Your thyroid is a butterfly-shaped gland in your neck, front and center. It’s function is related to every other system in your body, and it produces hormones that power your cells. Sometimes your thyroid is overactive and produces too many hormones, called hyperthyroidism, which is generally caused by an autoimmune condition called Grave’s disease.(1)
More often, people suffer from a condition called hypothyroidism, where the thyroid is not producing sufficient hormones. Hypothyroidism slows the other systems in your body down, and in the U.S., is frequently caused by an autoimmune condition called Hashimoto’s disease.(2) A complete thyroid panel testing is required to tell if your thyroid is functioning properly and optimal thyroid numbers can be very different than the reference range on standard blood labs. Symptoms can be seen in even subclinical thyroid function. As we will see in the following article, optimal thyroid health is essential for every body system to function optimally. When you schedule a Thyroid Health Consultation, we can go over the variety of options available to restore balance to this crucial system. Some of the common symptoms for each of the thyroid imbalances are shown below.
Symptoms of Hyperthyroidism
Symptoms of Hypothyroidism
Body Systems affected by the Thyroid
The symptoms of thyroid malfunction are related to the body systems that are affected by it. For example, damage to the thyroid gland affects one’s metabolism, causing the symptom of weight gain or loss. Let’s take a look at some of the body’s systems that are affected by thyroid malfunction.
The Nervous System
The central nervous system (CNS) can be greatly affected by an improperly functioning thyroid, and reacts differently dependent on the amount of hormone excreted. When the thyroid does not release the appropriate amount of hormones, it may cause mental exhaustion from brain inflammation or “brain fog”, fatigue, (3) depression (4), accelerated brain degeneration (5), and may contribute to the development of Alzheimer’s (5), Parkinson’s (6), or Huntington’s (7) diseases.
The Endocrine System
Thyroid hormone concentrations and signal pathways are critical for pancreas function(8) which excretes digestive enzymes and insulin necessary for digestion and maintaining blood sugar.(9) Additionally, thyroid hormones are required for proper excretion of dopamine receptor D4 by the pineal gland, which controls a wide range of processes such as mood, motor function, and cognition.(10) Thyroid function also modulates the hormone activity of the thymus, which produces hormones necessary for immune function.(11) Finally, the thyroid is an integral part of the hypothalamus-pituitary-adrenal (HPA) axis, which is a complex set of interactions that control stress reactions(12) and regulate many body systems including DNA methylation,(13) digestion,(14) mood, (15) immunity,(16) and energy storage and expenditure.(17)
The Circulatory System
The cardiovascular system responds to even slight changes in the amount of circulating thyroid hormones. Hyperthyroidism can cause increased heart rate, high blood pressure, atrial fibrillation, and atrial flutter by inducing a hyper-dynamic cardiovascular state.(18) Hypothyroidism causes a reduction in oxygen and energy consumption in heart muscles, a reduction in blood pressure and heart rate, and increases risk of heart failure, heart attack, high cholesterol and thickening of arteries.(19) These systems are interrelated and medications for each may inhibit the function of the other.(20)
Respiratory System
A dysfunctional thyroid causes decreased respiratory drive which results in a variety of pulmonary issues and impairment of the respiratory system. The hypermetabolic action of thyroid hormones in hyperthyroidism cause respiratory distress including hyperventilation and muscle weakness. Swelling of the thyroid can induce shortness of breath, wheezing, and cough.(21) Hypothyroidism may deteriorate pulmonary function in a variety of ways including muscle weakness, CO2 retention, and respiratory signaling causing labored breathing, swelling, and sleep apnea.(22)
Digestive System
Chronic constipation is oftentimes associated with hypothyroidism, while soft, frequent bowel movements are generally associated with hyperthyroidism. These digestive issues are partly due to metabolic fluctuations, but may also be created by issues originating in the stomach.
