Natural Strategies to Maximize Thyroid Function (Part 2 of 3)

In my post last week, I introduced the topic of thyroid health and the many misconceptions that the medical profession has about diagnosing and treating thyroid disease. In general, thyroid problems are under diagnosed because the standard blood tests used to evaluate function are woefully inadequate. At the same time, an underactive thyroid is often over treated with thyroid replacement hormones—which frequently cause even greater dysfunction. In my experience, a much more effective approach is to focus on the factors that underlie the dysfunction, providing the support needed to restore balance and function to an endocrine system that has gone awry.

Unfortunately, conventional “modern” medicine insists on viewing the thyroid as an independent entity, and treats any dysfunction by addressing only the thyroid. But in fact, the thyroid sits at the epicenter of the endocrine system and oversees the critical job of regulating the body’s metabolism. Although the thyroid gland weighs less than one ounce, the hormones it produces affect virtually every cell in the body.

 

New research suggests that thyroid-regulated problems may also underlie dementias, Down’s syndrome, Alzheimer’s disease, and age-associated cognitive function.^1,2  Attention Deficit/Hyperactivity Disorder (ADHD) is the most common behavioral disorder in children, and low thyroid function appears to be the common denominator linking toxic insults with ADHD.³ Along the same lines, mental retardation and epilepsy are neurological disorders much more prevalent in areas around the world with hypothyroidism.⁴

Women are at particular risk of thyroid disease and are five to eight times more likely than men to be diagnosed with the condition. The incidence of hypothyroidism increases with age—by age 60, nearly 17% of women and nine percent of men will have developed an underactive thyroid. In my experience, hypothyroidism is found at a much higher than average rate in women with breast cancer, and in people with other cancers including ovarian and prostate cancer. Hypothyroidism is also a major contributor to infertility and depression in women.

Common Factors Affecting Thyroid Health:

• Environmental stress

Environmental toxins including chemical pollutants, fluoride, mercury, and pesticides are detrimental to the thyroid. Mercury may diminish thyroid function because it displaces the trace mineral selenium, the most essential nutrient for the production of active thyroid hormone.⁵

Research indicates that fluoride, which is routinely added to community water supplies and to toothpastes and mouthwashes for the prevention of tooth decay, inhibits the functioning of the thyroid gland by interfering with iodine uptake. Flouride is chemically related to iodine (both are halogens), but because fluoride is more active, it displaces iodine. To avoid excessive exposure to fluoride, install a water filtration system and use dental care products that do not have added fluoride.^6,7

• Emotional Issues

Emotional issues are an important and often overlooked source of stress affecting thyroid function. Particularly for women, who may have learned to “silence their voice” in an attempt to please others or to be socially acceptable, an essential part of healing is to explore unresolved emotional issues as a source of stress. When women begin to use their voices to speak their truth, it’s not uncommon for their thyroid symptoms to subside.

• Menopause

Normal life cycle hormonal shifts—such as menopause—can adversely affect thyroid function. Women in menopause often experience fatigue and a significant decline in energy along with weight gain, dry skin and hair, depression, decreased libido, and increased cholesterol levels. While these symptoms are generally considered to be a classic depiction of menopause, they are often rooted in low thyroid function related to an overall dysfunction of the HPAT axis.

• Diet and Lifestyle

Many diet and lifestyle factors, including fasting, protein deficiency, excessive exercise, extreme stress, or even mild stress in certain predisposed individuals can trigger the onset of hypothyroidism. A diet containing excessive amounts of goitrogens such as raw cabbage or broccoli can also contribute to impaired thyroid function. In addition, nutrient deficiencies–specifically of selenium, vitamin D, iodine, zinc, and vitamin B-12–are commonly implicated in hypothyroidism.

