Why the Thyroid is important and what symptoms, imbalances and testing options you should be aware of
In this article I want to introduce you to the role of the thyroid in health and disease prevention. I will overview common symptoms and imbalances that can occur as well as possible testing.
In the UK it is said that around 2% of the female population have “full blown” hypothyroidism, with the male population around 0.2%. However, it is said that around 6-8% of women and 2-3% of men have sub clinical hypothyroidism (1). Evidently females are more prone to thyroid dysfunction, but I would also add that these numbers, in particular sub-clinic numbers, are likely to be significantly less than what is the actual case. I say this because sub-clinical hypothyroid is rarely recognised and hypothyroidism often goes undiagnosed. Part of the issue with this is that the standard of testing is often inadequate, for a full picture of what is going on with thyroid along with the norm reference ranges being substantially wider than optimal references ranges, meaning that the sub-clinical pictures are often missed, even if one presents with classic low thyroid symptoms. As a result, individuals often leave with a mis-diagnosis or no diagnosis at all.
The importance of the Thyroid hormones
Thyroid hormones are critical to health. Every cell in the body has receptor sites for thyroid hormone, allowing thyroid hormone to communicate freely with that cell and for it to influence what and how well that cell does what it does. Ultimately thyroid hormone is responsible for basal metabolic rate, and therefore a reduction in thyroid hormone can have a wide range of impacts on our health not just body weight changes, which is what it is most commonly associated with.
Symptoms of low Thyroid hormone
Some of the areas that low thyroid hormone has been associated with are:
- Reduced energy, needing to sleep lots, fatigue etc.
- Issues with not being able to lose weight when consistently in a predicted caloric deficit.
- Bone density/risk of osteoporosis.
- Cardiovascular disease, in particular elevated cholesterol is a common sign of low thyroid function.
- Reduced digestive function – increased risk of bacterial overgrowth, constipation, reduced production of acids and enzymes.
- Clearance of waste products and toxins from the body.
- Increased risk of anaemia – reduced red blood cell production impacting oxygen delivery and energy production, often resulting in fatigue, brain fog etc.
- Reduced wound healing, increased risk or injury/poor recovery from training.
- Reduced health of hair, skin and nails.
- Increased risk of gall stone formation.
- Low mood/depression.
Making sense of thyroid physiology
To help understand thyroid physiology I have created a short video below. This touches on how the body makes thyroid hormone and the various mechanisms involved.
Subjective assessment of thyroid dysfunction
Below you will find a list of questions associated with either elevated thyroid hormone or low thyroid hormone.
When considering these questions, I recommend grading them from never (0) – occasionally (1) – frequently (2) – all the time (3).
Symptoms associated with elevated levels of thyroid hormones (often an autoimmune condition or caused by excessive thyroid medication).
- I suffer with heart palpitations
- I feel a trembling from within my body
- My pulse rate is raised
- I feel nervous and emotional
- I find it hard to sleep at night
- I experience night sweats
- I struggle to gain weight, or I am losing weight without any change in diet or exercise
- I have more frequent bowel movements than normal with no change in diet
Did you score more than 12 out of 24? If so, this might be an area that is worth exploring with more objective testing.
Symptoms associated with low thyroid hormone (can be autoimmune, but also impacted by other hormones, nutrient status, stress, inflammation etc).
- I feel tired and sluggish
- I am gaining weight for no clear reason or am unable to lose weight with a diet and/or exercise program
- I feel cold a lot of the time, especially my hands and feet
- The health of my skin, hair and/or nails has deteriorated
- I lack in motivation and can often feel depressed
- My outer eyebrow appears to be thinning
- I have puffiness and swelling around my eyes, eyelids, face, feet & hands
- I suffer with headaches in the morning that diminish as the day goes on
- I feel mental sluggishness
Did you score 14 or more out of 27, if so, this may be an area that is worth exploring with more objective testing.
Blood Testing for Thyroid Function
Unfortunately, blood testing is largely inadequate and as a result many people have thyroid issues clinical or sub clinical that are left unresolved.
Below is a list of markers that I would consider running to help understand if there is a thyroid issue.
- Thyroid Stimulating Hormone (TSH)
- Total T4/Thyroxine (T4)
- Total T3/Triiodothyronine (T3)
- Free T4/Free Thyroxine
- Free T3/ Free Triiodothyronine
- Thyroid Peroxidase (TPO)
- Antithyroglobulin Antibody (TG)
A bonus marker but not as widely available is T3 Uptake.
Utilising these markers, you can typically have a very good idea of where the dysfunction is. This does not mean it will give you the answer yet on exactly what to do, but it will at least help you look in the right direction so that you can then investigate further or try and more targeted therapeutic approach if looking to address thyroid imbalances naturally.
For me the most important markers if running a more limited panel would be to always run TSH, Free T4 and Free T3. From just these three markers you can have a really good idea of thyroid physiology.
What goes wrong with thyroid hormone production?
Below is a short video where I look at possible dysfunctions that can lead to low thyroid symptoms.
In a future article we will look at solutions to help you restore/support optimal thyroid function, linking thyroid to nutrition, sleep, stress, movement and other physiological imbalances.
Getting support for Thyroid issues
If you think that you have symptoms associated with reduced thyroid function, and you want to look at what you can do naturally to help improve your symptoms and optimise your health. Please fill out the contact form below where we can get you working with a practitioner that can help.
- Dr Bryan Walsh Thyroid Course, 2012
- Institute for Functional Medicine Hormone Advanced Practice Module