Everything about the thyroid

“Glandula Thyreoidea”, a name that at first makes you think of a houseplant. In fact it is the official term for the thyroid: a vital hormone gland in our body that influences metabolism, growth and numerous other bodily functions. Its job: to release a certain amount of thyroid hormones into the blood at all times. If the metabolism needs more energy in particular situations (for example in the cold, during growth or during pregnancy), the thyroid adjusts its hormone production and gives the necessary push. What a great system.

The thyroid sits at the front of the neck. More precisely: directly below the larynx, where it nestles around the windpipe. It consists of two larger lobes and a band of tissue connecting them. This appearance has earned the thyroid the nickname “butterfly organ”. Its proper German name “Schilddrüse” (shield gland), thought through in classic scientific fashion, comes instead from its position. It sits at the part of the larynx known as the thyroid cartilage, in German the shield cartilage.

The tissue of the thyroid consists of many individual lobules, each wrapped in a fine layer of connective tissue. Inside the lobules are vesicles, the follicles, in which the thyroid hormones T3 and T4 are stored as small droplets. Below or between these vesicles, in the connective tissue of the thyroid, you find so-called C cells, either singly or in groups. They produce the hormone calcitonin, which influences the calcium and phosphate balance. The counterpart of calcitonin, parathyroid hormone, is formed in the parathyroid glands. They are attached to the thyroid lobes, that is to the butterfly wings.

The job of the thyroid described in one word? Regulation. In the area of metabolism, the various hormones formed in the thyroid influence, for example, whether you wake up, feel hungry or feel full. In the psychological area they can control, for example, whether you are all nervous and wound up or whether you are relaxed and take everything in your stride. So depending on what fits the moment, the thyroid mixes you the right hormone cocktail, like a barkeeper.

But how does our “in-house barkeeper” know when we need a little more push and when relaxation mode should set in? The brain is responsible for that. More precisely: the pituitary gland (the hypophysis) and the hypothalamus (a part of the diencephalon that sits directly above the pituitary gland).

If there is too little T4 in the blood (the hormone stored in the vesicles of the thyroid lobules) or if body temperature drops, the hypothalamus registers this and starts what amounts to a domino effect in the body. It begins by stimulating the production of TRH (thyroliberin). This TRH stimulates the production of TSH (thyrotropin) in the pituitary gland. Finally, TSH stimulates the production of T4 and T3 (triiodothyronine) in the thyroid. The concentration rises and everything is back in order. This chain of dominoes is also called the thyrotropic control loop.

The thyroid regulates our body by forming hormones. The most important ones are: T3, T4, calcitonin and parathyroid hormone. But where are these hormones formed and how do they work?

According to the German Thyroid Centre, around one third of adults in Germany have a thyroid disorder. The frequency rises with increasing age. On the Foodpunk blog you will find a detailed article about nutrition with thyroid problems.

• They lead to increased muscle activity and thereby raise body temperature.
• They raise oxygen consumption and stimulate breathing.
• They increase heart activity, that is heartbeat and blood pressure.
• They act on fatty tissue and on the lymphocytes.
• They stimulate the breakdown of fatty tissue and lead to faster breakdown of cholesterol.
• They stimulate the release of insulin from the pancreas.
• They stimulate protein biosynthesis and, at an extremely high concentration, lead to increased protein breakdown.
• They influence the development, differentiation and growth of all body cells.
• They are important for the development of the nervous system and the brain.

The thyroid is the central hub for metabolism and for the development of many body structures. A disturbance of its function often comes with severe limitations for those affected. In general, three forms of imbalance in the thyroid system are distinguished: goitre, hypothyroidism and hyperthyroidism.

A struma, usually called a goitre in everyday speech, is an enlargement of the thyroid. It can be so subtle that you can neither see it at first glance nor feel it. But there are also cases in which the thyroid reaches the size of a football. In Germany a goitre usually develops because of iodine deficiency. Because the building block iodine is missing, not enough T3 and T4 is formed. TSH signals a deficiency to the thyroid, which tries to raise production by enlarging its cells. In addition, new blood vessels and connective tissue form. Step by step a goitre develops.
Other possible causes are, for example, inflammation, an underactive thyroid, malignant tumours or certain medicines.

With an underactive thyroid, the thyrotropic control loop is disturbed. A high TSH value gives the thyroid the signal to produce T3 and T4. Because it is not working properly, it cannot produce enough to bring the hormone level back into balance. Accordingly, more TRH is released, which raises the TSH value again, the production of T3 and T4 is stimulated once more, but not enough can be produced, and so on.

