Today's guest post all about how to get your thyroid back to work when it's on strike is by the lovely and talented Martha Rosenstein.
Martha is a Nurse Practitioner and wellness advocate who has her own story of hypothyroidism and recovery to share....along with some practical tips that have worked for her patients.
To dive deeper into nutrition for hormone and thyroid support, CLICK HERE for access to my totally free Resource Library with all my guides, protocols, cheatsheets and free resources in one handy spot.
Take it away, Martha!
Are you one of the 20+ million Americans who suffer from thyroid disease?
According to the American Thyroid Association (ATA) women are five to eight times more likely than men to have a thyroid condition and one in eight women will develop a thyroid disorder during her life. Another staggering statistic is that up to 60% of those who have thyroid disease are unaware of it.
As a nurse practitioner, I cannot tell you how many people come to me complaining that “something doesn’t feel right.” They complain of feeling tired, run down, cold, depressed, irregular periods, and maybe even a very slow weight gain.
I’ve been through these things myself, I completely understand where they are coming from and how frustrating that can feel.
In 2014 I started suffering from extreme fatigue, gained 10 pounds in less than two weeks, and my hair was falling out. It took five doctors and over six months for someone to figure out that I had a reactivated mononucleosis infection. It also turned out that I had hypothyroidism, but it wasn’t diagnosed until I saw a nurse practitioner who practiced a more holistic approach. My labs were “normal” but not within the optimal or functional range. So while I wasn’t technically out of range, that meant that I was not in the range where people tend to feel the best.
Andrea's note: The same exact thing happened to me! So frustrating....the "normal range" is so broad it's almost a useless parameter, in my opinion. Ok, carry on...
After I got all of these things straightened out, I vowed to do all that I could to help other women not feel brushed off by the medical system. Not to feel like they are making all of their symptoms up. I had multiple doctors tell me that my symptoms were caused by stress and eating too many calories and that I needed to start tracking what I was eating. What they didn’t seem to understand was that not only am I an athlete, but it would be virtually impossible to eat enough calories to gain 10 pounds in under two weeks.
The reality is that we know our bodies best and if we don’t feel like something is right, it probably isn’t!
I work with a lot of people who feel that they have exhausted all of their options in trying to figure out what is wrong with them and are not sure what to try next. They’ve often been passed around from doctor to doctor and have seen all the specialists, but they still don’t have answers. I know when I was trying to figure out my health issues, I thought no one would ever understand what I was going through. It turned out that I was just talking to the wrong people! It wasn’t until I found someone who was willing to look at the big picture rather than each individual piece of my story that I got what I needed.
Hypothyroidism is the most common form of thyroid disease and over 80% of all cases of hypothyroidism are the autoimmune version of the disease, called Hashimoto’s thyroiditis. While most people with hypothyroidism do require medication to manage their condition (there’s no shame in that, thyroid hormones are insanely important), there are some very key nutrients that you can prioritize in order to make sure that you are still getting the most out of your thyroid.
These nutrients are especially important if you have Hashimoto’s thyroiditis because that means that you body is actually attacking your thyroid gland so the reason that it’s not working as well as it should is because it has been damaged. You cannot repair this damage, but you can do a lot to make sure that further damage doesn’t occur as well as making sure that the undamaged parts of your thyroid have all the nutrients it needs to function to the best of its ability.
Again, you’ll likely require thyroid hormone replacement at some point, especially with Hashimoto’s, but taking steps to prioritize nutrition to optimize your thyroid can go a long way in decreasing the amount of medication you might need.
WHAT IS HYPOTHYROIDISM?
First I want to briefly cover what hypothyroidism is: Hypothyroidism is a broad term that means that your thyroid hormone is not producing enough thyroid hormone.
There are several reasons why this happens:
- Your pituitary gland isn’t signaling your thyroid to produce thyroid hormones (it does this by releasing TSH or thyroid stimulating hormone).
- Your thyroid isn’t getting the signals that are being sent by the pituitary so it’s not producing enough thyroid hormone (in which case the problem is in your pituitary's control room and not your thyroid...tricky!)
