**Disclaimer: This post is not intended, nor is it suitable as a substitute for, professional medical advice. The purpose of this post is to share my personal experiences, information I’ve gathered, and the opinions formed, for education and entertainment purposes only. Please consult with your naturopath or physician before embarking on any supplementation or medication journey.**

I have a hypoactive thyroid. What is the thyroid? Cliff notes: It’s a gland in the lower, frontal part of the neck that secretes several hormones (collectively called thyroid hormone) used for metabolism, growth, brain function, body temperature, basically the entire body with all of its functions is influenced by the thyroid. There are many types of thyroid dysfunction, and it’s more and more common (especially amongst women) with each passing day. The two major varieties of thyroid disorders are:

HYPO active = it doesn’t produce enough thyroid hormone (very common). 
HYPER active = the thyroid makes too much (less common). 

It seems like everyone has a thyroid problem these days. Between antibiotic and hormone-ridden meats, GMO crops, nutritionally insufficient foods, tons of sugar, chronically high stress levels and all the other junk we’ve been eating our whole lives, it’s not a shock that the thing that regulates everything in our body is starting to have some problems. 

Let’s go back to November of 2008 and I will tell you how I came to find out about my lazy thyroid, and how I got in under control 6 years later. No, It won’t take you that long. Short story: I had a crappy doctor.  It was the week before finals at Marist College. While an all-nighter here and there isn’t out of the ordinary for a college junior during these terrible 5 days, I hadn’t slept in three. No matter how long I would lay there in the dark, I just could not fall asleep. Mind racing, heart pounding… I just assumed it was stress. This went on for 10 days. I would catch an hour or two here and there during the day, but other than that I was basically a zombie. Wide awake, wired, irritable, and frustrated. On the morning of the tenth day, at 6:30am (two hours before a final), I closed my eyes and finally took a nap. I woke up four hours later, having missed my exam. At this point, I snapped. I called my mom and told her something was wrong. She made a doctors appointment for me the next day. 

The doctors visit before the blood work was very odd. Here is how the conversation went. And yes, I still remember it because it was so, well…stupid. 
Medical Professional: “How are you sleeping?” 
Me: “I haven’t slept for more than a few hours every few days in over a week.” Medical Professional: “Are you feeling anxious, or jittery?” 
Me: “Yes.” 
Medical Professional: “Are you irritable?” 
Me: “Remember a few seconds ago when I told you I haven’t slept in over a week? Yes, I’d say I’m irritable.” 
Medical Professional: “Um..OK. Well, are you feeling depressed?” 
Me: Blank Stare, thinking to myself once again: I haven’t slept in 10 days. Yes, I’m feeling a tad depressed.” 
Medical Professional: “OK, so you either have a thyroid problem, or you’re bipolar. Here’s a script for blood work.” 

That’s great. Just sling out two VASTLY different diagnosis at me before anything more than a few questions. 

The blood work came back that I did, indeed, have a hypoactive thyroid and was not suffering from bipolar disorder. This was the first time I started investigating thyroid-related information. Turns out, hypo/hyperactive thyroid is often misdiagnosed as depression or bipolar disorder. Why? Well, the symptoms can present very similarly. Lack of sleep, irritability, depression, high energy, crashes, weight gain, weight loss, to name a few. If blood work isn’t run, women often get misdiagnosed and put on psychotics and anti-depressants instead of thyroid medication. It’s a dangerous mistake.

So what caused my sleeplessness? Well, the short of it is after years of not producing enough thyroid hormone, my brain sent signals that we needed to produce a ton of it. What other symptoms did I have? Weight gain. I never gained it like other people. I just looked full of air. Like someone stuck a bike pump up me and started blowing me up. Waking up in the morning was a struggle. Not normal, lazy person, I don’t want to get out of bed. Sandbags on my eyes, I will sleep for 15 hours because I can’t move kind of can’t wake up. I could literally barely open my eyes. Mood swings. Self-explanitory. Tons of hair in the shower drain. Gross flop-sweats in the middle of the night. This later became an indicator for me that my Synthroid (more on this later) dose was no longer working as the years went on. Every time I would start waking up in the middle of the night like someone had just dumped a bucket of water on me, I would call up my same old doctor to make another appointment, and as per the routine, she would simply increase my dose. Until the next time when she’d do it again. (I know I keep calling her a crappy doctor. Don’t forget, even med school has a last-in-their-class that still gets to be called ‘Doctor’, and we trust them without question. You have to find the right doctor for you.). This diagnosis, and resulting prescription for Levothyroxine (Synthroid), started my 6 year journey to finally get my thyroid healthy. So here, after years of mistakes, corrections, research, and self-experimenting these are the five things that I believe are most important in taking steps towards better thyroid health:

