*In the years prior to the discovery of peripheral T4-to-T3 conversion, most groups recommended treatment with natural thyroid preparations, such as desiccated thyroid, thyroid extract, or thyroglobulin, which contain both T4 and T3. However with the discovery of T4-to-T3 conversion and the development of the radioimmunoassay for TSH in the early 1 970s, not only was there a trend toward l-thyroxine monotherapy, but the recommended daily maintenance doses decreased significantly. These trends led to the adoption of the contemporary standard of care: l-thyroxine monotherapy administered at doses to maintain a normal serum TSH level.
Thyroid hormone replacement has been used for more than a century to treat hypothyroidism. Natural thyroid preparations (thyroid extract, desiccated thyroid, or thyroglobulin), which contain both thyroxine (T4) and triiodothyronine (T3), were the first pharmacologic treatments available and dominated the market for the better part of the 20th century. Dosages were adjusted to resolve symptoms and to normalize the basal metabolic rate and/or serum protein-bound iodine level, but thyrotoxic adverse effects were not uncommon. Two major developments in the 1970s led to a transition in clinical practice: 1) The development of the serum thyroid-stimulating hormone (TSH) radioimmunoassay led to the discovery that many patients were overtreated, resulting in a dramatic reduction in thyroid hormone replacement dosage, and 2) the identification of peripheral deiodinase-mediated T4-to-T3 conversion provided a physiologic means to justify l-thyroxine monotherapy, obviating concerns about inconsistencies with desiccated thyroid. Thereafter, l-thyroxine mono-therapy at doses to normalize the serum TSH became the standard of care. Since then, a subgroup of thyroid hormone–treated patients with residual symptoms of hypothyroidism despite normalization of the serum TSH has been identified. This has brought into question the inability of l-thyroxine monotherapy to universally normalize serum T3 levels. New research suggests mechanisms for the inadequacies of l-thyroxine monotherapy and highlights the possible role for personalized medicine based on deiodinase polymorphisms. Understanding the historical events that affected clinical practice trends provides invaluable insight into formulation of an approach to help all patients achieve clinical and biochemical euthyroidism.
“Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure. Sources of increased iodine exposure include the global public health efforts of iodine supplementation, the escalating use of iodinated contrast radiologic studies, amiodarone administration in vulnerable patients [amiodarone is a drug used to treat heart rhythm problems], excess seaweed consumption, and various miscellaneous sources.” [Leung]
“The effects of fluoride on various aspects of endocrine function should be examined, particularly with respect to a possible role in the development of several diseases or mental states in the United States. Major areas of investigation include . . . thyroid disease (especially in light of decreasing iodine intake by the U.S. population).” (National Research Council, 2006)
Thyroid surgery - Thyroid surgery may be performed if a patient is experiencing hyperthyroidism, goiters, thyroid nodules, or thyroid cancer. Thyroid surgery involves removing either all of the thyroid or a large portion of the thyroid gland, both of which diminish and/or halt thyroid hormone production. In this case, hypothyroidism will be a lifelong condition and the patient will need to take a supplemental thyroid hormone for the rest of their life.
18) Use Essential Oils: The anti-oxidant content and aromatherapy benefits of essential oils help to improve oxygenation and reduce the harmful effects of oxidative stress throughout the body. Some of my favorites for thyroid function include lavendar, frankincense and peppermint among others. Put a drop on your hands and mix together and then cover your nose and inhale the healing vapors. This will stimulate your brain and increase blood flow to your cranium. You can also rub them on the skin around your neck and thyroid region to reduce inflammation.
If you have signs or symptoms the same or similar to hypothyroidism, discuss them (for example, weight gain, constipation, or fatigue) with your doctor or other healthcare professional. A simple blood test is the first step in the diagnosis. If you need treatment for hypothyroidism, let your doctor know of any concerns or questions you have about the available treatment, including home or natural remedies.
Exercise: Many patients with hypothyroidism have reported benefits from practicing a yoga pose called the Shoulder Stand, or sarvangasana, which increases circulation to the thyroid. Lie on your back with your arms (palms up) along your sides. Raise your legs at a right angle to the floor. Then raise your hips so your chin rests on your chest, supporting yourself with your elbows and upper arms on the floor and your hands on your hips. Keep your neck and shoulders flat on the floor, and stretch your torso and legs as straight as possible. Hold as long as comfortable, slowly working up to 5 minutes a day. Don’t do this pose if you are pregnant or menstruating, nor should you try it if you have glaucoma, sinus problems or high blood pressure. The Shoulder Stand may be more effective if you use visualization practices, imagining the thyroid gland waking up from a long period of inactivity and producing more thyroid hormone.
Unless a food is fortified with iodine, the Food and Drug Administration doesn't require manufacturers to list it on their products. That's just one of the reasons why it's hard to know how much of this nutrient is in certain foods, says Ilic. But as a general rule, shellfish like lobster and shrimp are good sources of iodine, she says. In fact, just 3 ounces of shrimp (about 4 or 5 pieces) contains more than 20% of your recommended intake. Bonus: shellfish can also be a good source of zinc, too. Three ounces of Alaskan crab and lobster contain 6.5 and 3.4 milligrams of zinc, respectively.
Goitrogen Foods – Eating large amounts of raw Brassica vegetables like broccoli, cauliflower, cabbage, kale, soy and Brussels sprouts might impact thyroid function because these contain goitrogens, molecules that impair thyroid perioxidase. When consuming these cruciferous vegetables, it’s best to steam them for 30 minutes before consuming to reduce the goitrogenic effect and keep portions moderate in size. These pose more of a risk for people with iodine deficiencies.
Alcohol consumption can wreak havoc on both thyroid hormone levels in the body and the ability of the thyroid to produce hormone. Alcohol appears to have a toxic effect on the thyroid gland and suppresses the ability of the body to use thyroid hormone. Ideally, people with hypothyroidism should cut out alcohol completely or drink in careful moderation.
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