So, I may be a little sensitive to thyroid health because I suffer from Hashimoto’s Thyroiditis, which is an autoimmune condition that affects the functioning of the thyroid gland and hormones. I have absolutely no family history of thyroid disease, so I can’t blame crappy genetics. This is something I brought upon myself through poor diet, too much exercise, mismanaged stress, and terrible gastrointestinal integrity. These factors created the perfect storm in my body that led to the development of this super common autoimmune condition I have. Thankfully, however, lifestyle choices are just that– choices. They can be adjusted as needed in order to better manage your own health. Now, I’m not saying that you will completely heal yourself through food alone, but you can certainly do a lot to help your cause!
Undetected low thyroid function is an abundantly high cause of sub-fertility in both women and men. It is documented as the leading cause of unexplained infertility, yet is often overlooked as a potential culprit despite the ease of diagnosis and treatment once detected. Hypothyroidism in men can lead to decreased spermatogenesis, or low sperm production. In women, hypothyroidism can cause anovulatory cycles (not ovulating) which impairs the body’s ability to get pregnant. Hypothyroidism has been linked to lower levels of FSH and LH, both of which are needed to mature the egg and produce enough estrogen and progesterone to achieve pregnancy. Low thyroid function has also been linked to the development of cysts on ovaries.
“Sciency” Stuff… Beware:
The thyroid is a gland that sits on the base of the neck in front of the trachea and is shaped like a butterfly. It produces hormones that are necessary to the body to maintain metabolism and support normal hormonal fluctuations. Thyroid hormones include: thyroxine (T4), triiodothyronine (T3), T2, T1, and Reverse T3. When levels of circulating thyroid hormone are too low in the body, the hypothalamus secretes Thyrotropin Releasing Hormones (TRH) which then tells the pituitary gland (a portion of the brain that acts like a thermostat), to secrete Thyroid Stimulating Hormone (TSH), which tells the thyroid to secrete more thyroid hormone. It is a built in feedback signal to prevent the body from getting deprived of thyroid hormones. There are a few reasons thyroid levels can be low, which will be discussed a little later. Doctors will often test levels of TSH in the blood to determine if there is a state of hypothyroid, however, often times symptoms of hypothyroidism can be present while someone has normal levels of TSH.
The thyroid gland takes iodine that we get from foods and combines them with an amino acid, tyrosine, to make thyroid hormones. These hormones thus control our metabolism, growth, repair, and general development in the body. During pregnancy, the thyroid gland of the mother secretes thyroid hormones to help with fetal growth and development in the early stages. Therefore, identification of potential thyroid dysfunction is vital to the health of the mother and baby because if left untreated, can lead to deleterious effects.
Symptoms of Low Thyroid include:
- Fatigue
- Sluggishness
- Difficulty concentrating
- Feeling cold all the time
- Coarse, dry hair
- Thinning hair
- menstrual irregularities (lack of period, irregular periods, or abnormally heavy periods)
- Subfertility
- Decreased libido
- Fluid Retention
- Constipation
- Weight Gain
- Fibrocystic breasts
- Polycystic Ovary Syndrome
- Premenstrual Syndrome (PMS)
- Feeling of rapid heart-beat or skipped beats
- Elevated homocysteine
- Galactorrhea (being able to express milk without being pregnancy or actually lactating)
Causes of Hypothyroidism:
- Excess stress
- Poor eating habits
- Emotional stress
- Food sensitivities
- Caffeine
- Alcohol
- Immune Disorders
- Iodine Deficiency
- This is uncommon in America, but in underdeveloped countries, women can develop goiters on their glands which is palpable and sometimes even visible. In the United States, where the use of iodized salt is common, a goiter is more often due to the over- or underproduction of thyroid hormones or to nodules that develop in the gland itself (but we will get to that later!). Iodine is present in foods such as seafood, eggs, seaweeds, navy beans, yogurt, strawberries, raw cheese, and potatoes. Conversely, taking in too much iodine can also cause hypothyroidism. The iodization of salt in America has reduced instances of iodine deficiency, but can also contribute to excess levels if eaten in abundance.
