Thyroid: Fatigue, Weight Gain, & Depression

April 22, 2017

Thyroid: Fatigue, Weight Gain, & Depression

We’re diving into a complicated topic to help you understand how your thyroid works and why it might not be working. We’ll explain why the thyroid affects fatigue, weight gain, and depression and more importantly, what you can do about it.

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BRENNA: Good morning and welcome to Dishing Up Nutrition. I am Brenna Thompson, licensed and registered dietitian and this show is brought to you by Nutritional Weight & Wellness, a company specializing in life changing nutrition education and life changing nutrition counseling. Today we have a show many of you have asked for. It's a complicated topic but we are going to try our best to help you understand how your thyroid works, why it might not be working, and what you can do about it. So, grab your pen and paper so you can take notes.

SHELBY: Yes, Brenna, you're right. We've had many requests to do another show about the thyroid and how it affects fatigue, weight gain, and even depression. So, if listeners want more information, definitely get those pens and papers ready. But you can also get on our website, weightandwellness.com. Use the pull down menu to search for thyroid health. So, good morning listeners. I'm Shelby Hummel. I'm a licensed nutritionist and I work with clients out of our Wayzata office and also work with long distance clients, Skype clients. So, regardless of where you are in the world, I'm ready to work with you.

KARA: I know many of you are saying, “Oh thank goodness, a show about my thyroid because I don't think my thyroid is working.” What are some signs and symptoms you might experience if your thyroid is not working?

SHELBY:Well think about this. Do you have trouble getting out of bed in the morning? Or are you so tired in the afternoon that you have trouble putting one foot in front of the other?

KARA: As a nutritionist I've heard many clients describe this kind of fatigue, you know, sleeping 10 to 12 hours and still can't get out of bed in the morning, barely able to function. So, I should introduce myself. My name is Kara Carper. I'm a licensed nutritionist as well. And I've been working at Nutritional Weight & Wellness for over 10 years, so I also work in the Wayzata office with Shelby. And I've seen a lot of clients over the years with thyroid problems.

SHELBY: I imagine you have. Well let's face it, hyperthyroidism or low thyroid function can be very frustrating and it seems like the most frustrated clients with hypothyroidism are those who are wanting to lose weight. They come to us and they say, “Well I don't eat very much and I eat good foods but I still cannot lose the weight.”

BRENNA:  You know it's funny, I actually had a client on Thursday come in and that was her exact description. I mean she was barely eating anything for breakfast or lunch and she's known that she's had hypothyroidism since she was 13. And yet she goes “I'm eating barely anything and I eat good foods. And the scale will not budge.” There's something deeper going on. So, it is possible that these symptoms of fatigue, weight gain, depression, they could be connected to your thyroid or your thyroid not working.  Maybe you have gone to your doctor complaining of terrible fatigue, unexplainable weight gain, feeling depressed and asked for a thyroid test only to be told that your TSH looked fine. It's normal. And that TSH is typically the only one that doctors are running. And we’ll talk more about that. That's the thyroid stimulating hormone.

KARA: As nutritionists we hear this all the time. Clients tell us they've had their thyroid tested multiple times but their doctor keeps telling them their levels are fine. Maybe you've been told that chronic fatigue is just part of being a mom. I mean, yes that is a piece of it. But if it's going on for years and years and years, your kids are in high school. That's different. Like Shelby was talking about the unexplainable weight gain and moodiness. Are people telling you moodiness is just a part of menopause? Well, it doesn't have to be.

SHELBY: Well, it's definitely possible that you might have an undiagnosed thyroid condition. So, listeners, I want to tell you a little bit of a personal story because my sister was actually one of those people who, when she was a teenager, she was three-sport athlete, thought she was eating pretty well, but gaining weight. She was cold all the time. She was chronically constipated. And when she went to her doctor for that afternoon fatigue feeling like she couldn't keep her eyes open, her doctors said let's test your thyroid and sure enough her TSH came back in the “normal range.” But something was still not right and unfortunately it took her years and multiple providers to figure out that her thyroid was really under active and so she was diagnosed with Hashimoto's low thyroid. And one thing that I thought was really interesting is at age 17 she was diagnosed with really high cholesterol. And can you ladies guess what her doctor told her?

