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p.31
All combined, it's estimated 43 percent of Americans are genetically predisposed to celiac disease, and 81 percent are predisposed to gluten intolerance.

When it comes to diagnosing celiac disease, other markers to consider are positive antibodies against:

  • Gliadin, a protein in gluten
  • Transglutaminase, an enzyme in the intestines
  • Endomysium, a muscle sheath

When any or all of these is positive, it indicates a person is not just gluten intolerant, but has celiac disease. [...]

[...I]f a person with a gluten intolerance or celiac disease eats gluten regularly, her immune system is kept on a constant red alert, toiling virtually nonstop. Here's how it sets the stage for Hashimoto's: When immune antibodies tag gluten for removal, they stimulate the production of antibodies against the thyroid gland as well (again, because they are both so similar in structure). In other words, every time gluten is ingested, the immune system launches an attacknot only against gluten but also on the thyroid gland. What's worse, the immune response to gluten can last up to six months each time it's ingested. [...] All patients with an autoimmune thyroid condition should be screened for gluten intolerance or celiac disease,48 just as all patients with gluten intolerance or celiac disease should be screened for an autoimmune thyroid disorder.49 [...]

  1. Celiac disease in North Italian patients with autoimmune thyroid diseases.
    Spadaccino AC, Basso D, Chiarelli S, Albergoni MP, D'Odorico A, Plebani M,
    Pedini B, Lazzarotto F, Betterle C.
    Autoimmunity. 2008 Feb;41(1):116-21.
  2. Coeliac disease in Dutch patients with Hashimoto's thyroiditis and vice versa.
    Hadithi M, de Boer H, Meijer JW, Willekens F, Kerckhaert JA, Heijmans R, Peña AS,
    Stehouwer CD, Mulder CJ.
    World J Gastroenterol. 2007 Mar 21;13(11):1715-22.

Sea-Iodine, 1000 mcg, 60 vegetarian capsules

The purified algae extracts found in Sea-Iodine™ come from the pristine waters of Iceland, Nova Scotia, Italy and Norway, providing you with over 667% of the Recommended Daily Value of natural iodine.


Vitamin D3 with Sea-Iodine, 5,000 IU, 60 vegetarian capsules

For those members who would like the convenience and economy of taking vitamin D and Sea-Iodine™ in just one capsule, Life Extension® offers Vitamin D3 with Sea-Iodine™. As a result of startling evidence of a widespread vitamin D deficiency, prominent nutritional scientists are calling on Americans to increase their vitamin D intake to 1000 IU per day and higher. Life Extension® recommends that healthy adults supplement each day with at least 1000 IU of vitamin D. Elderly adults may benefit from higher doses such as 2000 IU daily, and even up to 5000 IU daily.


Vitamins D and K with Sea-Iodine, 60 vegetarian capsules

An avalanche of favorable studies has resulted in record numbers of Americans supplementing with vitamin D. Since it is virtually impossible to obtain adequate vitamin D from food sources, supplementation with 5,000-10,000 IU daily is required by most aging individuals.

Overlooked by almost everyone (except LifeExtension® members) is the critical importance of vitamin K. If one is concerned enough about their health to take higher dose vitamin D, it seems absurd to miss out on the proven benefits of vitamin K. For instance, vitamin D facilitates calcium absorption into the bloodstream and thus plays an important role in maintaining bone density. Less recognized is the need for vitamin K to transport calcium from the bloodstream into the bone. Vitamin K is also required by calcium-regulating proteins in the arteries.1-5 Together these two vitamins help maintain youthful calcium skeletal distribution while promoting vascular health.6-11

Vitamin K can be found in small amounts in the diet, but to obtain the desired higher potencies requires supplementation. Most Life Extension members obtain optimal potencies of long-acting vitamin K in the Super Booster or Super K formulations. An increasing number of new members, however, are asking for high-potency vitamin D—but are not taking any supplemental vitamin K.

To directly address this critical problem, Life Extension® has put together a new formula called Vitamins D and K with Sea-Iodine™. Like vitamins D and K, few Americans obtain optimal amounts of iodine. As people seek to limit their salt intake, this deficit is exacerbated since iodized salt is the principal source of this mineral in many diets. We expect the issue of iodine insufficiency to receive more media attention as new studies uncover the problems this creates. Sea-Iodine™ is included in this formula to provide iodine without the harmful effects of sodium.