1. Get The Right Tests

This was the first, and biggest mistake that was made in my thyroid care. In 2013/2014, I finally got fed up and found a new doctor. When she saw my previous blood work and current dosage of Synthroid (250 mcgs…basically as high as you can go), it took her all of five seconds to figure out that I didn’t have a full picture of what was really wrong. Before we can talk about the tests, we need to review the hormones themselves. Here’s the VERY short version: 

TSH – Thyroid Simulating Hormone. Released from the Pituitary gland and tells your thyroid to make thyroid hormones T4 and T3. 
T4 – Thyroxine. Inactive thyroid hormone that converts to T3.
T3 – Triiodothyronine. The actual active thyroid hormone that regulates practically every function in your body, including metabolism. It’s super important and tiny variances can make tremendous differences. There’s also Free T3 and Reverse T3Free T3 is the heavy lifer. 
Iodine – Building block of Thyroid hormones. They are made up of Iodine and Tyrosine (an amino acid) 
Antibodies – Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb). These will be present if you have an autoimmune condition called Hashimoto’s or Grave’s Disease. In this scenario, your body doesn’t recognize your thyroid as a part of your body and starts to attack the tissue. It’s more common than you’d think, so this is a very important test to have run.
Vitamin D – Vitamin D plays an important role in many metabolic functions in the body, and supports the thyroid. Low D is associated with low thyroid function.
Function

As I was saying, my former physician had only ever run TSH and T4. This is the standard thyroid panel that most doctors will run. She kept seeing that my TSH was high…so my brain was sending signals to make more, and my T4 (with each new prescription) would be high, then level out. Everything, to her, seemed under control. What she was prescribing, Levothyroxine, is all T4. This will become important later. My new doctor ran all of the above listed tests. 

Here’s how my tests shook out (blood taken on 2/10/2014): *The goal numbers I have written are based on the reference levels on my actual results paperwork. These may vary based on other opinions. T4: The goal is to show between .82 and 1.77. Mine was right in there at 1.23. Seems fine, right? TSH: The goal here is somewhere in the range of .1 – 1.0. I came back at 7.490. T3: You want 2.0-4.4. I was at the very bottom of the spectrum at exactly 2.0. Iodine: Ideally, somewhere in the 40-92 range. Again, I was on the lower end, but in range, at 47. No antibodies showed up.” 

So what does this all mean? Basically, my thyroid was going crazy. It was physically inflamed and had started to grow what could have eventually turned into a nodule. Signals kept being sent that there wasn’t enough T3, so more and more TSH was produced, resulting in more and more T4. That T4, however, wasn’t converting to T3 so it didn’t matter how much I took. Not only that, but my thyroid wasn’t getting the iodine needed to support the creation of the hormones in the first place. It’s like trying to build a house on quicksand with 1/2 of the bricks that you need. My previous physician could write me prescriptions for T4 all day long and it wouldn’t make a lick of difference. I needed direct T3 supplementation and conversion support. This is why I kept relapsing with symptoms and why I never really found balance. I heard a recent episode of Chris Kresser’s podcast in which he said that this EXACT problem is what 80% of his patients come in with. If only I had known this five years ago!

2. Get On the Right Medications

So what to do? I would love to tell you that you can just eat certain foods, or avoid certain foods, or take magic herbs and fix your thyroid levels. In all my research, I have yet to find that magic button. I have heard of people being able to come off of their medication, but I’ve yet to find any support for that. I believe it all depends on the degree of damage you’re starting with. It’s crucial for your body to function properly to have adequate thyroid hormone levels. You can’t simply diet and exercise your way out of this one, though what you eat is very important. 