• Sleep disorders

A good night’s sleep is essential for a healthy endocrine system. During sleep, anabolic hormones are restored; when we don’t sleep long enough or well enough, metabolic function is impaired, including thyroid function. Chronic sleep problems or insufficient sleep can lead to problems with the HPAA, and in turn, can lead to the development of an underactive thyroid.^8,9

Epidemiologic studies that show that people who sleep 6 hours or less per night have a 50% or greater chance of obesity. In addition to sleep quantity, sleep quality is also important. When a person wakes up several times during the night, the energy balance is disturbed; the resulting disruption in endocrine function can alter thyroid function and lead to weight gain.^10-13

I often consult with patients who are exhausted and concurrently suffer from chronic anxiety. This happens because although the HPAT axis is chronically under-active, adrenaline output allows the person to continue putting out energy without realizing the detrimental effects, until eventually a serious health breakdown occurs. Adaptogens combined with tonic herbs for the nervous system—such as milky oat seed (Avena sativa)—accompanied by lifestyle and dietary changes are the key to bringing the patient back to a state of balance and optimum health.

Balancing the HPAT Axis with Herbs and Nutrition

Bringing the body into balance, particularly when working with the endocrine system, ultimately depends upon our ability to adapt and to live in harmony with our internal and external environments. Botanical formulations to support the HPAT axis should be based on a foundation of adaptogens and include specific supportive herbs and dietary therapy for thyroid support.

Specific herbs to consider for improving thyroid function include: poke root (Phytolacca americana), blue flag (Iris versicolor), coleus (Coleus forskolii), guggul (Commiphora mukul), bladderwrack (Fucus vesiculosus), pulsatilla (Anemone pulsatilla), goat weed (Epimedium grandiflorum) (a Secondary Adaptogen), royal jelly (Apis mellifica) (a Secondary Adaptogen), and rosemary (Rosemarinus officinalis) (an Adaptogen Companion).

Healthy thyroid function is dependent upon a wide range of nutrients, especially selenium, folic acid, vitamins A, D, and E; zinc, and iodine. These nutrients support healthy thyroid hormone synthesis, promote the conversion of thyroxine (T4) to the more bioactive triiodothyronine (T3), address receptor dynamics, enhance nuclear binding, enhance the expression of thyroid hormone responsive genes, and help to reduce the risk of autoimmune thyroid dysfunction. Iodine is the most important trace element for the synthesis and metabolism of thyroid hormones. Within the thyroid, iodine is sequestered, oxidized, and bound to tyrosine to produce thyroglobulin, a protein that is used by the thyroid to make T3 and T4.

Specific Compounds to Support Thyroid Function

Rhodiola: One of the primary adaptogenic herbs that I recommend, rhodiola (Rhodiola rosea) is also beneficial for the thyroid gland. Soviet clinical studies have shown that combining rhodiola with exercise activates hormone-sensitive lipase, an enzyme that stimulates the breakdown of fat stored in adipose tissue. This action helps thyroid functions reset to normal hormone responses.¹⁴ Researchers found that obese subjects who took rhodiola extract had a mean weight loss of 19 pounds, an approximate 11% reduction in weight. In contrast, there was no significant weight change in the control group.¹⁵

Rosemary: Carnosic acid, one of the principal constituents in rosemary, has been found to potentiate the effects of vitamin D and retinoic acid on monocyte differentiation. Therefore, it is reasonable to assume that carnosic acid supports thyroid hormone (T3) mediated gene transcription.¹⁶

Tyrosine: People with hypothyroidism often have an overactive production of cortisol and an underactive production of catecholamines in the brain. This commonly manifests in cognitive difficulties such as “brain fog” or memory loss as well as mood alterations. Identifying this situation is particularly important, because many people suffering from depression or anxiety turn out to have hypothyroidism. In this event, the depressed or anxious person will benefit from N-acetyl tyrosine (a derivative of the amino acid L-tyrosine) and adaptogens.

L-tyrosine supports brain function by enhancing catecholamine biosynthesis, specifically the activity of the neurotransmitters norepinephrine and dopamine. Tyrosine is also required for the production of thyroid hormone T4, and low levels of tyrosine have been associated with hypothyroidism. N-acetyl tyrosine is preferable to L-tyrosine because of its increased solubility and stability, which makes it more bioavailable to cells.

