Thyroid health
Thyroid and hypothyroidism FAQ’s
by Marcy Holmes, NP, Certified Menopause Clinician
Answers to your questions about symptoms of thyroid problems, including hypothyroidism
Can I feel my thyroid if it’s enlarged? Where is it?
Your thyroid is a gland behind and wrapped around your Adam’s apple — it’s not the Adam’s apple itself. Your doctor can show you specifically where to feel. Most women are able to manually feel if it is enlarged once they know where to look.
Will my thyroid hurt if it’s enlarged?
Generally, no, unless your thyroid is inflamed — a condition known as thyroiditis. In such cases it is not uncommon for that area to be tender to the touch.
My doctor tells me my test results are normal, but I still have a few thyroid symptoms. Should I worry?
You want to clarify with your doctor what her or his idea of normal is. A range of normal is one thing, ideal is another. And there’s significant debate over what’s “normal.” We like to see TSH blood level tests come back at or very near 2.0. However, if a woman is symptomatic we will thoroughly evaluate her thyroid function, regardless of initial test results. If you are experiencing thyroid symptoms you may have a subtle imbalance that inhibits your thyroid hormones from being converted or utilized well by the peripheral systems in your body. Your doctor may also want to evaluate other important functions, such as your adrenals, your hormone levels and your GI tract, to rule out any problems there.
Can I combine bHRT and thyroid medication?
Yes. But understand that thyroid medication is very sensitive and should usually be taken alone, at least two to three hours apart from any food, supplements, vitamins, or other medication. Now that most of these medications (Synthroid, Levothroid) are T4 products, they will not have a stimulating effect and can be taken at bedtime.
My mother had thyroid problems — will I?
Thyroid problems, like hypothyroidism, often run in families. We don’t know whether genetics or emotional patterning is the bigger factor. Often a daughter will “inherit” her mother’s patterns of passivity or assertion, among other behaviors that affect thyroid function. There are also autoimmune irregularities that tend to show up with certain genetic strains. Knowing your family predilection for thyroid imbalance is a good thing. The sooner you pay attention to your diet and nutritional needs and address your underlying emotional issues, the better your chance will be to postpone or cancel out any vulnerability. It also means you should start testing your hormone levels earlier.
At what age should I get my thyroid checked?
You have probably already participated in a thyroid exam without even knowing it. A manual gland exam is part of every annual check-up, and often a part of your bi-annual dental hygiene appointments (that’s why they feel your neck). If you have a family history of thyroid conditions you should start getting thyroid blood tests at age 20, or earlier if you have symptoms — we see women in their late-teens and early 20’s with thyroid conditions. If you have no family history or symptoms, begin around age 30 and have a test every five years after that. You may have to ask for the test, because some PCP’s won’t do it unless you are showing symptoms. But the sooner you find an imbalance developing, the easier it will be to rectify without medication. Nutrition and lifestyle are powerful healing agents at any age, so it’s always beneficial to pay more attention to them rather than less.
I exercise all the time and I’m not losing weight. Is it my thyroid?
It’s prudent to get your thyroid checked if you think you are consistently burning more calories than you are ingesting but you are not losing weight. The thyroid manages our metabolism, so even a small imbalance could result in a slower pace of weight loss. But many other factors are probably involved — especially if you have no other thyroid symptoms — including the quality of your nutrition, the health of your digestive tract, your detox capabilities, and your hormone levels. It is also possible that your metabolism has stalled as a result of over-dieting. Click here for more information about the connection between the
thyroid and weight gain.
My doctor is recommending radioactive isotope implementation (or surgery) for my overactive thyroid. What should I do?
If you have been diagnosed with Graves’ disease and your doctor recommends radioactive isotope implementation, you may need these aggressive techniques to safely deal with an unstable, overactive thyroid. But if you have a borderline case of hyperthyroidism, it may be possible to find relief through less aggressive measures, especially a combination of holistic techniques like acupuncture and nutrition therapy, under the care of a very attentive practitioner. What’s most important is that you are informed about all your options and you feel confident you are making the best choice for yourself. If you aren’t comfortable with the decision, find another practitioner and get a second opinion.
I’ve had thyroid surgery and have to go on thyroid supplementation medication permanently. Is this going undermine my health?
No. What’s more, you now have an opportunity to really check in with your health practices and make some very positive, far-reaching lifestyle changes. Optimal nutrition and the appropriate supplements will help support your whole system and ensure that your body converts your medication properly and that your hormones stay balanced.
I’ve been on thyroid medication for five years; when can I go off?
It may be possible to discontinue your thyroid medication, but whether or not you can is quite complicated — it depends on why you started thyroid replacement therapy, if you have a chronic autoimmune condition, if the gland has been damaged, and whether you can be monitored over the next year to be sure your thyroid remains stable. You would need to find a good practitioner to work with, one who will pay close attention to your T3 and T4 levels as well as your individual nutritional and digestive issues. Many women successfully wean off medication using optimal nutrition, dietary supplements, and other holistic techniques — but you must be closely monitored by a professional.
So far, my thyroid is healthy. How can I keep it that way?
The best way to support your thyroid function (and your general health) is through quality nutrition that includes a daily medical–grade multivitamin. Regular testing and annual well-woman exams are also a great preventative. Many holistic practitioners refer to the thyroid area as the home of your voice, represented in Eastern medicine by the fifth chakra. Women often feel stifled and do not fully express themselves — their voices are trapped — and this can manifest as a thyroid imbalance. We encourage you to speak up for yourself. It may also be helpful to find a form of creative expression that helps you express yourself in your own unique voice.
Are there any foods or substances I should avoid to protect my thyroid?
No, as long as your foods are whole and natural — meaning free from artificial ingredients, preservatives, and additives and processed as little as possible — you can enjoy a cornucopia of food.
Are there foods I should add to my diet?
I often recommend seaweed products to my patients with sluggish thyroid or hypothyroidism because seaweed contains iodine. In small amounts, iodine is essential for healthy thyroid function. However, make sure to add these foods in moderation as too much iodine can actually harm the thyroid.
What about soy and thyroid health?
I sometimes advise my patients to limit soy products if they’re experiencing thyroid symptoms or conditions. There has been a lot of controversy about soy and the thyroid due to soy’s weak estrogen-like effects. We know that too much estrogen, or estrogen dominance, can have an upsetting effect on the thyroid. (This is one reason progesterone as well as phytotherapy may be a good, subtle preventative of thyroid problems — because it helps balance estrogen levels.) If you are eating soy for hormonal balance and it is not affecting your thyroid (or other areas of your health), I wouldn’t worry that it will cause a thyroid condition — but don’t start eating it in quantity without the guidance of your practitioner.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
Original Publication Date: 09/29/2005
Last Modified: 05/08/2008
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician