Mild Thyroid Failure Poses Hefty Risks If Left Untreated

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Mild Thyroid Failure Poses Hefty Risks If Left Untreated
Subclinical or borderline hypothyroidism poses more of a problem than most realize. Subclinical hypothyroidism is also medically known as mild thyroid failure. Immediate and long-term effects occur from this mild failure. Knowing the risks and consequences of mild thyroid failure should alert you to optimal management of the disorder.

Thyroid hormone is required for every cell of the body and brain in order to function. Inadequate thyroid function, even when it is borderline, can substantially change your health and quality of life. Fortunately, there are key nutrients that are essential for healthy thyroid function. Catching early thyroid dysfunction at the first signs can make it easier to improve thyroid health naturally.

[Jump to: Nutritional Options]

What is Mild Thyroid Failure?


Mild thyroid failure is also known as subclinical hypothyroidism or borderline hypothyroidism. The Mayo Clinic defines it as a serum thyroid-stimulating hormone (TSH) above the upper limit of normal despite normal levels of serum free thyroxine (T4). TSH is a common thyroid blood test. It is considered the necessary test for the diagnosis of mild thyroid failure rather than testing for hormone levels found in the blood stream. The reason is that TSH has a log-linear relationship with circulating thyroid hormone levels, i.e. a two-fold change in the free thyroxine will produce a 100-fold change in TSH. Another way of saying this is TSH levels change before free T4 changes. This is early stage thyroid cell destruction. The brain puts out more TSH to tell the remaining thyroid cells to work harder.

TSH normal lab values are under debate. Mayo Clinic reports that when TSH scores are above 10 mIU/L, then thyroid replacement hormone, e.g. levothyroxine is prescribed. When TSH scores are less than 10 mIU/L, then diagnosis and treatment is controversial. The Endocrine Society reports different optimal TSH scores depending on age. Optimal TSH range often discussed within the field of clinical nutrition is 1.3-1.8 mIU/L.

Mayo Clinic and the Endocrine Society report that mild thyroid failure may affect 3-13 percent of the American population or about 130 people for every 1000 individuals. This common problem affects women earlier in life, but by the time men are 60 years of age and older, they too struggle just as much as women with mild thyroid failure.

The causes for mild thyroid failure are the same as those that trigger complete thyroid failure. Hashimoto’s disease or chronic autoimmune thyroiditis accounts for over 90 percent of thyroid problems. Other causes include radioactive iodine treatment, anti-thyroid drugs or surgical thyroid removal, head and neck surgery, and other medications. Numerous other things interfere with and stress the thyroid.

Symptoms of Mild Thyroid Failure


Mild thyroid failure symptoms are like those of complete thyroid failure but are often attributed to aging and stress. Symptoms include depression, fatigue, elevated cholesterol and homocysteine levels, thyroid enlargement/goiter, coarse hair, cold intolerance, constipation, hoarse voice, hearing loss, heavy menstrual cycles, muscle aches, cramps, and stiffness, slow heartbeat, and heart disease. See how your thyroid is doing by taking the Thyroid Quiz.

There is considerable controversy for treatment of mild thyroid failure when TSH is less than 10 mlU/L. Often treatment is withheld, unless the patient is symptomatic, has fertility problems, a goiter is present, or positive anti-thyroid peroxidase (TPO) antibodies are noted. While the medical experts debate the treatment, it is important to see how mild thyroid failure affects other functions in the body. Knowing this information allows you and your provider to start connecting the dots and make informed choices.

Borderline Thyroid Increases Metabolic Syndrome Risk


A recent meta-analysis study looked at subclinical hypothyroidism and the presence of metabolic syndrome. Scientists reviewed nine studies and found that mild thyroid failure is indeed linked with a higher risk of metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur together, including high blood pressure, high blood sugar, excess body fat around the waist, and elevated cholesterol and/or triglyceride levels. Add mild thyroid failure to that list.

One recent study indentified nearly 47 percent of patients with mild thyroid failure had metabolic syndrome, especially elevated blood pressure and low HDL cholesterol levels. The biggest findings weren’t obvious thyroid problems, but were related with the systemic effects of poor thyroid function. High blood pressure and decreased HDL were prominent. Weight gain around the belly or central obesity and elevated triglycerides were also found and related to mild thyroid failure.

