Sarah* was a busy 49-year-old when she initially came to the clinic. She was the mother of two teenagers and working in a part-time professional job. She hadn’t felt well for the past six months, but routine blood tests hadn’t shown anything out of range. Looking at the thyroid results ordered through her GP, it was clear that although her markers were still within range, over the past three years, her thyroid levels had been changing. Her thyroid-stimulating hormone (TSH) was rising and her thyroxine (T4) levels were decreasing.
Sarah’s symptoms were broad and could be attributed to many reasons, such as the fact that she had entered perimenopause. She felt tired all the time, had put on weight despite no change to her diet, she often suffered from low mood, and her periods had become more irregular. These changes could easily be attributed to perimenopause, but first, it was important to determine if there was any involvement from the thyroid, so we ran an extensive thyroid blood panel to explore her thyroid picture more deeply.
This extensive thyroid panel confirmed the pattern seen in the GP blood test, but gave further important, detailed blood markers. Alongside low T4 levels and high TSH, Sarah also had low T3 and high-normal levels of antithyroid peroxidase (anti-TPO) antibodies. Sarah didn’t fit the criteria for a diagnosis of Hashimoto’s thyroiditis, but she was well on the way to developing it.
As part of Sarah’s treatment, we focused on balancing her immune system to reduce her antibody levels and supported her body to naturally increase her thyroid hormone levels. Strategies to balance her thyroid function and increase production of thyroid hormones focused on nutrition, lifestyle and the use of select herbs. Sarah is representative of many women I see in clinic who are suffering from low thyroid function, but do not have the blood markers to be diagnosed as having a thyroid disease. In this article, I’ve outlined some of the strategies I used with Sarah.
Nutrients for thyroid health
The thyroid gland is extremely vulnerable to nutrient deficiencies. Sometimes the correction of these deficiencies alone is enough to improve thyroid function. We can analyse the levels of these nutrients through blood investigations, as well as an analysis of the diet.
Iodine
Iodine is a trace mineral that’s essential for the production of thyroid hormones, as it’s a key component of both thyroxine (T4) and triiodothyronine (T3). Inadequate intake of iodine can lead to a reduced level of thyroid hormones and the development of a condition called goitre, which is the enlargement of the thyroid gland. The gland swells in an attempt to trap more thyroid hormone from the blood. Both iodine deficiency and excess can lead to thyroid dysfunction, so intake should be balanced. Sources of iodine include seaweed (such as kelp), seawater fish, shellfish, iodised salt and eggs.
Selenium
Selenium is a mineral vital for the conversion of thyroxine (T4) to the more active triiodothyronine (T3). Its importance to thyroid function is confirmed by the fact that there is more selenium in the thyroid gland than any other organ in the body. Selenium also plays an important role as an antioxidant that helps protect the thyroid from oxidative stress. Sources of selenium include brazil nuts, sunflower seeds, fish (like tuna and sardines), eggs, and whole grains.
Zinc
Zinc is another mineral important for the conversion of T4 to T3. It’s also needed for the formation and action of TRH (thyroid releasing hormone) and to facilitate T3 binding at its receptor. Sources of zinc include shellfish (especially oysters), red meat, pumpkin seeds and lentils.
Iron
Although not as readily associated with the thyroid as other nutrients, iron has an important role to play as it’s necessary for the production of the TPO (thyroid peroxidase) enzyme. This enzyme is needed for the thyroid to make T3 and T4. Sources of iron include red meat, poultry, legumes, and green leafy vegetables.
Omega-3 fatty acids
Having an adequate intake of omega-3 fatty acids can support thyroid health by reducing inflammation. A thyroid autoimmune disease (such as Hashimoto’s or Graves disease) creates inflammation and oxidation in the body. Sources of omega-3s include fatty fish (e.g. salmon, mackerel, anchovies, herrings), flaxseeds, chia seeds, and walnuts.
Vitamin D
Low levels of vitamin D impact the immune system, which can lead to the development of autoimmune thyroid disease. Ultraviolet radiation from the sun is necessary for the production of vitamin D in the skin, and is the best natural source of vitamin D. Small amounts of vitamin D can be obtained through food, such as oily fish (such as salmon and sardines), UV-exposed mushrooms and eggs.
Herbs for thyroid health
There’s a long tradition of treating thyroid dysfunction with herbal medicine. These are some of the most common herbs we use:
Ashwagandha
Ashwagandha, otherwise known as Withania somnifera, is an adaptogenic herb. It may help thyroid function by the following mechanisms:
- Increasing levels of T3 and T4
- Improving the conversion of T4 to T3
- Reducing cortisol levels, which can interfere with thyroid function
- Preventing oxidative stress in the thyroid gland
Bladderwrack
Bladderwrack (Fucus vesiculosus) is a type of seaweed that’s high in iodine, which is why it has traditionally been used to treat hypothyroidism. It’s important to use a reputable source of bladderwrack with a defined quantity of iodine, as taking too high amounts of iodine can be damaging to the thyroid.
