How To Balance Thyroid Hormones

What is the thyroid’s role in your body?

Divided into two lobes, the thyroid gland is a butterfly-shaped organ located in the midline of the neck. These lobes secrete two major hormones that are thyroxine (T4) and triiodothyronine (T3). Moreover, C-cells of the thyroid gland also secrete Calcitonin. Together these hormones are responsible for regulating the body’s metabolism, growth, and calcium balance.¹

Secretion of thyroid hormone is under the control of Thyroid Stimulating Hormone (TSH), which in turn is regulated by the hypothalamus. It is a well-known fact, that apart from a few exceptions, all the body tissues have thyroid hormone receptors and function in coordination to maintain the body’s weight and energy expenditure.²

Whenever the thyroid gland either secretes very little or too much thyroid hormones, then your body faces multiple challenges. These are precipitated in the form of weight changes, energy expenditures, altered metabolic rate, etc. These conditions called hypothyroidism and hyperthyroidism respectively also influence your heart rate, skin texture, temperature tolerance, fertility, menstrual cycle, etc.³

Causes of thyroid hormone imbalance

Thyroid hormone imbalance is undoubtedly the most common endocrine disorder thus affecting a large number of people worldwide. Thyroid disease can influence men, women, teens as well as children. However, it is a well-established reality that women suffer more than men.

Here is a list of factors that put someone at risk of developing thyroid hormone imbalance:

• If you have a family history of thyroid problems
• If autoimmune diseases such as Type I Diabetes Mellitus or rheumatoid run in your family
• If your medical history highlights the use of medications for hyperthyroidism (antithyroid medicines) or you have undergone radiotherapy using Radioactive Iodine
• If you have undergone thyroid gland surgery

Knowing the risk factors gives you an edge toward understanding certain signs and symptoms that one might experience if suffering from thyroid issues. On top of that, it also enables your physician to acknowledge your need to go for thyroid screening.

Even though having risk factors surely increases your chance of acquiring abnormal thyroid levels, it doesn’t guarantee that you will end up the thyroid hormone imbalance. On the contrary, having no risks doesn’t save one from developing thyroid disorders.

Hypothyroidism and hyperthyroidism

Hypothyroidism

The pathological condition with low levels of thyroid hormone is referred to as hypothyroidism. The prevalence rate is between 3-5% in Europe.⁴ Its varied clinical presentation can be explained biochemically.⁵ 

Thyroid stimulating hormone or ‘TSH’ is found in higher concentrations whereas the level of free thyroxin hormone is below the reference range in people suffering from hypothyroidism. This kind of situation primarily arises due to the following causes:⁶

Hashimoto’s thyroiditis

Also referred to as chronic lymphocytic thyroiditis, is the most frequent cause of low levels of thyroxine hormone. It is an autoimmune condition that leads to chronic inflammation of the thyroid gland, eventually causing underactive thyroid functioning. Hashimoto’s thyroiditis runs in families and generally affects women.

Postpartum (60%–70% transient)

This condition is similar to Hashimoto’s thyroiditis, affecting approximately 3 in 100 or 2 in 25 pregnant women. Postpartum thyroiditis precipitate if a woman’s gland inflames post-delivery. Does this imply that every pregnant woman develops this condition? Absolutely not! If someone has a history of thyroid condition before pregnancy or it runs in someone’s family, then it elevates the risk of developing this condition. 

Deficiency of Iodine

The production of thyroid hormone primarily depends upon the presence of Iodine. Thus, a diet deficient in iodine could cause a thyroid imbalance.

Apart from the mentioned causes, if someone is on anti-thyroid medications or has undergone surgeries on the thyroid gland, then the chances of developing hypothyroidism rise.

Hyperthyroidism

Characteristically, hyperthyroidism is diagnosed when there is a low level of TSH (thyroid stimulating hormone) and high levels of thyroxine (T4) or tri-iodothyronine (T3) or both in the blood.  There is also another condition called, thyrotoxicosis, which denotes increased secretion of thyroid hormones but from an extra-thyroidal source.⁷

With a prevalence rate of 0.8% in Europe similar to hypothyroidism, hyperthyroid is also more frequently observed in women, and is caused because of the following reasons:^6,7

Graves’ disease

This is the most common cause of hyperthyroidism in the United Kingdom. Grave’s disease is distinguished by the presence of Thyroid Stimulating Antibodies (TsAB). These antibodies block the binding of TSH on Thyroid receptors. Patients suffering from Grave’s experience symptoms typical of hyperthyroidism such as weight loss, rapid heart rate, irritability, excessive sweating, frequent bowel motions, etc.

Iodine-induced hyperthyroidism

Too much iodine in meals provides increased substrate for the synthesis of thyroid hormones. Apart from diet, excess iodine can be incorporated into medicines.  

Toxic unimodular or multinodular goiter

The development of nodules within the thyroid gland releases thyroid hormone in excess, causing hyperthyroidism. The presence of a single nodule is termed an adenoma and is known to be linked to genetic alterations, whereas the presence of multiple nodules is called a multinodular goiter.

Drugs and pituitary adenoma metastatic thyroid cancer 

These elements stand as additional contributors that might induce a state of hyperthyroidism.are some more factors that have the potential to cause a hyperthyroid state.

Symptoms of thyroid hormone imbalance

Thyroid imbalance affects different organs of the body. However, there are many symptoms one might experience if suffering from thyroid issues. The signs and symptoms shown by a thyroid patient might be similar to those exhibited in other diseases.

Symptoms of thyroid imbalance are different for people suffering from hypo and hyperthyroidism. The clinical manifestation of both these entities is mirror images of each other.