- Your thyroid is getting the signals from your pituitary gland and making plenty of T4 (the inactive form of thyroid hormone), but it’s not converting it into the active form, T3.
- Too much T4 is being converted into Reverse T3 which is another inactive form of thyroid hormone that helps to keep things balanced. (Oh boy, this is getting confusing....)
- An autoimmune condition, such as Hashimoto’s Thyroiditis is creating antibodies in your body that are attacking and damaging your thyroid so it can’t produce enough thyroid hormone.
SEE? LOTS TO CONSIDER.
Your thyroid is such an important part of your body and plays a role in your metabolism and other critical functions within your body such as breathing, heart rate, nervous system function, menstrual cycles, body temperature, cholesterol levels, and more.
Also, as I mentioned already, up to 80% of hypothyroid cases are autoimmune. So if you have been diagnosed with a thyroid condition but have not been tested for the autoimmune version of the disease, that’s worth testing for. That can be done with a blood test for thyroid antibodies and can be ordered by your healthcare practitioner.
MEDICATION VS. NUTRITION
In most cases of hypothyroidism, medication is required. However, there are a few cases when your labs may not be optimal but aren’t out of range and optimizing nutrition would be enough to get your thyroid working optimally again.
Andrea's note: It doesn't have to be one or the other!
If you are on medication for your thyroid, that doesn’t mean that you should ignore the nutrition piece. It can often be incredibly challenging to find the right dose of the right medication to get you feeling good again, and this is where nutrition can be incredibly helpful for those who are taking medication.
Having worked with hundreds of patients (and been through this myself) I know what the thyroid roller coaster feels like. You are excited when you get a diagnosis because that means you can finally start feeling better, only to find out that it can take months and months of tweaking your medication to get your symptoms to go away.
The nutrition piece is especially important if you have Hashimoto’s thyroiditis. There is no cure for Hashimoto's, but something that I often work on with my patients is making dietary and lifestyle changes that can reduce their symptoms and calm down their immune system.
Andrea's note: I do believe that autoimmune conditions can be put into remission...and if your body isn't attacking its cells and organs anymore, there won't be any symptoms left to reduce!
One of the most memorable patients I had was someone who switched to a Paleo diet and over the course of several months we actually had to decrease her medication several times. (Please note that you should NOT adjust your medication without the supervision of your personal healthcare provider!)
The following nutrients that I’m going to talk about are those that I have found to be most helpful in getting people who have hypothyroidism or Hashimoto’s back on track to feeling good, fast. In some cases, we have even been able to decrease medication doses once we got the nutrition piece dialed in (please don’t ever try and adjust your medication on your own, ALWAYS do this with the help of your healthcare provider).
Also, it’s worth mentioning that my philosophy on nutrients and supplementation is this:
If you can get it from food, you absolutely should.
If you use supplements instead of food, you need to have lab work done to ensure you aren’t taking too little or too much and to see how your body responds. (Test, don’t guess!)
On that note: More is not always better. This is why we test!
Without further ado...
4 NUTRIENTS TO PRIORITIZE IF YOU HAVE HYPOTHYROIDISM
Our thyroid gland requires iodine in order to produce thyroid hormones. So iodine deficiency CAN cause hypothyroidism, but this isn’t always the case in developed countries such as the U.S. But making sure that you eat plenty of iodine rich foods is still a good idea.
Make sure you are getting plenty of eggs, sea vegetables (kelp and seaweed), fish, and full-fat dairy if you tolerate it as these foods all contain iodine. Prioritizing these foods is especially important if you don’t eat packaged foods and use sea salt instead of iodized table salt. (Although the usable iodine content of table salt is questionable at best.)
Iodine is something that I rarely even recommend that people supplement with as too much can be just as harmful as not enough (and in some cases too much can cause symptom flares).
