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Welcome to the Cureality Thyroid Health Track
Recognizing a growing epidemic around us!
As many as 35% of the population now have thyroid dysfunction in some form, an epidemic due to a number of factors that affect all of us, such as endocrine disruption from the industrial chemicals that surround us.
It means that thyroid dysfunction impairs weight control, energy, cholesterol values, blood pressure, skin and hair quality, and many other facets of health. If it doesn’t now, it may in the future.
In Cureality, we educate Members on how to recognize thyroid dysfunction, how to craft a nutritional approach to maximize your potential for correcting it, and when thyroid replacement is necessary and when you need to take action to improve on what your healthcare provider tell you (it’s often woefully incomplete). We show you why and how ideal thyroid function empowers you in taking back control over health in so many other ways.
Click on any of the Cureality Thyroid Health Lessons on the left to learn more, earn certifications, and increase your standing in the Cureality Community.
CLICK HERE to learn more about all the Cureality Health Tracks
Thyroid Health Basics Lesson and Certification
Lesson Goal
To introduce and familiarize Members with the fundamentals of the Cureality Thyroid Health and earn the Cureality Thyroid Health Basics Proficiency Award.
Learn the Essentials
Decoding Thyroid Health
Marginal thyroid dysfunction is common and can be an important contributor to a multitude of health effects, such as increased LDL cholesterol, increased body weight/failure to lose weight, hypertension, high blood sugar, low energy and depression. Correction of even subtle degrees of thyroid dysfunction can help you regain full control over health. It also can make you feel happier, more energetic, and thinner.
The thyroid gland modulates metabolic rate, fine-tunes the function of virtually every tissue from lowly cells at the base of the fingers making fingernails, to the neurons in your brain guiding memory and thought, to the cells lining your arteries.
Hypothyroidism, or deficiency of active thyroid hormones, can wreak devastating effects on health. It’s been known for decades that, when severe, signs of hypothyroidism are obvious and even heart failure and death can develop. More recently, it has come to be recognized that even mild degrees of hypothyroidism can also contribute to poor health. Mild hypothyroidism is also proving to be far more common than previously suspected. Because it is less dramatic, it can go undetected for years. Subtle degrees of hypothyroidism can also be trickier to diagnose. Add to this the debate among the medical community over the boundary between “normal” and abnormally “low” thyroid function, not to mention the widespread tendency to treat only laboratory values while ignoring the patient, and many people endure varying degrees of hypothyroidism for many years that can culminate in substantial health problems.
It is Cureality’s mission to help identify every possible advantage for regaining control over health easily, simply, safely, and effectively. To that end, normal, no, perfect, thyroid function may be key.
Cureality Basics for Gaining Control over Thyroid Health - Recognize that any level of hypothyroidism, regardless of how mild, impacts health, including increased heart disease risk and impaired potential for weight loss.
- Follow the Cureality Diet that can help reduce thyroid inflammation; use the Cureality Kitchen recipes
- Assess thyroid status with free T3, free T4, TSH, reverse T3. Ideal TSH levels is 1.4 mIU/L or less.
- Consider assessing oral temperature immediately upon arising to assess whether temperature falls below 97.3º F.
- Synthetic T4 (i.e., levothyroxine, Synthroid) only to treat hypothyroidism is usually not optimal treatment. Natural hormone therapy (e.g., Armour Thyroid, Naturethroid) that provides T3 replacement along with T4 is more effective for most people with hypothyroidism. Lower levels of T3 and/or less than optimal symptom relief on T4 alone may suggest potential for benefit by adding T3 (liiothyronine) or converting to a preparation like Armour Thyroid.
- Correction of mild hypothyroidism can facilitate weight loss or break a weight “plateau,” improve mood, reverse hypothyroid phenomena like thinning hair and constipation; from a heart health viewpoint, it can reduce LDL, triglycerides, Lp(a), and homocysteine, and may help normalize endothelial function. It also facilitates atherosclerotic plaque regression.
Before we get to how to gain control over thyroid health, let’s first talk more about in what forms thyroid dysfunction occurs and why it develops.
The thyroid gland: A primer
The thyroid is a three inch-wide, butterfly-shaped gland located in the front of the neck. Though bridging across the trachea (airway) and located just beneath the surface of the skin, you should not be able to feel a normal thyroid. Enlarged thyroids can be felt, however.
The thyroid gland produces hormones that regulate body metabolism:
T4 (thyroxine): T4 accounts for 80% of the hormones produced by the thyroid gland. T4 is converted to the physically active hormone, T3, via the action of deiodinase enzymes in body tissues that remove one iodine atom. T4, with an elimination half-life of about 7 days (i.e., 7 days to drop to half its level), acts as a “reservoir” for supplying the much shorter-lived T3 to the body.
T3 (triiodothyronine): T3 is the truly active thyroid hormone that controls metabolic rate at the cellular level by mediating the rate of oxygen consumption of virtually every tissue in the body. The thyroid produces only small amounts of T3 directly (15-20% of bodily requirements), relying mostly on conversion of T4 to T3 in various organs, mostly the liver and kidney. T3 is a particularly powerful hormone, such that the body requires only picogram (trillionths of a gram) quantities per deciliter of blood to function properly.
