Your thyroid plays a part in nearly every metabolic process and when the thyroid isn't working you won't feel well! This small gland has an average weight of 16.4 grams in the adult. Shaped like a butterfly, it lies low on the front of the neck and below your Adam’s apple and in front of the windpipe. When the thyroid is its normal size, you can’t even feel it.
The thyroid secretes several hormones, collectively called thyroid hormones. The main hormone is thyroxine, also called T4, but there are others, including T3 and even lesser known T1 and T2. It requires adequate selenium, iodine, zinc, B vitamins and antioxidants for optimal function. Thyroid hormones act throughout the body, influencing metabolism, growth and development, and body temperature. During infancy and childhood, adequate thyroid hormone is crucial for brain development. Unfortunately, the thyroid gland is uniquely sensitive to drugs and environmental chemicals which may affect proper function.
More than 10 percent of the general population in the United States, and 20 percent of women over the age of 60, have subclinical hypothyroidism. But only a small percentage of these people are being treated. It is important to ask your doctor to check you thyroid function if you feel that you are having symptoms.
Often, at first, you barely notice the symptoms of hypothyroidism, such as fatigue and weight gain. You might simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms.
Top Sixteen Symptoms of Hypothyroid
- Fatigue
- Increased sensitivity to cold
- Constipation
- Dry skin
- Unexplained weight gain
- Puffy face
- Hoarseness
- Muscle weakness
- Elevated blood cholesterol level
- Muscle aches and pain
- Pain, stiffness or swelling in your joints
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Slower heart rate
- Depressed mood
- Impaired memory
Here is a simple checklist of symptoms that may indicate abnormal thyroid function:
____ My facial skin looks or feels thinner
____ My muscles feel weak, particularly the upper arms and thighs
____ I am having difficulty getting to sleep or staying asleep
____ I feel fatigued, exhausted all the time
____ I frequently require more than 8 hours of sleep at night
____ I feel better if I am able to take an afternoon nap every day
____ I am unable to tolerate exercise
____ I have less stamina or energy than others
____ My hair is coarse and dry, breaking, brittle, falling out
____ My skin is coarse, dry, scaly, thin
____ My hair is coarse and dry, breaking, brittle, falling out
____ My skin is coarse, dry, scaly, thin
____ My eyebrows are thinning, especially the outer 1/3
____ I frequently struggle with constipation or hard stools
____ I am always colder than others around me
____ I typically wear a sweater, even in the summer
____ I am having more breakouts or acne
____ I have pains, aches in joints, hands and feet
____ I have pains, aches in joints, hands and feet
____ I experience numbness or tingling in my hands & fingers
____ I am having irregular periods (women)
____ I am having irregular periods (women)
____ I am having trouble maintaining erection (men)
____ I am having trouble conceiving a baby
____ I have had one or more miscarriages
____ I feel depressed most of the time
____ I feel restless, or anxious
____ I am having trouble conceiving a baby
____ I have had one or more miscarriages
____ I feel depressed most of the time
____ I feel restless, or anxious
____ I have puffiness and swelling around the eyes and face
____ My moods change easily
____ My moods change easily
____ I have difficulty concentrating or focusing
____ I have more feelings of sadness
____ I seem to be losing interest in normal daily activities
____ I'm more forgetful lately
____ My hair is falling out
____ I can't seem to remember things
____ I have no sex drive
____ I am getting more frequent infections, that last longer
____ My eyes feel gritty and dry
____ My eyes feel sensitive to light
____ I have more feelings of sadness
____ I seem to be losing interest in normal daily activities
____ I'm more forgetful lately
____ My hair is falling out
____ I can't seem to remember things
____ I have no sex drive
____ I am getting more frequent infections, that last longer
____ My eyes feel gritty and dry
____ My eyes feel sensitive to light
____ I am having difficulty swallowing or feeling a lump in my throat
____ I have a hoarse or gravely voice
____ I have tinnitus (ringing in ears)
____ I feel some lightheadedness or dizziness
____ I have severe menstrual cramps
____ I have tinnitus (ringing in ears)
____ I feel some lightheadedness or dizziness
____ I have severe menstrual cramps
Other conditions that may be associated with thyroid dysfunction:
- Infertility or frequent miscarriage
- Acne
- High cholesterol
- Irregular periods
- Low libido
- Fluid retention
- Difficulty swallowing
- Respiratory difficulties
- Iron-deficiency
- Glaucoma
- Frequent headaches
Family history that suggests you could have a higher risk for hypothyroidism:
- Celiac Disease or gluten intolerance
- Goiter
- Prematurely gray hair
- Type 1 Diabetes
- Autoimmune diseases (rheumatoid arthritis, lupus, sarcoidosis, Sjogren's, etc.)
