Hypothyroidism – A bigger problem than we think?

Currently 5-10% of the population is diagnosed with hypothyroidism, however some experts estimate that between 25-40% of the adult population has suboptimal thyroid function.

Thyroid hormones regulate the activity of mitochondria, the energy powerhouses, in every single cell in the body, therefore they have an effect on virtually all of our bodily functions. So when we have a deficiency of thyroid hormones, symptoms can be wide-ranging and non-specific having a detrimental effect on overall health and often being mistakenly diagnosed for something else.

Sub-optimal thyroid function could therefore be a factor in many more conditions than is currently realised, and should be considered particularly in patients who do not respond well to interventions for other conditions.

Symptoms of low thyroid function include but are not limited to:

  • Depression
  • Difficulty losing weight
  • Dry skin
  • Headaches
  • Lethargy or fatigue
  • Memory problems
  • Menstrual problems
  • Hyperlipidaemia
  • Recurrent infections
  • Sensitivity to cold
  • Thinning of head hair
  • Voice changes

Thyroid hormones

Thyroid hormone activity is tightly regulated.  Firstly, the hypothalamus releases thyroid hormone releasing hormone (THRH), which stimulates the pituitary to release thyroid stimulating hormone (TSH).

TSH triggers the thyroid to produce T4 (thyroxine), a tyrosine molecule bound to 4 iodine molecules. About 20% of T4 is converted in cells into T3 (triiodothyronine, which is 4 times more potent than T4), by the removal of one iodine. Poor conversion may occur due to lack of co-factors or T4 may be converted to reverse T3; an inactive molecule still with a tyrosine and 3 iodine molecules but with a different structure to T3 and which can inhibit the action of T3. Any one or more of these pathways can be interrupted leading to hypothyroidism.

  • Primary hypothyroidism – low T4 or T3 and high TSH (it can also be high T4 but low T3 because of poor conversion e.g. due to lack of cofactors such as selenium and zinc)
  • Secondary hypothyroidism – low T4 and TSH, poor pituitary release
  • Tertiary hypothyroidism – low production of THRH from hypothalamus
  • Autoimmune – production of antibodies against the thyroid gland
  • Wilson’s syndrome – normal levels of T4 and T3 but high levels of rT3

Hypothyroidism will be diagnosed with blood tests to measure TSH and T4, alongside specific symptoms. Occasionally T3 and rT3 will also be tested. Factors that lead to increased rT3 production include stress, dieting and low iron levels. It is thought to be a way for the body to reduce metabolic rate so as to conserve energy, as rT3 inhibits the action of T3.

It is quite common to have subclinical hypothyroidism, where no diagnosis will be made based on blood tests as results are within the normal range. However thyroid function is not optimal and therefore individuals can experience vague symptoms which are treated with weight loss diets, antidepressants, statin medications, IVF etc. whereas the actual problem is thyroid dysfunction.

Subclinical hypothyroidism can be consistent with the above symptoms as well as a low basal body temperature (temp below 36.5oC taken immediately upon waking, although this can also be affected by adrenal, immune and menstrual function) and the Achilles reflex test (slowed in hypothyroidism), as well as suboptimal blood results or auto-antibodies.

If you are diagnosed with hypothyroidism you will likely be prescribed thyroxine (artificial T4 thyroid hormone) which can help to alleviate many associated symptoms. However, this is if T4 can be adequately converted to T3 – if selenium or zinc are low then this conversion may not work well and people may remain symptomatic.

For people with subclinical hypothyroidism there is little medical support available. It is possible, however, to support thyroid hormone production with nutritional interventions.

Key Nutrients

Many nutrients can be used to support thyroid health but these are the ones which are directly involved in the production of thyroid hormones:

Tyrosine – An amino acid that is a major constituent of T4, should not be supplemented along with thyroid hormone replacement medications e.g. thyroxine unless under the supervision of a qualified medical practitioner.

Iodine – four iodine molecules are combined with tyrosine to produce T4, should not be supplemented along with thyroid hormone replacement medications unless under the supervision of a qualified medical practitioner.

Selenium – a cofactor for the enzyme which manufactures T4, and the enzyme which converts T4 into T3.  Supplementation has also been shown to lower auto-antibodies to thyroid hormones.

Zinc and copper – cofactors for the conversion of T4 to T3.

A deficiency of any of these nutrients may lead to reduced levels of thyroid hormones.


Goitrogenic foods including soy and raw brassica vegetables (in large quantities) can bind to iodine, making it unavailable to the thyroid, thus inducing an iodine deficiency. Cooking inactivates this action therefore it is not necessary to avoid these foods but they should not be consumed raw in excess.


