Nutritional Thyroid Management

This week, at Origins Incubator, we talked about some thyroid cases and various approaches. For example, we worked up a 44-year old female with Hashimoto’s, who is not on any supplements or medications. She does have fatigue and irritability, along with some underlying triggers like mold, and has a history of rough pregnancies. However, she doesn't want to start taking any medications. 

Are there things that we can do in this case?  Absolutely!

Facts of the Case

As we dug into the case, we looked at the fact that her antibodies were trending down, still making aggressive levels of thyroglobulin antibody, and we talked about how not only do those have an effect in terms of decreasing thyroid function, but they have activity in the brain as well. 

Sometimes, when we're looking at thyroid cases, we might have an example of where antibodies are positive, but they're relatively symptomatically free in terms of what we would think about with thyroid symptoms. For example, maybe their energy is fine and are not experiencing weight gain or hair loss. And we wonder, “What do we do with this outlier in terms of elevation of antibodies?” Well, we want to check in, in terms of cognitive function as well, because like I said, they're not only active in terms of decreasing thyroid function, but active in the brain too. 

Realistic Approaches

Are there realistic approaches to shifting the numbers, shifting wellbeing, without jumping to medication?  In terms of elevation of thyroglobulin antibodies, a major reason they go up is because of an overproduction of reactive oxygen species in the thyroid. This will nick your thyroid hormone exposing odd epitopes, making the thyroid hormone look weird. And this sends off the antibody production. Of course, we would think about things like leaky gut and adrenal support, as decreasing gut base permeability helps us with most autoimmune conditions out there and improving thyroid function. Improving cortisol also helps to decrease that over activity of the immune system as well. 

In addition to that, what do we do to squelch those reactive oxygen species that are ripping up the thyroid hormone making it look abnormal? Well, one big thing that we do is we increase the local antioxidant response element and that is glutathione peroxidase. However, in this case, selenium was already more than optimal, and selenium is one of the major cofactors that will drive glutathione peroxidase. 

What else can we do? Well, anything that increases NRF2 transcription factors will turn on glutathione peroxidase in the thyroid. We know that we can utilize other glutathione strategies, things that increase glutathione, like a N-acetylcysteine, which will be effective as well. And in the case of shifting numbers, using over-the-counter thyroid glandulars can be useful, something like a T-150 that also combines botanicals, as well as things like zinc and selenium. Interestingly, zinc alone can increase thyroid hormone production as much as 30%. There’s also Ashwagandha, which has great research in terms of increasing thyroid numbers and also normalizing TSH. There are definitely evidence-based approaches that will shift serum thyroid numbers and can help get to the underlying cause. 

In this case of the 44-year old female with Hashimoto’s, who has a subclinical hypothyroidism with the TSH at 3.28, we'd like to generally see it less than 2.5, and her thyroid hormones more to the low side. Utilizing Ashwagandha, we can address both of these things, that failure of the pituitary to send a signal to the thyroid in an appropriate way. 

Conclusion

Can nutritional interventions be enough? Yes, there are things that we can do to begin to move the dial without jumping first to medication, especially in a highly compliant patient who's willing to make dietary change and who's willing to do things in terms of stress response. And again, we won't have to guess. We'll be able to track the numbers and see what's going on in the patient.

As you can see, it is reasonable to start with nutritional-based approaches, and then see if this meets the patient's needs. This is the best starting point with your thyroid patients.