Thyroid function and dysfunction


In last week’s tip I began a mini-series on the endocrine system by trying to explain the role of cortisol in our bodies, and trying to get across the fact that problems with cortisol, either lack of, too much of, or an inappropriate circadian rhythm, can cause a very wide variety of symptoms because of its interaction and effect on our other hormones.

Because cortisol is the hormone that is released when we are stressed, and considering we have not evolved very much from the time of primitive man when stressful events were almost always life-threatening, our brains prioritize the role of cortisol over the other hormones.

Like I said last week, if you are running from a lion, reproduction, digestion and sleep are not high on the priority list, so why waste the body’s resources on those hormones! Same thing in today’s modern world, except our “acute lion stress” is now chronic work stress, time stress, relationship stress, chronic pain etc.

The body only sees the stress, and figures you don’t need much of the other hormones because cortisol is needed now in order to save your life.

But to be healthy and to function well, we DO need those other hormones. For example, the thyroid hormones are in charge of our metabolism or our energy production, which in turn helps regulate our body temperature. Our body chemistry works best at 37 degrees Celsius or 98.6 degrees Fahrenheit, and if the temperature isn’t right, enzyme and catalyst activity is compromised. Pretty important stuff! 

We hear of people say they have "sluggish thyroids", and frequently they have difficulty controlling their bodyweight.  Or we say "that person has a high metabolism – they can eat absolutely anything and they won’t gain a pound." 

People that know me know that I am always cold. I wear long underwear until about May, and really struggle to stay warm in the winter no matter how many layers of clothes I’m wearing.  I like it hot – 25 to 28 degrees Celsius and I’m happy.  It only occurred to me very recently that maybe I have a thyroid issue.

I have a few of the other symptoms – very dry, scaly skin generally, and "chicken skin" on the upper arms and legs (yuck)!  Other symptoms of thyroid problems include  fatigue, depression, osteoporosis, infertility, muscle weakness, too hot, hair loss, memory problems, constipation, inability to sweat, heart-rate disturbances, increased homocysteine and C-reactive protein levels which are both risk factors for heart disease.

The thyroid gland sits on the front of the neck and secretes calcitonin which is needed for calcium absorption into the bones, which is why impaired thyroid function can lead to osteoporosis.

The thyroid also secretes thyroxine (T4) at the urging of thyroid stimulating hormone (TSH) which comes from the pituitary gland.  T4, the inactive form, is made up of four iodine molecules. It goes to the liver, which through liver enzyme activity, converts it into T3 by dropping an iodine molecule. 

T3 is the active form of thyroid hormone which regulates metabolism and body temperature.  If for some reason the liver does not have enough of the enzymes needed, Reverse T3, another inactive form of T3 is made.

If too little T3 is made, one has hypothyroidism, and if too much is made, one has hyperthyroidism.  Thyroid problems can stem from prioritizing cortisol so T3 does not get made, from inadequate iodine in the diet, or from a liver that is struggling in its detoxification role and can’t make the enzymes necessary to convert T4 to T3. 

The other halogens like chlorine and fluorine have a higher affinity for the iodine receptors than iodine does, so drinking chlorinated and fluoridated water may be responsible for an inability to absorb iodine, and thereby affect thyroid function. Another important reason to filter our water! 

Goitrogens like processed soy and peanuts also block the absorption of iodine.  Omega 6 vegetable oils are usually already rancid when consumed, and the oxidative processes seem to damage enzyme activity, increase inflammation, and block production of thyroid hormone. 

Coconut oil, a medium-chain fatty acid seems to aid thyroid function.  Mercury in the body displaces selenium, which is needed to convert T4 to T3.

To diagnose thyroid issues, the doctor must do more than simply measure Thyroid Stimulating Hormone (TSH), as even if TSH is below 2, thyroid problems may exist.