References

  1. J Bone Miner Metab. 2001;19(3):146-9.
  2. Osteoporos Int. 2007 Jul;18(7):963-72.
  3. J Bone Miner Res. 2007 Apr;22(4):509-19.
  4. Natural Vitamin K2 as Menaquinone-7.
    Monograph April 2006
  5. Blood. 2007 Apr 15;109(8):3279-83.
  6. Med. Hypotheses. 2007;(68):1026-34.
  7. J Am Coll Nutr. 1992 Oct;11(5):567-83.
  8. Endocrinology. 1984 Nov;115(5):1891-6.
  9. Curr Opin Lipidol. 2001 Oct;12(5):555-60.
  10. Atherosclerosis. 1995 Jul;116(1):117-23.
  11. Calcif Tissue Int. 1996 Nov;59(5):352-6.
Last Updated: 15 November 2011

Thyroid Problems
Iodine Deficiency, Toxins, Goitrogens,
Autoimmune Issues and Gluten Sensitivity

This page presents in-depth information on thyroid problems, hyperthyroidism and hypothyroidism, particularly with respect to the significance of iodine, its importance in the prevention of serious health and developmental problems.  Material has been selected from various authoritative sources and organized in an effort to provide the reader with an overview from which s/he might pursue additional avenues of research.  Illustrations have been added. Two comprehensive articles from LifeExtension® are presented, as well as three of their innovative products (see left sidebar).  There is also a segment detailing Datis Kharrazian's new book (2010:344pp.), Why Do I Still Have Thyroid Symptoms? When My Lab Tests are Normal (see left sidebar).

In 2008, researchers concerned about the growing threat of iodine deficiency analyzed 88 samples1 of iodized table salt—the main supply of this critical micronutrient for most people.2

Less than half of those tested contained amounts of iodine sufficient for optimal health.

Coupled with the trend of reduced salt consumption, rates of iodine deficiency are now reaching epidemic levels.

In the developed world, iodine deficiency has increased more than fourfold over the past 40 years. Nearly 74% of normal, “healthy” adults may no longer consume enough iodine.3,4

In this article, the latest data on this dangerous trend are presented. You will learn of iodine deficiency’s profound impact on overall health. You will discover iodine’s vital role in thyroid function and its link to obesity, cognitive impairment, heart disease, psychiatric disorders, and various forms of cancer. You will also find out how iodine can help ward off breast cancer and fibrocystic breast disease.

Unknowingly Robbing Our Bodies

In nature, iodine is a relatively rare element. It’s found in abundance in the ocean. Its presence in soil, on the other hand, is very low in many places around the world, including the United States.

Iodine is essential to life and especially crucial for brain development in children, making its deficiency the number one cause of preventable mental retardation worldwide.

It also plays a central role in healthy function of your thyroid gland. This is why the most visible symptom of iodine deficiency is goiter—the unsightly, painful enlargement of the thyroid gland that manifests as an enormous swelling around the neck and larynx.

Image Credit: AyurvedicTalk
Struma nodosa (Class II)

While goiter was relatively common a few generations ago, most middle age and younger Americans have never seen it. This is largely due to the industry practice of salt iodization in this country, first implemented in the 1920s after the effects of iodine deficiency were recognized and since emulated around the world.2,5,6 (The Morton company was the first to add iodine to salt in 1924, after a successful public health campaign.)7 Unfortunately, as evidenced by recent FDA findings, many table salt makers are now failing to add iodine in quantities sufficient to support optimal health.

Other consequences of iodine deficiency, so-called iodine deficiency disorders (IDD), are subtle and may inflict greater damage.6,8 It is estimated that IDDs affect between 800 million and 2 billion people worldwide; reduction in salt intake is likely to drive those numbers still higher.2,9-11

The health benefits of reducing salt intake have been well established.9,12,13 Millions of Americans are slashing their use of salt to protect themselves against high blood pressure and cardiovascular disease.

But by cutting our salt intake we are also cutting our iodine intake, which is why mean urinary iodine levels (a measure of iodine sufficiency) plummeted by more than half over a 20-year period.4,14 Additional, otherwise healthy behaviors have also contributed to inadequate iodine intake. (See Table 1.)

