
• Endothelial dysfunction

What about Thyroid Cancer?

If left untreated, a goiter or thyroid nodules can develop into cancer. There are several different types of thyroid cancer, the most common is papillary thyroid cancer, which usually grows in one lobe of the thyroid gland (about 70-80% of all cases). Follicular thyroid cancer accounts for about 20% of thyroid cancers. Other risk factors include genetics and the exposure to radiation.

What is the role of a naturopath?

A naturopath will examine all the above-mentioned parameters in detail and will try to identify the underlying issues. This will lead to identifying either disorder (hypo or hyperthyroidism) with or without the involvement of the immune system (autoimmune disorders such as Hashimoto's disease or Grave's disease). The specific treatment protocol which includes herbal medicine, supplements, appropriate life style recommendations and dietary guidelines will then be given to the patient. This complete package will ensure that the patient is fully supported after identifying the root cause of the problem.