Request that your doctor also measure free T3 and free T4 levels, as then it is easier to figure out where in the chain the problem is occurring.  It is quite possible that T3 is low and T4 is normal. In this case, the body is unable to convert T4 into T3, so the problem may be due to a liver or an adrenal/cortisol issue. 

Treating with a drug like Synthroid is completely useless in this scenario, as it only provides T4 and does nothing to aid the conversion into T3. Taking one’s temperature 3, 6 and 9 hours after rising for a few days can also be helpful to your physician in determining thyroid problems.

If you are getting your thyroid checked, to me it makes sense to also run a circadian cortisol test, because treating the thyroid if the cause is poor adrenal function is an exercise in futility.

Much of the info in this tip came from Bev Maya, a medical herbalist in the Vancouver area that practices functional medicine.

Related Tips
How hormones, neurotransmitters and steroids work
Mind and body; psyche and soma
Adrenal Fatigue
Cortisol, our stress hormone
Acute vs. chronic stress
Allopathic vs. functional medicine

Lecture by Bev Maya, Westcoast Women’s Clinic, July 11, 2007

O’Reilly, Denis Thyroid function tests – time for reassessment BMJ 2000; 320: 1332-1334.

Wilson, James Adrenal Fatigue, 21st Century Stress Syndrome Smart Publications, Petaluma, CA 2001.

Shoman, Mary Living Well with Hypothyroidism HarperCollins New York, NY. 2000.

Doerge, DR et al. Inactivation of thyroid peroxidase by soy isoflavons, in vitro and in vivo J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Sep 25;777(1-2):269-79.

Canaris, G et al. The Colorado thyroid disease prevalence study Arch Intern Med. 2000 Feb 28;160(4):526-34.

Adrenal and Metabolic Interpretive Guide, Biohealth Diagnostics Inc. 2006 Chronic Stress – The Number 1 Source of Illness

Tagawa N et al. Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and pregnenolone sulfate concentrations in patients with hyperthyroidism and hypothyroidism. Clin Chem. 2000 Apr;46(4):523-8.

Chronic Stress Response Chart

Steroidal Hormone Pathway Chart

Copyright 2007 Vreni Gurd


  1. susan w said,

    May 25, 2008 @ 12:53 pm

    I have had my thyroid destroyed with radiation, therefore I am taking levothyroxin 0.15MG my doctor now says my T4 level is to low he wants to try another pill, is their a herbal substitute i can take instead, my diet is soy based and I eat chicken and fish, I also have varient marfans syndrome, and recently having considerable pain in my spine and ankles, my doc says a bone density test will take up to a year.
    please advice

  2. Vreni said,

    May 25, 2008 @ 2:32 pm

    Hi Susan,

    I would suggest you contact someone who does functional testing, and run a full hormone panel to see what is going on with all your hormones. Try googling functional medicine and your location and see if anything comes up. You can also do it through Biohealth Diagnostics through phone consults if you want.

    You may want to rethink the soy based diet, as soy does a number on your hormones. Here is my post on that topic, and you can look further into the references to help you decide whether or not making a change feels right for you.

    I don’t know off hand of a herbal remedy which will up your T4 level – I’m not saying one does not exist, just that I’m not an expert in herbs. This is why I think going the functional medicine route may help you, as they may have good treatment suggestions that are not drug based, but they probably won’t give you anything until they have a full picture of what is going on.

    Metabolic typing may also help you a lot. (learning what ratio of protein fat and carbs are right for your biochemistry.) Let me know if you want to try that …

    Hope that helps!

