Hypothyroidism seems to be an epidemic. And the traditional tests for testing thyroid health, do not take into consideration CELLULAR HYPOTHYROIDISM.
It is common place for people to have a blood tests done and if the TSH (Thyroid Stimulating Hormone) is high, thyroxine medication is usually recommended/prescribed. However, the body is not that simple and neither is the thyroid.
HPT axis
It is important to understand that we have the HPT axis, the Hypothalamus-Pituitiary-Thyroid Axis.
TSH is a brain hormone, not truly a thyroid hormone.
The Hypothalamus releases TRH (Thyrotropin Releasing Hormone)
The Pituitary releases TSH (Thyroid Stimulating Hormone) in response to TRH
The Thyroid releases T4 in response to TSH
It is a bit like a relay race but not a race.
Lock and Key
Hormones act by binding to receptors, think lock and key. The only way to open that lock, is if you have the right key. Same with hormone receptors. You will not get a thyroid hormone unlocking an insulin receptor. The body is amazingly specific and pretty fantabulous. The thyroid hormone receptors in the Hypothalamus are TEN times more sensitive to thyroid hormones than anywhere else in the body. This means once the Hypothalamus gets the message there is enough thyroid hormone, it stops sending the message to the Pituitary to produce TSH. BUT the other parts of the body (other tissues) could still be thyroid hormone starved. So you can in essence have a LOW TSH and still have hypothyroid symptoms.
What are hypothyroid symptoms?
They vary across the board, but typically the text book hypothyroidism symptoms are overweight, thick, dry skin, hair loss or thinning, depression and some menstrual issues.
However, one can be of a slim build and still have hypothyroidism. The common symptoms of hypothyroid include:
Weight gain
Low mood
Poor memory
Puffy face
Dry skin
Thinning hair and eyebrows
Hair loss
Feeling cold when others are in T-shirts
Constipation
Reflux
Muscle weakness
High cholesterol and LDL
Palpitations
Gall bladder issues
Fatty liver disease
Insulin resistance
Insomnia
Bloating
Gas
You may find that your TSH levels are ‘normal’ or you may be on thyroxine hormone and still experiencing hypothyroid symptoms.
Hypothyroidism is more common than we would like and it has many root causes, we will be splitting this blog over several parts to dive in a bit more deeper.
Thyroid Hormones
Thyroid hormones are not just T3 and T4. It is not a surprise that some are led to believe this, as the narrative goes; ‘high TSH, take T4 for the rest of your life’.
Majority of the thyroid hormone T4 is made in the thyroid gland, but most is converted to T3 (the active form) in the peripheral tissues such as the liver, kidneys, gut, brain
This T4 is converted to T3 by a process called de-iodination, this is a fancy way of saying removal of an iodine. T4 has 4 iodines and T3 has 3. And enzyme called de-iodinase type 1, makes this conversion happen and this enzyme can only work if it has enough selenium and zinc and is not overwhelmed by toxic metals such as mercury, bromine etc. T3 is more biologically active than T4.
Thyroid hormone blood tests
In a full comprehensive thyroid profile test, there is free T3 (FT3) and free T4 (FT4) and then the T4 and T3 readings.
Most practitioners in nutrition medicine will use the standard full thyroid profile blood test which includes the following;
TSH
T4
T3
FT4
FT3
rT3
Thyroperoxidase Antibody
Antithyroglobulin Antibody
At the New School our full thyroid profile, we include toxic metals such as bromine, arsenic, mercury and key minerals (selenium, iodine) as and when required. BUT we rely on the client’s time line, their story. A full thyroid profile with all the glitter, is not going to help a client who is struggling with a H.Pylori infection or is in allostasis rather than homeostasis.
Free T3 (FT3) and Free T4 (FT4) versus T4 and T3
Simply, hormones are carried in ‘vehicles’ (proteins) around the body, otherwise they can start to create 'drama' where it is really not required. The FT3 and FT4 are unbound, they are FREE, they are not in a vehicle in other words not attached to a protein. So they are able to do their ‘job’.
The T4 and T3 is reading the total amount that is bound and unbound.
Hypothyroidism occurs when there is not enough thyroid hormone (moreso T3) locking into the thyroid receptors in the mitochondria and nuclei of your cells and sending off the message to the genes.
Unfortunately, the blood levels of T4 and T3 do not reflect the cellular levels of T4 and T3.
It is just like vitamins and minerals. Blood tests of vitamins and minerals do not indicate the cellular levels of vitamins and minerals. Common example is vitamin B12. One can have ‘within range’ B12 levels in the blood, but be low in cellular levels of B12. The cellular levels of B12 in nutritional medicine is tested in the form of an organic acid called MMA (Methylmalonic acid).
One can have cellular hypothyroidism even if:
On thyroid medication such as Levothyroxine or even T3
The thyroid gland is doing it’s job as expected
Blood tests reveal normal TSH, T4, and T3 levels
Normal blood levels of reverse T3 (rT3)
At the New School of Nutritional Medicine we do not view the thyroid as an isolated organ or any organ for that matter. This gland does not work alone. There are various hormones of the ‘thyroid’ community. But this community of hormones is impacted by a whole host of other communities.
In Part 2 we will be sharing more about improving thyroid health with nutritional medicine and addressing allostatic load through coaching. Our coaching curriculum covers a variety of topics that go deeper into the MINDBODY connection.
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From the team at the New School Of Nutritional Medicine.
Learn about the Founder & Principal of the New School of Nutritional Medicine, Dr Khush Mark PhD HERE.
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