The incidence of hypothyroidism is steadily rising in the United States with women more commonly affected than men. The most common cause of hypothyroidism in adults is Hashimoto’s hypothyroidism – an autoimmune condition in which the person’s immune system makes anti-bodies to the thyroid hormone. Hashimoto’s is often difficult to detect as many patients have a period of hyperthyroidism (high energy, weight loss) before their thyroid crashes and symptoms of fatigue, hair loss, constipation, weight gain, low body temperature and high blood pressure can set in. Many physicians just screen for TSH (thyroid stimulating hormone), which is often normal in Hashimoto’s patients. Hashimoto’s often sets in after pregnancy even if the pregnancy is not carried to term or after a viral syndrome. Taking a thorough patient history and running the appropriate labs is crucial for early detection. Treatments like low dose naltrexone therapy can actually reverse the autoimmune process. Increasing plant sterols, avoiding goitragenic foods and eating an anti-inflammatory diet are good starts for treatments.
Sometimes hypothyroidism is simpler in that the thyroid gland is not producing enough hormone (T4) The brain keeps sending the signal to produce T4 through TSH (thyroid stimulating hormone) so lab results will show an elevated TSH. Many debates surround what is the ideal level of TSH for optimal thyroid health and this can differ from patient to patient.
The thyroid gland can be functioning normally but the thyroid hormone T4 is not being converted into T3, which is the usable form for the body. This can be due to selenium deficiency or impaired organ function.
To complicate matters further, sub clinical hypothyroidism often called Wilson’s Syndrome has normal lab values and is diagnosed clinically.
Patients require different treatments – some respond better to synthetic thyroid over animal derived thyroid. Some choose synthetic based on ethical, religious and personal preferences. Acupuncture, herbs, nutritional changes and supplementation can also alleviate the symptoms of hypothyroidism.