The danger of low dietary iodine is further compounded by your body’s decreased ability to utilize it, the result of contamination by a ubiquitous environmental toxin called perchlorate.

Originally developed for explosives and rocket fuel,18 perchlorate now pervades ground water and food supplies throughout the US. It’s even used as a flavor-enhancer in certain foods.19-21 Perchlorate blocks the thyroid gland’s ability to absorb and utilize dietary iodine, an effect that is of concern when iodine intake drops off.18,22

This visualization is from The Wall Street Journal (Perchlorate Runoff Flows To Water Supply of Millions: A Fuel of Cold War Defenses Now Ignites Health Controversy, Peter Waldman, December 16, 2002). It is from an article discussing how a chemical from perchlorate can make people ill. The visualization shows how perchlorate blocks the thyroid's ability to absorb iodide, which it uses to produce essential hormones. Credit: Wall Street Journal. Via: A1-LeslieIkemoto. Option: Read the full article here.

The US recommended dietary allowance (RDA) for iodine is 150-290 micrograms (mcg) for adults, while the Food and Nutrition Board of the Institute of Medicine has set the tolerable upper limit at 1,100 mcg.18,23,24

These guidelines may be inadequate to address certain health conditions.

They were first established as sufficient only to prevent goiter. Daily doses for optimal health of 3,000-6,000 mcg have been used without side effects in studies of people with other iodine deficiency-related health conditions such as polycystic breast disease.18

By way of comparison, the average daily Japanese consumption of iodine ranges from 5,280 to 13,800 mcg of iodine, with no harmful effects and a host of benefits.18,25,26 The Japanese experience is shedding new light on the importance of iodine, not only for thyroid health, but on other body functions as well. In particular, compelling evidence is emerging about the role of iodine in maintaining breast health, a major concern for millions of American women.

Since thyroid function is a puzzle to many people, we’ll begin with a brief overview of that important gland and its requirements for iodine. Then we’ll turn to the role of iodine in maintaining breast health, particularly in preventing breast cancer and fibrocystic breast disease.

Your Thyroid Gland and the Role of Iodine

Your thyroid gland is located in the front of your neck, just below your voice box. The thyroid produces two forms of thyroid hormone, both of which are derived from the amino acid tyrosine and several atoms of iodine. Thyroid hormones control your body’s metabolism, regulating everything from body temperature and heart rate to glucose consumption and even blood lipid levels.27-29

Too much thyroid hormone (hyperthyroidism) results in an excessively high metabolic rate. People with this condition have rapid heart rates and often palpitations,29 excessive sweating, and may feel much warmer than other people do, even in a cool room. In extreme cases they may lose weight and experience muscle weakness.

Too little thyroid hormone (hypothyroidism) results in just the opposite set of symptoms: a slower than normal heart rate,29 a chronic feeling of being cold, constipation, unexplained weight gain, dry skin, hair loss or coarse dry hair, weakness, muscle aches, depression, and fatigue.30,31 In extreme cases, people with low thyroid function experience cognitive decline,32 and babies born to mothers with inadequate iodine levels are at high risk for a unique form of mental retardation known as cretinism. Cognitive impairment caused by low thyroid function is reversible with iodine or thyroid hormone supplementation.32,33

Both over- and under-production of thyroid hormone are associated with the thyroid gland swelling known as goiter. In hyperthyroidism, the goiter is the result of inflammation of the gland as it is under attack by an overactive immune system.

What You Need to Know: Iodine Deficiency
  • Iodized salt is the chief source of iodine in the industrialized world.
  • Rates of iodine deficiency have reached epidemic levels, increasing fourfold over the past 40 years.
  • Recent scientific analysis reveals that many commercial table salt brands now contain inadequate amounts of iodine.
  • Iodine is critical to healthy thyroid function.
  • Inadequate iodine intake causes weight gain, low energy, depression, cardiovascular disease, cognitive decline, and a variety of cancers.
  • Iodine is vital to breast health in older women, with low intake correlated to increased risks for breast cancer and fibrocystic breast disease.

In hypothyroidism, the goiter develops as the thyroid attempts to make more thyroid hormone in the absence of sufficient dietary iodine.

