Mild Hypothyroidism Thyroid Disease Symptoms Iodine Deficiency

Correcting Mild Hypothyroidism

Hypothyroidism, or underactive thyroid, is a tricky subject. Its symptoms are wide-ranging and non-specific, and turn up in all sorts of other health problems. Trickier still is the subject of mild hypothyroidism. For some in the medical establishment, mild hypothyroidism is simply not a problem because it falls outside the diagnosis radar, as defined by blood tests.

• However, that opinion is changing, as more doctors and researchers are beginning to question the definition of ‘normal’ with regard to the reference ranges set by laboratories to assess the level of thyroid hormones in the blood.

Read And Learn More: Health Problems And Dietary Solutions

• In the meantime, and until there is a shift in the received wisdom on the subject, the best you can do is be as well-informed as possible on the workings of the thyroid gland.
• This chapter is a guide to those of you who feel you might have mild, or sub-clinical, hypothyroidism those of you who find yourself in the situation of having had the tests and been given the all-clear, whilst experiencing the symptoms of a condition you technically don’t have.
• It is an unfortunate fact that it is usually only when symptoms become bad enough to show up on blood tests that any help becomes available.
• First, a bit of background on what the thyroid does, and how it can go wrong.

Mild Hypothyroidism Anatomy Of A Gland

The thyroid is a gland at the front of the neck, shaped rather like a butterfly and consisting of two lobes, one on either side of the wind-pipe and joined by tissue called the isthmus. It governs metabolism in virtually every cell of the body and is responsible for your overall metabolic rate – in other words, the speed at which you burn food for fuel.

• Hormones are secreted by the thyroid as part of a process of hormone production which begins in a section of the brain called the hypothalamus. The hypothalamus produces a hormone called thyrotrophin-releasing hormone (TRH).
• TRH travels to the pituitary, a gland in the brain, where it stimulates the release of thyroid-stimulating hormone (TSH).
• TSH does exactly as its name suggests: it stimulates the thyroid to produce hormones. Two hormones, to be precise.
• These are thyroxine (aka T4 because it contains four atoms of iodine) and triiodothyronine (aka T3 because it contains three atoms of iodine).
• Thyroid hormone is the term used to describe both these hormones together. T4 is converted to T3, its active form, in the thyroid but also in other parts of the body, including the liver and the brain. However, this conversion takes place only if the body is up to the job.
• An inability to convert T4 to T3 can cause problems, but more of this later. The pituitary gland is a sensitive feedback device it detects levels of circulating thyroid hormone and adjusts output accordingly.
• As thyroid hormone levels in the blood decline, TSH levels increase. As thyroid hormone increases, TSH decreases.
• Almost all of the thyroid hormone in your blood is transported around by proteins. But a very small amount – 0.03 per cent – is not attached to proteins and is described as being ‘free’. It is only this free thyroid hormone which can enter the body’s cells and be of any use.
• It is extraordinary but true that, to date, no one knows what the point is of all that protein-bound thyroid hormone in the body.

What the Thyroid Does

• The hormones produced by the thyroid stimulate metabolism and are responsible for your basal metabolic rate (BMR) by regulating the speed at which cellular activity is carried out. Your BMR is the rate at which you metabolize nutrients when at rest.
• Metabolic activity creates heat, so the thyroid is also responsible for maintaining body temperature. That is why coldness is a symptom of hypothyroidism.
• The thyroid hormone stimulates the metabolism of protein in muscles, as well as carbohydrates and fats for energy. So if you don’t produce enough thyroid hormone, you may find you put on weight rather too easily.
• All organs depend on the thyroid gland the heart relies on thyroid hormone to pump blood, the lungs need it for respiration, the intestinal tract for the transition of food. Bones require thyroid hormone for growth.
• It stimulates brain activity, which is why excessive amounts can cause overanxiety and too little can result in mental apathy.