  3. Kevin said,

    September 7, 2010 @ 7:19 pm

    Susan W. It sounds like your doctor may be using you as a test subject wanting to try another pill on you. I agree with Vreni concerning thyroid function and cortisol. Cortisol also causes the liver to over produce glucose at night when we are alseep between the hours of 2am-8am. It is what Diabetics call the “Dawn Syndrome” where in their blood sugar levels increase no matter of the amount of insulin is taken before bedtime. This type of blood sugar is not made from the foods we eat but rather the liver produces it from stored fat and also catabolizing the existing muscle tissues. (muscle atrophy)
    Excess blood sugar also inhibits thyroid function. This will explain why so many diabetics are also having thyroid issues.
    My mother was taking Synthroid for 5 years, and she is Diabetic. Synthroid as it turns out acually should never be prescribed to a diabetic as it blocks the action of insulin receptor sites in the organs, muscles and the brain so that blood sugar can not be taken up by the muscles to be converted into glycogen.
    Also because Synthroid is a T4 that must be coverted into a T3 which requires an expenditure of energy it should not be prescribed to an individual on a caloric restricted diet, such as a diabetic.
    My mother stopped taking the synthroid and instead has been using the iodine supplement Lugol’sPlus, it is a pure non radioactive form of dietary iodine that the thyroid needs for proper function, and she is amzed by how she is feeling. Her body temp which was told to her by her doctor to be normal at 97.3 is now right on 98.6 every afternoon and before bed when she checks it. Her body temp is average of 97.9-98.3 in the mornings which is perfectly normal for 8am after a sleep of 8 hours when the metabolism has slowed down.

    Another important, and overlooked fact. You should not have your lab work performed first thing in the morning due to the “dawn Syndrome” Because your blood sugar, cortisol, and thyroid function will give false readings. It is far better to check these by doing what my mother now does. She will eat a light balanced meal at 6am on test day and then fast until 2-3pm when she will get her blood work done. As stated earlier the excess cortisol does not begin to clear from your blood until 10:00am and this means that a “true” reading can not be performed until the afternoon.
    If the moderator will allow the website where she purchases the Lugolsplus iodine is
    I supply this as only a means for you to learn more o.k. I am not promoting this product except I see first hand with my mother that it is helping her.

  4. Julia hardman said,

    January 20, 2013 @ 8:58 pm

    Could you please update this Site with any new info since the last updated info, which says it was 2007. I have been diagnosed with thyroid cancer 7yrs. Ago, last test with ultrasound in 2011 showed it to be smaller. I have chosen to go the natural route rather than have it removed. I have suffered from clinical depression in the past and my naturopath has said the risk of depression is greater for me, possibly untill my meds are right. I am not on any meds at the moment and I am 62. . I don’t see any facts for this medical condition on your site

  5. Vreni said,

    January 21, 2013 @ 1:08 am

    Hi Julia – I do not see myself as a thyroid expert. I just synthesized some information for the post above. If you want to work with someone that helps people deal with thyroid issues with food, google and contact Josh Rubin at East West Healing. He does Skype consulting all over the world.

  6. Judi Whiteaker said,

    May 29, 2013 @ 2:51 pm

    I am a T2 Diabetic that went into early menopause at the age of 24 r/t a total hystercetomy. I was recently dx’d w/ hypothyroidism (borderline on tx) TSH was 7.3, but was prescribed Levothyroxine 25mcg. I hade been taking it for 2 weeks before I had an increase/intensity in my hot flashes and anxiety, coupled with tachycardia. I have stopped it and have been off the Levothyroxine a 4 days and still having issues w/ the what I call “hot flashes from hell”. I am unisured so please, do not tell me to go back to the Dr. Was wondering where a lot of people do not take it on an empty stomach, if maybe I am absorbing it too much and too quickly? I am thinking on resuming, but this time with food.
    Any advice would be greatly appreciated.

  7. Vreni said,

    May 29, 2013 @ 9:39 pm

    I would suggest you look for a functional medicine doctor, not a regular doctor, to sort which part of your endocrine system is at the root of your thyroid problem. Is the issue really your thyroid, or is it your adrenals? Or liver enzymes? Perhaps google functional medicine doctor and your home town? You may need to do a 24 hour urine test, or a circadian thyroid test. Another idea would be to contact Josh Rubin, who corrects thyroid problems through diet. A long journey, but well worth it.

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