Iodine deficiency is the most common cause of goiter, and since it causes hypothyroidism, is also the most common endocrine (glandular) problem in the world.18 Iodine deficiency is most prevalent in people who live far inland, away from the oceans that provide our best source of iodine. Those areas are commonly referred to as “goiter belts,” because of the high rates of impaired thyroid function.5

Iodine deficiency disorders can produce symptoms of low thyroid function (hypothyroidism) even without abnormalities in measured thyroid hormone levels.34 Recent evidence suggests, for example, that iodine deficiency is linked to obesity, cognitive impairment, psychiatric disorders, fibromyalgia, and a variety of cancers.34

Paradoxically, another major consequence of mild-to-moderate iodine deficiency in older adults is hyperthyroidism (excessive thyroid function), especially in women.35 This is the result of rapidly growing thyroid gland nodules that over-produce thyroid hormone; it can trigger cardiac arrhythmias, osteoporosis, and muscle wasting.35

Among those negative consequences is the impact of iodine deficiency on breast health. Compelling data are emerging that link iodine deficiency to breast cancers and high rates of fibrocystic breast disease, two of the greatest concerns of older women in the US. It’s worth exploring those data here; including evidence that iodine supplementation can promote healthy breast tissue.

Fortunately, all iodine deficiency disorders and related health dangers can be prevented by adequate intake of iodine.8

Table 1. Why Health-Conscious Americans Suffer From Iodine Deficiency
Healthy Action Unintended Reduction in Iodine Consumption
Are you using less salt overall? Iodized salt is a major source of iodine in America; using less salt means you’re getting less iodine2
Are you putting less salt on your food directly? Salt used in cooking loses up to 62.4% of its iodine content15
Are you using Kosher or sea salt? These forms of salt contain little or no iodine
Are you eating more vegetables and less meat? Foods of plant origin have lower iodine content than foods of animal origin16
Are you exercising regularly? A substantial amount of iodine is lost in sweating during regular exercise regimens17

The Emerging Role of Iodine in Breast Health

Iodine deficiency is rapidly emerging as a major risk factor for breast cancer.

Human breast tissue and breast milk contain higher concentrations of iodine than the thyroid gland itself, which contains just 30% of the body’s iodine stores.18,36,370 Breast tissue is rich in the same iodine-transporting proteins used by the thyroid gland to take up iodine from the blood.18,38 The evolutionary reasons for this are clear: iodine is essential to the developing newborn brain, so the mother’s body must have a direct means of supplying iodine to the nursing infant.18,39

[...] There is an observed correlation between thyroid dysfunction and breast cancer (1,2,3), particularly hypothyroidism (3,4). Decreased function of the thyroid gland and rising TSH are also associated with a doubling in the risk of development of fibrocystic breast disease (5).

Next, iodine and breasts. Both breast tissue and thyroid tissue concentrate iodine (6) and deficiency of iodine causes “atypical tissue and physiologic changes in both” (7). One researcher noted that “geographic differences in the rates of breast, endometrial, and ovarian cancer appear to be inversely correlated with dietary iodine intake” (8). For example, in Japan seaweed (high in both iodine and selenium) is a major part of the diet and may play a role in the low incidence of both benign and malignant breast disease in that country (9).

A study on rats demonstrated a reduction in breast cancer incidence with iodine treatment (10). With regard to fibrocystic breast disease, randomized, double-blind, placebo-controlled, multicenter clinical trials (the gold-standard of conventional medicine!) have demonstrated that supplementation with iodide/iodine significantly reduced breast pain, tenderness, and nodularity (11,12).

So how does this work? One theory is that iodine deficiency leads to a state of excess estrogen (13), increasing the risk of a whole host of cancers. Iodine is also believed to suppress tumour growth (14), induce tumour cell death (15), and regulate genes that influence hormone metabolism, cell cycle, growth, and differentiation (16).

So why is this useful information? Everything in the body is connected, particularly the endocrine system. So, when something is going wrong in one area, like thyroid function, there are likely also going to be issues either immediately or down the road with another area, particularly reproductive organs. The causal mechanisms are not clear yet, but it is prudent to assess breast health when patients present with thyroid dysfunction and vice versa. There is evidence to suggest that iodine is effective nutritional treatment for fibrocystic breast disease and it may also be useful in reproductive cancers. Molecular iodine, rather than iodide, was found to be most effective and have the least adverse effects on the thyroid (12). [...]

Anterolateral view of the right breast. Illustration depicting cancer in glandular tissue and lymph nodes of the breast.

Anterolateral view of the right breast. Illustration depicting cancer
in glandular tissue and lymph nodes of the breast.
Credit: MEDICAL RF.COM/ SCIENCE PHOTO LIBRARY.
Accessed: 15.10.11

Iodine plays an important role in the health of women’s breast tissue.40 In the presence of chemicals and enzymes found in breast tissue, iodine has been shown to exert a powerful antioxidant effect equivalent to vitamin C.18,41 Iodine-deficient breast tissue exhibits chemical markers of elevated lipid peroxidation, one of the earliest factors in cancer development.18,42-45

Iodine-deficient breast tissue also shows alterations in DNA and increases in estrogen receptor proteins.40 Coupled with iodine deficiency-induced increases in circulating estrogen levels, these changes can substantially increase the risk of breast cancer in women with low iodine levels.44

Iodine also helps regulate levels of the stress hormone cortisol and contributes to normal immune function.46,47 Abnormal cortisol levels and deficient immune function are significant contributors to the risks of breast cancer; women with fibrocystic breast disease may also suffer from elevated cortisol levels.48-51

Taken together, these biological factors explain the well-known link between iodine deficiency and thyroid disease, thyroid cancer, and breast cancer, all of which predominate in postmenopausal women.42,52,53

The link between iodine consumption and breast cancer is most evident when you compare the Japanese and Western diets against cancer incidence.

Japanese women consume a diet high in iodine-rich seaweed, which provides them with an iodine intake 25 times higher than the average American woman’s.54 Japanese women also have breast cancer rates roughly one-third of those found in American women, a difference that disappears in Japanese women who immigrate to the US, where they consume considerably less seaweed.18,52,55

Studies of iodine therapy for breast cancer prevention are encouraging. Continuous iodine given to cancer-prone rats cut mammary tumor rates nearly 2.5-fold.56 Breast cancer cells avidly absorb iodine, which in turn suppresses tumor growth and causes cancer cell death.57,58

Added dietary iodine reduces the size of both benign and malignant breast tumors, an effect credited in part to iodine’s direct reduction of lipid peroxidation levels.54,56 Although the doses of iodine used in these studies are substantial, equivalent to 5,000 mcg daily, no toxic effects of iodine were observed, either on thyroid function or in other tissues.18,54,56 Further benefits may be obtained by supplementing with selenium in addition to iodine; selenium is an essential cofactor in the enzymes used in thyroid and breast tissue to make optimal use of dietary iodine.4,11,25

In addition to its obvious role in preventing breast cancer, increased iodine intake may be important in mitigating another common, if less lethal, breast disorder—fibrocystic breast disease or FBD.

While harmless, fibrocystic breast disease is extremely common. It is found in at least 9% of all women who undergo biopsies, though the actual rate is probably much higher.18,59 Animal studies have shown that fibrocystic breast disease can be induced by depriving breast tissue of iodine.11,40,60 These changes can be reversed by iodine doses equivalent to 5,000 mcg per day in humans.18,61

Women with fibrocystic breast disease obtain substantial relief from oral administration of iodine at doses of 3,000-6,000 mcg, with 65% achieving improvements according to their own and their physicians’ assessments.62 In those studies, only 33% of placebo recipients reported any benefit. No side effects were detected at any of the doses used.18

It is becoming increasingly clear that iodine deficiency interferes with optimum breast health, and intake of levels far higher than the recommended dietary allowance of 150-290 mcg is required to achieve benefits. Daily amounts of 3,000-6,000 mcg may help relieve the symptoms of fibrocystic breast disease.18

Table 2. Prevalence of Iodine Deficiency in Australia3
Group % With Mild Deficiency % With Moderate to Severe Deficiency Total % Deficient
Pregnant Women 29.6 19.8 49.4
Postpartum Women 34.6 19.2 53.8
Diabetic Patients 37.8 34.1 71.9
Normal Volunteers 47.4 26.3 73.7

The Role of Iodine in Cardiovascular Health

[...] It’s true that there are certain foods that contain goitrogens, which are compounds that make it more difficult for the thyroid gland to create its hormones. However, the piece of the puzzle that’s missing in the advice to “avoid” this food or that one because it contains a goitrogen is that you can limit or even eliminate the harmful effects of these compounds in so many ways — either by limiting the amount you consume, or by preparing the food in such a way as to break down the goitrogenic compounds. Sometimes eliminating the goitrogen is as simple as steaming your vegetables before you eat them!

