As we age we lose our hormones. Most people think about this in relationship to estrogen, progesterone ad testosterone, but thyroid hormone production decreases with age as well. In addition, hormone changes and nutrient deficiencies may exacerbate thyroid hormone deficiency.
Symptoms of hypothyroidism include fatigue, loss of energy, weight gain, difficulty losing weight, depression, dry skin, brittle nails, brittle hair, itchy scalp, hair loss, cold intolerance, constipation, puffy eyes and face, tingling in the wrist and hands, elevated LDL cholesterol, memory loss, fuzzy thinking, loss of sex drive, slowness of speech, hoarseness, muscle and joint pain, and headaches.
Subclinical hypothyroidism may present itself with mild symptoms or just fatigue which needs to be differentiated from other hormone deficiencies such as estrogen or cortisol.
To complicate matters, hormone changes such as elevation or decline in cortisol from adrenal stress or fatigue, and imbalances in estrogen can affect the production and availability of thyroid hormone. In addition, deficiency of iron, B vitamins, iodine, selenium, and zinc can also have a negative effect.
Thyroid deficiencies are often under-diagnosed since most practitioners only measure TSH and T4 hormones as a gauge of function. The body converts T4 to the active hormone T3. With nutrient deficiencies, you may not be able to adequately convert T4 to T3. In addition active T3 can be diluted by an inactive molecule called reverse T3, usually present more commonly in stress. Neither T3 or reverse T3 are usually measured. Thyroid antibodies are other tests also usually ignored. Elevated thyroid antibodies called Hashimoto’s disease, indicate the thyroid is making antibodies against itself. Although many physicians feel it is not necessary to treat this condition, others feel that it results in inconsistent thyroid hormone production that needs support.
Thyroid replacement should be given as a combination of T4 and T3 (Armour thyroid or compounded T4 and T3), instead of T4 (Synthroid) alone. Again, if you are unable to convert T4 to T3, then T4 alone will not help. In cases of high reverse T3, it is best to replace T3 alone.
The symptoms the patient is having may often be the best guide to treatment.
Candice Lane, MD, 1250 La Venta Dr., Ste. 206, Wesrlake Village, CA, 91361, 805 496-7869, 877-496-4289.