Thyroid Disease

Thyroid disease is the name given to any thyroid condition. Women are much more likely to have some sort of thyroid disorder than men. It is also more common in people over the age of 35, and often runs in families. It is impossible to say just how common thyroid disease is because the answer depends on whom you ask. According to Dr Barry Durrant-Peatfield, author of Your Thyroid and How to Keep it Healthy, estimates – made by physicians specializing in hypothyroidism – range from 10 per cent of the population to 80 per cent.

• Those figures are much higher than official estimates, which state that about 1.9 per cent of women and 0.1 per cent of men in the UK will develop hypothyroidism at some point in their lives. About 2 per cent of women and 0.2 per cent of men will develop hyperthyroidism – overactive thyroid – at some point in their lives.
• You are more at risk of developing thyroid disease if:
  • There is a family history of the condition
  • You are pregnant
  • You have coeliac disease or any other autoimmune disorder (see below)
  • You have been exposed to radiation
  • You are on certain medications which can trigger disease, notably lithium
  • You have a low intake of iodine
  • You are diabetic. It has been estimated that 10.8 per cent of diabetics have thyroid disease.
• There are several types of thyroid disease the most common are hyperthyroidism, goitre, thyroiditis, thyroid eye disease, nodules, thyroid cancer and hypothyroidism. If you have normal thyroid activity, you are described as being euthyroid.

Hyperthyroidism: The opposite of hypothyroidism, with this condition the thyroid produces too much thyroid hormone rather than too little. Therefore symptoms are the direct opposite of those of hypothyroidism: everything is too fast rather than too slow.

• Hyperthyroidism Signs And Symptoms
  • Weight loss
  • Insomnia
  • Hyperactivity
  • Rapid heartbeat
  • Palpitations
  • Diarrhoea/frequent bowel movements
  • High blood pressure
  • Irritability
  • Anxiety
  • Dry skin or thickening of the skin
  • Britde hair
  • Tremor
  • Menstrual irregularities
  • Feeling of ‘overheating’
  • Bulging eyes
  • ‘Club’ nails
  • Visibly enlarged thyroid gland.
• What Causes Hyperthyroidism: The most common cause of hyperthyroidism is Graves’ disease, which is an autoimmune disorder where the body produces thyroid-stimulation antibody (TSA) which attacks the thyroid. In response to this attack, the thyroid overproduces thyroid hormone. Graves’ disease is more likely to occur if other family members have also been affected.
• Treatment for Hyperthyroidism
  • Hyperthyroidism is usually treated with anti-thyroid drugs which suppress the production of thyroid hormone. It may also be treated with beta-blockers to calm the heart rate.
  • In some cases, part of the thyroid may be surgically removed in a procedure known as partial thyroidectomy.
  • This can be a bit tricky as exactly the right amount needs to be removed to be effective and to avoid hypothyroidism arising from removing too much.
  • Giving radioiodine (radioactive iodine in pill form) is another form of treatment as it reduces the gland’s activity. This form of treatment is not given to children or pregnant or breastfeeding women and can only be carried out by authorized medical staff.

Goitre

• This is an enlarged thyroid gland which is visible as a swelling in the neck. A goitre can be caused by either hypothyroidism or hyperthyroidism. It can also be caused by insufficient or excessive iodine intake or elevated levels of thyroid auto-antibodies.
• Symptoms experienced may include difficulty swallowing, chest pain and a full feeling in the throat. There may also be shortness of breath.

Thyroiditis

• This is any inflammation of the thyroid, of which there are several types, including Hashimoto’s thyroiditis. The result is mild hypothyroidism or temporary Hashimoto’s.
• There is also postpartum thyroiditis which occurs in women just after giving birth and usually resolves itself within a few months on its own.

Thyroid Eye Disease

• Also known as Graves’ ophthalmopathy, this is a condition which tends to affect people with Graves’ disease but it can also affect those with Hashimoto’s thyroiditis.
• The condition is characterized by upper eyelid retraction and swelling of fatty tissue behind the eye, which makes the eye appear to bulge, giving the sufferer a startled expression.
• Other symptoms include dry or watery eyes, itching, a feeling of grittiness, aching eyes and double vision. The condition tends to resolve itself over time without requiring any medical intervention, although in some cases this may be necessary.

