Thyroid Controversy

A couple of months into winter and many people are noticing the cold, fatigue, and weight gain more this year than last. They may write-off the changes to the “winter blues”… but could a more serious health concern be responsible for these changes? 

Low thyroid function, also known as hypothyroidism, mimics many other health disorders and is difficult to accurately identify despite its prevalence. Some studies suggest that hypothyroidism may affect as much as 10% of the population, particularly women over the age of 55. The symptoms of hypothyroidism are vague and include intolerance to cold, mild weight gain, fatigue, aching muscles, and constipation. Some less recognized symptoms include high cholesterol, forgetfulness, and wrist pain that mimics carpel tunnel syndrome. Some people have no symptoms at all but identifying the condition might still be worthwhile given that hypothyroidism has been linked to heart disease, arthritis, and depression.

How to best identify and treat a person with hypothyroidism is somewhat controversial. A medical professional may assess the health of your thyroid gland with a blood test that measures Thyroid Stimulating Hormone (TSH), a hormone produced by the brain. An abnormally high TSH may mean that your brain is working excessively hard to stimulate the underactive thyroid gland. In Ontario, most laboratories indicate that you do not have an underactive thyroid if your TSH level is below 5. However, the American Association of Clinical Endocrinologists stated over 5 years ago that this range should be reduced to 3, so that anyone previously considered “healthy” with a TSH between 3 and 5 should be assessed further for hypothyroidism.  Other professional associations advise that a TSH hormone test is never adequate for identifying a person with hypothyroidism, and others still advocate for treatment of symptoms no matter what the test results say. This leaves a patient wondering how they might ever find the cause of their symptoms and receive proper treatment. 

How to treat thyroid concerns is also a rather unresolved issue.  An uncomplicated case of hypothyroidism is conventionally treated with a daily prescription of synthetic thyroid hormone. This prescription must usually be continued for life because the drug “tells” the thyroid gland that no more thyroid hormone is required. The gland shuts down. By comparison, a healthcare practitioner trained in whole-body medicine may perceive that the problem is not the thyroid gland at all, but an underlying imbalance that could be hormonal or immune in nature. The solution requires treating these underlying imbalances to remove barriers to optimal thyroid gland function. From this perspective, the thyroid condition is viewed as a symptom rather than the problem to treat, and its function is optimized, rather than inhibited. 

Part of a naturopathic prescription for removing barriers to optimal thyroid function includes a good diet and healthy digestive tract, since thyroid hormones are dependent on many vitamins and minerals at various stages of production. Iodine is one key ingredient, but be cautious in taking too much since too much as well as too little iodine can result in hypothyroidism. Other necessary nutrients include balanced amounts of selenium, zinc, tyrosine, B-vitamins, and vitamin A. 

A class of foods known as goitrogens may interfere with proper thyroid hormone metabolism. Raw soybean products, including soy milk and tofu, are considered goitrogens and may aggravate thyroid conditions if consumed in large quantities for many months. This news is particularly important for menopausal women who consume large amounts of soy to help mitigate menopausal symptoms. The negative impact of soy may be minimized by consuming at least 4 servings of sea vegetables each week, since these vegetables are a good source of iodine. Goitrogenic compounds are also present in a family of vegetables known as cruciferous vegetables, which includes cabbage, kale, broccoli, cauliflower, and brussel sprouts. Some of these compounds may be inactivated by steaming or boiling, however the heat will also inactivate compounds that help maintain a healthy estrogen balance. 

It is not a coincidence that the foods known to potentially interfere with optimal thyroid function are the same foods that impact the predominantly female hormone estrogen. This association is also noted in the thyroid side-effects of drugs prescribed to change estrogen balance. The complicated relationship between thyroid and estrogen hormones is another point in favour of the holistic perspective that an imbalance in one body system will have a chain reaction to other areas, and whole-body treatment is required to get the thyroid gland back on track. This is essential for true healing.