Anemia has been strongly associated with thyroid dysfunction(23), and the reduction of thyroid hormones in hypothyroidism seems to have an effect on red blood cell production(24) which may be caused by a lack of gastric acid in the stomach.(25) Gastric acid levels are important for nutrient absorption and gut flora, and insufficient levels can cause a variety of digestive issues such as heartburn, acid reflux, gall stones, and anemia. It seems counterintuitive that a lack of stomach acid would cause acid reflux, but when food isn’t able to be digested properly due to low acid, the stomach has to work longer to break down the food we eat. This condition, called hypochlorhydria, slows the whole system down and the delay pushes acid back up the esophagus. It’s kind of like squeezing a water balloon in the middle, some goes up, and some goes down. These changes in the gut microbiota can cause many other health issues in the various systems of the body, and may even lead to the development of gastric cancer.(26)
The Reproductive System
It’s not surprising that this hormone producing gland is responsible for so many aspects of reproduction. Whether male or female, hyper- or hypothyroid, autoimmune or not… thyroid function has a profound impact on one’s reproductive system.(27) Thyroid hormones control the development of ovarian, uterine, and placental tissue in women, and an imbalance can lead to a wide variety of reproductive issues including menstrual problems, inability to ovulate, polycystic ovarian syndrome, spontaneous abortion, preeclampsia, premature birth, low birth weight, and birth defects.(28) Short menstrual cycles and low bleeding are usually associated with hyperthyroidism and infrequent periods with long menstrual cycles are more commonly seen with hypothyroidism. (27) (28) Men who suffer from thyroid dysfunction may see low sperm counts, improperly formed and slow moving sperm, low testosterone, reduced sexual desire, erectile dysfunction, ejaculatory disorders, and gynecomastia.(29) Thyroid disorders also affect fetal development of the brain,(30) and both fetal and post natal heart development.(31)
The Musculoskeletal System
Thyroid hormones are a critical component in the childhood development of the skeletal system and are an essential regulator of adult bone mineralization and strength.(32) Both, hypo- and hyperthyroidism can result in increased fracture risk and bone density changes,(33) even in subclinical cases where an individual’s hormone levels fall within a normal reference range.(34) Thyroid hormone signaling also affects muscle development, function, and repair by reducing muscle growth, changing muscle plasticity, altering energy metabolism and expenditure, and inhibiting muscle regeneration.(35)
Integumentary System
The integumentary system includes our skin, glands, hair, nails, and nerves. Since the thyroid affects so many of the body’s systems, symptoms of thyroid imbalance can be seen in all of these areas in a wide variety of ways. The skin is the largest organ in the body, and protects the rest of the body from the environment around us. It synthesizes vitamin D from the sun and protects us from infection. Our glands can help remove toxins through sweat, hair regulates body temperature, and nails protect fingers and toes. Nerves are part of both, the nervous system, and the integumentary system and are responsible for sensory perception and response. Dermatologic manifestations can be a sign of hidden thyroid disorders and may include soft tissue tumors, thyroid dermopathy, nail plate separation and fungus, excessive sweating, hirsutism, acne,(36) dry, brittle hair, hair thinning and loss,(37) and increase of nerve fiber layer thickness which can result in cold hands and feet(36), optic neuropathy, macular thinning, eye disease, (38) and inflammation that can cause peripheral neuropathy.(39)
Lymphatic System
Hashimoto’s disease is also known as chronic lymphocytic thyroiditis. It is an autoimmune disease where your lymphatic vessels become more numerous and enlarged in the thyroid and cause gaps to form so that the thyroid cells are not able to communicate with each other properly. (40) Hashimoto’s has been associated with non-Hodgkin’s lymphoma,(41) Hürthle cell carcinoma,(42) and papillary thyroid cancer.(43) The lymphatic system is crucial to the uptake of fat-soluble vitamins A, D, E, and K(44), some of the very same nutrients required for healthy thyroid function. The lymph also transports immune cells and dictates adaptive immune responses.(45)
Immune System
We already know the effects of thyroid imbalance on the digestive system, and that the gut plays a huge part in the function of our immune system. We have discussed how the lymphatic system transports immune cells, and when it is not functioning properly, the immune system cannot function properly, either. Changes in the endocrine system will also impact the immune system. The immune system can, in turn, impact thyroid function and may lead to the development of these autoimmune thyroid diseases. There is a complex relationship between the thyroid and the immune system, and they affect each other in direct and indirect ways. The truth is, we know many of the factors that contribute to thyroid autoimmune disease, but we don’t know exactly how it is developed.(46) Prevalence of autoimmune thyroid diseases is rising and likely involves a combination of genetic, environmental, and nutrient factors.(47) Western diet habits, nutrient blockers in food additives, emulsifiers, and artificial sweeteners, bile acid synthesis, and circadian rhythm changes all affect the function of the thyroid and immune systems.(48) Recent studies have also shown that the COVID-19 virus and it’s treatment may also cause reversible thyroid dysfunction, and may make an existing thyroid issue worse.(49) Do not lose hope! At Renewed Hope Nutrition Center, personalized plans can be created for each individual to interrupt these cycles of destruction and guide the body back to homeostasis, in a holistic way.
