What is your thyroid?
Your thyroid is a small butterfly shaped gland that sits in your neck and governs how energy is used in the body. The thyroid is governed by our hypothalamus, a part of the brain that tells the pituitary gland to produce a hormone called thyroid stimulating hormone or TSH. TSH tells the thyroid to produce either more or less thyroid hormone, T4. When your thyroid produces enough of the hormones, T4 (thyroxine) and T3 (triiodothyronine) we experience balanced metabolism, regular bowel movements, clear thinking, normal reproductive function and good mood. However, hypothyroid conditions are becoming more prevalent. The most common thyroid condition in the U.S is an autoimmune form of hypothyroidism caused Hashimoto’s Thyroiditis. Overall, Hypothyroidism is estimated to affect 5% of people and occurs almost 8 times more frequently in women than in men. While an overactive thyroid or hyperthyroidism is also possible, it is less prevalent.
What causes thyroid dysfunction?
The thyroid is very sensitive to even the slightest disruption of homeostasis. Therefore, a number of things may cause the thyroid to become sluggish. Some of the most prevalent are:
1) Immune system malfunction
Sometimes the immune system can become confused and start attacking its own tissues. In Hashimoto’s, the most common cause of underactive thyroid, the immune system creates autoantibodies against thyroid tissue and mounts an attack creating inflammation. Thyroid tissue starts to produce less T4 and T3 and we experience hypothyroid symptoms. While we don’t know for sure what causes autoimmune conditions, one of the most fleshed out theories proposes that a trifecta of conditions must be met: A genetic component, leaky gut or increased intestinal permeability and some kind of environmental trigger like a virus or illness.
2) Environmental exposures
Endocrine disruptors like dioxins (found mostly in fatty tissue of animals), BPA (found in plastics and the lining of cans) and PCBs (found in plastics, rubber and copy paper) can mimic hormones and block receptors in the body, causing hormonal imbalances. Additionally, bromine, fluoride and chlorine found in tap water are similar to iodine (a critical nutrient for thyroid health) and may displace it in the body, contributing to hypothyroidism. Heavy metals like mercury (we are exposed mostly due to eating contaminated seafood), and lead and cadmium found in our water and soil also inhibit thyroid function. Drinking filtered water, eating organic pastured meats and wild caught fish, choosing clean beauty products (check out the EWG’s healthy living app), and not heating food or drinking water in plastic containers can help avoid exposures that may slow thyroid function.
3) Nutrient deficiencies
There are certain nutrients that are very important for thyroid hormone creation and conversion of T4 to its active counterpart T3. Becoming deficient in iodine, iron, selenium, tyrosine or zinc may inhibit thyroid function and contribute to a sluggish thyroid.
4) Chronic stress
Our main stress hormone, cortisol may also impede thyroid function. It impacts gut health, where a portion of our T4 is converted to T3 and it causes our tissues to be less sensitive to thyroid hormone. Being under chronic stress or experiencing frequent intermittent stressors are very much implicated in triggering or worsening thyroid dysfunction.
5) Certain medications
Some medications may impede thyroid function. In particular, oral birth control pills increase sex hormone binding globulin (SHBG) which bind thyroid hormone and decreases its availability for cellular uptake. If you are on birth control pills and have hypothyroidism, think about discussing alternative methods of contraception with your MD. Other medications that may impact thyroid hormone uptake or even the effectiveness of your thyroid medication are cholesterol lowering drugs, acid blockers like PPIs and some anti-depressants. Check with your MD regarding side effects and alternatives if possible.
Signs and Symptoms of thyroid dysfunction
The main signs and symptoms of an underactive thyroid are:
- Fatigue/low energy
- Trouble sleeping
- Low libido
- High cholesterol
- Thinning hair
- Trouble losing weight or unexplained weight gain
- Low basal body temperature
- Cold intolerance
- Brittle nails
- Dry, itchy skin
Many times, women complain of many if not all of these symptoms and their doctors tell them that they are just getting older. You are within your rights to insist on a thyroid panel to rule out hypothyroidism or find another MD that is more considerate of your opinion.
Nutrients for thyroid health
As mentioned above, it’s vital to make sure you are getting enough selenium, iodine, zinc and tyrosine. Other nutrient deficiencies like iron and Vitamin D are implicated in low thyroid as well. Additionally, calming the stress response and inflammation are key components to healthy thyroid function so adaptogens like ashwaganda or rhodiola, Omega 3s and curcumin may also be beneficial. While a food first approach is best, often we find that a nutrient is needed in a therapeutic quantity or that it is difficult to meet our need with only food and that’s when a supplement may help. Always check Vitamin D and Iron levels before supplementing and check with your health care provider before adding any supplements.
