| “Your thyroid panel looks great. We’ll just keep you on the same dose”, which wasn’t the WRONG answer, per se, but not the answer I expected because of how I was feeling. I thought, “surely, my thyroid must be SO off, so I’ll just get a higher dose and feel better in no time”. Easy peasy! Nope, my labs looked great. You’d expect that with the level of brain fog, fatigue, muscle aches, heart palpitations, and disrupted sleep I was having that my thyroid panel would be a mess. So, with seemingly no real action steps to choose from, I actually did have a choice: I could do nothing and stay the same or do something and hopefully feel better. Not sure about you, but I’d rather fail trying than not try at all. Being the hard-headed person I am, I just couldn’t leave it alone, so I did some digging and uncovered: Super low Vitamin D (which is vital for the immune system, inflammation control, hormone health, and more) – Low magnesium – Low potassium – High calcium: potassium ratio (which hinders thyroid hormone uptake) – Low blood sugar and HgbA1C (lower is not better! In fact, it revealed I was having major hypoglycemic episodes. Macronutrient AND micronutrient management is key here. AKA making sure your carbs, proteins, and fats are balanced AND that your minerals are also balanced to allow the proper regulation of glucose and insulin) – Iron overload (even without taking iron supplements. Yikes!) As a health expert, it was sort of embarrassing to have so many deficiencies, but it was a wake-up to me that although I was supplying a good amount of nutrients via my pretty well-rounded diet, it still wasn’t enough to keep up with the demands of the biggest drain on my system: STRESS. With most things in health, it’s essential to start with the foundations. As boring as it may sound, building a solid foundation is critical to having sustainable improvement. Essential Foundations: Eating enough food in the proper proportions and portions for your body at intervals that make sense for your schedule. Repleting nutrients to make sure your body has essential building blocks for optimal function Assessing stress and adjusting accordingly within reason. (Remember, it’s not NO stress, but KNOW your stress) Getting good quality sleepMoving your body in joyful ways So when you’re doing all of that but you’re still not feeling great, then you can go to the next layer to determine where imbalances and kinks in the system may be happening. When it comes to thyroid status, that means making sure that the Thyroid Hormone Journey is running as smoothly as possible, which is impacted by: Nutrient status Stress levels Gut health integrity Blood sugar balance Inflammation This is why my “The BRAIN Method” was born– realizing how much we can influence the way our body is feeling and functioning. The thyroid hormone journey is a multi-step process with lots of opportunities for missteps— both intentionally and unintentionally done by your body. I review this journey in great detail in Brain Fog Bootcamp: Thyroid, but here is the gist of it: 1. Signaling: the brain triggers the thyroid to produce more or less hormone based on the amount circulating and the levels of stress perceived. TSH (thyroid stimulating hormone) is the star of the show here, but stress and perceived stress actually steals the limelight. 2. Production: once triggered, the thyroid produces hormones. This is the often the most influential kink in the process for many who have hypothyroidism. Under-production can stem from thyroid and thyrocyte damage related to autoimmunity can lead to inability of the thyroid to adequately produce hormones. Nutrient deficiencies also impair production, since micronutrients are the building blocks of thyroid hormones. Lastly, stress can impair production of thyroid hormones. 3. Conversion: then the thyroid hormones have to be converted from less active T4 to more active T3. This mainly happens in the liver and gut and requires macronutrients (like carbs) and specific micro-nutrients like zinc, magnesium, and selenium. Stress and inflammation hinder this process pretty dramatically. 4. Transport: the hormones have to be carried through the body which requires carrier proteins, electrolytes, and fluid volume. 5. Absorption: getting into the cells to actually be utilized can pose quite a problem when nutrients are out of balance (especially calcium, sodium, and potassium), there is inflammation present, stress is high, and blood sugar is dysregulated. There are other factors to consider, but I’ll focus on the biggest influences: stress, inflammation, blood sugar, and nutrient deficiencies/ imbalances. This is where cellular hypothyroidism takes place— with the cells becoming resistant to the thyroid hormones. 6. Utilization: properly using the hormones requires different micronutrients to produce energy. Let’s hone in on the “absorption” step of the thyroid journey because, in my opinion, this is the most eye-opening yet under-appreciated and misunderstood step. On paper your labs could be picture-perfect, but in reality, you feel like absolute garbage— so when the labs and symptoms don’t align, it is helpful to know how to pivot and search for answers and action steps. In a previous post, I reviewed that blood labs, although an extremely helpful tool, may not always depict the reality of how you’re actually feeling. Blood labs assess serum values of thyroid hormones which reflect their status OUTSIDE the cell. In contrast, how you feel and function is dictated by the hormones actually getting INTO the cells to provide the necessary fuel for energy production and metabolism support. Why would thyroid hormones have a hard time getting INTO cells and instead hang out in the serum? There are quite a few reasons, but the most common ones include: 1. Low potassium levels and/or imbalanced potassium to calcium: Potassium helps to draw hormones into the cells, but when calcium levels are high relative to potassium, it acts as a deterrent to thyroid hormones and prevents the cellular uptake. So, while potassium levels could be “normal”, they need to be balanced with calcium. This is something I assess via HTMA testing with clients. It gives us an idea of where there may need to be more targeted mineral support to create better balance. 