BRENNA: To quit eating fat or go on a statin medication.

SHELBY: Thankfully they didn't prescribe a medication. But, Brenna, you're right. They told her don't eat animal products, cut the fat off of steaks and pork chops and things like that and don’t eat butter. They told her find margarine. And my parents growing up on farms knew that that was the wrong message.

BRENNA: Yeah, I think it's really good that you highlighted at least three other symptoms there of hypothyroidism: being cold all the time, especially like your fingers and your toes. You mentioned the chronic constipation. Yeah. And then a lot of people including doctors don't make that connection between that high cholesterol and hypothyroid.

KARA:  Yeah, big connection with all of those. So, is your sister doing well?

SHELBY: She's still working with a nutritionist. It's hard to hard to get information from family members when your sister is a nutritionist but she's working on it and she is noticing, I actually just talked to her last week and she says she’s lost a couple pounds. She's working on it.

KARA: That's wonderful. I'm so glad she got the diagnosis finally.

BRENNA:  So, then once she did get the diagnosis I'm guessing they started her on medication and did that help her feel better.

SHELBY: Yep, so her holistic doctor was getting her on some supplements to help her thyroid get to working better. So, yes, she is doing some natural.

KARA:  Awesome. So, have you ever noticed that it seems like more women than men have low thyroid function? Well, it's not in your head because women are five to eight times more likely to develop a sluggish thyroid.

BRENNA: And Dr. Isabella Wens, pharmacist and author of two books on thyroid health, says, “Even though the thyroid is shaped like a butterfly, it's more like a canary in the coal mine.” If your thyroid isn't working right it's a sign that something is creating a lot of inflammation and distress in your body.

SHELBY:   Yep, you're right, Brenna. And it looks like we might need to go to our first break.

BRENNA:  All right. You are listening to Dishing Up Nutrition brought to you by Nutritional Weight & Wellness.

BREAK

BRENNA:  Welcome back to Dishing Up Nutrition. Before we went to break, today's topic is all about Hashimoto's hypothyroid and not even just the autoimmune form Hashimoto's, but low thyroid function in general, as well. And we were just talking about the fact that women are five to eight times more likely to develop Hashimoto's than men. And so, a lot of people say they have multiple women in my family who have this disease, but we don't frequently hear that men have it.

SHELBY:  Yeah, and I bet you guys didn't know that about 12 percent of the population will develop low thyroid function at some point in their lifetime. So, we have to be thinking what might be causing so many sluggish fibroids.

BRENNA: Well, there are many, many causes and we certainly don't have time to discuss all of them today, but if you have been diagnosed with hypothyroidism there is a very good chance that it is the auto immune form. In the United States the most common form of low thyroid is the auto immune form called Hashimoto's thyroiditis. And I think that I read that it was actually 90 percent of low thyroid cases are Hashimoto's. So, as nutritionists we work with many clients who have autoimmune diseases including Hashimoto's. And we always look at food first. You have to just think what are you eating or not eating that could cause your thyroid to be inflamed? That's a really interesting question. There are certain foods that cause inflammation in our bodies and for some people the foods are going to cause inflammation in the thyroid gland.

SHELBY:  Yes. So, when we look at that Hashimoto's thyroiditis-- anything with -itis means that it's inflammation. So, inflammation in the thyroid. So, if you've been listening to Dishing Up Nutrition for the past 12 years you may be screaming at the radio going, “I bet it's sugar!” And listeners, you are right. Yes, sugar causes inflammation. But, we won't get on that soapbox today. We have some other foods that we want to discuss that can cause inflammation for the thyroid. What do you think of?

BRENNA: Well, if you're wondering, “Do I have Hashimoto's thyroid disease? Is this something I need to be worried about?” Are there blood tests that I can ask for? And then if you end up being diagnosed with Hashimoto's, what foods should I eat or avoid so that I can slow down this inflammation or this attack on my thyroid?

SHELBY:  Yeah. And Brenna, you're right, Hashimoto's really is an attack on the thyroid. So, Tyler, I hope you're listening because here comes the Star Wars analogy. So, listeners think it's as if it is the Star Wars Jedi spaceship being attacked and destroyed by the Dark Side. So, in my mind I see lots of light sabers and laser guns and over time that attack makes it impossible for your thyroid to make those thyroid hormones. And think about it. If your thyroid doesn't work, if your thyroid’s under attack it’s not working, so think of all the other things in your body that may not be working.