Thyroid Increases Deadly Risks with Heart, Stroke, and Sleep Apnea


One study found that the presence of metabolic syndrome and hypothyroidism in men had a significantly increased risk of death from cardiac causes. Men had greater problems with elevated triglycerides and blood sugar with increased insulin resistance than women. Men were more likely to die from cardiovascular causes with low thyroid function.

The concern of poor thyroid health including borderline hypothyroidism and major cardiovascular events has a long history of debate. In a very large study consisting of 17 cohort studies and over 47,573 adults who were followed from 1972-2014, an increased risk was identified. The researchers found that patients who were younger than 65 and had mild thyroid failure and higher TSH concentrations had an increased risk of dying from a stroke. Subclinical hypothyroidism was defined as TSH levels of 4.5 - 19.9 mlU/L with normal T4 levels.

The Journal of the American Medical Association (JAMA) also found increased risk with cardiac events and death with subclinical hypothyroid function. The same TSH levels were used. The risk increased particularly in those who had a TSH concentration of 10 mlU/L or greater. Furthermore, heart failure was increased in individuals who had subclinical hypothyroidism and other thyroid disorders. Researchers found that risks of heart failure events were increased with both higher and lower TSH levels particularly for TSH levels of 10 or higher or a TSH of less than 0.10 mlU/L. Improving thyroid health reduced the events and risks.

Sleep apnea often coincides with increased cardiac and cancer risk and is also linked with mild thyroid failure. Individuals who had subclinical hypothyroidism were more likely to have sleep apnea. Those that had the poorest thyroid health and elevated TSH levels had greater complications with sleep apnea.

Women’s and Men’s Health Changes


Women with mild thyroid failure were more likely to have menstrual concerns. An April 2016 publication found endometrial lining issues more common in women with any type of thyroid problem. In this study, it found that 42.85 percent of women who were hypothyroid or subclinical hypothyroid had a thickening of the endometrial lining. Medical treatment of this concern often leads to removal of the tissue either by D&C or a hysterectomy.

Women who had hyperthyroidism had just the opposite effect to the endometrial lining; it atrophied in 60 percent of the patients. The authors of this study nicely pointed out, “Assessment of thyroid function should be done in all patients with menstrual disorders to avoid unnecessary interventions like curettage (D&C) or a hysterectomy.” Gallstones and gallbladder problems are also related to mild and more significant hypothyroidism. Before allowing body parts like the uterus or gallbladder to be removed, check the thyroid.

Problems in the bedroom may also reflect subclinical hypothyroidism. Few studies suggest that patients with subclinical thyroid function have an increased sexual dysfunction. One study found that women with mild thyroid failure were less interested in sex, had difficulties with arousal, lubrication, and pain.

Men who have thyroid dysfunction are also likely to have sexual problems. Erectile dysfunction (ED) is extremely common in men with both hyperthyroid and hypothyroidism. The purple pill or the other latest-and-greatest ED pill will not solve the thyroid problem. Improving thyroid health solves the ED.

Osteoporosis and Calcium


Mild thyroid failure also affects bone density and calcium levels. Researchers compared patients with healthy thyroid and subclinical thyroid and were matched for age and gender. Those patients who had subclinical hypothyroid had significantly higher incidence of bone mass loss and lower levels of calcium. This information should be kept in mind the next time your medical provider writes you a prescription for Boniva or other harmful bone drugs.

Sense of Smell and Taste Lost with Subclinical Thyroid Issues


The loss of smell and taste is not something that one oftentimes thinks about with thyroid symptoms. However, research published earlier this year found that patients who had mild thyroid failure had trouble with identifying smells and had intolerance to “bitter tastes”. After an average of three months of thyroid treatment, the bitter taste tolerance improved and the sense of smell returned for the subclinical hypothyroid patients.

The inability to smell is associated with a lack of zinc and can be an early sign of neurodegeneration. Zinc is also needed for thyroid support. The picky eater who prefers only the sweet, salty, and/or sour tastes should be evaluated for subclinical thyroid function. This includes children and adults. Children who have an aversion to bitter tastes are far more likely to become obese; mild thyroid failure might be driving this more than we realize.

Common Liver Disorder Associated with Mild Thyroid Failure


One of most common disorders of the liver worldwide is fatty liver disease. Several studies have confirmed an association between mild thyroid failure and fatty liver disease in adults of all ages. Poor liver function clearly affects thyroid hormone. Thyroid hormone is converted from the non-active T4 to the biologically active form of thyroid hormone by your liver.

