By Hilary Sheinbaum
Like many health and wellness topics discussed and debated on the Internet, there’s a lot of dangerous misinformation out there regarding thyroid health. A quick Google search of “thyroid health” populates guidance on diet and foods, supplements, and more. While some advice and tips are accurate, it can be hard to tell what’s right from wrong — and decipher what info applies to your body. That said, it’s important to speak with your doctor — specifically an endocrinologist — before adopting a new routine, buying products, and starting a thyroid treatment plan (if you need one at all).
To gather information and feedback, we brought our questions to Dr. Jordan Geller, a physician based in Los Angeles and Palm Beach, who is dual board-certified in Endocrinology, Diabetes, and Metabolism, and Internal Medicine.
Read on for what Dr. Geller had to say about thyroid health — including symptoms for thyroid issues, solutions, and the basics including what your thyroid is and what it does.
The thyroid gland is about the size and shape of a butterfly. It’s in your neck — just right in front of your throat. Every system in the body needs the thyroid for something, whether it’s our brain function, growth, and development throughout childhood and adulthood, our digestive system, skin, hair, nails, body temperature, metabolism, bone health, reproductive health — everything is dependent on thyroid.
The way I explain to my patients is it’s the gas pedal if it’s overactive, and the brake pedal if the thyroid is underactive.
Hyperthyroidism is the gas pedal. Everything’s revved up, so they’re hot. They feel sweaty. They tend to lose weight without trying. They’re anxious. Their heart is beating fast. They have diarrhea.
The more common scenario that we see, called hypothyroidism — that’s like the brake pedal. Everything’s slowed down, so people feel tired. They have brain fog. They often gain weight. They feel cold. They’re constipated. They may be losing hair. Their nails may crack, and they just have fluid retention and swelling.
Typically we tend to see the onset in the teenage years, twenties, or thirties, but it can happen at any point. The most common cause is an autoimmune condition — and the body’s immune system gets confused and attacks a thyroid, which causes it to get low.
There are numerous other environmental or nutritional things that can affect the thyroid, for example, low iodine is a huge cause of underactive thyroid.
It’s a much more common condition in someone who has a family member with it, and about 8 or 10 times more common in women. Medications can affect the thyroid, too.
Whenever you take a hormone you don’t need, it shuts down your own powerline because your body says “Oh, I’m getting this somewhere else. I don’t need to make my own.” It can also cause side effects of too much thyroid — rapid heart rate, anxiety, and unhealthy weight loss.
There are a lot of different thyroid products out there. The hormone is called T4, which is what the thyroid gland makes. The body converts it to what’s called T3, the active hormone. You can get a thyroid hormone prescription as T4, and the body will hopefully convert it to T3. But, not everyone makes enough T3 when they take T4, so in those scenarios, we give both.
If someone has been inappropriately put on thyroid, we’ll taper them down slowly. Thyroid hormone takes a week for levels to go down by half, so it will slowly taper out of your system. I do recommend frequent monitoring — month by month at first and then quarterly, then two times a year.
There’s a lot of art to this. It’s not just science. There’s not a one size fits all.
Dr. Geller is a board-certified Endocrinologist specializing in the diagnosis and management of complex hormone disorders. He earned his medical degree from the University of Southern California and completed a postdoctoral fellowship at Cedars-Sinai Medical Center in Los Angeles. He also completed an NIH fellowship in Clinical Research and was the past Clinical Chief of the Division of Endocrinology, Diabetes & Metabolism at Cedars-Sinai Medical Center. Dr. Geller has lectured at national symposia and authored numerous publications in the field of Endocrinology. Geller Endocrinology and Internal Medicine has offices in Los Angeles and Palm Beach.
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