Nodules: These are usually benign lumps which grow in the thyroid and are fairly common. Symptoms are similar to those of hyperthyroidism, such as weight loss and palpitations, but can also resemble hypothyroidism. There may be difficulty swallowing, pain, ten¬derness and a feeling of fullness in the throat.

Thyroid Cancer

• Less common is thyroid cancer, where lumps growing in the thyroid are malignant and may require surgical removal of the whole gland. This is fairly uncommon and a diagnosis will be established by biopsy.
• Treatment may involve radioactive iodine therapy, radiation or chemotherapy but is most likely to involve surgery to remove either part of the thyroid or all of it. The survival rate for this cancer is fortunately very high.

Hypothyroidism: Also known as an underactive thyroid, this is a condition whereby the thyroid simply isn’t making enough thyroid hormone. Bearing in mind that the thyroid is the gland responsible for metabolism, if it is underactive you are likely to experience symptoms of slowness and sluggishness, both physical and mental.

• Hypothyroidism Signs and Symptoms
  • Fatigue
  • Dry, coarse skin
  • Weight gain
  • Feeling cold
  • Hair loss
  • Loss of the outer third of eyebrows and sometimes eyelashes
  • Slow pulse
  • Constipation
  • Brittle nails sometimes grooved
  • Changes in skin pigmentation
  • Water retention, puffiness (oedema)
  • A hoarse or husky voice
  • Shortness of breath
  • Enlarged thyroid (goitre)
  • Aching muscles
  • Apathy
  • Depression, including post-natal depression
  • Poor night vision
  • Menstrual irregularities/infertility
  • Slow heart rate
  • Loss of libido
• What Causes Hypothyroidism?
  • There are many possible causes, some of which can be traced as far back as the womb. If the thyroid fails to develop properly in the unborn baby, it may be born with hypothyroidism.
  • All babies in the UK are screened for this shortly after birth and if treated can expect to develop normally.
  • A major cause of hypothyroidism is autoimmune disease. An autoimmune disease is a condition whereby the body fails to recognize its own cells and instead treats them as the enemy and attacks them. Autoimmune thyroid disorders are most likely to strike during the first trimester of pregnancy or shortly after delivery.
  • Women generally are more prone than men. The most common autoimmune disorder to cause hypothyroidism is Hashimoto’s thyroiditis.
  • If you have an existing autoimmune disorder such as type 1 diabetes, Addison’s disease or rheumatoid arthritis, your risk of developing Hashimoto’s is increased.
  • Typically with this condition, TSH values are high while T3 and T4 levels are low. Hashimoto’s can initially cause hyperthyroidism but eventually leads to hypothyroidism because the thyroid’s ability to produce hormones is destroyed.
• Other Causes of Hypothyroidism
  • Surgery: The thyroid may be fully or partially removed if there is cancer or some other condition which requires surgery. If part of the thyroid remains, hormones may still be produced but probably not in sufficient quantities.
  • Medication: The best-known pharmaceutical to interfere with thyroid production is lithium – its side effects include thyroid suppression.
  • Fluoride and mercury toxicity: Mercury is antagonistic to selenium, which is an essential element for thyroid health. Fluoride is known to suppress thyroid activity and, in children, excess fluoride in drinking water has been shown to affect thyroid hormone output.
    • The jury is still out on whether or not fluoride is a cause of hypothyroidism in the general population.
    • Hypothalamus and pituitary disorders. Both of these glands are involved in thyroid hormone production, so any disorder of or damage to these glands can cause hypothyroidism.
  • Iodine deficiency
    • One highly significant but almost always overlooked cause of hypothyroidism is iodine deficiency. Iodine is a trace element which is a component of thyroid hormone.
    • It is required in minute amounts – 150 micrograms (meg) is the recommended daily intake – and is found in seafood, seaweed (where it was first discovered), dairy foods (because it is routinely added to cattle
      feed), some vegetables and anything which contains iodized salt.
    • Iodine deficiency is a major cause of hypothyroidism worldwide, with around 2 billion individuals across the globe thought to have insufficient iodine intake.4 South Asia and sub- Saharan Africa are particularly affected.
    • When the deficiency is severe, so are the consequences, especially for growth and development. During pregnancy and early infancy, iodine deficiency can result in cretinism, which is characterized by stunted growth and mental disability and is irreversible. Iodine deficiency is recognized by I the World Health Organization as the most common preventable cause of brain damage in the world today.
    • The most successful and cost-effective way to prevent iodine deficiency is iodization of salt. Where this is not possible, iodine supplements may be given.
    • The World Health Organization recommends that pregnant and breastfeeding women have a daily intake of 200 micrograms. In developing countries, iodine supplementation – in the form of iodized salt, bread or oil – has successfully prevented goitre in adults.
  • Why Is Iodine Deficiency Such a Huge Problem Around the World
    • The scale of the problem is due to the fact that most of the iodine on the planet is in the sea, not in the soil. This was not always the case. In this instance, intensive farming and human meddling cannot be held accountable for global iodine shortages.
    • One of the main causes is glaciation during the last Ice Age, which exposed the iodine-rich layers of soil to rain, flooding and wind, which washed the iodine into the sea.

