Thyroid Thursday Episode 64: The Missing Link Causing Your Chronic Hypothyroid Symptoms
Hi. It’s Dr. Eric Balcavage. We’re back for another edition of Thyroid Thursday, and today we’re going to talk about the missing link that’s probably causing your chronic hypothyroid symptoms. And that missing link is stress.
Now I know what you’re thinking. I’m just another doctor, going to tell you that it’s all in your head. And that’s really not what I’m talking about. Stress comes in multiple forms. There’s physical stress like falls, accidents, injuries, poor posture, too much activity, excessive exercise, or too little activity. It could be chemical stress; what you eat, what you drink, food allergies, food sensitivities. It could be medications and antibiotics. It could be toxins. It could be organic chemicals that get in from your food. There’s lots of chemical things that can drive a chronic stress response. It could be emotional stress. It very well could be emotions, and those emotions aren’t just that you’re depressed.
It is the stress of finances. It’s the stress of work. It’s the stress of family. It’s the stress of kids. It’s the stress of just your whole lifestyle that can create an inflammatory process in the body. And the last, it can be microbes. The bacteria, the yeast, viruses, the parasites that come in from outside or the things that are just overgrowing inside the body.
These things can all create a stress response on the body. The body is acutely adapted to short-term stress. It’s actually a good thing. Short-term stress allows the body to break down a little bit, heal, repair, regrow, and revitalize us. Short-term stress and short-term inflammation is what the body is adapted to.
The problem is that chronic low grade or chronic high-grade stress creates chronic inflammation, and chronic inflammation changes our physiology. It takes us out of a state of balance, what we call homeostasis, and puts us into a strained or stress state called Allostasis. Chronic stress equals chronic inflammation, and that alters physiology and starts to create adaptations in our physiology that cause us to have symptoms. Those are warning signs.
And it really has an impact on thyroid physiology, because when there’s a stress response at the cellular level, one of the first things that the cells do is to try to down-regulate cell metabolism. And since thyroid hormone is what regulates cell metabolism, deactivation of your thyroid hormones occurs at the peripheral cells. Now this occurs while the gland is still functioning fine. I really break down this thyroid dysregulation process. We’ll break it down into two main phases.
Phase one is the stress response and the initiation of a cell danger response by your peripheral cells. What the cells are trying to do is to decrease metabolism of the cell, and it does that by taking your T4 and T3 and deactivating it. Converting it to reverse T3 and converting it to T2. By deactivating your thyroid hormone at the cellular level, the cell metabolism can decrease. But this causes you to have hypothyroid symptoms. And you can have those hypothyroid symptoms even though your gland is working fine, even though your TSH is normal, and even though your blood shows normal values of T4 and T3.
If this stress response persists for an extended period of time, then phase two kicks in. And the cell danger response releases particles that actually initiate an immune
attack on the thyroid gland. We call that thyroid autoimmunity, and that’s typically what we see with Hashimoto’s thyroiditis. Now some people would say that the immune system is out of control and this is a mistake by the body. But I don’t believe that. I think it’s the second phase of the cell danger response where it’s saying, hey, if I can’t control metabolism just at the cellular level, let’s go to the gland and destroy it, and then there’s less work for the cells to do. It makes perfect sense.
When doctors look at you and they say well, you have all the symptoms of hypothyroidism, let’s just test TSH and T4, what we know now from the research is that TSH in this strained state, this allostatic state, is no longer a valid marker of thyroid physiology. Especially because the same inflammatory mechanism that’s deactivating your thyroid hormone at the peripheral cells, meaning away from the pituitary gland and the brain, can also be reducing the ability of the pituitary gland to produce TSH. The inflammation will suppress TSH.
When you have these hypothyroid symptoms, you’re deactivating thyroid hormone at the peripheral level. The inflammation suppresses the pituitary, so TSH looks normal. And, it may even look low normal or low, and your doctor looks at that and says you can’t have a thyroid gland problem because your TSH is normal or low. And that’s just not true when we’re in this allostatic state.
What do you do?
One, you want to look at your life. You want to look at what’s going on in your life. What are those stressors? Are you over exercising? Are you under-exercising? Are you eating too little, and that may be a case. Are you not sleeping well? Do you have disrupted sleep all night? That’s when the body heals and repairs. That’s a stressor. Do you breathe improperly? Do you have lots of emotional stress in your life, lots of baggage that’s just putting a lot of stress on the system? You need to look at your diet, your lifestyle, your habits, the emotional things that are going on in your life, and you must try and get those things under control.
The only way to really do it sometimes is to step back or find somebody else to help you look at those processes. Because to you, it may not seem like these are stressors. This is your everyday life. But more often than not, it is the accumulation of all those stressors in your everyday life that are creating a lot of the stress on the body, pushing you out of homeostasis, causing the deactivation of your thyroid hormone. So, you need to start breaking those things down.
I highly recommend that when you get lab work done, you get a comprehensive thyroid panel. It’s more than TSH and T4. You should also get a comprehensive metabolic panel, because there are a number of inflammatory markers on a comprehensive metabolic panel that can tell us that inflammation is occurring and it’s causing the deactivation of your thyroid hormone, regardless of what your TSH and T4 values are.
The third thing I highly recommend is that you find a functional medicine doctor like myself to help you with this process. You can make some of those changes. If you know your diet’s lousy, clean that up. If you know you don’t have good sleep habits, you’re staying up too late watching TV, working on your computer or checking Facebook, shut those things off 8:00, 9:00 at night. Try and have better sleep habits. If you know you’ve got a lot of stress baggage, emotional stress baggage in your life, figure out how to adapt to it better or how to get rid of some of that stuff.
But beyond that, find a functional medicine doctor. We are trained to get at the root cause of what’s driving these chronic inflammatory responses and chronic autoimmune issues. And if we can get at the root causes and help you fix some of those things, your cell danger response and this chronic stress and inflammatory response can calm down. Thyroid physiology can come back on.
Hopefully that was helpful for today. The missing link to your chronic hypothyroid symptoms may be caused by chronic stress and chronic inflammation. Look forward to another Thyroid Thursday in the coming weeks. Take care.
Dr Eric Balcavage
