A cropped image of a young woman showing a graphical image of a thyroid gland on her neck.

Hypothyroidism: Causes, Symptoms, & Natural Treatments

by Dr. Matt Olesiak, M.D.

DrAn estimated one in 300 people in America has hypothyroidism, though the symptoms are mild or unnoticeable in most cases (1).

In this guide, we'll define hypothyroidism and discuss causes, symptoms, and natural treatment options.

What is Hypothyroidism?

Hypothyroidism occurs when the thyroid gland fails to produce enough thyroid hormone. This disorder is also known as underactive thyroid.

It is the opposite of hyperthyroidism (overactive thyroid), where the thyroid gland produces too much thyroid hormone.

What is the Thyroid Gland?

The thyroid gland is a small butterfly-shaped organ located in the front lower part of the neck. Its primary purpose is to produce two thyroid hormones that are released into the bloodstream: triiodothyronine (T3) and thyroxine (T4). These hormones are essential for your body to function properly.

What Does the Thyroid Do?

The thyroid's primary job is to regulate metabolism, or how your body creates and uses energy. It's often called the "master gland of metabolism." So, the thyroid gland is essential for regulating weight. But its responsibilities go far beyond that.

You see, it regulates your "metabolism and bodily function by transporting energy in the form of glucose to your cells." (2)

Therefore, thyroid hormones help regulate many critical functions, including: (3)

Body temperature
Cognitive function
Reproductive function
Cardiovascular function and health
Absorption and digestion of food
And so much more.

Indeed, thyroid hormones are responsible for promoting, maintaining, and regulating every organ, gland, tissue, and cell function in your body!

Keep this in mind when we discuss the symptoms of hypothyroidism.

An image of an anatomical model of a thyroid gland and blood in test tubes for the analysis of hormones on doctor's table with a doctor consulting with a patient in the background.

How the Thyroid Controls Hormone Levels

The thyroid, hypothalamus, and pituitary gland work together to control hormone levels. Specifically, when the hypothalamus senses that thyroid hormone levels are too low, it tells the pituitary gland to release appropriate amounts of thyroid-stimulating hormone (TSH), which tells the thyroid how much or how little of T3 and T4 to produce.

In this way, the thyroid gland produces and maintains a healthy T3 and T4 balance. But if thyroid hormone production runs low and this balancing act is disturbed, it can trigger chronic hypothyroidism.

Signs and Symptoms of Hypothyroidism

Common symptoms of hypothyroidism can include:

Weight gain
Inability to lose weight
Fatigue
Dry skin
Brittle nails
Dry hair
Hair loss
Joint pain or swelling, pain, or stiffness
Constipation
Puffy face
Muscle aches, stiffness, weakness, or pain
Increased sensitivity to cold temperatures
Irregular menstrual periods
Trouble sleeping
Cardiovascular problems
Depression
Anxiety
Mood swings
Lethargy
Inability to concentrate
A short temper
And more

Types of Hypothyroidism Disease

The three types of hypothyroidism are as follows:

Hypothyroidism: The gland does not produce enough thyroid hormone, which is the subject of this guide.
Cellular hypothyroidism: The gland produces enough thyroid hormone, but the cells cannot utilize it properly.
Hashimoto's thyroiditis: An autoimmune disorder in which your immune system attacks your thyroid gland. Hashimoto's is the most common type of hypothyroidism. (4)

Causes of Hypothyroidism

The causes of hypothyroidism vary and can include (7):

Autoimmune Disease

The immune system is responsible for fighting off infections, but it can mistakenly turn against the body's cells and tissue in some cases. For example, in Hashimoto's disease, the most common type of hypothyroidism, the immune system mistakenly attacks the thyroid gland cells and their enzymes as foreign invaders and destroys them, leaving the gland unable to produce thyroid hormone.

Thyroid Surgery

If surgery is performed on the thyroid to remove a nodule, cancer, or other reasons, it can negatively affect thyroid hormone production. Surgically removing the entire thyroid will always lead to hypothyroidism. But if it is just partially removed, there is a chance that the part left will still be able to produce enough thyroid hormone.

Thyroiditis

Thyroiditis is the medical term for an inflamed thyroid. This condition can be caused by an autoimmune attack, such as Hashimoto's disease, or a viral infection. When this happens, the thyroid can empty all its stored hormones into the bloodstream, initially causing brief hyperthyroidism (overactive thyroid) before switching to hypothyroidism.

Iodine Intake

To function correctly and to keep hormones in balance, the thyroid needs a precise amount of iodine. This mineral is critical for making thyroid hormones. Taking in too much or too little iodine through the diet can cause hypothyroidism. It can also be dangerous to your health.

According to the National Institutes of Health:

"Getting high levels of iodine can cause some of the same symptoms as iodine deficiency, including goiter (an enlarged thyroid gland). High iodine intake can also cause thyroid gland inflammation and thyroid cancer. Getting a huge dose of iodine (several grams, for example) can cause burning of the mouth, throat, and stomach; fever; stomach pain; nausea; vomiting; diarrhea; weak pulse; and coma. (8)

The recommended amount of iodine for male and female adults is around 150 mcg of per day, which you should be able to quickly get through your diet by adding iodized table salt to your foods. However, consuming too much sodium can create health problems. (Iodized salt contains roughly 45 mcg per gram.) Other great food sources of iodine include: (9)

Cod (3 ounces ) - 158 mcg
Plain nonfat Greek yogurt (1 cup) - 116 mcg.
Oysters (3 ounces) - 93 mcg
Fish sticks cooked (3 ounces) - 58 mcg

Pituitary Gland Damage

The pituitary gland plays a crucial role in thyroid hormone production, telling the thyroid how much hormone to make. Consequently, if the pituitary is damaged by surgery, a tumor, or radiation, it may not give proper instructions to the thyroid gland. The result is often hypothyroidism or hyperthyroidism.

