Category: Thyroid Health

by Marcelle Pick, OB-GYN NP

In addition to the most recent studies showing why plants, herbs and minerals can help strengthen our thyroid health, I’m hearing from women who are feeling better without prescription medication also shows how beneficial natural remedies can be.

Let me tell you about Bonnie, a young woman who was diagnosed with subclinical hypothyroidism in her early 30’s. Her complaints of dry, itchy skin and weight gain had at first seemed unremarkable. Bonnie lived in a northern state, so she was accustomed to dry skin during the winter months, in addition to gaining some weight due to the inclement weather.

When Bonnie’s itching became unbearable, she knew something was wrong. She also knew that her mother had been diagnosed with hypothyroidism and had been taking prescription medication for years, yet still experienced some symptoms.

When she learned her thyroid health wasn’t perfect, Bonnie just wasn’t satisfied with the option of taking prescription medication. She chose instead to consider a natural approach first to see if it would help and looked for information. Her practitioner worked alongside of her and within six weeks of initiating supplements, Bonnie was starting to find relief.

If you’re wondering about your thyroid health, we can help you take a closer look. Nature can often provide the support you need in the best way possible.

How plants and minerals help support your thyroid

Your thyroid plays a part in almost every other system in your body. It is often called the master gland. All other bodily systems also affect your thyroid. As a result, symptoms of thyroid imbalance may begin when your thyroid gland is not producing enough hormones, or when there are imbalances in other body processes that interfere with your thyroid. Especially of importance is your adrenal health.

Depending on your unique requirements, specific plants and minerals may:

• Provide an increase in energy levels (fatigue and weight gain are the chief complaints we hear related to thyroid issues).
• Help maintain thyroid hormone regulation. Help support healthy thyroid cell metabolism.
• Provide support without requiring you to be on prescription medication for the remainder of your life.

Even if you are taking prescription medication for hypothyroidism (an underactive thyroid), obtaining additional support through plants and minerals may be an excellent option to help support your body. It may lead to a decrease in the amount of prescription medication you need. The thyroid gland relies on two key nutrients to help in the balance and they are iodine, and selenium.

My natural prescription for thyroid support

The complex link between the bodies systems is why natural support is so important for anyone concerned about their thyroid health. The trace minerals of iodine and selenium are the most well-known natural remedies, but other options may be beneficial too.

Many plants and minerals have the ability to adapt in order to provide support for your body. They are able to copy what your body is able to do naturally when it is working at its best. This is known as the “adaptogenic effect.” It allows your body to use what it needs, even if you don’t recognize exactly what is wrong.

Your thyroid support apothecary

Discover several different all-natural remedies in our all-natural apothecary. We always recommend that you keep your health care practitioner informed of any natural remedies you are taking and that you check in regularly and report any changes.

Remember to take good care of yourself overall, by eating natural and healthy foods, exercising regularly and by managing your emotional stress.

Take time for yourself each day, even if it’s only a few minutes to practice deep breathing or simple stretches.

A lifetime of feeling better

We talked again with Bonnie not long ago. She’s so relieved not to be taking prescription medicine. And she is encouraging her mother to incorporate nutritional supplements to her regimen, hoping the additional guidance can help her handle her symptoms. Bonnie also reports that in addition to experiencing relief from her dry skin, itching and weight gain, she has more energy, both at work and with her exercise routine.

We know that everyone has different symptoms and comes from various situations. That’s why it is vital for you as an individual to understand all your options. That way, you can decide what is best for you. For many women, nature’s remedies offer a good first step.

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by Marcelle Pick, OB/GYN NP

• What is a goitrogen?
• What foods contain goitrogens?
• Enjoy your goitrogens with a sprinkling of common sense

My patients with hypothyroidism sometimes ask about stories they’ve heard in the news or seen on-line about the effects of certain foods on their thyroid health. Soy is their most common concern, but broccoli, peanuts, strawberries, kale, and other vegetables are also on this list. The message my patients hear, unfortunately, is that if you have any sort of thyroid dysfunction, you shouldn’t consume these foods — ever. And that’s a shame, because this all-or-nothing approach means that women with thyroid problems remove healthy, nutritious foods from their diet when they really don’t have to.

