Hypothyroidism Info for Dancers: Part 2

If you haven’t read part 1 yet, head there first to learn about what the thyroid is and how it works, what hypothyroidism and Hashimoto’s is, signs and symptoms, plus lab work to get checked!

In this post:

• Causes and underlying drivers of hypothyroidism and Hashimoto’s

• Ways to support optimal thyroid health with nutrition and lifestyle strategies

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MAJOR CAUSES & UNDERLYING DRIVERS OF HYPOTHYROIDISM

There are several major causes or drivers of thyroid dysfunction, including stress, nutrient deficiencies, gut issues, chronic dieting and under-eating, genetic predisposition, infections, toxin exposure, and more.

These things are often tied together, and it may be difficult to pinpoint any one exact thing that caused thyroid dysfunction. Additionally, causes of non-autoimmune vs. autoimmune (Hashimoto’s) hypothyroidism, can be quite different. This is why, if you’re struggling with hypothyroidism, it’s really important to know if it’s due to autoimmunity or not.

We’ll be here all day if I talk about every single possible underlying driver of hypothyroidism, so let’s just cover a few big ones, particularly the ones you have more control over. (I’m not going to get into genetics, infections, and toxin exposure, as that’s a bit beyond my nutrition scope.)

#1: CHRONIC STRESS

Like most systems in the body, the endocrine system is very sensitive to stress. When your body is under chronic stress, it responds by downregulating thyroid function. (source) 

Thyroid function and the stress response are in the same loop. Both the adrenal glands and the thyroid are controlled by the hypothalamus and the pituitary gland, in the brain. The adrenal glands, through the stress hormone cortisol, have a big impact on thyroid function. (source)

What happens when cortisol* levels are chronically elevated:

• Decrease production of thyroid stimulating hormone (TSH). Recall from part 1, TSH is produced by the pituitary gland and it basically tells the thyroid how much thyroid hormone to make. 

• Inhibit the conversion of T4 to T3. Remember, T4 is the inactive form of thyroid hormone, and T3 is the active form. T3 is what actually goes into the cells and does the work, so it’s absolutely essential that T4 to T3 conversion is working well. 

• Up-regulate the conversion of T4 to reverse T3 (the metabolically inactive form of T3)

*SIDE NOTE: Let’s clear up cortisol confusion real quick, because there’s a lot of misinformation about it on social media. Cortisol is a hormone most commonly known as the “stress” hormone. While it IS involved in our stress response, it plays a lot of other important roles as well, including maintaining blood sugar levels, blood pressure regulation, sleep/wake cycles, inflammation regulation, and more. The common myth online is that we need to avoid things that “spike our cortisol,” that cortisol is something to be constantly lowered. This is not the full, accurate picture. Cortisol follows a diurnal pattern. It should be highest in the morning and then slowly taper off throughout the day, and be lowest at night. Chronically elevated cortisol, however, can have negative health effects.

It’s important to know that stress is NOT just mental and emotional. There are also physiological stressors. 

Common stressors include:

• Not getting enough sleep

• Over-exercising and under-recovering

• Being constantly on the go, rushing around all the time

• Not eating enough calories 

• Nutrient deficiencies

• Infections and chronic inflammation

• Prescription medications, especially with prolonged use

• Gut dysfunction, poor digestion and absorption of food

• Mental and emotional distress

• Exposure to toxins

Addressing stress is absolutely critical to supporting and improving thyroid health. We tend to not give stress the credit it’s due, meaning we ignore the impact stress has on our overall health. We ignore just how much stress consumes our day-to-day lives. I encourage you to think of stress management as the bottom of the pyramid in terms of things that are most important or impactful to our health.

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#2: NUTRIENT DEFICIENCIES & CHRONIC UNDER-EATING

The thyroid is an extremely nutrient-dependent organ, from both a macronutrient/calorie AND micronutrient perspective. Deficiencies or insufficiencies in nutrients that the thyroid requires to function are quite common, and in some cases may be a significant contributor to hypothyroidism. When I’m working with a hypothyroid client, one of the first things we do is investigate their nutrient status and intake of specific nutrient dense foods! 

Nutrients essential for thyroid health: 

• B vitamins

• What it does → supports the production of thyroid hormones (B12 is particularly important)

• Food sources → liver, red meat, fish, poultry, legumes, cooked leafy greens

• Iodine

• What it does → one of the key building blocks of thyroid hormones

• Food sources → seaweed, cod, shrimp, oysters, dairy

• Iron

• What it does → supports the enzyme that converts iodide to iodine, and is also essential for converting T4 to T3

• Food sources → liver, red meat, poultry, seafood

• Selenium 

• What it does → supports the enzyme that converts inactive T4 to active T3

• Food sources → Brazil nuts, seafood, liver, red meat, poultry

• Vitamin D

• What it does → helps T3 bind to receptors on cells; one study found that 85% of those with Hashimoto’s were deficient in vitamin D (source); anecdotally, every single hypothyroid client I’ve worked with had extremely low levels of vitamin D on blood work