- Hashimoto’s Thyroiditis
- This is an autoimmune condition in which the body begins to attack the thyroid hormone. It is the most common cause of hypothyroid among women in America and is 7 times more common in women than in men. This can be identified on a full thyroid panel by looking to see if thyroid antibodies are present. Typical dietary management here include elimination of gluten and other food sensitivities, repletion of nutrients that play a role in thyroid hormone production, and controlling the overactive immune system. Hashimoto’s is another cause of goiter development, or enlargement of the thyroid.
- In Functional Medicine, we believe that the development of chronic conditions, such as autoimmunity, begin in the gut. While you may have a genetic predisposition to something, which is like having a loaded gun, whether or not you pull the trigger of that genetic gun depends largely upon lifestyle factors (toxin exposure, stress, food choices) as well as the level of gut permeability (or “Leaky Gut”) you may have. Two of the three factors are manageable, so focus through nutritional and lifestyle therapy is on those.
- Pregnancy
- Sometimes during pregnancy, women will produce antibodies to their own thyroid gland and develop Postpartum Hypothyroidism.
- Congenital Disease
- For unknown reasons, some babies are born with a defective thyroid gland or have inherited the disorder from one or both parents.
- Estrogen Dominance or Excess Estrogens
- High levels of estrogen and reduce levels of active thyroid. Nowadays, “estrogen dominance” (or having too high a ratio of estrogen to the other sex hormones) is increasing in prevalence due to synthetic estrogen-like hormones, called “xenoestrogens” creeping into our diet through modern day factory farming practices, more use of plastic products, synthetic hormone replacement, and reduced function of detoxification pathways in the body. Xenoestrogens can be stored in the fat cells for decades and concentrate in fatty areas such as breast tissue. Excess fat produces estrogen hormone, so having too much body fat can further exacerbate high estrogen levels. Signs of estrogen dominance include weight gain, menstrual irregularities, poor memory, loss of libido, breast tenderness, fluid retention, and bloating.
Complications of hypothyroidism:
- Infertility or sub-fertility
- Anemia
- Recurrent miscarriage
- Pre-eclampsia
- Placental abruption
- Birth Defects
- Preterm Labor
- Low Birth Weight
- Stillbirth
Management Options
Food as Medicine Approaches
- Iodine: Seaweed, seafood, organic full-fat dairy products, eggs, strawberries, white potatoes (Be careful about taking iodine supplements unless working with a practitioner! Everyone reacts differently and if taken unnecessarily, can actually make matters worse!)
- Selenium: Brazil nuts, cheese, eggs, liver, nutritional yeast, grass-fed butter, cold water fish, garlic, onions, leeks, green vegetables
- Zinc: Grass-fed red meats, duck, turkey, Brazil nuts, pumpkin seeds, cucumbers, beets, whole grains, herring
- Omega-3 Fatty Acids: Cold water fish (salmon, sardines, anchovies, mackerel, trout)
- L-tyrosine: Seafood, eggs, poultry, pork, wild game, beans, pumpkin seeds.
- Vitamin B12: Grass-fed and organic animal products
- Avoid diets that at too “low carb” as carbohydrates are needed to convert inactive thyroid to active thyroid
- Ensure you are eating healthy fats and proteins at each meal.
- Optimize your gut health!
Foods to Avoid:
- Gluten and gluten containing grains (wheat, barley, rye, spelt, kamut)
- Common inflammatory foods (see above)
- Soy (may contribute to decreased effectiveness of thyroid function)
- Raw “goitrogenic” foods: cauliflower, broccoli, cabbage, kale (These may be better tolerated if cooked).
A Word on Thyroid Medications:
Always seek help from your doctor to determine the best approaches for medication management. There are natural and synthetic options, both of which are good, and your doctor can help you to identify which fits well for your personal medical history. Even the best of intentions with diet may not be enough to fully support your thyroid to get you out of a state of hypothyroidism. Due to the extreme importance of thyroid hormones for conception, fetal development, carrying a baby to term, and having a healthy baby upon birth, do not neglect to get your thyroid properly and professionally analyzed.
As much as I am an advocate for “food first”, there is always a time and place for medical intervention. I took thyroid hormone medication during pregnancy to provide my thyroid with the extra support it needed during such a demanding time. The risks of not taking the medication were not worth it to me, but to each is own! ?
