Fatigue, weight gain, insulin resistance, depression, and dementia are all associated with the degenerative aspects of aging. Yet many of these symptoms may actually be caused by hypothyroidism, a deficiency of the thyroid gland, which is often overlooked and misdiagnosed. A simple thyroid stimulating hormone (TSH) blood test can reveal your thyroid status and help you avoid misdiagnosis of these symptoms.

However, right upfront, it is necessary to say that often people test negative for thyroid disease yet they display every symptom associated with it.  A regular M.D., in many cases, is not going to be helpful because most tend to go with only the lab test results.  An estimated 5% of Americans suffer from hypothyroidism and many go undiagnosed. Patients and their doctors often disregard common symptoms, mistaking them for “normal” signs of aging.

Role of the Thyroid Gland

The thyroid is a small, butterfly-shaped organ in the neck, located above the collarbone and below the Adam’s apple. This tiny gland is vital to regulation of the body’s metabolism. Made up of small sacs, the thyroid is filled with an iodine-rich protein called thyroglobulin, along with the two thyroid hormones, T4 (tetraiodothyronine, or thyroxine) and T3 (triiodothyronine). T3, the more active of the two thyroid hormones, is produced in much smaller amounts than T4, which accounts for about 93% of the hormone produced. Most of the T3 is created by conversion from T4, which occurs in the liver and kidneys.

The primary function of these two hormones is to convert food into energy and to regulate the body’s other systems. A deficiency in the production or absorption of thyroid hormones can cause a global decline in the body’s metabolic reactions and lead to a host of symptoms, most commonly fatigue, weight gain, low body temperature, dry skin, and hair loss in the eyebrows.  But low thyroid function, hypothyroidism, can also produce more far-ranging symptoms, potentially affecting all of the body’s organs and cells.

Testing for Hypothyroidism

Diagnosing hypothyroidism has sparked an ongoing debate in the medical community over what hormone levels constitute a hormone deficiency. Generally, doctors use the TSH blood test to diagnose thyroid conditions. TSH is produced in the brain’s pituitary gland. A pituitary that produces excess TSH indicates that the thyroid is functioning below par and therefore requires more stimulation than normal. The problem lies in defining the standard range for TSH levels.  But, even at the edges of the so-called “normal” range, many patients suffer from untreated hypothyroidism, with significantly diminished health.

Even when tests reveal “normal” TSH levels, the presence of hypothyroidism may be suspected, especially in older patients, as thyroid deficiencies often imitate age-related symptoms. In such cases,  a stimulation test using thyrotropin-releasing hormone (TRH) may be performed to disclose low thyroid performance even if a blood test is normal. The TRH stimulation test is conducted only under the direct supervision of a physician. The test requires the intravenous injection of the hormone TRH with additional blood sampling before and after the injection. The results of this test help to distinguish between outright hypothyroidism and “subclinical” or developing hypothyroidism. In some individuals (and depending on the physician’s interpretation of the laboratory tests), outright hypothyroidism may take as long as 20 years to develop. With the help of measures such as the TRH stimulation test, a doctor is able to diagnose hypothyroidism when the onset of symptoms (fatigue, weight gain, etc.) precedes abnormal laboratory values. Early intervention therfore may save patients from years of needless suffering.

Symptoms of Hypothyroidism

Primary: Low metabolism or tiredness and weight gain, though there are many other indicators. According to the pioneering physician Broda Barnes, author of Hypothyroidism: The Unsuspected Illness, there are at least 47 symptoms of low thyroid function—most of them overlooked by blood tests. “The development and use of thyroid function blood tests,” Barnes wrote, “left many patients with clinical symptoms of hypothyroidism undiagnosed and untreated.” For this reason, Barnes estimates that up to 34% of the adult population has some form of thyroid deficiency.

In addition to fatigue, symptoms may include depression, dementia, decreased cognitive function (“brain fog”), a weakening of the immune system, constipation, weight gain and fluid retention, irregular menstrual cycle, infection, discoloration of the skin, hair loss, and drooping eyelids. A sluggish thyroid can also be linked to a fatty liver or high cholesterol, candida, and low glucose and insulin levels. In extreme cases, untreated hypothyroidism can cause anemia, low body temperature, and heart failure.  Additional tests to better determine the significance of such symptoms include a liver panel, a complete blood count (CBC), a chemistry panel including a cholesterol profile, the candida antibody test, and a fasting insulin level.

