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THYROID DISEASE

What is it?

The thyroid gland, situated in the front of the neck, is responsible for producing hormones which control our metabolism.

Common symptoms of an underactive thyroid gland - known as hypothyroidism are:

Weight gain
Low body temperature
Constipation
Hair loss
Dry flaky skin
Fluid retention
Slow reflexes
Fatigue
Rapid ageing
Slowness of thought and cognition
Goitre (enlarged thyroid) - not always present
Depression
Loss of interest in sex
Carpel tunnel syndrome
Puffiness around the eyes

Hypothyroidism is commonly the end result of autoimmune disease, usually Hashimoto's thyroiditis or due to shrinkage or degeneration in the thyroid gland due to ageing or poor nutrition.

A goitre is an enlargement of the thyroid gland. A goitre may be associated with increased, decreased or normal levels of thyroid hormone, depending on the cause. Some causes of goitre include Graves' disease, Hashimoto's disease, viral infection, iodine deficiency, pregnancy, puberty and tumours within the thyroid gland. Nodular changes producing multiple cysts in the thyroid gland is a common cause of goitre. Goitres may sometimes reach very large sizes and compress the trachea (wind pipe) or oesophagus causing difficulty breathing or swallowing.

Various ways of treating an underactive thyroid gland

For patients suffering hypothyroidism, replacement therapy with thyroid hormone tablets is given for life. Some doctors believe in the concept of resistance to thyroid hormone, which means that your body cells become unresponsive to normal amounts of thyroid hormone. People with thyroid resistance complain of tiredness and excessive weight gain, and yet their blood tests for the levels of thyroid hormone are normal and in rare cases may be even greater than normal. In such cases supplemental doses of thyroid hormone have been tried, but this is not without danger, as too much thyroid hormone can strain the heart and increase the risk of osteoporosis. Patients receiving thyroid hormone tablets need to be carefully monitored by their doctor to keep their blood levels within the normal range. In those who are obese because of thyroid resistance, special tests to measure the metabolic rate can be done by a hormone specialist (endocrinologist). If the metabolic rate is low, extra thyroid hormone tablets are given to increase the metabolic rate back into the normal range, when weight loss should occur. There are two types of thyroid hormone - Thyroxine or T4 and Triiodothyronine or T3. In the body (especially the liver, muscles and the heart) T4 is converted to T3. T3 is the more active and potent form of thyroid hormone. If you have an underactive thyroid gland and do not feel well, or are unable to lose weight by taking thyroxine (T4) tablets alone, you could ask your doctor about the possibility of changing to, or supplementing with Tertroxin (T3) tablets. Logically, T3 tablets are likely to be more effective in those with a poor response to T4 tablets because T3 has a more rapid and powerful effect on your metabolism. Tertroxin tablets must be given two or three times daily. Your doctor can tailor-make your dosage for you to keep you feeling and looking good and to maintain your blood tests within the normal range.

Another option is desiccated porcine thyroid extract (one brand name is Armour). This contains both T4 and T3 hormones in a similar ratio found in the human body. This type of thyroid medication requires a doctor's prescription and is available from compounding pharmacies.

For those people who wish to avoid porcine (pig) derived hormones, another alternative is compounded T4 and T3 thyroid hormones. These are manufactured from the amino acid tyrosine and are also available from compounding pharmacies. Tyrosine is the amino acid the body manufactures thyroid hormones out of.

Overactive thyroid gland - known as hyperthyroidism

If there is an over production of thyroid hormone (hyperthyroidism) the whole metabolism speeds up, giving rise to symptoms such as a rapid heart beat, increased appetite, weight loss, diarrhoea, intolerance of heat, irritability, tremor, malaise and muscle weakness. This is called hyperthyroidism or thyrotoxicosis. The most common cause of thyrotoxicosis is Graves' disease, which is an autoimmune condition (see Autoimmune Disease) often associated with protruding eyeballs (exophthalmos). Graves' disease accounts for 85% of all hyperthyroidism.

Thyroid dysfunction and menopause

Thyroid problems are very common, especially in women around the time of the menopause. The most common type of thyroid problem is underactivity of the gland (hypothyroidism). In this disorder the thyroid gland is not able to manufacture sufficient amounts of thyroid hormone. Thyroid hormone controls the metabolic rate of the body, speeding up the rate at which the cells convert food energy into physical energy.

Thyroid Hormones

The thyroid gland produces the hormone called Thyroxine, which is also known as T4. Most of the Thyroxine (T4) is converted in the body into a more active form of thyroid hormone, which is known as Triiodothyronine or T3.

T3 has 10 times the ability to stimulate the thyroid receptors on the cells. Both T4 & T3 stimulate the energy factories inside the cells to burn food calories at a faster rate. This is why those with an over-active thyroid gland lose weight, even though they are eating much more than normal. See my new thyroid book called "Your Thyroid Problems Solved".