It’s true that there are certain foods that contain goitrogens, which are compounds that make it more difficult for the thyroid gland to create its hormones. However, the piece of the puzzle that’s missing in the advice to “avoid” this food or that one because it contains a goitrogen is that you can limit or even eliminate the harmful effects of these compounds in so many ways — either by limiting the amount you consume, or by preparing the food in such a way as to break down the goitrogenic compounds. Sometimes eliminating the goitrogen is as simple as steaming your vegetables before you eat them!

So let’s look at what goitrogens are, where they occur in our food, and how we keep them from affecting our thyroid function so we can enjoy our favorite healthy foods without concern for our thyroid health.

What is a goitrogen?

Most goitrogens are naturally-occurring chemicals that are ingested in foods or drugs. These chemicals can interfere with thyroid function in different ways. Some compounds induce antibodies that cross-react with the thyroid gland; others interfere with thyroid peroxidase (TPO), the enzyme responsible for adding iodine during production of thyroid hormones. Either way, the thyroid isn’t able to produce as many of the hormones that are needed for regulating metabolism. See my other articles on nutrition and thyroid health for more on how this works.

For people with healthy thyroid function, the thyroid simply compensates and makes more of the hormones as they’re called for. But in some people whose thyroid function is already compromised, the thyroid gland may actually grow more cells as it tries to make up for inadequate hormone production, eventually forming a goiter (a swelling or enlargement of the thyroid gland).

What foods contain goitrogens?

You may be surprised by how many common foods contain goitrogenic compounds, but the good news is, in most cases you don’t have to cross them off your grocery list. Let’s take a look at some of them and discuss how you can keep them in your diet, even if you have hypothyroidism.

• Gluten. It may surprise people to see gluten at the top of my list of potential goitrogens, but the truth is that gluten sensitivity contributes to a wide range of autoimmune responses aside from celiac disease (the one for which it’s best known). Gluten sensitivity has been found to go hand-in-hand with autoimmune disorders such as type 1 diabetes, Addison’s disease, Sjögren’s syndrome, rheumatoid arthritis, and autoimmune thyroid disease. I commonly recommend that my patients consider eliminating gluten from their diets, particularly if they already have an autoimmune disorder. If you have autoimmune hypothyroidism, you might want to consider limiting your intake of wheat, barley, and rye, or even going completely gluten-free (we have a lot more to say about this in our article about gluten). I also suggest that women with autoimmune thyroid disease consider screening for celiac disease, because undetected celiac can be one reason that women continue to have hypothyroid symptoms despite higher and higher doses of thyroid replacement hormone.

If you’d like to keep gluten in your diet but you’re concerned about your thyroid, try scaling back on how often you eat it. Be aware that gluten is included in a great many processed foods, so it may help if you look for those varieties that advertise as gluten-free. And instead of having wheat bread or baked goods with your meal, consider substituting gluten-free grains or saving them for the occasional treat. You may find after awhile that you don’t miss gluten nearly as much as you may have thought (but if you find yourself craving bread or pasta, it could be a sign of gluten sensitivity).

• Soy isoflavones. Soy is a very healthy food that has been demonized by various groups, something we discuss in our article on the soy controversy. One legitimate concern these groups raise is the fact that soy does contain goitrogenic compounds, specifically the soy isoflavone genistein. This compound, just like thyroid hormones, accepts iodine molecules from the thyroid peroxidase (TPO), which again, is the enzyme that also transfers iodine to the thyroid hormones. Some researchers have suggested that genistein and similar isoflavones may compete with thyroid hormones for iodine or alternatively may “block” the action of TPO, but recent studies indicate that as long as an individual has sufficient iodine in the diet, soy isoflavones do not adversely impact thyroid function. “If one begins with poor iodine nutrition, removing goitrogens from one’s diet will not restore iodine nutrition.”

— Dasgupta, P., et al. 2008. Iodine nutrition: Iodine content of iodized salt in the United States. Environ. Sci. Technol., 42 (4), 1315–1323.

The other good news is that the goitrogenic activity of soy isoflavones can be at least partly “turned off” by cooking or fermenting. With soy foods, you may want to favor fermented, cultured, or otherwise “aged” soybean products such as tempeh, soy sauce, miso, and natto. These methods of processing soybeans alter the activity (goitrogenicity) of the phytochemicals they contain. If you do eat whole soybean foods such as edamame or tofu, eat them cooked or steamed.