With an overactive thyroid there is a low TSH value in the blood (TSH: the value that says “the lower I am, the less T3 and T4 needs to be produced”). The thyroid is therefore led to believe that hormone production should be wound down. But because it is “overfunctioning”, too much is produced anyway. The concentration of T3 and T4 becomes too high, so that only a reduced amount of TRH is released. This again produces a low TSH value in the blood and the cycle starts over.

Another possible cause of hyperthyroidism is a disorder of the pituitary gland. In that case the pituitary gland produces more TSH than it should. The consequence: the thyroid is stimulated into excessive hormone production.

An overactive thyroid can also develop from an extremely high iodine intake. Contrast agents that are sometimes used in X-ray examinations can contain iodine and thereby stimulate hormone production. But a continuously excessive intake through iodine-rich foods (algae products) can also lead to overactivity.

As you can partly tell from the names, thyroxine and triiodothyronine contain iodine atoms. So it is important to take in enough iodine through your diet so that the thyroid can use it. One option is to take in iodine through sea fish (for example plaice, salmon and cod) or algae. A supply through animal and plant foods from farming, such as dairy products, eggs, broccoli, spinach, kale or meat, is also possible. However, the iodine content in German arable soils is often too low to supply us adequately. That is why Germany has had a recommendation to iodise table salt since 1980.

But careful. Please do not order the nearest iodine supplement from the online shop straight away. Iodine can also be overdosed and should only be taken in the recommended amount. According to the German Nutrition Society (DGE), an age-dependent iodine intake of 40 to 80 micrograms a day is recommended for infants and 200 micrograms a day for adolescents and adults. The recommended amounts for pregnant and breastfeeding women are somewhat higher, at 230 to 260 micrograms a day, since the supply for the baby has to be included. In Germany a maximum recommended daily dose of 500 micrograms applies. This value is not exceeded by a normal diet.

At Foodpunk we generally use sea salt, rock salt, mountain salt or Himalayan salt in our programmes, none of them iodised. Instead our plan contains a wide variety of fish and seafood. Now and then you can also build algae into your diet (for example nori sheets, used for sushi) or use a high-quality algae or iodine supplement. One more tip: in health food shops you can get iodised herb salt or iodised rock salt.

Even if you think “that is obvious, iodine stimulates the production of thyroid hormones, so bring it on”, you should not be hasty. While with an underactivity caused by an iodine deficiency the intake of iodine-rich foods can help, with Hashimoto’s it is unfortunately the wrong move and can lead to a worsening of the symptoms. So you should not simply take in more iodine and hope for the best, but first clarify what the cause of the hypothyroidism is.

Selenium is an important component of the deiodinases, the enzymes responsible for removing an iodine atom from T4 and thereby for the formation of T3. It can therefore help to ease the symptoms of a deficiency. However, a selenium deficiency is sometimes an accompanying feature rather than the reason for the undersupply of the cells with T3, so it cannot fully combat the symptoms.

Because the metabolism is particularly stimulated, it is important to take in enough nutrients to supply the body with sufficient energy. Attention should be paid to the quality of the nutrients. If treatment with medication is started, hormone production normalises, the metabolism winds down and the calorie intake should be reduced again as well. The no-gos with an overactivity are stimulating foods such as coffee or other caffeinated drinks, tea high in theine (black tea, green tea and so on), cola or alcohol.

Because carbohydrates generally tend to lead to more inflammation, they should be avoided or reduced in autoimmune conditions such as Hashimoto’s. A ketogenic diet therefore makes particular sense. Detailed tips on nutrition with Hashimoto’s and Graves’ disease are being worked up in an article of their own and will follow soon. Here is a basic framework for a first orientation:

• Healthy fats are beneficial because of their immunosuppressive effect. Omega-3 fatty acids in particular are anti-inflammatory.
• Phytochemicals are also anti-inflammatory. With a large amount of vegetables or berries you can give the body extra help in containing the inflammation.
• Selenium has an antioxidant effect and reduces oxidative stress in the body (which is particularly harmful to an organism with an autoimmune condition).
• Vitamin E, which occurs for example in nuts and plant oils, can, like vitamin C (peppers, citrus fruit), help to contain the inflammatory processes.
• An AIP (autoimmune protocol) shows what does you good individually.