When we are under physical, psychological or environmental stress our adrenal glands release cortisol. High levels of cortisol can interfere with the conversion of T4 to T3, leading to a reduction in T3, and have been shown to increase rT3. Therefore, stress management and adrenal support is vital when supporting the thyroid. The adrenal glands should be supported both with diet and lifestyle.

Vitamins C, B5 and B6  support normal adrenal function and cortisol production.

Magnesium is considered a natural tranquiliser due to its function to relax both skeletal and smooth muscle. It is also an essential cofactor for many enzymes involved in the production of adrenal hormones and therefore is depleted in times of stress.

Phosphatidyl serine has inhibitory effects on HPA (stress) axis – it has been shown to lower cortisol levels.

Adaptogenic herbs, such as Ashwagandha, Siberian ginseng, Panex ginseng and Rhodiola, modulate the stress response.

Lifestyle –  many lifestyle factors can help to reduce cortisol levels and calm the mind and body here are a few examples:

  • Meditation or mindfulness
  • Moderate, enjoyable exercise
  • Yoga
  • Reading


Local conversion of T4 to T3 by the enzyme intestinal sulfatase in the gut is supported by healthy intestinal bacteria. Lipopolysaccharide (LPS) produced by dysbiotic bacteria inhibits this enzyme, again reducing T4 to T3 conversion. Therefore, in order to support conversion of T4 to T3 a healthy gut flora should be encouraged.

For example, by consuming prebiotic and fermented foods such as: chicory, apples, Jerusalem artichoke, dark green leafy vegetables, olives, plain yoghurt, kefir, raw sauerkraut and kimchi; and taking a live bacteria supplement, containing a wide variety of beneficial strains.


Hashimoto’s disease is a form of autoimmune hypothyroidism. Onset of Hashimotos’ disease has been associated with coeliac disease as well as non-coeliac gluten sensitivity. Gluten has been shown to cause local inflammation of the enterocytes which line the digestive tract.

Gliadin found in gluten can activate zonulin which has a negative effect on the permeability of the gut leading to damage and the progression of leaky gut. When this happens larger proteins, allergens and toxins are allowed into the blood stream. This can lead to systemic inflammation and triggers immune complexes, which have the potential to produce antibodies against proteins that are similar to our own body tissues, and therefore lead to autoimmune disease.

In order to help modulate autoimmunity the health of the gut should be considered as well as immune modulating nutrients:

  • Remove gluten and casein which have been shown to have a detrimental effect on gastro-intestinal permeability
  • Glutamine, found in bone broths or as a supplement, supports the repair of the gastro-intestinal lining
  • Vitamin D3 – T helper 1 (Th1) is an essential part of the innate immune system, particularly in response to infection. However, the balance of Th1 cells with T helper 2 (Th2) cells needs to be tightly regulated. Excess Th1 compared with Th2 for prolonged periods of time, in the absence of acute infection, is known as Th1 dominance and is associated with tissue specific autoimmune diseases such as Hashimoto’s. Research has shown that D3 can reduce Th1 dominance.
  • Reduce exposure to xenobiotics which have been shown to increase thyroid autoantibodies. See Cytoplan blog: Planning and implementing a detox for ways to reduce exposure and support detoxification.


Inflammation is at the heart of most chronic diseases particularly autoimmune diseases, the Western diet and lifestyle tends to promote inflammation. It is essential that inflammation is reduced as much as possible in all people including those with reduced thyroid function. Pro-inflammatory cytokines have been shown to depress levels of circulating T3 and may interfere with the HPT (hypothalamus-pituitary-thyroid) axis. The following can help to reduce inflammation:

  • Reducing foods high in omega 6 – e.g. farmed meats, dairy products and vegetable oils (such as sunflower and corn oils).
  • Increasing sources of omega 3 from e.g. oily fish and flax, chia seeds and/or a supplement containing EPA.
  • Curcumin – found in turmeric, has been shown to inhibit Cox-2 enzymes which produce inflammatory prostaglandins.
  • Obtaining good levels of vegetables (6-8 per day) including dark leafy greens high in anti-inflammatory phytonutrients and antioxidants.

T3 Receptor Binding

It has been shown in patients with hypothyroidism that the ability for T3 to bind to receptors in the mitochondria can be diminished. This can be due to genetic mutations but can also be affected by nutrient status:

Vitamin A regulates retinoic acid which interacts with thyroid receptors and may improve thyroid hormone activity.

