Dealing with Hypothyroidism

The thyroid gland, located at the base of your neck, is the main metabolism gland in your body. If your thyroid gland is not working correctly, either through not getting the appropriate signals, or conversely not producing the right hormones, you will have a difficult time losing weight.  However, to say that the thyroid gland only impacts body composition would be a dramatic over-simplification. Why's that?? Well...

  • Every single cell in the human body has receptors for the major thyroid hormone(s) T3 and/or T4 and requires T3 signaling for optimal function.
  • Low thyroid hormone levels are associated with elevated triglycerides.
  • There’s a higher chance of mental retardation in kids whose moms had hypothyroidism during pregnancy.
  • Low thyroid hormone also can lead to poor digestive function and constipation.
  • Thyroid hormone influences other major hormones in female reproductive health, notably by making progesterone receptors more sensitive, meaning a woman with intense PMS symptoms every month, may actually be dealing with a thyroid issue.

The thyroid is also incredibly sensitive to external signals. It can be negatively impacted by a number of chemical compounds including fluoride, several heavy metals and other synthetic compounds, which is why many hypothesize that thyroid issues are on the rise due to increased exposure to these things in modern society. How prevalent is hypothyroidism? Well, it's estimated that nearly 10 million Americans, mostly women, are dealing with some dysfunction in their thyroid physiology.

At the most basic level, the function of the thyroid gland is to produce the hormones T3 and T4, which regulate gene transcription throughout the body. Basically, T3 makes every cell in your body work optimally when levels are appropriate. But... why have this regulated at all? Wouldn't you always want your cells running optimally???

Thyroid hormones are HIGHLY regulated during the transition from the fed to the starved state. This has been well-studied in some animal models where a drastic reduction in calories rapidly suppresses T4 and T3 levels.  This was also shown in humans in something called The Vermont Study as well as several others where carbohydrate consumption was implicated as being critical for optimal thyroid functionality. Why does the body suppress thyroid function in a "starved" state?? Caloric restriction at high levels represents a severe threat to survival and because thyroid hormones set the basal metabolic rate, a drop in thyroid hormone levels should reduce extend to use of energy stores (AKA body fat). Basically, this is an evolutionary survival mechanism from a time period where humans could go long periods of time without eating. 

Why is this a problem for you?  Well, when you try to diet yourself into a 6-pack through pretty extreme measures, your thyroid function is decreased in an attempt to basically keep you alive. Your basal metabolic rate drops, you stop moving around as much (non-exercise activity thermogensis, or NEAT, drops) and basically you are no longer in the calorie deficit you were a month ago when you started dieting in the first place.  So you push the calories even lower and lower, try to do more in the gym which causes increased stress, an altered immune state and next thing you know, your body is broken.  Now... this is the extreme case, but we see it happening more and more frequently. 

So, what are we going to do about it... well, its a good idea to figure out if we have a thyroid problem in the first place.

How do you know if you might have a thyroid issue?

The obvious answer is to go to the doctor and get tested, but there are a number of problems with taking that approach alone, notably that your lab values are going to be compared to a "standard" range of people. Note I did not say HEALTHY people, just the average amongst the population.  Do most of the people you encounter on a day-to-day basis look healthy???  Secondly, most physicians don't want to check anything beyond TSH, but to get a real good picture we need to look at T3 and T4, and T3 uptake at a minimum.

So, if we're going to take matters into our own hands, some symptoms to look out for would be

  • Consistent fatigue
  • Muscle weakness
  • Weight gain and difficulty losing weight
  • Dry skin and coarse, dry hair, and/or hair loss.
  • Cold, especially in extremities and fingers
  • Constipation
  • Depression
  • Menstrual cycle abnormalities
  • Low sex drive

OK, so don't go full hypochondriac on me and assume you have an issue with your thyroid if you occasionally have one or two of those symptoms.  But, if that list rings a little too close to home, its time to get some additional testing done.

Lets assume things are out of whack and you do have a thyroid issue, what can we do about it?  Sadly each case is really unique and you need someone that can help figure out which aspects of your life are really the cause.  Too much stress? Over-active immune system? Leaky gut? Vitamin and mineral imbalances? Liver issues? All could be at play.  With that in mind... we're going to present to you a case study of one client and how we helped move her in the right direction.

"Stress, vitamins and goitrogens, oh my!"

This client came to us after hitting a major plateau with weight loss. We made some adjustments, but she was still not seeing the kind of changes we would expect. At this point, we asked her to reach out to a doctor where it was discovered that she was having some issues with her thyroid as TSH was elevated.  

Looking at the big picture, our client was extremely active within the CrossFit community-working out, coaching, and was in general very health conscious. One of her biggest goals was to get her energy back, so she could train the way she wanted to in the gym, and to have enough energy to live the life she enjoyed. She wanted abs too, but at this point, those became a secondary focus - our primary goal was to get her healthy... and remember, abs don’t always mean your healthy.