- Crohn's disease or ulcerative colitis
- Multiple sclerosis (MS)
- Elevated cholesterol levels
Ten Tips To Support a Healthy Thyroid:
- Eliminate gluten from your diet! One in three patient's with Hashimoto's thyroiditis are sensitive to gluten.
- Selenium is essential to a healthy thyroid and the first thing I recommend for those with autoimmune thyroiditis or Hashimoto's. You can get 200mcg of selenium by eating 2-3 organic brazil nuts daily!
- Wild caught fish, like salmon, supple ample omega-3 fatty acids which are essential for optimal thyroid function. If you don't eat fish frequently, you can supplement with a high quality Omega3 supplement, like Thorne OmegaPlus 2-3 caps daily.
- Get plenty of sunlight to optimize your vitamin D levels and take 1000-2000IU daily of Vitamin D3.
- Herbs that support thyroid function include ashwaganda, eleuthero and other adrenal adaptogens. One of my favorite formulas is Gaia Herbs Thyroid Support
- Dandelion greens, carrots, spinach, kale, Swiss chard, collard greens, and sweet potatoes are all rich sources of essential Vitamin A
- Use organic coconut oil in your cooking — it's great for high heat cooking and sautéing many different meats and vegetables.
- Filter your drinking water from chlorine and other harmful chemicals which suppress the thyroid and block iodine
- Find daily ways to detox, like using a sauna, taking epsom salt baths, adding chlorella, parsley, or cilantro to your daily smoothie to help your body detoxify from chemical exposures (petrochemicals, PCBs, pesticides, and mercury)
- Work on lowering stress levels through daily gratitude, prayer, meditation, yoga, deep breathing!
Environmental Toxins May be Poisoning Your Thyroid
Many environmental factors have the potential to impact thyroid function. Some of these factors include:
- Potassium perchlorate, which inhibits iodine uptake by the thyroid, is used in rocket propellant, fireworks, and automobile airbags. Potassium perchlorate is stable in the environment and contaminates water throughout the United States. Newborns and infants are most susceptible to this inhibitory effect on iodine transport. The thiocyanates in cigarette smoke can have effects similar to potassium perchlorate.
- Isoflavones (phytoestrogens), found in soy proteins, are thyroid peroxidase inhibitors.
- Pesticides induce glucuronidation of T4 and reduce T4 half-life.
- Polychlorinated biphenyls are industrial chemicals that were banned in 1975 but still are routinely detected in the environment. They have been shown to reduce T4 levels in animals and are neurotoxic. Their effect varies because of partial agonist effect at the thyroid hormone receptor and their varied chemical structure.
- Bisphenol A—used in plastics, as resins for coating food cans, and as dental sealants—antagonizes T3 activation of the thyroid hormone b-receptor in rats, causing a thyroid hormone resistance–like syndrome.
- Keep your home free from these and other toxic chemicals
- And read the blog on MTHFR for how your genes can also make you more susceptible to thyroid dysfunction and poor detox!
A Prescription for Hypothyroid
If you are truly suffering from hypothryoid, no amount of nutritional supplementation will replace your abnormally low levels of thyroid hormone. Ask your doctor to do comprehensive thyroid lab testing including: TSH, free T4, free T3, total T4, total T3, reverse T3, thyroid peroxidase antibodies (TPOs), and thyroglobulin antibodies (TgAb). An ultrasound to evaluate the appearance of the thyroid is necessary if you are experiencing symptoms of enlarged thyroid or nodules.
