The Thyroid Gland, Naturopathic vs. Conventional Treatment
Ever since Oprah decided that she couldn’t lose weight on account of her thyroid gland, all women with weight loss challenges have been demanding that their thyroid hormones be tested. More often than not, these levels come back within the “normal” range on the conventional lab tests, leading to a lot of frustration. We all would like to blame an endocrine issue for the wall that we all hit around 35 when we actually have to start paying attention to what we’re eating. The trick is to figure out when weight loss issues can be attributed to a hypothyroid disorder, when they are really just about necessary lifestyle changes and when it is a combination of both.
For starters, let’s go over the anatomy and physiology of the thyroid gland. The levels of thyroid hormone in our systems determine our body temperature, our basal metabolic rate (metabolism), how quickly our digestion moves, how easily we transform food into energy and how easily we are able to expend that energy. When the thyroid levels in our bodies start to go down, the anterior pituitary part of our brain signals the thyroid gland to make more thyroid hormone. This signaling occurs using the hormone TSH, which is the hormone measured in the most common laboratory test used to assess thyroid health. When the thyroid can’t make anymore thyroid hormone the TSH level continues to rise. If the actual Thyroid hormones were to be assessed at this point, they would come out low.
Whenever having the Thyroid gland assessed by your Doctor, always ask for not only the TSH, but also the “free” levels of T3 and T4 (the two measurable Thyroid hormones). The reason for the many tests: many women’s TSH levels will come back within the “normal” range when their Thyroid hormones come back low. This is a very common situation that never gets discovered because it is normally only the TSH level that is tested. This situation illustrates the point that we come back to over and over again in the hormone discussion: all people are different and unique in their chemistry and many of us do not fit into the “normal” ranges of the conventional laboratory tests.
So, what to do if you feel like your metabolism is becoming sluggish, skin dry, hair falling out, constipation sets in and you just don’t feel like yourself? Ask for the tests above from your PCP or your friendly neighborhood Naturopathic Doctor. If indeed you are diagnosed with a hypothyroid disorder, you have a couple of options for treatment. Conventional Doctors almost exclusively will prescribe Levothyroxine, or Levoxyl, which is a synthetic version of T4 (one of the Thyroid hormones). The potential problem with this medication is that T4 is the inactive form of thyroid hormone, meaning that the body has to take it and convert it to T3, the active form of Thyroid hormone that is usable in metabolism. Many people with hypothyroid disorder are unable to do this conversion properly. This is how it happens that someone supplemented with Thyroid hormone can have a normal TSH level but actually be undermedicated and still have all the signs and symptoms of hypothyroidism: they are not converting the T4 into T3.
As it turns out, like all health issues, hypothyroidism cannot just be treated in isolation. That is to say, your thyroid gland doesn’t just go south one day out of the blue. There are a whole lot of steps that lead up to thyroid dysfunction, including poor nutrition choices, adrenal fatigue (see Cortisol, Stress and the Adrenal Glands) and genetic defects that inhibit the body’s ability to process B Vitamins (more on “Methylation Defects” in next month’s newsletter). Prescribing thyroid hormone does not erase all of these pre-existing issues and so we should not be surprised when thyroid supplementation is not 100% effective.
From a Naturopathic point of view, treatment of the thyroid looks much different than in conventional medicine. Treatment choices range from the conventional Levothyroxine, to the more natural Naturethroid, to herbs and vitamins that support thyroid function. The treatment plan is selected based on many factors including the extent of thyroid dysfunction, the amount of stress in the person’s life and how efficiently they are processing said stress and genetic ability to incorporate B (important cofactors for thyroid function) into the biochemistry. Again we return to the fundamental premise of Naturopathic Medicine that everyone is unique and therefore must be treated uniquely.