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Potential Root Causes of Thyroid Dysfunction

Learn about six potential causes of thyroid dysfunction.
Potential Root Causes of Thyroid Dysfunction
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It may be small, but it sure is mighty. “It” being your thyroid gland!

The thyroid is a butterfly-shaped gland, about two inches long, that sits near the nape of your neck. It releases thyroid hormones -- T4 and T3 -- that regulate your body’s metabolism, energy levels, and overall well-being. Every cell in your body needs thyroid hormone to function properly.

Sometimes, things can go wrong, causing your thyroid to produce too much or too little thyroid hormone. As a result, you can develop symptoms of hypothyroidism -- the most common thyroid disorder -- or hyperthyroidism.

There are many potential causes of a thyroid disorder. And more than likely, a thyroid disorder is triggered by a combination of factors. Below, we’ll explore six possible causes of thyroid dysfunction and ways that you can manage them.

Genetic predisposition

Genetics are complex and often play a role in thyroid dysfunction. Those with a family history of thyroid disorders have a higher chance of developing one themselves.

When both parents have an autoimmune thyroid disorder, their children often have high levels of thyroid antibodies. High thyroid antibodies are a risk factor for developing a thyroid autoimmune disorder like Hashimoto’s. Likewise, having a sibling with an autoimmune thyroid disease also increases your risk of developing a thyroid disorder.

A family history of Hashimoto’s isn’t the only risk factor for developing an autoimmune thyroid disease. Having a first-degree relative who lives with a non-thyroid autoimmune disorder like type 1 diabetes or Crohn’s disease has a higher risk of developing Hashimoto’s. But genetics alone don’t usually determine whether you will develop a thyroid disorder. Environmental factors also play a significant role.

While you can’t change your genes, understanding your medical history allows for early detection and proactive management. Regular appointments with your medical provider, especially if thyroid issues or autoimmune disorders run in your family, can keep your thyroid health in check.

Autoimmune diseases

Autoimmune diseases occur when the immune system mistakenly attacks the body’s tissues. Medical conditions like Hashimoto’s and Graves’ disease are examples of autoimmune disorders that target the thyroid.

In Hashimoto’s, thyroid antibodies destroy the thyroid gland, lowering thyroid hormone production. This results in an underactive thyroid. Hashimoto’s is the primary cause of hypothyroidism, which affects 1 in 5 adult Americans.

In contrast, those with Graves’ disease have an overactive thyroid gland, causing hyperthyroidism, with elevated levels of thyroid hormone. Graves’ disease affects 1 in 100 (1%) Americans and is responsible for most cases of hyperthyroidism in the US.

If you’ve been diagnosed with autoimmune thyroid disease, work closely with your healthcare team. Medications and lifestyle changes can help manage symptoms and prevent further thyroid damage. In the case of Hashimoto’s, levothyroxine, a thyroid hormone medication, is often prescribed to resolve the thyroid hormone deficiency. This medication increases thyroid hormone levels, allowing your body to function correctly.

Chronic inflammation

Inflammation is your body’s natural response to an injury or an attack. Typically, inflammation starts at the time of injury or attack and goes away once the injury or attack is over. Sometimes, inflammation becomes chronic. Over time, chronic inflammation can take a toll on your health, including your thyroid and metabolic processes.

Chronic stress, poor diet, or an untreated infection can worsen inflammation. Several studies link chronic inflammation to a leaky gut, a precursor to thyroid autoimmune conditions. A leaky gut occurs when the junctions between cells in the GI tract loosen up. As a result, toxins can enter the body, further contributing to inflammation and impacting thyroid function.

To lower inflammation levels and support your thyroid’s well-being, try

Nutrient deficiencies

Your thyroid depends on various nutrients to function at its best. Nutrient deficiencies can lead to thyroid dysfunction.

Iodine is the nutrient most often talked about when it comes to thyroid dysfunction. Without enough iodine in your diet, your thyroid can’t make enough thyroid hormone. Iodine deficiencies aren’t common in the US, as many foods like salt are fortified with it.

Iodine isn’t the only nutrient your thyroid depends on. Other nutrients include:

  • Selenium: This antioxidant is essential for your thyroid health. Low levels can increase your risk of thyroid disease and other health conditions.
  • Zinc: Zinc helps convert T4 (the inactive form of thyroid hormone) to T3 (the active form), acts as an antioxidant, and improves poor concentration.
  • Iron: You need sufficient iron to make thyroid hormones and transport oxygen throughout the body. More oxygen to your muscles means higher energy levels.
  • Magnesium: Like zinc, magnesium has many roles in the body, including digestion, blood sugar metabolism, and blood pressure regulation. Your thyroid needs magnesium to convert T4 to T3. Low magnesium may lead to high levels of thyroid antibodies. As we learned, high thyroid antibody levels increase one’s risk of developing a thyroid autoimmune disorder.
  • Vitamin D: Known as the “sunshine vitamin,” vitamin D helps improve TSH levels and reduce inflammation. It also protects against heart disease and can increase your energy levels. Many studies link vitamin D deficiency with thyroid dysfunction.

Eating a well-balanced and varied diet can prevent nutrient deficiencies. But, planning a weekly menu that meets your thyroid’s needs can be challenging. Consider working with one of Paloma Health’s nutritionists who understands the nutrients you need to optimize your thyroid’s health. They can help you add thyroid-friendly foods to your diet and identify foods that may worsen your thyroid function.

You can also take supplements if you feel you aren’t getting enough nutrients from your diet. But be sure to talk to your healthcare provider first. Taking too much of certain nutrients can be just as bad for your health as having low levels.

Stress or trauma

Life can be demanding, and your body’s stress response helps you handle short-term challenges. During a stressful event like a near-car accident, two stress-related hormones – cortisol and epinephrine – first spike and then come back down. Cortisol tends to stick around longer and helps you deal with daily stressors.

Chronic stress or traumatic events can lead to high cortisol levels, thus disrupting the delicate balance of your hormonal systems. A 2021 study in men compared TSH levels before and after the COVID-19 lockdown. Results showed that TSH levels decreased mainly in those with significant life changes, especially in their work environment. Thyroid hormone levels were not affected in this study. 

Furthermore, those living with post-traumatic stress disorder (PTSD) are at a higher risk of developing Hashimoto’s than those without PTSD. Experts aren’t sure how PTSD contributes to autoimmune thyroiditis but suspect PTSD may:

  • Interfere with the body’s natural stress response
  • Increase inflammation
  • Alter immune system functions

Adding stress management techniques into your day, such as yoga or mindfulness, or even doing a hobby you enjoy, can help lower stress and improve your hormonal balance. When it comes to thyroid function, your mental and emotional well-being is as important as taking care of your physical health.

Chronic infections

Believe it or not, infections can affect your thyroid function acutely and chronically. Sometimes, during an infection, an individual can develop thyrotoxicosis. Thyrotoxicosis is characterized by high T4 levels with a low or undetectable TSH level (hyperthyroidism). After thyrotoxicosis resolves, hypothyroidism develops. In these cases, hypothyroidism often resolves on its own and is referred to as subacute thyroiditis. An estimated 5 to 10% of subacute thyroiditis cases result in permanent hypothyroidism.

Many viruses, including Epstein-Barr virus (EBV), HIV, and adenoviruses, can contribute to the development of hypothyroidism and other types of thyroid dysfunction. Subacute thyroiditis symptoms usually develop 6 to 8 weeks after an infection diagnosis. Still, it can take up to 6 months for thyroiditis symptoms to develop.

More recently, COVID-19 has also been linked to thyroid gland dysfunction and disorders. Experts believe that the inflammatory process and oxidative stress from the COVID-19 infection trigger an overactive immune system, resulting in an underactive thyroid gland. But more research is needed to understand the link between COVID-19 and Hashimoto’s.

If you suspect a chronic infection may be contributing to your thyroid issues, talk with your healthcare provider. Your provider may order blood work to check your thyroid levels. Cases of both overt hypothyroidism and permanent hypothyroidism often require management with thyroid hormone replacement medications.

A note from Paloma Health

With many potential causes of thyroid dysfunction, your thyroid gland health requires expertise and personalized care. At Paloma Health, our thyroid specialists manage all aspects of treatment for hypothyroidism. With easy and convenient home blood test kits and a team of hypothyroidism-focused health care providers, Paloma focuses on treating you as a whole person, not just your thyroid. Treatment options include traditional medications as well as holistic and functional medicine approaches to help relieve hypothyroid symptoms. Take the first step towards optimizing your thyroid health and book a free consultation today.

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Emilie White, PharmD

Clinical Pharmacist and Medical Blogger

Emilie White, PharmD is a clinical pharmacist with over a decade of providing direct patient care to those hospitalized. She received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences. After graduation, Emilie completed a postgraduate pharmacy residency at Bon Secours Memorial Regional Medical Center in Virginia. Her background includes caring for critical care, internal medicine, and surgical patients.

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