Diet for thyroid health
The dietary guidelines for a focus on thyroid health are simple: choose anti-inflammatory, whole foods. This means staying away from added sugars or artificial sweeteners, packaged and processed grain or starch based snack foods and vegetable oils and trans fats.
1) Aim for 8-10 servings of vegetables a day. While some controversy exists surrounding cruciferous vegetables (broccoli, kale, cabbage, and Brussels sprouts) and lowered thyroid function, the concern is that eating large quantities of these vegetables raw can slow thyroid function. So, enjoy these vegetables steamed or roasted. Much of your T4 to T3 conversion happens in the liver so consuming vegetables that support detoxification and liver health are beneficial. Artichokes, burdock root, dark leafy greens, and dandelion are all liver supportive, but any and all non-starchy vegetables can be eaten in abundance.
2) Eat zinc, iron and selenium rich foods! Good sources of these nutrients are grass-fed lean red meat, free range poultry, brown rice, dark chocolate, shrimp, wild caught fish, pumpkin seeds, quinoa, garbanzo beans, broccoli, spinach, and brazil nuts. Try adding a couple servings of these foods into your weekly diet.
3) Choose slow burning carbohydrates. When woman restrict calories or eat very low carbohydrate diets, our brain gets the message that we should conserve energy and thyroid function may slow. Choosing a starchy vegetable like sweet potato, squash or a root vegetable like rutabaga or yams and opting for wild rice or quinoa in small amounts are the best choices. These are full of fiber and help slow the spike of blood sugar and insulin. I recommend 1-2 servings a day of a starchy vegetable/ancient, gluten free grain.
4) Nix the dairy and gluten. Evidence suggests that both celiac disease and non-celiac gluten sensitivity (NCGS) are associated with the autoimmune form of hypothyroidism, Hashimoto’s. Even if you don’t have an autoimmune condition, skipping the processed grains, breads and pastas improves blood sugar, weight loss, mood and brain function as long as they aren’t replaced with other gluten free processed foods. Additionally, due to its processing and origins, dairy often contains hormones, most notably estrogens from pregnant cows, that can worsen hormone dysfunction and drive inflammation. I recommend choosing organic, grass fed dairy in sparing amounts only or try goat’s milk dairy instead as the A2 casein is less inflammatory than the A1 casein found in cow’s milk dairy.
5) Choose your meats wisely. Eating conventionally raised, feed lot meats mean we are likely ingesting inflammatory Omega 6s from their grain based diets as well as their stress hormones and estrogens or growth hormones. These outside hormone exposures are linked to all sorts of issues, and very notably hormonal imbalances like estrogen dominance which can throw off adrenal and thyroid function. Choose grass fed, organic beef and organic, free range poultry and eggs when possible.
If it isn’t clear to you yet, adrenal and thyroid heath are inextricably linked. We can’t talk about thyroid health without considering how stress can impact not just our thyroid, but our overall hormone balance. Working on stress management is an ongoing challenge for many, but it is worth it. While we cannot avoid all stress, we can manage our perception of a stressor. Here are some great tips on how to de-stress on the daily:
1) Set aside at least 10 minutes for yourself every day. This might mean taking a lunch time walk, sitting by yourself in the quiet with your coffee in the morning, journaling before bed or spending some time in quiet meditation or trying a quick yoga session. Whatever brings you the most joy and calm, do that for at least 10 minutes every day.
2) Exercise! Physical activity produces endorphins which makes us feel good, and gentle movement like yoga or walking helps to lower stress hormones. Work your way up to 150 minutes weekly, but start small if you need to. Even 10 minutes of exercise a day can help.
3) Get a good night’s sleep. Easier said than done, but creating a bedtime ritual for yourself is a great way to catch some quality Z’s. Power off your screens, have a cup of tea, take a hot bath, spend 5 minutes counting your blessings, write in a journal, meditated, or whatever resonates with you!
There are many factors that impact thyroid function. Eating a well balanced, nutrient dense diet, avoiding environmental exposures when possible and managing stress are all important components. If you feel you are struggling with thyroid issues and need help, talk to your doctor about testing or seek out another trusted health care provider for help. At RED dietitians, we strive to identify the root cause of your issues and use food as medicine to help heal them. If you struggle with symptoms of low thyroid, we can help! Contact us today for your personalized plan and get on the path to long term health.
Caturegli P, DeRemigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmunity Reviews. 2014;13(4-5):391–397.
Written and contributed by Liz McKinney, MS, CNS, LDN