EPA/DHA improves gene transcription in relation to thyroid receptor function.

Zinc is a cofactor for thyroid receptor production.

As with many if not all chronic conditions there is rarely one factor that leads to disease onset, therefore all of the above should be considered when optimising thyroid health. Thyroid health should always be considered in individuals with conditions associated with symptoms of low thyroid activity such as CFS, fibromyalgia, depression, weight gain, cognitive decline and sub-fertility but this list is not exhaustive.

For further information about supporting thyroid health, the effects of low thyroid function and support for those with thyroid conditions visit Thyroid UK website, www.thyroiduk.org.uk.

If you have any questions regarding the topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.

amanda@cytoplan.co.uk, 01684 310099

Amanda Williams and the Cytoplan Editorial Team: Joseph Forsyth, Emma Williams, Simon Holdcroft, Clare Daley and Helen Drake

Related Cytoplan Products

Thyroid Support  

Thyroid Support has been developed to offer a Wholefood base multi mineral supplement to support thyroid health. Thyroid support contains Kelp, L-Tyrosine plus active nutrients to help ensure optimum levels of naturally-occurring thyroid hormones.

Adrenal Support

Adrenal Support contains a combination of vitamins, minerals, herbs, nutrients and plant extracts that may help support healthy adrenal function especially during stressful periods. This includes optimum levels of beneficial Food State™ pantothenic acid (vitamin B5), liquorice, ginseng and iodine.

Organic Kelp

Cytoplan’s kelp supplement comes in gluten-free capsules and contains 3 species of wild bladderwrack (the type of seaweed). The kelp is not only an organically rich source of iodine but also naturally ‘nutrient dense’ containing a broad spectrum of minerals, trace elements, micro-nutrients and vitamins, prebiotics and carotenoids. These act as catalysts in the body and stimulate vital enzyme reactions.

Acidophilus Plus

Acidophilus Plus contains Lactobacillus Acidophilus and 8 further live native bacterial strains, plus a small amount of prebiotic. This blend of native bacterial strains is designed to have activity throughout the whole GI tract.

Those on thyroid medication should consult their doctor before taking these products.


Last updated on 1st June 2018 by cytoffice


31 thoughts on “Hypothyroidism – A bigger problem than we think?

  1. Ooo-er. I am almost as baffled as when I started. For years I have felt I had thyroid problems but doctors tests tell me I am “normal” whatever that is. There are so many suggested supplements here (many of which I take anyway) that I am left wondering what to do for the best. It might help if there were an addition to this article suggesting step by step actions. Try this and this for a month, if no improvement try this and this,,, and so on. But how does one check for “improvement” ?
    Bottom line – I suppose – there is no substitute for a one to one, face to face investigation and a personal diagnosis – but how on earth does one go about that when mainstream doctors only use the standard test and tell you there is nothing wrong.

    1. To Mrs Soar, I too have realised after reading Dr Peatfield’s book on Your Thyroid, that I have been ‘Hypo’ for much of my life, but test results always came back ‘normal’ Seeing a naturopathic doctor, using a good multivitamin and mineral , and moving to a veggie diet plus a lot of fish, with occasional venison or organic chicken, turkey, duck, plus no sugar or alcohol seem to have sorted out my digestive system. I have noticed over many years, that in the summers, (more Vit D), when I eat a lot more home grown fruit and veg I feel even better.
      I ensure the gut biome is working well and helping process and absorption of food nutrients, with pro and pre biotic pills every few weeks, for a few days if I feel a bit “down” Could be a good place to start.
      Something not always considered is WiFi and cell phone proximity especially screen use in the evening and at night, which has effects on all cells, our neurological systems and sleep– all vital for a healthy body.
      Good luck with your progress in this. It has taken me 5 or 6 years of research and experiment, but is worth it to feel well

      1. Wendy – I had to giggle when I saw your ‘veggie’ diet – with chicken, turkey, duck, venison and fish.
        My diet has been thus for years – with home grown veg. There is nothing wrong with my digestion apart from the fact that the contents move rather slower than I would like. My main problem is too much avoirdupois and regular bouts of feeling knackered. I try to avoid WiFi as much a possible,. and I use F.lux to turn my screen light brown after dark.

    2. A very good article, which I read fllowing the article on chronic fatigue. I wish I had had them when I had chronic fatigue in the eighties, then everybody thought it was psychological and treated you for depression.

      The subclinical thyroid is also very useful as I have symptoms and don’t show up as such on tests. The problem is for all of us that we need a NHS based on or combining complementary medicine with the less aggressive of the allopathic stuff. It would be cheaper too.

