Symptoms and Support for Hypothyroidism - Ask a Nutritionist

January 23, 2025

Ever wonder if your thyroid might be why you’re feeling tired, cold, or just “off”? Our registered and licensed dietician Brandy Buro breaks down everything you need to know about hypothyroidism in a super simple and relatable way. From common symptoms to the tests you actually need, plus the foods and nutrients that can make a difference, Brandy’s got you covered. If you’ve been struggling with hypothyroidism, this episode is packed with tips to help you start feeling better—naturally! Don’t miss it!

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• Your Thyroid Explained
• How Stress Affects Your Thyroid
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Transcript:

BRANDY: Hello and welcome to Dishing Up Nutrition's “Ask a Nutritionist” podcast. My name is Brandy Buro and I'm a Registered and Licensed Dietitian here at Nutritional Weight & Wellness. Today we're doing a special episode all about the thyroid and specifically symptoms of hypothyroidism. So January is Thyroid Awareness Month, so I just wanted to take this opportunity to help our listeners learn more about this really important gland.

What is the thyroid & its functions?

So let's talk about what the thyroid is. The thyroid is a gland that's shaped kind of like a butterfly, and it sits at the base of your neck. So it's a really small gland, but it plays a very significant role in your health. Your thyroid hormones affect pretty much every cell, every tissue, every single organ in the body.

So this is a really important piece of how we function, and a well-functioning thyroid will help the body use energy efficiently. It's going to help you regulate your temperature, and basically it allows your brain, your heart, your muscles, and all other organs to function properly. So you may have an over or under functioning thyroid and not even realize it. The thyroid is usually an overlooked issue when it comes to addressing other health issues.

What is hypothyroidism & its symptoms?

The most common condition related to thyroid function is hypothyroidism. So hypothyroidism basically means that your thyroid is underactive and does not produce enough of the thyroid hormone. And 90 percent of thyroid imbalances are due to hypothyroidism. And the most common symptoms of hypothyroidism are extreme fatigue, muscle weakness, low blood pressure, depression, brain fog, feeling cold all the time.

You might even see some irregularities with your menstrual cycles and you can start seeing hair loss, poor hair growth, poor nail growth. I also see changes in digestion and you may also see unexplained weight gain. And unfortunately many people with these symptoms have been prescribed medication to just address the symptoms.

Maybe they've been prescribed antidepressants or sleeping pills, or maybe a laxative if they've developed constipation, or maybe they've just gotten the advice, you need to exercise more and eat less in order to lose weight. But these are not really solutions to the underlying issue of an underactive thyroid.

Why are proper thyroid diagnoses not always happening?

So a lot of times these, these symptoms just persist, and you don't really feel better in the end. So this can be really frustrating, to say the least. Many Americans do not receive the proper diagnosis of thyroid issues. So here are some reasons why that might be happening.

First of all, symptoms of thyroid imbalances are not always obvious and can look like a lot of unrelated issues. So you just heard that long list of symptoms. That's not a comprehensive list. And even just looking at those symptoms, you wouldn't necessarily expect like low blood pressure to be connected to maybe poor hair growth. So they can seem sort of unrelated. It can be difficult to make those connections.

Another reason thyroid issues are not often diagnosed is because the common tests that's done to screen for thyroid issues usually involve just one or two lab tests. Usually they're just looking at the TSH or the thyroid stimulating hormone and sometimes they'll also look at free T4. So these two labs don't really tell us the whole picture of what's going on with your thyroid. So I suggest getting the full thyroid panel done in order to diagnose a thyroid imbalance.

So the full thyroid panel will include not just the TSH and that free T4, but it will also have free T3, reverse T3, and the thyroid antibodies. So if you're getting your thyroid tested, you may as well ask for that full thyroid panel so you get the full picture.

Oftentimes, I meet with clients who report that their thyroid is doing just fine. They had their TSH checked at their last physical, and it was within normal range. You know, we look at that value and find that it might have been within normal range within the clinic's guidelines, but they're still dealing with all symptoms that make me suspect they have a thyroid imbalance.

So what I do is I encourage my clients to get that full panel done and sit down with me to review them together because for a lot of people, they feel their best when their thyroid numbers are in a much tighter range compared to what their clinic describes as normal.

So there's definitely a difference between what is “normal” and what is optimal for an individual. If you suspect that you have an under functioning thyroid, I suggest finding a doctor who is willing to run that full thyroid panel that includes the thyroid antibodies. Typically, a naturopathic or a functional medicine doctor who specializes in this type of thing will be totally comfortable and actually probably recommend running a full thyroid panel, and they'll probably consider a tighter range for those labs to be optimal, compared to a conventional clinic.

