Feeling Fat, Fatigued and Fuzzy?

March 18, 2009

Posted by Kevin Passero, ND

The 4 Fs — feeling fat, fatigued and fuzzy — can be used to describe how someone with hypothyroidism feels. Now the majority of people do not have a diagnosed case of hypothyroidism, but many people suffer from a condition that I call subclinical hypothyroidism.

Weight gain or increased difficulty losing weight, low energy, fatigue and foggy thinking — these are all classic symptoms associated with an underfunctioning thyroid gland. In addition, low thyroid function can cause dry skin, hair loss, chronic constipation, depression, high cholesterol, low body temperature, high blood pressure and water retention. Many people are aware of this and will report to me that they have had their doctor check their thyroid values and their blood work came back normal from the lab. They receive no treatment, despite the fact that they go on experiencing these symptoms.

Redefining “Normal” Thyroid Function

Standard thyroid lab tests are designed to look for thyroid disease. Values outside of the normal range will only arise if the thyroid is in serious trouble. The reference range for thyroid values is huge. To put it into context, let’s use an analogy. Imagine that the standard thyroid value range is equal to a football field, roughly 100 yards. If your values end up in either end zone, they are outside of the range and you are diagnosed as having a serious thyroid problem. The middle of the range would be the 50 yard line, right in the center of the field. Well let’s say your football team is on the 1 yard line, right next to the end zone. Technically you are still within the “normal” range, but I think it’s clear that this situation is very different from your team being on the 50 yard line. In the eyes of most doctors, as long as you are still anywhere on that field you are normal and nothing should be done about your thyroid function.

My opinion and that of many other holistic doctors, is that if your values are at the 1 yard line, you are so close to being in the abnormal range that something should be done. Traditionally, doctors view thyroid lab results in black and white, which is unfortunate because the human body does not work this way. It works in shades of grey.

Within the range of what is traditionally considered normal, there is an area I refer to as the “optimal range.” This represents not what is normal or abnormal, but what is ideal for the highest level of functioning for your body. In fact, “normal ranges” are based on information gathered from people that might not even be like you in regards to age, weight or sex.

Subclinical hypothyroidism is what happens when your thyroid values are still in the normal range, but not in the “optimal range.” This can lead to many of the symptoms associated with hypothyroidism.

What Is the Best Way to Test Your Thyroid?

The most common test for thyroid function tests the TSH value. The range for this test is very large and goes from 0.5 all the way up to 5.5. As long as your results fall anywhere within this range, your thyroid function is considered “normal.” However, there is a much narrower range that is more closely associated with optimal health. The ideal range for TSH should be between 1.2 and 3.2. It is a little counterintuitive, but a higher TSH indicates an underactive thyroid gland. This means that any TSH over 3.2 indicates that you might have an underfunctioning thyroid.

There are two other very important tests to ask your doctor for when considering how your thyroid function might be affecting your health.

1. Free T4: T4 is the main thyroid hormone circulating in your body. Low levels will lead to symptoms associated with low thyroid. Free T4 is the hormone that is circulating without being bound to a carrier protein. If the hormone is bound to a carrier protein, it is not available for our cells to utilize. Various issues, like hormone imbalances, can affect how much of the hormone is free and how much is bound.

2. Free T3: This is probably the most important and most overlooked test of thyroid function. T3 is not the most abundant circulating thyroid hormone, but it is the most active. In fact, it is many times more potent than T4. If T3 levels are low, you may have hypothyroid symptoms. What’s more, your TSH and T4 levels can look completely normal and even optimal, even if your T3 levels are very low. In this scenario, your doctor may be 100% sure that your thyroid is not to blame for your symptoms, when in fact it is a thyroid problem! Any other T3 test is not good enough. It has to be the Free T3 test in order to appropriately diagnose the situation.

Some Nutrients to Consider

To keep your thyroid functioning optimally, there are a few nutrients to consider taking. Some provide general support for overall thyroid function and others offer support specifically for the issue of subclinical hypothyroidism. Just keep in mind that endocrinology is a very complex issue, and it is best to approach these problems under the guidance of an experienced health practitioner.

Iodine: Iodine is probably the most important nutrient for proper thyroid function. All active thyroid hormone must contain iodine. Although you might use iodized salt on your food, you may not be getting enough of this valuable nutrient. I suggest incorporating more seaweed into your diet. Although this might sound strange, seaweed has a very high natural concentration of iodine and can be a superfood for the thyroid. Many Japanese and macrobiotic recipes include seaweed as a staple. If including it in your diet won’t work, I suggest looking into kelp supplements. Kelp is a type of sea vegetable that also naturally contains high amounts of iodine. It comes in capsule, liquid and tablet forms.

Selenium: This mineral nutrient is necessary to activate the deiodinase enzyme that converts T4 into the more active thyroid hormone T3. Selenium is categorized as an enzyme co-factor, meaning its presence is necessary for that enzyme to work properly. Supplementing with 100 – 200 mcg per day can ensure that enough selenium is present for this enzyme to work properly.

Tyrosine: This amino acid is the building block for thyroid hormone. The “T” in T4 and T3 are abbreviations for tyrosine. (The numbers 4 and number 3 refer to how many iodine molecules are attached to the tyrosine.) Supplementing with additional tyrosine ensures that enough building material is present to synthesize adequate amounts of thyroid hormone.

Ashwaganda: Ashwaganda is an Ayurvedic herb with many health benefits. It has been used for centuries to improve strength and stamina in weakened or sick individuals. However, there is scientific data to support its ability to aid in the conversion of T4 into T3. This makes it very helpful in cases subclinical hypothyroidism that are due to T4 to T3 conversion issues.

The Anti-Aging Bottom Line: If you are suspicious that you have a thyroid problem, but standard lab analysis has not shown anything abnormal, consider sharing this information with your doctor, or finding a practitioner who routinely uses Free T4 and Free T3 tests to assess thyroid function. Subclinical hypothyroidism can easily be addressed with the right type of natural support.