Hypothyroidism means that the thyroid gland is underactive, and makes too little thyroid hormone. Thyroid disease is a general name for a medical health condition that does not allow your thyroid to make the right amount of hormones that control metabolism (a process where the food you eat is transformed into energy).

The thyroid, which is a butterfly-shaped gland that`s located low on the front of the neck below your Adam’s apple, wrapped around the windpipe (trachea), controls your metabolism with a few specific hormones which are created by the thyroid and tell your body’s cells how much energy to use — T4 (thyroxine, contains four iodide atoms) and T3 (triiodothyronine, contains three iodide atoms).

When your thyroid functions as it should, it will maintain the right amount of hormones to keep your metabolism working at the proper speed and creates replacements as the hormones are used.

However, if your body produces too small amounts of thyroid hormone, you may develop hypothyroidism. While at the other hand, if your body produces too much thyroid hormone, you may develop hyperthyroidism

In addition, this is all supervised by the pituitary gland (located in the center of the skull, below your brain), which monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses an imbalance of thyroid hormones in your body, it will adjust the amounts with its own hormone called thyroid stimulating hormone (TSH). As a result, the TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal (1).

These two main thyroid disorders are serious and need to be treated by your healthcare provider. However, along with conventional treatment you may find some help in home remedies, changes in diet as well as in some vitamins.

Thyroid Disease Types

Common disorders of the thyroid are Graves’ disease, Hashimoto’s thyroiditis, Graves’ disease, thyroid nodules and goiter.

• Hyperthyroidism. In hyperthyroidism, the thyroid gland is overactive. As a result, it makes too much of its hormone and causes your body to use energy too quickly. It affects about 1 % of women and is less common in men. Most common cause of hyperthyroidism is Graves’ disease (affects about 70 % of people with an overactive thyroid). However, nodules on the thyroid (toxic nodular goiter or multinodular goiter) can also cause the gland to overproduce its hormones.
• Hypothyroidism. In hypothyroidism the thyroid gland is underactive, and can make too little thyroid hormone. For instance, in the US, it affects about 4.6 % of people 12 years old and older, and is often caused by Hashimoto’s thyroiditis, surgery to remove the thyroid gland, or damage from radiation treatment (29, 30, 31, 32).

Hypothyroidism (Underactive Thyroid) Symptoms and Sings

Although thyroid disease may cause many different symptoms, it’s unlikely you’ll undergo all of them. However, many signs of both – hypothyroidism, and hyperthyroidism are often similar to the symptoms of other medical conditions, so it can easily be confused for something else. In case underactive thyroid (hypothyroidism), the symptoms generally develop slowly and you may not realize you have a health problem for several years (1, 5).

Symptoms of an Underactive Thyroid (Hypothyroidism) Can Include:

• Tiredness (fatigue).
• Being sensitive to cold temperatures.
• Having a hoarse voice (when the voice involuntarily sounds breathy, raspy, or strained (also known as dysphagia or hoarseness).
• Gaining weight. 
• Constipation.
• Depression.
• Slow movements and thoughts, experiencing forgetfulness.
• Muscle aches, weakness and muscle cramps.
• Dry and scaly skin.
• Dry and coarse hair.
• Hair loss.
• Brittle hair and nails.
• Loss of libido (sex drive).
• Numbness, pain and a tingling in the fingers and hands (carpal tunnel syndrome).
• In women, irregular menstrual cycles or heavy periods.
• Memory problems and depression among elderly.
• Slower growth and development in children.
• In addition, earlier start of puberty among teenagers (1, 4).

Hypothyroidism (Underactive Thyroid) Causes

Hypothyroidism may be caused by other diseases that affect the way the thyroid gland works.

• Thyroiditis. An inflammation (swelling) of the thyroid gland which can lower the amount of hormones your thyroid produces.

• Autoimmune disease, Autoimmune thyroiditis (Hashimoto’s thyroiditis and atrophic thyroiditis). In some cases the immune system mistakes thyroid gland cells and their enzymes for invaders and can attack and damage them.

• Postpartum thyroiditis. This usually temporary condition occurs in 5% to 9% of women after childbirth. 

• Iodine deficiency or too much iodine. Thyroid uses iodine to produce hormones. An iodine deficiency is a very common issue among several million people around the world. However taking in too much iodine can also cause or worsen hypothyroidism. Therefore, the most important is the iodine balance.

• Congenital hypothyroidism (hypothyroidism that a baby is born with) or a non-functioning thyroid gland. A few babies are born without a thyroid or with only a partly formed one, or all of their thyroid in the wrong place (ectopic thyroid). The condition, where the thyroid gland doesn’t work correctly from birth affects around 1 in 4,000 newborns. This may cause physical and mental issues in the future (if left untreated).