Body Systems affected by the Thyroid
While many environmental factors can trigger autoimmune conditions, there are several other factors that can cause thyroid issues. Nutrient deficiencies in micro- and macro-nutrients, hypothalamic–pituitary–adrenal (HPA) dysregulation like adrenal fatigue, Addison’s and Cushing’s syndrome, and Thyroid-gut-axis (TGA) disruption caused by intestinal dysbiosis can all affect thyroid function. Luckily, most of these imbalances can be corrected through the reduction of environmental factors, dietary changes in the food one eats, and nutritional supplementation. At Renewed Hope Nutrition Center, we can help you design the path to wellness that best suits your needs. Schedule a Thyroid Health Consultation today!
References:
(1) Mathew P, Rawla P. Hyperthyroidism. [Updated 2021 Dec 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537053/
(2) Patil N, Rehman A, Jialal I. Hypothyroidism. [Updated 2022 Feb 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519536/
(3) Ettleson MD, Raine A, Batistuzzo A, et al. Brain Fog in Hypothyroidism: Understanding the Patient's Perspective. Endocr Pract. 2022;28(3):257-264. doi:10.1016/j.eprac.2021.12.003
(4) Siegmann EM, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW. Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis: A Systematic Review and Meta-analysis [published correction appears in JAMA Psychiatry. 2019 Jun 19;:]. JAMA Psychiatry. 2018;75(6):577-584. doi:10.1001/jamapsychiatry.2018.0190
(5) Quinlan P, Horvath A, Eckerström C, Wallin A, Svensson J. Altered thyroid hormone profile in patients with Alzheimer's disease. Psychoneuroendocrinology. 2020;121:104844. doi:10.1016/j.psyneuen.2020.104844
(6) Charoenngam N, Rittiphairoj T, Ponvilawan B, Prasongdee K. Thyroid Dysfunction and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2022;13:863281. Published 2022 May 4. doi:10.3389/fendo.2022.863281
(7) Saleh N, Moutereau S, Durr A, et al. Neuroendocrine disturbances in Huntington's disease. PLoS One. 2009;4(3):e4962. doi:10.1371/journal.pone.0004962
(8) Chen C, Xie Z, Shen Y, Xia SF. The Roles of Thyroid and Thyroid Hormone in Pancreas: Physiology and Pathology. Int J Endocrinol. 2018;2018:2861034. Published 2018 Jun 14. doi:10.1155/2018/2861034
(9) Atkinson MA, Campbell-Thompson M, Kusmartseva I, Kaestner KH. Organisation of the human pancreas in health and in diabetes. Diabetologia. 2020;63(10):1966-1973. doi:10.1007/s00125-020-05203-7
(10) Kim JS, Bailey MJ, Weller JL, et al. Thyroid hormone and adrenergic signaling interact to control pineal expression of the dopamine receptor D4 gene (Drd4). Mol Cell Endocrinol. 2010;314(1):128-135. doi:10.1016/j.mce.2009.05.013
(11) Fabris N, Mocchegiani E, Mariotti S, Pacini F, Pinchera A. Thyroid function modulates thymic endocrine activity. J Clin Endocrinol Metab. 1986;62(3):474-478. doi:10.1210/jcem-62-3-474
(12) Lin L, Wu J, Yuan Y, Sun X, Zhang L. Working Memory Predicts Hypothalamus-Pituitary-Adrenal Axis Response to Psychosocial Stress in Males. Front Psychiatry. 2020;11:142. Published 2020 Feb 28. doi:10.3389/fpsyt.2020.00142
(13) Wadji DL, Tandon T, Ketcha Wanda GJM, et al. Child maltreatment and NR3C1 exon 1F methylation, link with deregulated hypothalamus-pituitary-adrenal axis and psychopathology: A systematic review. Child Abuse Negl. 2021;122:105304. doi:10.1016/j.chiabu.2021.105304