Thyroid Nutrition


Selenium and the omega-3 fish oil DHA are vital to helping the liver do its job to activate thyroid hormone and help get rid of the fatty liver problems. Several other nutrients also help reduce fatty accumulation in the liver and obesity, but also provide antioxidant protection to the thyroid. The most important nutrients to consider help with glutathione production. This will end up helping both the thyroid and liver. Fat soluble antioxidants are the most important. These include tocotrienols/super form of vitamin E, r-alpha lipoic acid, NAC, vitamin K, coenzyme Q10, and milk thistle.

Research also demonstrates that vitamin A supplementation can reduce the risk of mild thyroid failure. After a four-month randomized, double-blind controlled trial, it was found that intake of 25,000 IU per day of vitamin A remarkably reduced elevated TSH levels in obese and non-obese women.

If you are having thyroid symptoms, but also any of these highlighted disorders (heart disease, metabolic syndrome, sleep apnea, osteoporosis, endometrial problems, libido changes, fatty liver, sluggish gallbladder, loss of smell, or aversions to bitter tastes, check your thyroid. Support your thyroid. Medical providers are often unwilling to provide thyroid hormone replacement for subclinical hypothyroidism. This is where nutritional support can help fill the gap.

There are numerous nutrients needed for a healthy thyroid. The most basic nutrients needed for thyroid health are selenium, manganese, vitamin D, iodine, zinc, iron, protein, amino acids like tyrosine, and the B vitamins. Consider adding in vitamin A and other nutrients like vitamin E, r-alpha lipoic acid, NAC, vitamin K, coenzyme Q10, and milk thistle to provide antioxidant support to the thyroid. Furthermore, healthy thyroid function intimately depends on healthy adrenal function. If patients are given thyroid treatment and the adrenal glands are not producing adequate cortisol, trouble will occur.

Subclinical hypothyroidism puts a silent strain on the body. It is like running the car with low oil. The car will still get you there. It will look and generally sound fine, but it puts a lot of strain on the car. Eventually, something will break in the car because of the strain. Subclinical hypothyroidism is mild thyroid failure. How much failure of a broken body part do you need before you take action? Nourish and support your thyroid to help prevent further failure and the far reaching effects on your body.

Nutritional Options


Selenium – This trace mineral is highly concentrated in the thyroid gland and vital for thyroid function. It is known for its antioxidant protection to the thyroid and integral for major antioxidant systems that protect the thyroid from inflammation. It is a required nutrient for converting thyroid hormone from T4 to the active T3.

Manganese – This “anti-pear shape” trace mineral nutrient is also vital to thyroid and liver function. It is critical in blood sugar and fat metabolism. Manganese provides vital antioxidant protection for the thyroid and cell engines.

Vitamin D – Every cell in the body needs thyroid hormone and vitamin D to work. Without adequate vitamin D, high levels of inflammation occur and causes gene signal disruption and poses great risk for autoimmune thyroid and other disorders.

Iodine – Iodine and the amino acid tyrosine form the basic structure of thyroid hormone. Without adequate iodine, thyroid nodules and goiters are more apt to develop. Compounds like chlorine, fluoride, bromide, perchlorates, and thiocyanates in our water and food compete against iodine terribly affecting thyroid health.

Vitamin A – This fat soluble vitamin has been shown to reduce elevated TSH levels in mild thyroid failure. Vitamin A is critical for vision and eye health, cell growth, immune system function. It plays critical roles in forming and maintaining heart, lungs, kidneys, skin, gut, and other organs. Individuals with thyroid distress often do not convert beta carotene well into vitamin A.

Zinc – Insufficient zinc diminishes the activation or conversion of thyroid hormone from T4 to T3 and shuttles it into non-active reverse T3. Zinc is also needed to bind thyroid hormone to the DNA of cells. It is easily lost in sweat and stress. Lack of zinc is associated with lowered sex drive.

Iron – Considered the backbone of healthy blood, this mineral is also a key nutrient needed to help make zinc and thyroid hormone work. If you don’t have enough iron, you are anemic. This places great stress on all aspects of metabolism including thyroid causing fatigue, cold intolerance, headaches, dry skin, exercise intolerance, and shortness of breath.

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