Optimizing thyroid function: a manual

It’s May 25, World Thyroid Day. It’s a day to bring attention to thyroid health.
You may wonder where your thyroid is and why is it so important. Well, it’s located in your neck, and it’s shaped like a butterfly surrounding your trachea. As to why it’s important, think of it this way, the thyroid produces only micrograms of thyroid hormone, which is used by all the cells of your body for energy. If this tiny flow of hormones suddenly stopped, we would drop dead. That’s how important your thyroid hormones are!  You can see that it’s important that your thyroid functions well. Unfortunately, that is often not the case! Here are some sobering statistics from the American Thyroid Association:

  • An estimated 20 million Americans have some form of thyroid disease.
  • Up to 60 percent of those with thyroid disease are unaware of their condition.
  • Women are five to eight times more likely to have thyroid problems.
  • One woman in eight will develop a thyroid disorder during her lifetime.

That is bad news if you are a woman and you don’t know the status of your thyroid function. It’s time to change that. The reality is that thyroid health can be the small difference between feeling good and feeling terrible. Often thyroid dysfunction can go undetected, due to poor screening or symptoms attributed to another cause. It’s important to know the exact symptoms.

When your thyroid is underactive, it’s called hypothyroidism.It is important to know the possible signs of hypothyroid dysfunction. You don’t need to have them all! One or more of these symptoms can indicate a problem: Fatigue, increased sensitivity to cold, constipation, dry skin, weight gain, muscle weakness, aches, tenderness and stiffness, pain, stiffness or swelling in your joints, hair falling out, depression, brain fog, anxiety and elevated cholesterol levels.

When your thyroid is overactive, it’s called hyperthyroidism. It is important to know the signs of hyperthyroid dysfunction. You don’t need to have them all! One or more of these symptoms can indicate a problem: Unintended weight loss, rapid or pounding heartbeat, increased appetite, nervousness or anxiety, tremor, sweating, increased sensitivity to heat, muscle weakness, difficulty sleeping, skin thinning.

You’ll notice that some of these symptoms are common and could be explained by a few different life circumstances. Being a new parent, having a stressful job, working out regularly, working out not enough, overindulging in food or alcohol – these are all life circumstances that could hide thyroid issues. It is important to get your thyroid checked if you have even a few of the above symptoms.

Check it out
It’s easy and usually inexpensive to get a blood test. The tests to assess thyroid function are TSH, free T3, free T4, and two thyroid antibodies; TPO and TG. TSH (Thyroid stimulating hormone) is produced by the pituitary gland in response to how much thyroid hormone is detected in your blood. This occurs in an ongoing feedback loop in your complex endocrine system. T4 is made by your thyroid gland and is the inactive version of the hormone. It needs to be converted by your body into the active form – T3, and then it can be used by the cells for energy. Antibodies indicate the presence of autoimmunity against your thyroid gland. All the parts inform the whole picture of thyroid health.

Some doctors screen the thyroid with only one test, TSH. This is only one element of the thyroid system, however, and you need to look at more than that to be sure you have properly screened for a problem. A thyroid specialist once said that looking only at TSH is like only looking through the front door at a house you want to buy. It really is important to see the entire house before you commit! The additional tests will give you a sense of how much hormone you have available for your body to use, how well you are making it and converting it from T4 to T3. Antibodies show if you have any autoimmunity, which is very common, and something you want to absolutely know.Your doctor may not want to do this level of testing or may feel it is unnecessary. This is a sign that you need to have a conversation with your doctor about what you want and need, since it is your body, and you have the right to know the details of how it is functioning. If your doctor still refuses, it may be time to find a new, more open-minded doctor. I suggest a functional medicine doctor. This is a person committed to finding the root causes of disease, rather than treating the symptoms only.

Lab levels vs. optimal levels
Once you get tested, then you’ll get your results. Easy, right? Not so much. Normal thyroid lab levels are very broad. “Normal” TSH goes up to 5.0 on most labs, even higher on others. These levels were actually established using unhealthy patients! Despite industry attempts to refine these lab values, they have persisted without change. You don’t want your hormone levels to be “normal”, you want them to be optimal. Optimal levels are a far narrower range than the established lab values. This disparity also accounts for cases of undiagnosed hypothyroidism in people who feel terrible, but their labs are “normal.” Compare these levels to any tests you have on hand. Pro tip: always ask your doctor for a copy of your labs, and make accounts at the labs where you draw blood and you will always have access to results online.