The goitrogenicity of soy can also be offset by pairing it with products containing iodine. I tell my patients with thyroid problems that if they already eat soy products and wish to continue, they should be sure to include additional iodide in the diet, in the form of seaweed products such as kombu or nori. For people who don’t already use soy regularly, I suggest that they simply continue whatever limited usage they already have and not worry about it too much, as such small amounts aren’t likely to impact the thyroid too greatly — but keep in mind that if you eat processed foods containing certain soy-based additives like soybean oil or hydrolyzed soy protein, they could be a “hidden” source of soy isoflavones that many hypothyroid woman could probably do without!

So unless you have a true soy allergy, I wouldn’t worry too much about every little soybean or soy shake you consume. More importantly, if you do include soy in your diet and have concerns about your thyroid function, it’s worthwhile to have your iodine levels checked by your practitioner, who can (if necessary) offer you supplemental elemental iodide in amounts that are correct for your profile. We also recommend that people with thyroid problems who consume soy regularly include good dietary sources of selenium — and be sure to continue monitoring thyroid hormone levels regularly with their practitioner.

• Isothiocyanates. These compounds are primarily found in cruciferous vegetables, such as cabbage, Brussels sprouts, broccoli, broccolini, cauliflower, mustard greens, kale, turnips, and collards. Isothiocyanates, like soy isoflavones, appear to block TPO, and they may also disrupt signaling across the thyroid’s cell membranes. But no one would argue that these vegetables are bad for you, given that they are filled with vitamins, minerals, antioxidants, and a variety of nutrients we all need (aside from being delicious!). Women with thyroid problems definitely should not avoid them — instead, enjoy them steamed or cooked, as the heat alters the isothiocyanates’ molecular structure and eliminates the goitrogenic effect.

Are there more? Maybe… Certain “potentially goitrogenic” compounds are also present in small amounts in peanuts, pine nuts, millet, peaches, strawberries, spinach, and cassava root, among others. I tell my patients who are concerned about these foods that unless they’re consuming them in high amounts on a continual basis, they’re not likely to have undue impact on their thyroid health, because the possible goitrogens are present in such minute quantities.

I’d like to emphasize that these foods won’t pose a problem for people with healthy thyroid function, nor will they be harmful when used in moderation by those whose thyroid function is impaired, but excessive use of foods containing goitrogens may trigger or exacerbate a thyroid problem. This is all the more reason to make sure your diet contains a variety of delicious, healthy, whole foods — we weren’t meant to eat the same thing over and over!

Enjoy your goitrogens with a sprinkling of common sense

I’m always dismayed when women are told they have to avoid a healthy food when there isn’t a very good reason for it (a food allergy, for instance). It would be a shame if women with thyroid problems avoided these goitrogenic foods altogether, because most of what I’ve listed above contain beneficial micronutrients and have strong value as healthy foods that support digestive, skeletal, cardiovascular, and immune function. It just doesn’t make sense to deny the rest of our body the benefits of these foods when the threat they pose to our thyroid is so slight and can be eliminated so easily! So I suggest that we all use a little common sense when it comes to goitrogens and our thyroids — steam, cook, or ferment your vegetables to reduce the goitrogenic compounds, rotate your choices so that you’re not eating the same foods every day, and above all,enjoy them as part of a richly varied diet of wholesome foods.

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by Marcelle Pick, OB/GYN NP

• Iodine deficiency — how common is it?
• From intake to uptake — why are some of us so iodine deficient?
• How’s your iodine? — iodine testing and treatment

We’ve all heard of iodine, of course. But if we were asked to define iodine’s role in human health, we might either think of it as merely an added ingredient to table salt (though many people don’t know why exactly), or as the bright orange tincture used by our parents to disinfect our childhood cuts and scrapes. But iodine is a critical element for healthy thyroid hormone production, and if it’s not available in the tiny amounts needed by the thyroid gland, there can be wide-ranging physical consequences.

These days, I have a growing concern that many of us may not be getting enough of this essential element. But although evidence of widespread iodine deficiency seems clear to me, the idea is still controversial in conventional medical circles. In a recent Newsweek article, an eminent medical school professor pronounced iodine deficiency to be rare in women in the US. Many of the magazine’s readers might not even give the subject a second thought. Yet compelling data were recently reported by the Centers for Disease Control suggesting that some 2.2 million women nationwide could have low iodine.

To learn more about the roles iodine, selenium, and other key nutrients play in thyroid function, see our article, “Simple Dietary Changes That Can Help Your Thyroid Naturally.”

