Thyroid Treatment for Underactivity (Hypothyroidism)

Dr. Reeder will discuss and select appropriate options for treating hypothyroidism depending on full evaluation and test results.

Opitimising thyroid function MUST be done under supervision by your clinical response, blood testing, temperature monitoring, and a new computerised neuromuscular reflex response test.

This is an in depth table summary of most supplements and hormones used in treating the underactive thyroid as well as toxic and other environmental factors.

Stimulating thyroid gland to make more T4
Supplement	Description	Testing	Treatment	Side-effects
Iodine	Essential for production of thyroid hormone. Deficiency used to be common, still happens. Is added to salt, some people don't eat salt. Children very susceptible. Other halogens may interfere e.g. Bromine and Chlorine and Fluoride. (it was once used to treat overactive thyroid).	Not easy to test. Best is a 'Urinary Iodine Loading Test	As kelp or actual Lugol's iodine, under medical supervision. Oral Iodine/Iodide tablets	High intake unlikely to cause adverse problems unless past history or family history of thyroid disease. Lack of iodine causes enlarged thyroid (goitre)
Tyrosine	Thyroxine is basically Tyrosine (an amino acid) plus 4 atoms of iodine.	Dietary and digestive assessment	Improve dietary protein or supplementation of Tyrosine 500mg 3x daily	nil
Herbs Kelp Guggal Coleus Bacopa Withania Coconut oil	Kelp contains iodine, it is an iodine supplement. Other herbs can stimulate the thyroid gland. Coconut oil also stimulates the gland. A great saturated fat option for cooking with.		Early treatment when very mild sub clinical hypothyroidism.
Supporting conversion of T4 to active T3
Selenium	An enzyme 5'deiodinase splits 1 iodine off T4. This process requires Selenium. Too much can do the opposite and block the enzyme. Two other enzymes systems need selenium, glutathione peroxidase (protects thyroid cells) and thioredoxin reductase. Other factors affecting T4 to T3 are stress, starvation, illness, drugs espec steroids (cortisone, prednisone etc). Also in stress, T4 can be converted to rT3 (reverse T3 which can block receptor sites on and in cells from access by normal T3. Maybe this is the body's way of slowing down the metabolism under major stress.	Testing by blood Selenium levels and/or Hair Mineral Analysis.	If deficient, up to 300mcg daily as drops. Often with iodine.	Excess selenium can cause toxicity. It is vital to understand that selenium and iodine work together. If iodine is taken in presence of low selenium, over-production of T4 can occur. If low iodine and high selenium, initial hyper then hypo can occur. So must not take selenium if iodine deficient.
Copper and Zinc	Also need balancing together. Excess of one can reduce the other. High copper may block T3 inside the cell mitochondria (the powerhouse of the cell) and low copper affects the thyroid cells T4 production.		Copper is 2mg daily Zinc is 30mg daily Best as chelated form Ratio is 1:15	Too much copper can block several other nutrients - Zn, Mg, I, Mn,B1, C, E, Folate.
Progesterone	In women it assists excretion of copper which increases if estrogen is relatively high when progesterone low. Copper retains sodium which retains water (some women get fluid retention)	Assessment may prove progesterone deficiency by symptoms and blood testing	Refer to hormone page.	Refer to hormone page.
Omega 3 fish oils	May assist in the transport of T3 through the cell membranes.		1000 mg 2-3 daily	nil
Thyroid Hormones
Thyroxine T4	If T4 production cannot be improved by support as above, or the gland is incapable of functioning from disease, then synthetic T4 is typically given. This may be all that is necessary providing T4 can convert to T3 and can be transported into healthy cells and mitochondria. If not, T3 may be required as well.	Blood tests and clinical response	Doses range depends on degree of deficiency Usual dose is 50-200 mcg. Must be under medical supervision. Absorption can be altered by many drugs and poor diet.	Overdose can occur if not monitored. Anxiety, heart palpitations, tremor, twitching, chest pains, bone thinning over a long time.
Tri-iodothyronine T3	Used less often but many T4 treated patients may still not feel well after months of treatment. They may have persistent symptoms of hypothyroidism despite normal T4 and low range T3. (i.e. T4 resistance) Adding small doses gradually may make a huge difference. But first we try supplements as above to improve T4 conversion.	Blood tests and clinical response.	Big range from 7.5mcg up. MUST always be under medical supervision.	As above .
Natural Thyroid extract (Armour) (Whole Thyroid)	Usually pork of bovine derived. Has same hormones as human. Can be extremely effective when balancing is difficult and in mild to moderate gland failure. Benefit is that it contains a good balance of ALL thyroid hormones T4, T3, T2, T1 etc. It is obtained from compounding pharmacies. Constituents may vary from batch to batch (then so can prescription Thyroxin). May represent a more 'natural and complete' option.	Blood tests and clinical response.	30-120 mg daily. 60mg = 100mcg of T4
Adrenal Cortisol	It is imperative that adrenal function is assessed. As with the whole endocrine (hormone secreting) system, each requires balancing with the other. Synchrony or interdependance is vital. Cortisol strongly influences the level of thyroid receptor activity.	Adrenal function tests are done in all cases	Different approaches may be required depending on the status of the adrenal gland.	Adrenal hormone cortisol levels must be maintained within the normal range. As with any human function, excess or deficiency can result in serious health malfunction. Careful monitoring is essential.
Toxic Antagonists - that interfere with Thyroid function
Fluoride, Chlorine, Bromides	In same chemical group as iodine. May block iodine absorption. Controversial ; is fluoridation of water a contributing factor to so much thyroid underactivty? It also depletes zinc - necessary for T4 production.
Toxic metals (Lead, aluminium, mercury, cadmium, arsenic, copper, antimony)	All can block various nutrients needed by the Thyroid.
Brassicas	Uncooked brassicas (brussels, broccoli, cauli, cabbage, kale, peanuts, watercress) can block T4 production in some people. Soy also is a 'goitrogen'.
High GI diet	Metabolic syndrome, even diabetes can reduce conversion of T4 to T3. Overweight people especially if insulin resistant can be thyroid underactive. See Metabolic Syndrome.	Blood tests.	Low GI (glycaemic diet) or Mediterranean Diet.
Certain prescription drugs