• • • Soil erosion has resulted in the depletion of this crucial element everywhere, with parts of Africa, China, Russia and Asia severely iodine-deficient and all mountainous areas particularly at risk.
    • It is not surprising, therefore, that thyroid problems are especially common in areas which were once covered by glaciers.
  • Iodine Deficiency in the UK
    • Whereas salt-iodization programmes are in place across much of the developing world, no such programme is in place in the UK.
    • Consequently, there is very little iodized salt consumed here. That may not be such a bad thing, considering that we consume too much salt in the first place and are usually exhorted to cut down. But that still leaves the problem of potential iodine deficiency which is not being addressed.
    • Data suggests that iodine deficiency is more common than generally believed. Although not as severe as in developing countries, mild to moderate iodine deficiency is not uncommon in European countries.
    • The more severe the deficiency, the more severe the frequency and severity of iodine-deficiency disorders.
    • A review of studies of pregnant women across Europe concluded that most women in Europe are iodine-deficient during pregnancy.
    • There is concern that pregnant women in the UK do not have enough iodine, putting their unborn child at risk of reduced intelligence scores and impaired motor skills.
    • A study published in 2008 of 31 women in Surrey, which measured iodine concentration in urine, found that approximately 30 per cent of the women were classified as mildly to moderately iodine-deficient.
    • Because we get most of our iodine from seafood and dairy produce, anyone who avoids these foods might be at particular risk of deficiency.
    • Therefore vegans and vegetarians are even more vulnerable. There is a paucity of studies on iodine status in the general population, but one study of 30 vegans, published in 1998, found that 36 per cent of the males and 63 per cent of the females had lower than the recommended intake of iodine.
    • The fact is there are no screening programmes for iodine deficiency in the UK because it is assumed that deficiency does not exist.
    • The British Nutrition Foundation states, on its website, that ‘Nowadays iodine deficiency is very rare in the UK.’ This is odd, because according to the Department of Health’s National Diet and Nutrition Survey of Adults aged 19 to 64, in 2003, although men appeared to have an adequate intake of iodine, women aged 19-24 were found to have an average intake of 130 meg iodine and women aged 25-34 had an average intake of 145mcg – below the recommended amount.
• Treatment for Hypothyroidism
  • The standard treatment is thyroxine, which is given as a synthetic hormone called levothyroxine. Thyroxine is readily converted in the body to T3, and as a result levels of TSH return to normal. It often takes a while to find the right dosage for each individual.
  • Too much thyroid hormone replacement over a period of time can lead to symptoms of hyperthyroidism. Side effects include an increase in the risk of atrial fibrillation (irregular heart rhythm) and bone loss.
• Testing for Hypothyroidism: There are various tests which your GP can arrange those described below are the main tests in use today.
  • Total Thyroxine (TT4)
    • This test measures the amount of T4 in the blood. However, because T4 is protein-bound and therefore inactive, this is not an accurate measure of thyroid hormone.
    • Test results can also be skewed by the fact that certain drugs, including HRT and the contraceptive pill, can produce a false high reading. Other drugs, such as steroids, can lead to a lower test reading. This test has largely been replaced by measuring free thyroxine.
  • Free Thyroxine (FT4): This tests the amount of free thyroxine in the blood – the thyroxine which is free to be converted to T3, the active form of thyroid hormone. Free thyroxine is not affected by drugs, although certain factors such as severe illness can influence the test outcome. However, this test does not actually indicate how much, if any, T4 is converted to T3.