• Surgery that removes a part or all of the thyroid gland. In case thyroid nodules, thyroid cancer, or Graves’ disease, some people may need to have part or all of their thyroid removed. However, in case part of the gland is left, it may be able to produce adequate amounts of thyroid hormone.

• Radiation treatment. Some patients with nodular goiter, Graves’ disease, nodular goiter, or thyroid cancer are treated with radioactive iodine (I-131). Individuals with lymphoma, Hodgkin’s disease, or cancers of the neck or head are treated with radiation. All these treatments may cause a partial or total loss of thyroid function.

• Medicines. Drugs such as amiodarone, lithium, interferon alpha, and interleukin-2 may prevent the thyroid gland from being able to make hormones normally.

• Damage to the pituitary gland. When the pituitary, the “master gland,” which tells the thyroid how much hormone to make, is damaged (by a tumor, radiation, or surgery), it may no longer be able to offer the thyroid directions, and the thyroid may stop making enough hormone.

• Rare disorders that infiltrate the thyroid. In addition, in a few people, diseases such as for example amyloidosis, sarcoidosis or hemochromatosis can deposit abnormal substances in the thyroid and impair its ability to function (1, 2).

Hypothyroidism (Underactive Thyroid) Risk Groups

Thyroid disease is extremely common and approximately 20M people in the US have some type of thyroid disorder. Although, thyroid disease can affect anyone and be also present at birth (typically hypothyroidism) — it influences woman (often after menopause in women) about 5 to 8 times more likely than a man.

You may be at a higher risk of developing some type of thyroid disease if you:

• Have a family history of thyroid disease or Graves’ disease.
• Have an autoimmune disease or other medical condition which can include:
  • Pernicious anemia.
  • Type 1 diabetes. For individuals with type 2 diabetes, the risk is lower, but still existing, and you’re more likely to have a thyroid condition later in life. Those with type 1 diabetes may be tested for thyroid disease more often — immediately after diagnosis and then every year or so — than people with type 2 diabetes.
  • Celiac disease.
  • Primary adrenal insufficiency.
  • Lupus.
  • Rheumatoid arthritis.
  • Sjögren’s syndrome.
  • Turner syndrome.
• Take a medication that’s high in iodine (amiodarone).
• Are older than 60.
• Are a woman.
• Have had anti-thyroid medications, thyroidectomy, radiation or radioactive iodine treatments for cancer or past thyroid condition.
• Received radiation to your neck or upper chest.
• Have had thyroid surgery (partial thyroidectomy).
• In addition, have been pregnant or delivered a baby within the past 6 months (1, 6, 7).

Hypothyroidism (Underactive Thyroid) Complications

Hypothyroidism – if untreated, can lead to a following health problems:

• Goiter.
• Heart problems.
• Mental health issues.
• In case of very severe hypothyroidism that hasn’t been diagnosed or treated, your risk of developing low serum sodium goes up. This could lead to seizures.
• Peripheral neuropathy.
• Myxedema.
• Infertility.
• In addition, birth defects (1, 6).

Thyroid Disease Diagnosis

If you suspect you might have some type of thyroid disease, make an appointment with your doctor who will make the necessary tests such as:

• Blood tests.
• Imaging tests.
• Physical exams (1).

Hypothyroidism Treatment – Conventional Medicine, Alternative Medicine, Supplements, Lifestyle and Home Remedies

Conventional Medicine

There are a variety of ways to treat thyroid disease and each certain treatment will depend on the cause of your condition. Therefore, your doctor will monitor your treatments and make adjustments over time.

However, it may take some time to control your hormone levels and find the right treatment method for you.  The goal for the treatment is to return your thyroid hormone levels to normal, and luckily individuals then can usually live a normal life with a thyroid disease.

In Case Low Levels of Thyroid Hormones (Hypothyroidism), The Main Treatment Option is:

• Thyroid replacement medication. This standard treatment involves adding thyroid hormones back into your body with daily use of the oral synthetic thyroid hormone levothyroxine. It reverses the symptoms of hypothyroidism and restores adequate hormone levels. As a result, you’ll likely start to feel better soon after you begin treatment. In addition, this treatment gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine will probably be lifelong, but because the dosage you need may change, your doctor is likely to check your TSH level every year (1, 6).

Alternative Medicine, Diet, Supplements, Lifestyle and Home Remedies for Hypothyroidism

The conventional treatments for thyroid diseases are the most reliable ones. However, although eating certain foods will not cure thyroid disease, some nutrients and minerals may play a vital role in managing the underlying condition.

