Understanding Your Thyroid: It's Role, Common Issues & Treatments

Your thyroid gland, a small but mighty organ located in the front of your neck, plays a vital role in regulating your metabolism, energy levels, and overall well-being. As we often do, we'll lean on Dr. Peter Attia, a physician and expert in longevity and preventative medicine to make sure the information is accurate and valuable. I tried to keep it the least medical jargony possible, so bear with me.

How Your Thyroid System Works

The thyroid gland produces two main hormones: T4 and T3. These hormones are essential for metabolism, energy regulation, and even the health of your hair, nails, and bowel function. Here’s how it works:

1. The Chain of Command:

• The hypothalamus (in your brain) releases a hormone called TRH.

• TRH signals the pituitary gland to release TSH (Thyroid-Stimulating Hormone).

• TSH then tells your thyroid to produce T4 and a smaller amount of T3.

2. The Role of T4 and T3:

• T4 is mostly inactive when it’s first produced. It needs to be converted into T3 by enzymes called deiodinases to become the active form of the hormone. T3 does all the heavy lifting, keeping your metabolism humming and your body functioning smoothly.

• There’s also a less helpful hormone called reverse T3, which can block the effects of active T3. This reverse hormone often shows up during periods of stress, illness, or even nutrient shortages.

3. Why Testing Matters:

• Doctors typically look at TSH levels to assess thyroid function. However, relying solely on TSH can sometimes miss underlying issues like high reverse T3 levels, which can mimic symptoms of an underactive thyroid (hypothyroidism).

Common Thyroid Challenges in Midlife

Thyroid issues become more common as we age, especially for women. Here’s what you should know:

1. Hypothyroidism (Underactive Thyroid):

• Affects 4-10% of the population, with a higher prevalence in women starting around age 40.

• The most common cause is autoimmune hypothyroidism (like Hashimoto’s thyroiditis).

• Symptoms include fatigue, weight gain, cold sensitivity, depression, and hair thinning.

2. Hyperthyroidism (Overactive Thyroid):

• Less common, affecting 1-3% of people. Often caused by Graves' disease or overactive thyroid nodules.

• Symptoms include anxiety, rapid heartbeat, weight loss, heat intolerance, and irritability.

3. Subclinical Thyroid Disease:

• Mild thyroid dysfunction, particularly hypothyroidism, affects 4-20% of middle-aged and older adults.

• It’s often detected through blood tests even before symptoms appear.

Why Women Are More Affected

Women are 5-10 times more likely than men to develop thyroid disorders. This disparity may be linked to hormonal changes during perimenopause and menopause, which can increase susceptibility. Other risk factors include a family history of thyroid disease, autoimmune conditions like type 1 diabetes or rheumatoid arthritis, and iodine imbalances.

Diagnosing and Treating Thyroid Issues

If you suspect a thyroid problem, a simple blood test measuring TSH and sometimes T4 and T3 levels can provide clarity. However, interpreting these tests can be tricky because thyroid function isn’t always straightforward. For instance, you might have normal TSH levels but still feel symptoms if your reverse T3 is high or your active T3 is low.

Standard Treatments:

• Most hypothyroidism cases are treated with synthetic T4 (levothyroxine). This works for many people because their bodies can convert T4 into the active T3 hormone.

• For those who struggle to convert T4 properly, adding T3 or using desiccated thyroid (a natural combination of T4 and T3) might help.

• Managing lifestyle factors like stress, inflammation, and insulin resistance can also support better thyroid function.

Routine thyroid screening isn’t something everyone needs to worry about but the American Thyroid Association suggests women over 35 get tested every five years. If you’re experiencing symptoms like fatigue, unexplained weight changes, or mood shifts, it’s worth discussing thyroid testing with your doctor.

Maintaining a balanced diet, staying active, and managing stress—just like you would for any other system in your body—can go a long way in supporting thyroid health.

I’m here to support you on your journey to a healthier, fitter life. As always, I appreciate your feedback and suggestions. Let me know what topics you’d like me to cover in future issues by replying to this email.

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Be well,

Dave

Please note: This newsletter is designed for informational purposes only and should not be taken as professional medical advice. Always consult with a healthcare provider for advice tailored to your health and fitness needs.