Because the thyroid governs metabolic processes extending all the way down to the cellular level, every organ and system of the body can potentially be affected by its dysfunction. For example, hypothyroidism can affect the digestive tract, leading to constipation. This occurs when a sluggish metabolism affects the cells lining the gut walls, in turn slowing peristalsis, the contractions that govern bowel movements.

Slowed metabolic activity in the brain can manifest as lowered mood and depression, the result of a decreased production of neurotransmitters. Nerve cells that are not firing well may produce decreased cognitive function. In fact, many elderly people with hypothyroidism have been misdiagnosed as suffering from dementia.

Types of Hypothyroidism
The connection between the thyroid and the hypothalamus-pituitary axis results in three different types of hypothyroidism.

    * Primary hypothyroidism arises from a deficiency in the thyroid itself.
    * Secondary and tertiary hypothyroidism involve the pituitary and hypothalamus, respectively.

In tertiary hypothyroidism, the hypothalamus shuts down protectively in response to stress, producing low levels of thyroid hormone.  Often linked to chronic fatigue syndrome and fibromyalgia, this condition can cause low body temperatures, a tendency toward infections, and the other metabolic consequences of low thyroid. It has been suggested that problems with the mitochondria, the cellular structures that furnish us with energy, may cause this suppression of the hypothalamus. Since dysfunction of the mitochondria is also a result of hypothyroidism, here again we have an example of how processes behave reciprocally in the body.

Thyroid and Hormonal Imbalances

Thyroid function is intimately tied to adrenal function, which reciprocally acts to stimulate the pituitary, where TSH is produced. If the adrenals are not working well, the thyroid and pituitary often will be affected.  A progesterone-estrogen imbalance can similarly interfere with thyroid function as well as result from diminished thyroid function.

Causes of Dysfunction

In addition to treating both symptoms and organic dysfunction, it is important to identify and eliminate all other possible causative factors. These may include:

Iodine Deficiencies: Iodine is an important component of T4 and T3. Although dietary iodine deficiencies are now almost nonexistent in the US, some people need to supplement their iodine intake with kelp, seaweed, or iodine tablets. Iodine is also found in a number of dietary supplements which contain other trace minerals needed for optimal endocrine function—such as iodine, magnesium, zinc, copper, and manganese—as well as tyrosine, the precursor to thyroid hormone.

Toxicity/Heavy Metals:  Metal toxicity, determined by hair analysis, can be addressed with chelation, both intravenous and oral. Selenium supplementation can also help remove heavy metals by working in conjunction with glutathione peroxidase, a compound found in asparagus, garlic, and mushrooms.  A blood test can determine if selenium supplementation is needed; if so, there are several options, including Se-methylselenocysteine caps.

Candida: Candida is detected using stool testing for overgrowth of yeast and yeast antibodies. Eliminating yeast, sugar, and wheat from the diet helps to starve out candida. People suffering from this disorder should eliminate even honey and fruit sugars from their diet at first, and then slowly reintroduce them into the diet later. There are a number of anti-candida yeast supplements on the market with acidophilus and herbs to support a healthy intestinal environment.

Environmental Radiation: Radiation can cause free-radical damage to the thyroid, as has happened in Ukraine as a result of the Chernobyl nuclear reactor disaster. The cell mitochondria are also prone to free radical damage. I recommend turning off cell phones and unplugging bedside electronic and electrical devices (including the telephone) at night, even though these devices produce relatively low levels of radiation. Because electromagnetic radiation in food can also be problematic, eating organic food whenever possible is also recommended.

Treating Hypothyroidism

Conventional treatment calls for patients to take an oral, synthetic form of T4. Synthroid®, is the most popular such medication.  Many people, however, respond better to Armour® Thyroid (or other natural Thyroid meds), which is desiccated porcine thyroid. An article in the New England Journal of Medicine claimed greater improvements in mood and brain function with Armour® Thyroid than with the synthetic version. Your doctor will need to prescribe this medication.

Helpful Supplements

• Herbals:  Ashwagandha and Panax Ginseng can be helpful to alleviate fatigue.
• Vitamins:  Natural supplements for thyroid problems include vitamins A, B complex, B12, C, and E; coenzyme Q10; and especially the minerals magnesium, manganese, selenium, and zinc. Deficiencies of any of these minerals can prevent the conversion of T4 to T3 and should be corrected. Sufficient protein iodine and especially the amino acid tyrosine are necessary to make T4 in the thyroid gland.
  

Conclusion
The causes and effects of hypothyroidism are interrelated. Healthy thyroid function depends on the action of other glands, and many key processes in turn depend on healthy thyroid function. Using integrative medicine to treat these interrelated functional areas can offer patients tremendous benefits.