• Sources → SUNLIGHT is the best source, you can also get some vitamin D from cod liver oil and fatty/oily fish

• Zinc

• What it does → plays a role similar to selenium and supports the enzyme needed to convert T4 to T3. We also need zinc to trigger the hypothalamus, which monitors thyroid hormone levels

• Food sources → oysters, crab, shrimp, pumpkin seeds

• Vitamin A (in the retinol form, not beta-carotene)

  • What it does → helps bind thyroid hormone to receptors

  • Food sources → beef liver, egg yolks, full fat dairy, grass-fed butter, oily fish

Obviously, this is just for informational purposes, I have no way of knowing if you have a nutrient deficiency! I share this list of nutrients and foods just to show that eating a wide variety of these nutrient-dense foods is supportive of thyroid health (and overall health, for that matter). 

I typically do not recommend supplementing with any of these (unless of course your doctor advises you to do so). I always take a food-first approach, especially considering minerals and vitamins are both synergistic and antagonistic. They all affect each other: some work together, others can interfere with the absorption, metabolism, or function of another. Supplementing with one–especially if you don’t need it–could really throw off another. 

How does one end up with nutrient deficiencies in the first place? 

1. Not eating enough foods that contain certain nutrients

2. Impaired digestion, resulting in poor ability to break down food and actually absorb/utilize nutrients from food

3. Certain medications can deplete some vitamins and minerals (for example, hormonal birth control is known to deplete magnesium, selenium, zinc, B vitamins, vitamin C, and vitamin E)

4. Chronic stress can deplete magnesium, sodium, potassium, vitamin C, iron, and zinc

PSA: Your thyroid needs carbs!

Going low carb is often touted as the best way to lose weight, but I promise you it is not without consequence (not to mention, it’s completely unnecessary to lose weight).

Drastically cutting out carbohydrates from your diet absolutely impacts your thyroid. Low carb intake can decrease production and secretion of thyroid hormone, as well as reduce the conversion of inactive T4 to active T3 (this conversion requires an enzyme called 5’-deiodinase, and low carb diets reduce this enzyme activity—source).

I personally have experienced first hand how eating low carb for a long time can reduce thyroid function and induce a hypothyroid or subclinical hypothyroid state, and I have seen it in practice with many of my 1:1 nutrition clients.

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#3 DIGESTIVE ISSUES & POOR GUT HEALTH

This is a complicated one. The gut-thyroid connection can be a vicious cycle, because hypothyroidism causes poor digestion, which can in turn contribute to poor thyroid function. It’s kind of like the chicken or the egg, which came first?

Poor gut health can also contribute to low free T3 levels, because some of the T4 to T3 conversion takes place in the gut.

Here are a few ways poor digestion and gut health can impact the thyroid:

1. We need to be able to digest food properly to actually absorb nutrients needed for optimal thyroid function; if digestion is impaired, nutrient absorption will likely be impaired.

2. If gut infections like parasites, pathogens, or yeast overgrowth are present, they can act as a stressor to the body, which long term can impact thyroid function.

3. We need a healthy immune system for optimal thyroid function, and gut health has a HUGE impact on immune system health.

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HOW TO SUPPORT OPTIMAL THYROID HEALTH (from a nutrition perspective)

A lot of information is kind of weaved throughout explanations above, but to recap everything in one place: 

1. Eat enough food to get enough macronutrients your thyroid needs (including carbs), and balance your meals with all 3 macronutrients (protein, fat, carbs) to support healthy blood sugar regulation. 

2. Eat a wide variety of nutrient dense, whole foods to get all the micronutrients (vitamins and minerals) your thyroid needs.

3. Keep stress in check! If you’re a super stressed person and it’s taking a toll on your health, you need to figure out how to deal with that. Take some things off your plate. Retrain yourself to slow down and not rush through life. 

4. Work on improving digestion and gut health (I have an entire e-book dedicated to this!)

5. Practice good sleep hygiene, support your circadian rhythm, and get daily natural light exposure. (Highly recommend this podcast about the impact of light and circadian rhythm on hormone function—it is INCREDIBLY important!)

*A note about gluten, because you may be wondering if gluten impacts thyroid health. The short answer is: maybe. It depends. There is a high comorbidity of celiac disease and Hashimoto’s, but not everyone with hypothyroidism needs to cut out gluten. If you are struggling with hypothyroidism or Hashimoto’s, it is probably worth experimenting with going gluten free for a short period of time to see if you experience symptom relief (1 month is typically recommended). The research on the relationship between gluten and hypothyroidism is complex; if you’re interested in this topic, I recommended checking out this blog post from Paloma Health.

I hope this was helpful and insightful, and that you learned something new :)

If you’re struggling with hypothyroidism, or you’re unsure if you have it but feel like you have many of the common symptoms, I would love to help. Schedule your FREE consultation call today!