Diet & your thyroid

Now let's talk about diet and your thyroid. When somebody has an underactive thyroid, we always suggest eliminating a few common food sensitivities. This could look like removing soy, corn, dairy, eggs for some people, in some cases peanuts and cashews, but I would say everybody dealing with a thyroid issue should remove gluten grains.

This is because a sensitivity to gluten grains like wheat, barley, rye and even oats because of cross contamination is really many times linked to something called Hashimoto's. Hashimoto's is the most common type of hypothyroidism and it's considered an autoimmune disease. In fact, 90 percent of all cases of hypothyroidism are actually the autoimmune condition Hashimoto's.

Many people have this condition but don't realize it because they have not been properly diagnosed. So that's why we encourage you to meet with a medical professional who has run through those lab tests with you and done the full thyroid panel so that you don't just get brushed off after getting your TSH tested and find that it's in a “normal” range.

The dietitians here at Nutritional Weight & Wellness will spend the time that you need to figure out a plan to heal and support your thyroid, especially if you have that diagnosis of an underactive thyroid. So like I mentioned, when I hear hypothyroidism, as a dietitian, I first think about starting a gluten free diet.

What does gluten have to do with autoimmune hypothyroidism?

So what does gluten have to do with autoimmune hypothyroid? Well, the protein within gluten, which is called gliadin, is molecularly very similar to the thyroid gland. So when gluten enters the bloodstream, which can happen through the digestive system if you have something called leaky gut, which basically means your gut is damaged, there's little microscopic holes in your gut.

That kind of leaves the door open for little bits of food, even gluten, to enter the bloodstream. Now when that happens, your body sees that as a foreign invader. It's not supposed to be floating around in the bloodstream. So your immune system is going to kick into gear and attack it as if it were a foreign invader.

It's just doing its job. But the problem with that is the thyroid protein looks so similar to the gluten protein that the body starts getting confused. And while it's attacking the gluten protein, it also starts attacking the thyroid because it thinks that the thyroid tissue is part of the problem and it tries to get rid of it.

So that's why when we're working on thyroid health, I always recommend following a gluten free diet as best as you can. 100 percent gluten free is best because that is going to help you protect and preserve the thyroid function that you have left.

The importance of a gut healing protocol

Along with that, we work on a gut healing protocol. We have to heal that leaky gut so that there's less potential that anything is going to get into the bloodstream and cause inflammation. So usually I'll recommend supplementing with something called L-glutamine. L-glutamine is part of most gut healing protocols. So this is an amino acid, which means it comes from protein, but it's very effective in helping repair the intestinal lining. So it helps patch up those microscopic holes that you can find in leaky gut.

Protein’s importance for healing the thyroid

Now that brings me to my next point regarding diet for healing your thyroid. We need protein. A big piece of the thyroid healing plan is to eat enough protein and getting high quality protein to support your energy and to support your metabolism. So dietary protein is also going to support the production of the T4 hormone.

So this means you need some grass fed meat, chicken, turkey, eggs, wild caught fish, and seafood. So what you want is about four to six ounces of a good quality animal based protein at least three times a day and maybe one or two ounces with a snack. Bonus points if you can sneak some liver into your protein options, because that's basically nature's multivitamin.

It contains a very high amount of nutrients that support your thyroid. So not only does protein increase your metabolism, but it's also going to provide the amino acid tyrosine, which is necessary to produce thyroid hormones. You could supplement with N-Acetyl L-Tyrosine, which is basically the active form of tyrosine.

So you can do this supplement all on its own. But it's also usually found in a thyroid supplement that has not just tyrosine, but a few other nutrients that support your thyroid. So we carry something like this on the Nutrikey website called Thyrotain. So I love that supplement. This is a pretty comprehensive supplement for your thyroid health.

It helps the production of T4 and T3, but it also has nutrients in there that can help convert free T4 into T3, which is considered the active form of the thyroid hormone that the cells actually absorb and use for metabolic functions.

The importance of eating healthy fat for thyroid function

In addition to protein, we need to talk about the importance of eating enough fat for your thyroid. Our bodies need good, healthy fats to produce thyroid hormones. We also need fat to absorb vitamins and minerals, maintain good energy, and regulate our blood sugar. Fat can help us prevent those blood sugar crashes.

So, the right amount of fat is about a tablespoon of coconut oil, a tablespoon of olive oil, half of an avocado, a quarter cup of nuts or seeds. So add a serving to every meal and snack to get the benefits from those fats. You really want to avoid low calorie diets and low fat diets because these plans basically are not providing enough nutrients to support good thyroid function.