The first thing we took into consideration was her diet history.  She had been at an extreme deficit for an extended period of time.  As we just went over, this can cause a ton of stress on the body, exacerbating an already out of control thyroid. So the first thing we did was to get her OUT of that calorie deficit to create a less stressful environment for her body to heal in. Generally speaking, asking someone to eat more to lose weight doesn’t go over to well, but luckily the client understood the purpose and agreed to our approach. We went to a higher carb/protein ratio in terms of macros and cut back on fats, as depending on their source, fats can cause excessive free radicals and extra stress on the body.  Additionally, we asked the client to really try and spread her protein out throughout the day to attempt to balance out blood sugar levels and improve satiety.

We next went about eliminating any extra stress or irritants that often times alter the thyroid and related hormones. We eliminated any foods that could be considered inflammatory (highly specific from client to client, but in general gluten and dairy are a good place to start). On top of that, we removed RAW cruciferous vegetables (broccoli/cauliflower/Brussel sprouts/kale/spinach). These types of veggies contain elevated levels of goitrogens;  Goitrogens can block the process by which iodine is incorporated in the key thyroid hormones thyroxine (T4) and triiodothyronine (T3). Fun fact, T3 has THREE iodine molecules and T4 has... you guessed it, FOUR.  Goitrogens, also inhibit the actual release of thyroid hormone by your thyroid gland, and disrupt the peripheral conversion of the thyroid storage hormone T4 into the active thyroid hormone T3.

Next was soy. Soy hides in a lot of products as a filler so we had to be mindful with this one. Soy has a significant amount of isoflavones and these compounds are often considered endocrine disruptors.  We definitely want to avoid those with a thyroid issue.  There's also some evidence that soy products can also disrupt the absorption of certain medications and supplements that we were going to be implementing. 

Next was coffee (GASP!!!). We wanted to limit coffee to a minimal amount for two reasons. First was to get an accurate gauge of the client's energy levels and how well she was responding to the plan.  Secondly, excessive caffeine can also interfere with the absorption of certain medications and supplements that were being incorporated.

We suggested trying to stick to sweet potatoes, squash, fruit, and COOKED vegetables as the as primary carb sources.  Cooking the veggies helps with the goitrogen issue above, and cooked vegetables are just easier to break down for the body.  As we mentioned, there are often digestive issues with hypothyroidism, so anything we can do to make digestion easier is a good idea.  We also made suggestions to focus on foods rich in Vitamin D (whole eggs, fish, mushrooms). Vitamin D play a crucial role in the production, conversion, and activation of the thyroid hormones. We also tried to increase the clients intake of iodine and selenium as well through the consumption of fish, seaweed, salted nuts (brazil nuts in particular are good for thyroid issues), and sunflower seeds. Iodine is a necessary component to hormone production/secretion in the thyroid. 

When it came to straight supplementation, we took a gentle approach as it was important to the client, and went with vitamin D and vitamin B12.  B12 is great for overall energy, thyroid/hormone health, and most people don’t get enough through diet. Not only can thyroid issues contribute to vitamin B12 deficiency, but ongoing vitamin B12 deficiency can lead to people being less likely to respond to treatment for their thyroid and interfere with getting relief from their symptoms.

Finally, we added the adaptogen ashwagandha. We suggested this versus some other options since it can be taken as a tea and the client was wary of adding another pill to her routine.  In this case we were looking for an adaptogen that would provide immune support and hormone health.  On top of encouraging your thyroid to produce more or less hormones depending on your needs, taking this herb also offers other benefits like appropriately regulated cortisol levels (stress hormone) and improved insulin sensitivity, both important for achieving body comp goals

We also made sleep and hydration a huge priority. With her decreased energy levels sleep was easy, so we had to try to work our way from needing naps to get through the day and getting good quality sleep at night. 8+ hours in a pitch black room was the goal. Getting in enough water does wonders for your body and allows it to carry out the daily function it needs to for survival and to operate at its prime.

The pictures below show how well her body responded to the changes we made, but what is so much more important is that she was able to get back to her normal workout routine, didn’t need naps on a regular basis, and was overall happier. These pictures are approximately 6 weeks apart and at the end of those 6 weeks her symptoms were pretty much resolved.

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The caveat with this is client is that whenever stress levels increased, symptoms would increase/pop back up.  Emotional stress is SO IMPORTANT in thyroid conditions and something that is often overlooked in clients.  You'd be surprised how many people with hypothyroidism had a traumatic incident in their past OR are dealing with a current stressful situation in their life such as a demanding job with 80 hour work weeks, a family illness, etc.  But that's another post entirely...

If you're looking for help with something similar reach out to us here.  We're always ready to help get you on the path to long term health.

Co written by M2 coachs Casey Mendrala and Mike Molloy