BRENNA: And that's what your sister experienced. Her circulation wasn't good, her digestion wasn't good, fatigue.

KARA: Absolutely. Everything slows down. Your metabolism slows, of course. We frequently recommend that our clients go back to their doctor and ask for a test. Actually, a couple of tests for thyroid antibodies. So, there are two different thyroid antibody tests. There are that TPO and the TG. And in 80% of all Hashimoto's cases, one or both of these antibodies will be elevated. And there are some people who have Hashimoto's and those antibodies are going to be within a normal range, making it a little bit harder to diagnose, but typically with Hashimoto's we'll see elevated antibodies.

BRENNA: I was just going to say maybe we should tell people that TPO stands for thyroperoxidase. And then the TG is the Thyroglobulin.

SHELBY: Thank you. So TPO and TG. And just to kind of touch on that, I know that when clients are coming in and I asked them, “Oh, you've marked that you have thyroid stuff. Do you do what your test numbers were?” “Well, no my doctor just said that they were in the normal range.” So, then when we do get to sit down and look at some of that blood work we get a little bit more information from some of those antibody tests.

BRENNA: I had a client that I had mentioned earlier in the show who I just started working with this past week. She actually had been diagnosed with hypothyroid when she was 13. But she just now later in life finally had her antibodies tested.

KARA: So, her other numbers were off her, but she hadn't had the antibodies yet.

BRENNA:  And she was on medication and her TSH was looking normal, but she was not feeling well. And so her new doctor finally tested those antibodies. And from that we're making changes. OK. So, they were positive. Very high.

SHELBY: So, did you ladies know that research studies show that there's a very specific gene that appears to be connected to auto immune diseases like Hashimoto's. And when those genes are turned on, people start to feel symptoms. So, how do we turn on those genes? It goes back to food. So, when people eat gluten, they're turning on those very specific genes that are connected to autoimmune stuff. So, it triggers that person's immune system to go on high alert. So, those antibodies are attacking the thyroid. So, it all goes back to food, right?

KARA:  Right. It does always go back to food. And this is why we frequently recommend clients follow a gluten-free diet. We often hear people saying, “Well, isn't gluten-free just a fad diet?” But when we look at the research studies between 1998 and 2004, and that's just kind of a range I looked at because that's when a lot of them were done, these studies found that many people, about 30 to 40 percent of people with celiac disease, carry a gene called HLADQ2. They have this gene. But what's interesting is that a large number of people with Hashimoto's also carry this gene. So, there is a connection. Now, by removing gluten foods from the diet, clients are removing a toxin to their body and to their thyroid.

KARA: So, and we probably can all relate to this, but when you're sitting down with a client and you've established that there is a Hashimoto's diagnosis, what I'm finding is when I recommend gluten free, people are saying, “Well, I don't eat that much. I only eat a little bit.” But ladies, when we talk about gluten free, a little bit of gluten can create the auto immune response.

BRENNA: Dr. Thomas O'Brien, who really specializes in the gluten sensitivity, says that having even just one bite of gluten or a food that has gluten in it will cause inflammation for up to six months.

KARA:  And, yeah, I think he even says like a bite, like a pinky fingernail size amount of gluten. So, I just wanted to throw that out there because it is really a serious topic. When we say “gluten free” to get rid of that auto immune response does that really have to be gluten free? So, what that means is just removing all the gluten-containing grains in any foods made with them. And so those would be wheat, rye, barley, or spelt.

SHELBY: Yes. So, listeners, if you're thinking about those foods, there you go. Muffins, bagels, pancakes, are all out. The canned soups, the pastas, takeout pizza, and even takeout Chinese.

BRENNA:   Sad day. Interesting that you did mention that Chinese takeout because soy sauce is frequently made with wheat. So, if you actually turn that bottle of soy sauce around it's fermented wheat and soybeans. And we know that research also shows that soy is not a good food for our thyroids either. But why is this? What is wrong with soy?