(14) Jang SH, Woo YS, Lee SY, Bahk WM. The Brain-Gut-Microbiome Axis in Psychiatry. Int J Mol Sci. 2020;21(19):7122. Published 2020 Sep 27. doi:10.3390/ijms21197122
(15) Berardelli I, Serafini G, Cortese N, Fiaschè F, O'Connor RC, Pompili M. The Involvement of Hypothalamus-Pituitary-Adrenal (HPA) Axis in Suicide Risk. Brain Sci. 2020;10(9):653. Published 2020 Sep 21. doi:10.3390/brainsci10090653
(16) Leach S, Suzuki K. Adrenergic Signaling in Circadian Control of Immunity. Front Immunol. 2020;11:1235. Published 2020 Jun 23. doi:10.3389/fimmu.2020.01235
(17) Seal SV, Turner JD. The 'Jekyll and Hyde' of Gluconeogenesis: Early Life Adversity, Later Life Stress, and Metabolic Disturbances. Int J Mol Sci. 2021;22(7):3344. Published 2021 Mar 25. doi:10.3390/ijms22073344
(18) Osuna PM, Udovcic M, Sharma MD. Hyperthyroidism and the Heart. Methodist Debakey Cardiovasc J. 2017;13(2):60-63. doi:10.14797/mdcj-13-2-60
(19) Udovcic M, Pena RH, Patham B, Tabatabai L, Kansara A. Hypothyroidism and the Heart. Methodist Debakey Cardiovasc J. 2017;13(2):55-59. doi:10.14797/mdcj-13-2-55
(20) Omidi N, Khorgami M, Tajrishi FZ, Seyedhoseinpour A, Pasbakhsh P. The Role of Thyroid Diseases and their Medications in Cardiovascular Disorders: A Review of the Literature. Curr Cardiol Rev. 2020;16(2):103-116. doi:10.2174/1573403X15666191008111238
(21) Lencu C, Alexescu T, Petrulea M, Lencu M. Respiratory manifestations in endocrine diseases. Clujul Med. 2016;89(4):459-463. doi: 10.15386/cjmed-671.
(22) Iyer SK, Menon SK, Bahuleyan B. An Analysis of Dynamic Pulmonary Functions of Hypothyroid Patients. J Clin Diagn Res. 2017;11(3):CC10-CC12. doi:10.7860/JCDR/2017/24653.9579
(23) Fein HG, Rivlin RS. Anemia in thyroid diseases. Med Clin North Am. 1975;59(5):1133-1145. doi:10.1016/s0025-7125(16)31963-0
(24) Erdogan M, Kösenli A, Ganidagli S, Kulaksizoglu M. Characteristics of anemia in subclinical and overt hypothyroid patients [published correction appears in Endocr J. 2013;60(4):541. Mehmet, Erdogan [corrected to Erdogan, Mehmet]; Aybike, Kosenli [corrected to Kösenli, Aybike]; Mustafa, Kulaksizoglu [corrected to Kulaksizoglu, Mustafa]]. Endocr J. 2012;59(3):213-220. doi:10.1507/endocrj.ej11-0096
(25) Cellini M, Santaguida MG, Virili C, et al. Hashimoto's Thyroiditis and Autoimmune Gastritis. Front Endocrinol (Lausanne). 2017;8:92. Published 2017 Apr 26. doi:10.3389/fendo.2017.00092
(26) Lahner E, Conti L, Annibale B, Corleto VD. Current Perspectives in Atrophic Gastritis. Curr Gastroenterol Rep. 2020;22(8):38. Published 2020 Jun 15. doi:10.1007/s11894-020-00775-1
(27) Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31(5):702-755. doi:10.1210/er.2009-0041
(28) Silva JF, Ocarino NM, Serakides R. Thyroid hormones and female reproduction. Biol Reprod. 2018;99(5):907-921. doi:10.1093/biolre/ioy115
(29) Kumar A, Shekhar S, Dhole B. Thyroid and male reproduction. Indian J Endocrinol Metab. 2014;18(1):23-31. doi:10.4103/2230-8210.126523
(30) Prezioso G, Giannini C, Chiarelli F. Effect of Thyroid Hormones on Neurons and Neurodevelopment. Horm Res Paediatr. 2018;90(2):73-81. doi:10.1159/000492129
(31) Li M, Iismaa SE, Naqvi N, Nicks A, Husain A, Graham RM. Thyroid hormone action in postnatal heart development. Stem Cell Res. 2014;13(3 Pt B):582-591. doi:10.1016/j.scr.2014.07.001