2. Low sodium/potassium ratio: each cell is equipped with a sodium/potassium pump which controls the flow of nutrients, hormones, and waste into and out of the cell. Again, imbalance here can affect cellular uptake. Reasons for the imbalance could be: low potassium intake, high sodium intake relative to potassium intake, and stress. 3. Inflammation: inflamed cell membranes can impair the entry of hormones into the cells. 4. Under-eating: when calorie intake is too low for what the body requires, the body switches into “calorie saver” versus “calorie burner” mode. With the thyroid being the regulator of the metabolism, it makes sense that if food intake is too low, the body compensates by dialing back how quickly it is burning through resources. It does this by preventing entry of thyroid hormones into the cells and thus slowing metabolism. 5. Stress: stress is another factor that impairs the amount of thyroid hormones, glucose, and nutrients from getting inside the cells. Again, thinking about your body as an adaptive ecosystem, metabolism is often decreased when faced with high amounts of physical and emotional stressors. 6. Low cell-membrane supporter nutrients: these include micronutrients and metabolites like choline, omega-3 fatty acids, and minerals. 7. Imbalanced fatty acids: our bodies require unsaturated and saturated fatty acids for optimal cell membrane integrity. Unsaturated fats (olive oil, nuts, seeds) provide fluidity and flexibility to the cells while saturated (animal fats, coconut) give stability and strength. The combination of these in the diet helps make the cell membranes strong and bendy— just like they’re supposed to be! 8. Over-Medication and/or Over-Saturation of Thyroid hormone: since it’s unsafe to be in a hyperthyroid state, if there is too much medication coming in or the body is overproducing thyroid hormones, the cells can build up resistance and prevent entry. I actually see this often when someone requests higher doses of medication from their doctors to help with energy and weight loss, but the increase in medication leaves them feeling more tired and sometimes even weight gain! How can you assess if your cells are resisting: – Are your labs “normal” and maybe even “optimal”, but you’re still feeling hypothyroid? – Do your labs show high/normal T4 and high/normal TSH? (What’s going on? Hormones aren’t getting into the cells and showing “normal” in the serum, but the Thyroid Stimulating Hormone from the brain is getting the feedback that the body needs more hormones) – High calcium/potassium ratio on an HTMA test. Again, it isn’t JUST about having high calcium and/or low potassium, but the balance of the two minerals. What can you to help improve uptake without doing lab testing? 1. Assess and optimize potassium intake. From working with clients >10 years, MOST people don’t hit minimum potassium requirements which is about 3500-4000mg/day. (This is not advice. If you’re on medication that affects potassium levels, you’ll want to adjust for that. Speak with your provider). The Standard American Diet is generally pretty high in sodium, which ideally is balanced with potassium. Potassium-rich foods are mostly vegetables, fruits, nuts, seeds, beans, grains, avocado, coconut, and aloe vera. You can do an audit for a few days to see where you stack up in your potassium intake and adjust accordingly. 2. Manage stress like it’s your job. Ugh, I know I’m a broken record with this, but stress not only impairs cellular uptake in response to adrenaline and cortisol, but stress can increase potassium excretion (read: lead to lower levels of potassium) and increase calcium retention. This is a BIG reason for that imbalanced Ca:K ratio (K = potassium). Rises in tissue levels of calcium occur in response to chronic stress due to calcium’s side effect of calming and numbing. Calcium diminishes the sensitivity and reactivity of the nervous system, which is an adaptive mechanism the body utilizes to soothe during seasons of high stress. High calcium can also occur due to:Vitamin D supplementation without Vitamin K2 presentCopper toxicityIodine deficiencyLow levels of sodiumLow levels of magnesium 3. Add in more omega-3 rich foods: after doing hundreds of fatty acid blood tests, I’ve had exactly ZERO people come back with normal levels of omega-3 fatty acids relative to omega-6. Omega-6 fatty acids and omega-3 fatty acids are both essential (which means we have to get them through the diet), but the typical diet is disproportionate in omega-6 to omega-3. 4. Address inflammation. Work on decreasing inflammatory foods (refined oils, ultra-processed foods), and increasing anti-inflammatory foods (a quick tip: choose foods that are naturally vibrantly colorful and aim to get 2 or more colors on your plate). |
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