Hypothyroidism is when the thyroid is not producing enough thyroid hormone (T3 and T4) to maintain homeostatic balance.  This can occur from an autoimmune condition called Hashimoto’s or from a nutritional deficiency in either tyrosine or iodine.  A deficiency in thyroid hormone affects nearly every tissue in the body.  The most common symptoms of hypothyroidism include:

• FATIGUE, lethargy, weight gain
• Depression
• Anemia
• Dry skin, coarse hair, lateral eye brow thinning
• Weak muscles, muscle cramps, joint pain (especially in shoulders)
• Constipation because intestinal peristalsis slowed down
• Cold intolerance
• Bradycardia (slow heart rate), hypertension
• Menstrual disturbances namely menorrhagia (heavy bleeding) and infertility
• Decrease in Vitamin A levels in the skin, which can cause a yellowish color change
• Myxedema – a non-pitting edema (swelling) of the eyelids, face, legs, and muscle tissue
• Goiter – lump or swelling on the thyroid

Hyperthyroidism is when the thyroid is producing too much thyroid hormone (T3 and T4) causing very specific symptoms.  This thyroid disorder is usually autoimmune in nature and thought to arise from a defect in a segment of the immune system called the suppresser T-lymphocytes.  Other factors that can contribute to too much thyroid hormone are iodine excess, Corticosteroid therapy or Lithium therapy.  The most common symptoms of hyperthyroidism include:    FATIGUE

• Nervousness and anxiety or racing thoughts
• Excessive sweating and heat intolerance
• Heart palpitations
• Increased appetite with weight loss
• Tremor
• Insomnia
• Increased bowel motility – diarrhea
• Periorbital edema – swelling behind the eyes causing them to protrude

If a thyroid disorder is suspected by a doctor after an intake and physical exam, then specific thyroid tests are ordered to determine extent and variation of the thyroid disorder present.  The results of these tests can determine the appropriate therapy that will be most effective.  The most common tests are the TSH, Free or Total T3, Free or Total T4 and antibody testing.  

TSH stands for Thyroid Stimulating Hormone that is produced in the pituitary gland and acts on the thyroid to let it know that more thyroid hormone is needed.  This hormone generally is high in hypothyroid conditions and low in hyperthyroid conditions.  The normal range for TSH is considered to be about 0.5 to 2.0.  Between 2.0 and 4.0 is considered subclinical hypothyroidism that may need to be treated.  In this case a Free T3 can be helpful to determine treatment.  Free T3 is active, available thyroid hormone.  

Many times a TSH can be normal and the Free T3 can be very low.  There is a subset of hypothyroidism that is caused by a deficient enzyme conversion of T4 into T3.  It appears that the TSH and T4 are normal, but the T3 continues to be low.  In this case specific thyroid treatment is needed to improve symptoms.  However, this variant of hypothyroidism is missed because basic screening tests only test for the TSH and rarely the Free T3.

There are several treatments available to correct a thyroid imbalance.  There are medications that contain just T4 (Synthroid or Levothroid) and medications that contain a combination of T4 and T3 (Armour).  For hyperthyroidism there are medications that help to block the stimulation of the thyroid and decrease the production of thyroid hormone.  Taking organic forms of iodine, like that found in sea salt can also be helpful to some degree along with specific lifestyle changes.