KARA:  Well, studies show that soy can block iodine absorption into the thyroid. And I've met with several clients who, after losing weight, by eating maybe only bars and shakes ended up being diagnosed with low thyroid and then regained all the weight that they had lost on that sort of crash diet. And this makes sense to us because those bars and shakes are typically made from soy protein. It's very hard to find a shake in a bar that isn't made from soy. Especially in your regular grocery store. And so the soy protein blocks iodine to their thyroid. So, that's going to slow down thyroid function and metabolism.

BRENNA: Yes, and I think you mentioned the fact that it was a crash diet where these people are just drinking the shakes for breakfast and you're doing these bars for snacks. So, it's not enough food, but that alone can send our body into more of a starvation kind of mode. And that actually slows our thyroid function too. And if people think back to The Biggest Loser, they did studies on the people several years afterwards and found that their thyroids were low because they had literally just starved themselves into a low thyroid.

SHELBY:  Well we'll talk more about the thyroid and other things that affect that when we come back from break. You are listening to Dishing Up Nutrition.

BREAK

KARA:  Welcome back to Dishing Up Nutrition. I'm Kara Carper, certified nutrition specialist and licensed nutritionist. And before break, Brenna was talking about signing up for our Nutrition 4 Weight Loss 12- week series. And just to kind of clarify how you can sign up for that you can go to our website weightandwellness.com or you can call her office 651-699-3438. And so, I'd like to share a recent client success story from the Nutrition 4 Weight Loss 12-week series. And this was Nancy’s testimonial. Nancy said, “My husband and I took the Nutrition 4 Weight Loss class that started in January. We're not perfect at it. And for me eating at regular times is a challenge since I get distracted with work and life and I'm not much of a cook. But, we've each lost 23 pounds so far. Today I had to buy new pants. I never get the bloated or exhausted feelings anymore. We are on the right track!” So, that's just one of many of our clients’ success stories. It's pretty phenomenal and she's even saying, “Hey, we're not perfect. We're real, people busy. I don't like to cook.”

BRENNA: And I always tell clients that. I say I don't expect you to be perfect, I just expect you to try. So, back on our topic we were talking and discussing hypothyroid. We had a question over break.

KARA: Oh yeah let me just quickly answer that because somebody called in and was wondering if we were going to address something called hyperthyroidism. So, a fast thyroid. Unfortunately, we're not going to have time to address low thyroid and high or hyper thyroid today. We're just focusing the show on hypo today, but I do want to comment to the listener or anyone else that has this situation, if the hyperthyroidism stems from an auto immune condition called Graves Disease, which most of hyper-thyroid is from Grave's Disease, the protocol that we're talking about for food stay away from sugar, gluten, soy, that applies to Graves disease as well.

BRENNA: Yes, because Grave's is still an attack on the thyroid. So, it's just that this is the point where the thyroid, instead of slowing down immediately, it's kind of speeding up, it's making lots and lots of thyroid hormone.

KARA:  So, hopefully if you have Grave's disease you can get some takeaways from listening today on what we recommend for any auto immune condition.

BRENNA: Now, before break we had been talking about soy and how soy can block thyroid receptors. But, there's also evidence showing that soy makes it hard for the body to turn T4 into the active T3 hormone and we're going to discuss more of that T4/T3 here coming up in just a bit.

KARA:  So, now you know that eating pasta, bread, doughnuts, pie crust, pancakes, and cereal that contain gluten could actually be slowing down your thyroid. So, what are you going to do about it? And I always ask my clients, “Are you willing to give up these foods for the next six months to see if you can reduce the information and stop the attack on your thyroid?”

SHELBY:    You're right, Kara. When we're working with clients we're upfront with them and we know it's not easy to change the food that you're eating. But, we've found that it works. So instead of doing chicken noodle soup from the can we have homemade Chicken and Wild Rice Soup because we know that many of those canned soups contain it in gluten.

BRENNA:  And if a client stops eating gluten how will they know if their thyroid is working better? Well, first they might notice that they've got more energy, they're having fewer mood swings, they might lose weight. But there are a few lab values that would tell us their thyroid is working better, as well.

