Feeling fatigued? Noticing poor memory and concentration? Cold hands and feet? Weight gain? Difficulty conceiving?
These are common symptoms of hypothyroidism or subclinical hypothyroidism. A doctor will usually request a TSH (thyroid stimulating hormone) test, and if the result falls within the normal range of 0.4–4.00 mU/L, you are generally told that everything is fine.
So why do naturopaths or nutritionists often give a different interpretation?
Put simply, we assess the test through a different lens. A GP views the result from a disease perspective and will prescribe medication if the result meets that threshold. If you are diagnosed with hypothyroidism (TSH higher than 4 mU/L with low T4 and/or T3), thyroxine is usually prescribed.
A naturopath, however, views the result from a preventative health perspective, aiming to address the issue before it becomes a disease. One of the strengths of naturopathy and herbal medicine is the ability to support a person’s symptoms early, before they progress to the point where medication is required.
Diet, lifestyle changes and supplementation can often produce significant improvements in health and wellbeing.
If thyroxine is prescribed, it is typically required for life. An optimal TSH level is considered to be between 1.0–2.5 mU/L, and optimal T4 is above 14 pmol/L. You may have a suboptimal thyroid if your TSH is above 2.5 mU/L and T4 and/or T3 is low.
T4 and T3: Thyroid Hormones
When T4 levels drop (commonly due to low iodine intake), the pituitary gland increases TSH production to stimulate more T4.
T4 converts to T3, and T3 is the more active hormone in the body. If zinc and/or selenium are deficient, T4 does not convert efficiently, which can contribute to low T3 levels.
Foods rich in iodine include eggs, seafood, iodised salt and Himalayan crystal salt. Oysters provide zinc, and Brazil nuts are rich in selenium. A naturopathic prescription often includes iodine, zinc and selenium within a multivitamin. Managing stress is also important, as high cortisol levels interfere with optimal thyroid function.
Withania (Ashwagandha) is a herb I particularly value. It is best taken at night after dinner as it may cause drowsiness. It supports T4 levels and is widely considered one of the most effective herbs for reducing cortisol, helping to ease the effects of stress and anxiety.
Herbs that support energy levels are usually taken during the day. It is best to work with a qualified medical herbalist to determine which herbs are appropriate for you. An active lifestyle is also vital for healthy thyroid function. Exercise has been shown to increase T4 and T3 and reduce TSH.
Thyroid Antibodies
A follow-up test (TSH, T4 and T3) is carried out 6–8 weeks later if the patient has not responded well to the initial protocol. If symptoms persist, thyroid antibodies are checked.
Elevated thyroid antibodies indicate Hashimoto’s Disease, an autoimmune condition in which immune cells attack the thyroid, causing inflammation and eventual gland damage. Unfortunately, there is no medication that treats Hashimoto’s directly, apart from thyroxine to replace thyroid hormone. I often prescribe a high-quality echinacea supplement to support healthy immune function and help keep thyroid antibodies in check.
Bovine Thyroid Extracts
A randomised controlled trial showed that patients preferred desiccated thyroid extract over thyroxine and experienced more weight loss. These extracts are not available over the counter in Australia, but they may be purchased online from the United States.
Hyperthyroidism
Although hypothyroidism is more common, some women experience hyperthyroidism. Symptoms include rapid heartbeat, insomnia and weight loss. If a woman’s TSH is below 1, her T4 or T3 is elevated and she has symptoms of an overactive thyroid, herbal treatment can often reverse the condition if addressed early.
Herbs I have used clinically for hyperthyroidism include lemon balm and bugleweed. Including soy milk in the diet may also help, as it is known to interfere with thyroid function. However, people with hypothyroidism should avoid soy milk, lemon balm and bugleweed.
Lemon balm is frequently used in herbal formulas for sleep and anxiety, so check your herbal teas or sleep remedies and avoid them if you have a sluggish thyroid.
According to the Blood Type Diet, O blood types are more likely to develop an underactive thyroid. Interestingly, they are advised to avoid grains and dairy, the same two foods a naturopath commonly removes from the diet for hypothyroidism. More research in this area, and into the relationship between blood types and disease, would be valuable.
Conclusion
Supporting healthy thyroid function often requires a personalised approach, and small changes can make a remarkable difference. By addressing nutrient deficiencies, managing stress, incorporating targeted herbal support and making thoughtful dietary and lifestyle adjustments, many people experience significant improvements long before medication becomes necessary. Whether you are dealing with low thyroid function, autoimmune involvement or early signs of imbalance, working with a qualified naturopath or medical herbalist can help you identify the most effective path forward and restore your overall wellbeing.
