Hashimoto’s & Hypothyroidism – Essential Cofactors for Thyroid Hormone Conversion

With January being Thyroid Awareness Month, I thought it would be an ideal time to take a deeper dive into last month’s topics: Hashimoto’s autoimmune thyroiditis and hypothyroidism. In that post, I discussed the similarities and differences between Hashimoto’s and hypothyroidism — and I briefly explained how certain nutrients like selenium, iron, zinc, and iodine are required for effective thyroid hormone production, secretion, conversion, and metabolism. 

But what does all of this mean, exactly, and why does it matter? Let’s take a closer look at these four essential nutrients for thyroid function and discuss why they’re so important for effective thyroid hormone production as well as our overall health and well-being!

Essential Nutrients & Their Impact on Thyroid Health

Also known as thyroid cofactors, selenium, iron, zinc, and iodine are four essential nutrients that play a massive role in thyroid hormone production, secretion, and metabolism. Our bodies rely on these and other nutrients to produce thyroid hormones, convert inactive thyroid hormones to their metabolically active form (more on this later), and move the metabolically active form of these hormones into our cells. And last but certainly not least, these essential nutrients are needed to support healthy thyroid function. That’s why we call them “essential”, after all!

If our cells don’t have adequate amounts of these essential nutrients available to use when needed, our endocrine glands (for example, our thyroid and pituitary glands) cannot properly produce, secrete, convert, and metabolize the hormones required for optimal thyroid function (more on these below). The result? Symptoms of an underactive thyroid or overt hypothyroidism, in many cases. Common hypothyroidism symptoms include fatigue, cold intolerance, hair loss, brittle nails, weight gain, and dry skin. 

Thyroid Cofactors, Hashimoto’s, & Hypothyroidism

When patients report experiencing hypothyroidism and/or Hashimoto’s symptoms, a good starting point is to test them for potential nutrient deficiencies (or insufficiencies) in addition to testing their thyroid antibodies and thyroid hormone levels. But unfortunately, most conventional medical doctors only look at thyroid hormones when making a diagnosis of thyroid dysfunction. 

If thyroid hormone tests are inconclusive, conventional medical practitioners may examine the thyroid gland via a thyroid ultrasound as a next step. Additionally, they may look at thyroid antibodies when Hashimoto’s autoimmune thyroiditis is suspected. 

Despite what these tests may show; however, the standard treatment for Hashimoto’s and hypothyroidism is the same: levothyroxine (or thyroid hormone replacement therapy). Levothyroxine is the most commonly  – and only remedy – prescribed medication for Hashimoto’s and hypothyroidism (even though Hashimoto’s thyroiditis and hypothyroidism are two different conditions!). 

This is why so many patients continue to experience symptoms despite starting treatment for an underactive thyroid and/or Hashimoto’s thyroiditis! Oftentimes, additional steps need to be taken to modulate the immune system, correct nutritional deficiencies, address toxins, and more.

Tests for Hypothyroidism, Hashimoto’s, & Thyroid Nutrients

So while Hashimoto’s thyroiditis and hypothyroidism are two different conditions (remember, the former is an autoimmune disease and the latter is a thyroid hormone disorder), both can affect thyroid hormone metabolism and thyroid gland function if left unaddressed and untreated. As such, nutrients like iron, iodine, zinc, and selenium matter regardless of whether a patient has Hashimoto’s, hypothyroidism, or both (and also for preventing these conditions from developing in the first place!).

These essential thyroid nutrients affect the production, secretion, conversion, and metabolism of hormones such as:

  • Thyroid-stimulating hormone (TSH).
  • Total thyroxine (T4).
  • Total triiodothyronine (T3).
  • Free thyroxine (FT4).
  • Free triiodothyronine (FT3).
  • Reverse triiodothyronine (rT3).

We’ll discuss the importance of free T3 and free T4 below!

Free T3 & T4 for Thyroid Hormone Conversion

Measuring a patient’s free T3 (FT3) and free T4 (FT4) is a crucial step when Hashimoto’s or hypothyroidism symptoms are present, as these results tell us how well the body is converting T4 (the metabolically inactive thyroid hormone) to T3 (its metabolically active form). Metabolically active means the hormone is free (or available) for our bodies to use when needed. This is the hormone that enters the cells and affects the body!

Lacking adequate amounts of selenium, iron, zinc, and iodine; however, affects proper thyroid hormone conversion. T4 is the inactive thyroid hormone that needs to be stored in the body and converted to T3 in order to become metabolically active — and essential nutrients are needed to make this happen. 

Furthermore, other biochemical processes are involved – either directly or indirectly – in the activation process.

  • Methylation, which is the biochemical means by which the body mediates the activity of many genes as well as the activity of B-Vitamins that are involved in thyroid hormone conversion.
  • Oxidation is a normal byproduct of every living cell; which is usually mitigated by anti-oxidant enzymes that require nutrients like selenium to function. In situations of nutrient deficiencies, these anti-oxidant enzymes often cannot work to their full capacity, leading to increased oxidative stress, and which that, increased inflammation which impacts the conversion of thyroid hormones as well as the production of thyroid antibodies.

When patients present with signs and symptoms of thyroid problems (or they suspect they could have hypothyroidism and/or Hashimoto’s autoimmune thyroiditis), I like to run the thyroid hormone tests listed above (e.g. TSH, FT4, and FT3) and a few others such as:

  • Iron, zinc and zinc-copper balance.
  • Depending on the situation, other nutrients like, magnesium, vitamin D,  and B vitamins. 
  • Other nutrients such as iodine, selenium, taurine and essential fatty acids (such as omega 3’s) are highly important; however, testing is more complicated and often times these nutrients are substituted based on clinical need rather than testing measures.
  • Markers of oxidative stress and methylation capacity, like Total Oxidative Stress (TOS) and Homocysteine.
  • Thyroid Antibodies, namely: Thyroid peroxidase antibodies (TPO) and Thyroglobulin antibodies (TG).
  • Thyroid stimulating hormone receptor antibody (TSI) to distinguish other thyroid conditions from Grave’s disease.
  • Reverse T3 (rT3).
  • Depending on the situation, sex hormones and stress hormones such as cortisol.

If nutrient deficiencies are indeed playing a role in a patient’s thyroid-related symptoms, addressing these deficiencies can make a positive difference in how they feel!

Depending on the specific situation, addressing nutrient deficiencies (or insufficiencies) may include dietary changes, supplementation, stress management, self-care, and other lifestyle interventions. 

Foods such as saltwater fish and seaweed, for instance, are rich in iodine — while selenium can be found in red meats, chicken, fish, and Brazil nuts. Spinach is an excellent source of zinc, and many dark leafy greens are rich in iron. These are just a few of the many nutrient-rich foods that can help to support thyroid hormone conversion and function!

Book Your Naturopathic Functional Medicine Visit!

If you’re experiencing signs and symptoms of thyroid problems, suspect you could have a nutrient deficiency, or are still feeling poorly despite taking medication for Hashimoto’s or hypothyroidism, please call +971-800-6686 to book an appointment with me. We’ll use a variety of approaches to get to the root of your symptoms and reestablish the natural balance within your body! 

Ready to get to the root of your Hashimoto’s or hypothyroidism symptoms this Thyroid Awareness Month? Do you suspect you have Hashimoto’s disease or an underactive thyroid?

Connect with me to learn how naturopathic functional medicine can help!


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