Functional medicine optimal thyroid lab levels:

  • TSH: 1-2 or lower
  • Free T4: 1.1-1.5
  • Free T3: 3.2-4.4
  • Thyroid peroxidase antibodies (TPOAB): less than 9 (0 is optimal)
  • Thyroglobulin antibodies (TGAB): less than 4 (0 is optimal)

Thyroid function self-test:
Take your basal body temperature in the morning before moving or getting out of bed. Reach over and just put the thermometer in your mouth and wait. Take your temperature for a week. If it averages below 97.6, it is likely you have a sluggish thyroid, and further testing is warranted.

Maintaining causes
If you keep dropping a hammer on your toe, there is no remedy I will be able to give you that will stop the pain. You must stop dropping the hammer on your toe! In homeopathy, we have a phrase to describe something that is causing or perpetuating a health problem: a maintaining cause.
You need to remove maintaining causes that are harming your thyroid and its function, and you need to add in health-promoting foods and nutrients that will optimize thyroid function. There are a few key maintaining causes with thyroid dysfunction: stress, food sensitivities and triggers, lack of nutrients needed by the thyroid, gut dysfunction, toxins and stealth infections. It is important to remove maintaining causes to achieve optimal thyroid health.

Stress, in particular, is a maintaining cause. There is not a single stress-free person in my practice. Historically speaking, stressors were intense and short-lived for our ancestors. A threat to our safety called for immediate action. Normal organ functions, including thyroid production, is depressed during intense stress, in order to emphasize the fight or flight functions. Threats to safety of our ancestors were followed by an immediate reset of the parasympathetic system. This is the main difference between then and now. We are in a long-term stress situation. We never get that reset to parasympathetic. We face stressors at home, at work, in our interpersonal relationships. We also have silent stressors, like social media, the news and just facing our email inboxes daily. Stress is particularly toxic for the thyroid glandand affects your thyroid gland in many ways. When you are under stress, your body steals the building blocks of thyroid hormone to make cortisol instead, leaving you with less hormone to work with. Stress also triggers your body to create reverse T3, instead of T3, which is an inactive form of thyroid hormone, leaving you with less energy. Stress impacts the tissues of your cells, making them resistant to thyroid hormone, making it harder to get T3 into the cells, where it is needed to make energy. This is just scratching the surface of the very direct ways stress impacts your thyroid gland. Reducing stress will make your thyroid healthier, and will ultimately give you more energy, weight loss, and better clarity of mind. Meditation is my go-to solution for stress reduction and overall better outlook on life.

Food sensitivities and triggers
When you consume foods to which you are sensitive, your gut gets inflamed. Inflammation can lead to “leaky gut”, in which your protective intestinal barrier is compromised. Gluten in particular causes this problem, in both gluten-sensitive and non-gluten sensitive people. It does this by stimulating zonulin, which compromises the tight seal between the cells in your gut. Normally, your intestinal lining is very strict about what can pass through it and into your body. But with “leaky gut”, food particles that would not normally be allowed to pass can “leak” into your bloodstream. These molecules are be flagged by your immune system as foreign, increasing inflammation and immune activity. Additionally, some molecules, such as gluten and casein, look similar to thyroid tissue. This is how it is possible for your body to flag thyroid tissue as “foreign” and trigger thyroid autoimmunity. Common food triggers for thyroid dysfunction are gluten, dairy, and soy. Other common sensitivities are corn and egg. You’d be surprised about how many things you eat all the time that could be causing a problem. You’ll never know until you try an elimination diet. This is the gold standard for identifying food triggers and sensitivities. For me, it was almonds. I love almonds, they are the epitome of healthy and good. But not for me, they turned out to be the source of all my problems. I’m sad, but also much happier that I know what was causing my problem.

Many nutrients are needed in the complex process of thyroid hormone production. Iron, tyrosine, selenium, omega-3 fatty acids, iodine, zinc, Vitamin D, B vitamins and Vitamin A are all essential to make and convert thyroid hormones. Making sure that you are consuming these in the right amounts will help your thyroid perform optimally. On the other hand, there are foods and substances that hamper thyroid function. The foods discussed above, such as gluten and dairy proteins can pose an ongoing thyroid problem due to molecular mimicry, for example. Get to know what is healthy for your thyroid, and what is harmful, and you can make optimal health choices going forward.

