Your thyroid is a small butterfly-shaped gland that resides in the front of your neck. Though the thyroid is small, it is mighty. In charge of producing several thyroid hormones, your thyroid is very important to your metabolism and protein production. Your thyroid hormones are used throughout the body, in nearly every tissue.
Thyroid diseases are fairly common and impact hundreds of millions of people worldwide. Thyroid diseases lie on a spectrum – ranging from conditions where the thyroid makes too much hormone, to those where the thyroid doesn’t make enough. Symptoms can be very mild and about half of all people with thyroid conditions don’t realize they have a problem. Furthermore, thyroid conditions may be difficult to diagnose when they produce only mild or non-specific symptoms.
Hypothyroidism and hyperthyroidism are on opposite ends of the spectrum. When your thyroid isn’t making enough hormones, it’s called hypothyroidism. When your thyroid is making too many hormones, it’s called hyperthyroidism.
Interestingly, an overactive immune system can be at the root of both types of thyroid conditions. When the immune system begins attacking the thyroid, it can cause either hyperthyroidism or hypothyroidism. Autoimmune diseases of the thyroid include Hashimoto’s thyroiditis (hypothyroidism) and Graves’ disease (hyperthyroidism).
Common thyroid conditions include:
Your symptoms and treatment plan will differ depending on whether or not your thyroid is making too much or too little hormone. It will also differ depending on whether or not you have an autoimmune disease.
Before we start talking about specific thyroid diseases and conditions it is important to understand how the body uses hormones to ‘talk’ to itself. We are going to dive into a little biochemistry – how we, as living beings, ‘chemically communicate’ with ourselves. ‘Chemical conversations’ can get pretty complicated so let’s stick to the big picture of what happens in our bodies.
You have an area in your brain called the hypothalamus that talks to the anterior portion of pituitary gland (also in your brain) and tells it to release thyroid stimulating hormone (TSH). TSH is like a bull horn. It is used to instruct your thyroid whether to make more or less thyroid hormones. The louder (higher the number) it gets, the more underactive the thyroid is and more thyroid hormone is needed. The quieter (lower number) it is, the more overactive your thyroid gland is and it needs to decrease production. TSH then travels from your pituitary gland to the thyroid and tells the thyroid gland to produce thyroid hormones. Thyroxine (T4) and triiodothyronine (T3) are the primary hormones produced by the thyroid gland, with T4 being produced four times more often than T3. T3 however, is the more active form of thyroid hormone and is responsible for our metabolism – the way our body uses energy. Breathing, heart rate, weight, muscle mass, menstrual cycles, fertility, nervous system activity, body temperature, cholesterol levels and much more are impacted by our thyroid hormones. In fact, every cell in your body has thyroid hormone receptors (binding sites) indicating that thyroid hormone activity is critically important when it comes to living a Fully Functional® life. Both T4 and T3 travel outside of the thyroid gland where T4 is converted into more T3 and impacts bodily functions as mentioned above. T3 is like the ‘gas pedal’ for our metabolism but we also have something called Reverse T3 produced in the body. More tends to be produced when the body is under considerable stress because it is similar to a ‘brake pedal’ and it signals the body to slow down. Unfortunately, many doctors don’t measure Reverse T3 levels and don’t get a full picture as to the ‘thyroid conversation’ in the body. The levels of T4 and T3 in the system then provide a feedback mechanism to the brain to tell it to make more or less TSH…and thus the cycle continues.
Now let’s take a closer look at the different thyroid conditions.
Hypothyroidism is the most common form of thyroid disease. It occurs when your thyroid gland isn’t producing enough hormone. Usually, but not always hypothyroidism is caused by autoimmunity, in which case it’s called Hashimoto’s thyroiditis. Hypothyroidism can also be caused by nutrient deficiencies, toxic exposures, chronic stress, damage to the thyroid gland, surgery or removal, and radiation treatment. Many people who have hypothyroidism don’t necessarily realize they have a problem because the symptoms can be very mild and their lab work may be in the ‘normal’ range.
