Thyroid problems affect millions of people in Canada, 90% of which are women. The thyroid gland is the body’s internal regulator of our metabolism. The active thyroid hormone T3 controls how quickly the body performs biological processes, burns calories and uses energy.
If the thyroid secretes too much hormone, hyperthyroidism results; whereas not enough thyroid hormone results in hypothyroidism. Hypothyroidism is far more common than hyperthyroidism.
Most cases of hypothyroidism are caused by Hashimoto’s – an autoimmune condition that gradually damages the thyroid gland.
Patients with any type of thyroid condition may present with enlarged thyroid glands (goitre) and/or thyroid nodules. However there are also many patients with confirmed thyroid conditions who don’t have visibly enlarged thyroid glands!
Thyroid symptoms can vary and not all individuals will present in the same way.
What are the symptoms of hypothyroidism?
Symptoms of Hyperthyroidism or Grave's
You’ll notice that these are generally the opposite of hypothyroidism!
Symptoms of Hashimoto's
Hashimoto’s may present more like hypothyroidism overall. Some patients with Hashimoto’s also experience periods with a combination of both hypothyroid and hyperthyroid symptoms.
Due to the autoimmunity, and depending on the level of damage to the thyroid gland, there can be irregular thyroid hormone production, or release of excessive hormone as the gland is damaged. Over time, most Hashimoto’s patients settle into a hypothyroid picture.
What Causes Thyroid Conditions?
Many factors can cause thyroid problems. Women are most susceptible, especially during times of hormonal stress, for instance during menopause and either during or after pregnancy. Any major hormonal shift can trigger a thyroid condition.
As previously mentioned, Hashimoto’s causes up to 90% of hypothyroidism in North America. The most common cause of hyperthyroidism is Grave’s Disease, another autoimmune condition.
Evidence now suggests that dysbiosis (an imbalance of the gut’s bacterial ecosystem), hormonal shifts, infections, stress and food sensitivities may contribute to autoimmune thyroid conditions, along with environmental toxins such as halogens, heavy metals, and endocrine disruptors.
Other factors that contribute to thyroid dysfunction include; low iron (anemia), viral infections causing subacute thyroiditis and excessively restrictive diets. Additionally, many individuals become hypothyroid as a result of surgical or chemical treatment of hyperthyroidism.
How We Diagnose Thyroid Conditions
Thyroid Blood Tests
Measuring ALL of the thyroid hormones in blood is crucial for each patient.
Our patients typically complete a comprehensive thyroid panel including:
TSH, free T3, free T4, Anti TPO, Anti TG, Reverse T3
Conventional clinics often test only for TSH and not the full panel of thyroid hormones. TSH is made by the pituitary gland and it tells the thyroid to make T4. The tissues of the body will then convert T4 into T3 as needed. The ability of the tissues to convert T4 into active T3 is variable and is lower in people with health conditions such as hormonal imbalance, stress, inflammation, insulin resistance and who are restricting calories. In these situations, T4 is converted into reverse T3, an inactive thyroid hormone, rather than into active T3.
We strongly believe that testing for TSH alone is not enough to give a complete picture of thyroid health in patients who are suffering with symptoms.
A common example we see is patients who have difficulty converting T4 to T3 and who feel unwell despite a “normal” TSH. These patients often have normal T4, low T3 and high reverse T3 despite a normal TSH. Reverse T3 is an inactive hormone that the body provide more clarity in patients who have difficult to treat or more complex thyroid issues.
The reference range for TSH is also controversial and we follow a tighter reference range to achieve the improvements in energy and health that the patient is seeking.
Thyroid antibodies (Anti TPO and Anti TG) are essential to know if the patient has an autoimmune thyroid condition such as Hashimoto’s.
Cortisol testing for Adrenal Function
The health of the adrenal glands may be assessed through urine, blood or saliva to determine the levels of cortisol in the body. These adrenal hormones influence thyroid function. Abnormal amounts or disruptions to the daily rhythm of the stress hormone cortisol may inhibit thyroid hormone function. The most accurate testing for adrenal function is through urine or saliva.
Testing for Iron, Vitamin B12, Vitamin D, Magnesium, Zinc, Inflammation, Insulin Resistance and more
Each patient is different and as a result we may suggest testing in specific areas. For example, women who are menstruating should have iron levels assessed. Patients who are vegetarian, or who are taking certain medications should have Vitamin B12 levels assessed. We look at each factor that’s relevant to healthy thyroid function and address them.
Dried Urine Iodine, Selenium and Bromine
For patients who want to go deeper, we offer testing for the main elements associated with thyroid function. Iodine deficiency is on the rise for two reasons: decreased intake of iodine, and increased intake of bromine. The Iodine Plus urine test can help determine whether you have sufficient iodine and whether excess bromine could be negatively impacting your iodine status. Iodine Plus also includes selenium and cadmium. Selenium is an essential element for thyroid function, and cadmium is known to interfere with the actions of selenium.
Natural Treatment for Thyroid including NDT
We focus on ensuring that your thyroid health is supported with a combination of nutrition, supplements, lifestyle suggestions and if needed, natural thyroid hormone replacement (NDT) by our prescribing NDs.
We also have a great deal of experience with patients who have been on T4 only medication (Synthroid) and are still not feeling well. We can offer support for thyroid hormone conversion and/or a prescription for NDT – a medication that contains BOTH T4 and the active form of thyroid hormone, T3. This can be a game-changer for many patients in this category, particularly if they struggle with low T3 levels.
When prescribing NDT we are precise and methodical in our approach as there is a “sweet spot” this medication which is often quite exact.
For patients with hyperthyroidism, we offer natural support that can reduce excessive levels of thyroid hormone, often allowing patients to recover normal thyroid function over time as the thyroid heals. Since many thyroid conditions are autoimmune in nature, we include immune-regulating elements in our protocols.
Our Doctors who are taking New Patients for Thyroid
The doctors listed below have all qualified for and received their prescribing license for NDT.
Dr Kelly Clinning
Dr Samina Mitha
Dr Fiona McCulloch
Articles on Thyroid
A recent study has given us interesting insights into how thyroid hormone test levels are
A recent study was done on women with Polycystic Ovarian Syndrome (PCOS) who also have
Recurrent pregnancy loss, or repeated miscarriages are devastating and challenging to treat. There are numerous causes so a full work-up should be completed to gain clarity into the underlying cause and treat appropriately. We present an evidence-based review of current information in this field of reproductive medicine.
An examination of the nutritional and hormonal causes of hair loss in women, along with natural treatments. Part 1 of a 2 part series.
T regulatory cells are one of the most important immune cells when it comes to keeping autoimmune disease at bay. They are involved in suppressing the immune response when it is finished its work. In conditions like Hashimoto’s and Grave’s, two autoimmune thyroid diseases, these cells are often not at their optimal levels.