(32) Williams GR, Bassett JHD. Thyroid diseases and bone health. J Endocrinol Invest. 2018;41(1):99-109. doi:10.1007/s40618-017-0753-4
(33) Gogakos AI, Duncan Bassett JH, Williams GR. Thyroid and bone. Arch Biochem Biophys. 2010;503(1):129-136. doi:10.1016/j.abb.2010.06.021
(34) Blum MR, Bauer DC, Collet TH, et al. Subclinical thyroid dysfunction and fracture risk: a meta-analysis. JAMA. 2015;313(20):2055-2065. doi:10.1001/jama.2015.5161
(35) Salvatore D, Simonides WS, Dentice M, Zavacki AM, Larsen PR. Thyroid hormones and skeletal muscle--new insights and potential implications. Nat Rev Endocrinol. 2014;10(4):206-214. doi:10.1038/nrendo.2013.238
(36) Lause M, Kamboj A, Fernandez Faith E. Dermatologic manifestations of endocrine disorders. Transl Pediatr. 2017;6(4):300-312. doi:10.21037/tp.2017.09.08
(37) Wolff H, Fischer TW, Blume-Peytavi U. The Diagnosis and Treatment of Hair and Scalp Diseases. Dtsch Arztebl Int. 2016;113(21):377-386. doi:10.3238/arztebl.2016.0377
(38) Blum Meirovitch S, Leibovitch I, Kesler A, Varssano D, Rosenblatt A, Neudorfer M. Retina and Nerve Fiber Layer Thickness in Eyes with Thyroid-Associated Ophthalmopathy. Isr Med Assoc J. 2017;19(5):277-281
(39) Castelli G, Desai KM, Cantone RE. Peripheral Neuropathy: Evaluation and Differential Diagnosis. Am Fam Physician. 2020;102(12):732-739
(40) Di Tomaso L, Battista S, Annarita D, Sciarra A, Morenghi E, Roncalli M. Cracking spaces in Hashimoto thyroiditis are lymphatic and prelymphatic vessels. Am. J. Surg. Pathol. 2010;34:1857–1861. doi: 10.1097/PAS.0b013e3181fb40fa
(41) Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin's Lymphoma. Med Sci (Basel). 2021;9(1):5. Published 2021 Jan 30. doi:10.3390/medsci9010005
(42) Stanciu M, Bera LG, Popescu M, Grosu F, Popa FL. Hashimoto's thyroiditis associated with thyroid adenoma with Hürthle cells - case report. Rom J Morphol Embryol. 2017;58(1):241-248.
(43) Pan J, Ye F, Yu C, et al. Papillary Thyroid Carcinoma Landscape and Its Immunological Link With Hashimoto Thyroiditis at Single-Cell Resolution. Front Cell Dev Biol. 2021;9:758339. Published 2021 Nov 5. doi:10.3389/fcell.2021.758339
(44) Ohtani O, Ohtani Y. Organization and developmental aspects of lymphatic vessels. Arch Histol Cytol. 2008;71(1):1-22. doi:10.1679/aohc.71.1
(45) Esterházy D, Canesso MCC, Mesin L, et al. Compartmentalized gut lymph node drainage dictates adaptive immune responses. Nature. 2019;569(7754):126-130. doi:10.1038/s41586-019-1125-3
(46) Pyzik A, Grywalska E, Matyjaszek-Matuszek B, Roliński J. Immune disorders in Hashimoto's thyroiditis: What do we know so far?. J Immunol Res. 2015;2015:979167. doi:10.1155/2015/979167
(47) Dong YH, Fu DG. Autoimmune thyroid disease: Mechanism, genetics and current knowledge. Eur Rev Med Pharmacol Sci. 2014;18(23):3611-3618.
(48) Fernández-García V, González-Ramos S, Martín-Sanz P, Laparra JM, Boscá L. Beyond classic concepts in thyroid homeostasis: Immune system and microbiota. Mol Cell Endocrinol. 2021;533:111333. doi:10.1016/j.mce.2021.111333
(49) Lisco G, De Tullio A, Jirillo E, et al. Thyroid and COVID-19: A review on pathophysiological, clinical and organizational aspects. J Endocrinol Invest. 2021;44(9):1801-1814. doi:10.1007/s40618-021-01554-z
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