So let’s look at what goitrogens are, where they occur in our food, and how we keep them from affecting our thyroid function so we can enjoy our favorite healthy foods without concern for our thyroid health.

What is a goitrogen?

Most goitrogens are naturally-occurring chemicals that are ingested in foods or drugs. These chemicals can interfere with thyroid function in different ways. Some compounds induce antibodies that cross-react with the thyroid gland; others interfere with thyroid peroxidase (TPO), the enzyme responsible for adding iodine during production of thyroid hormones. Either way, the thyroid isn’t able to produce as many of the hormones that are needed for regulating metabolism (see my article on nutrition and thyroid health for more on how this works).

For people with healthy thyroid function, the thyroid simply compensates and makes more of the hormones as they’re called for. But in some people whose thyroid function is already compromised, the thyroid gland may actually grow more cells as it tries to make up for inadequate hormone production, eventually forming a goiter (a swelling or enlargement of the thyroid gland).

[Read More → What foods contain goitrogens?]

Iodine and iodine-rich foods enjoy a long history as natural therapies for hypertension and cardiovascular disease.4 Even when no overt symptoms are evident, hypothyroidism can contribute to heart disease and stroke, and it increases the risk of death from these conditions.63-65

Thyroid dysfunction creates unfavorable disturbances in lipid profiles, elevating low-density lipoprotein (LDL) and total cholesterol levels and raising the risk of atherosclerosis.27,28,66 Hypothyroidism also weakens the heart muscle, causing it to “squeeze” less firmly with each contraction; it can cause cardiac arrhythmias as well.29,63,67 These effects may not be evident at rest, but become important during moderate exercise.63 Low thyroid function is also associated with higher waist-to-hip ratios, an obesity-related risk factor for cardiovascular disease.68

Restoring normal thyroid function helps reverse multiple cardiovascular risk factors, most notably adverse lipid profiles.27 Yet mainstream medicine has traditionally used thyroid hormone treatment, which may be dangerous if it over-drives an already weakened heart.69

Iodine therapy shows promise in safely and effectively modulating these health concerns.

Iodine Protects Against Stomach Cancer

The thyroid gland, breast tissue, and portions of the digestive tract share similarities in that all of them contain a rich concentration of iodine.42,70 Stomach lining cells in particular concentrate iodine, capitalizing on its antioxidant effects.71

This has led medical researchers to investigate whether iodine deficiency plays a role in cancers of the digestive tract.

They found that people living in iodine-deficient areas of the world are not only prone to iodine-deficiency goiters, but also have higher rates of stomach cancers.71 Stomach cancer patients in a landlocked area of Iran were 2.5 times as likely to have severe iodine deficiency than control patients.72 Gastric cancer is the most common cancer in parts of northeastern Turkey where iodine deficiency is common, and iodine levels in gastric cancer tissue were markedly lower than those in surrounding healthy tissue.73

Increased iodine intake has been strongly correlated with a reduction in stomach cancer rates in recent years.74

Iodine From The Sea: The Most Effective Natural Form

Earth’s oceans are the main repository of iodine on the planet, and nowhere is iodine as highly concentrated as in seaweed. In particular, seaweeds such as kelp and bladderwrack are capable of concentrating and storing iodine at astonishingly high levels. Scientists speculate that these primitive plants accumulate iodine to protect themselves from oxidative stress in the open ocean.75 Humans can reap the benefits of this natural process, because the iodine in these seaweeds is in the most biologically available forms, making it ideal for consumption.

Summary

Iodine is critical to healthy thyroid function. Its deficiency can cause weight gain, low energy, depression, cardiovascular disease, cognitive decline, and a variety of cancers.

