Dr. Christina Christoforou ND

The thyroid gland is this little bowtie structure that sits in our throats. A lot of times, we palpate the thyroid to see if it’s a little bit bigger. Suppose there are any nodules, called goitre; it indicates something is wrong with the thyroid.

The thyroid gland is responsible for releasing hormones, specifically T-3 and T-4. It helps regulate metabolism and thermal regulation—keeping our body temperature balanced.

The thyroid also affects organs like the heart, GI tract and sex hormones. The endocrine system is a complex network of organs and glands, the thyroid gland being one of them. The responsibility of these organs and glands is to release hormones to help best balance the body, whether it’s growth, development or reproduction. Other examples of glands and organs would be the pancreas or the ovaries. In our brain, we have the pineal gland, hypothalamus, and the adrenal gland. These glands work synergistically together. When one of the glands or organs is off, it often sets off a ripple effect.

There is a normal-acting thyroid, and then there are two other extremes. We call them hypothyroidism, the underactive thyroid, and hyperthyroidism, the overactive thyroid. Typically, we see more of an underactive thyroid or hypothyroidism. Then there is also the autoimmune condition called Hashimotos. A hyperthyroid is usually called Graves disease.

Signs and symptoms that a lot of my female patients come in for are things like fatigue, which right away could be related to an underactive thyroid. Fatigue, depression, weight gain, cold all the time, hair loss, dry skin, lower heart rate, constipation – because everything is slowing down with an underactive thyroid.

For an overactive thyroid, think of it as your thyroid working much quicker. Signs and symptoms would be increased heart rates, diarrhoea, anxiety, insomnia, weight loss, feeling hungry all the time, mood swings, and fatigue.

A thyroid panel is what I like to use. So main ones are the TSH, or thyroid stimulating hormone, the T3, T4 and the antibody tests. The antibody tests are to check autoimmune thyroid conditions. So that would be the TPO and Tg antibodies. If those antibodies are elevated, then we’re dealing with an autoimmune thyroid condition. The other one I like to test is called Rt3 or reverse T3.

If you feel a nodule during a physical exam, we need to do a thyroid ultrasound and rule out something like thyroid cancer.

If a patient complains about being stressed, we look at the adrenal gland, which releases cortisol. The am and pm cortisol and DHEA are important as well.

If patients complain about their periods being off, we’ll check progesterone, estrogen, DHT and testosterone levels.

If there is a complaint about weight gain, we also need to look at the pancreas and insulin. Low T3 can also be related to insulin resistance.

Inflammation, too, is a big contributing factor. So I might throw in inflammatory markers, like ESR, CRP or hs-CRP.

We want to get to the root cause of an overactive or underactive thyroid. As naturopathic doctors, we’re all about looking at the full picture. We ensure that your hormones, sex hormones and adrenals work synergistically together. When one organ or glans is off, it will affect everything else.

It could cause vitamin and mineral deficiencies. Selenium and zinc are both essential for T4 to be converted to T3. Iodine is another big one. Tyrosine is an amino acid found in meats, nuts, seeds, and beans. If you’re not getting enough protein in your diet, you’re not getting that tyrosine. And tyrosine is required for your body to make T4.

Another big thing is stress. If you’re dealing with an illness or infection, your immune starts attacking the thyroid, causing the autoimmune Hashimotos.

Hormonal changes in women during pregnancy or after giving birth can cause issues. What women go through when it comes to pregnancy and after delivery cause quick shifts in hormones.

Another thing that we don’t even think about is plastic, which interferes with iodine uptake. So if you have a lot of plastic water bottles or Tupperware and you’re putting hot food in there, that will impact your iodine uptake and your thyroid.

Medication, like Metformin or SSRIs, will also impact your thyroid gland. If there is a lot of inflammation or if you have a fatty liver, that will also drive down T3.

First and foremost, diet. Brazil nuts have about 50 micrograms of selenium. Typically, we’d need to consume about 200 micrograms per day of selenium.

Oysters, mussels and clams, which aren’t things people eat every day, have the highest amount of zinc. A lot of times, I would supplement with zinc.

