Thyroid Support

Thyroid disorders are very common in women. A woman is 5-8 times more likely to be diagnosed with a thyroid disorder than a man. The reason we care about treating hypothyroidism is because if left untreated, it can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction.

Hypothyroidism is a condition where the thyroid functionality is lower than normal, and exists in two forms, overt and subclinical (SCH). SCH is a common condition especially in women, with a prevalence higher than 20% in those over 75 years of age. Autoimmune thyroid diseases are the main cause of SCH, with Hashimoto thyroiditis being the most common. In fact, Hashimoto’s occurs in approximately 5% of the Caucasian population and it is associated to 10-15% of SCH cases. Furthermore, SCH is at risk of progression to the overt form.

Despite the long-term risks associated with SCH, such as cardiovascular disease, dyslipidemia, infertility etc, the management of SCH still remains highly debated.

What are risk factors for developing a thyroid condition?

Family history of thyroid disease
Are a woman
Older than 60 years of age
Have an autoimmune disease, such as Type 1 diabetes or celiac disease
Have been treated with radioactive iodine or anti-thyroid medications

What are common symptoms of hypothyroidism?

Cold intolerance
Constipation
Depression
Difficulty concentrating
Dry skin
Fatigue
Hair thinning/hair loss
Memory impairment
Joint stiffness

It’s important to note that symptoms of hypothyroidism also vary with age and sex. Infants and children may present more often with lethargy and failure to thrive, whereas women may present with menstrual irregularities and infertility.

Laboratory Assessment

The most commonly run test for thyroid is serum thyroid-stimulating hormone test. In a clinical setting, if the serum TSH level is elevated, testing is repeated with a serum free thyroxine (T4) measurement. TSH levels are most optimal under 2.5 mIU/L. If you have a history of thyroid cancer, then your oncologist would like to see your TSH much lower, usually less than 0.5 mIU/L. When it comes to assessing your thyroid markers with a Naturopathic Doctor, you will notice that we like to do more testing than just TSH and FT4. For example, when it comes to miscarriage and difficulties conceiving, TSH doesn't tell us the whole story. Thyroid antibodies can be elevated without TSH getting flagged as an issue. This is why I always advocate for my patients to get a full thyroid panel completed and this includes TSH, Free T3, Free T4, Thyroid peroxidase antibodies (TPO), and Thyroglobulin antibodies.

What are some evidence-based solutions that you can start to explore with your healthcare provider?

Myo-Inositol

Myo-Inositol has a relevant role in thyroid function and autoimmune diseases. It is a B vitamin. Many clinical studies have shown that after treatment with Myo-Inositol plus Selenium (MYO+Se), TSH levels significantly decreased in patients with subclinical hypothyroidism with or without autoimmune thyroiditis. Talk to your practitioner about the appropriate dose for you.

Vitamin D

Vitamin D levels are found to be lower in patients with thyroid conditions like Hashimoto’s thyroiditis and Graves’ disease. Lower levels are also seen in those with thyroid nodules. Some studies have found Vitamin D to be an independent risk factor for developing thyroid nodules. Vitamin D is also a blood test that I advocate my patients get tested. In Ontario, it is a $35 test, however it is the best 35 you will spend when it comes to your health. We cannot tell by looking at you if you Vitamin D deficient.

Selenium

Selenium is a necessary micronutrient for thyroid hormone synthesis and function. Selenium has been shown to protect against oxidative stress in thyrocytes (cells of the thyroid gland.) Some studies have reported lower levels of selenium in patients with thyroid nodules. Talk to your practitioner about the appropriate dose for you.

A note on iodine: This is a supplement that I often see is self-prescribed when patients come to my office. I want to highlight that it is actually very rare to be iodine deficient in North America especially since foods have become fortified (like salt.) Excess iodine is what can actually lead to an increase in thyroid nodules.

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