An introduction to the Thyroid: essential reading for anyone flagged with altered thyroid function

• 

Let's start with the basics - what does the thyroid actually do in our bodies?

Why is it so important?

The thyroid is a butterfly shaped organ at the base of the neck. Think of it as the accelerator pedal for the body: when underactive ('hypothyroidism'), everything slows down (temperature, energy production, cell growth, metabolism) and when overactive ('hyperthyroidism'), everything speeds up.

You might have come across the idea of some people having a ‘fast’ or ‘slow’ metabolism, this is the gland that determines this.

The thyroid Influences virtually every system in the body: heart rate, mood, menstrual cycle, our hair, our skin, how well we grow and repair and most crucially, our metabolism, which we see often reflected first in someone’s weight.

Our brains are responsible for controlling the thyroid. They detect our energy needs, and in response, send a signal to the thyroid in the form of TSH (thyroid signalling hormone) which tells the thyroid whether to speed things up, or slow things down. The thyroid gland is like a car, and TSH is the petrol that fuels it.

Our bodies are fundamentally designed to protect us: we are wired for survival. Any level of stress, famine, fasting, malnutrition will be detected by our brains, which will then reprogramme the thyroid to slow things down to preserve energy for survival.

What happens next?

Depending on the instruction from our brain, the thyroid releases more or less of a certain hormone, called T4. But again, we have endless safety mechanisms in place. This thyroid hormone T4 is released in an inactive state, and needs to be activated by specific nutrient-dependent enzymes in order to function.

This can create a bottleneck in thyroid function, because it is a step that relies on our state of nutrition in order to occur. Once T4 has been activated, it turns into T3, which is the most important marker to check in blood tests, because it is a real-time indication of the message that your thyroid hormone is sending out, ie. what speed to function at.

This cascade of events is important to understand, as where the regulation or system breaks down can indicate what the underlying reason (or root cause) is. If the T4 isn’t converted to T3, or if the cells aren’t taking up the hormone correctly, you will have symptoms despite a GP saying your thyroid results are ‘normal’.

Autoimmune vs Non-Autoimmune Thyroid Disease

What's the difference between autoimmune thyroid conditions like Hashimoto's and non-autoimmune hypothyroidism? How do we know which one we have?

When autoimmunity becomes part of the picture, we have a slighter tricker situation to deal with. This is because our body’s own immune system has started to attack the thyroid tissue, which destroys the gland slowly, eventually causing it to lose its function. We know this is happening because our blood shows elevated antibodies, TPOAb and TgAb.

Conversely, when our thyroid gland is slow but there aren’t antibodies present, it is more likely that we are looking at a case of nutrient deficiencies, stress, medication interactions or issues with the signal coming from the pituitary gland in the brain.

Making the distinction is fundamental because the treatment is completely different, and standard thyroid medication does not work for both! Understanding your own personal baseline, where your markers are when you feel great, and what shifts when you start to experience symptoms is the best thing you can do to protect your thyroid health.

Every one is different, and the standard ranges for blood markers do not apply to everyone.

A nutritional therapist or functional medicine practitioner can build this picture and advise on the best course of action for you.

If your thyroid function has been flagged by your GP, make sure you understand what is really happening. The absolute minimum (that all GPs can do) is assess your TSH, T4, T3, TPO and Tg antibodies. Ask for ferritin, folate, B12, vitamin D, HbA1c, fasting glucose and cholesterol panel. This gives you the fundamental information to start to build a picture, and an indication of where you need to start.

There are some key patterns to look out for:

High TSH and low FT4 = primary hypothyroidism, can be preclinical, very common.

• Look at stress levels, are you fasting too much? Are you doing intensive cardio workouts without correct fuelling?

• Do you have selenium, B vitamins, zinc and iron in your diet?

Normal TSH and low FT3 = conversion issue.

• This is most commonly down to nutrient availability: improve your whole grains, fresh fruits and vegetables, nuts and seeds to maximise your nutrient intake.

• If you have gut symptoms (bloating, gas, abdominal discomfort) then its more likely to do with your digestive strength rather that your current diet, so working on building your stomach acid is going to be beneficial.

Functional practitioners like us at Remedy Clinic fill the gaps that GPs don’t have resources for. Ideally we work together to take the pressure off GPs and support you before a real medical need is created.

Its not a competition, we are here to support GPs and will always take a look at standard blood tests for you to help put together the jigsaw puzzle of your health.