SHELBY:  Yep, and we mentioned earlier that many people who ask their doctors for a thyroid test are only having that TSH lab tested. So, while this is one marker to look at, it's only a small piece of the puzzle. So, it can be kind of deceiving. So, most labs and therefore many doctors and even hormone specialists, those endocrinologists, believe that a normal TSH level is between 0.3 and as high as 10. But then we start to say well that's a pretty big range. Is that the optimal range?

BRENNA:  Yes, just because that's the range doesn't mean it's optimal. And studies show that someone who is healthy will have a TSH between 0.3 to 2.5. Now, do I have time for a short story here? So, a couple of years ago my husband was under a lot of stress with work and we had just bought our house and just a lot going on. And over the summer he kept complaining of the fact that it was hard for him to sleep. He was kind of having that like tired but wired feeling and he was getting cold all the time. And this is a man who never complains about being cold. And finally one night he started having heart palpitations and we ended up in the E.R. of course. And they said, “Well we think this is just a panic attack.” But they happened to run his TSH because they thought maybe he was having a hyper thyroid episode. But sure enough his TSH was over 5. And so, I knew something is going on here. And I learned after doing a whole bunch of research over the next couple of weeks, when you're under a lot of stress and your body produces a lot of cortisol, that blocks your thyroid receptors and you can become hypo thyroid. So, those little real life examples there.

KARA: So, his TSH was over five, which is high, indicating hypothyroid.

BRENNA: Yes, the thyroid was working really hard, but not producing the right hormones. And so we know from these studies that anything over 3 I start to say something's going on here. Something's not right.

Oh, and we've got a caller.

SHELBY: Yeah, should we take a call? Good morning, Sherry. Welcome to Dishing Up Nutrition. You have a call for us this morning?

CALLER: Yes, I do. This is so interesting. So, my husband, when he was 18, was diagnosed with high cholesterol. We thought it was hereditary and things like that. He’s not overweight. And then at 30, diagnosed with thyroid issues. Now he's at 59 and he got off all his high cholesterol meds. We've dealt with it with diet. But, my question really kind of is with his levels, they've been good. The doctor keeps saying they're really good with his medications, but can they ever get off of the meds? And what is a good amount of the medication? What's a good amount for him to be taking, because I had read when you're over 50 in a male you shouldn't be taking this amount. So, I guess I have so many questions, but I'm just curious to see does he have to stay on this for the rest of his life? Or are there other ways to get off of them?

KARA: So, just to clarify, you think he’s on the levothyroxine or the Synthroid?

CALLER: Yes, that’s what it is.

KARA:  And it sounds like that's managing his symptoms?

CALLER: Exactly. Yes.

KARA: OK. So, he's doing well and his numbers are in good ranges. From my understanding, and the research shows that some people do need to be on medication for the rest of their lives. Not everyone, but unless he were able to reduce the medication and have his numbers be in range and be symptom-free, that would be a different scenario. But if he lowered the medication and started getting symptoms back and his numbers were out of range, sounds like he does better on the medication.

CALLER: Yes. And then we were kind of afraid to mess with too many things because he does have high blood pressure too at times and sometimes when you were just talking about your husband with stress and all that goes together. But I just thought it was so interesting when you said cholesterol and thyroid and blah blah blah. And that many years ago. So, no, I'll just keep listening. But I just thought I might have to make an appointment to come and see you girls because maybe we can do something different.

KARA:  I think that's a great idea. You want to cover all the bases. Make sure that there's nothing that he is missing where he might be able to do something natural with food and potentially lower his medications.

CALLER: Yes. And I'm thinking about a future for our kids and grandkids too because it all runs in the family it seems like. But I will keep listening. I love this show.

SHELBY: Thanks for calling, Sherry. Have a great day! Do we have time for just quick call? Yes. Good morning, Alex, you have a question for us?

CALLER:  I do, yes. So, when you were describing your husband's symptoms, like, “Oh my gosh, this is everything I've been going through!” So, my hands and my feet are almost always cold. And I have been sleeping terribly for the last few months, and I started getting these really weird heart palpitations, where like sometimes my heart was beating a really forceful beat, and at times it was just really, really fast and I’m like, “What's going on?” So, I went and I actually saw a cardiologist and he said that I'm fine. I exercise five to six times a week. I’m vegetarian and I eat really healthy. And they tested my blood, but I don't know what they tested it for. They checked like my neck and everything like they felt around. But I don't know if they tested for anything specific, but all my cholesterol and all the bloodwork all that stuff came back fine. So, something has to be off. So, I don't know. I'm wondering what you think.

