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A woman holding her neck where the thyroid is

4 Ways to Understand Your Thyroid Better (Thyroid Series Part 1)

1 in 8 women will suffer from thyroid disease at some stage of their life. With stats that high, it's important that women understand the thyroid better.

1. What is the thyroid gland and how does it work?

The thyroid gland is a butterfly shaped gland in the neck that sits below the Adam’s apple and just above the suprasternal notch, the beautiful depression at the base of the neck made famous by the movie The English Patient. 

Woman placing her hand on her neck where the thyroid gland is

Its best-known function is regulating metabolism; to manage how effectively and efficiently our body utilizes energy. But the thyroid also plays a lesser-known role in maintaining steady calcium and phosphate levels in the blood which is crucial for bone health. 

Everyone is born with a thyroid gland although research by the American Thyroid Association indicates that women are 8 times more likely to suffer with thyroid trouble than males. 1 in 8 women will suffer from thyroid disease at some stage of their life. 

The thyroid gland works through a negative feedback system with the brain explained in the image below. The hypothalamus, the hormone CEO of the body, sends a signal called thyroid releasing hormone (TRH) to the pituitary gland, it’s management team. TRH triggers the pituitary to send out a new signal to the thyroid gland called thyroid stimulating hormone (TSH). And this does just what it says. It instructs the thyroid to start producing the hormones needed for metabolism and many other functions in the body.

These two thyroid hormones are called tri-iodothyronine (T3) and thyroxine (T4). T3 and T4 levels in the blood stream are sniffed out by the micromanaging hypothalamus and pituitary. And if corporate feels the thyroid isn’t pulling its weight, the CEO has another meeting with management and more TSH is sent to the thyroid instructing it to work harder and make more T4 and T3. If the thyroid is working a bit too hard, it’s efforts are recognized by the hypothalamus and pituitary which then pull back a bit on the release of TRH and TSH, lightening the pressure on the thyroid.

Illustration of the thyroid feedback loop

If the thyroid isn’t working properly, there’s either a problem at the level of the brain or an issue within the thyroid itself. Thyroid disorders caused by problems in the hypothalamus or pituitary gland are rare, by far the majority of thyroid diseases arise from within the thyroid itself.

There are two ways the thyroid itself can malfunction. Either it becomes overactive causing hyperthyroidism or becomes underactive causing hypothyroidism. In both cases it is an autoimmune inflammatory process that causes the disease. Meaning, the body itself attacks the thyroid causing it to become inflamed and dysfunctional. Overactive thyroid disease is most commonly seen in women between the ages of 20 to 40. Whilst underactive thyroid disease is seen more commonly in middle aged women.

2. What do the thyroid hormones actually do?

T4 and T3 have a very busy work load regulating or being involved in the following:

Appetite. The thyroid gland exerts a direct influence on appetite in its work to balance the body’s energy requirements. Indirectly this also means that the thyroid plays an important role in body weight.

Body temperature. Through its influence on heart rate, increasing energy availability and influencing appetite, the thyroid sets in action cellular biochemical reactions which release heat and ultimately impact basal body temperature.

Bone Density. Throughout our lives our skeleton is in a constant state of bone re-modelling. Thyroid hyperactivity causes bone loss to occur at a faster rate than it can be replaced resulting in bone thinning – osteopaenia and osteoporosis.  

Bowel Function. Thyroid hormones regulate the speed of digestion and bowel movement. Lack of thyroid hormones slows bowel and gastric emptying leading to indigestion, bloating and constipation. An overactive thyroid speeds gut transit causing diarrhoea and poor absorption of nutrients from the gut because everything is passing through too quickly.

Brain function. In childhood thyroid hormones are essential for health brain maturation. Throughout life, these hormones play a role in helping us feel alert and focused as well as improving our coordination, reflexes and memory.

Cholesterol. Thyroid hormones regulate cholesterol levels by being involved in both the production of cholesterol and getting rid of excess. In hypothyroidism unhealthy cholesterol is not broken down and removed from the body as efficiently as usual. As a result, cholesterol levels rise increasing the risk of heart disease.

Fertility. The level of T3 and T4 influences the reproductive axis, altering the nature of menstruation and its frequency. Thyroid disease is also associated with an increased risk of miscarriage. 

Heart rate. Thyroid hormones directly affect the contractility of heart muscle and the speed of contractions i.e. the pulse rate and rhythm.

Mental Health. Thyroid dysfunction can significantly affect mental health with links to depression, anxiety, personality changes, bipolar disorder and even dementia. 

Muscle Tone. Thyroid hormones are involved in regulating energy usage by muscle cells. Lack of thyroid hormones can lead to loss of muscle volume as well as increased stiffness and aches of the muscles.

Sugar levels. Although it’s not understood exactly why, a strong link has been found between underactive thyroid and higher blood sugar levels. 

A stressed woman lying on her bed with her hands covering her face

3. What are the triggers for thyroid hormone disease?

Stress. We know that stress is a significant trigger for autoimmune disease and research into understanding exactly how this happens is still ongoing. However, there is proof that stress activates pathways in the body that lead to low grade inflammation which can eventually a manifest as a physical disease. Thyroid disorders can be brought about by extreme physical, emotional and physiological stress. The risk of thyroiditis (thyroid inflammation) is increased in women 7-fold in the first 12 months after giving birth. Not only has there been immense physiological and physical stress on the body at this time, but it is also a very emotional time. 

Family History. Thyroid diseases are hereditary. An Indian research project showed up to nine fold increased risk of developing hypothyroidism if a first degree family member was affected compared to the risk for the general population. 

Other Autoimmune Disease. Having another autoimmune condition like diabetes, rheumatoid arthritis, or lupus to name a few, can increase the risk of developing thyroid disease. About 25% of people with autoimmune disease have a tendency to develop another autoimmune condition.

Smoking. Smoking is a risk factor for developing autoimmune disease by triggering the inflammatory pathways in the body. Strong links have been established between smoking and developing hyperthyroidism, while less clear associations have been noted between smoking and hypothyroidism.

A plate of leafy green vegetables and berries

4. How to look after your thyroid

Watch your iodine intake. Underactive thyroids need more iodine, overactive thyroids need less iodine. Common sources of iodine include table salt (iodized) and seafood, shellfish in particular. 

Increase antioxidants. These help to mop up free radicals, rogue electrons, that can damage DNA and are involved in inflammation. Great antioxidants include berries, leafy greens and nuts and seeds as these are good sources of vitamin C and E.

Magnesium. Magnesium plays a very important role in the conversion of inactive T4 to active T3. Get your magnesium hit from nuts and seeds like almonds and walnuts and pumpkin seeds.

Selenium. Like magnesium, selenium is essential for the synthesis and activity of the enzymes which convert T4 to the more metabolically active T3. Eggs and brazil nuts are excellent sources of selenium.

Limit pro-inflammatory foods. High sugar foods, gluten, processed foods and red meat all increase inflammation levels in the body. Keep these foods to a minimum.

Cut down on caffeine. With caffeine being a stimulant, it can overstress the thyroid, affecting hormone production and metabolism if you over-do your consumption.

Limit Soy Products. Soy produces oestrogen which, in excess, preferentially binds to the proteins that are meant to carry T3 and T4 around the body for use by the cells. Too much oestrogen makes thyroid hormones less bioavailable. 

De-stress. For some tips on stress reduction read my post 10 Simple Ways to Reduce Stress. And if all else fails, meditate, meditate, meditate!

Love yourself, love your thyroid. Over the next weeks my thyroid series will continue with more about specific thyroid diseases. Stay tuned, and please get in touch if you have any questions or suggestions! 

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