Therefore, diet can influence both – the production of thyroid hormones and how the thyroid functions. You can consider the following lifestyle tips, natural remedies and supplements as additions or alternatives to your treatment plan.

Alternative Medicine, Diet, Supplements, Lifestyle and Home Remedies for Hypothyroidism Include:

• Natural extracts containing thyroid hormone such as desiccated thyroid extract. Even though most healthcare providers suggest synthetic thyroxine, natural extracts containing thyroid hormone derived from the thyroid glands of pigs are also available. However, these extracts are available by prescription only, so do not confuse these with the glandular concentrates sold in natural foods stores (12, 13).

• Selenium. Although further studies are needed to determine weather selenium supplements can help prevent or treat thyroid disease, selenium is a trace element that plays a part in thyroid hormone metabolism and has shown promising results in some studies. Your body requires selenium for the metabolism of thyroid hormones. Therefore, the maintenance of a physiological concentration of selenium (selenostasis) through a balanced diet or, alternatively, via supplementation is essential not only to prevent thyroid disease but also to maintain overall health. In addition, according to research, selenium may help improve some of the symptoms of autoimmune thyroid disease, such as thyroid eye disease (Graves’ orbitopathy). Moreover, individuals who use anti-thyroid medications, and also take selenium supplements may reach normal thyroid levels more quickly than those who do not. However, consult your doctor, before taking any supplements. Selenium rich diet includes foods such as:

  • Brazil nuts,
  • seafood like tuna, halibut and shrimp,
  • meats like ham, grass-fed beef, turkey, chicken,
  • fortified pasta and cereals,
  • rice and oatmeal,
  • eggs,
  • cottage cheese,
  • baked beans,
  • in addition, spinach (8, 9, 14, 23).

• Vitamin B-12. Low levels of thyroid hormones may also influence your body’s vitamin B-12 levels. Therefore, taking a vitamin B-12 supplement may help you with the tiredness and repair some of the other damage hypothyroidism caused. As the disease also influences your vitamin B-1 levels, you can take vitamin B complex supplements or add more B vitamins to your diet. However, talk with your doctor about how much vitamin B-12 may be right for you. Vitamin B rich foods include:

  • peas and beans,
  • asparagus,
  • sesame seeds,
  • tuna,
  • cheese,
  • milk,
  • In addition, eggs (8, 12, 22).

• Sugar-free diet. Sugar as well as processed foods may cause risen inflammation in your body. Inflammation on the other hand may slow down the transformation of T4 to triiodothyronine, or T3, another thyroid hormone. As a result, your symptoms of thyroid disease may become worse. Even more, removing sugar from your diet may be beneficial for your stress levels, skin, and energy levels, as sugar only boosts your energy level in the short term (8).

• Avoid cruciferous vegetables. Although cruciferous vegetables might be beneficial for a person with hyperthyroidism, anyone with hypothyroidism (decreased thyroid function) should avoid eating large amounts of these foods. These cruciferous vegetables include for instance:

  • Brussels sprouts and cabbage,
  • collard greens and mustard greens,
  • turnip roots and greens,
  • kale and arugula,
  • radishes and rutabagas,
  • bok choy,
  • cauliflower,
  • in addition, broccoli and broccoli rabe (14, 16).

• Probiotics. Probiotic supplements contain live helpful bacteria that can help keep your stomach and intestines healthy. According to animal studies that have investigated the link between gut microbiota and thyroid function – supplementation of probiotics have shown beneficial effects on thyroid hormones and thyroid function in general, as dysbiosis is common finding in thyroid disorders. However, before taking any supplement, first talk with your doctor, as the Food and Drug Administration hasn’t approved the use of probiotics for the prevention or treatment of any condition. Besides supplements, foods that contain probiotics include:

  • fermented foods such as sauerkraut,
  • fermented drinks, such as kefir, kombucha, yogurt,
  • in addition, some cheeses (8, 10).

• Gluten-free diet. Notable number of people with thyroid disease also have celiac disease, a digestive disorder in which gluten triggers an immune response in the small intestines. Although research doesn’t currently support a gluten-free diet for the treatment of thyroid disease, many people with hypothyroidism and Hashimoto’s thyroiditis do feel better after not consuming wheat and other gluten-containing foods. However, before making the decision to remove gluten from your diet, talk with your doctor or dietician, as some prepackaged, gluten-free foods aren’t healthy, because these foods can have a higher fat content and less fiber than wheat- containing products (8, 11).