As we learn more about how iodine functions in the body, research is revealing connections between diet, environment, and the rise of thyroid, breast, and immune health problems in women. Maybe you’ve had recent thyroid testing that came back borderline, or you’ve been diagnosed with hypothyroidism (inadequate production of thyroid hormones), and you’re already on thyroid medication. Perhaps you have fibrocystic breast condition and avoid salt by choice or due to high blood pressure. If so, it’s possible you could benefit from more insight into your iodine status and available testing and treatment options.

Iodine deficiency — how common is it?

As a practitioner of functional medicine, I am more and more intrigued by iodine. How widespread is iodine deficiency?  Why is it downplayed, and even overlooked here in the US?  When iodine deficiency was first recognized as a public concern in the 1920’s, iodine was subsequently added first to flour, then to salt, and the problem was considered solved.

In the US, it’s estimated that one in seven women suffers from iodine deficiency.

-Caldwell, K., et al. 2005; Hollowell, J., et al. 1998

But many people don’t know that flour isn’t iodized anymore, and iodization of salt is still voluntary in the US — only one-fifth of our salt is actually iodized. In reading further, I’ve found that we’re trending back toward iodine deficiency. Iodine intake has declined 50% in North America in the past 30–40 years, and this is consistent with what I’m seeing in my patients.

As recently as 2004, the New England Journal of Medicine defined our iodine status here in the US as “marginal,” based on data acquired from the International Council for the Control of Iodine Deficiency Disorder and the World Health Organization (WHO). More specifically, the WHO data suggest the greater risk in the US is not iodine deficiency per se, but iodine-induced hyperthyroidism (overproduction of thyroid hormones) or iodine-induced hypothyroidism. Interestingly, both these problems can occur when people who are already iodine-deficient are given too much iodine, too quickly. I believe practitioners need to proceed more cautiously when prescribing iodine supplements, slowly bringing levels up rather than overloading right up front. (More on our treatment protocol for iodine deficiency below).  But the WHO perspective seems to confirm that iodine deficiency does exist here in the US.

For more information about hypothyroidism, read our numerous articles on the topic in our Thyroid Health Category in our Health Library.

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Learn about low thyroid function – issues and approaches to hypothyroidism in women

by Marcelle Pick, OB/GYN NP

The thyroid gland is a little winged gland in our necks that controls the rate of function for every cell and gland in the body, including growth, repair and metabolism. It’s fair to say that you can’t maintain optimal health unless your thyroid is working pretty well.

While the thyroid is vital to both genders, women have a greater tendency than men to suffer thyroid problems, especially hypo- (low) thyroid function. No one clearly knows why. It probably has to do with the interplay between our reproductive hormones — i.e., estrogen and progesterone — and our thyroid hormones. Many women experience underactive or hypothyroid issues during perimenopause, just as some do during adolescence or pregnancy, the two other stages in our lives of tremendous hormonal flux.

Since these are times of hormonal change, it makes sense that an imbalance in female hormones would strongly impact thyroid function. In fact, we often see hypothyroidism in our patients as part of a larger pattern of long-term hormonal imbalance.

Unfortunately, conventional medicine typically views the thyroid in isolation from the other systems of the body. And quite frankly, the success rate of conventional medical treatment for hypothyroidism is far from encouraging. In so many cases women with thyroid problems spiral steadily downward, feeling worse as the years go by and finding themselves on an ever-expanding list of medications.

I would encourage you instead to see the thyroid as an integral part of your overall health picture. In this section of our website we explore the main aspects of low thyroid function, hypothyroidism, and hyperthyroidism from a holistic perspective. What we find is that with this approach to thyroid health, we can often restore and then maintain healthy thyroid function in our patients.

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by Marcelle Pick, OB/GYN NP

Over the years, I’ve treated a number of women with unusual weight gain or difficulty losing weight. They often ask me, “Is it my thyroid?”.

The answer for many of these women is yes, but the connection isn’t simple. Thyroid function is intimately connected with your metabolism — thyroid hormones basically regulate calorie consumption. But a healthy thyroid also depends on the proper functioning of other body mechanisms, including your neurotransmitters, your reproductive hormones and your adrenal glands.

The thyroid and weight gain

Because patients with an underactive thyroid tend to have a very low basal metabolic rate, one of the most noticeable symptoms of hypothyroidism is weight gain and difficulty losing extra weight. (Sometimes an overactive thyroid can mimic an underactive thyroid by causing weight gain, although this is less common). A minority of women with hypothyroidism don’t gain weight. The difference arises from their individual biochemistry, the quality of the calories they consume, and how they use those calories.