My new doctor put me on two things: a prescription for ArmorThyroid, and an iodine supplement. Armour is a porcine-derived, blend of naturally occuring T3 and T4. From my understanding, ArmourThyroid was initially the go-to thyroid replacement for years, then Synthroid came along in all it’s synthetic glory and thanks to aggressive and smart marketing, took over as the default (it’s in the top 10 prescriptions in the US for last year) and the natural, pig-gland-based version got left in the dust and forgotten about. There’s also a bovine-derived version called NatureThroid. On 4/17/2014, just over nine weeks on the right medication for me and some iodine, we ran another panel. My TSH dropped from 7.29 all the way down to .11. My T4 levels calmed down to 1.0. The kicker, T3, finally came up to a normal range (goal is 2.0 – 4.4) at 3.4. I spent six years of my life trying to jam a square peg into a round hole. After just two months of the proper protocol, I was sleeping on a normal cycle, my night sweats had VANISHED, and I finally started to lose weight that I had been holding onto for years. My mood improved, my mind was clearer. A new day had come! Then there’s the Iodine.

Iodine

We don’t hear much about iodine, but this little element is your thyroid’s best friend. If you remember, thyroid hormone is made up of iodine so it only makes sense that consuming it would help it function. The problem is, modern diets don’t consist of very much sea vegetables and iodized salt usually also comes with caking agents and bleach. While you can (and should) try to incorporate more iodine containing foods into your diet, it’s more than likely that you will need to supplement if you’re deficient.  Personally, I went with Global Healing Center Detoxadine: Nascent Iodine. A drop or two every morning did the trick for me. Big big HOWEVER, on this one: If you have an autoimmune disorder like Hashimotos, iodine increase could exacerbate the problem. As always, consult with your physician and do some research to find out what’s best for you. This is simply what worked for me.

3. Keep Carbs Low-ish, But Don’t Go Too Low.

Paleo is often considered to be synonymous with low-carb. Mostly, because everyone seems to forget that sweet potatoes, fruits, and vegetables are in fact carbs. They also seem to think that anyone eating anything close to a “Paleo” diet is sitting at home chewing on cow bones with their bare hands and drinking bacon smoothies. Many folks to really well, once they’ve healed their blood sugar and digestion with things like white rice and white potatoes as well. 

To use carbs for energy, your body must first convert them into glucose. It is the simplest of carbs and the form that can be utilized by our cells. Glucose is needed in order to convert T3 to T4, so if you have a pre-existing thyroid dysfunction, you likely won’t thrive on a very low carb diet (I’m talking under 50g per day), Your thyroid is a major player in regulating your metabolism, so we don’t want to do anything to put too much stress there. This means keeping blood sugar regulated, while maintaining adequate energy stores. It’s a little bit of a Goldie Locks situation. Not too much, not too little, but just right. Stress brought on by high blood sugar is a problem for your thyroid, but stressing it by not supplying what it needs to function isn’t the answer. I find that avoiding very dense, starchy carbs or those from sugars works best for me, along with keeping my carb intake to mid-day/evening. Breakfast is generally protein/fat heavy, with lunch and dinner being where I get most of my carbs from fruit and veg. This also supports keeping cortisol (stress hormone) levels where they should be. If I have a particularly taking workout, I’ll make sure to get some extra carbohydrates in afterwards. Experiment and find where you feel your best. This means not bloated, sluggish, or tired…we want satisfied, energized and feeling great. Around 100g per day is a good place to start and go from there.

