Thyroid
The History of thyroid disorders goes back as far a written records.1
As early as 2700 BC the Chinese used seaweed to treat goiter, an enlargement of the thyroid gland.
1475 Chinese physician treats goiter with minced thyroid glands
1500 Leonardo Da Vinci makes the first drawing of the thyroid gland.
1602 Cretins (physical and mental retardation due to low thyroid) are first recognized in Switzerland
1820 Goiter and cretinism are treated with iodine
1884 The first surgical removal of thyroid gland for Grave’s disease
1917 Thyroid hormone, thyroxin, became available for sale at $350/gram (Gold at the time was $0.61/gram)
1917 X-rays used to treat Grave’s disease
From ancient times to the modern era little has really changed in the diagnosis and treatment of thyroid disorders – that is, until the 21st Century.
Low Thyroid
Many people come into the office with symptoms of low thyroid. Many people are already on some form of thyroid supplement. Most of these are dried and ground-up thyroid glands from pigs or cows. These glandular supplement have been around for centuries, and have worked very well. Today, we have the same hormone, T4, or thyroxin, that is made synthetically.
Symptoms of low thyroid include:
Feeling slow and sluggish
Tired all the time
Lack of energy
Feeling cold easily, especially in the hands and feet
Hair falling out
Weight gain
Delayed reflexes
Constipation
What causes low thyroid?
When the thyroid gland can’t produce the hormones; when the body doesn’t convert the inactive T4 to the active T3; or when anything interferes with the action of the thyroid hormone people can be hypothyroid.
Common causes are:
Stress – high cortisol levels cause low thyroid by:
a. Higher Reverse T3, which blocks the normal T3 from working
b. Lower TSH so the thyroid gland makes less T3 and T4
Low selenium3 has multiple effects on the thyroid, causing inflammation and the inability to convert the inactive T4 into the active T3
Low Tyrosine – this amino acid forms the backbone of the thyroid hormone. When it is deficient, the gland is unable to function.
Low iodine is common, as explained above.
Lack of vitamin D3 decreases the binding of the T3 hormone to the receptor.
Toxins such as fluoride, bromide, lithium, mercury, and pesticides inhibit thyroid production or use.
Immune dysfunction can cause antibodies to be made against the various components of the thyroid gland, proteins, or enzymes.
Many of these can lead to an enlarged thyroid gland, called a “goiter.”
Goiter
A goiter is simply an enlarged thyroid gland at the base of the neck, and is often caused by low thyroid. Some are barely noticeable, while others can get so large they impair breathing and swallowing.
Pei was a woman from China who went to her doctor with a bump on her neck. The doctor thought it might be a goiter so he sent her to an endocrinologist. The specialist did some tests that proved she had goiter, and sent her on to a thyroid surgeon. The surgeon told her about only two options: surgically remove the gland, or she could have radioactive iodine to kill the gland. She found that she would have to be on thyroid pills for the rest of her life with either treatment so she opted not to treat. Over the course of ten years the gland was getting bigger, and bigger. She went to several other doctors to see if there was anything else she could do, but they only gave her the same two options. Finally, it had gotten so large that she was having difficulty swallowing so she went to a surgeon and had the gland removed.
If the thyroid gland doesn’t get iodine it starts getting bigger. Seaweed contains a concentrated amount of iodine, which was recognized by the Chinese thousands of years ago as a treatment for an enlarged thyroid gland. Over the years, this information has been lost and re-gained several times. Currently, though we know the history, yet we continue to use drugs and surgery for goiter instead of iodine. In the case of Pei, the first doctor could have told her about iodine, which usually shrinks the gland by about 1/3, and she would have avoided surgery, and the mass in her neck.
What causes a goiter?
When there is not enough thyroid hormone in the body, the pituitary gland makes more Thyroid Stimulating Hormone, TSH, which tells the thyroid gland to make more. If, for some reason, the thyroid gland can’t make more, it just keeps getting bigger. Iodine deficiency is very common in the world and is therefore the main reason for goiter.
Because of the use of sea vegetables, those who live in coastal regions have a lower incidence of goiter. Iodine is necessary for the production of thyroid hormone, so if there isn’t enough the gland enlarges due to stimulation from the pituitary to make more.
While iodine deficiency causes by far the majority, there are other causes of enlarged thyroid glands.
Autoimmune thyroiditis (Hashimoto’s)
Grave’s Disease stimulates the TSH receptors to make more thyroid hormone
Selenium deficiency2 prevents the conversion of T4 into T3, the active hormone
Goitrogen ingestion (foods, chemicals, and drugs the inhibit thyroid, causing it to enlarge – this only happens if you are already on the edge of deficiency, such as with low iodine)
Pituitary tumor that secretes TSH
Thyroid cancer
Hyperthyroidism (elevated thyroid)
Mitch was a chef at a 5-star hotel in the area. I had seen him on several occasions, and told him he needed to lose weight (never trust a skinny chef, right?). After more than a year without seeing him, he came in and I didn’t recognize him – he had lost almost sixty pounds, he was red, sweaty, and his eyes looked like they were popping out of his head! He said he had been like this for several months, but it wasn’t going away. Tests showed his thyroid problem, Graves’ disease. Since we know that the antibodies are stimulating the TSH receptors, causing the gland to overproduce thyroid hormone, we decided to suppress the hormone with “goitrogens” – lithium and lots of cruciferous vegetables. I also recommended selenium in high doses (5mg) for a few months to increase his glutathione peroxidase and decrease the antibodies. This worked, and he felt much better over the next few months – but he started to gain back the weight.
