Q: For the past couple of years I have been gaining weight, which I seem unable to lose, no matter how much I diet. Also, I'm always tired, no matter how much sleep I get. Could I have some sort of thyroid problem?
A: The classic "constellation" of symptoms indicative of an underfunctioning thyroid system is fatigue, constipation, thinning hair, cold intolerance, and inability to lose weight. Sometimes not every symptom is present, but this clinical picture is increasingly common. One hundred years ago, an underfunctioning thyroid system was extremely rare. Today, it is very common, particularly in women. In fact, many of my female patients are on medication for low thyroid. Typically, if they have seen a conventionally trained doctor, they are on Synthroid, a synthetic version of the weaker human thyroid hormone levothyroxine, or T4.
Human thyroid hormone comes in two major configurations: T3 (which is three iodine molecules) and T4 (four iodine molecules). The active hormone is T3, which is converted by stripping away one iodine molecule from T4, the "storage" form of thyroxin. This conversion happens mostly in the liver, but also in the peripheral tissues. One of the reasons we are seeing much more hypothyroidism is because we are living with polluted air, water, and soil, and we eat foods contaminated with plastics, pesticides, and hormone mimickers. This is literally jamming up the works. We are developing thyroid receptor resistance, similar to insulin receptor resistance of type 2 (or adult onset, or high-fructose-corn-syrup-induced) diabetes.
Additionally, we have less iodine in our diets than before. We have become salt phobic, and salt is a major source of iodine. (It's true that too much salt is a bad thing, but so is too little.) Salt is not the best way to get your iodine, however. Seafood is a good source of iodine, but many people are more careful about eating fish today due to fear of mercury and other heavy metal poisons in seafood. The single best nutrient source of iodine is kelp (sprinkle 1/4 teaspoon on your food daily).
Here's another reason that iodine is deficient in most urban dwellers today. If you look at a chemical periodic table, you will see that iodine is a "halogen" and in the same column as fluoride, bromine, and chlorine. These other halogens, widely used to "treat" our community water systems, displace iodine by blocking the cell receptors for iodine. The net result of all this pollution is that low thyroid system function has become pandemic.
Many of my patients have been frustrated when going to their medical doctor with this list of symptoms (cold, constipated, can't lose weight) and told because their lab results are "normal" that there is nothing wrong with their thyroid gland. This is called euthyroid, which means that even though the lab results seem normal, there is still something off with the thyroid system function. Think of the thyroid gland as the gas pedal for your body. Just because there's gas in the tank and you're pressing the gas pedal, doesn't mean the engine is going to work correctly.
Many conventionally trained doctors will check only TSH, or thyroid-stimulating hormone, a secretion from the pituitary gland in the brain. TSH is secreted in response to lower levels of T3 and T4 in circulation. As hormone levels go down, TSH goes up in an attempt to force more thyroid hormone production. Naturopaths prefer to see TSH between 0.5 and 2 nanograms per milliliter. A conventional doctor regards TSH level as high as 5.5 as "fine." It is not fine. TSH is an extremely potent hormone, and a small rise indicates a significant deficit.
In addition to TSH levels, I always check for the indicator of the most common type of hypothyroidism, the autoimmune disease Hashimoto's thyroiditis, in which antibodies to
the thyroid tissue (TPO) can be measured in the blood. I also calcu late ratios between the T3 and T4 values. Often, when patients have been medicated with synthetic T4 for years, but still aren't feeling great, the T4 levels are high, but the active T3 is low. Giving more Synthroid is not the appropriate remedy.
Please find a well-trained naturopathic physician (go to naturopathic.org and click on Find a Doctor) or holistic MD to help you sort out your possible thyroid issue.