Andrea's note: Iodine supplementation is a hot topic, and supplementing it isn't as easy as just popping a pill. For anyone with an under-active thyroid I recommend reading "The Iodine Crisis" by Lynne Farrow and familiarizing yourself with the role iodine plays in your thyroid health and how to safely supplement it. This book was life-changing for me...no exaggeration!
Selenium is something that almost every American is deficient in. It is important in thyroid function because it is required for the creation of many of the enzymes needed to convert T4 into T3. There is also some evidence that iodine supplementation is only an issue for the thyroid when selenium deficiency is also present.
Selenium is abundant in seafood, meat, poultry, mushrooms, cabbage, broccoli, spinach, seeds, and Brazil nuts. In fact, eating just two Brazil nuts daily would give you an adequate amount of selenium.
It is estimated that one in 10 Americans are deficient in zinc. And to complicate things further, zinc and copper need to be present in the body in a relatively specific ratio and we tend to get more copper than zinc into our bodies (copper tends to be more abundant than zinc), making the 8:1 to 12:1 ratio of zinc to copper difficult to maintain.
(Ahhhhhh this is maddening, right?!)
Adequate levels of zinc are needed to produce TSH and T4 as well as convert it into T3. Beef, lamb, and oysters have the highest levels of bioavailable zinc. Other great sources are crab, lobster, poultry, pumpkin seeds, cashews, and almonds though plant sources tend to have less bioavailable zinc than animal sources.
4. VITAMIN D
Research has established a link between vitamin D deficiency and hypothyroidism as well as a correlation between low levels of vitamin D and higher risk for developing all autoimmune disease.
Vitamin D (which is actually a hormone) is a tricky subject. This post by Chris Kresser goes into much deeper detail about how and why supplementation can be problematic, and I highly recommend reading it.
Vitamin D is one nutrient (hormone) that I almost always suggest supplementing, especially if you live in a northern climate, but as you can see from the article I linked, it’s not just as simple as giving a dosage. (This is, again, where testing and working with a knowledgeable practitioner can be helpful.)
But first (and I know this isn’t a food source), getting 15-20 minutes of sunlight on your skin daily (without sunscreen) is by far the best way to get vitamin D.
This is hard if you live in a rainy or Northern climate (I live in Alaska, we can only get strong enough sunlight here for 2 months of the year to actually make vitamin D). Which is why I also recommend supplementing most of the time.
However, there are several food sources of vitamin D that can help boost your levels. Foods such as fish, eggs, mushrooms, and liver are great sources of vitamin D.
Andrea's note: READ THIS POST all about the myths concerning sunscreen and UVA/UVB damage from sun exposure and you might even find yourself in a tanning bed to boost that Vitamin D production....Say whaaaattt????
GREAT....SO NOW WHAT?
You might be thinking that all this nutrient talk is great...but how are you supposed to eat all of these foods that have all of these nutrients that are good for your thyroid?
First of all, don’t ever get stressed out or beat yourself up over something you have or haven’t done with your diet. That doesn’t solve any problems (and actually makes a lot of them worse).
Next, if you are eating a mostly whole-foods diet and trying to get a variety of different foods in, then you are probably already doing better than the average person when it comes to these nutrients, so go you!
Finally, if you take nothing else away from this, you might have noticed that many of these nutrients can be found in fish or seafood, so I would say that making sure you are eating wild-caught fish or seafood 3-5 times per week is the best way to optimize these nutrients (bonus points if you do it on the beach to get more vitamin D).
REMEMBER, YOU CAN JOIN THE THOUSANDS OF OTHER WOMEN WHO HAVE TAKEN THEIR HEALTH INTO THEIR OWN HANDS WITH ACCESS TO MY FREE RESOURCE LIBRARY!
Martha describes herself as a Nurse Practitioner, Athlete, and Nutrition Nerd. She has over 9 years of clinical experience helping people who have chronic or autoimmune illness get their health back, is a chronic fatigue survivor, and has personal experience with her mother and a fatal autoimmune disease. Helping people to better understand their diagnosis and test results, tailor nutrition to maximize healing, and empowering them to ask for what they need is what she loves doing! You can find more about Martha on her website, and podcast.