Yet rates of iodine deficiency have reached epidemic levels, increasing fourfold over the past 40 years. A startling 74% of normal, “healthy” adults may no longer be consuming sufficient quantities.

Recent scientific analysis reveals that many commercial table salt brands now contain inadequate amounts of iodine. Emerging evidence points to the severe impact of low iodine on a wide range of health issues, including increased risks of breast cancer and fibrocystic breast diseases.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at
1-866-864-3027.


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Millions of Americans suffer from fatigue, weight gain, depression, and cognitive impairment. Many believe that they have no choice but to accept these seemingly “age-related” declines in quality of life.

Underactive thyroid (hypothyroidism) is often overlooked or misdiagnosed and can be the underlying cause of these symptoms. Patients and their doctors often disregard these common signs of thyroid hormone deficiency, mistaking them for normal aging.1

Overactive thyroid (hyperthyroidism) afflicts fewer people than hypothyroidism, yet the symptoms can be equally devastating. Subclinical hyperthyroidism, characterized by suppressed thyroid stimulating hormone (TSH) levels accompanied by normal thyroid hormones (T4 and T3) levels,2 has been associated with increased rates of cardiovascular disease; arrhythmia in particular.3 Overt hyperthyroidism compromises bone health,4 elevates blood glucose levels,5 and often causes anxiety.6

Fortunately, a simple blood test for TSH, T3 and T4 can reveal an underlying thyroid condition and help direct treatment to improve the symptoms.1, 2

In this protocol we will discuss the function and regulation of the thyroid gland, and the systemic implications of both hypothyroidism and hyperthyroidism. We will examine the importance of proper testing and interpretation of thyroid hormone levels and reveal natural approaches for maintaining optimal thyroid hormone levels.

Role of the Thyroid

The thyroid is a butterfly-shaped organ located just below the Adam’s apple in the neck. Made up of small sacs, this gland is filled with an iodine-rich protein called thyroglobulin along with the thyroid hormones thyroxine (T4) and small amounts of triiodothyronine (T3).

The primary function of these two hormones is to regulate metabolism by controlling the rate at which the body converts oxygen and calories to energy. In fact, the metabolic rate of every cell in the body is regulated by thyroid hormones, primarily T3.7

In healthy individuals the gland is imperceptible to the touch. A visibly enlarged thyroid gland is referred to as a goiter. Historically, goiter was most frequently caused by a lack of dietary iodine. 8 However, in countries where salt is iodized, goiter of iodine deficiency is rare.

Thyroid Regulation

The production of T4 and T3 in the thyroid gland is regulated by the hypothalamus and pituitary gland. To ensure stable levels of thyroid hormones, the hypothalamus monitors circulating thyroid hormone levels and responds to low levels by releasing thyrotropin-releasing hormone (TRH). This TRH then stimulates the pituitary to release thyroid stimulating hormone (TSH).9,10 When thyroid hormone levels increase, production of TSH decreases, which in turn slows the release of new hormone from the thyroid gland.

Cold temperatures can also increase TRH levels. This is thought to be an intrinsic mechanism that helps keep us warm in cold weather.11

Elevated levels of cortisol, as seen during stress and in conditions such as Cushing’s syndrome, lowers TRH, TSH and thyroid hormone levels as well.12,13

The thyroid gland needs iodine and the amino acid L-tyrosine to make T4 and T3. A diet deficient in iodine can limit how much T4 the thyroid gland can produce and lead to hypothyroidism.14

T3 is the biologically active form of thyroid hormone. The majority of T3 is produced in the peripheral tissues by conversion of T4 to T3 by a selenium-dependent enzyme. Various factors including nutrient deficiencies, drugs, and chemical toxicity may interfere with conversion of T4 to T3.15

Another related enzyme converts T4 to an inactive form of T3 called reverse T3 (rT3). Reverse T3 does not have thyroid hormone activity; instead it blocks the thyroid hormone receptors in the cell hindering action of regular T3.16

Ninety-nine percent of circulating thyroid hormones are bound to carrier proteins, rendering them metabolically inactive. The remaining “free” thyroid hormone, the majority of which is T3, binds to and activates thyroid hormone receptors, exerting biological activity.17 Very small changes in the amount of carrier proteins will affect the percentage of unbound hormones. Oral contraceptives, pregnancy, and conventional female hormone replacement therapy may increase thyroid carrier protein levels and, thereby, lower the amount of free thyroid hormone available.18