• Foods containing iron. Iron is vital for your thyroid, as it makes the hormone T4, and converts T4 to T3. According to research, anemia and iron deficiency seem to be associated with thyroid dysfunction – particularly hypothyroidism (5, 8).
  Iron rich foods include:

  • liver, beef, chicken, turkey, and pork,
  • oysters and fish,
  • fortified cereals,
  • dried fruits (apricots, peaches, plums, raisins),
  • spinach, garden thyme, dandelion, nettle, raspberry,
  • blueberry,
  • pumpkin,
  • tofu,
  • seeds such as sesame, poppy, sunflower and pumpkin and flax seeds,
  • legumes (beans, chickpeas, lentils, peas),
  • nuts (especially hazelnut),
  • in addition red beet juice (24, 25, 26, 27, 28).

Checking Thyroid at Home

To do a quick and easy self-exam of your thyroid at home you need a mirror and a glass of water. Follow these steps:

1. Firstly, try to identify where your thyroid is located. You should find it on the front of your neck, between your collar bone and Adam’s apple.
2. Secondly, tilt your head back and at the same time – look in a mirror. Look at your neck and try to focus your attention on the space you will be looking at once you start the exam.
3. Thirdly, take a drink of water while your head is leaned back, and watch your thyroid as you swallow. Look for bumps or lumps which you may be able to see when you swallow the water.
4. In conclusion, repeat this test a few times to get a good look at your thyroid. If you see any lumps or bumps, reach out to your healthcare provider (1).

NB! The information provided here is for informational purposes only, so do not consider it as health care or medical diagnosis and treatment. Do not consider this information as a guarantee of the results you want to achieve. In addition, this information is not intended to replace the advice of your physician or other healthcare professional.

Even more, you should not use it to diagnose or treat a health problem. Before changing or discontinuing your existing medication, treatment, or care, or taking any dietary supplements, be sure to consult with your healthcare professional or doctor before starting any diet or program, or if you suspect you may have a medical condition.

Compiled by: Maria-Helena Loik

Photos: Pexels.com, Picabay.com, Shutterstock.com

Sources:

1. Thyroid Disease: Causes, Symptoms, Risk Factors, Testing & Treatment (clevelandclinic.org)
2. Hypothyroidism | American Thyroid Association
3. Hyperthyroidism: Causes, Symptoms, Treatment, Diagnosis & More (healthline.com)
4. Underactive thyroid (hypothyroidism) – Symptoms – NHS (www.nhs.uk)
5. Overactive thyroid (hyperthyroidism) – Symptoms – NHS (www.nhs.uk)
6. Hypothyroidism – Symptoms and causes – Mayo Clinic
7. Hyperthyroidism – Symptoms and causes – Mayo Clinic
8. 5 Natural Remedies for Hypothyroidism (healthline.com)
9. Selenium – Health Professional Fact Sheet (nih.gov)
10. Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? (nih.gov)
11. Celiac Disease and Thyroid Disease | BeyondCeliac.org
12. Desiccated thyroid extract vs Levothyroxine in the treatment of hypothyroidism
13. Desiccated thyroid extract – Wikipedia
14. Best diet for hyperthyroidism: Foods to eat and avoid (medicalnewstoday.com)
15. Thyroid Disease, Osteoporosis and Calcium (medicinenet.com)
16. Concentrations of thiocyanate and goitrin in human plasma, their precursor concentrations in brassica vegetables, and associated potential risk for hypothyroidism (nih.gov)
17. Bone mineral density in patients of Graves disease pre- & post-treatment in a predominantly vitamin D deficient population (ijmr.org.in)
18. Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence study (nih.gov)
19. Turmeric For Your Thyroid – Dr. Izabella Wentz (thyroidpharmacist.com)
20. Possible protective effect of curcumin on the thyroid gland changes – light and electron microscopic study – PubMed (nih.gov)
21. Vitamin B12 deficiency common in primary hypothyroidism – PubMed (nih.gov)
22. Vitamin B12 and Vitamin D Levels in Patients with Autoimmune Hypothyroidism – Karger Publishers
23. Selenium and Thyroid Disease: From Pathophysiology to Treatment (hindawi.com)
24. Hemoglobin, iron, and vitamin B12 deficiencies and high blood homocysteine levels in patients with anti-thyroid autoantibodies – ScienceDirect
25. Chronic anemia and thyroid function (nih.gov)
26. The link between hypothyroidism and iron deficiency – Endeavour Wellness Clinic (endeavourclinic.com.au)
27. Multiple nutritional factors and thyroid disease – PubMed (nih.gov)
28. The influence of iron status on iodine utilization and thyroid function – PubMed (nih.gov)
29. Common Thyroid Gland Diseases and Problems to Watch For (healthline.com)
30. Thyroid | Hormone Health Network
31. Hyperthyroidism | American Thyroid Association
32. Hypothyroidism (Underactive Thyroid) | NIDDK (nih.gov)