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Everyone I talk to lately seems to be tired. The answer to the simple question “how are you?” used to be “Fine” today it’s “Tired”. Why are so many people tired? Unfortunately, there is no simple answer. Just like any other complaint, being tired, medically known as fatigue, is a symptom of many different conditions. So many, that it would take a book to list them. Today we are going to focus on one of the more common reasons for fatigue, hypothyroidism.

The thyroid is a small gland that sits in the middle of the front of your neck. Like all your glands it plays a very important role in your health. The thyroid’s primary function is to regulate metabolism and it does so by releasing several critical hormones. Thyroid hormones are also involved in maintaining body temperature and blood calcium levels. The important thing to understand about thyroid hormones is that they are dependent upon our diet or more specifically the amount of iodine we get in our diet. Thyroxine (T4), the principal hormone produced and secreted by the thyroid, is made up of protein and iodine and is the less active form of thyroid hormone. The thyroid also produces small amounts of the more active Triiodothyronine (T3). The majority of T3 is made in the liver and kidneys from T4 and is also iodine dependent. Iodine is in a class of chemicals called halogens that include bromine, fluoride and chlorine. Our bodies, however, are mostly dependent on iodine. Unfortunately, the American diet is skewed in favor of the other halogens over Iodine. Bromine is added to breads, medications and flame retardants, fluoride and chlorine are added to drinking water and we often swim in chlorinated pools and shower in chlorinated water. The overabundance of non-iodine halogens have a detrimental effect on our bodies, they displace iodine. This sets the stage for an iodine deficiency which not only impacts the function of the thyroid gland, but also affects virtually every tissue in the body. Although the thyroid gland is the largest reservoir of iodine in the body, this elusive halogen is present in varying quantities in hair, skin, nails, liver, breast and virtually every tissue in the body. So what happens when there is an iodine deficiency? The thyroid can no longer keep up with the body’s demand for thyroxine (T4) and triiodothyronine (T3) and the levels start to drop. When blood levels of T4 and T3 drop it signals the pituitary to produce thyroid stimulating hormone (TSH) in an effort to stimulate the thyroid to produce more hormones. As the thyroid production continues to wane TSH rises, T4 and T3 levels drop. The result? Fatigue, hair loss, chills, brittle nails, dry skin, mental fogginess, weight gain or the inability to lose weight and your neck gets fat (goiter). These are just some of the symptoms of a hypothyroid. Is iodine deficiency the only cause of hypothyroid? Absolutely not, there are many other causes that can lead to hypothyroidism, but that’s the subject of another newsletter.

How can the health of your thyroid be assessed. The best way to determine thyroid function is through blood or salivary testing. The more common route is blood testing. Unfortunately often when I look at blood work brought in by patients, I notice TSH is the only thyroid test ordered. In order to best assess thyroid health your physician should be getting several values including TSH, free and total T4 and T3 as well as assessing the presence or absence of antibodies which could signal an autoimmune thyroid problem. Determining the cause and nature of a thyroid problem is the key to proper treatment and energy replenishment. Have you had your thyroid checked today?

Dr. Nadia R. Malek, DC, DACBN 

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