  • Triiodothyronine (T3): This is measured as free T3 (not protein-bound) and total T3 (attached to a protein). Although very useful, it does not measure how much T3 actually enters the cells.
  • Thyroid-stimulating Flormone (TSH)
    • This is thought to be a good measurement of either excessive or insufficient thyroid activity. A high reading indicates hypothyroidism because the body is increasing its production and release of TSH in an effort to push up T4 levels.
    • A separate, low T4 test result would usually confirm the diagnosis. A low TSH reading suggests hyperthyroidism because there are already high levels of T4 circulating in the blood. Again, certain conditions such as pregnancy or the presence of tumours can cause a reduction of TSH levels.
  • Thyroid Auto-antibody Testing
    • Thyroid conditions may be caused by the body failing to recognize its own tissues and therefore creating antibodies against itself.
    • Hashimoto’s thyroiditis and Graves’ disease are two such conditions. The antibodies which the body creates to ‘fight’ itself are called auto-antibodies, and a blood test can reveal the presence of abnormal amounts of these auto-antibodies. This can cause either hyper- or hypothyroidism.
  • Urine Iodine Excretion
    • This is a very useful test, especially if you are vegetarian or vegan, or just avoid seafood and/or dairy produce. However it is not normally offered by GPs so you would probably have to arrange for it to be carried out privately (see the Resources chapter for laboratory details).
    • Urinary iodine excretion is believed to be a good indicator of dietary iodine intake. It also monitors excessive iodine intake.
• Mild (Sub-clinical) Hypothyroidism
  • Sub-clinical hypothyroidism is defined as having elevated TSH levels but normal free thyroid hormone levels. If this is what your test results indicate, you are regarded as being in a pre- hypothyroid state. Sub-clinical hypothyroidism is believed to be a precursor to clinical, overt hypothyroidism.
  • It is not considered a condition in itself, and there is ongoing debate about whether or not it should be treated. But there is another ongoing debate, and that is about whether or not the tests themselves, rather than the results, are the problem.
• Thyroid Disease The Trouble with Tests
  • Thyroid testing is by no means conclusive – if only a simple blood test could be that simple.
    The dilemma lies in the reference range – that is, the point between A and B of the test results which is considered to be ‘normal’.
  • Another difficulty is that blood tests indicate hormone levels in the blood, not in the tissue itself, and it is thyroid hormone in tissue that counts.
  • All too often when a test result comes back normal, the patient may be persuaded to stop worrying about his or her health problems because, according to the test results, none exists.
  • So, the difference between mild, or sub-clinical hypothyroidism and overt hypothyroidism is determined by a line on a chart mapped out by the laboratory carrying out the test. The trouble is, different laboratories set different cut-off limits of what is considered normal.
  • The normal range is purely arbitrary and some people believe that it is too wide, with the result that almost everyone falls into it.
  • In the UK, the upper limit of normal for TSH may be 4.0mU/L, 5.0mU/L or even higher, depending on which laboratory performs the test. It has recently been proposed that the upper limit of ‘normal’ TSH in blood tests should be reduced to 3.0 or even less in order to ‘catch’ people with sub-clinical hypothyroidism.
  • One reason for this is that higher levels of anti-thyroid antibodies are detected in people with serum (blood) TSH levels between 3.0 and 5.0 ml/L. The medical world has historically misinterpreted these results as ‘normal’.15 Yet patients with these results are thought more likely to go on to develop overt thyroid disease.