Selenium: Under normal conditions, the thyroid gland expresses many of the known selenocysteine-containing proteins and retains high concentrations of selenium even when there is an inadequate supply of selenium. Sufficient selenium is necessary for the conversion of T4 to T3, and a deficiency may cause T4 to be converted preferentially to rT3 (reverse T3, which is biologically inactive). An adequate supply of selenium is essential not only for thyroid hormone synthesis and metabolism, but also protects the thyroid gland from damage such as that caused by excessive iodide exposure.¹⁷

Selenium supplementation has been shown to reduce rT3, increase free T3, and reduce TSH levels.¹⁸ Because selenium-dependent enzymes affect immune function, even a minor deficiency of selenium can contribute to the development of autoimmune thyroid diseases such as Hashimoto’s thyroiditis. Studies show that supplementing with selenium may lessen inflammatory activity in patients with autoimmune thyroiditis, especially in those with high activity.^19,20

Zinc: Zinc is necessary for normal thyroid metabolism, and laboratory studies show that a deficiency is associated with a 30 percent decrease in serum levels of T3 and free tyroxine when compared to control groups receiving adequate levels of zinc.

Research indicates that zinc also influences the healthy expression of thyroid hormone-responsive genes by influencing transcription factors affecting T3 nuclear receptor interactions.²¹ In studies, researchers noted improved results in wound healing (slow healing of wounds is a common symptom of hypothyroidism) when thyroid replacement therapy was accompanied by zinc supplementation.²²

Vitamins A and D: Vitamin A (retinoic acid) and vitamin D (1,25-dihydroxycholecalciferol) are both critical for the proper functioning of the thyroid gland. An insufficient supply of vitamin A has been shown to negatively affect the pituitary gland’s production of TSH (thyroid stimulating hormone), which in turn slows down thyroid activity and decreases the amount of thyroid hormones produced. In addition, vitamin A is necessary for the absorption of iodine by the thyroid.

Research suggests that vitamin A provides the functional support necessary for the regulation of thyroid hormone-responsive genes.²³ Research also indicates that there is a strong interaction between vitamin A and thyroid hormone in the regulation of genes that encode cellular-detoxification enzymes.²⁴

Currently, research suggests that vitamin D deficiency, a common finding in aging populations, is associated with an increased incidence and severity of autoimmune disease, including Hashimoto’s thyroiditis. Studies also show that many people diagnosed with hypothyroidism have low levels of vitamin D. Our bodies manufacture vitamin D from cholesterol through the activation of sunlight on the skin. As such, sunlight is vital for proper endocrine balance, including thyroid function.

NADH: This coenzyme of vitamin B3, a reduced form of nicotinamide adenine dinucleotide (NADH), is present in all living cells and plays a key role in the body’s energy production. NADH, the primary carrier of hydrogen, produces energy in the form of ATP through a series of biochemical reactions. For optimal energy production, a sufficient supply of NADH is necessary.

NADH also aids in the transformation of the amino acid tyrosine into the neurotransmitter dopamine. Dopamine plays a critical role in cognitive function (such as concentration and memory), energy, sexual drive, mood, and muscle movement. Without NADH, the body lacks energy and the antioxidant defense system fails. I have found NADH, taken as a supplement (five milligrams, two times per day), to be helpful for people with hypothyroidism. It is also beneficial when taken with tyrosine (350 to 700 milligrams), specifically when T4 levels are low. In the diet, NADH is found in meat, fish, and poultry.

Thoughts on Supporting Thyroid Health

It is obvious that the factors affecting the thyroid are numerous and varied. It makes sense that a program to address thyroid health must be equally multifaceted, particularly when thyroid function has been compromised. Only then can an effective strategy be implemented that supports the body in returning to optimal functioning.