BRENNA: Many different things here. I would say make an appointment with a nutritionist. It sounds like there is a lot that's going on here, but I would highly recommend making an appointment with a nutritionist, so you can call our office 651-699-3438. We would love to help you out. Definitely if you've been feeling more stressed recently, if you are exercising five days a week, that could be adding to your stress, making problems worse. Being vegetarian, you may not be getting enough protein to support your thyroid.

SHELBY: Well stay tuned, Alex, because we're going to be talking about some other things, especially some other foods that are going to be important for thyroid health. So, thanks for your call this morning and I hope you get a chance to come see one of us. So, we're going to have to take a quick break here. But I just wanted to ask you listeners. Is it possible that a vitamin or a mineral deficiency could be contributing to your low thyroid? So, think about that. What vitamin or mineral do you think it is and Brenna will give us the answer when we come back from break. Be right back.

BREAK

BRENNA:  Welcome back to Dishing Up Nutrition. I'm Brenna Thompson, registered and licensed dietitian. Today's topic is all about low thyroid. Before break, Shelby asked, “What vitamin or mineral deficiency might be contributing to your low thyroid?” If you guessed zinc and selenium and iodine then you’re a winner. Zinc and selenium are both needed for the thyroid to work right to make their T3 and T4, but they're also needed for the conversion of T4 into T3. Now, what foods do you think are high in zinc?

SHELBY:  Any guesses? Meat! We know people who do not eat enough animal protein might be low in zinc. And very important for T4 getting converted into T3. So, think about it. If you don't have enough zinc could that be preventing your thyroid from working, right? So, then we have another one. What foods are high in selenium?

BRENNA:Well, this one's a little bit harder to find, but Brazil nuts. Those giant nuts that you find in the nut mix at parties. Those are my grandpa's favorite. Those are high in selenium. Now, oysters are also high in selenium. Oysters and other seafoods, and of course iodized salt is also high in iodine. So, eating plenty of animal protein, Brazil nuts, and using iodized salt can help us prevent deficiencies which might slow down our thyroid. So, all you listeners are going to be going out and buying oysters and steak this weekend and Brazil nuts.

SHELBY:So, if you need a high-quality zinc or a high-quality selenium supplement stop into any one of our twin cities locations or you can go to our products page at nutrikey.net and order online.

BRENNA: And before break we were talking about TSH and how so many people go to their doctor and they say, “Doctor, I want my TSH tested so we know if my thyroid is low or not.” And they get tested and it comes back and their doctor says it's normal. But really, just because it's normal doesn’t mean it’s optimal. So, we want our TSH to be between about 0.3 to 2.5. Anything above 3, we might have some inflammation, some trouble brewing there. So, a high TSH just shows that the brain is trying to call the thyroid and tell it to make more T4 and T3, those thyroid hormones. And if the TSH keeps going up, it's kind of like the brain keeps calling and calling, but the thyroid just isn't getting the message.

SHEBLY: The thyroid isn't picking up the phone. And without enough T4 or T3 thyroid hormones, it's as if everything in our body is slowing down. So, think about it. Our brains slow down. Maybe we have mood swings, maybe we have fatigue. And our metabolism slows down. So, all of those people who are tired and gaining weight, think about our digestive tract slowing down. So, that's where we talk about like my sister who was chronically constipated. I can remember her being constipated when she was really little.

BRENNA: Wow. So, this was going on for a long time. And without enough thyroid hormones we can't get any energy into our cells. No energy to our brain, no energy to our muscles, no energy anywhere.