How toxins affect the thyroid gland

Toxins from the environment may alter the thyroid function. Eduardo Gaitan from Univ Mississipi found that drinking water contaminated with petrochemicals results in blocked activity of thyroid hormones. ( Ref Jounal of Clinical Endocrinology & Metabolism 1983 Vol. 56). Polychlorinated biphenyls (PCBs) can alter thyroxine levels and result in symptoms of thyroid disorders (Science, vol.267). It is now understood that the environment, diet and nutrition influence thyroid function in a number of ways and may relate to thyroid disorders of non specific origin (Annual Review of Nutrition -1995 Vol 15).

If you are suffering from a very over active thyroid gland (thyrotoxicosis) - eat plenty of foods which help to suppress thyroid hormone production (goitrogenic foods) such as broccoli, cauliflower, cabbage, Brussels sprouts, turnips, peanuts, millet and soybeans. Thyrotoxic patients should avoid stimulants like caffeine, coffee, tea, amphetamines and nicotine. If you have an underactive thyroid, eat these goitrogenic foods in moderation only, and instead include often - eggs, fish, chicken, parsley, apricots, dates, prunes, and kelp and other seaweeds such as arame, wakame, kombu, etc. Cooking mostly inactives goitrogens in foods like broccoli, cabage, turnips, etc. Hypothyroid patients should avoid toothpaste containing fluoride, and drink purified water free of fluoride and chlorine.

Tests of the Thyroid Gland

The function of the thyroid gland can be accurately checked by measuring the levels of thyroid hormone in the blood. A goitre may be investigated by means of a nuclear or ultrasound scan. Your doctor can arrange this. A lump in the thyroid gland may require a fine needle biopsy of the gland.

Thyroid function tests are used to:

Diagnose an underactive thyroid (hypothyroidism) and an over active thyroid (hyperthyroidism). Evaluate thyroid gland activity. Monitor the response to thyroid therapy. These tests include the thyroid stimulating hormone test (TSH), the thyroxine test (T4), the triiodothyronine test (T3). The blood tests for thyroid gland function should ideally measure the following three hormones –

Hormone Normal Range
Thyroid Stimulating Hormone (TSH) 0.5 to 4.0 mU/L
Free T 4 8.0 to 22.0 pmol/L or 4-11 ug/dl
Free T 3 2.5 to 6.0 pmol/L or 110-230

In addition to these tests it is essential to have a thyroid antibody blood test. This test checks for antibodies produced against the thyroid gland, which are present in autoimmune thyroid disease. Thyroid antibodies can be raised a long time before thyroid hormone levels become abnormal; therefore this test is excellent at identifying thyroid disease in its earliest stages.

A thyroid antibody test consists of:

Anti-thyroglobulin Antibody (TgAb) Cut off titre = 100
Anti-microsomal Antibody Ab (TPOAb) Cut off titre = 100
(This antibody is also called thyroid peroxidase)

Not all laboratories measure or record thyroid hormone levels the same way. Each laboratory will provide a range of values that are considered normal for each test.

Recent research has shown that a Thyroid Stimulating Hormone (TSH) level greater than 2 mU/L may indicate the early stages of thyroid disease and require further investigation.

Results

If the T 4 and/or T 3 levels are found to be below the normal ranges, and the TSH (Thyroid Stimulating Hormone) is found to be above the normal range, we can say that the thyroid gland is under active. Most doctors consider the sensitive thyroid stimulating hormone (TSH) test to be the most accurate measure of thyroid activity. By measuring the level of TSH, doctors can determine even small problems in thyroid activity. Because this test is VERY sensitive, abnormalities in thyroid function may be determined before a patient complains of any symptoms. TSH "tells" the thyroid gland to secrete the hormones thyroxine (T4) and triiodothyronine (T3). Before TSH tests were used, standard blood tests measured levels of T4 and T3 to determine if the thyroid gland was working properly. The triiodothyronine (T3) test measures the amount of this hormone in the blood. T3 is normally present in very small amounts, but has a significant impact on metabolism. It is the more active component of the thyroid hormones.

Abnormal thyroid function results may be due to:

Acute thyroiditis (inflammation of the thyroid gland)
Thyrotoxicosis (acute severe elevation of thyroid hormones)
A tumour (benign or malignant) within the thyroid gland that produces large amounts of thyroid hormone (toxic thyroid adenoma)
Thyroid failure in infants (cretinism)
Underactivity of the thyroid gland (Hypothyroidism)
Overactivity of the thyroid gland (Hyperthyroidism)
Kidney failure
Endemic deficiency of minerals such as iodine and selenium
Autoimmune disease - known as Hashimoto's thyroiditis. This is an autoimmune condition where the body's own immune system is attacking the thyroid gland. All autoimmune conditions have a basis in poor intestinal and liver function, as a poorly functioning liver causes hyperstimulation of the immune system which then turns on itself. High levels of toxins in the intestinal tract increase inflammation in the body and irritate the immune system.
Viral infection of the thyroid gland
Genetic factors - there is often a family history of thyroid diseases
Contrast X rays using iodine
Medications such as Heparin, Heroin, Lithium, Phenytoin, Oestrogen therapy, Propranolol, Oral contraceptives, Anabolic steroid drugs or male hormones.
Pregnancy

The latest News in Medicine on thyroid cancer

Thyroid cancer is the most common cancer of an endocrine gland, (hormone producing gland). It usually arises out of a lump or nodule in the thyroid gland. The vast majority of thyroid nodules are not cancerous, but a small percentage are. There are a few different types of thyroid cancer; luckily the majority are readily curable.

