Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani and today’s talk is gonna be on nutrition for your thyroid, how important nutrients and nutrition are for healthy thyroid function. We’ll do a brief overview of how the thyroid works in case you haven’t seen any of my past videos on the thyroid, just so you’ll have some foundational info so you can see how healthy thyroid works and then what you need or what maybe you’re missing that’s preventing your thyroid from functioning optimally on the nutritionally side. So let’s dig in.
Overview of Thyroid Hormone Production
Again steps for healthy thyroid hormone production. So let’s outline how the thyroid hormonal cascade or domino rally works. So the first step we have is really the brain signaling down to the thyroid like this. This pathway is known as our TSH or our thyroid stimulating hormone. Our TSH is coming from the brain particularly the pituitary and it’s telling the thyroid to make thyroid hormone. Now from there, our thyroid then spits out some T4 and about 20% of that T4 actually gets converted to T3 at the thyroid, about 20% and we’ll review some of the nutrients that we need to help that conversion. So 20% actually happens in the thyroid gland. The other 80% actually happens peripherally. So we look down here at that 80%, 60% of that 80 actually happens here at the liver. So healthy liver function is very important. So if we’re getting toxins in our food, chemicals, various plastics, we’re not getting enough sulfur-based amino acids or antioxidants in our diet to run those pathways, our liver maybe burdened and that may affect our body’s ability to convert and activate thyroid hormone. One of the enzymes that’s responsible for thyroid conversion, the 5-deiodinase enzyme–you break it down 5-deiodinase. De-i is taking an iodine off. So the T and the number 4 stands for how many iodines there are. The 4 stands for the number of iodines. So where de-iodinate something, we’re pulling an iodine off and that’s why it goes from T4 to T3, because we’re pulling 1 iodine molecule off it and we’re doing it with that liver-based enzyme known as the 5-deiodinase enzyme which is selenium-based. So things like egg yolk, seafood, nuts, seeds–things like that are gonna be very rich in selenium which we’re gonna need for–for that liver enzyme to work. And selenium is also a strong precursor to glutathione. So selenium also helps with our detoxification, also supports the liver. Liver is very important for thyroid hormone conversion.
Next we see gut bacteria. We need good, healthy gut bacteria because about 20% of conversion is responsible in and around the gut with acetic acid or the various sulfatase enzymes, and these enzymes are important at taking inactivated T3 and activating it. So if you have dysbiosis or imbalances in gut bacteria from various infections, pathogens, or even small intestinal bacterial overgrowth, that can throw off the balance of your gut bacteria and that can decrease your gut’s ability to activate thyroid hormone.
Next is the adrenal glands. The adrenals are profound, very, very important for activation of thyroid hormone, mainly because of the fact that if we’re under adrenal stress, that can increase our reverse T3 levels. So really simple, I count the adrenals as being a–a 20% contributor of activating thyroid hormone. It does it a couple of ways. If the body’s under too much stress, cortisol is too high–if we have high cortisol, we’ll have more reverse T3s and reverse T3 is inactive T3. So inactive T3–imagine this being our receptor site here–let me pull out a different color so you can see it better. If this is our receptor site here–this is our receptor site for our thyroid hormone, okay, that’s our cell. And if this is reverse T3 here, like so, and let’s just draw a molecule here, T3, like so. What happens is this reverse T3 molecule gets in the receptor site, like so, doesn’t have the same metabolic effect of the T3. So the T3 can’t make its way into the receptor site because the receptor site is blocked. So that’s kind of how reverse T3 works. It’s like taking a gun and putting bullets in the magazine to that gun that are blanks. So you gotta fire–fire that gun and the effect that you’re looking for is that bullet to come out but all you hear is the noise, but you don’t get the actual end result. Same thing. Metabolically, we see a hormone in that receptor site, but it’s a hormone that doesn’t have the same type of stimular–stimulation that thyroid hormone does at the nuclear receptor site level.