KARA: So, when you said no energy to our brain, I don't know if we've talked about this symptom yet, but that makes me think of brain fog, which is a very common type of hypothyroid. We're not getting energy anywhere. So, I have a client story that I'd like to share. I mean, we have many clients with hypothyroidism, but this particular one comes to mind just because we started talking about mineral deficiencies. So, her numbers were off and so and she was seeing a doctor who recognized that she had hypothyroidism and her symptoms had been difficulty losing weight. She had some hair loss and hair thinning. And that's another thing I don't know if we've talked about, that thinning of the outer part of the eyebrows is a sign of hypothyroidism. She also had that brain fog and the fatigue. And so, her full thyroid panel showed that the T4 was actually fine. But it was that T3, the active form that we really need to get rid of all the symptoms. That T3 was low. So, she did not necessarily want to go on a synthetic medication. So, she asked for advice on are there some things that I can try to and naturally increase that. So, you guys were just talking about the importance of selenium and zinc to turn the T4 into the T3. So, that's really all she did. She added in some selenium and zinc and a few months later she actually noticed a difference already. Her symptoms were decreasing. So she went in and got retested and she was excited. Her T3 was in the good range.

BRENNA:I think it's important to say that it was a couple months later. Not the next day. These things can take some time.

SHELBY:  So, let's talk a little bit more about the T4 and the T3 thyroid hormones. So, T4 is the most abundant thyroid hormone. It's made in the highest amount. But, it's actually not used by the body.

KARA:  Isn’t that interesting that it is often the one that is tested. And it's not used by the body, so T3 is actually the active and the usable form of our thyroid hormone. So, our thyroids will make some T3. Most of it is made when the T4 converts into T3. That happens in the liver or the muscles.

BRENNA: And this means that someone might have a normal T4, like your client. But if they can't convert it into T3 they will still have hypothyroid symptoms. So, if you've had your T4 checked it should be between 6 and 12. If it's lower than that then that's a sign that your thyroid is struggling to actually make the T4. And so, if you're not making T4, you're not making T3. And a normal T3 should be between 100 and 180, but if it's low we have to find out if it's because the fibroid isn't making T4 or is your body not converting the T4 into T3? So, hopefully the listeners are understanding the importance of getting all these numbers from your doctor. We need to know all these numbers.

SHELBY:  Yes, so think about it. What might be preventing your thyroid from making T4 and T3? And what might be preventing your body from being able to convert that T4 into the active form of T3?

KARA: If you have Hashimoto's auto immune hypothyroid your thyroid will not be able to make T4 or T3. And as we just discussed, having a zinc, selenium, or iodine deficiency will mean our body cannot make T4 and therefore it will not be able to convert it into T3.

SHELBY: Yeah, and did you guys know that there are foods that can block those thyroid receptors. So, there are food-like substances that block receptors on the thyroid. So, what sort of foods do you think of when we talk about that?

BRENNA:Well, I think of things that are going to be hard and crusty like trans fats. Those will create a crust around our cells blocking those receptors and then also excess chlorine will block thyroid receptors as well.

KARA: New York City banned trans fats in restaurants several years ago, but you can still find trans fats in many other places, so snack cakes, cookies, pie crust made with Crisco.

SHELBY:   Yeah, and if you're drinking diet soda made with sucralose, commonly known as Splenda, then you're taking in a lot of chlorine, which also blocks those thyroid receptors from being able to absorb and use iodine to make T4.

BRENNA: Well, I think we've had a really in-depth conversation today. And it is time to wrap up our show. But, before we go, let's try and recap the most important points. If you're struggling with fatigue, depression, and weight gain and your TSH looks normal, you could still have a thyroid imbalance.

SHELBY:And keep asking your doctor to test those additional thyroid hormones. The TSH, the T4, the T3, and those thyroid antibodies, TPO and TG. So, this will help you find out if you're taking the right medication and if you should really be following a gluten-free and a soy-free diet.

BRENNA: We know this might sound really daunting having to give up your cereal, your soy milk, the snack cakes and your diet soda, but let me suggest calling our office 651-699-3438 and schedule an appointment with a nutritionist to help you navigate these diet changes.

SHELBY:Yes, and if your mind’s spinning around all those thyroid levels that we talked about, make an appointment with a nutritionist. We talk about this all the time.

KARA:  Yes, we know this stuff inside and out. And we just really want to thank you for listening to Dishing Up Nutrition today. If you found this show interesting, please share it with a friend or a family member.  Our message each week is how eating real foods supports your health. It's a simple, but powerful life changing message.

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