The conversion of T4 to T3 can go awry: the deiodination process also creates what is known as “reverse” T3 (rT3), structurally similar to T3 except for the location at which T4 loses an iodine atom. rT3 is indistinguishable from T3 on most diagnostic tests. rT3 also binds to the same tissue receptor sites as T3 but is inactive and therefore blocks the action of “real” T3. It is thought that the body regulates T3 and rT3 production as a means of increasing and decreasing metabolism in response to conditions such as sickness, stress, and scarcity of food. (A controversial condition known as Wilson’s Syndrome, in which a disproportionate amount of rT3 is produced due to overproduction of cortisol by the adrenal glands during excessive stress, is currently being debated as the cause of certain forms of hypothyroidism.)
T2 (diiodothyronine), T1 (monoiodothyronine): The thyroid produces only trace amounts of T2 and T1 with additional production occurring from the further activity of deiodinase enzymes on T3. Little is known about the effects or purpose of T2 and T1. Recent research suggests they may be necessary for conditions in which rapid energy utilization is required, such as cold exposure or overfeeding and may also be involved in reducing weight via regulating effects on fat storage.
The thyroid gland is under the control of the pituitary gland (deep within the brain). The pituitary produces thyroid-stimulating hormone, TSH, to stimulate thyroid production of thyroid hormones, T4 and T3. If tissue levels of T4 and T3 are low, the pituitary responds by increasing TSH. The TSH level is therefore the mostly commonly used clinical blood test used to diagnose hypothyroidism.
After release into the blood, T3 and T4 are transported through the body by attaching to the blood protein, thyroxine-binding globulin (TBG). T3 and T4 are only active when disassociated from TBG and in their “free” form. Reflecting their impressive potency, less than 1% of all T3 and T4 are present in their free state, but it is the “free” form, the biologically active form, that we are most interested in.
Thyroid disease basics
Disorders of the thyroid can be broken down into two general categories: hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Hypothyroidism is far more common and more insidious, often evading diagnosis for years. Hyperthyroidism, while important, is less common and carries less implication for our efforts and will therefore not be the focus of our discussion.
Hypothyroidism is a condition in which the thyroid produces inadequate amounts of thyroid hormones, T4 and T3. Hypothyroidism usually shows itself through one or more signs and symptoms including: - Reduced energy, fatigue, need for more sleep
- Inappropriate feelings of being cold when other people feel warm, reduced or absent sweating
- Dry, itchy skin
- Dry, brittle hair; hair loss or thinning
- Difficulty losing weight
- Short-term memory impairment, slowed thinking
- Feelings of pins and needles in the hands and feet (paresthesias)
- New constipation
- Puffiness around eyes, hands, ankles, and feet due to fluid retention
- Carpal tunnel syndrome
- Heavier and/or more frequent menstrual periods, worse cramps, worse premenstrual symptoms
- Depression, sadness or indifference
- Goiter (swelling in the front of the neck, caused by enlargement of the thyroid)
- Abnormally slow heart rate
- Higher diastolic blood pressure (bottom value)
- Iron deficiency anemia, low ferritin (an iron storage protein)
Diagnosing hypothyroidism by symptoms alone can be difficult, as symptoms are not specific to hypothyroidism or may be vague. Blood levels of thyroid hormones, free T3 and T4, along with TSH, are therefore used to confirm the diagnosis.
Diagnosis can be especially troublesome in lesser degrees of underactive thyroid function. The frequency of hypothyroidism increases with age and, though estimates vary due to differing cut-points for TSH, most estimates cite a range of 2-4% early in life to as high as 15-20% later in life, with greater prevalence in females. However, with more strict criteria, the percentage of people with more subtle degrees of hypothyroidism is likely 25-30%, not uncommon at all.
TSH remains the primary method of confirming that symptoms may be attributable to hypothyroidism. Unfortunately, there is extensive disagreement about what constitutes a “normal” TSH level. The standard (though disputed) TSH ranges (in mIU/L) from the American Thyroid Association are listed below. (These are not followed in Cureality.) - 0.0 - 0.4 Hyperthyroidism
- 0.4 - 2.5 Normal Range
- 2.5 - 4.0 At Risk (repeat TSH test at least once a year)
- 4.0 - 10.0 Sub-clinical (mild) hypothyroidism
- Above 10.0 Hypothyroidism
Other commonly used laboratory tests to gauge thyroid function include:
Free T4 (fT4) and free T3 (fT3): The preferred tests that measure T4 and T3 unbound to protein and therefore active, excluding the 99% of hormone bound to proteins. Reference ranges for free T4 and T3 are supplied by the test lab. As with TSH, what is “normal” for the standard population may not be normal for every individual and there can be considerable differences in the T4 or T3 levels ideal for each person.
There are a number of other thyroid tests, such as T4 uptake and T3 uptake, that have been replaced by direct measurement of free T4 and free T3 and should therefore not be used.
Thyroid inflammation can be responsible for both hypo- and hyperthyroidism and can be identified by antibodies against thyroid components:
Thyroid Peroxidase Antibody (TPO Ab)
Thyroid peroxidase (TPO) is a thyroid enzyme responsible for manufacturing thyroid hormones. A common autoimmune condition results in the body attacking the TPO enzyme. Approximately 90% of sufferers of the inflammatory thyroid disorder, Hashimoto’s thyroiditis, will test positive for elevated TPO antibodies (Carlé 2006).
Thyroglobulin Antibody (TG Ab)
Approximately 60% of Hashimoto’s thyroiditis sufferers will test positive for elevated thyroglobulin antibodies. Testing positive for both TPO and TG antibodies increases the likelihood of Hashimoto’s thyroiditis to 95%. |
