Functional Medicine Approach to the Thyroid
42 million people in India have thyroid disorders
and up to 60 percent of these people are unaware of their condition. Hypothyroidism, specifically, is the most common of thyroid disorders in India, affecting one in five to ten adults.
Hypothyroidism is one of the most common thyroid disorders. One recent analysis suggested that up to one in 10 Adult women in India has clinical or subclinical hypothyroidism. Hypothyroidism is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other unpleasant symptoms. In fact, every cell in the body has receptors for thyroid hormone.
These hormones are responsible for the most basic aspects of our body’s function, impacting all major systems. Thyroid hormone directly acts on the brain, the GI tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gallbladder and liver, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism, and body temperature regulation. The thyroid can be compared to the central gear in a sophisticated engine: if that gear breaks, the entire engine goes down with it.
Conventional Medical Approach to Thyroid Disorders
In medicine, the key to choosing the best treatment is an accurate diagnosis. If the diagnosis isn’t correct, the treatment will be ineffective—or even cause harm. Unfortunately, misdiagnosis is common in the management of hypothyroidism. If a person visits a doctor with hypothyroid symptoms, she will simply be given replacement hormones without any further inquiry into the cause of her condition. Even worse, if she has hypothyroid symptoms but her lab tests are normal, she’ll be told that she’s “fine.” If the patient insists that she’s not, she might be sent home with an antidepressant, but no further clue about the cause of her symptoms.
The problem with this approach is that thyroid physiology is complex. The production, conversion, and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms but may not show up on standard lab tests. It’s incorrect and even negligent to assume that all cases of hypothyroidism share the same cause and require the same treatment. Yet that’s exactly what the standard of care for hypothyroidism delivers.
Although a prescription for thyroid hormone replacement is sometimes necessary, the first step should always be to determine why the thyroid is malfunctioning in the first place. Sometimes addressing the underlying cause of the thyroid problem is enough to resolve it without resorting to thyroid hormone replacement.
Underlying Causes of Thyroid Disorders
The two major causes of thyroid disorders are nutrient deficiency (primarily iodine, zinc, and/or selenium) and autoimmune disease. Iodine is a crucial nutrient for thyroid function. Thyroid hormone is rich in iodine, and deficiency of iodine can cause both hypothyroidism and goiter (a swelling of the thyroid gland). Zinc is required for the synthesis of thyroid hormone, and deficiency of zinc has been shown to result in hypothyroidism. Selenium, a cofactor for iodothyronine deiodinase, is required to convert T4 (the inactive form of thyroid hormone) into T3 (the active form of thyroid hormone). Selenium deficiency exacerbates conditions caused by inadequate iodine intake. The most common autoimmune cause of thyroid problems is Hashimoto’s disease. In Hashimoto’s disease, the body attacks the thyroid gland, progressively destroying its capacity to produce thyroid hormone and resulting in hypothyroidism. Some studies suggest that up to 90 percent of people with hypothyroidism have Hashimoto’s disease. Graves’ disease is another autoimmune disease that affects the thyroid gland, but it causes the thyroid to become enlarged and overactive, which results in hyperthyroid symptoms.
Many doctors will simply run a TSH test for diagnosis of Thyroid disease. However, this misses critical information you need about your patient’s thyroid metabolism. There are about five major thyroid patterns that are missed by standard tests. I always order a combination of thyroid markers including TSH, T3, T4, free T3, free T4, and thyroid antibodies.
You can figure out if your patient’s thyroid issues are due to an autoimmune process by testing for thyroid antibodies (thyroglobulin and thyroid peroxidase antibodies). Thyroid peroxidase antibodies is nearly 100% positive in people with autoimmune thyroid disease. Data shows that nearly 20% of normal population have raised Antibodies against Thyroid and they are at risk of developing Hypothyroidism. In other words 20% of Adult population had already started autoimmunity against thyroid and still they have enough thyroid tissue that produces hormone so their hormone level are within normal limit but they are on way to develop hypothyroidism.
Here’s the key thing to understand: if autoimmunity is causing thyroid problem, balancing and regulating the immune system—and thus slowing or stopping its attack against the thyroid gland—should be a primary goal of treatment. Replacement thyroid hormone may still be necessary; the destruction of thyroid tissue in Hashimoto’s disease is irreversible, so if it isn’t caught early on, replacement hormone will often be required to normalize thyroid function. But addressing the immune imbalance is critical to stopping further destruction of thyroid tissue, and in cases where Hashimoto’s is caught early enough, it may prevent hypothyroidism from developing in the first place.
Likewise, if iodine and/or selenium deficiency is driving your patient’s thyroid problem, then restoring healthy iodine and selenium levels is the most logical first step to take. Again, this may not eliminate the need for replacement thyroid hormone, but it can often significantly reduce the dose that’s required to normalize thyroid function.
Features of Our Program
- History and Medical record analysis from Functional Medicine perspective
- Elimination of Goitrogens from Diet
- Identification of Nutrition deficiency and Target supplementation.
- Complete Lab testing.
- Lifestyle Management
- GUT ( Digestive System) Healing
- Bioidentical Hormone Replacement
- Thyroxine (T4) and Liothyronine (T3) Hormone Replacement
We offer a free 15-minute consultation to help you better understand our approach and to see if it is a fit for you. This consultation is a chance for you to discuss some of your key health goals and concerns.