I Take Thyroid Meds But I Still Feel 'Off'

            Anywhere from 10-12 million people in the United States have either been diagnosed with hypothyroidism or have an underactive thyroid.  Most are taking some type of synthetic thyroid medication yet around 15 percent still experience the symptoms that took them to the doctor's office in the first place.  One reason for this may be that a synthetic thyroid hormone only contains T4 which the body has to convert to an active T3 which is the powerhouse of energy metabolism.  

            Medical doctors order a blood test that measures the thyroid stimulating hormone (TSH) which is produced in the pituitary gland.  A TSH test reports how strongly the pituitary gland is pumping out the hormone, but it fails to report whether the T4 is actually be converted to active T3.  If there is no T4 conversion there is no energy production.  There are blood tests that delve deeper into what is really going on with your thyroid hormone production.  Ask your doctor to include a T4, Free T4, T3, Free T3, and Reverse T3 along with the standard TSH test.  Unfortunately, you might have to ask for a referral to an Endocrinologist to find a medical doctor that knows how what those test results mean.  If you are unable to find a medical doctor that is unwilling to run those tests, seek out a naturopathic doctor in your area.   

            It is important for you to know that both stress and thyroid hormones are produced through the hypothalamus – pituitary – adrenal (HPA) axis.  During times of stress, the hypothalamus (in the brain) releases the corticotropin releasing hormone (CRH).  Next the release of the CRH prompts the pituitary gland (at the base of the brain) to release the adrenocorticotropin hormone (ACTH).  And finally, the ACTH controls how much cortisol (stress hormone) the adrenal glands release. 

            When the HPA Axis is activated during stressful times the release of cortisol causes a negative feedback loop slowing down the hypothalamus and pituitary glands, so no more stress hormones are released.  Since both of these glands govern the production of thyroid hormone, it slows that down too.  At the same time, the stress response causes the release of cytokines (inflammatory immune cells) which make the receptors the thyroid hormones attach to less receptive.  That means that even though you may be taking thyroid medication, and your thyroid levels appear normal, you may still have an underactive thyroid. 

            There are other things that can interfere with thyroid hormone production, besides stress.  In order for the thyroid gland to work properly, it needs Adenosine Triphosphate, commonly referred to as ATP.  Most people remember hearing a little about ATP in their middle or high school biology class.  In short, ATP is the energy produced in our cells.  Without ATP, the HPA Axis is unable to produce the precursors to the thyroid hormone.  To give your body the best chance of producing the ATP it needs, you need to be eating healthy, organic foods.  If you are unable to get the nutrients your body needs from the foods you eat, you may need to look into supplementing specific nutrients – but that's a blog for another day. 

In the meantime, eat well, while avoiding raw cruciferous vegetables, which contain goitrogens that can block the production of T4 and cause the formation of Reverse T3.  Your cells are unable to use Reverse T3 for energy production causing everything to slow down.  You might be asking yourself, what exactly are cruciferous vegetables?  This category of vegetables includes but is not limited to arugula, bok choy, broccoli, cauliflower, cabbage, radishes, turnips, brussel sprouts, kale, and collard greens.  I know what you're saying to yourself because I said it too.  You're wondering why your doctor never told you to avoid these raw vegetables.  Well, sadly, it is probably because they were never taught this information in medical school.  The positive take away to this is that you can eat these vegetables as long as you cook them.  Cooking inactivates the goitrogens.  Consider adding relaxing activities like yoga or meditation to help lower the stress in your life.  Consider adding specific herbs which can help support the body during time of stress.  Eleuthero (Eleutherococcus senticosus) is one of those herbs.  It is an adaptogenic herb that helps control the amount of cortisol released by the adrenal glands.  Eleuthero has an affinity for the adrenal medulla, which is the inner most part of the adrenal gland.  It makes sense that supplementing with eleuthero would be able to help the adrenal glands recover quicker during stressful times, and, therefore, create a shorter negative effect on the thyroid hormone production process. 

Keep in mind – the more you know the better off you are when you talk to your doctor about how you are feeling.  You deserve a doctor that listens to you and is willing to work with you on your journey to wellness.        

References

Cain, N. (2019). 4 Herbs to Combat Adrenal Fatigue.  Retrieved from the website of Dr. Nicole Cain, M.D. at https://drnicolecain.com/4-herbs-to-combat-adrenal-fatigue/

Fidler, M. (2017). History and Benefits of Eleuthero.  Retrieved from the Integrative Therapeutics website at https://www.integrativepro.com/articles/history-and-benefits-of-eleuthero

Hoffman, D. (2003). The Adrenal Glands: Herbs to support the adrenal medulla. Herbs to support the adrenal cortex.  Medical Herbalism: The science principles and practices of herbal medicine. Pg.455-456. Healing Arts Press. Rochester, VT.

Hoffman, R. (2016). The Ugly Truth Emerges About Synthetic Thyroid Medication.  Retrieved from the website of Dr. Ronald Hoffman (Intelligent Medicine) at https://drhoffman.com/article/the-ugly-truth-emerges-about-synthetic-thyroid-medication/

Honda, M. (2018). The Thyroid Gland. Reverse Thyroid Disease Naturally: Alternative treatments for hyperthyroidism, hypothyroidism, Hashimoto's disease, Grave's disease, thyroid cancer, goiters, fatigue, and more… Ch. 1.  Hatherleigh Press. United States.

Myers, A. (2022).  The Adrenal-Thyroid Connection.  Retrieved from the website of Dr. Amy Myers, M.D. at https://www.amymyersmd.com/article/adrenal-thyroid-connection/

Pederson, M. (2010). Siberian Ginseng root (Eleutherococcus senticosus). Nutritional Herbology – A reference guide to herbs - pg. 158-159.  Whitman Publications. Warsaw, IN