Thyroid Dysfunction

Hyperthyroidism

In hyperthyroidism, the thyroid gland produces too much thyroid hormone, which can significantly accelerate the body's metabolism. Typical symptoms of hyperthyroidism include sudden weight loss, a rapid heartbeat, sweating, nervousness or irritability. Hyperthyroidism affects about one percent of the population.19

Extreme hyperthyroidism, or thyrotoxicosis, can culminate in what’s referred to as “thyroid storm”.20 In this medical emergency, patients suffer from elevated heart rates and blood pressure, extreme exhaustion, and high fever. Thyroid storm sharply increases a patient’s risk for stroke and heart attack, and is fatal for up to 50% of patients, even with the best medical care.21

Hyperthyroidism: What you need to know

Hyperthyroidism is usually caused by Graves’ disease characterized by symptoms such as rapid heartbeat, sweating, nervousness, tremors, muscle weakness, sleep difficulties, increased appetite and sudden weight loss.22 Affected individuals can also experience thyroid storm—a potentially deadly medical emergency.23

Medical Treatment of Grave’s disease 24

  • Anti-thyroid drugs, such as methimazole or proplythiouracil, inhibit the production of T3.
  • Radioactive iodine, which causes destruction of the overactive thyroid gland.
  • Surgical removal of the thyroid gland (thyroidectomy).
  • Beta-blockers may be used to control the high blood pressure and increased heart rate associated with hyperthyroidism.

Nutritional Support of Hyperthyroidism

  • Increased thyroid activity increases loss of L-carnitine through the urine. Individuals suffering from hyperthyroidism may, therefore, require supplemental L-carnitine.25
  • L-carnitine supplementation helped prevent or reverse muscle weakness and other symptoms in individuals suffering from hyperthyroidism. Clinical trials have shown that doses of 2,000-4,000 mg/day of L-carnitine are helpful in individuals who suffer from hyperthyroidism.26
  • Passion flower (Passiflora incarnata ) and valerian (Valeriana officinalis) are botanicals that have a calming effect on the nervous system27,28 and thus may help control the symptoms of an overactive thyroid.

Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormones, characterized by a reduction in metabolic rate. The main symptoms of hypothyroidism are fatigue, weakness, increased sensitivity to cold, constipation, unexplained weight gain, dry skin, hair loss or coarse dry hair, muscle cramps and depression. However, most symptoms take years to develop. The slower the metabolism gets, the more obvious the signs and symptoms will become. If hypothyroidism goes untreated, the signs and symptoms could become severe, such as a swollen thyroid gland (goiter), slow thought processes, or dementia. 29

Subclinical hypothyroidism, an often under-diagnosed thyroid disorder, manifests as elevated TSH, normal T4 and normal T3 levels.30 Individuals with subclinical hypothyroidism are at greater risk for developing overt hypothyroidism.31 An August 2010 study reported that 8.3% of women with no history of thyroid disease suffer from subclinical hypothyroidism.32 An article in the American Family Physician in 2005 estimated that about 20% of women over the age of 60 suffer from subclinical hypothyroidism.33

There is evidence that the standard blood TSH test reference range may cause many cases of hypothyroidism to be missed. Most physicians accept a reference range for TSH between 0.45 and 4.5 mU/L to indicate normal thyroid function. In reality, though, a TSH reading of more than 2.0 may indicate lower-than-optimal thyroid hormone levels.34

According to a study reported in Lancet, various TSH levels that fall within normal range are associated with adverse health outcomes.26

  • TSH greater than 2.0: increased 20-year risk of hypothyroidism and increased risk of thyroid autoimmune disease
  • TSH between 2.0 and 4.0: hypercholesterolemia and cholesterol levels decline in response to T4 therapy
  • TSH greater than 4.0: greater risk of heart disease

There is another and separate problem brought on by these overly broad normal ranges for TSH. People already diagnosed and being treated for hypothyroidism are often not taking correct doses of thyroid replacement hormone. A November 2010 study reported that about 37% of people being treated for hypothyroidism were taking incorrect doses, about half too much and another half too little hormone.35 [...]
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