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Thyroid

Has your get up and go gone? Get tested. Not all fatigue is due to thyroid malfunction, so how do you tell the difference?

Your thyroid is a small butterfly-shaped gland that produces hormones that influence essentially every organ, tissue and cell in your body. Thyroid disease, if left untreated, can lead to heart disease, infertility, muscle weakness, osteoporosis and, in extreme cases, coma or death -- yet it’s estimated that half of the cases in the United States remain undiagnosed.

Hypothyroidism (under active thyroid) affects some 80 percent of people with thyroid disease. Symptoms of hypothyroidism include fatigue, forgetfulness, depression, constipation, and changes in weight and appetite.
Thyroid-related fatigue begins to appear when you cannot sustain energy long enough, especially when compared to a past level of fitness or ability. If your thyroid foundation is weak, sustaining energy output is difficult. You will notice you just don’t seem to have the energy to do the things you used to be able to do.




Key symptoms of Thyroid Fatigue:


Feeling like you don’t have the energy to exercise, and typically not exercising on a consistent basis.
· A heavy or tired head, especially in the afternoon, as your head is a very sensitive indicator of thyroid hormone status.
· Falling asleep as soon as you sit down and don’t have to do anything.




How do you know if your yhyroid is not working properly?


Your body will likely let you know, and fatigue is the most common sign, followed by depression and muscle weakness. Along with the symptoms above, signs of an under active thyroid also include:

· Difficulty losing weight despite proper diet and exercise
· Sensitivity to cold
· Dry, rough or scaly skin, and dry, tangled hair
· Hair loss, particularly from the outer part of your eyebrows
· Brittle nails, cold hands and feet




Thyroid Description


The butterfly-shaped thyroid gland is located in the front of your neck and wraps partially around the windpipe. The gland is responsible for making thyroid hormones that control the metabolism of all cells in your body. If the thyroid overproduces hormones, you can have a condition called hyperthyroidism. This condition commonly causes symptoms such as a forceful and rapid heart beat, insomnia, sudden weight loss, breathlessness, nervousness, irritability, sweating, and frequent bowel movements.1

Many people can also suffer from different degrees of low or under active thyroid function, called hypothyroidism. Symptoms of a thyroid gland producing too little thyroid hormone can include a slow metabolism, listlessness, lowered body temperature, weight gain, constipation, muscle soreness, feeling cold, fatigue, depression, high cholesterol and homocysteine, painful joints, dry skin, and hair loss.1-4




Thyroid Hormones


There are two types of thyroid hormones: Thyroxine (T4) and Triiodothyronine (T3). T4 is inactive and kept in reserve; T3 is the active hormone. Thyroid hormones control the growth, differentiation, and metabolism of each cell in our body. They also control how fast our body uses the fuel that we consume, particularly carbohydrates and fat.1 This helps to regulate our body temperature and fat percentage. About 80% of thyroid hormone production is T4, the inactive thyroid hormone that is typically held in reserve by the body. T3 makes up only 20% of thyroid hormone production,5 but it is the active hormone that the body uses to function. T4 is converted into T3 when thyroid hormone is needed.

The release of the thyroid hormones is controlled by thyroid stimulating hormone (TSH), which is produced in the pituitary gland. Low circulating levels of thyroid hormone are detected by the hypothalamus, which then instructs the pituitary to release TSH. When sufficient amounts are released, the hypothalamus communicates with the pituitary to stop or slow down. Because of this complicated feedback loop, high levels of TSH in the blood often mean the pituitary is trying to stimulate thyroid hormone production, but the thyroid gland is not responding. This condition is known as hypothyroidism.




Benefits of the Thyroid


· Regulates temperature, metabolism, and cerebral function
· Increases energy, body temperature, and warmth
· Increases fat breakdown, resulting in decreased weight and lower cholesterol
· Protects against cardiovascular ailments 3,6
· Improves cerebral metabolism
· Supports cognitive function 7
· Relieves symptoms of thin sparse hair, dry skin, and brittle nails




Side Effects


The most common side effects from too high a dose of thyroid hormone are heart palpitations, 8 increased pulse, excessive sweating, heat intolerance, and nervousness.




Administration


The recommended form of thyroid replacement is an Armour Thyroid Compound, which is a combination of T3 and T4. 9 Studies show that a percentage of patients prefer the combination of T4 and T3 over T4 alone. 10,11 The combination allows the body to receive the active and inactive form to treat those patients who are not able to properly convert. In contrast, traditional physicians continue to prescribe the synthetic thyroid hormone T4 or Synthroid. Synthroid is only T4 and may not convert to T3.




References


References

1. Huber MA, Terézhalmy GT. Risk stratification and dental management of the patient with thyroid dysfunction. Quintessence Int. 2008 Feb;39(2):139-50.

2. Asranna A, et al. Dyslipidemia in subclinical hypothyroidism and the effect of thyroxine on lipid profile. Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S347-9.

3. Kutluturk F, et al. Changes in metabolic and cardiovascular risk factors before and after treatment in overt hypothyroidism. Med Glas (Zenica). 2013 Aug;10(2):348-53.

4. Rao ML, et al. Low plasma thyroid indices of depressed patients are attenuated by antidepressant drugs and influence treatment outcome. Pharmacopsychiatry. 1996 Sep;29(5):180-6.

5. Sapin R, Schlienger JL. [Thyroxine (T4) and tri-iodothyronine (T3)determinations: techniques and value in the assessment of thyroid function]. Ann Biol Clin (Paris). 2003 Jul-Aug;61(4):411-20.

6. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001;344(7): 501-509.

7. Bunevicius R, et al. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med. 1999 Feb 11;340(6):424-9.

8. Toft AD. Thyroid hormone replacement – one or two? N Engl J Med. 1999 Feb 11;340(6):469-70.

9. Gaby AR. Sub-laboratory hypothyroidism and the empirical use of Armour thyroid. Altern Med Rev. 2004 Jun; 9(2):157-179.

10. Escobar-Morreale HF, et al. Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone. Ann Intern Med. 2005 Mar 15;142(6):412-24

11. Sesmilo G, et al. Serum free triiodothyronine (T3) to free thyroxine (T4) ratio in treated central hypothyroidism compared with primary hypothyroidism and euthyroidism. Endocrinol Nutr. 2011 Jan;58(1):9-15.