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Hypothyroidism is a common condition whereby the thyroid gland is not functioning at its optimal level. It tends to occur more commonly in women than in men, often after periods of extended stress and multiple childbirth experiences (one and the same?!). The thyroid gland is intricately involved in the body’s metabolism, such that our metabolism slows down considerably when the thyroid gland is not functioning properly.


As mentioned above, stress can play a significant role in the development of hypothyroidism. Our inactive thyroid hormone (Free T4) has 2 different biochemical pathways it can follow. With adequate nutrients, Free T4 can convert to Free T3, our active thyroid hormone. Stress, however, can instead convert Free T4 to Reverse T3, which is another inactive thyroid hormone. 


If you are Hypothyroid, what symptoms may you experience?


Hypothyroidism can result in a variety of symptoms, the most common including fatigue, weight gain, low moods, constipation, dry skin, apathy and amotivation.


Is there any simple way of testing whether you are Hypothyroid?


The most simple and accurate way to determine if your thyroid is not functioning optimally is to take 3 morning temperatures during your periods (if you a woman who is still menstruating). It is important to have your thermometer next to your bed so that you can place it under your tongue on waking first thing in the morning. If you temperatures are below 36.0 celcius, it is highly likely that your thyroid is underactive. Temperatures between 36.0 and 36.2 may indicate borderline hypothyroidism.


Doctors can order TFTs (Thyroid Function Tests), however, most conventional Pathology laboratories only test for TSH (Thyroid Stimulating Hormone) and Free T4 which is actually an inactive thyroid hormone. To be utilised, Free T4 needs to be converted to Free T3 which is the active thyroid hormone in the body. Unfortunately, Free T3 is not often tested. Integrative doctors also aim for an ideal TSH level to be below 2.0, rather than the 5.0 that some conventional labs still consider acceptable. 


Thyroid antibodies may also be ordered to see if there is an auto-immune component to the disease.


What medications may be recommended?


Conventional doctors generally prescribe thyroxine for cases of diagnosable hypothyroidism. Generally the lowest dose is initially prescribed with bloods performed at 3 weekly intervals until the dose is correct. In terms of medications, Integrative medical practitioners may either use thyroxine combined with the below nutritional/ herbal supplements in order to increase the conversion of inactive Free T4 to active Free T3. Otherwise, they may use either SRT3 (Slow Release T3-active thyroid hormone) or Armour Thyroid (derived from porcine source). These should only be used under the strict supervision of a registered medical practitioner. 


Are there Nutrients/Herbs that may help?


In order to help the body convert inactive free T4 to active Free T3, we especially need the nutrients iodine, selenium, zinc, Vitamin A, Vitamin E and the amino acid, tyrosine.


Kelp (seaweed) is also a good source of iodine.


A commonly used herb for the treatment of hypothyroidism is Withania (Indian Ginseng), traditionally used in Ayuvedic medicine.


Of course, we must have a functional digestive system in order to make sure we absorb these nutrients, whether by food or supplement. 


What Eating Plan should you use?


You should trial a Food Elimination Regime to assess if any foods are contributing to a sluggish thyroid. An Insulin Resistance Healthy Eating Plan is also structured to minimise hypoglycaemia that may be associated with or mimicking a sluggish thyroid. 


Are there any Superfoods you should eat more of?


Yes. The following foods may assist with a slow thyroid over the long term:


Omega 3 Fish; Salmon, Tuna, Herring, Mackerel, Sardines, Ocean Trout


Seaweed and iodised foods


Apricots, dates, egg yolk, parsley, potatoes, prunes, raw seeds and grains.


Chillies and green teas may also help.


Are there any healthy foods that are considered to disadvantage the thyroid?


The goitrogen and thiocyanate foods may negatively influence thyroid function including cabbage, brussel sprouts, cauliflower, turnips, spinach, radish, horse radish, broccoli, sweet potato, lima beans, peanuts; apples, pears, walnuts and almonds.


Considering there are many beneficial foods amongst this group, trying to diversify the diet away from these foods as much as possible without completely limiting them (1-3 total serves per day of all combined) rather than completely excluding these foods may be a more sensible and sustainable approach compared to complete elimination.


People diagnosed with autoimmune thyroiditis should also be assessed for coeliac disease.


How about Exercise?


A balanced approach to exercise is important to addressing Hypothyroidism. Both cardiovascular exercise and strengthening exercise will help stimulate the thyroid. Yoga also focuses on stimulating glandular function through stimulating the hormonal system. You are therefore encouraged to aim to exercise for a minimum of 30 minutes per day.


Note we said aim. In instances where energy and fatigue are limited due to Hypothyroidism, a graduated exercise programme may be necessary to build up 30 minutes or more. Start in small increments if necessary, first aiming for 30 minutes total in broken amounts (e.g. 6X5minutes, 5X6 minutes, 4 X 7 minutes, 4 X 8 minutes, 3X10 etc).


The key is to improve from whatever level you are now, however small that is. Do not be put off by slow progress, as long as eventual improvements are achieved.


And smoking?


This is probably the most significant change you can make in your life if you are a smoker. If you cannot quit without assistance, this being the majority of smokers, it may be sensible to join a multidisciplinary programme. Peer support is often essential to the success of any quit smoking plan.


Remember, although pharmaceutical approaches that replace nicotine via chewing gum, patch or otherwise are often helpful, eventually they must be weaned otherwise you may simply be trading the risk of lung cancer for other diseases.

Is sleep important?


What about Sleep?


Healthy sleep patterns are important for all hormonal imbalances as hormonal regulation follows regular daily cycles (circadian). If you have irregular or unhealthy sleep patterns seek to normalise these (see Sleep Health section by clicking this link).


How does stress affect Thyroid function?


Stress affects all hormonal imbalances through the physiological stress response. If you are experiencing stress in your life managing this can be an important contribution to hormonal balance.


What should I consider doing about this?


Identify the reason for your stress. Any of the following interventions may be appropriate depending upon your own individual circumstances.


Relaxation and Meditation independent or as part of a Yoga programme

Other Effects Based Stress Managements techniques

Cause Based Stress Management Techniques

Achieving Work Life Balance

Learning to effectively manage Emotions

Prioritising Family and other Relationships (including healing old wounds)

Becoming connected with your community, environment and, if you are spiritual, the concept of God/Universe that matters to you