There are several different ways that the thyroid gland can malfunction. The most prominent way is due to the autoimmune disease Hashimoto’s thyroiditis, which accounts for approximately 90 percent of cases of clinical hypothyroidism in the US.
An autoimmune disease is one in which the body’s immune system has gone into overdrive and accidentally started attacking its own cells as a result of poor gut barrier health. In Hashimoto’s thyroiditis, the thyroid gland is the victim.
You can find out for certain if you have Hashimoto’s (as opposed to other kinds of thyroid malfunction) only through getting blood work done. A quick explanation of thyroid function is helpful for understanding this blood work
First, your thyroid gland works only after it receives a “green light” signal for production by the pituitary gland, which comes in the form of Thyroid Stimulating Hormone (TSH). When TSH gets to the thyroid gland, the thyroid gland makes a molecule called T4. That’s not the end of it, though. T4 is not used by your body’s cells. T3 is. T4 is converted to T3 by the liver. T3 then goes on to be active in the body. It is responsible for delivering energy to all of your cells.
In Hashimoto’s thyroiditis, the body receives a TSH signal from the pituitary gland, but the thyroid gland struggles to produce T4. As a result, low T4 is the primary marker most doctors look for on a blood exam to signal Hashimoto’s thyroiditis. High TSH is also a potential indicator of Hashimoto’s, as TSH levels increase when the body tries to convince the weakened thyroid to make more T4. The final and most definitive test for Hashimoto’s thyroiditis is a test for the actual thyroid antibodies (TPO) themselves. When present in high quantities in the bloodstream, you know that your thyroid gland is being attacked.
The way to overcome Hashimoto’s thyroiditis is to heal the gut as well as possible. Do so using the recommendations made earlier: avoiding gut irritants such as grains, dairy, and even legumes, focusing on vitamin-rich foods like vegetables, organ meats, and egg yolks, consuming fermented foods or probiotic supplements on a regular basis.
Unfortunately, with Hashimoto’s, some or much of the thyroid gland is irreparably destroyed. If that is the case, you will likely need to go on some form of thyroid hormone supplementation to achieve optimal health.
While Hashimoto’s may be the most common form of hypothyroidism, it is not the only one. The other primary form of hypothyroidism that affects women is simple thyroid sluggishness. Many women struggle from this regardless of whether their blood thyroid hormone levels are clinically “low” or not. It is entirely possible to suffer from this problem and not test “officially low,” but close to it.
Regardless of whether you test “super low,” “low,” or simply “moderate,” nearly all women can benefit from optimizing thyroid function.
Thyroid production slows down in response to stress. This is what I have called thyroid “sluggishness” (and no, this is definitely not a medical term). This includes both physical and psychological kinds of stress. Physical stressors include undereating, a low-carbohydrate diet, excessive weight loss, over-exercise, or an inflammatory diet. Psychological stressors are all the usual pressures that come from adult life. In response to both types of stress, thyroid production shuts down in two primary ways. First, signals from the HPAT axis say, “Stop!” This “stop!” signal shows up on blood tests as lowered TSH production. With low TSH comes a lower T4 level, and often a lower T3 level as well.
The second way that stress impairs thyroid function is to throw a wrench in the link between T4 and T3 production. Stress causes the body to produce something called Reverse T3, which actually blocks T3 from working in your body. Therefore, a blood test that indicates this kind of hypothyroidism will show lower T3, elevated RT3, and possibly T4 and TSH on the low end as well.
The way to overcome “sluggishness” is to reduce stress, sleep more, eat when you are hungry and stop when you are full, and perhaps, most importantly, make sure you eat plenty of carbohydrates. The liver needs carbohydrate in order to convert T4 to T3. Be sure to eat at least 100 grams of dense carbohydrate every day (approximately four servings of fruit or starch) on a low-fat diet, and at least 25-50 grams (1-2 servings of fruit or starch) on a low-carb diet.