The thyroid is a powerful gland that regulates metabolism and balance in the body. Millions of people, especially women, live with hypothyroidism without the proper evaluation tools. Low thyroid activity is commonly associated with fatigue, inability to lose weight, hair loss, brain fog, dry skin and a multitude of other symptoms. When optimizing thyroid health, it’s important to know why the thyroid is not functioning properly. Nutritional testing may be helpful in identifying the root of this dysfunction and eating adequate amounts of specific nutrients will help to support thyroid health.

If a patient presents with low thyroid symptoms, a conventional medicine practitioner will likely only evaluate the thyroid through a blood test measuring thyroid stimulating hormone, or TSH. High TSH is referred to as hypothyroidism, as the pituitary gland secretes more TSH in an attempt to increase thyroid activity. However, the TSH marker doesn’t detect every type of thyroid dysfunction. A patient with high TSH levels would likely receive a prescription for a synthetic version of the thyroid hormone T4 to help lower TSH. This may present a problem as many people who have hypothyroidism can’t convert T4 to the active thyroid hormone T3 as efficiently as those with healthy thyroids. Introducing synthetic T4 may increase circulating amounts of the stress hormone reverse T3, which competes directly with T3. While the conventional hypothyroidism medications may lower TSH, many people’s symptoms may persist due to this competition. 

Specific foods and nutrients can help support proper thyroid balance. The thyroid uses iodine to make thyroid hormones, including T4, so it’s important to supplement the diet with high-iodine foods, such as salmon and sardines, and various types of seaweeds. The T4 hormone is normally converted to the more active version of the hormone, T3. The conversion of T4 to T3 in healthy cells is facilitated by zinc, iron, vitamin A, and selenium. Brazil nuts in particular have large amounts of selenium and eating only one to two per day contributes to adequate intake. Look to pumpkin seeds and oysters for foods with high levels of zinc.

These key thyroid health markers—TSH, free T4, free T3, and reverse T3 antibodies—pinpoint where the main imbalances lie in someone with suspected thyroid issues. Additionally, testing thyroid antibodies can reveal whether someone’s hypothyroidism is related to autoimmunity, which occurs when an overactive immune system attacks the thyroid. This is called Hashimoto’s disease, and it is a common cause of hypothyroidism. Addressing immunity through improved gut health and avoiding foods that tend to be inflammatory, such as gluten, dairy and sugar, may be beneficial for those with Hashimoto’s disease. 

Additionally, when there is mental or emotional stress, the adrenal glands release stress hormones, which can inhibit thyroid hormones even further. Incorporating mind-body exercises into our daily lives can help support all the dietary changes necessary to support thyroid health.

A conventional medicine approach may not get to the root cause of thyroid dysfunction. Addressing full-body wellness through working with a functional medicine practitioner to optimize nutrition and supplementation is key when optimizing your thyroid health. 

Bridgitte Carroll, MS, RDN, LDN, is an integrative and functional dietitian in Waltham, MA. She works one-on-one with clients utilizing a systems approach to get to the root cause of bodily imbalances. She is currently accepting new clients at her office at Johnson Compounding and Wellness. For more information, call 781-893-3870 or visit NaturalCompounder.com.