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Thyroid Ultrasound - What Can Go Wrong with Your Thyroid - Amy Myers MD®

What Can Go Wrong with Your Thyroid

Written by Amy Myers, MD

This is the first article in a multi-part series on the thyroid. Follow along as we explore how the thyroid works and how you can use The Myers Way® Four Pillars of Health to prevent, control, or reverse thyroid disease.

Thyroid disease is a topic particularly near and dear to my heart because I battled thyroid disease in medical school after being diagnosed with Graves’ disease. I have since made it my mission to help those facing thyroid disease and other chronic illnesses overcome their symptoms and return to optimal health.

According to the American Thyroid Association, more than 20 million Americans suffer from thyroid disease, and up to 60% of them are unaware of their condition. For women, the statistics are even more alarming. Women are five to eight times more likely than men to develop thyroid disease.

To understand what can go wrong with your thyroid and how to reverse your symptoms, let’s first take an in-depth look at what role the thyroid plays in your body.

Understanding How the Thyroid Works

Your thyroid powers every cell in your body through the hormones it produces. These hormones determine the energy level and reproduction of each cell, keeping your organs powered up and managing your overall metabolism. The process of creating, regulating, and delivering these hormones begins in your brain.

 

The Thyroid, Hypothalamus, Pituitary Gland, Thyroid Hormones - Infographic - Amy Myers MD®

 

The hypothalamus, which is responsible for managing hunger, thirst, sleep, hormones, and body temperature, among other important functions, monitors the level of thyroid hormones present in your bloodstream. If it determines energy levels are low, it sends out Thyroid Releasing Hormone (TRH), to your pituitary gland. Your pituitary gland, a pea-sized gland at the base of your brain, releases Thyroid Stimulating Hormone (TSH) directly to the thyroid.

Your thyroid is then prompted to produce thyroid hormone using an amino acid called tyrosine and iodine. It converts the tyrosine into thyroglobulin and attaches between one and four iodine atoms, creating T1, T2, T3, and T4 respectively.

Thyroid Hormone Production

The primary output of your thyroid is T4, thyroglobulin plus four iodine atoms—a storage form of the hormone. It is circulated throughout the bloodstream and stored in tissues so it’s available when needed. A much smaller percentage of the hormones produced is T3, the active form of thyroid hormone. T2 and T1 make up an even smaller percentage, and although we now know T2 is involved in metabolism rate, researchers are still unsure of what role these two hormones play.

When each local area of your body determines that it needs active T3, it converts the storage T4 to active T3 using an enzyme called deiodinase. This enzyme strips one of the outside iodine atoms off of the T4, turning it into Free T3 (FT3). Your body also uses a portion of the T4 to create Reverse T3 (RT3). This is done by stripping away one of the inside iodine atoms, creating another inactive form of thyroid hormone that can attach to Free T3 receptors.

The T3 enters cell membranes with the help of cortisol and regulates how much energy your mitochondria produce. Your mitochondria are the “power plants” of your cells and there are trillions of them in your body. Free T3 acts as a gas pedal for the mitochondria, revving up power production. Reverse T3 acts as a brake pedal, slowing down the power.

These micro-level reactions are a part of your endocrine system and work to control important metabolic factors such as heart rate, fatigue, weight regulation, brain function, and more. When your thyroid isn’t functioning properly it can affect any or all of these separate systems, creating a wide array of symptoms that might seem unrelated yet can all be traced back to your thyroid.

What Can Go Wrong: Types of Thyroid Disease

Hypothyroidism – An Underactive Thyroid

The most common form of thyroid disease is hypothyroidism, which is when your thyroid is underactive and does not produce enough thyroid hormone. This can be because your pituitary gland is malfunctioning and not sending enough TSH to your thyroid, or your TSH levels are normal, but your thyroid isn’t producing enough T4 and T3 to adequately fuel your cells. Hypothyroidism causes a general slowing down of your metabolic processes, and can lead to these symptoms:

  • Fatigue
  • Brain Fog
  • Weight Gain or Inability to Lose Weight
  • Cold Hands or Feet
  • Hair Loss
  • Constipation
  • Poor Concentration
  • Infertility
  • Low Libido
  • Depression
  • Decreased Heart Rate
  • Decreased Body Temperature

Hyperthyroidism – An Overactive Thyroid

On the other end of the spectrum is hyperthyroidism, which is less common but more dangerous than hypothyroidism. The type of thyroid disease I was diagnosed with, Graves’ disease, is a form of hyperthyroidism. In patients with hyperthyroidism, the thyroid produces an excess of thyroid hormones, sending your body into overdrive and producing symptoms such as

  • Rapid heart rate
  • Severe Anxiety and Panic Attacks
  • Insomnia
  • Weight Loss
  • Hair loss
  • Increased Body Temperature
  • Shakiness or Tremors
  • Loose Stool
  • Increased Hunger

Digging Deeper: Root Causes of Thyroid Disease

Autoimmune Thyroid Disease

Hypo- and hyperthyroidism are how thyroid disease manifests, however, there are several possible underlying causes. Most patients’ thyroid disease is triggered by an autoimmune condition. As you know, autoimmune disease occurs when the immune system mistakenly attacks your own cells. Hashimoto’s disease (hypothyroidism) and Graves’ disease (hyperthyroidism) are both autoimmune diseases. In this series, we discuss how toxins and gluten contribute to autoimmune thyroid disease. You can uncover all five environmental triggers of thyroid dysfunction in The Thyroid Connection Summit, featuring empowering education and actionable advice from 35 experts. You can also discover how to overcome the root causes of thyroid dysfunction in my book, The Thyroid Connection, which includes a 28-day plan to jumpstart your thyroid.

Many doctors who suspect a patient has something wrong with their thyroid only check their thyroid hormone levels, which indicate if the patient has hypo- or hyperthyroidism. They will not determine if it is caused by an autoimmune disease. I highly recommend that any patient diagnosed with thyroid disease have their thyroid antibodies checked using blood tests for Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb). This is crucial because once you have one autoimmune disease, you are 3 times more likely to develop another one. Fortunately, these two blood tests are very accessible and inexpensive, and can even be run without a doctor ordering them.

Non-Autoimmune Thyroid Disease

Although thyroid disease is triggered by autoimmunity, there are several other factors that can be the culprit behind what went wrong with your thyroid. If you’re lacking vital nutrients essential for thyroid function, you may be at risk of developing thyroid disease. Tyrosine and iodine are needed to create thyroid hormone. Selenium, zinc, and iron are needed to convert T4 to T3. Vitamin D or B are necessary for regulating metabolism and hormones. Luckily, these deficiencies can all be corrected fairly easily which is why I recommend everyone take supplements such as a high-quality multivitamin.

Other causes of thyroid disorders include pituitary disease, adrenal system imbalances, and thyroid cancer.

Over the next several weeks we will look at the what I discuss in The Thyroid Connection and in The Thyroid Connection Summit: how diet, the gut, toxins, stress, and infection all play a role in what can go wrong with thyroid health, as well as how the abundance of chemicals in our modern lifestyles might be sabotaging our iodine levels, and how to choose the best thyroid medication. This information will help you improve your thyroid health, and overall wellness to set you on the right track for living your best life naturally.

For more information, check out my interview with Mary Shomon on the importance of thorough thyroid testing and diagnostics. If you want to test your thyroid levels at home, I recommend using LetsGetChecked home thyroid tests. You can do the test in the privacy of your own home and then discuss your results with your functional medicine doctor.