Sub-clinical hypothyroidism is probably taken more seriously in the US, where estimates of the prevalence of this condition are 4-10 per cent of the general population and 7-26 per cent of the elderly population.

• • Sub-clinical hypothyroidism is believed by many experts to represent mild thyroid failure and, according to researchers writing in the Journal of Clinical Endocrinology and Metabolism, ‘is a clinically important disorder that has adverse clinical consequences and that should be treated in most if not all, cases.
  • People with mild hypothyroidism may experience common overt hypothyroid symptoms, especially dry skin, fatigue, poor memory, intolerance to the cold, puffy eyes, constipation and hoarseness.
  • Of three randomized, controlled studies which examined the effects of giving thyroid hormone to people with sub-clinical hypothyroidism, two reported significant improvement in symptoms.
  • Other studies have found mixed results – some positive but some with no significant improvement.
  • Clearly, more research in this area is required.

Do You Have Mild Hypothyroidism

Here is a common scenario in my practice. A woman aged, say, between 30 and 60 comes to see me complaining of fatigue, depression, overweight and constipation. She has no get-up-and- go and feels generally apathetic. She has gone to her GR who has arranged for an unspecified thyroid test, which has shown ‘normal’ results.

Me: Do you know what sort of test you had?

Client: No – just that it was a blood test.

Me: Do you have a copy of the results?

Client: No, I haven’t.

Clients rarely have any idea of the details of the tests they have undergone. I always find this extraordinary and would recommend that everyone obtains a copy of the results of whatever test they have had, for future reference. Anyway, at this point I direct attention towards their main concern, which is usually but not always weight gain.

Me: Do you know why you have gained weight? What I mean is, do you feel your weight gain is justified, or is it a mystery?

Client: I don’t understand it. I eat less than everyone else I know, go to the gym four days a week, but the weight’s just not shifting.

Me: Do you have a history of dieting? Have you tried all sorts of extreme diets in the past?

• These last two questions I consider highly significant. I have found, over and over again, that people I suspect might have mild hypothyroidism do not eat more than normal (in fact, often less) and they tell me they have been on every kind of diet for years.
• Severely restricting food intake is one of the best ways of guaranteeing weight gain. First, you lose weight and feel great. Then your weight reaches a plateau. Then you struggle to keep up the restricted eating, and feel depressed because you are suffering but not seeing results.
• Then you give up and give in to the constant hunger pangs and find you actually gain more weight than you lost, just by returning to your original eating habits.

The fact is that drastic reduction in food intake slows down the metabolic rate – or rather, slows down the activity of the thyroid gland in an effort to retain fat stores (your Stone Age body thinks it’s dealing with a famine).

• As calorie intake falls, so too does the level of thyroid hormone output. So you have to eat less and less to lose any weight at all or even just to maintain the same weight.
• You can only keep this up for so long, as every dieter will concur. This system evolved over millennia as a defence mechanism against famine and you cannot beat it. Studies have confirmed that underfeeding results in a decrease in metabolic rate.
• More specifically, calorie restriction actually results in lowered T3 production.
• Getting the thyroid to return to normal production, after years of calorie-restricted dieting, is not easy.
• So you might be suspicious if you have any of the symptoms of overt hypothyroidism, listed above, and even more so if you are overweight but not overeating, and have a history of yo-yo dieting.