Thyroid cancer affects approximately 15 000 people in the USA each year. In Australia in 1997 there were 860 new cases diagnosed and 71 deaths from thyroid cancer. In Australia it is the sixteenth most common type of cancer. Women are two to three times more likely to develop thyroid cancer than men. Unfortunately the incidence of thyroid cancer is rising, particularly along the east coast of Australia and Tasmania. Between 1980 and 1999 Tasmania experienced a whopping 273.4 percent increase in thyroid cancer. This is believed to be largely due to aerial spraying of plantation forests in Tasmania. The pesticides used end up in drinking water and are strongly linked to the development of this cancer.

Thyroid cancer often goes undetected because it may produce no symptoms at all; thyroid hormone levels are usually normal. If the cancer goes undetected for too long, it may spread to other areas of the body. Exposure to radiation is the biggest risk factor for thyroid cancer, along with exposure to some pesticides and deficiency of the minerals iodine and selenium.

The sooner you detect any cancer, the better the outcome.

You should become familiar with what your thyroid gland looks and feels like; that way you can pick up any changes in its size, or feel lumps at an early stage.

The Thyroid Neck Check

This is a test you can do yourself at home which is advocated by the American Association of Clinical Endocrinologists. It will help you to pick up changes in the appearance or texture of your thyroid gland at an early stage.

To perform this test you will need a glass of water and a hand held mirror.

1. Hold the mirror out in front of you so you can clearly see the area of your neck just below your Adam’s apple and above your collarbone.

2. Tip your head back, while continuing to look at this area.

3. Take a sip of water and swallow.

4. Look at your neck while swallowing. Check for any lumps or bulges while you swallow. Don’t focus on your Adam’s apple; your thyroid gland is located further down your neck, closer to your collarbone. Take a few sips of water and repeat this process.

5. If you see or feel any lumps or bulges in this area, see your doctor straight away. A thyroid nodule is likely to move when you swallow.

Recommended books

"Your Thyroid Problems Solved" - An indepth guide to all thyroid conditions and their holistic treatment.

"The Liver Cleansing Diet" - an 8 week liver cleanse.

"The Healthy Liver and Bowel Book" - vital healthy eating principles to follow for life.

"MAGNESIUM The Miracle Mineral You won't believe the DIFFERENCE it makes to your HEALTH!" This is my latest book and discusses Magnesium as being essential for hundreds of chemical reactions that take place in the body every second, with recent findings also indicating that it offers a wide range of important health-promoting benefits. See page 9 for these benefits.

Raw Juicing

“Thyroid Dysfunction and Goitre” juice: see page 136 of “Raw Juices can save your Life”

Recommended supplements:

Selenium tablets

Take 2 tablets twice daily - Selenium is vital for the conversion of thyroxine (T4) thyroid hormone to its more active T3 form.

Liver tonic powder or capsules

Take 1 teaspoon twice daily in water or juice, or take 2 capsules twice daily to improve the step 1 and 2 detox pathways in the liver to break down fat-soluble toxins. In cases of thyroid disorders it is vital to improve the liver function to reduce the amount of potentially toxic chemicals that may damage the thyroid gland.

Magnesium powder or tablets

Take 1 teaspoon daily or 2 - 4 tablets daily - It is particularly beneficial in cases of thyroid gland over activity (hyperthyroidism). Kelp and other seaweeds (such as arame, wakame, nori etc.), are an excellent source of iodine and other trace minerals to support thyroid function. Sea salt is high in minerals.

Vitamin D, Selenium, Iodine and Zinc capsules

Take 1 capsule per day with food. Each of these nutrients helps thyroid hormone function. Deficiencies of these nutrients are extremely common in thyroid patients.

Orthodox medical treatment

There are various ways of treating an over active thyroid gland. The drug carbimazole may be used. This drug blocks the synthesis in the thyroid gland of thyroid hormone. Beta-blocking drugs are sometimes used to relieve some of the symptoms of thyrotoxicosis such as tremor and a rapid heart beat. Another option is surgery in which part, or all of the thyroid gland is removed. Another option is the administration of radioactive iodine, which accumulates in the thyroid gland and partially or totally destroys the gland by local radiation. One problem with radiation and surgery is that the patient often develops subsequent hypothyroidism.