Black cumin
Black cumin (Nigella sativa) may help decrease TSH levels and increase T3 levels. It has anti-inflammatory and antioxidant properties which make it particularly useful for the chronic inflammation and oxidative stress, which is so damaging to the thyroid gland in autoimmune conditions such as Hashimoto’s thyroiditis.
Be mindful of goitrogens
Goitrogens are substances found in certain foods that can interfere with iodine uptake and hence impact thyroid hormone production. They’re found in cruciferous vegetables like broccoli, cauliflower, and kale, as well as soy-based foods. Goitrogenic foods contain compounds called glucosinolates, which can block the enzyme thyroid peroxidase (TPO), impairing thyroid hormone synthesis.
While these foods are generally nutritious, eating them raw in large amounts may negatively impact thyroid function in people who have an existing thyroid dysfunction and/or iodine deficiency. People with normal thyroid function and adequate iodine intake are unlikely to have a problem consuming moderate amounts of goitrogen-containing foods.
Stress and cortisol levels
Chronic stress and elevated cortisol levels can disrupt the hypothalamic-pituitary-thyroid (HPT) axis, which controls thyroid hormone regulation. Under stress, the body may increase the production of reverse T3 (rT3), an inactive form of T3. This is thought to be a survival mechanism, reducing the body’s metabolic rate during times of chronic stress to conserve energy. High levels of rT3 can lead to hypothyroid-like symptoms, even if thyroid hormone levels appear normal. Measuring reverse T3 is done as part of our extensive thyroid profile blood test.
Environmental toxins
Several environmental toxins act as endocrine disruptors, interfering with the production, metabolism and action of thyroid hormones. Minimising exposure to these chemicals has a positive impact on thyroid health. Some common ones include:
Bisphenol A (BPA)
BPA is a chemical found in plastics, such as water bottles and food containers. It’s an endocrine disruptor that can bind to thyroid hormone receptors, blocking the normal action of thyroid hormones.
Perchlorates
Perchlorates are chemicals used in rocket fuel, fireworks, and explosives, and they can contaminate water and soil. Perchlorates can block iodine uptake in the thyroid, potentially leading to hypothyroidism.
Pesticides
Pesticides such as organochlorines and organophosphates can interfere with all aspects of thyroid health including thyroid hormone synthesis, regulation and metabolism.
Phthalates
Phthalates are commonly found in plastic packaging and personal care products. There is a direct correlation between higher levels of exposure to these chemicals and thyroid disruption. Phthalates can be particularly damaging to young children.
Halides
The halogens fluoride, chloride, and bromide can disrupt thyroid function by competing with iodine, essential for thyroid hormone production. This interference can block iodine uptake, reducing T3 and T4 hormone levels, which regulate metabolism. To reduce exposure, use a reverse osmosis water filter (or the best water filter you can find to fit your budget), choose fluoride-free toothpaste, avoid processed foods with brominated oils or potassium bromate, and opt for natural cleaning products.
Heavy metals
Heavy metals such as mercury, lead, cadmium, and arsenic can negatively impact thyroid function by disrupting hormone synthesis, interfering with iodine uptake, and promoting oxidative stress.
Mercury, often found in dental amalgams and contaminated fish, can block the enzyme needed for thyroid hormone production. Lead, commonly from old paint or contaminated water, has been linked to reduced thyroid hormone levels and impaired TSH regulation.
Cadmium and arsenic, found in some industrial processes and contaminated foods or water, contribute to oxidative damage in the thyroid, hindering its function. Over time, exposure to these heavy metals may lead to hypothyroidism, fatigue, weight gain, and other thyroid-related issues. Reducing exposure and supporting detoxification can help mitigate their harmful effects.
A comprehensive approach to improving thyroid health
By addressing these key areas – nutrition, lifestyle, herbs, and toxin reduction – Sarah was able to naturally support her thyroid and improve her symptoms without the need for medication. Her energy levels returned, her mood stabilised, and she started to lose the weight that had crept on.
For many women like Sarah, small but targeted changes can make a profound difference in their well-being, even before thyroid disease is fully diagnosed. If you’re experiencing similar symptoms, it may be worth exploring how natural approaches can help optimise your thyroid function.
*Sarah is a real patient, but we’ve changed her name and image to protect her privacy.