      On a different subject; does anyone know of a vitamin C, or can you produce one, in powder form based on natural plants, capable of being mixed with lyposomes for high dosage. Will your oranges based one do it?

    3. Mrs Soar,
      I’d advise you follow HeathUnlocked:Thyroid; Thyroid UK; Stop the Thyroid Madness (Facebook and the book by Janie Bowthorp) and Hypothyroid Mom (ditto) for starters. You can test your own blood privately at home using kits as advised by Thyroid UK, which will look at far more than NHS which only tests TSH and T4. Good luck.

  2. Very interesting article especially the comment about Omega 3 and 6 , which on our Vegan diet can be difficult to obtain enough Omega 3 if one doesn’t eat Chia seeds and Flax .

  3. A good article except for one thing. You recommended raw sauerkraut for gut health but this should not be eaten by anyone with hypothyroidism. Fermentation does not alter or reduce the goitrogens in brassicas, only cooking does.

  4. Can you tell me where you get your organic kelp from please? I am concerned to avoid not only radioactive iodine from kelp growing in the path of the waters effected by the Fukushima nuclear plant disaster, but also in waters that might contain high levels of bromine, as this will be taken up by the same receptors in the kelp (and in humans) as the iodine receptors. Although you state that your kelp is ‘organic’ do you analyse it for the two factors I have mentioned? I have asked other suppliers about this and they do not seem to have an answer.
    Thanks – Afifah

  5. I have struggled to lose weight for many years now, despite being healthy and regular excersise, my weight seems to increase, have had blood tests from the doctor and all has come back normal, I am convinced there is something not quiet right, where can I go to find out exactly as reading all the information just gives me information overload.

    1. Always ask for the number on your TSH test, the receptionist sometimes tells me mine is “normal” at 4 (but I always ask what the result is), but I want to be “Optimal” therefore I aim for just under 1, which makes a massive difference in how I feel. I am Hypo & have Hashimotos.
      Sadly with Thyroid issues, if you’re in the UK, you have to research a lot & do all the hard work.
      Fab article!

    2. I have also struggled with being overweight and hypothyroidism. The naturopath I see suggested I tried the Cura Romana diet by Leslie Kenton. I am now 2 stone lighter after 3 months and have discovered what foods my body likes and some surprising foods that it doesn’t e.g. almonds. You need to take the Cura Romana essential spray (beware of fakes). You can get it from Helios Pharmacy.

    3. I had normal thyroid results apart from positive TPO. I put on loads of weight and despite eating a good diet and exercising, I couldn’t lose it.
      Eventually a private GP put me on Levothyroxine and Liothyronine as I don’t convert T4to T3
      What I have discovered is that exercising too much isn’t good for the thyroid and the way I found to lose 2 stone was following the Cura Romana diet by Leslie Kenton. This diet helps you find out which foods make you put on weight, in my case, pork, almonds, yogurt and wheat.

  6. Hi. Having been diagnosed with ME/fibromyalgia over the last 14 years, and my GP refuse to do a full thyroid check, earlier this year I paid for a private test to find that I have a high keel of reverse T3. On presenting the results to my GP, he lectured me on ‘normal’ parameters and showed me the door saying all he could offer me was a mental health assessment. Which I found insulting and extremely upsetting. what would you recommend in supplementation to help reduce a high reverse t3. Thank you

  7. There is so much about hypothyroidism , I miss so much more about hyperthyroidism as it `s rather common in Dk. Otherwise thank you for your good information. Best wishes Lise Lotte P-N.

  8. I’ve had hypothyroidism for few years now and it’s nearly been a month I’ve been taking Cytoplan thyroid support supplements. Ive realised taking these supplements has helped me a little bit like sometimes I’ll feel normal like nothings wrong with me. But sometimes I feel lazy and moody ( l don’t know if that’s because of the menstrual cycle). I guess it’s only been a month taking these tablets so I will still continue taking these for 3 months as I have a blood test to see if my Thyroid function is improving. That’s when I’ll know if these supplements are helping or not.

  9. I also have a question.
    Does hypothyroidism have any effect on our heart beat????
    I’ve been having abnormal heart beat for e.g. sometimes its very fast and beats very hard i can feel it throbbing and sometimes very slow.

  10. I have hypothyroidism and take 125 thyroxine a day but I am still tired and overweight. I have also been diagnosed with ulcerative colitis so I would be grateful if you could recommend a supplement that would help. Thank you

  11. Might be helpful to point out that in areas where the water is fluoridated, thyroid function will be depressed. People should use appropriate filters (usual kind not up to the job) to remove this toxin or buy bottled water.

