Let's Talk About Thyroid Health: Hyperthyroidism & Thyroiditis

Diving into some more thyroid awareness today, talking specifically about Hypothyroidism, Hashimoto’s disease and the less talked about Thyroiditis. I have recently experienced my own struggles with thyroiditis including actually getting it diagnosed. Will soon share some of the Naturopathic treatments I have found support and results from

The Thyroid

This is the butter-fly shaped gland located in the front of the mid-neck. The thyroid influences many different functions in the body including metabolism, stress response, mood regulation, fertility, muscle function and digestion. The thyroid makes thyroxine (T4) and in lesser amounts, triiodothyronine (T3). It is regulated by both the hypothalamic-pituitary-thyroid axis (HPT) and the hypothalamic-pituitary-adrenal axis (HPA). Through a feedback system in the body, the anterior pituitary gland secretes thyroid stimulating hormone (TSH) when the thyroid needs to make more hormones (T4/T3) to increase various functions in the body.

It is important to note that T4 is mostly inactive in the body and needs to be converted to T3 in order to carry out its functions.

Where It Can Go Wrong

There are many different factors that can contribute to the development of thyroid dysfunction resulting in hypothyroidism (underactive), Hashimoto’s (auto-immune driven underactive thyroid), hyperthyroidism (over-active), and Grave’s disease (auto-immune driven overactive thyroid).

Hypothyroidism and Hashimoto's

Hypothyroidism is the most common thyroid disorder. As compared to hyperthyroidism that has few direct causes, hypothyroidism can be caused by a variety of genetic, pathological, nutritional and lifestyle factors. Hypothyroidism is diagnosed from having a high TSH and low free T4/T3. Subclinical hypothyroidism is also very common and the diagnosis can be missed as T4/T3 can be normal, yet TSH elevated. Patient symptoms, however, can be as severe as acute hypothyroidism regardless of an official diagnosis. Hashimoto's is another autoimmune thyroid disease where auto-antibodies attack the thyroid gland, causing damage and reduced thyroid function. This is the most common cause of hypothyroidism. Factors that can directly cause or contribute to the development of hypothyroidism/Hashimoto's includes:

• Stress (significantly lowers conversion of T4-T3)

• Infection/Inflammation (can trigger inflammatory cascade and prompt an autoimmune response)

• Genetic susceptibility

• Hormone fluctuation in pregnancy

• Poor gut/liver health

• Nutritional deficiencies (Specifically iron, tyrosine, iodine, zinc, selenium)

• Anaemia

• Alcohol/Smoking

• Certain Medications, and Endocrine disrupting chemicals

Symptoms can include but are not limited to...

• Depression,

• Fatigue

• Loss of libido

• Cold intolerance

• Muscle aches

• Dry/Itchy skin

• Constipation

• Weight gain

• Irregular/Heavy periods

• Bloating

• Swelling

• Brain fog

• Hair loss

• Elevated cholesterol

• Enlarged thyroid

Thyroiditis

The least common cause of Thyroid dysfunction and can be easily missed due to abnormal testing. The name describes the condition, in which the thyroid is inflamed. This can be caused from a viral/bacterial infection, autoimmune reaction, nodule growths, certain medications/drugs, or an inflammatory cascade in the body. Patients will typically experience hyperthyroidism due to the thyroid leaking hormones into the blood stream from damaged cells. This can last 1-3 months followed by potential hypothyroidism for 2-6 months due to thyroid over-exertion. It can take about 12 months for the thyroid to return to normal function. In this case a patient may experience symptoms of both hyper and hypothyroidism within the year.

Specific Things to Note for Testing

Hypothyroidism is diagnosed by a blood test showing high TSH, low free T4 and/or low free T3. The autoimmunity or Hashimoto's is diagnosed by having high thyroid peroxidase (TPO) and/or thyroid globulin (Tg) antibodies. Having a full thyroid panel conducted is important to understand exactly what is going on in the body.

Often times initial tests only include TSH, which is not an accurate representation of thyroid function. Ideally testing will include TSH, Free T4/T3, Reverse T3 and Thyroid antibodies (TPOAb, TgAb, TRAb). Blood tests should be conducted on a 10 hour fast, but no more than 12 hours with no strenuous exercise the day before. Thyroid ultrasounds may also be conducted to check for enlarged nodules impacting thyroid function.

Thyroiditis can be hard to diagnose as it is not a "true" thyroid disease in the sense there is functional issues. It is often a transient condition and as such TSH can often be NORMAL, yet T4/T3 elevated in the hyperthyroid stage. It is common practice in Australia for GP's to only check the TSH and only if it is out of range will they test further.