I give my patients supplements if they need more iodine from their diet. A thyroid complex supplement usually contains selenium, zinc, iodine, and tyrosine. I also like to incorporate Rhodiola or Ashwagandha. You have to be careful with ashwagandha as it’s an autoimmune condition. If we’re dealing with an overactive thyroid, we use a herb called bugleweed and lemon balm or valerian.

As naturopathic doctors, we can prescribe desiccated thyroid, a natural form. It is a combination of T3 and T4. To manage stress, we may do things for adrenal support, like acupuncture and IV therapy.

Women can be in perimenopause for a while before they hit menopause. It’s a confusing time for women to know whether it’s perimenopause or menopause because many of the signs and symptoms overlap. The way we define menopause is by not having a period for 12 consecutive months. If you’re fluctuating between having a period and no period, it’s still considered perimenopause. Some main symptoms you see are hot flashes, night sweats, insomnia, irritability, weight gain, migraines and depression. Sometimes, women also have urinary incontinence.

Testing is a good way to start so we know what’s happening with the hormones. We check for estradiol, cortisol, and progesterone. If there are complaints about weight gain, I run a thyroid panel. Another essential level to check is FSH. During menopause, FHS levels tend to double or triple, which is a sure indicator of menopause.

I make recommendations depending on the severity of the symptoms. If symptoms like hot flashes and night sweats are debilitating, I recommend supplementation along with diet and lifestyle changes. If it’s not too bad, then focusing on diet is enough. I find that the Mediterranean diet is beneficial. Eating foods with phytoestrogens, like flaxseed, chickpeas, lentils and beans, are also beneficial as these foods bind to the receptor that the estrogen goes to. This helps in creating a balance, so your estrogen levels don’t see fluctuations. I also like to focus on brassica family foods. Vegetables like broccoli, cauliflower, Brussels sprouts etc., tend to have something called hydroxy or indole-3-carbinol, which ensures that your body is not making bad estrogens.

Regarding lifestyle changes, I find that women who are more stressed and anxious tend to have more symptoms. Focusing on stress reduction can be helpful. Incorporating things like mindfulness, whether it’s meditation or yoga, can help. We also look at sleep patterns and a good bedtime routine—putting lights out, dropping the temperature down a little bit, wearing looser clothes, and avoiding things like alcohol or coffee and spicy foods as they tend to exacerbate symptoms.

Chasteberry, also known as Vitex, is a hormone balancer. During menopause, estrogen and progesterone levels go down. Vitex helps balance these hormones and reduces a lot of symptoms. I find that Black Cohosh helps with night sweats. I recommend using a product that combines Chasteberry and Black Cohosh. Also, adding supplements for adrenal support like Ashwagandha helps women manage stress. It’s important to balance out cortisol levels because high cortisol can worsen symptoms.

As naturopaths, we can now prescribe bioidentical hormones. There’s been a lot of controversy around synthetic hormones since the 2002 study that was stopped short when women started to experience severe side effects of synthetic hormones. They saw a 200% increase in blood clots, a 40% increase in the risk of stroke, and a 26% increase in breast cancer risk. That’s when medical doctors stopped synthetic hormone replacement therapy.

Bioidentical hormones have been around since the 1930s. But since that study in 2002, even medical doctors started to use more of them. These hormones are plant-based and very identical to the ones in our bodies. Taking them as pills or creams is the best way to go. Bioidentical hormones can prevent breast cancer as they inhibit breast cell division. They are also heart friendly as they prevent clots and osteoporosis. So the benefits are multitude. The estriol cream, which you apply vaginally, works amazing for vaginal dryness. You can even play around with the dosages and figure out what works best. As for synthetic hormones, I don’t think medical doctors even prescribe them to their patients anymore.

Within a week or two, most of my patients start to notice a reduction in hot flashes and night sweats. With progesterone, they also notice weight loss. They find that their mood is much more balanced and see a decrease in feelings of anxiety and depression. Overall, most of them come back saying that they feel fantastic.