What is a Thyroid disorder? Your thyroid gland is responsible for many important functions such as energy production, growth and development, digestion, regulation of body temperature, breathing and reproduction. This butterfly-shaped gland is located just under your larynx and produces hormones T3 and T4 through extracting and absorbing iodine from our blood. This process is controlled by signals between the thyroid gland, pituitary gland and the brain.
Low levels of T3 and T4 circulating in the bloodstream signals the hypothalamus in the brain to release thyrotropin-releasing hormone (TRH), which further triggers the pituitary gland to make thyroid stimulating hormone (TSH). TSH communicates with your thyroid gland to make T3 and T4, hormones you need for various biological processes.
If you believe your thyroid health is just about producing the right amounts of TSH, T3 and T4, you could not be more mistaken. For example, T4 is mostly an inactive hormone and it needs to be converted into T3, a more active hormone that is used by your cells. What's more, your cells should be able to absorb T3. These delicate processes involving conversion and absorption of thyroid hormone are easily wrecked by factors such as poor gut health, high stress, chronic inflammation, nutritional deficiencies and gluten sensitivity. This can result in poor thyroid function. Let’s explore some important facts about thyroid health that one should know about.
1. Stress can make your thyroid problems worse
Chronic stress can send your adrenal glands into a complete disarray, disturbing the workings of hypothalamus and pituitary gland. Since these two glands are directly involved in the production of thyroid hormones, overburdened adrenals can interfere with this process. Chronic diseases, metabolic disturbances, sleep deprivation, unhealthy diet and stressful life events can stress out your adrenal glands.
Can stress cause thyroid issues?
Chronic stress triggers your adrenal gland to make more cortisol, a stress hormone that can damage thyroid health in more ways than one. Cortisol affects the functioning of your pituitary gland, which impacts the secretion of TSH. Chronic stress and the increased cortisol levels can also interfere with the conversion of inactive T4 into active T3. This leads to a higher level of reverse T3 (rT3).
Let's talk a little bit about rT3, another thyroid hormone your body produces. Your liver transforms some of the inactive T4 into reverse T3. This is done to get rid of extra T4 hormones floating in the blood. At times, your body favours the conversion of T4 into rT3, especially when your body needs additional energy to heal or repair itself. For example, when your body is exposed to extreme cold, has undergone trauma or surgery or when you are struggling with a chronic ailment and high stress levels, your body naturally produces more rT3. A problem with reverse T3 hormone is that it is metabolically inactive and it prevents the cells to take in T3 hormone. In this case, a person may have a good amount of T3 hormone in circulation but still present with symptoms of hypothyroidism. It's interesting and important to note that in this scenario medications and hormone replacement therapy may not work.
How does stress affect gut health?
Chronic stress is a known trigger for poor gut health. It can increase the risk of conditions like gut dysbiosis and leaky gut. Did you know healthy gut promotes healthy conversion of T4 into T3? And on the flipside, poor gut health and gut inflammation give rise to inflammation all over the body. Two of the many risk factors for autoimmune problems includes Grave's and Hashimoto's.
The cascading effect of stress does not end here. Prolonged stress is also known to increase blood sugar levels that can cause metabolic syndrome and insulin resistance. Interestingly, the relationship between your thyroid health and metabolic health is a two-way street. While metabolic disorders can disturb your thyroid function, poor thyroid health can also toss your metabolic health in to total chaos.
Can stress increase estrogen levels?
Chronic stress also increases estrogen levels, which elevates the levels of thyroid binding globulin (TBG). TGB is a transport protein that binds to T3 and carry the hormone to the cells and tissues. Once this complex of T3 and TBG reaches the cells, T3 detaches itself from the transport protein to go and bind to thyroid hormone receptors present on the cells. T3 hormone is now free and available to be absorbed and used by your cells. Now, raised TBG levels in the case of estrogen dominance could mean there will be reduced levels of free T3 available for the cells to use. This leads to hypothyroidism related symptoms. Ageing, use of birth control pills, hormone replacement therapy and excessive stress levels are some of the main reasons why you may have high levels of estrogen.
2. Your gut and thyroid health are related
Your thyroid gland produces more T4 than T3. Now, T4 is a metabolically inactive hormone that needs to be converted into more active T3. Approximately 20% of this conversion takes place in the gut, where a healthy and thriving gut flora provides an enzyme group called deiodinase that enables some part of this conversion. (Liver and skeletal muscle are other sites of T4 to T3 conversion).
When the balance between healthy and bad bacteria is disturbed, it is called gut dysbiosis. In this case, the gut flora will no longer be a good source of enzymes that are required for T4 to T3 conversion and this may result in low levels of T3 hormone in the blood.
