January is Thyroid Awareness Month and, since we focus on hormonal health, we think there is a lot to be aware of when it comes to your thyroid! Here’s a little background:
Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It is one of your endocrine glands, which make hormones. Thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities are your body's metabolism, so your thyroid is kind of like the body's thermostat.
If you tend to run cold and have a sluggish metabolism, your thyroid may be on the under-active side. If you tend to run warm, flush easily and have a high metabolism, your thyroid could be overactive.
For people with female hormones, the most common thyroid condition is Hypothyroidism, or under-active thyroid function where the thyroid gland doesn’t produce or release enough thyroid hormone. While hypothyroidism affects approximately 1 in 300 people in the US, it is thought to be under-diagnosed and expected that 13 million Americans have hypothyroidism without realizing it (Gaitonde et al., 2012).
Common symptoms of an under-active thyroid gland include
fatigue
weight gain
feeling cold
constipation
dry, coarse skin & hair.
Hashimoto’s Thyroiditis
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune condition where the immune system produces antibodies which attack the thyroid gland. This autoimmune attack damages the thyroid and makes it less able to produce and release thyroid hormone. Blood tests showing the presence of thyroid peroxidase (TPO) antibodies and elevated Thyroid Stimulating Hormone (TSH) are indicative of Hashimoto's. Although it may seem counterintuitive for TSH to be elevated, when the thyroid is under-active the brain signals the body to produce more TSH, in hopes of stimulating the release of additional thyroid hormone.
Standard treatment for Hashimoto’s thyroiditis is levothyroxine medication, which supplements the body with synthetic T4 thyroid hormone. T4 is a precursor hormone to T3, also referred to as active thyroid hormone. In order for our cells to use thyroid hormone, T4 must first be converted to T3.
Beyond TSH: The Importance of a Full Thyroid Panel
While thyroid testing looks at TSH levels as a first step to a hypothyroid diagnosis, this marker alone does not show how efficiently T4 is converted to T3. To assess this, T4 should be measured in conjunction with T3 uptake. These markers together provide more information about the conversion of T4 to T3, an important mechanism involved in hypothyroid.
There are a few other important thyroid tests that should be part of a comprehensive thyroid blood panel. Tests for Thyroid Peroxidase antibodies (TPO) and/or Thyroglobulin antibodies are needed to determine if someone’s hypothyroid symptoms are caused by the autoimmune disease Hashimoto’s Thyroiditis.
If you think you may have hypothyroid symptoms, ask your doctor for a complete thyroid panel that includes these other tests.
What can I do if I have hypothyroid or Hashimoto’s thyroiditis?
In addition to medication, certain supplements may be helpful. T4 to T3 conversion can be aided with certain supplements such as Selenium and Zinc.
Selenium is an essential trace element found naturally in some foods, including Brazil nuts, fish, ham, pork, beef, turkey, chicken, eggs, brown rice, mushrooms, spinach, lentils, cashews, and bananas. Selenium has several antioxidant properties and has been shown to reduce systemic inflammation in the body and aid in immune function. Additionally, it is important for thyroid function and hormone synthesis. In fact, the highest concentration of selenium in the body is in the thyroid.
Selenium works with iodine to activate three selenium-dependent iodothyronine deiodinases, which can then activate or deactivate thyroid hormones. Those with a selenium deficiency are more likely to develop hypothyroidism, Hashimoto’s, an enlarged thyroid (goiter), thyroid cancer, and Graves’ disease.
Because selenium is a micronutrient, it is possible to acquire high enough concentrations through foods, such as those listed above.
Zinc is another trace element essential for development, growth, and a healthy immune system. It has also been shown to benefit the reproductive and nervous systems. Zinc is needed for the synthesis of thyroid hormones and helps produce T3, T4, and TSH. At the same time, we need thyroid hormones for Zinc to be absorbed. As a result, a deficiency in Zinc can contribute to hypothyroidism and supplementation of Zinc can be an important complement to thyroid medication.
In an RCT of 68 women with hypothyroid, Zinc supplementation, either alone or in combination with Selenium was found to improve thyroid function in female hypothyroid patients (Mahmoodianfard et al., 2015). Zinc alone was found to improve the ratio of free T3 to free T4. Free T3 and T4 refers to the amount of T3 and T4 which are available in the body. This improved ratio suggests better conversion of T4 to T3. The combination of Zinc and Selenium supplementation together significantly increased levels of free T3 and free T4, and lowered TSH levels in the body.
Acupuncture For Hypothyroid:
At Six Branches Family Acupuncture, we offer acupuncture and Chinese herbal medicine to support thyroid health. Acupuncture can be helpful at supporting patients experiencing various systemic symptoms of hypothyroid, and has also been shown to help balance hormones directly.
In a case series of acupuncture and fire cupping treatment for patients with hypothyroid, acupuncture twice per week for three months, was shown to be helpful at lowering TSH to normal levels and reducing the needed dosage of levothyroxine (Nair & Jyothi, 2021). In addition to hormone level regulation, patients had a significant improvement in fatigue, hair loss, and feelings of cold feet. The results of this study were sustained three months after the conclusion of acupuncture treatment.
Something often used in combination with acupuncture treatment is moxibustion, or moxa. Moxa is made of the herb Mugwort and used to warm acupuncture points or areas of the body. Those with hypothyroid often benefit from the warming nature of moxa treatment, which for many may enhance the effects of acupuncture alone. In a study of patients with Hashimoto’s thyroiditis, moxa therapy in combination with levothyroxine medication was compared to levothyroxine alone (Xia et al., 2012). Results of the study showed that those who received moxa in combination with medication had significantly lower TSH than the medication alone group. Free T3 and free T4 also increased significantly in both groups. This study provides encouraging data that moxa can be supportive for those with Hashimoto’s in conjunction with conventional treatment.
References:
Gaitonde, D. Y. (2012). Hypothyroidism: an update. South African Family Practice, 54(5), 384-390.
Mahmoodianfard, S., Vafa, M., Golgiri, F., Khoshniat, M., Gohari, M., Solati, Z., & Djalali, M. (2015). Effects of zinc and selenium supplementation on thyroid function in overweight and obese hypothyroid female patients: a randomized double-blind controlled trial. Journal of the American College of Nutrition, 34(5), 391-399.
Nair, P. M., & Jyothi, N. (2021). Role of Acupuncture and Fire Cupping in Reducing the Thyroxine Dose and Improving the Thyroid Function in Hypothyroidism Patients: A Case Series. Journal of Acupuncture and Meridian Studies, 14(5), 200-205.
Xia, Y., Xia, M. Z., Li, Y., Liu, S. M., Ju, Z. Y., & He, J. S. (2012). Effect of aconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) on thyroid function in patients of Hashimoto's thyroiditis. Zhongguo zhen jiu= Chinese acupuncture & moxibustion, 32(2), 123-126.