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An estimated 27 million Americans have some form of thyroid disease.  Up to 60 percent of those with thyroid disease are not aware of their condition.  Women are five to eight times more likely than men to develop thyroid problems.  80% of hypothyroid conditions in the US are thought to be auto-immune conditions

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The Importance of the Thyroid:

The thyroid gland sits right under the top of the sternum at the base of the neck.  From this seat it secretes hormones called T3 (triiodothyronine) and T4 (thyroxine).  These hormones circulate in the blood stream and interact with every cell in the body.  Lack of ideal thyroid hormone function leads to a global decline in cellular functionality in all bodily systems.

The thyroid is a central player in the complex web of human metabolism and is very sensitive to even minor imbalances in other areas of physiology.  The thyroid gland is the most common site for the development of an autoimmune disease. Hashimoto’s thyroiditis, is an autoimmune condition of the thyroid that is considered the most prevalent auto-immune condition.

Hashimoto’s is said to account for up to 90% of all cases of hypothyroidism in the US.  Often times, this condition is misdiagnosed an improperly treated.  This results in a continual worsening of the thyroid gland as it gets destroyed by the immune system.  Overtime, these individuals decline in their basal metabolic rate and lose energy, mental function, mood and gastrointestinal motility.

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Thyroid Physiology:

The thyroid responds to messages from the hypothalmus and pituitary gland in order to get out and interact with the cells of the body.  The hypothalmus is like the thermometer of the body, it is constantly checking the blood environment for optimal balance of hormaones, nutrients and neurotransmitters. 

When the hypothalmus decides we need more thyroid hormone in circulation (cold weather or increased activity level for example) it sends a chemical messenger called thyrotropin-releasing hormone (TRH) which goes to the pituitary gland.  The pituitary than sends thyroid stimulating hormone (TSH) over to the thyroid.  TSH activates the production of a protein called thyroglobulin.

TSH also activates an enzyme called thyroid peroxidase (TPO).  This enzyme combines thyroglobulin, iodine and hydrogen peroxide to create both T3 and T4.  About 93% of the hormone made in the thyroid gland is T4 with 7% being T3.

T4 circulates through to the liver where 60% of it is converted into T3 through the glucoronination and sulfation pathways.  If the liver is sluggish it will cause a problem in T4-T3 conversion.  Another 20% is converted into reverse T3 which is permanentely inactive.  The final 20% is converted into T3 sulfate and T3 acetic acid which can then be further metabolized by healthy gut bacteria to produce more active T3.

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Problems with T4-T3 Conversion:

One common problem with hypothyroidism is a poor T4-T3 conversion.  As we have discussed, the thyroid produces 93% T4 and then the T4 travels into the liver for conversion to T3 and reverse T3.  The gut converts the other 20% of T4-T3.

T4 is inactive and cannot perform the normal thyroid function.  It must be converted to T3 to be used by the cells.  Here are possible scenarios of why someone would have normal T4 but low T3

1.  Liver Problems:  If the liver is sluggish than it will not be able to convert the normal 60% of T4-T3 by the 5’deiodinase enzymes.  This will result in lower T3 levels.  A sluggish liver could be due to a liver disease, an infection like Hep C, a toxic body, nutrient deficiencies, methylation and glutathione problems, etc.

One common problem is estrogen dominance where the individual has taken into too many exogenous estrogen compounds from the environment through food, plastics, cosmetics, etc.  This can cause the liver to become sluggish and unable to perform its role effectively.

2.   High Stress:  When someone has high stress or trauma they will often overproduce rT3.  rT3 is inactive and it functions to slow the body down (thyroid has a speeding up effect) which is necessary in times of stress or trauma for the body to heal.  Chronic stress can drive rT3 up for a prolonged period of time which results in less T3 activity with the cell and a functional hypothyroidism.

Low selenium and zinc can also drive up rT3 levels.  Other causes of high rT3 may include iron-deficiency anemia and low B12.

3.  Gut Dysbiosis:  20% of the active T3 is formed in the gut.  If the individual struggles with small intestinal bacterial overgrowth or Candida and they have an overpopulation of bad microbes it can result in lowered T3 formation.

On a lab test this sort of a problem can show up with TSH being normal or high, T4 is normal but T3 is low and T3 uptake is low.  If you are testing for rT3, that can often be elevated in cases of low T3 uptake.


Immune Modulation:

Most thyroid disorders are characterized by a hyper responsive immune system and autoimmunity.  There are several key factors that must be addressed to regulate and better coordinate the immune system.

1.  Poor Blood Sugar Stability:  Blood sugar imbalances cause immune dysfunction and malcoordination.  Stable blood sugar is critical for a healthy immune response.

2.  Low Vitamin D Levels:  Individuals with low vitamin D3 levels (below 40 ng/ml) are at significant risk for developing chronic inflammation and auto-immunity.

3.   Gut Dysbiosis:  Poor microbial balance in the gut microbiome leads to leaky gut syndrome and chronic inflammation.  The gut must be addressed in order to get well.

4.   Mitochondrial Dysfunction:  The mitochondria are the energy producing organelles in each cell of the body.  They are extremely key in the bodies ability to handle oxidative stress.  Dysfunction in the mitochondria leads to increased free radical and oxidative stress which creates immune alterations.  This is a classic sign in Hashimoto’s autoimmune pathophysiology.

5.  Low Glutathione Levels:  Glutathione is the major anti-oxidant within every cell of the body.  It is critical for white blood cell (WBC) function as the WBC’s encounter tremendous amounts of free radical and oxidative stress every second of the day.  Low glutathione leads to chronic inflammation and often to auto-immunity.

6.  Poor Omega 6:3 ratio:  The average person has significantly more omega 6 fats than omega 3 fats.  The increased omega 6 stimulate the release of pro-inflammatory mediating prostaglandin molecules.  This is a key factor in the development of chronic inflammation and auto-immunity.

7. Upper Cervical Subluxation:  The bottom of the skull (occiput) and the first bone (atlas) play a significant role in the coordination patterns of the brain and immune system.  Dysfunction at this joint torques and compresses the top of the spinal cord and increases inflammatory activity in the body.

8.  Environmental Toxins:  Exposure to high levels of infectious microbes, environmental chemicals such as plasticizers, pesticides, herbicides, personal care products, heavy metals and biotoxins such as mold wear down the bodies glutathione levels, alter the gut microflora and increase inflammatory activity in the body.

9.  High Stress and Poor Breathing Habits:  High mental and emotional stress increases stress hormone production which induces inflammatory activity within the body.  Short and shallow breathing habits can simulate chronic mental and emotional stressors on the physiological level.

10.  Lack of Sleep:   Poor sleep promotes immune dysfunction and increased inflammation.  Good sleeping habits and optimal melatonin secretion reduce inflammation and promote improved tissue healing.

11.  Methylation:  Methylation is a key process that protects DNA, turns on and off genetic traits and helps to detoxify environmental chemicals.  Many individuals have certain genetic polymorphisms that limit their ability to appropriately methylate. Methylation plays a very important role in T cell function and poor methylation status is associated with the development of auto-immunity.

12.  EMF Exposure:  Electromagnetic frequency exposure has been shown to alter the function of the immune system and increase one’s susceptability to developing an auto-immune condition.