The Role of Cortisol for Thyroid Conversion
So on that note, we need healthy levels of cortisol for thyroid conversion to happen. So the adrenals are also affected because high levels of cortisol, stress, etcetera–this can actually affect TSH. TSH levels can go off with extreme amount of stress via cortisol and if we’re depleted, if our adrenals are so dysfunctional where cortisol levels are now low, like at a stage 3 adrenal fatigue person, then if that low level is present, we’re not gonna have enough cortisol to make that conversion happen, and we need cortisol to really activate that thyroid hormone. When we do thyroid temperature testing, we’ll see chronically low temperatures with low thyroid function. When we see adrenal stress, we’ll see aberrations in temperature greater than .3 degrees Fahrenheit. So what we’ll see when we have adrenal and thyroid is if this is the threshold we wanna be at temperature-wise, we’ll have low temperature but we’ll have aberrations in low temperature. If it’s just straight low temperature, that’s a thyroid dysfunction. If it’s low and aberrant, that’s thyroid and adrenals. And if it’s normal and aberrant, that’s just adrenal function. So that’s a great way that you can use temperature to assess whether you have a thyroid, adrenal issue, or both.
Nutrients and Thyroid Hormone Activation
So on that note, now that everyone has a good background of how the thyroid gland is converting a lot of these T4 and T3 into active hormone, now that you have that foundation, let’s talk about some of the nutrients that are involved for activating thyroid hormone. So first off, we have TSH. The brain needs vitamin A. It needs zinc, it needs B vitamins, it needs protein, asparagine, the various amino acids to make our TSH. That’s the signaler. So TSH is an inverse hormone. It goes high when thyroid hormone is low and it goes low when thyroid hormone is high essentially. So if I’m yelling at someone and I’m not getting their attention, I’ll have to raise my voice louder until I get their attention. Think of that as what TSH is doing. The brain is yelling down to the thyroid to make hormone and if it’s not high enough, it will increase the amount of TSH. A very bad indicator to use for thyroid dysfunction because it’s so late stage. It comes on so late in the game, 5 to 10 years down the road–we really wanna be looking at the actual active hormone downstream, the T3 that’s activated down here. This is much more important and much more indicative of an early stage thyroid issue and a lot of times people may have fine levels of TSH, because T4 feeds back into the brain better than T3. We could have normal levels of T4 but have low levels of T3, and it may not even be reflected in the TSH. I see that all the time in my patients. That’s why we gotta be very careful. We actually have to look at TSH, T4 free and total, T3 free and total, and maybe even look at reverse T3 as well and the thyroid antibodies. So again we talked about the nutrition, vitamin A, zinc, various B vitamins, and protein for healthy thyroid hormone function knocking that first domino over which is TSH. And again if we have a gut issue, you can see nutrition isn’t just a given. If we take in nutrient-rich foods, but we have a gut issue and a malabsorption and low stomach acid and dysbiosis and infection, you can see how that may impede the absorption of these nutrients, thus causing deficiency even though we’re having a really good diet intact. So keep that in mind, we always gotta look deeper at the gut, deeper at the liver, and deeper at the adrenals. We can’t ignore these three body systems.