  12. Where does your Kelp come from? The unfolding nightmare,hell on earth, Fukashima; makes this an important question.

    1. Dear Tony

      Thank you for your question about our Organic Kelp. Our kelp comes from waters around the Outer Hebrides, from a sustainable organic source, it is tested and guaranteed free of all impurities and pollutants including radiation. I hope this answers your question. If you have any other questions please do contact me – clare@cytoplan.co.uk

      Best wishes

  13. I have hypothyroidism plus vitiligo and two types of alopaecia.
    Two close members of my family have chrons disease and caeliac disease.

    I wonder if I would benefit from a gluten free diet. Have you come across this link in your findings.

    1. Hi Rita,

      Thank you for your blog comment. Yes a gluten free diet is something that I would recommend. However, first visit your GP and ask to be tested for coeliac disease. You need to be regularly eating gluten for this test to be valid. Testing for coeliac disease is now recommended in the NICE guidelines for those with a diagnosis of hypothyroidism. When you have had the test done, then remove gluten from your diet. Even if the result is negative there is a related condition called “non coeliac gluten sensitivity” which will not be picked up by this test. If you switch to gluten-free it is important to identify and remove all sources of gluten. When eating gluten free aim to choose foods that are naturally gluten free eg sweet potatoes, quinoa, buckwheat flour, rice etc rather than “gluten-free products” which are highly processed. It is ok to eat gluten-free products on an occasional basis but some people when switching to gluten free over-rely on them. Also bear in mind that wheat etc provides a significant percentage of the fibre intake in our diet (>70%) so you need to ensure you eat lots of vegetables (and nuts/seeds, fruit) to obtain adequate fibre. We do have a handout detailing foods to avoid etc when eating gluten free. Please email me if you would like a copy clare@cytoplan.co.uk. See also a blog we have written on the subject. I hope this helps.

      All the best,

  14. I am worried about my granddaughter and what the family can do to give her the best possible chance of not developing thyroid problems. Let me explain my mother had overactive thyroid, her sisters had thyroid issues, I have under active thyroid. My daughter has overactive thyroid and is on carbemazole. Her husband had overactive thyroid until he had iodine treatment but is now obviously under active and takes 100 mcg of thyroxine as do I. My question is the doctors are doing a ‘watching brief’ on my granddaughter who is 10 years old until she reaches pubity. Is there anything that she could take to offer her the best chance of not getting a thyroid issue or are the indications not good?

    1. Hi Margaret,

      It is good that the Doctors are keeping an eye on your granddaughter. With the family history it is possible that she has an increased susceptibility to thyroid problems, but with careful diet and lifestyle applications any susceptibility will be modifiable.

      If you would like some advice from one of our Nutritionists, we can assess any predisposing factors in her present diet and lifestyle that can be addressed before symptoms occur. Diet, lifestyle and genetics all play a part in an individual’s susceptibility to thyroid problems, but it is a good idea to start understanding how these can be modified ahead of symptoms occurring.

      We do offer a free health questionnaire. If you would like to complete and return a health questionnaire, we will send you some written diet and supplement recommendations.

      I hope this helps.
      All the best,

      1. Hello Kate thank you for your quick response. I have printed off the six page questionnaire and will send this to Cytoplan as I have been a purchaser for many years. Please feel free to e mail me direct at the address given to you. Thank you again.

  15. Is it possible to stop taking thyroxine and use thyroid supporting supplements instead? I’ve been on 75mcg thyroxine for the last 20 ish years. I’m now 73

    1. Hello Ruth,

      Thank you for your question on our blog. No you cannot stop taking thyroxine and switch to thyroid supporting supplements instead. Also if you are taking thyroxine, then our Thyroid Support supplement would not be suitable. There are however other things that you can take – I would suggest an all-round multivitamin and mineral, some fish oil and a friendly live bacteria supplement as foundation support. Some people may also find some supporting the adrenals to be useful. For more tailored advice you might be interested in our free health questionnaire service – if you complete and return a health questionnaire, we will send you some written diet and supplement recommendations. In the meantime, the products I suggest are:

      CoQ10 Multi – start with 1 per day, after 7 days increase to 2 per day
      Krill Oil (2 per day, however if taking any other medications please check with us first whether this is suitable. For example a lower dose would be necessary with blood thinning medication)
      Fos-A-Dophilus – live bacteria – 1 per day at the end of a meal

      As mentioned above, please do not stop taking your thyroid medication.

      Best wishes, Clare

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