Why eating enough of the right foods is important for thyroid function

You might be tempted to try to eat less if you find that you are gaining weight because of a low functioning thyroid, but don't fall into that trap. Here's a little reminder on why eating enough and eating enough of the right foods is so important for your thyroid function and weight management. So the thyroid hormone aids in directing your overall metabolism, even while you're resting, even while you're sleeping.

If someone with hypothyroidism is not eating enough calories, it's very easy for the body to store calories as fat if your basal metabolism is low. Oftentimes women will under eat to try to lose weight, which causes an even slower metabolism because your body adapts and it figures out how to survive on less energy.

So this, combined with other hypothyroid symptoms, may cause somebody to become more sedentary. We need to eat enough protein and enough fat to support a better working thyroid, give us better metabolism so we have more energy and we can remain active.

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Common specific nutrient deficiencies with hypothyroidism

Now let's talk about some specific nutrient deficiencies that are common with hypothyroidism. Zinc is something that I often see with an underactive thyroid. Zinc is needed to produce the TSH, thyroid stimulating hormone, but it's also needed to produce free T4 and free T3. So some good food sources of zinc are red meat, pumpkin seeds, and oysters. Some other signs to know if you're low in zinc are white spots on your nails, poor wound healing.

Maybe it takes a long time for you to heal from a cut or a burn or even a cat scratch. Or maybe you get sick a lot. Maybe you have low immune function. Another sign is you're starting to lose your sense of taste or maybe you find yourself adding a ton of salt to your meals. Those are all signs of a zinc deficiency. But we need zinc. So watch for those signs.

Selenium is another key mineral for making thyroid hormones. A very simple solution to make sure you're getting enough selenium is to eat two Brazil nuts every day. So Brazil nuts are really rich in selenium. I have some clients that think of their Brazil nuts as their selenium supplement for the day. Some other good food sources of selenium include fish, seafood, and those organ meats like that liver we just talked about.

Avoid artificial chemicals, fragrances & plastics for thyroid health

In addition to diet, the environment can play a pretty big role on the health of your thyroid, so we want to avoid toxic chemicals like artificial fragrances and plastics as much as possible in our daily routines. A great resource to get started with this is the Environmental Working Group. So, you can head to their website, ewg.org. You can actually search on their website to double check how clean or toxic a household product is or a beauty product is. So, ewg.org is a really great resource to use.

Stress & its influence on thyroid issues

Stress can also be a big factor when it comes to thyroid issues. Our endocrine system is all connected, which includes the thyroid, your adrenal glands, and your reproductive organs. So stress that impacts the thyroid could be from chronic life stressors. Something that's an ongoing stress in your life that's never resolved, or it could even be an infection like Lyme disease.

Or maybe you're just somebody that is kind of generally kind of high strung or an anxious person. This all sort of triggers stress in your body, and it can trigger overproduction of cortisol, our stress hormone. So high levels of cortisol can impair your thyroid hormone, which can result in a low thyroid function.

So if you can manage your stress, reduce your stress, your thyroid numbers might improve. For stress management, I recommend getting enough sleep, very effective in managing stress. I also recommend some gentle exercise, something really calming, like yoga, stretching, walking outside. You can try meditation or guided breathing practices for stress management. Regular outdoor and sunshine exposure is a good way to manage stress, but you have to find something that's going to work for you.

Supplements that can help with stress management

A couple other things that can help with stress management. There are a few supplements that can be useful. Ashwagandha is an herb that can help calm stress and actually improve thyroid function. Ashwagandha is something that I suggest using in acute states of stress. So if you're maybe going through a rough period at work, you've got deadlines, or maybe you're packing up your house, getting ready for a move, big stressors like that, and it is something that I recommend taking a few weeks off every few weeks, so kind of cycling on and off if you find the ashwagandha helpful.

There are a few other supplements that can help for just calming the brain, calming the mind. L-theanine is one of my absolute favorites for, you know, anxious thoughts, general anxiety. 5-HTP and GABA are a couple of other options to kind of rotate through. So all of these options are supplements that I would review in more depth during a one on one appointment just to determine which one or which combination is best for the person in front of me.

Well, we just scratched the surface on this very important topic today. If you would like to get the best support with your thyroid issues naturally, I highly encourage you to make an appointment with me or any one of the dietitians here at Nutritional Weight & Wellness.

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Don't wait to start feeling better. Get the support that you need now. We have in person or virtual appointments, whatever is the most convenient for you. And our website is full of free resources and articles all about thyroid health. So head to our website, weightandwellness.com if you want to learn more.

Check Out More Resources on Thyroid Health Here!

Well, that is it for today's show. I hope you found this episode helpful and informative. Thank you all so much for listening and have a great day.