The clinical impression of an underactive thyroid gland:

• Chronic fatigue
• Intolerance to cold/ hypothermia
• Weight gain
• Bowel issues such as constipation
• Bradycardia
• Slow reflexes
• Mental slowing and depression
• Irregular menstrual cycle

The clinical features of an overactive thyroid:

• Hypothermic/ experience raised temperature when others feel cold
• Loss of weight
• Increase in appetite
• Thinning of hair
• Anxiety, irritability, and nervousness
• Heavy menstrual flow
• Hoarseness in voice

Types of thyroid hormones

There are two types of thyroid hormones - the first is thyroxine and the second is triiodothyronine. The terms you must have heard commonly are T4 and T3 respectively.

Thyroxine is secreted in a concentration of 90% as pro-hormone and has to be converted to triiodothyronine for required action. Approximately, 10% of triiodothyronine is secreted by the thyroid gland in active form.

Actions of both T3 and T4 are orchestrated via thyroid hormone receptors (TR). A major proportion of circulating hormones is bound to protein (thyroid-binding globulin), making the concentration of “free” and bound hormones clinically relevant.

Your thyroid is also responsible for producing calcitonin, a hormone that controls your body’s calcium metabolism. While calcitonin plays an important role in maintaining your overall health, it’s not directly linked to thyroid hormone dysregulation.

How thyroid hormone imbalances affect your 

Fertility 

The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology define infertility (clinical definition) as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse".

According to the research done, thyroid hormone has both direct and indirect effects on human fertility.

Limited literature has been found about subclinical and overt hyperthyroidism and female infertility. In general, if females of reproductive age are not managed timely, then the rate of early pregnancy loss is increased.¹⁰

However, both subclinical and frank hypothyroidism is linked to a high risk of female infertility as well as unfavourable or late pregnancies. Clinical hypothyroidism has a number of ovulatory changes in females of fertile age which can manifest in the form of altered lengths and disturbances of menstrual cycles.¹⁰

Menstrual cycle

Menstrual disturbances are observed both in cases with overactive and underactive thyroid. Hyperthyroid patients most commonly observe a state of amenorrhea (no menstrual flow) and oligomenorrhea (decreased menstrual flow). Some patients might also experience anovulatory cycles, i.e., no ovulation during the entire menstrual cycle.⁹

On the contrary, polymenorrhea (increased menstrual bleeding) is a key disturbance observed in hypothyroid patients. Moreover, such people also encounter Galactorrhea (milky discharge from nipples).⁹

How to balance thyroid hormones

Once you are diagnosed with thyroid hormone disorder, it becomes essential to balance these altered hormonal levels. You can either follow a traditional or pharmacological approach or you can try some natural remedies.

To balance your hormones pharmacologically, you must consult your physician. If you are diagnosed with hypothyroidism, then your doctor will prescribe you a tablet that will replace your missing hormone. However, most often you will be asked to continue this medication lifelong. The medical management of hyperthyroidism depends upon the severity of the disease and the underlying cause. The most frequently opted option is radioactive iodine which destroys the gland, following which doctors put patients on medication to compensate for the absence of the thyroid gland.

However, if you are hesitant to bring pills into your routine, then you can always adopt some natural remedies that include:

Maintaining a balanced diet

Choosing healthy eating over carbonated and carbohydrate-enriched items can surely bring a lot of difference in your physical health. Gluten, artificial sugar, and other junk food items can deteriorate your hormonal levels by elevating inflammatory processes in the body.

De-stress yourself

Go on a walk, relax on a beach, indulge yourself in yoga or any sort of workout, enjoy some music; do whatever helps your body de-stress. It activates your parasympathetic nervous system, promoting the health of your thyroid glands.

Supplement yourself with vitamins and minerals

Vitamins such as Vit A (retinol) are known to catalyze the production of T3 and stabilize the levels of TSH. You can easily inculcate it in your diet by consuming fish, Cod-liver oil, and butterfat, or you can simply opt for Vitamin A capsules.

Similarly, adding seeds and nuts to your meals fuels you up with selenium which is known to be essential for conversion of T4 to T3.

Iodine balance

Iodine is the backbone of thyroid production. Make sure, your intake of iodine is appropriate. Too little or too much of this element can end up in thyroid hormonal imbalance

Summary

The thyroid gland is a small butterfly-shaped gland situated in the midline of the neck. The gland secretes two major hormones: thyroxine and triiodothyronine, known as T4 and T3. These hormones are responsible for your body’s metabolic activities and energy expenditure. Thyroid stimulating hormone under the control of the pituitary gland monitors the secretion of thyroid hormones.

If you are suspecting yourself to be suffering from thyroid hormone imbalance, you must look for signs and symptoms such as weight loss, hyperthermia, dry skin, amenorrhea, and increased metabolic rate in hyperthyroidism.

Exact opposite symptoms as - increased weight, abnormal menstrual cycle, decreased metabolism, hypothermia, and lethargy are indicators of hypothyroidism.

According to the American Thyroid Association, the prevalence rate is seen more in women. Moreover, up to 60 percent of the population with thyroid imbalance are unaware of their situation.

Women in fertile age groups who suffer from thyroid issues can face challenges in the form of disturbed menstrual cycle and infertility.

So, if you are confirmed with hormonal imbalance, then you can get it managed by your physician or you can choose to balance it through natural methods such as altering your diet and lifestyle, managing stress, and supporting your diet with vitamins and minerals.

Thyroid disease is a life-altering medical condition that demands constant management. With the right knowledge and guidance from your physician, one can lead a normal life even with thyroid hormone imbalance.