References

1. Labudova O, Cairns N, Koeck T, Kitzmueller E, Rink H, Lubec G. Thyroid stimulating hormone-receptor overexpression in brain of patients with Down syndrome and Alzheimer’s disease. Life Sciences 1999; 64(12): 1037-1044.
2. Prinz PN, Scanlan JM, Vitaliano PP, et al. Thyroid hormones: positive relationships with cognition in healthy, euthyroid older men. Journal of Gerontology Series A 1999; 54(3): M111-M116.
3. Kidd PM. Attention Deficit/Hyperactivity Disorder (ADHD) in children: Rationale for its integrative management. Alternative Medicine Review 2000; 5(5): 402-428.
4. Fylkesnes, Nygaard. Dementias and Hypothroidism. Tidsskr Nor Laegeforen 2000; 120(8): 905-907.
5. Kucharzewski M, Braziewicz J, Majewska U, Gozdz S. Concentration of selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases. Biological Trace Element Research 2002; 88(1): 25-30.
6. Bürgi H, Siebenhüner L, Miloni E. Fluorine and thyroid gland function. Journal of Molecular Medicine 1984; 62(12).
7. Tokar’ VI, Voroshnin VV, Sherbakov SV. Chronic effects of fluorides on the pituitary-thyroid system in industrial workers. Gigiena truda i professional’nye zabolevaniia 1989; (9): 19-22.
8. Rodrigues NC, da Cruz NS, de Paula Nascimento C, da Conceição RR, da Silva AC, Olivares EL, Marassi MP; Sleep deprivation alters thyroid hormone economy in rats. Exp Physiol. 2015 Feb 1;100(2):193-202.
9. Gary KA1, Winokur A, Douglas SD, Kapoor S, Zaugg L, Dinges DF. Total sleep deprivation and the thyroid axis: effects of sleep and waking activity, Aviat Space Environ Med. 1996 Jun;67(6):513-9)
10. Femke Rutters, PhD, Stress, Sleep and Social Jetlag: The Obesity Epidemic’s Psychosocial Side, Medscape Diabetes & Endocrinology © 2015, WebMD, LLC, October 19, 2015, http://www.medscape.com/viewarticle/852558_print date: 01/19/2016
11. Rutters F, Gerver WJ, Nieuwenhuizen AG, Verhoef SP, Westerterp-Plantenga MS. Sleep duration and body-weight development during puberty in a Dutch children cohort. Int J Obes (London). 2010;34:1508-1514.
12. Gonnissen HK, Hursel R, Rutters F, Martens EA, Westerterp-Plantenga MS. Effects of sleep fragmentation on appetite and related hormone concentrations over 24 h in healthy men. Br J Nutr. 2013;109:748-756.
13. Hursel R, Gonnissen HK, Rutters F, Martens EA, Westerterp-Plantenga MS. Disadvantageous shift in energy balance is primarily expressed in high-quality sleepers after a decline in quality sleep because of disturbance. Am J Clin Nutr. 2013;98:367-373.
14. Ramazanov Z, et al. New secrets of effective natural stress and weight management, using Rhodiola rosea and Rhodendron caucasicum. East Canaan: ATN/Safe Goods Publishing, 1999.
15. Ibid.
16. Danilenko M, Wang X, Studzinski GP. Carnosic acid and promotion of monocytic differentiation of HL60-G cells initiated by other agents. Journal of the National Cancer Institute 2001; 93(16): 1224-1233.
17. Zimmermann MB, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 2002; 12(10): 867-878.
18. Rothfeld G, Romaine D. Thyroid Balance. Cincinnati: Adams Media, 2002.
19. Zimmermann MB, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 2002; 12(10): 867-878.
20. Olivieri O, Girelli D, Azzini M, et al. Low selenium status in the elderly influences thyroid hormones. Clinical Science 1995; 89(6): 637-642.
21. Rebagliati I, Raices M, Ricci C, Weisstaub A, Hagmuller K, Zaninovich AA. Effects of zinc on brown fat thermal response to cold in normal and triiodothyronine-treated hypothyroid rats. Bulletin of Environmental Contamination and Toxicology 2001; 67(5): 641-648.
22. Erdogan M, Ilhan YS, Akkus MA, et al. Effects of L-thyroxine and zinc therapy on wound healing in hypothyroid rats. Acta chirurgica Belgica 1999; 99(2): 72-77.
23. Pallet V, Audouin-Chevallier I, Verret C, Garcin H, Higueret P. Retinoic acid differentially modulates triiodothyronine and retinoic acid receptors in rat liver according to thyroid status. European Journal of Endocrinology 1994; 131(4): 377-384.
24. Haberkorn V, Heydel JM, Mounie J, Artur Y, Goudonnet H. Influence of vitamin A status on the regulation of uridine (5’)diphosphate-glucuronosyltransferase (UGT) 1A1 and UGT1A6 expression by L-triiodothyronine. British Journal of Nutrition 2001; 85(3): 289-297.