A functional medicine approach to thyroid concerns
The thyroid gland plays a major role in the regulation of many body processes, especially those related to metabolic function. Maintaining optimal function of the thyroid and balanced levels of its main hormones, triiodothyronine (T3) and thyroxine (T4), is vital for overall health. Thyroid dysfunction is quite common and may result from conditions such as thyroiditis and hypothyroidism. In the United States, hypothyroidism is estimated to affect approximately 10% of adults. The autoimmune condition known as Hashimoto’s thyroiditis is the most common type of hypothyroidism, affecting one to two percent of people in the US, most of them women. In this disorder, a dysregulated immune response impairs the production of thyroid hormones. On the flip side from a low-functioning thyroid is hyperthyroidism, which impacts about one percent of people in the US, with women and older adults more likely to develop the condition.
At Tendwell, we take a functional medicine approach to thyroid issues. Functional medicine is an approach to healthcare that aims to identify and address the underlying causes of disease rather than simply treating the symptoms. This approach focuses on understanding the individual's unique biochemistry, genetics, lifestyle, and environment to create personalized treatment plans. When it comes to diagnosing and treating thyroid issues, we follow several steps.
First, we take a detailed patient history to understand the individual's medical history, lifestyle factors, diet, stress levels, environmental exposures, and any other relevant information. Second, a comprehensive physical examination helps identify any physical signs or symptoms related to hypothyroidism, such as fatigue, dry skin, brittle nails, hair loss, weight gain, cold/heat intolerance and brain fog. Third, as we say in functional healthcare, “test don’t guess.” Functional medicine practitioners typically order a much more comprehensive set of laboratory tests to assess thyroid function and other related parameters, compared to conventional PCPs. These may include measuring thyroid hormone levels (TSH, free T3, free T4), thyroid autoantibodies (TPO antibodies, Tg antibodies), Reverse T3 (rT3) and potentially other hormone levels (e.g., cortisol, sex hormones) to assess the overall hormonal balance. A key difference in treatment is also the interpretation of lab values. Functional medicine providers interpret laboratory results based on optimal ranges. These ranges are narrower than conventional ranges and reflect the values at which individuals are more likely to experience optimal health.
Functional medicine seeks to identify potential triggers contributing to the hypothyroid condition, such as nutrient deficiencies, food sensitivities, gut health issues, chronic stress, or environmental toxins. Based on the comprehensive assessment, a personalized treatment plan is developed to address the individual's specific needs. This plan may include dietary modifications, supplementation (e.g., iodine, selenium, vitamin D, iron), lifestyle changes (e.g., stress management, exercise), and potentially other therapies like herbal medicine or acupuncture. Adequate intake and availability of micronutrients such as iodine and iron are crucial for thyroid hormone synthesis, while selenium and zinc are needed for the conversion of T4 to T3 (the active form of thyroid hormone). In addition, supplements used as complementary treatments may positively impact thyroid functioning. For example, ashwagandha has been used to help address thyroid dysfunctions. Studies have shown that providing 600 mg of the root extract daily over 8 weeks has improved serum TSH and T4 over placebo.
Gut health is also a major part of thyroid health and treatment from the holistic perspective. A 2020 clinical trial (n=60) investigated the effect of synbiotic supplementation (which combines pre and probiotic ingredients) on thyroid function. Patients with hypothyroidism on levothyroxine either received 500 mg/day of the synbiotic or a placebo for eight weeks. After treatment, results indicated a beneficial effect, with TSH concentration, levothyroxine dose, and fatigue severity scale scores significantly decreased in the synbiotic group compared to placebo. At Tendwell, we often use comprehensive stool testing to assess the microbiome and overall gut health as a way to fine tune patient care.
Among the different factors that may negatively affect thyroid health, endocrine disruptors (EDCs) can have a potentially major impact on the function of this gland. A 2021 investigation on EDCs, which are often found in foods, food packaging, water, and personal care products, indicated that EDCs such as bisphenol A (BPA), phthalates, and flame-retardant compounds, including polychlorinated biphenyls (PCBs), can interfere with thyroid gland functioning and thyroid hormone transport. Working with a functional medicine doctor or nurse practitioner to reduce exposure to these chemicals can be impactful in our modern environment.
Some dietary changes that can help support your thyroid include:
Eating foods rich in iodine such as seaweed, fish, and iodized salt.
Eliminating gluten.
Reducing dairy intake.
Eating foods rich in selenium such as Brazil nuts and eggs.
Eating foods rich in zinc such as oysters, beef, and pumpkin seeds.
Eating foods rich in iron such as spinach, lentils, and red meat.
Eating foods rich in vitamin D such as fatty fish and egg yolks.
Addressing toxicant exposures, systemic inflammation, and chronic stress are also approaches to enhancing thyroid health.
Make an appointment today to find out more.
Links: Restoring Thyroid Hormone Balance | The Institute for Functional Medicine (ifm.org)