What To Do If You Think You Might Have Mild Hypothyroidism

• First, go to your GR If you have already had a test, but do not know what type, ask. You are entitled to know. You specifically want to know if you have had a TSH test and antibody test, as these are the most indicative.
• If you have not had these tests, request them. If they turn out to be positive, you will be prescribed thyroid hormone.
• Whatever the result, check the reference ranges of what is considered a normal reading. If the upper limit is high, i.e. 4.0m(J/L or 5.0 mU/L and your result is close to that borderline, remember that the limit is a contentious, arbitrary figure and some experts might consider that a positive result.
• Discuss this with your GR and point out that mild hypothyroidism often progresses to overt hypothyroidism.
  If you prefer, you can have a test carried out privately. The total thyroid screen is comprehensive as it measures all thyroid hormones as well as levels of auto-antibodies free T3, free T4, total T4 and TSH.
• See the Resources chapter for details of a laboratory that carries out this test. Consider the results to be for your information only if they are positive, you should return to your GP for further discussion about what to do.
• If you are vegan or have a low dairy and/or low seafood diet and do not regularly consume edible seaweeds, I suggest you have a urine iodine test.
• For your next step, you can try a useful test which you can carry out yourself at home, which is free and does not involve blood or urine samples.
• It is called the basal temperature test. This test was first described in 1945 by the famous Dr Broda Barnes, who devoted his professional life to the study of the thyroid gland.
• Having said that, many conventional doctors repudiate the accuracy of this test and insist that only a blood test (which is hardly free from controversy) will do.
• But I think that, although it is by no means conclusive, it is a very useful tool, especially if your cluster of symptoms all point towards some sort of thyroid malfunction.
• The basal temperature is the body temperature when totally at rest – asleep, in fact. A low basal body temperature is thought to be indicative of an underactive thyroid. See below for details on how to do the test.

The Basal Temperature Test

• Get an old-fashioned glass thermometer. Digital thermometers are not thought to be as accurate for this test.
• Place it by your bed at night, having shaken it well to make sure it is at 94°F/34.4°C or below.
• Take your temperature immediately upon waking. Place the thermometer under your arm for a full 10 minutes and lie as still as you can.

The Basal Temperature Test Write down the reading.

• Repeat this every morning for a couple of weeks, minimum, in order to get a good idea of your average body temperature.
• Do not perform this test if you have a cold or any infection which might temporarily raise your body temperature. Drinking a fair bit of alcohol the night before can have the opposite effect, i.e. cause your body temperature to drop slightly.
• Women who are still of menstruating age should be sure that the second, third and fourth days of menstruation are included.
• Your normal basal temperature should be between 97.8°F/36.5°C and 98.2°F/ 36.8°C. An average reading of less than this should arouse suspicion that your thyroid might be working below par.
  • If all your testing suggests mild hypothyroidism rather than clinical hypothyroidism, and no treatment is offered by your GR do not despair.
  • There are a few natural approaches which you may find beneficial. Unfortunately, dietary therapy is not always the most effective therapy – in my experience, changing a client’s diet to include more of the nutrients vital to thyroid health is only effective if that client’s diet is poor in the first place, and probably lacks those nutrients.
  • The most important of these nutrients – other than iodine, which has already been discussed, are described below.

The Basal Temperature Test Selenium

• This trace element is needed for the conversion of T4 to T3 and is present in high concentrations in the normal thyroid. Dietary selenium levels have been falling for years – as long ago as 1997 the British Medical Journal claimed it was ‘time to act’ on the worrying depletion of selenium levels in soil throughout the world, including Europe.
• The author reported that 22 years previously, selenium intake in Britain was 60mcg/day, compared to 34mcg/ day in 1997. Selenium is found in Brazil nuts (one of the richest sources), meat, fish and cereal grains.

The Basal Temperature Test Zinc: Is required for all hormone production, including thyroid hormone. Like selenium, it is also required for the conversion of T4 to T3. Good sources include meat, especially red meat, fish, seafood and lentils. Once absorbed in the body, it is combined with the amino acid tyrosine.

The Basal Temperature Test Tyrosine

• Amino acids are the building blocks of protein, and this amino acid is a precursor to thyroid hormone. The body can make it from other amino acids, but meat, dairy and wheat are rich sources.
• Other minerals required for thyroid function include calcium, chromium, magnesium, copper and iron. Essential vitamins include the B complex and vitamin C.

