Is My Thyroid Out of Balance? Hypothyroidism and Naturopathic Care

Low energy, brain fog, unexplained weight gain, trouble sleeping – do you have some or all of these symptoms? Have you done blood work and your thyroid and other test results are considered normal?

Or are you on thyroid medication already, but you are still not feeling your best?

If so, you might have to investigate your thyroid even further. Your thyroid might also related to the following: 

• Waking up groggy and unrefreshed, 
• Not being able to function without having that second cup of coffee, 
• Crashing when you come home in the evenings in front of the TV
• Feeling disappointed in not having the energy to care for yourself

Fatigue is one of the most common concerns I see in my practice and I often hear variations of this statement: 

“I am always exhausted, I wake up exhausted. I don’t have the kind of energy I used to. I have been exhausted  for a long time.”
Even if fatigue is not the initial reason for a visit, it often comes up as an area that people want to work on.

I realize how incredibly frustrating fatigue can be, especially in that it can hold people back from being fully engaged and present in their lives. If someone comes into my practice experiencing these symptoms, I will likely assess for hypothyroidism.

What Is Hypothyroidism?

The thyroid is a gland and it’s part of the endocrine system – the system that communicates throughout the body via hormones (chemical messengers). Your thyroid can be under-functioning or over-functioning – so it can produce an excess or deficiency of thyroid hormones. With hypothyroidism, you are not producing enough thyroid hormones, and this can lead to some or all of the following symptoms:  

Common hypothyroidism symptoms include:

• Fatigue 
• Difficulty waking in the mornings
• Unrefreshing sleep
• Feeling cold
• Cold hands and feet
• Brain fog (Difficulty concentrating)
• Skin changes
• Hair thinning (coarse or dry) 
• Drop in sex drive
• Difficulty with memory

• Digestive issues (typically constipation but can also be diarrhea or loose stools)
• Low mood or depression
• Anxiety and/or difficulty managing stress
• Blood pressure and cholesterol changes
• Aches and pains 
• Restless leg syndrome 
• Menstrual cycle irregularities

The incidence and prevalence of hypothyroidism has been on the rise since the 1950s._¹ This number continues to rise, with 4% to 10% of the general population in the Global North having subclinical hypothyroidism  and 2% to 6% seeing this develop into overt hypothyroidism. ²

How Do You Diagnose Hypothyroidism?

Hypothyroidism is diagnosed with a blood test. In my practice, I run a full thyroid panel including the following tests: TSH, Free T3, Free T4, reverse T3, anti-thyroglobulin and anti-TPO. This comprehensive panel allows me to see what pattern of imbalance is causing the hypothyroidism and can therefore guide our treatment, including a short-term and longer-term plan. Some of the questions this panel answers are:

• Is your thyroid out of balance? 
• If so, is your thyroid underactive or overactive?
• If underactive, what is the potential cause? 
• Is this a case of subclinical hypothyroidism or overt hypothyroidism?
• Is this a pattern of autoimmunity?
• Is this a pattern of nutrient imbalance(s)?

Causes of Hypothyroidism

Similar to other conditions, hypothyroidism can be multifactorial, so these causes may be all tied together. The most common causes of hypothyroidism are: 

• an autoimmune condition (Hashimoto’s Thyroiditis) 
• environmental toxins
• low nutrient status 
• excess stress 
• imbalance in the digestive system 

A thorough evaluation of symptoms and testing is important in identifying the cause(s) of hypothyroidism.

Treatment Options

The conventional treatment (what you will likely be prescribed by your primary care provider or endocrinologist) is levothyroxine. Levothyroxine (trade name Synthroid) is the thyroid hormone T4. With some patients, levothyroxine will be enough to resolve symptoms. With others, additional or alternative support is needed. 

When it comes to treating thyroid disorders from a naturopathic approach, it’s important to know which imbalance we are working with before initiating treatment. 

• Is there an autoimmune piece?
• Are there nutrient imbalances?
• Do we need to address digestion?
• Is there enough thyroid hormone being made?
• Is there enough thyroid hormone being converted?

When we have answers to these questions, a combination of diet, supplementation and herbs have been shown to benefit thyroid function. For instance, for hypothyroidism, diets low in gluten³ and dairy⁴ can help to decrease inflammation and balance immunity. Assessing and treating the gut for microbial imbalances like Small Intestinal Bacterial Overgrowth (SIBO) can also help lessen the autoimmune response of Hashimoto’s.⁵ Additionally minerals like selenium⁶ and zinc⁷, adaptogens like ashwagandha⁸, and herbs such as guggal⁹ have also been shown to improve thyroid function. 

To learn more about thyroid imbalance, check out this free recorded webinar on thyroid health by Dr. Tania Tabar, ND and Download a Free Handout at this link here.

Want to learn more about your own health?

Consult with a naturopathic doctor to learn more about your own personal case. A naturopathic doctor can requisition necessary blood work including a full thyroid panel as see above, and guide you in creating a treatment plan.

---

1. McLeod, Donald SA, and David S. Cooper. “The incidence and prevalence of thyroid autoimmunity.” Endocrine 42, no. 2 (2012): 252-265. https://doi.org/10.1007/s12020-012-9703-2.
2. Allan, G. Michael, Michelle P. Morros, and Jennifer Young. “Subclinical Hypothyroidism and TSH Screening.” The College of Family Physicians of Canada. The College of Family Physicians of Canada, March 1, 2020. https://www.cfp.ca/content/66/3/188.
3. Krysiak, Robert, Witold Szkróbka, and Bogusław Okopień. “The effect of gluten-free diet on thyroid autoimmunity in drug-naïve women with Hashimoto’s thyroiditis: a pilot study.” Experimental and Clinical Endocrinology & Diabetes 127, no. 07 (2019): 417-422. https://pubmed.ncbi.nlm.nih.gov/30060266/
4. Asik, Mehmet, Fahri Gunes, Emine Binnetoglu, Mustafa Eroglu, Neslihan Bozkurt, Hacer Sen, Erdem Akbal, Coskun Bakar, Yavuz Beyazit, and Kubilay Ukinc. “Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance.” Endocrine 46, no. 2 (2014): 279-284. https://pubmed.ncbi.nlm.nih.gov/24078411/
5. Fasano, Alessio. “Leaky gut and autoimmune diseases.” Clinical reviews in allergy & immunology 42, no. 1 (2012): 71-78. https://pubmed.ncbi.nlm.nih.gov/22109896/
6. Ventura, Mara, Miguel Melo, and Francisco Carrilho. “Selenium and thyroid disease: from pathophysiology to treatment.” International journal of endocrinology 2017 (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307254/
7. Maxwell, Christy, and Stella Lucia Volpe. “Effect of zinc supplementation on thyroid hormone function.” Annals of Nutrition and Metabolism 51, no. 2 (2007): 188-194. https://pubmed.ncbi.nlm.nih.gov/17541266/
8. Gannon, Jessica M., Paige E. Forrest, and KN Roy Chengappa. “Subtle changes in thyroid indices during a placebo-controlled study of an extract of Withania somnifera in persons with bipolar disorder.” Journal of Ayurveda and integrative medicine 5, no. 4 (2014): 241. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296437/
9.  Panda, Sunanda, and Anand Kar. “Guggulu (Commiphora mukul) potentially ameliorates hypothyroidism in female mice.” Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives 19, no. 1 (2005): 78-80. https://pubmed.ncbi.nlm.nih.gov/15798994/