Often the “metabolic burn” continues to fall as calories are reduced when dieting. That’s why some women with low thyroid can have weight gain even when they severely restrict calories. In order to fix your metabolism, you have to understand your entire health picture, not just your thyroid.

The thyroid in women

More women than men suffer from hypothyroidism, and many more women than men with thyroid issues have problems with weight gain. Most thyroid problems occur within the gland itself and often don’t reveal themselves until a broader pattern of hormonal imbalance develops. That’s why thyroid issues, menopause and weight gain often appear together.

Why do women experience low thyroid and weight gain with such frequency?  The reasons are manifold, but primarily:

• Women spend much of their lives dieting, usually in a yo-yo cycle of feasting and then fasting. This undermines your metabolism and decreases your metabolic rate, a compounding factor for the thyroid, especially during perimenopause.
• Women tend to internalize stress, which affects their adrenal, brain, and thyroid function, resulting in increased cravings for sweets and simple carbs to provide instant energy and feel good hormones.
• Women experience monthly hormonal fluctuations that affect their biochemistry.

What you can do about hypothyroidism and weight gain

The first thing to do if you are experiencing stubborn weight gain is to talk to your practitioner. She or he may ask for a thyroid test or measure TSH (thyroid stimulating hormone). I have found in my practice that many women who test within the “normal” range of traditional medical standards still need thyroid support. Their TSH may be only slightly elevated, but enough so that it influences their metabolism and causes weight gain.

For these women, supplemental nutrients such as selenium and a regular meal plan that balances a proper ratio of protein to carbohydrates increases their metabolic functioning and they begin to lose weight. In some cases, a low-dose thyroid replacement hormone is also needed.

There is a lot of controversy in the endocrinology world regarding hypothyroidism treatment. There are those that believe that patients who test within the normal range but have very low basal metabolic rates and very low basal temperatures need thyroid supplementation. There are others that argue that only patients with significant abnormalities should be supported with thyroid hormones.

At Women to Women we look at the individual needs of each patient and treat her accordingly — sometimes using medication, sometimes not. Weight gain is not sufficient evidence to conclude that someone has a thyroid abnormality, but it is one part of the picture we try to bring into focus. Efforts to lose weight without addressing related thyroid issues are doomed to fail. The greatest success is found through a holistic, natural approach that considers thyroid function as an integral part of your overall hormonal balance.

For more information on this topic, read our many informative articles in the Thyroid Health section of our Health Library.

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by Marcelle Pick, OB/GYN NP

When I talk with women suffering with unexpected weight gain, often one of the first questions I am asked is “Is it my thyroid?”

Sometimes, my answer is “yes” — after all, our thyroid hormones play a huge role in regulating our metabolism and how we use nutrients.

And research shows that even small changes to the thyroid function can cause weight gain. In fact, many women who have been told their thyroid test results are “normal” may still have a reduced thyroid function (subclinical hypothyroidism) that’s enough to cause weight gain and other bothersome symptoms.

At the clinic, I work with women suffering from a wide range of thyroid issues — from those just starting to suspect they have a thyroid problem to those already taking medication. And I tell each and every one of them how they can benefit from natural thyroid support and a holistic approach that considers thyroid function as part of overall hormonal balance.

The thyroid and unexpected weight gain: an early signal

Unexpected weight gain and difficulty losing weight may be one of the first noticeable signals that you’re struggling with hypothyroidism (a sluggish thyroid) or subclinical hypothyroidism. Many women tell me about their frustration with gaining five pounds every year and not being able to figure out why!

Reduced thyroid function may be the result of the thyroid’s impaired ability to produce hormones, or the body may have difficulty using the thyroid hormones. Either way, problems with your thyroid hormones may cause the rate at which you use nutrients (your metabolic rate) to slow down.

We are especially prone to thyroid issues and weight gain as women because the thyroid is linked to other systems that affect weight — including the proper functioning of our neurotransmitters, reproductive hormones, and adrenal glands.

Thyroid issues affect women of all ages

While we see women of all ages with thyroid issues, there are times in your life when your hormones fluctuate more and when the development of thyroid issues may be even more likely:

If you experience PMS

When you’re pregnant

 During perimenopause and menopause

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