When it comes to chronic fatigue and fibromyalgia the problem lies with a gland in our brains called our hypothalamus. This gland is responsible for initiating and regulating our hormones including thyroid hormones, cortisol, estrogen, progesterone and many more.
The hypothalamus starts the process by sending hormones to another nearby gland called the pituitary. The pituitary continues the hormonal cascade by sending hormones to the thyroid, adrenals and ovaries. This stimulates them to make their own hormones that have effects at receptors around our body. Because it all starts with the hypothalamus, it’s easy to see that a problem there leads to problems everywhere.
All of these hormones do many different things in our bodies. They regulate our immune system, blood pressure, pulse rate, blood flow, metabolism, fluid retention, reproduction, weight, mental function, and mood. Hormonal systems are often suppressed in CFS and fibromyalgia.
In this post series I’ll go over each system, the hormones involved, symptoms of dysregulation, and what to do to bring each back into balance.
If you missed my post about adrenals check it out here.
We’ll continue by taking a look at the thyroid…
What Is the Thyroid?
The thyroid gland is a butterfly-shaped gland that is located at the front of our neck and it’s involved in regulating many of our other body systems including our brain, heart, reproductive, adrenal and digestive systems so it’s really important for it to be functioning well.
In hypothyroidism, the thyroid gland is functioning at lower levels than normal which can be caused by many things including autoimmune conditions, infections, medications, or nutrient deficiencies to name a few. These can lower thyroid hormones, make cells less sensitive to thyroid hormone, or even damage or enlarge the thyroid gland itself.
What Are Symptoms of Hypothyroidism?
Since the thyroid is involved in regulating so many of our body systems, hypothyroidism symptoms can be broad. Common ones include fatigue, weight gain, brain fog, hair loss, dry skin, constipation, bloating, and depression. Other hormones can be affected and women may have irregular periods or difficult and painful periods.
What Are Thyroid Hormones and How Do You Test Them?
Most doctors will test thyroid function with thyroid stimulating hormone (TSH) and thyroxine (T4) but there are other tests that can give a broader picture of thyroid function. There's another thyroid hormone called triiodothyronine (T3) that is the active hormone that helps regulate many of our body systems.
Some doctors don't test for T3, but I think it can be helpful to see how well the body is converting inactive T4 to active T3 and you want to make sure there are adequate amounts of T3. If the conversion isn't going well there are ways to promote it with nutrients to help you feel better.
The problem with testing is that the acceptable range is too wide so someone may have hypothyroidism but their labs will look normal because they’re still technically in range.
Each lab may have their own normal ranges for thyroid hormones, but I think these levels would be considered optimal. Functional medicine practitioners usually have a more narrow range of what would be optimal for thyroid hormones. These are the ranges that I look for in my patients and where many of them feel their best.
-TSH: 1-2 uIU/mL
-Free T3 (fT3): 3.2+ pg/mL
-Free T4 (fT4): 1.1+ ng/dL
What You Can Do About Hypothyroidism if You Have Chronic Fatigue Syndrome
Usually the first thing you do about low thyroid is to give medication. A common one to start with is levothyroxine (Synthroid), which is synthetic T4. Those with CFS may not be able to convert inactive T4 to active T3 or may need higher levels of T3. If levothyroxine isn’t helping you feel better, you might want to try something like Armour, which is bioidentical T3 and T4. There may also be thyroid receptor resistance, which is when the receptors aren’t responding to the thyroid hormones like they should. You may need very high levels of T3 to get a response.
A low dose trial of Armour can be safe as long as your fT4 levels are monitored and you don’t have heart disease. A low dose to start at would be 15 mg per day, working your way up in 30 mg increments over 6 weeks. You’ll know if you’ve taken too much because you’ll feel shaky, hyperactive and have a racing heart. In that case you can stop taking it or lower the dose. You could also take a half dose in the morning and in the afternoon.
Excess thyroid hormone can cause osteoporosis so it’s a good idea to have a DEXA scan every 6 -24 months if that’s a concern for you.
As your hypothalamus heals, you may be able to taper off the medication.
Dietary Support for Hypothyroidism
While medication may be necessary and helpful, there are also dietary recommendations that you can do to help your thyroid produce hormones and make sure your hormones are being converted to the active form your body needs to thrive.
Iodine
This nutrient is especially important because you need it to make thyroid hormones. The thyroid takes the amino acid tyrosine and attaches iodine to it to make thyroid hormones. Too much iodine can be a bad thing when it comes to your thyroid so try to stick to around 150 mcg/day.
Sources: fish, scallops, seaweed, yogurt, milk, eggs
Selenium
This nutrient works with iodine to produce thyroid hormones and with conversion of inactive T4 to active T3. It’s also beneficial if you have autoimmune hypothyroidism, known as Hashimoto’s, because it can lower antibodies and protect the thyroid as an antioxidant.
Sources: tuna, shrimp, sardines, salmon, turkey, cod, chicken, lamb, scallops, beef, whole grains, seeds, Brazil nuts
Zinc
This nutrient helps with production of thyroid hormones and conversion of inactive T4 to active T3. Sources: seafood, beef, lamb, sesame seeds, pumpkin seeds, lentils, beans, cashews, turkey, quinoa, shrimp.
Copper
This nutrient helps with conversion of inactive T4 to active T3
Sources: liver, eggs, yeast, beans, nuts, and seeds.
Lifestyle Changes for Hypothyroidism
Exercise - There are a couple lifestyle tips that may help support the thyroid. I think one of the most important is regular exercise. Exercise may stimulate thyroid hormone production and make cells more sensitive to the hormones. Exercise can also help with energy, weight and mood, which can all be part of hypothyroidism.
Reduce Stress - When you’re stressed your body releases a hormone called cortisol. Cortisol can slow down thyroid activity, reduce thyroid hormone production and bind up hormone to make it less active. Stress reduction can be done in many ways. Think about what you like to do, what brings you joy and happiness, and what relaxes you. This can include self-care routines, setting boundaries, working out, meditating, hobbies, journaling or staying connected with people you love. Really anything that makes you feel good can be part of managing stress.
Botanical Support for Hypothyroidism
Coleus (Coleus forskohlii) - This plant is in the mint family and can improve thyroid hormone production as well as increase the active thyroid hormone T3. Caution with peptic ulcer and if you're taking blood thinners.
Guggul (Commiphora mukul) - Hypothyroidism can cause elevated cholesterol. This herb can reduce the plaque forming LDL cholesterol by stimulating the thyroid gland and increasing T3 production.
Ashwagandha (Withania somnifera) - This is a great herb for sleep, immune support, stress management and brain fog. It may normalize thyroid labs in as little as 8 weeks. The thyroid and adrenals work closely together so it's beneficial to address high cortisol because it can decrease thyroid activity.
Stay tuned for the next article, where I’ll dive into reproductive hormones, explore the links between estrogen, progesterone and CFS, and share practical tips to balance your hormones!
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In health,
Dr. Jamie
This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
Resources
Bove, M. (2018, December 4). 10 Botanicals to Support a Healthy Thyroid. Lecture presented at Gaia Herbs Professional Solutions Web Seminar.
Romm, Aviva. “Hypothyroid Testing: 6 Labs To Ask For.” Aviva Romm MD, 17 Dec. 2018, avivaromm.com/hypothyroid-testing-need-know/.
Teitelbaum, J. (2007). From Fatigued to Fantastic (3rd ed.). Avery.
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