Thyroid Issues: Everything You Need to Know About Your Thyroid

This gland has gotten a lot of attention in recent years, as more people are understanding the key role it plays in helping the body function properly and how it can affect so many other areas of our health. The unfortunate part is that when it’s not working like a fine-oiled machine, thyroid issues can arise impacting our body physically and emotionally, often leading to weight gain, weight loss, mood swings and more.

In essence, a good, balanced thyroid keeps us humming and keeps our hormones in check. When it’s out of balance, however, we tend to become sluggish, our metabolism takes a nosedive and we experience hair loss, heart arrhythmias and trouble going to the bathroom. Basically, a bad thyroid is a recipe for not feeling well.

To help you understand more about the vital role your thyroid gland plays in your health and what pattern of thyroid symptoms might signal a problem, let’s start with the basics.

What is the Thyroid?

The thyroid is a butterfly-shaped gland that sits just below your Adam’s apple (yes, you still have one even if you’re a female—men’s are just more prominent!). Averaging around 2-inches long, the thyroid is made up of two sides called lobes that sit on either side of your windpipe and are often connected by a type of tissue known as isthmus (though some people don’t have this connecting part and instead have two separated thyroid lobes).

what are thyroid issues?

Male thyroid gland anatomy in x-ray viewThink of your thyroid as the keeper of your hormones. As part of your body’s endocrine system, the thyroid glands produce, store and then release these hormones into your bloodstream and then throughout your body. From there, these hormones are tasked with controlling some pretty important functions, including the rate at which your body burns calories, your heart rate, body temperature, digestion and mood among other things. As you can see, when your thyroid levels are off-balance, a whole host of thyroid problems can go wrong throughout your entire body.

What Causes Thyroid Issues?

It’s estimated that around 20 million Americans have some form of a thyroid disease, with up to 60 percent of those unaware that they even have the condition in the first place. And of that 60 percent, around two-third suffer from hypothyroidism specifically, or an underactive thyroid.

Unfortunately, women are five to eight times more likely than our male counterparts to develop this kind of condition, along with the elderly, likely because these we are more susceptible to autoimmune diseases and inflammation, the root of many thyroid conditions.

Some factors that play a role in enhancing someone’s likelihood of developing thyroid issues such as hypothyroidism include:

Hashimoto’s disease

This autoimmune disease occurs when the thyroid becomes inflamed and is the leading cause of hypothyroidism in the U.S. Thyroid symptoms or signs may be silent at first, or characterized by swelling at the front of the throat, and typically progress slowly over time, leading to a drop in thyroid hormone levels in your body. Some key signs include fatigue and lethargy, unexplained weight gain, constipation, brittle nails and hair (or even hair loss), a puffy face, muscle aches and tenderness, sensitivity to cold, depression and even lapses in memory.

Poor diet

As I always say, proper nutrition is like the fuel that drives your body to function properly. A diet lacking in key vitamins and minerals (especially iodine, iron, selenium, and magnesium, which are all vital to proper thyroid function) can lead to hypothyroidism.

I often recommend that my patients with a family history of hypothyroidism or hypothyroid symptoms take supplements to make up for some of the key thyroid nutrients—50 ug of iodine, 30 mg of chelated iron, 200 IU of selenium, and 200 to 400 mg of chelated magnesium, are a few of my standard recommendations.

Food allergies and intolerances, especially gluten sensitivity, are increasingly being recognized as thyroid saboteurs, and I see this in practice repeatedly. In fact, I think almost 40% of my patients with thyroid issues have a gluten sensitivity or celiac disease.

A poor gut

We know that 70 percent of our immune system is in the gut, so this is the first place we go when we’re dealing with autoimmune-related thyroid problems. One of the best ways to ensure a healthy gut is to remove inflammatory foods from your diet, such as sugar, gluten and dairy.

Research shows that gluten in particular is strongly linked to Hashimoto’s and Graves’ so I recommend most of my patients with thyroid issues eliminate or drastically reduce their gluten intake.

So, your best mode of defense is to incorporate gut-healing (AKA probiotic-rich) foods such as kombucha, water, kefir, sauerkraut—all are essential in healing an inflamed, leaky gut and calming an overactive immune system.  I usually have my thyroid patients limit fermented foods to a few times per week, simply because another common pattern for many thyroid patients is an overgrowth of candida, or yeast in the gut. Some fermented foods contain yeast strains as well, so balance is key in addition to avoiding the refined sugars, alcohol and dairy that can contribute to yeast.


While it’s uncommon, some babies are born with a genetic condition called congenital hypothyroidism. In addition, some evidence shows that a person is more likely to develop hypothyroidism if a close family member also has the disease, as well as any other autoimmune disease.

Sedentary lifestyle

Just like proper nutrition, exercise is vital to your health. Physical activity helps keep a lid on stress and your hormone levels in check. Constant stress forces the thyroid to work harder, overtaxing the organ to the point that it starts to decline, so in addition to getting the proper amounts nutrients, be sure not to slack on sleep and exercise.


I often warn my patients that when stressed, we tax our adrenal glands and pump out cortisol, forcing the thyroid to work harder and, eventually, triggering hypothyroidism. Stress also depletes important nutrients from the body that keep the thyroid and the adrenals in balance. Manage stress through exercise, set boundaries and schedule your own personal self care with cortisol-lowering activities like yoga, swimming, acupuncture or massage.