Dietary Factors Affecting Thyroid Function

Certain foods contain substances called goitrogens, which are believed to enlarge the thyroid and cause hypothyroidism by blocking the conversion of T4 hormone to T3. They can inhibit the body’s ability to use iodine, which is essential for thyroid hormone synthesis. Foods which contain goitrogens include the brassica family: kale, sprouts, cauliflower, and cabbage. Other goitrogenic foods include soya, radishes, watercress, mustard, turnips, cassava and peanuts.

• As you can probably tell, these are, in fact, foods which we would ordinarily consider to be very healthy and desirable. A lot of people regularly eat green vegetables and other goitrogen-containing foods and they do not develop goitres or any other thyroid problems.
• There are two explanations for this: first, cooking these foods disables the goitrogens so they become harmless and, secondly, it is generally believed that eating moderate amounts of these foods is unlikely to have a negative effect on thyroid activity; it is thought that problems are only likely to arise where iodine is deficient.

Seaweed is an excellent, rich source of iodine. If you are vegetarian, vegan or avoid dairy and seafood, I would suggest adding edible seaweeds regularly to your diet. Once the preserve of the health food store, you can now buy these in most large supermarkets.

• Contrary to what you might think if you have never tried them before, they are in fact very tasty. They used to be a regular feature of the British diet, but sadly no more. Having said that, the current fashion for foraging in the wild might see seaweed make a much-deserved comeback.
• It is rich in many minerals, not just iodine, and lends itself particularly well to stews and stir-fries. Nori, kombu, dulse and red seaweed (also called carragheen) are common staples.
• The Japanese make good use of seaweed in their traditional dishes and among the most popular are nori, wakame and arame – all of which are available in the UK.
• Unless you know that you are iodine-deficient, it is not recommended that you start taking iodine supplements in the form of seaweed supplements, such as kelp, bladderwrack or bugleweed, because if you over-consume iodine you may put yourself at risk of developing hyperthyroidism. If in doubt, have yourself tested for iodine deficiency.

Mild Hypothyroidism Case History

Michelle is a good case history because she was so typical, and because she illustrates how difficult it is to stimulate the thyroid through dietary measures alone. Michelle had plenty of symptoms of an underactive thyroid, but according to her GP’s test results her thyroid was fine. Her main concern was her weight gain, and yes, she had a history of trying all sorts of rather bizarre diets.

• As a consequence she had put on about 2 stone and, despite her extraordinary self-discipline when it came to healthy eating and exercise, she just could not shift any weight. Not even a pound. She refused to go back to her doctor for more tests, and I was getting nowhere with her diet.
• Because her diet was so good and so varied (including plenty of dairy and seafood), and she also took a basic multivitamin and -mineral supplement, I felt it was unlikely that she was deficient in any of the nutrients essential for thyroid health.
• After a few visits I felt I had no option but to advise other therapies. So off Michelle went to a medical herbalist. The results were astonishing – in less than a month, she reported losing 2 lb.
• That might not sound much to you, but to Michelle, it was extraordinary and uplifting. I lost touch with Michelle as she did not need to see me again, but the last time I heard from her she told me she had continued to lose more weight, albeit very slowly.

Mild Hypothyroidism Other Therapies

As well as herbalism, I often recommend acupuncture as this therapy is particularly useful for stimulating sluggish glands and organs. The thyroid can be incredibly stubborn but does often respond to the stimulating effects of acupuncture.

Mild Hypothyroidism Further Investigations

If you are highly stressed and suspect sub-clinical hypothyroidism, Overcoming Adrenal Fatigue. Stress is believed to inhibit thyroid function by decreasing the production of TSH and inhibiting the conversion of T4 to T3. Therefore, by dealing with stress, you may find that your symptoms relating to mild underactive thyroid activity clear up. Excessive oestrogen levels are known to suppress thyroid hormone, so if in addition to the symptoms of hypothyroidism you also experience symptoms associated with PMS or menopause.