Ever found yourself with a total body bummer: depression, insomnia, tiredness, irritability, cold hands, shortness of breath, heart palpitations, poor memory, menstrual problems? All this could mean just about anything. But one thing your holistic practitioner or doctor will certainly want to check is your thyroid, that tiny gland in your throat. When it conks out, people are said to suffer from hypothyroidism (low thyroid).The problem is, allopaths and naturopaths have quite different definitions of what "low" is and how to treat it. Holistic practitioners have traditionally advised patients to measure thyroid function by taking their temperature daily, though many now believe that method is useless. The most reliable way to measure thyroid function is a blood test to check your thyroid-stimulating hormone (TSH) and thyroid hormone levels.
If TSH is too high, your thyroid isn't keeping up with its workload and the pituitary gland, which makes TSH, is working overtime to get it going again. But how high is too high? In general, doctors believe a reading of 5 or more is abnormal, whereas holistic types are more likely to say 2 or higher. Not only do the two sides disagree on diagnosis standards, but they also advise different treatment paths.
Allopaths will prescribe thyroxin (T4), a slow-acting thyroid hormone that the body converts to the active hormone T3 as it is needed. Naturopaths are more likely to try nutritional intervention with iodine-rich kelp and other minerals first, and send a patient to a holistic GP for prescriptions for T4 and T3 if that doesn't work. They also posit that low T3 levels could be caused by exhausted adrenal glands.
The medical profession, on the other hand, is less apt to see low adrenal hormone production as a problem and more likely to believe that treating with kelp can be potentially dangerous. But most important, many endocrinologists worry that prescribing T4 if it isn't absolutely necessary can seriously tamper with your long-term health - one reason they test the blood levels of those taking thyroxin every few months.
This is an area where the stakes are high, so be careful where you put your trust, and get at least two or three opinions on both sides of the fence when it comes to that butterfly-shaped gland.
what the experts say
"Everyone has felt the symptoms associated with underactive thyroid at one time or another. They are related to a thyroid problem only in combination with high TSH. If the TSH level is normal, then I would pursue other avenues. Depression, anxiety and many other disorders can have similar symptoms. I see no evidence that the adrenals cause thyroid disease, but you can get adrenal problems and thyroid problems occurring concurrently because both can be caused by auto-immune disorders. You can get either an overactive or an underactive thyroid as a result of too much iodine. There's no need for supplemental iodine in the Toronto area because of iodized salt and the fertilizers used to grow fruits and vegetables."
JAY SILVERBERG, MD, staff endocrinologist, Sunnybrook and Women's College Hospital, associate professor of medicine, University of Toronto
"The problem is the conversion from T4 to T3. There can be a number of reasons why that doesn't occur. One of the most common is low iron. A number of other nutrient deficiencies also prevent that proper conversion. Another reason would be low cortisol (an adrenal hormone) levels. I do see iodine deficiency, but not a high amount of it. If TSH is at the higher end of normal, iodine and tyrosine supplementation would be an excellent place to start. Kelp or seaweed is a nice way to get iodine."
MARILYN MAY, naturopath
"Only people with thyroid issues who show low basal body temperature (BBT) are severely hypothyroid. Conversely, lots of normal people have low BBT, too. The TSH measurements assess thyroid function very well. If people are vulnerable to auto-immune thyroid disease (have a family history of it), then they should be cautious about high-iodine foods such as sea vegetables. There has also been misinformation about using a combination of T3 and T4 as treatment. When doctors give both, they end up suppressing TSH and making the person chemically hyperthyroid. Over 10 years, it increases the risk of cardiac complications such as auricular fibrillation. If you suppress TSH and make the person the least bit hyperthyroid, you also increase the risk of osteoporosis."
ROBERT VOLPE, MD, professor emeritus, U of T, department of medicine, division of endocrinology, officer of the Order of Canada
"Low thyroid based on symptoms and body temperature is grossly overdiagnosed. I believe you should diagnose at the lower TSH level and take into account the symptoms. You also have to rule out other endocrine problems that can mimic low thyroid, like adrenal insufficiency and ovarian, testicular and pituitary problems. Certain heavy metals like mercury can suppress the thyroid. The majority of people who have been told by a naturopath that they have low thyroid don't need thyroid hormones but rather nutritional intervention, perhaps zinc, copper, selenium and iodine. They need more protein and should eliminate refined carbohydrates. If you want to weaken your thyroid, the best thing you can do is eat tons of sugar."
ZOLTAN RONA, MD, MSc
"When the adrenals are tired by stress, the thyroid tries to keep the metabolism up, but it will tire quite easily. You can form antibodies against your own thyroid hormones if your gut isn't working properly."
VERNA HUNT, naturopath, chiropractor