Hypothyroidism - An Integrated Treatment Approach

To understand what hypothyroidism is, it is important to first understand what the thyroid is, and the role of the thyroid in the body. The thyroid is a small gland located at the front of the neck, just below the Adam’s apple. The thyroid is responsible for releasing two thyroid hormones, T3 and T4. These thyroid hormones act much like the accelerator on your car- they determine how fast or slow your body’s metabolism runs.  

Thyroid hormones are able to stimulate almost every cell in the body, and control your body’s metabolic rate. This means that thyroid hormones affect the speed at which cells use oxygen and make proteins, and can affect things like heart rate, body temperature, growth, breathing rate, digestion, energy consumption, weight, fertility, and skin health. Clearly, the thyroid is an incredibly important gland!

So what happens when the thyroid is underactive?

When the thyroid is underactive, it is not producing enough thyroid hormones to maintain normal metabolic rate and normal cell function and energy usage. This condition is called hypothyroidism.   

What are the causes of hypothyroidism?

One of most common cause of hypothyroidism is Hashimoto’s thyroiditis. Hashimoto’s thyroiditis is an autoimmune condition in which your body produces antibodies that attack the thyroid gland, causing progressive damage to the gland. Many people show no signs or symptoms of the condition until the gland is too damaged to produce adequate levels of thyroid hormones to maintain normal metabolism. 

Chronic iodine deficiency can also cause hypothyroidism, as iodine is required by the thyroid to produce thyroid hormones. This is a major cause of hypothyroidism in developing countries.

Hypothyroidism can also be caused by a failure of the pituitary gland to secrete adequate amounts of thyroid-stimulating hormone (TSH). As the name suggests, TSH is needed to stimulate the thyroid to produce and release thyroid hormones. This is called secondary hypothyroidism, and is a less common form of hypothyroidism.

Other causes of hypothyroidism include certain medications, and treatment of hyperthyroidism.

Symptoms of hypothyroidism

Symptoms of hypothyroidism are related to the slowing of metabolism. Symptoms include weight gain, low body temperature, slow heart rate, dull facial expressions, fatigue, depression, intolerance to cold, dry skin, brittle hair and hair loss, poor concentration and memory, hoarse voice, slow speech, and constipation.

Treatment options for hypothyroidism

There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management. It is important to note that in thyroid conditions, it is possible to alternate between hyperthyroidism and hypothyroidism. Regular monitoring of signs, symptoms, and blood tests by your healthcare team is recommended to prevent large swings in thyroid function. Therapies that you may find beneficial include:

  • Medical management: Your GP or endocrinologist may recommend thyroid hormone replacement medication to normalise thyroid hormone levels.
  • Dietetics: A dietitian may construct a meal play that ensures nutrient requirements are met, and to prevent weight gain and nutrient deficiencies.
  • Psychotherapy: Stress may contribute to thyroid dysfunction, and may worsen symptoms. Depression is also common in hypothyroidism and it is important that psychological support is sought in managing your psychological well being.

Naturopathic approach to disease

This section will discuss some of the naturopathic approaches to management of hypothyroidism. The information in this section is of a general nature only, and should not be used as a substitute for medical advice or consultations with you health care provider. We advise you to consult your health carers before considering commencing any of these therapies.

Diet

Consumption of goitrogens should be limited, especially if iodine levels are already low. Eating goitrogens can slow thyroid activity by inhibiting iodine uptake and decreasing thyroid hormone production. Dietary goitrogens include raw brassicas (vegetables from the cabbage family), linseed, millet, and soy.

Lifestyle

Stress seems to play an important role in disrupted thyroid function. Stress management or stress reduction techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

Identify and correct nutrient deficiencies

The thyroid gland needs a number of nutrients to produce thyroid hormones. Some of the most important ones are iodine, zinc, selenium and an amino acid called tyrosine. It is important to make sure that you are getting the correct amounts of each of these nutrients to ensure optimal thyroid function. If deficiencies or inadequate intakes are identified, adjusting the diet or supplementation with the necessary nutrient may be recommended.

Specific nutrients

Selenium

Several studies have found that supplementation with selenium resulted in a decrease in thyroid antibodies in patients with Hashimoto’s thyroiditis. These studies suggest that selenium may decrease the inflammatory activity and improve the altered immune function seen in Hashimoto’s thyroiditis.

A note on iodine

While iodine deficiency is a common cause of hypothyroidism, iodine levels are normal in many cases, especially in developed countries. Excess intake of iodine can induce both hypothyroidism and hyperthyroidism, and iodine supplementation in hypothyroidism may result in hyperthyroidism. Due to the complex nature and variety of causes of hypothyroidism, increasing iodine intake should only be done where indicated in select cases and under the guidance of a medical practitioner.  

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of hypothyroidism. Your multidisciplinary team may include general practitioners, endocrinologists, naturopaths, dieticians, osteopaths, acupuncturists, yoga and meditation instructors, counsellors and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional well being.