Hashimoto’s Thyroiditis and Hypothyroidism What happens when things go wrong

The thyroid is a rather complicated issue. Hypothyroidism or Hashimoto’s Thyroiditis causes everything to slow down whereas Hyperthyroidism or Graves Disease causes everything to speed up. This sounds great when it comes to metabolism but can ultimately lead to hypothyroidism. More on that next week.

So how do you know if you have hypothyroidism? Are you experiencing any of the following common symptoms:

  • Are you tired a lot or have trouble sleeping?
  • Are you listless?
  • Are you rundown and get sick a lot?
  • Do you have less than one bowel movement a day or feel like you don’t completely evacuate when you do go?
  • Are you cold all the time, especially your hands and feet?
  • Are you achy for no apparent reason?
  • Does your brain seem to work in slow motion?
  • Are you depressed?
  • Do you have excessive bleeding?
  • Do you have high cholesterol?
  • Have you gained unexplained weight, mostly fluid?

If you experience several of the above symptoms, I would strongly suggest you go to your family doctor, explain what’s happening and ask them to send you for the following blood tests:

  • TSH
  • Free T3
  • Free T4
  • Reverse T3

I’ll talk more about these numbers shortly. But first … a little explanation.

One of the biggest challenges people (mostly women) face is a lack of diagnosis of hypothyroidism.

Many medical doctors (especially ones who have been practicing a while) are using an outdated range reference.

Doctors are unaware of the latest information, which shows improved outcomes for people treated with borderline thyroid function (also known as subclinical hypothyroidism).

Some doctors rely on the myth that the numbers don’t lie. They believe that TSH alone tells the story but sometimes T3 is low due to exposure to thyroid disruptors from the environment. It’s the relationship between TSH and free T3 that is most important.

Women are disempowered. Most women don’t experience thyroid issues until after the age of 35 so of course it’s all in their head. Or they’re just aging and weight gain is a “natural” part of aging. Or they just don’t want to work out and eat healthy. THAT is all a bunch of hogwash! So rather than being prescribed antidepressants, sleeping pills or accept that you need to purchase “fat” clothes or be sent to a psychiatrist, you should push for more answers or go to a naturopath or nutritionist for help.

How do the hormones work together? I’ll try not to get too sciency. TSH is made by the pituitary gland, which is regulated by the hypothalamus and limbic system in the brain. When you have hypothyroidism, you don’t make enough of the thyroid hormones (T3 and T4) to meet the body’s need and you make too much TSH in the brain. The main cause of Hashimoto’s Thyroiditis (an autoimmune disease) is when the immune system attacks the thyroid, which leads to high levels of thyroid hormone in the blood, plus antibodies. Over time, the battle causes the weakened thyroid to stop making as much T3 and T4 and the feedback system tells your control system to make more TSH. When it makes more TSH in the pituitary, it travels to the thyroid in the blood and orders the gland to make more thyroid hormone. You either keep up with demands or you don’t. Perhaps because the immune system is destroyed by the thyroid or an environmental toxin is disrupting its functions, symptoms such as fatigue, weight gain and mood changes start to appear.

Thyroid by the numbers. Most people are familiar with TSH but are you also familiar with T4 and T3 and how their numbers affect your health? T4 is the inactive version of the thyroid hormone. T4 must be converted to T3 (the active component of the thyroid hormone) and a small portion gets converted into reverse T3, which acts as a feedback system to keep you in balance.

Overt hypothyroidism – TSH levels are high but total free T3 and T4 are below normal. This affects less than 1% of the population.

Subclinical hypothyroidism – TSH levels are high (above 2.5) but total free T3 and T4 are normal. This affects approximately 9% of the population.

Then there are gradations of thyroid imbalance. This “middle ground” requires attention but not necessarily with medications. You can heal the thyroid naturally.

TSH upper limit should be 2.0-2.5 but make sure you have bloodwork done consistently in the morning as the time of day does affect the numbers.

TSH greater than 4 has been shown to put women at a greater risk of a heart attack.

When the body is stressed or on a very calorie-restricted diet, a signal is sent to produce more reverse T3, which slows down your metabolism so your body can deal with the stress and the cycle continues. Normal blood tests of TSH and T4 do not accurately reflect what’s happening INSIDE the cells, where T4 gets converted to T3 and reverse T3. Testing reverse T3 predicts survival and physical conditions better than other thyroid tests and people with low serum T3 and high reverse T3 had worse physical performance associated with aging (such as arising from bed, dressing, eating, walking, hygiene and grip) than those with normal levels.

After giving birth, some women develop postpartum thyroiditis when the immune system attacks the thyroid resulting in mood swings, lethargy, thinning hair and difficulty with weight loss.

Perimenopausal women (ages 35-50) are more likely to suffer from thyroid issues, and are most likely to develop Graves Disease (hyperthyroidism), which we’ll discuss next week. Over time this disease burns out the thyroid and you end up with hypothyroidism.

There are so many reasons why you need to investigate if you suspect you might have thyroid issues. Make sure you get a copy of your test results and if you’re not happy with your doctor’s response, see a naturopath or nutritionist for help.

We’ll talk more about what Grave’s Disease is next week. Until then, enjoy your week!

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