Treating the Thyroid

The thyroid is a butterfly shaped gland that sits right on top your collarbones and in front of your trachea (your breathing tube). It consists of a right and left upper and lower lobe, connected via a thin isthmus.

When palpated by a physician, it can cause a little gagging since there is mild compression of your breathing tube, but the exam is done quickly.

The Thyroid tissue consists of lobule units of follicular cells.  These are the cells produce your thyroid hormones, thyroxine (T4) and triiodothyronine (T3).

In between the follicular units, or within their walls, there is the thyroid medulla, which contains the parafollicular cells, also known as C cells. These cells produce calcitonin, which lowers calcium levels in your blood (opposite the parathyroid gland which elevates calcium levels).   

Why is the thyroid so important?  Here is a list of the vital actions the thyroid hormones direct in your body:

1. They help in the overall growth, development, and differentiation of all the body cells.

2. They regulate the basal metabolic rate (BMR)—that is, your metabolism.

3. They help in the overall development and function of central nervous system in children.

4. They stimulate body and mental/emotional growth.

5. They stimulate heart rate and contraction.

6. They regulate carbohydrate, fat, and protein metabolism. 

7. They also help in the metabolism of vitamins.

8. They control the body temperature.

9. They help degrade cholesterol and triglycerides.

10. They maintain the electrolyte balance.

11. They support the process of red blood cell formation.

12. They enhance mitochondrial metabolism—the mitochondria are the “powerhouses” of each cell where the cell produces the energy it needs to function.

13. They increase the oxygen consumptions by the cells and tissues.

14. They influence the mood and behavior of a person.

15. They stimulate gut motility.

16. They also enhance the sensitivity of the beta-adrenergic receptors to catecholamines. 

17. They interact with the adrenals, ovaries, testes to help keep all in balance 

Here are the hormones involved with the thyroid:

1. Thyroid Regulating Hormone: The hypothalamus sends this to the pituitary

2. Thyrotrophin Stimulating Hormone: The pituitary then sends this hormone to the thyroid to have it make T4 and T3

3. Thyroxine (T4): Around 97% of what the thyroid makes is this hormone, which is a protein molecule called thyroglobulin combined with four iodines. t can be bound or free. One the free is active in our bodies

4. Liothyronine (T3): Free T4 enters cells and is converted to T3, but removing an iodine molecule. This signals your DNA to signal your mitochondria to make energy and then the cell can do whatever that cell is supposed to do. 

Most MDs unfortunately only draw TSH to gauge thyroid functioning. That isn't that helpful. Here are how the we check the thyroid:

1. TSH: Ideally 0.5-2.5 (if it goes higher it indicates low thyroid function)

2. Free T4: Ideally in the 1s

3. Free T3: Ideally in the 3s

4. Reverse T3 (sometimes)

5. Thyroid Binding Globulin

6. Thyroid antibodies to thyroid peroxidase and thyroglobulin

7. Adrenal cortisol

Antibodies:

1. Thyroglobulin antibodies

2. Thyroid peroxidase antibodies

3. Thyroid stimulating immunoglobulin antibodies 

Elevation of RT3:

1. Life stressors: infection, illness, medications (metformin, oral contraceptive pills, bioidientical hormones, beta blockers), diabetes, COPD, liver or heart disease, depression, PTSD

2. Reduced calorie intake, especially low carbs

3. Lab error—especially if on thyroid or has autoimmune thyroid disease

4. No reason at all

5. Chronic heart failure esp Afib, Heart attack

6. Inflammatory conditions

7. Elderly patients

The thyroid can go become low in three main ways:

1. Subclinical hypothyroidism: This is when your TSH is elevated, showing low thyroid function, but your FT4 and FT3 are normal. It's the initial step of your thyroid struggling.

2. Hypothyroidism: When you actually have this, your TSH is elevated and FT4 and FT3 are low, but your antibodies are negative.

3. Hashimoto's hypothyroidism: TSH is elevated, FT4/FT3 are low and one or both of the thyroid antibodies are elevated. You may at times have elevated antibodies but your thyroid labs otherwise are normal.

That means your thyroid is still able to function even though your immune system is attacking it. Many things can cause auto-immune disease in the thyroid.

When your thyroid is not working you may have some of these common main signs/symptoms:

1. Fatigue, poor stamina

2. Hair loss

3. Water retention/edem

4. Weight gain

5. Problematic periods: heavier, longer bleeding

6. Depression, irritability, lack of motivation

7. Feeling cold

8. Elevated cholesterol

9. Dry skin and hair

10. Reduced libido

11. Constipation

Many things go into treating an under functioning thyroid:

1. Tidying up the diet and reversing insulin resistance, which can block thyroid secretion of hormones.

2. Food sensitivity testing for auto-immune conditions (gluten is particularly associated with auto-immune thyroid disease, but it's not always the problem, so getting a test is best to know what is driving your autoimmunity). Other tests include heavy metal or chemical toxicity.

3. There are many nutrients and botanicals associated with maximizing the functioning of the thyroid.

4. A patient doesn't always need to go on thyroid medication, but many patients do.

5. Low Dose Naltrexone: this is a great compounded, safe medication to help a patient with either auto-immune thyroid condition to help reduce the auto-immune process. Dr. Morstein recommends it to any patient with significantly elevated thyroid antibodies.

Nearly 5 out of 100 Americans over 12 years old have under-functioning thyroids. If you feel this good be happening to you, Dr. Morstein is definitely an expert on the thyroid. She's been asked to do her comprehensive thyroid lecture at three different medical conferences. Having a thyroid that works well is vital for good health, physically and mental/emotionally.