What are Symptoms of Thyroid Problems?

When my patients tell me they’ve been feeling more tired than usual I don’t immediately think it’s thyroid issues related—that is, unless it’s coupled with other telling signs including, but not limited, to the below:

  • Depression
  • Anxiety
  • Unexplained weight gain
  • Sensitivity to cold
  • Constipation
  • Muscle aches and pains
  • Hair loss, brittle nails
  • Trouble breathing
  • Changes in menstrual cycle
  • Palpitations
  • Eyebrow and/or eyelash thinning

To determine whether or not hypothyroidism is the catalyst for your symptoms, your doctor will run a blood test to check your levels of the hormones T4 (thyroxine) and  THS (thyroid-stimulating hormone). When your TSH is high, hypothyroidism is often diagnosed. It’s possible to receive a diagnosis of mild hypothyroidism, which is essentially the condition in its early stage, though it can progress to full-blown hypothyroidism if the necessary lifestyle changes are not made.

In practice, we aim for a TSH between 1-2, which is where the majority of my patients feel best. I’ve learned, however, that each person has a unique set point when it comes to the thyroid. Some patients feel hyperthyroid, for example, if their TSH drops below 2. Additional markers are often helpful, including, a reverse T3, Free T3 and T4, total T3 and T4.

What can you do for optimal thyroid health?

Depending on the severity of their condition, some patients may need medicine for their thyroid issues in order to keep their thyroid in check and have it functioning properly. Treatment would depend on the specific pattern of symptoms and the corresponding hormonal deficiency. However, the first line of defense that I recommend to all my patience is making the necessary dietary changes that will help, not only with thyroid dysfunction, but also many of the corresponding symptoms as well.

Food First

Here’s what I recommend to pile on your plate to boost your thyroid function:

Fatty fish

Salmon, especially, contains a hefty dose of omega-3 fatty acids as well as a powerful combination of antioxidants including DMAE and astaxanthin (which is what causes the pink hue we love so much!). All of these help control inflammation and keep hormone levels in check. I recommend that my patients eat fish twice a week to make sure they’re getting their fill.


Eggs are packed with the selenium and iodine our body needs for proper thyroid function. In addition, eggs are a major source of protein, cholesterol, B vitamins, fat-soluble vitamins and minerals. Don’t pass on the yolk, either, as it contains much of these thyroid-friendly elements.


Once again, fat is where it’s at—the good kind, that is! This creamy, green fruit, which we love to enjoy as a vegetable, is loaded with omega-3 fatty acids, which are essential to brain and endocrine health (remember—your thyroid is part of your endocrine system!).


Nearly all seeds—sesame, pumpkin, flax, chia—are great sources of amino acids, which help balance thyroid levels. Make sure to get your fill by tossing some on your meals. Need some inspiration? Try my Cherry Cocoa Chia Pudding, which is both dairy- and gluten-free!

Leafy green veggies

Whether you enjoy yours sautéed or in a salad, dark, leafy greens are essential to a healthy diet. They’re high in all the key nutrients including calcium, magnesium, iron, potassium, phosphorus, zinc and vitamins A, C, E and K. Let’s just say your thyroid is a BIG fan of leafy greens.

Garlic and onions

Many thyroid sufferers notice that with thyroid disease comes decreased immunity function. Load up on garlic and onions (with a piece of gum to follow!) for immunity-boosting properties with anti-inflammatory and antiviral benefits. They have also been shown to help improve LDL/HDL cholesterol balance.

When it comes to foods to stay away from, I tell my patients to cut down on allergy-prone foods like soy and gluten, as well as cruciferous veggies like broccoli, cauliflower and Brussels sprouts. These cruciferous vegetables are considered goitrogenic, meaning they can inflame the goiter, triggering hypothyroidism.

Gut Smarts

Even when talking thyroid, we have to be gut smart. Add probiotic-rich foods to your diet, including bone broth and fermented foods. Limit high-yeast foods and lower gluten to no more than one serving per day.

Supplement Savvy

If your thyroid numbers are borderline, you have a family history of hypothyroidism or you notice more hypothyroid symptoms, supplement (with your physician’s supervision) the key thyroid nutrients. These include:

  • Iodine 50 ug: Start with a dose of three 50 UG per week to make sure you tolerate this supplement well.
  • Selenium 200 ug: Selenium helps keep the thyroid functioning, so add this thyroid supplement to your regimen in a daily dose.
  • Elemental Iron 30 mg: Iron is needed for optimal thyroid function. Consider adding in iron to your supplement regimen.

Medication for Thyroid Issues

There are so many thyroid medications on the market and they need to be personalized to your particular thyroid needs. The most common thyroid medication prescribed is usually levothyroxine or a T4 replacement. Additional medications include t4/t3 combinations, including Armour thyroid, Naturethroid and Westhroid or t3-only medications like cytomel or liothyronine. Managing thyroid medications can be tricky and each patient responds to certain thyroid medications best, making thyroid management more complex than simple prescription writing.

When it comes to your thyroid, remember to eat for optimal thyroid function and safeguard your gut health. Have your thyroid levels checked every year and even more often during pregnancy, perimenopause and menopause. Learn where you and your thyroid feel best, so that you and your doctors can always steer your thyroid plan in the right direction.