Radiation Treatment

Any time radiation therapy is applied to the head, neck, or thyroid, it can damage the thyroid gland. There are also situations where doctors will use radioactive iodine to purposely destroy the thyroid to treat thyroid cancer or other conditions.

Medications

Several medications can interfere with the thyroid's ability to make thyroid hormones. These medications include lithium, interfering alpha, and amiodarone. Each of these affects the thyroid gland differently. For example, lithium increases the iodine within the thyroid gland, thus reducing its ability to produce both significant hormones.

Hypothyroidism Risk Factors

A 3d illustration of the brain, thyroid gland and pituitary gland in a human body.

Hypothyroidism risk factors include:

Gender: Women are eight to 10 times more likely to develop hypothyroidism than men (10).
Age: Hypothyroidism is more common in those 60 and older.
Genetics: A family history of this disease appears to increase your risk.
Medical conditions: Certain medical conditions spur hypothyroidism, such as viral infections or autoimmune diseases.
Diet. An iodine deficiency can lead to this disease.
Pituitary disorder: This can decrease the production of thyroid-stimulating hormones, making hypothyroidism more likely.
Radiation treatment. Applying radiation treatments to the head or neck to treat cancer or other conditions can damage the thyroid gland, contributing to an underactive thyroid.
Medications. As referenced above, some medications can increase the risk for this disease.
Pregnancy. An estimated one in 10 women gets postpartum thyroiditis, which is an inflammation of the thyroid gland (11). Pregnancy can also worsen hypothyroidism.

How is Hypothyroidism Diagnosed?

Hypothyroidism is diagnosed by taking a blood sample and analyzing it for TSH and, in some cases, thyroxine to confirm the patient's symptoms (12).

This TSH test is the best screening tool for hypothyroidism.

What is the Medical Treatment for Hypothyroidism?

The standard medical treatment for hypothyroidism is thyroid hormone therapy using synthetic thyroid hormone levothyroxine. (13)

Taken orally, this medication reverses hypothyroidism along with its symptoms. Thyroid hormone levels are periodically checked to ensure the correct dosage amount.

Treating Hypothyroidism Naturally

Below are several natural ways to treat hypothyroidism symptoms. Most of them involve diet and nutrition, as these factors significantly affect thyroid function.

Reduce Stress

Chronic stress and thyroid disease are intimately linked. How?

When you're stressed, your body releases the stress hormone cortisol into your bloodstream. Ideally, cortisol levels will diminish when you are no longer worried. But unfortunately, many people are chronically stressed, leading to constantly elevated cortisol levels.

Too much cortisol in the bloodstream taxes the thyroid gland, making it work harder to produce enough thyroid hormone for your body's needs. If it goes on long enough, it can lead to thyroid hormone imbalances that increase the risk of hypothyroidism.

The solution is to learn to manage your stress healthily.

Easy Ways to Manage Your Stress

Below are a few easy ways to manage stress.

Take leisurely walks, preferably outdoors. Combining exercise and breathing the fresh air is guaranteed to ease stress and improve your mood.
Get a dog or cat. Pet ownership is associated with lower stress levels.
Meditate. Whether you decide to meditate for 5 or 30 minutes, the act of closing your eyes, relaxing your body, clearing your mind, and taking slow deep breaths has been shown to reduce stress and improve health.
Stream or rent a comedy movie or TV show. Research shows that laughter really is the best medicine, as it reduces stress and strengthens the immune system! (14)
Practice yoga
Participate in aerobic exercises, such as jogging, bicycling, or swimming.

Get More Vitamin B-12

An underactive thyroid can significantly reduce your body's B-12 levels leading to one of the most common symptoms of hypothyroidism -- fatigue.

To combat this issue, try to consume more foods that contain vitamin B-12 or take a daily supplement.

Vitamin B-12 Foods

Foods rich in vitamin B-12 include:

Salmon
Shellfish
Nonfat plain Greek yogurt
Egg
Swiss cheese
Ham
Chicken
Animal organ meats like beef and liver
Sardines

Eat Selenium-Rich Foods

Selenium is a trace element that plays a critical role in the body and is essential for thyroid gland function after iodine. (15, 16)

Selenium Foods

To ensure you get enough thyroid-supporting selenium, be sure to include some of these foods in your diet:

Brazil nuts
Chicken
Oats
Beef
Tuna
Oysters
Salmon
Sunflower seeds

Please check with your doctor to see how much selenium you need each day if you have an underactive thyroid.

Get an Adequate Intake of Iodine

Iodine is essential for thyroid function, so you must get enough through your diet.

Iodine Foods

As previously mentioned in this guide, you can get iodine by consuming the following foods:

Cod
Seaweed
Eggs
Green beans
Bananas
Dried kelp
Iodized salt

However, avoid going overboard. Insufficient or excessive iodine intake can impair thyroid function.

Reduce Sugar Intake

Sugar causes systemic inflammation that can negatively affect thyroid hormone levels, potentially leading to hypothyroidism.

Remember that most of your sugar intake comes from processed foods, so reducing sugar requires that you limit your consumption of these foods.

This isn't too bad, though, as you can replace them with health-supporting choices, such as mouth-watering salmon, lean proteins, healthy fats, and various nonstarchy vegetables.

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