What can you do to support your thyroid?
Hi, I am doctor Leen. I am a general practitioner and a functional medicine doctor based in London. It is estimated that one in 20 people in the UK have a thyroid problem and it’s a condition I see commonly in general practice. Today we will discuss what you can do to support your thyroid.
The mind-blowing fact is that this is not commonly discussed in general practice. We ‘aka doctors’ are so focused on prescribing medications for under and over-active thyroid that a lot of doctors forget (and more importantly not trained) to discuss lifestyle changes the patient can do to support his/her thyroid. I hope after reading this brief article you will feel more confident in finding ways to support your thyroid via lifestyle changes. Remember, this information does not replace medications or advice from your healthcare professional.
Firstly, it’s important to know what causes thyroid hormone imbalance to be able to know how to fix it:
We know that stress increases cortisol production and this suppresses the production of thyroid stimulating hormone (TRH and TSH) from the glands in the brain called the ‘pituitary gland’ and the ‘hypothalamus’. This in return reduces the production of thyroid hormones from the thyroid gland itself (1).
Inflammation is when the body immune response is activated, it releases proteins to help with cell signalling which are called inflammatory cytokines. This can happen when a foreign body enters the body (like viruses or bacteria) but it can also happen in autoimmune conditions (This means the body's natural defence system (immune system) attacks healthy parts of your body). Conditions can include – rheumatoid arthritis, inflammatory bowel disease or coeliac disease. You can also see inflammation in heart disease, diabetes, cancer and asthma.
Viral infections, including EBV (Epstein barr virus, aka ‘glandular fever’) have been involved in auto-immune conditions of the thyroid. There is high prevalence of EBV infection in cases of Hashimotos’ and Graves disease (autoimmune conditions affecting the thyroid)
4. Dietary factors
a. Gluten: As discussed above, patients with coeliac disease are at increased risk for developing thyroid disease and vice versa. By following a strict gluten free diet for these patients, it shows improvement in thyroid function. In addition, people with gluten sensitivity and autoimmune thyroid issues, having gluten free diet has also showed improvement in thyroid function.
b. Low calorie diet: A significantly low-calorie diet, from a long term diet, is considered a physiological stress and is known to reduce T3 (active thyroid hormone).
c. Nutritional deficiencies: A common example is selenium. Selenium plays an essential role in thyroid hormone production. Multiple researches have shown that selenium supplementation has reduced thyroid antibodies levels. Zinc is also a nutrient that’s when deficient it can reduce thyroid hormone. Supplementation or increasing these nutrients in the diet can take up to 12 months to show effect on thyroid. Other important nutrient here are iron and vitamin A&D, they can impair thyroid hormone production when low or deficient. I would recommend having a consultation with a health care professional before starting any supplementation.
d. Toxins: there are many examples of toxins that affect the thyroid. Lead and cadmium are an example where in high levels they can disrupt the thyroid.
e. Medications: such as proton pump inhibitors (e.g. Nexium or omeprazole), lithium, Beta blockers, phenytoin, birth control pills
In Functional Medicine Doctor clinic we sit down with patients to untangle which of these factors are causing thyroid hormone imbalances. We then do testing checking for the full thyroid panel this includes: TSH, T3, T4, RT3, TT3, TT3/RT3, FT3/FT4, Thyroid Antibodies, Iron, Vitamin D, Iodine, Vitamin A, zinc and selenium levels.In some patients we can consider doing a celiac panel, food sensitivities, toxic minerals, and stool analysis (depending on the history and possible triggers)
We then implement a realistic individualised autoimmune protocol (including lifestyle changes, diet change) which is useful for reducing systemic inflammation and improving thyroid function.