Guide to Hypothyroidism

 Overview

The thyroid gland produces two different types of hormones, the iodothyronines and Calcitonin. While calcitonin plays a huge role in our bodies, it will be the iodothyronines that we will focus on as they are the major players in thyroid disorders. So, what are the iodothyronines and what functions do they serve in the body?

There are two different kinds of iodothyronines (which will be referred to as "thyroid hormones" from here on out) and they are thyroxine (T4) and triiodothyronine (T3). These two hormones are absolutely essential and necessary for body development, growth and energy metabolism among other things. Thyroxine (T4) is what is known as a "prohormone" meaning that on it's own, it has little to no effect and must be converted in the body to the biologically active form which is triiodothyronine(T3). There are many steps that go into the process of producing these thyroid hormones in the thyroid gland. It can certainly get confusing and complicated but most important parts to understand about the process are:

· It is essential to have the necessary amounts of iodide available in the body (iodide is a single ion whereas iodine is a compound). Not having the necessary amount of iodide in the body can lead to a lack of hormone production and an enlarged thyroid gland, also known as a goiter.

· Having the appropriate amount of another hormone known as thyroid stimulation hormone (TSH) is also essential. TSH is a hormone that signals the thyroid to make thyroid hormone. TSH comes from the pituitary gland.

The ability of your body to convert the T4 hormone into the T3 hormone.

The last point in an interesting one. As mentioned in the opening paragraph, T4 is a prohormone and it not very active in the body by itself. It needs to be converted to the active form, T3. Our bodies actually produce MUCH more T4 than it does T3! In fact, about 60-80% of the thyroid hormones that are body produces is T4 and must be converted to T3. While our thyroid does produce some T3 on its own, the vast majority of the T3 that is in our body at any given time has been converted from T4. So it's pretty clear that the conversion of T4 to T3 is hugely important to the proper functioning of our bodies. Unfortunately, some people possess a decreased ability to perform this conversion and because of this, they need different medications than someone who is able to properly convert the hormone.

So what are the functions of the thyroid hormones?

They play a huge role in brain and total body development.

They regulate energy expenditure in the body and also regulate how your body takes in and consumes oxygen.

They influence many different aspects of heart function includes how hard and how fast it beats.

They greatly impact of bodies metabolic processes including how we metabolize our food and how our body deals with fat and cholesterol.

Causes

Disorders of the thyroid can result in either too much or too little production of the thyroid hormones. When a medical practitioner wants to test how your thyroid is working, they typically will order what is known as a thyroid function test (TFT). Two of the most common tests that are performed measure two things in your body, TSH (thyroid stimulation hormone) and the amount of T4 in your body. There are additional tests as well, but these two are by far the most common. While we won't spend much time discussing TSH, it is important to know that TSH does not come from the thyroid itself, but from the pituitary gland. TSH stimulates your thyroid to produce more thyroid hormone.

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The most common disorder of the thyroid is hypothyroidism (low thyroid hormone). Hypothyroidism is actually divided into three separate categories, based on what the cause of hypothyroidism is.

Primary hypothyroidism - This occurs in people that who cannot, for a variety of reasons, produce enough thyroid hormone themselves.? The reasons include an autoimmune disorder known as Hashimoto's disease and insufficient iodine intake. In developed countries of the world, insufficient intake of iodine is extremely rare. Iodine is most commonly added to table salt (ever wonder why salt is commonly sold as iodized salt?) and we therefore generally intake sufficient amounts.