Heal your gut
The inside of your gut is actually the outside world! Your digestive system is directly connected to the outside. Just open your mouth, envision where it ends up and you’ll see what I mean. That means pathogens can be inside your gut at any point, and they must be prevented from entering the protected area that is your body. Luckily, your body is beautifully designed to do just that. Your intestinal lining is one cell thick, with tight joints between cells. This barrier guards from pathogens and undigested food particles passing into your bloodstream and from interacting with the many immune cells that lie just beyond this wall. When this lining is compromised, and unwanted things are allowed to pass, it can cause inflammation, autoimmunity and food sensitivities. Keep your gut intact, and your microbiome healthy with glutamine, probiotics, prebiotics, fiber and by eliminating foods that cause inflammation.

Industrial chemicals, heavy metals, mold, cleaning products and hormone disrupting plastics are just a few of the toxins that can bind to cells in our immune system, nervous system and endocrine system, causing damage and loss of function. Soft plastic bottles with BPA, pesticide residue on fruits and vegetables, flame retardants in furniture and mercury from fish or dental fillings could be causing an overload of your detoxification system and damaging your thyroid health. If you suspect issues, get them checked out by a functional medicine doctor and start detoxing. Additionally, start removing unhealthy chemicals from your life by greening up your cleaning, beauty and home products. Eat organic fruits, vegetables, meat and dairy. Limit your tuna intake. Support detoxification with glutathione, green tea, methylfolate and peaceful sweating in a sauna or an epsom salt bath.

Stealth infections are chronic infections that have a low level of symptoms, ones maybe you don’t even notice, they are just always nagging in the background. Epstein-Barr and CMV are associated with several autoimmune diseases. It’s important to check for stealth viruses especially if you have a history of viral illness or had a recent exposure, or are experiencing painful, swollen glands. Fatigue is a well-known symptom of hypothyroidism. If your fatigue doesn’t improve with treatment, make sure to get screened for other potential causes like mold exposure, Lyme and Epstein-Barr.

How homeopathy can help
Thyroid-focused homeopathic treatment has three facets; constitutional treatment, organ support, and client education. Constitutional treatment focuses on the entire picture of the client, allowing for patterns that are stuck to become free, on both the physical and emotional levels. For example, anxiety reduces, self-worth improves, constipation is eliminated, and hay fever improves. There is often significant or complete relief of many issues with the constitutional remedy alone. Thyroid-specific organ support gives the thyroid the boost it needs to perform optimally. This remedy is chosen based on the client’s history of thyroid dysfunction; when it presented, what other symptoms are present concurrently and results of lab tests. The final piece is education about thyroid health. This is critical because, as you have read above, lifestyle and diet are factors in thyroid health that are often entirely within our control. I spend time educating and supporting each one of my clients in changing their habits and helping them move toward optimal health.

Educate yourself
Educate yourself about your health. Many diseases and system dysfunctions arise from aspects of our lives that are entirely within your control. Thyroid health is no exception. What you eat, how you de-stress, what products you choose to use in your house and on your body, and what nutrients you choose to take will all have a profound effect on optimal thyroid health. Learn about your body, how it is supposed to work, and take the time to care for it. You only have one thyroid, and it is essential to your physical and emotional well-being. See this list for resources on thyroid education.

Thyroid health resources
Aviva Romm, MD
The Adrenal Thyroid Revolution

Izabella Wentz, PharmD
Hashimoto’s Thyroiditis; lifestyle interventions for finding and treating the root cause
Hashimoto’s Protocol; a 90-day plan for reversing thyroid symptoms and getting your life back

Amy Myers, MD
The Thyroid Connection; why you feel tired, brain-fogged, and overweight

Mark Hyman, MD
The Ultra Thyroid Solution eBook
Podcast: The Doctor’s Farmacy

Susan Blum, MD
The Immune System Recovery Plan; a doctor’s 4-step plan
(Especially if you have Hashimoto’s or Graves – autoimmune thyroid conditions)

Functional medicine resources
Institute for Functional Medicine Practitioner Finder

With love and optimism,





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