Common drug options for thyroid replacement include:
- T4 preparations
- Synthroid
- Levothroid
- Levoxyl
- levothyroxine
- Tyrosint
- T4/T3 preparations
- NaturThroid
- Armour Thyroid
- ERFA thyroid
- dessicated thyroid
- Westthroid
- Thyrolar
- T3 only preparations
- Cytomel
References:
Could Thyroid Dysfunction Be Causing My Symptoms?
Drugs and Environmental Toxins take on the Thyroid
NEJM: Drugs that Influence Thyroid Function
18 Comments
Very comprehensive and useful information. Will use it as direction to in improve health and well-being. Many thanks.
Just wondering where the statistic about 1/3 of Hashimoto’s patients being gluten sensitive came from. Was this from a published study, or from your clinical practice?
Hi Ed,
In my clinical practice I would estimate > 50% of my patients with Hashimoto’s have gluten-intolerance, celiac disease or non-celiac gluten sensitivity (NCGS). I have many references but most are correlating the incidence of celiac disease and Hashimoto’s and not the more common NCGS so it’s hard to estimate when you combine both. When you look at the link between the HLA types DQ2 and DQ8 and autoimmunity, it is very clear that patients with any autoimmune disease should avoid gluten. You can read more here
I have all 16 symptoms of hypothyroidism …..just added Cytomel to my journey….my Tsh is 3.8 my T3 was 2.2 ….T4 0.72 ….I asked my CNP to increase my Cytomel….she declined….she raised my Levothyroxin instead from 112mg to 125mg…..had a TT eight years Ago…..still playing with my labs/symptoms …..about to throw in the towel.
Hi Laura
If you are not feeling well, you may need to find a T4/T3 combo or add cytomel. Everyone is different but keep trying until you feel better!
warmly
Dr Jill
Hi,
I have a lot of those symptoms although I’m anemic as well so it’s hard to tell what’s causing what. In your opinion, does someone with these numbers need thyroid medication right now or would you work on getting antibodies down first? Are my numbers hypothyroid enough that they could be causing my symptoms?
TSH – 4.2 (0.400-4.200)
FT3 – 3.6 (1.5-3.5)
FT4 – 1.0 (0.6-1.5)
Anti-TPO – 1,000
Hi Jenna
Best to discuss with your doctor. I cannot give you medical advice here.
warmly
Dr Jill
Besides a pituitary issue, what can cause a high TSH with optimal Free T3 and T4 levels? My Reverse T3 is 16.2 so I don’t think it’s that. My TSH isn’t lining up with my T3 and T4 and I’ve been to several doctors and they can’t tell me why besides a pituitary issue which I’ve been checked for and don’t have.
high TSH is subclinical hypothyroid
Hi Dr. Carnahan,
Thanks for this info! If TSH is normal (2) and t3/t4 (free and bound) are below normal, what could that mean?
Thanks!
Hi Dr. Jill,
I have Hashimoto’s and my TSH has steadily been in the 4’s. I’m having swelling in my thighs, arms, and feet. As well as in my abdomen. My stomach, thighs, arms, and feet are huge. My PCP says this is likely thyroid since edema is a symptom. But my functional doctor says she sees a lot of thyroid patients and that isn’t a symptom most patients has so she doesn’t think it’s that. Is it possible this could be thyroid with a TSH in the 4’s or should I be looking elsewhere?
Myxedema is often a sign of hypothyroid
Hi Dr Jill,
If someone has Hashimoto’s with a TSH of 6, do you recommend they should take thyroid medication while working on getting antibodies down or will working on getting antibodies down bring their TSH down?
I treat if symptomatic and TSH > 3.5
Hi Dr. Jill,
Is a Free T3 of 3.2 too low or optimal?
Hi Erica
This needs to be interpreted in light of your clinical picture and other labs. When someone has chronic illness, it is not unusual to have lower T3 and normal T4 as a protective mechanism of the body.
Warmly
Dr Jill
Hi Dr. Jill,
I have Hashimoto’s and hypothyroidism and I have very low ferritin levels. Doctors put me on iron supplements and it’s not absorbing. I looked it up and I found that it’s pretty common to have hypothyroidism and low ferritin levels together. Why is this? Does one cause the other?
Yes, these very commonly co-exist.
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