This illustrates the symptoms, problems, and treatment of Graves’ Disease, a common cause of hyperthyroidism.
Those who make too much thyroid hormone have the opposite symptoms from low thyroid:
Sweating easily
Palpitations of the heart
Feeling hot
Nervousness
A fine tremor
Anxiety or panic attacks.
Weight loss
Most describe a feeling of being pushed.
Thyroiditis
A common cause of too much thyroid is too much inflammation. The syndromes have various names such as Hashimoto’s thyroiditis, Graves’ disease, and autoimmune thyroiditis which are all due to inflammation in the thyroid gland. The process making thyroid hormone creates a lot of inflammation so the thyroid gland requires a large amount of selenium, a mineral that is part of the enzyme glutathione peroxidase, which prevents damage. When people are low in selenium they have more inflammation in the thyroid gland, which can lead to thyroiditis. Further treatments include dietary changes, herbal treatments, and stress reduction.
How do we test for thyroid function?
Doctors are taught to screen for thyroid disease using the pituitary hormone TSH.4 If the TSH is low, this indicates that the pituitary gland has enough or too much thyroid hormone. However, if the TSH is high, this means the brain thinks there isn’t enough thyroid hormone. The problem is that this test can be fooled easily.
If there is a large amount of Reverse T3, the brain will think there is enough thyroid, but it doesn’t work well.
Lack of selenium could slow the conversion of T4 to T3
Stress causes high cortisol which can suppress TSH, even if your hormones are low – or it can even cause low thyroid with normal or low TSH.
Remember, the most important test is you! If you have the symptoms of low thyroid, you can do the blood tests, but that doesn’t guarantee a diagnosis. Sometimes, if the diagnosis is not clear, and the patient has symptoms of low thyroid, I will do a trial of thyroid hormone – if the symptoms resolve, there is a good chance (though still not perfect) that this is the problem. Thyroid glandular supplements can be found where vitamins are sold. I usually start with about 30mg or 1⁄2 grain.
How to keep your thyroid gland functioning well throughout your life
What is very interesting is that nothing has changed over the centuries of thyroid treatment. We understand why, but we have no better way of treating the thyroid, except with the same things that have been used in the past. If we provide all the things the thyroid gland needs, and keep inflammation down, it will generally function well throughout your life. Just like we learned in the history, we can do the same things:
Iodine. It doesn’t seem possible to get too much because the kidneys are so good at getting rid of the extra. People only have problems with iodine when they have other deficiencies, such as selenium or tyrosine. The best way to take this is to get about 10mg (they may come in 5, 6.25, 12.5, 25, 40, and 50mg – any of these is fine) every day for 90 days, and then take one per week. This will be sure to keep your levels up, and will not get depleted. Seaweed, kelp, nori, and sushi will give adequate amounts, if you prefer to get it in food.
Selenium. 200 micrograms per day for 90 days, and then 1mg once per week. (it’s hard to get a 1mg tablet, so just take 5 of the 200mcg) If you want to get it from food, eat BRAZIL NUTS, as they are the only food in the United States with a significant amount of selenium.
Stress reduction. This doesn’t mean you need to avoid all stress, only that you need some relief:
Eat a low-carb diet because the stress hormones are affected by sugar
Exercise to sweat every day to release endorphins
Connect with people – loving relationships reduce stress
Write in a journal, especially about how you feel
Meditation and prayer for about a half hour per day
Pursue a hobby that captures your whole attention
Lower inflammation. The best way to keep inflammation down is with the diet. The less we
eat, the less inflammation we make so fewer calories will be helpful. Aside from this, there are several things to keep in mind.
Eat less omega 6 oils (corn, soy, canola)
Avoid sugar or artificial sweeteners
Use spices like pepper, turmeric, cinnamon, and so forth.
Eat grass-fed meat, eggs, butter, and dairy
Avoid packaged or prepared foods – if it has a list of ingredients, it’s best not to eat it
The thyroid gland is essential to maintain your metabolism, keep your energy up, prevent aging, and allow you to function normally. For this reason it’s very important to keep it in tip-top shape. There is no medicine that is better than the treatments that have been used for centuries.
………………..
1) http://www.thyroid.org/events/thyroid-cancer-tumor-history
2) http://www.ncbi.nlm.nih.gov/pubmed/21523503
3) http://www.wellnessresources.com/health/articles/seleniums_vital_role_in_thyroid_hormone_function
4) http://chriskresser.com/5-thyroid-patterns-that-wont-show-up-on-standard-lab-tests