Next is T4. So iodine is an important nutrient for thyroid hormone creation. So the process known as iodination involves iodine and tyrosine being cleaved together. So the T actually stands for in T4 or T3, it stands for tyrosine, okay not thyroid but tyrosine–that’s an amino acid and the 4 and the 3 stand for the number of iodines. So we don’t need too much iodine to have this healthy conversion and this activation. There’s a–a lot of debate out there that we need more, you know, into the milligram, high milligram range. Some say we only need the RDA, a couple hundred micrograms, 250 or so to be exact to make our thyroid hormone. Again we gotta be careful because iodine can be a strong stimulator of autoimmunity. There’s a great deal of research showing that excess iodine can actually stimulate Hashimoto’s. It activates TPO or thyroglobulin antibody that can increase thyroid destruction. Again a lot of people say that the reason why iodine’s a–a contributing issue with autoimmune condition is because people also are very, very low in selenium and when our iodine–when iodine is being fused to thyroid hormone via this process known as iodination, what happens as a result is hydrogen peroxide gets kicked out. And this hydrogen peroxide can be very inflammatory and can cause our B cells to come up and infiltrate and start attacking the thyroid tissue. So that’s why if you’re giving any amount of sele–if you’re giving any amount of iodine, you wanna make sure there are adequate levels of selenium there because selenium comes in and it actually neutralizes the hydrogen peroxide, pulls an oxygen off it and makes it H20 which is water, which is very benign. So you can see giving iodine and not having selenium there by its side can definitely be a recipe for destruction. So with iodine, be very careful of it. Make sure you’re working with a functional medicine doctor. Make sure you’re not autoimmune or have any autoimmune symptoms before you give iodine at higher levels. A couple hundred mics will probably be okay, but double check with your functional medicine doctor.
Again you can see iron is really important. If you have a microcytic, hypochromic anemia, that’s gonna be a major issue. Low iron–we need iron to make thyroid hormone but we’d also need iron to help carry oxygen throughout our body. B vitamins–B6 is super important because B6 helps with dopamine activation and if we go up one stream here and we look at like, let’s say, the hypothalamus which is the top part of the brain, we actually need dopamine from the hypo–dopamine production to actually stimulate the hypothalamus to make TRH. And TRH is important at stimulating TSH. So dopamine is essential and a lot of people may have neurotransmitter issues that need to be fretted out doing a in-depth organic acid test.
So iodine, tyrosine, iron, B6–your B vitamins are really important for energy, for making the Krebs cycle go around. I did a video on the mitochondria recently. Take a look at that video to get more info on B vitamins. Vitamin C is a really important antioxidant and helps the adrenals as well. And vitamin D is really important for immune function. A lot of people with Hashimoto’s and hypothyroid autoimmune issues tend to have a vitamin D polymorphism at the receptor site of the vitamin D receptor and they need higher levels of vitamin D, 70 to a hundred. So be very mindful if you have an autoimmune thyroid. Make sure your vitamin D levels are up at 70 to a hundred, just to make sure you have that therapeutic immune balancing effect. And we already talked about the nutrients needed for our T4 to T3, that selenium is essential, also for the autoimmune effects of helping to neutralize the hydrogen peroxide into water. And then zinc is also very important. Zinc is important for thyroid conversion. Zinc is also essential for sex hormone production, making testosterone essentially, and then also it’s an important building block for making hydrochloric acid. If we don’t have hydrochloric acid levels adequate enough, we won’t keep a nice low pH in the stomach. If we don’t have that nice low pH, we won’t be able to break down protein and fat adequately and we’ll have a harder time ionizing minerals. We need to ionize minerals and hit them with hydrochloric acid, so then we can then take them in our blood, so they’re not like rocks floating in our bloodstream. We actually wanna ionize them so they’re absorbable. So that’s really important. If we have issues with these nutrients, we may see other problems in the thyroid hormone chain that could be happening as well.
And like I mentioned, a thyroid autoimmunity is a big issue–40% of people that test for thyroid autoimmunity actually test–they are a false negative. They may come back negative but they may still have a positive thyroid. So make sure you get your thyroid looked at either palpation-wise and/or if you need, get an ultrasound run just to make sure there are no nodules or inflammation in the thyroid that could be caused by Hashimoto’s. So outside of that if you have a thyroid issue or nutritional issue or neurotransmitter issue that could be affecting your thyroid, and you’re not quite sure the next step to take, click on screen. Again schedule a consult with me, subscribe to the videos, and get my Thyroid Hormone Balancing Series for more information how you can get your thyroid back into balance.
Thanks a lot. This is Dr. J signing off.