Let’s Talk Thyroid

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Evaluation And Treatment Of Hypothyroidism


By Dr. Melissa P. Broyles

Weight gain? Fatigue? Depression? These are just a few symptoms of an underactive thyroid gland. Thyroid hormones are needed for every cell in the body. Therefore, a deficiency of thyroid hormones can diffusely affect the body and cause a host of symptoms, including:   depression, fatigue, weight gain, forgetfulness, cold sensitivity, high cholesterol, high triglycerides, high blood pressure, swelling, menstrual abnormalities, dry skin, hair loss, brittle nails, muscle weakness, constipation, shortness of breath and impaired kidney function. Hypothyroidism affects 5% of the US population.  However, if the diagnosis is based on symptoms and basal body temperature, not solely on laboratory results, it is possible that the prevalence of hypothyroidism is closer to 40% of the US population. This is partly due to the fact that mild cases of hypothyroidism may not be detected by blood tests. Hypothyroidism is more common in females with an 8:2 female to male ratio.

The most common cause of hypothyroidism in the US is Hashimoto’s disease. Hashimoto’s is an autoimmune disease where antibodies bind to the thyroid gland and impair thyroid hormone production. Hashimoto’s is a genetic disease that is triggered by environmental toxins (i.e. perchlorate, iodine in excess, fluoride, and mercury.) There is also a correlation between Hashimoto’s disease, intestinal permeability (leaky gut) and food allergy, namely gluten.

Laboratory evaluation of hypothyroidism should include: TSH, free T4, free T3 and thyroid antibodies. Thyroid antibodies are used to diagnose Hashimoto’s disease and have a 90% accuracy rate. T3 hormone is 4-8 times more potent than T4 and is critical for cellular function.  A subset of people are not able to convert T4 to T3 hormone.

The treatment of hypothyroidism consists of a diet rich in iodine, zinc, copper, selenium (i.e. seafood, liver, nuts and seeds), and tyrosine, an amino acid found in protein. These nutrients, in addition to vitamins A, C, and E, are necessary for thyroid hormone production. In most cases supplemental forms of these nutrients are necessary. However, it is not recommended to take supplemental iodine unless a person is iodine deficient. Iodine excess can trigger Hashimoto’s disease in genetically susceptible individuals.

Thyroid hormone replacement therapy is indicated in most cases of hypothyroidism.  Synthetic treatment is available in either T4 or T3 forms. There is also natural desiccated thyroid medication which contains a combination of T4 and T3 hormones. It is important to take these medications on an empty stomach to increase their absorption and effectiveness.

Lastly, exercise stimulates thyroid function and increases tissue sensitivity to thyroid hormones.  Invigorating sports, i.e. water sports, are especially helpful. Overheated environments should be avoided as they slow down thyroid function.

To receive a comprehensive thyroid evaluation and a holistic treatment plan for hypothyroidism, please
call 610-459-3773, or visit

I have been a patient of Dr. Broyles for over a year now, and have found her to be a kind and concerned professional. I have been having trouble with my weight since I was a child. Over the years I have gained and lost more weight than I could count. I am 67 and heavier than I have ever been in my whole life. It didn’t seem to matter what I did to lose weight I still keep getting heavier. In February of 2013 Dr. Broyles ask  me if I was really serious about losing weight; I told her if I don’t do something I was fearful of death. At that time she began to work with me on a weight management and proper eating program. I have lost 25 pounds since I’ve started eating properly. I feel much better and stronger. The swelling in my legs is all but gone. I was getting varicose veins around the ankles and starting up my legs. They are disappearing. Blood pressure is down. Sugar is down. Cholesterol is down. My clothes fit better and I feel better. I am happy . . .”  ~ Bob V

“I was tired of being treated for each symptom and not as a whole person. I thought that the few issues I have could be interconnected, like my migraines and hormonal issues such as night sweats. I wanted to see an Integrative physician who would address all of my problems. I have been seeing Dr. Broyles for four months and can honestly say that I have not felt this well in a long time. I am now off of my blood pressure medication, I am on vitamin supplements, and we are addressing my hormonal imbalance. Dr. Broyles listens to all of my concerns and tries both conventional and alternative solutions. She is very patient and spends a lot of time both listening and explaining what could be wrong, and how to address the issues.  Her office is warm and relaxing, and is conducive to healing.  I am very happy that we have started this relationship.”   ~ Maria M.



* Profile photo by Roy McDowell, Royal Photography, Wilmington, DE

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