Prevention is a foundation of Functional Medicine which I practice. 

When I think of a disease that could easily be prevented if screened for early—Thyroid immediately comes to mind. In fact, almost 10% of the population is estimated to have some degree of thyroid imbalance, but only 1% is officially diagnosed. This means that 9 out of 10 people with early thyroid disease will likely not get the preventive help they need.

I think of the thyroid gland as a mirror of our personal lifestyle. As our environment changes, so does the thyroid. Its function is designed to be activated or suppressed in response to the daily stressors and metabolic demands we face. 

Surprising Symptoms of Thyroid Imbalance

Patients with an imbalanced thyroid gland present with a variety of complaints. Some of them are:

  • Mental & physical fatigue
  • Unintentional weight gain or loss
  • Insulin resistance or Metabolic Syndrome
  • High cholesterol despite one’s best dietary efforts
  • Depression
  • Infertility

Causes of Thyroid Imbalance: A Functional Medicine Perspective

How Stress Sabotages Thyroid Function in Functional Medicine

When Holistic and Functional Medicine doctors consider thyroid etiology for the patient’s presenting symptoms, they usually consider what kind of past or current stressors surround their patient. It is a well-known fact that stress suppresses thyroid function at multiple levels and should be considered right away. In fact, stress affects the production of thyroid releasing hormone at the hypothalamic level, influences the production of thyroid stimulating hormone at the pituitary level, interferes with the production of the T4 hormone by the thyroid gland itself, and even at the peripheral level by affecting the conversion of T4 to T3 hormone. Thus, it should come as no surprise that we consider the Ayurvedic (ancient Indian) view of the body chakras, thyroid function is intimately connected with blockages in the Throat Chakra. It takes experience and a unique skill set to treat thyroid by fusing the best of Western and Eastern healing modalities. 

Environmental Triggers: A Hidden Cause of Thyroid Issues

In addition to stress, we should always consider what environmental triggers the patient could have potentially been exposed to. Could an infection or some sort of inflammation create a compromised milieu for the functioning of the thyroid gland? Many different viral, bacterial, fungal, and even parasitic infections can trigger autoimmune inflammation of the thyroid gland. Therefore, identification and treatment of any such underlying infection is of utmost importance.

Nutritional Deficiencies: A Missing Piece in Thyroid Health

Another consideration: Is there some sort of nutritional deficiency or a presence of food sensitivity, which could potentially compromise functioning of the thyroid gland? Getting checked for food sensitivities or Celiac might get us some answers. The most common deficiencies identified in newly diagnosed thyroid patients are: Vitamin A, Vitamin D, Selenium, Vitamin E, Vitamin K, Iron, Zinc, and B12. If any such deficiency is identified, prompt supplementation may lead to correction of the imbalance. 

For example, a systematic review and a meta-analysis of Selenium supplementation in the treatment of Hashimoto’s thyroiditis in the thyroid: The Official Journal of the American Thyroid Association has concluded that—on the basis of the best available evidence—Selenium supplementation is associated with a significant decrease in the Thyroid Peroxidase Antibody titers at 3 months and with improvement in mood and general well-being. Another 2017 study in the International Journal of Endocrinology concluded that Selenium supplementation in patients with Hashimoto’s thyroiditis may be useful even for those who are already being treated with levothyroxine.

Iodine: Too Little or Too Much?

I must also mention a common dietary question I hear from patients: HOW does Iodine fit into the picture of a healthy thyroid?

In truth, there is no straightforward answer to this question. It seems like Iodine deficiency as well as the excess of Iodine in the diet or supplementation, can cause disturbances with thyroid. I typically recommend that the salt the patient consumes for cooking should be iodinized. Interestingly, Iodine deficiency seems to be most prevalent in pregnant, vegetarian, and vegan patients. In fact, a study in the Annals of Nutrition and Metabolism discovered that 80% of the vegans included in the study suffered from Iodine deficiency, and the proposed reason was that vegans do not eat fish and other sea products, which are all rich in Iodine. Nevertheless, I do not recommend taking any Iodine containing supplements with more than 150 micrograms of Iodine (a recommended daily value, RDA). Food intake via seafood products is always more natural, in my humble opinion, than pushing high doses of supplements. 

The Functional Medicine Approach: Addressing the CAUSE—Not Just the SYMPTOM

Overall, the takeaway message of this article is this: If you feel that your symptoms could be resulting from thyroid imbalance, get it checked out and consider how managing your stress, diet, and lifestyle can help you heal this common condition.

Lifestyle interventions, however small, always improve thyroid function, and this is most likely thanks to the mitigation of an inflammatory state, which either directly or indirectly instigated thyroid dysfunction in the first place. 

The content of this article has not been evaluated by the Food and Drug Administration. This blog post is not intended to diagnose, treat, cure, or prevent any disease.