Hypothyroidism Flashcards
What are the 5 classifications of hypothyroidism?
Primary Secondary Tertiary Peripheral Subclinical
Define Primary classification of hypothyroidism
High TSH, low T4 and T3. Due to iodine deficinecy, autoimmunity, viral infections,drugs, postpartum
Define Secondary Hypothyroidism
Rare. low TSH. Inadequate TSH from pituitary gland to signal thyroid hormone release.
Define Tertiary hypothyroidism
Rare hypothalamic disease where there is inadequate TRH
Define Peripheral hypothyroidism
Insensitivity to thyroid hormones
Define subclinical hypothyroidism
What the GP considers normal. Elevated TSH and normal FT4.
What is the optimal status of TSH?
2.5 or less
Hypothyroidism is linked to risk of what diseases?
Heart failure Coronary artery diseases Infertility Cognitive impairment Fatigue
List some symptoms of hypothyroidism
Fatigue Weight gain/inability to lose weight Irregular/heavy periods low libido Infertility/miscarriage Puffy face Swollen eyelids Goitre Oedema Intolerence to cold Joint/muscle pain/weakness High cholesterol (LDL) Dry skin Elbow keratosis Brittle nails Hair loss Thinning of hair or eyebrows Brain fog Depression Easy bruising Constipation Gas/bloating Headaches Bradycardia Carpel tunnel syndrome
What are the causes/risks of hypothyroidism?
Iodine deficiney Goitrgoens Women (oestrogen) Increasing age (40years) Drugs - amidraone/lithium Congenital Lack of key nutrients Chronic stress Blood sugar imbalance Infection Inflammation HPT disruptors Alcohol Smoking Hereditry Post-ablative therapy/surgery Post partum
What is Hashimoto’s Thyroiditis?
An autoimmune response disease that attacks the thyroid tissue reducing thyroid hormones.
Hashimoto’s Thyroiditis (HT) affects which gender moreso? At what ratio?
Females. 10:1
What clinical test results indicate HT?
High TSH
low FT4
High TPO
Presence of anti-Tg and TB||
What complications are often implicated with HT?
EBV
H.pylori
What are the causes/risk factors of HT?
EBV H. pylori Excess iodine SNPs - VDR, GC. MTHFR Coeliac Disease LEaky gut Food allergens Sleep apnoea Heavy metals - mercury, lead, cadmium Triclosan Increased pro-inflammatory cytokines
What allopathic treatment is used in HT? What is absorption of the drug impaired by?
Levothyroxine (synthetic T4) Coeliac disease Atrophic gastritis Coffee PPI
What nutrients need to be carefully considered when considering supplementation for HT?
Tyrosine and Iodine
When taking a naturopathic approach to HT, list ways in which triggers and mediators can be address…
Micronutrient status Support T4-T3 conversion Review iodine status Optimise digestion Support methylation Remove thyroid disruptors Address dysbiosis/SIBO Assess pathogens Heavy metals Support detoxifiaction and elimination Support SCFA-producers Assess for coeliac disease Identify food intolerances Increase exercise Identify sleep disorders
Name naturopathic ways to approach HT
Reduce inflammation
- omega3:6 ratio
- avoid transfats, sugar, alcohol, smoking, high GL foods, limit arachodonic acid foods
-Blood sugar balance and improve insulin sensitivty
- Increase antioxidant sources to reduce oxidative stress
Reduce Goitrogens
Balance T-cell functioning
- Address intestinal permeability
- Commensal bacteria
- Support SIgA
How can goitrogens be reduces?
Soaking, cooking, steaming, boiling
What nutritional support can be given to someone with HT?
Selenium - 150-200mcg/day (Narrow Toxicity Range)
Zinc - 15-30mg/day
Iron - Up to 10mg/day (30mg/day if deficent)
Vitamin A - 2000IU
Tyrosine - 200-500mg
Vitamin D - 2000IU
Antioxidants - Vit. C, E. Cysteine and Glutathione
Copper
B2
B3
Why is Selenium useful as nutritional support in HT?
Antioxidant Anti-inflammatory Increases T3 Contains selenoenzymes Reduces cytokines nad thyroid antibodies
Why must caution be taken with selenium when supporting HT?
It has a narrow toxicity range and excessive levels can increase iodine deficiency
Why is Zinc useful when supporting HT?
Cofactor for D2
Plays a role in TRH synthesis
DNA-binding component of thyroid receptors
Low Zn = low levels of FT3, normal T4 and elevated RT3
Why is Iron needed for support in HT?
TPO is haem-dependant
Anaemia decreases T4 and T3
Anaemia blunts the efficacy of iodine supplements
When must you not supplement with Iodine in cases of thyroid conditions?
In autoimmune thyroid diseases, hyper thryoid or with thyroxine use
How can vitamin A be useful in supporting HT?
A deficiency increases TSH
Deficiency reduces iodine uptake
Modulates thyroid hormone receptor functions
How can tyrosine be useful in supporting HT?
Precursor to thyroglobulin
How can Vitamin D support HT?
Deficiency of vitamin D is high in autoimmune thyroid diseases
Modulates the immune system
What herbs can be used when supporting HT?
Black seed oil
Thyroid Glandulars - Porcine/bovine thyroid concerntrate
Ashwagandha
Guggul
How can Black seed oil help suopprt HT?
Antioxidant
Modulates immune system
Reduces TSH. TPO antibodies, increases T3
How can Thyroid glandulars support HT?
the like’for’like principle - provides T3, T4 and relevant cofactors
How can ashwagandha be supportive in HT?
Improves TSH, T4 and T3 levels
Immunomodulator
Aids T4-T3 conversion
How can Guggul support HT?
Enhances iodine uptake and TPO
