Hypothyroid from an Integrative Perspective

I am in awe of the intricate design and interdependence of the many systems of the body. When there is an imbalance within the body, there is an interaction of genetics with an individual response to the environment, the psyche and/or lifestyle over time.

Hypothyroidism occurs when the thyroid is not producing enough thyroxine. When thyroxine is low, you may experience symptoms such as depression, constipation, hypersensitivity to cold, numbness, muscle cramps, chronic digestive issues, dry hair and skin and weight gain. The thyroid gland acts as the engine of the body. It regulates metabolism, which is the way the body uses energy. Thyroid hormones affect nearly every organ in the body. Thyroid hormone production is regulated by thyroid-stimulating hormone (TSH), made by the pituitary gland. The pituitary gland, which is located in the brain, is the “master gland” of the Endocrine system. The most common cause of hypothyroid in the United States is Hashimoto’s disease. Hashimoto’s is an autoimmune disease whereby the body attacks and destroys the thyroid gland.

The typical test for thyroid function is TSH. When TSH is high it indicates that the thyroid is not producing enough thyroid hormone. A high TSH begins the search for the cause of low thyroid function. The next step is to see if there is an autoimmune process occurring. The symptoms of Hashimoto’s may resemble a roller coaster whereby the individual is fatigued, depressed, constipated, has low libido and the next week feels anxious and cannot sleep. The TSH levels of this individual may also fluctuate and he or she may be constantly having their thyroid medication adjusted. Hashimoto’s Disease is the immune system attacking the thyroid. Hormones in the gland flow into the blood stream, metabolism speeds up and the individual looks like they are hyperthyroid. Hyperthyroid symptoms include heart palpitations, nervousness, insomnia, night sweats and weight loss. Over time, there is a loss of function of the thyroid and the individual is tired, cold, gains weight and is presenting with hypothyroid symptoms. I recommend that anyone who has hypothyroid symptoms have their antibodies checked. The most important test for Hashimoto’s is thyroid peroxidase antibodies (TPO Ab).

Why does it matter that we know the cause of Hypothyroidism? When the underlying cause is Hashimoto’s, it is essential to balance and calm the immune system. In Hashimoto’s, one side of the immune system is often dominant. A T-Helper cell (TH-1) dominant person has too many natural killers and cytotoxic T-cells. A TH-2 dominant person has too many B cells, the part of the immune system that puts information into memory. Dominance can be measured via cytokines.

There is significant evidence that there is a link between gluten intolerance and Hashimoto’s. The gluten molecule is similar to the thyroid gland molecule, which may negatively affect an overactive immune system in a gluten intolerant individual. Thus, if you have Hashimoto’s it is recommended that you be tested for gluten intolerance and avoid gluten products. Additional treatment for Hashimoto’s includes vitamin D, which is an immune modulator and needs to be given in therapeutic doses. Other nutrients that modulate the immune system include glutathione, superoxide dismutase and probiotics. Dr. Datis Kharrazian* has researched herbs that affect the Th-1 and Th-2 pathways. Once treated, the immune system comes back into balance and the thyroid replacement stabilizes. Since many practitioners use thyroid supplements containing iodine to treat hypothyroid, it is essential to determine if the cause is Hashimoto’s. Iodine dramatically worsens Hashimoto’s by increasing TPO and hence TPO antibodies.

What triggers Hashimoto’s? An active or chronic infection, such as viruses or environmental toxins, insulin resistance, gluten intolerance, estrogen fluctuations, vitamin D deficiency, iodine excess may provoke an autoimmune response. It is not uncommon for peri-menopausal and postpartum women to be diagnosed with Hashimoto’s.

While there are many causes of hypothyroid, I want to mention the relationship of the adrenals to the thyroid. I have learned that if you treat the thyroid, you also need to treat the adrenals. Adrenal stress affects the conversion of T4 into the active form of T3, which is the thyroid hormone the body can use. Chronic stress also weakens the immune system, which can exacerbate or trigger Hashimoto’s. When the adrenals are continually releasing cortisol, the pituitary gland may become sluggish and lead to low progesterone in women. Chronic elevated cortisol affects the liver and consequently its ability to metabolize estrogen. This contributes to an estrogen dominant situation, thus further intensifying hormone imbalances in peri-menopause. While the adrenals can and should be treated, it is essential to identify and address the cause of the chronic stress. This includes removing some adrenal stressors, such as alcohol, nicotine, caffeinated drinks, allergenic foods, inadequate sleep and negative beliefs. It is not uncommon for individuals who are stressed to reach for sweets, which can then affect your blood sugar balance. By now it must be apparent that the many systems in the body are all interconnected. It is essential to look at the whole picture and support the systems of the body that are not functioning optimally.

Remember, just as the body is an interconnected matrix, so too is the relationship of mind to body. The body is an expression of the mind. In the same way that it is important to become conscious of what we are eating, it is just as important to become aware of our beliefs. It is possible to clear unworkable beliefs and choose the thoughts you desire. The secret to health is to be in the present moment, conscious of our thoughts, taking time to live from choice. The energy of our thoughts effect our cells and organs. We are interconnected mind, body and spirit. Let us all connect to wholeness within ourselves and our world.

*Kharrazian, Datis, "Why Do I Still Have Thyroid Symptoms,"  2010.