Common symptoms of hypothyroidism include:
When you’re tested for hypothyroidism, your doctor should check several of your hormone levels, including thyroid stimulating hormone (TSH). It’s also important to be tested for autoantibodies, which would indicate you have Hashimoto’s thyroiditis – an autoimmune condition. Not every doctor does this because they believe the treatments are the same and therefore the underlying cause doesn’t matter. At Vine Healthcare we know that failure to address the underlying causes of autoimmunity can result in the progression to other autoimmune diseases. One of the things we tell patients based upon years of experience treating autoimmune conditions is that “autoimmunity begets autoimmunity.”
If you have a thyroid condition, it’s important that you are your best advocate. It takes time to figure out exactly what you need to be manage your hormone levels so you can get your life back. Take the time to do so carefully with an certified Functional Medicine doctor you trust.
As noted above, it’s estimated that 90% of all people with hypothyroidism actually have Hashimoto’s thyroiditis. Hashimoto’s thyroiditis is one of the most common forms of autoimmune disease, where the immune system attacks the thyroid gland. Though men and women can get this condition at any age, it’s most common in women between the ages of 20 and 40.
If you are diagnosed with Hashimoto’s thyroiditis, you’ve probably had it for up to 10 years before the symptoms caused you enough trouble to send you to the doctor. In fact, Hashimoto’s can be stable for years. Only after it’s triggered by another condition or stress to the immune system, do the symptoms typically worsen.
Symptoms of Hashimoto’s thyroiditis are the same as those of any cause of hypothyroidism which include:
Hyperthyroidism is when the thyroid gland is overactive and producing too much thyroid hormone. Similar to hypothyroidism, this condition is more common in women. Hyperthyroidism can be caused by Graves’ disease, nodules on the thyroid, and goiter.
Symptoms of hyperthyroidism include:
Graves’ disease is an autoimmune disease that causes hyperthyroidism. It’s the most common form of hyperthyroidism in the United States and usually affects women between the ages of 20 and 30. If you have Graves’ disease, you’ll have some or all of the hyperthyroidism symptoms listed above. Graves’ disease patients often experience distinctive bulging eyes (called “proptosis”) with associated vision problems and often have issues with an irregular or rapid heartbeat.
Graves’ disease is often treated with thyroid destroying treatments. This should be done with extreme caution because once your thyroid damaged, it won’t produce hormones well, which will result in hypothyroidism.
Goiter is when the thyroid gland becomes enlarged. Usually this is caused by iodine deficiency, which is more common outside of the United States. Goiter can also occur as a symptom of hyperthyroidism even in patients who get sufficient iodine. Similar to other thyroid diseases, goiters are more common in women. Factors that increase the risk of developing goiter include certain medications, pregnancy, radiation exposure, and genetics. Only when goiter becomes severe enough, do you notice the following symptoms:
Usually goiter is easily managed, though it shouldn’t go untreated. If you think you have goiter, be sure to make an appointment with a certified Functional Medicine Physician who’s experienced in treating thyroid diseases. A thyroid ultrasound may be needed to exclude cancer.
Thyroid nodules are usually non-cancerous growths that form on the thyroid gland. Usually thyroid nodules are too small to feel. Thyroid nodules can be caused by iodine deficiency and Hashimoto’s. The thyroid nodules are normally benign, though they can be cancerous.
Most thyroid nodules are asymptomatic. Sometimes thyroid nodules can cause excess thyroid hormone production and other times they can cause low levels of hormones – in which case your symptoms might look similar to hyperthyroidism or hypothyroidism, respectively. An ultrasound may be required to establish the diagnosis of thyroid nodules.
It is essential to identify the source of your thyroid condition so that it can be quickly addressed and on occasion diminish or completely eliminate the need for hormone replacement. This isn’t to say that you won’t need thyroid hormones or treatment but when steps are taken to address the underlying root cause, the amount of thyroid hormone replacement or duration of/type of treatment is quite often greatly reduced.
We take all of our patients through our Fully Functional® Process, including those with thyroid disease. Treatments are geared at helping patients become their most healthy, productive, joy-filled selves:
Our treatments are geared at helping patients become their most healthy, productive, joy-filled selves:
If you are in Carmel, Indiana or the Indianapolis area and are looking for a certified Functional Medicine Physician with extensive experience in thyroid diseases, Drs. Ellen and Scott Antoine have years of experience in treating and successfully managing thyroid (and many other) chronic conditions. You can request an appointment here or call our office at 317-989-8463.
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The Center for Fully Functional Health® is led by a team of award-winning, internationally recognized physicians, committed to providing personalized, life-changing care.