A lot of factors can cause gut dysbiosis, which can trigger conditions like leaky gut syndrome to develop. In leaky gut syndrome, the tight junctions along your intestinal lining develop tiny holes and allow the content of your gut to move from the intestine into the bloodstream. Your immune system responds by launching an attack, which creates a cascade of inflammatory reactions. As a result of this, your immune system goes in an overzealous mode and starts attacking its own healthy tissues, causing more and more inflammation. If not treated, leaky gut and the resulting inflammation may increase the risk of various types of autoimmune disorders including Hashimoto's and celiac disease. To conclude, there is a strong gut health and thyroid connection.
3. Nutritional deficiencies can affect your thyroid health
When it comes to your thyroid health, certain vitamins and minerals play a huge role. For example, you need magnesium, zinc, vitamin B12 along with protein to make thyroid stimulating hormone. Selenium activates an enzyme required for the conversion of T4 into T3. Other nutrients such as iodine, vitamin A, vitamin D, iron and manganese also play a big role in various processes such as production of thyroid hormones, conversion of inactive T4 into active T3 and cellular uptake of T3.
Hashimoto’s disease is an autoimmune disorder where the immune system starts attacking the thyroid gland, leading to inadequate production of thyroid hormones. It produces symptoms such as extreme fatigue, weight gain, puffiness in the face, hair loss and even depression. If not treated, Hashimoto’s can be life threatening. Studies show that vitamin D deficiency can increase the risk of autoimmune thyroid disorders. In addition, people with hypothyroidism have been found to have low levels of Vitamin D. Vitamin D can be a helpful supplement in Hashimoto’s thyroiditis as it may delay the progress of hypothyroidism and also decrease the risk of cardiovascular incidents in people with this condition. [1] Taking high quality vitamin D supplements can keep your thyroid gland healthy and well-functioning.
4. Gluten sensitivity puts you at a risk of developing thyroid dysfunction
What comes to mind when you think of gluten sensitivity? Chances are that you’re thinking about celiac disease, an autoimmune disorder that involves the inflammation of the small intestine. It is caused when a genetically predisposed person consumes gluten. Gluten is a protein that is found in grains like wheat (and its derivatives), barley and rye. It is worth noting here that people with celiac disease are prone to developing other autoimmune conditions including autoimmune thyroid disease, lupus and Crohn's disease. It is a sad truth that gluten sensitivity is not considered as an important factor in your thyroid health.
Does gluten affect thyroid?
Let's see how gluten intolerance affects your thyroid health. Gluten contains a protein called gliadin, which is quite similar to an enzyme called transglutaminase. Now, this enzyme is also present in very high concentrations in the thyroid gland. When a person who has sensitivity or intolerance to gluten consumes gluten, the immune system produces specific antibodies to destroy gliadin. These antibodies also start attacking and damaging your thyroid gland because of the presence of transglutaminase. This may increase the risk of Graves’ and Hashimoto’s.
5. A normal TSH result can still mean issues with thyroid.
The thyroid-stimulating hormone or TSH test is a useful tool to screen for any thyroid dysfunction. It is a great predictor of your overall thyroid health. However, you can have normal levels of TSH, T3 and T4 hormones in your blood but still have hypothyroidism. One of the main conditions that cause this is subclinical hypothyroidism (thyroid hormone levels are borderline low and TSH levels are mildly raised). People with hypothyroidism like symptoms should not rely on just TSH readings. [2] Pregnancy can also result in an elevated TSH reading, especially if one has a mild thyroid disorder that doesn’t still qualify as clinical.
6. Women are more likely to develop thyroid disorders
Did you know women are more vulnerable to developing thyroid disorders than men? If you go by the statistics, approximately one in 8 women will develop a thyroid problem at some point in their lives. In addition, women with thyroid issues may experience different symptoms. For example, women with hypothyroidism, where the body is making too little thyroid hormone, may experience lighter menstrual bleeding. On the other hand, women with hyperthyroidism, where the body is making too much of thyroid hormone, may experience heavy and irregular periods. Thyroid issues can also lead to early menopause, infertility and health complications during pregnancy, both for the mother and the child. Hypothyroidism is known to increase the risk of complications such as premature labour and miscarriage, and increases the risk of developing an ovarian cyst.
Fortunately, the risks and complications associated with thyroid disorders can be managed if the problem is diagnosed in time. It is important to understand that the signs of thyroid disorders such as fatigue, depression, mood swings, change in appetite, change in weight are vague symptoms and can be easily misunderstood as symptoms of some other health problem. It is best to consult a doctor to get a full thyroid panel done that also checks for other markers besides TSH, T3 and T4 such as free T3 and reverse T3 to get a full picture of your thyroid health.
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