5. Eat A Thyroid-Friendlty Diet

This also means avoiding foods that cause problems. The first to go being, gluten grains, soy, dairy, and refined sugar. Soy needs to go. It’s a psuedoestrogen, it acts like estrogen in your body. We’re trying to regulate hormones, not add fake ones. Another problem with soy and grains is that they contain very high levels of phytic acid with out any beneficial nutrients to make them worth while. Phytic acid is a survival mechanism of seeds and it binds to essential minerals like magnesium, iron, and zinc, preventing us from being able to absorb them. All of the standard inflammatory items gotta go, but get the big four out first. Gut health plays a big part in a happy thyroid, so it’s vital to minimize problems there by kicking problematic foods. Gluten is a MONSTER when it comes to the thyroid, especially for those with serious (and even mild) gluten intolerances. Why? Well to put it simply, the amino acid chain of gluten is identical to part of the amino acid chain that is your thyroid tissue. Let’s think of if like a robbery. A man in a blue jacket and red hat (gluten) robs your store. The cops (immune system) show up and you give them a picture of the perp…which you snapped thanks to iPhone. They go out looking for a man in a blue jacket and red hat. Another man in a blue jacket and red hat (your thyroid) is enjoying a walk down the street. The cops see him and assuming he’s the guy who took your stuff, ambush. A case of mistaken identity. If you have a gluten intolerance, it is extremely important to remove it from your diet. If you have an auto-immune disease like Hashimoto’s or Grave’s, eliminating gluten 100% is a non-negotiable. Treat it like it’s crab and you have a shellfish allergy.

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There’s a lot of talk about the phytic acid content of cruciferous veggies (broccoli, Brussels Sprouts, kale, cauliflower) compounding the problem of a hypoactive thyroid. From my research, the facts still seems to be a bit shaky, but the theory is that their goitrogen content, which stalls the absorption of iodine, can cause and/or exacerbate hypothyroidism. The consensus seems to be that this is really only a problem if you’re essentially living off of those vegetables and only eating them raw, as the benefits of these nutrition-powerhouses outweigh the cons. Much of that family of plant is high in B complex vitamins, iron, folic acid, and antioxidants.  Cooking them reduces the goitrogen/phytate content. Crucifers are great for your liver, which helps regulate blood sugar and THAT is good news for your thyroid. Let’s meet in the middle and say, eat these very nutritious foods, just don’t go making raw kale-broccoli shakes three times a day.

Some foods that support thyroid function: 
Brazill nuts – contain selenium, another element that helps it tick. 2 Brazill nuts/day gets you the recommended daily amount. 
Sea vegetables and shellfish: Iodine 
Coconut oil – MCTs, can help support metabolism, anti-inflammatory, and more. Omega-3 fats – Grass-fed beef, wild caught salmon, healthy fats in general (olive oil, avocado, ghee, grass-fed butter) – Again, more anti-inflammatory goodness. Fats also help heal your gut, better your brain function, keep your blood sugar stable, and do a million other things but THAT is for another day.

It took me too long to finally find balance with a healthy thyroid. After years of feeling permanently a little bit crappy all the time, I now wake up with energy, I perform well, I have a normal sleep cycle, my gut is healed, I don’t always feel like a have a kernel of popcorn in my throat (from swelling), I actually want to do things, I’m no longer indifferent to everything around me (that’s a symptom, too) and it only took finding the right doctor and making important lifestyle changes to do it. 

I will probably be getting blood work checks every six months for the next few years to make sure everything stays where it should, but that’s a cheap price to pay. Your thyroid controls everything. It makes the cells in your body do what they’re supposed to do. Getting it balanced and healthy is vital. Hopefully these steps will help you learn from my mistakes, and get you asking the questions that will get on a road to better health. Don’t be scared to ask questions. Your well-being is your responsibility. If I had done more research when I was first diagnosed, I may have known what questions to ask, and maybe I would’ve found balance sooner. If your doctor isn’t open to your questions, it might be time to find one who is. It’s your body. You have the right to discuss your treatment. I wish I had done that sooner, but better late than never! My thyroid isn’t perfect, but it’s healthier and I’m happier, than I’ve ever been and that’s really something.

Sources used:

ArmourThyroid.com Thyroid Disorders by Chris Kresser Mercola.com Thyroid.org (though I don’t agree with their listing of soy and dairy. Though it is an iodine source, soy is VERY and dairy can be problematic.) ChrisKresser.com Carbohydrates for Fertility and Health, Stephanie Ruper The Paleo Approach by Sarah Ballantyne, PhD How to Help Your Thyroid With Virgin Coconut Oil Eat The Yolks, by Liz Wolfe, NTP

And my experience, experiments, and self-study over the past 6 years.