Hypothyroidism is a medical condition that denotes an under-performing thyroid gland, incapable of producing adequate amounts of thyroid hormones necessary to fulfill the body's metabolic requirements.

This health issue often lies beneath the surface, subtly influencing various bodily processes, and results in a wide spectrum of clinical manifestations, ranging from mild to severe symptomatic manifestations.

Crucially, the thyroid gland, nestled in the front of our necks, shoulders an immense responsibility for maintaining the intricate balance of our metabolic activities. It accomplishes this task by secreting two primary hormones into the bloodstream: Thyroxine (T4) and Triiodothyronine (T3). These hormones essentially govern the speed and efficiency at which cells convert nutrients into energy—a process we recognize as metabolism.

When the thyroid is functioning normally, it maintains a fine equilibrium, ensuring our cells operate at a steady, optimal pace. However, if the thyroid is unable to secrete enough of these hormones (a state referred to as hypothyroidism), it results in a general metabolic slowdown across the body.

This can potentially impair the body's growth, repair, and several other necessary functions, consequently negatively impacting an individual's overall health status.

What Causes Hypothyroidism?

Hypothyroidism, often portrayed as an invisible enemy with widespread effects, does not occur in isolation. The condition can stem from various underlying causes, each initiating a series of biological events that ultimately lead to an underactive thyroid.

To better understand and possibly prevent this disruptive metabolic disorder, one must first delve into the common causes of hypothyroidism.

There are several potential causes of hypothyroidism, including:

Autoimmune Thyroiditis (Hashimoto's Thyroiditis)

Regarded as the leading cause of hypothyroidism in industrialized nations, Hashimoto's thyroiditis shines a spotlight on the sometimes paradoxical behavior of our own bodies.

This autoimmune condition occurs when the body's defense mechanism, the immune system, misidentifies the thyroid gland as a foreign invader and launches an attack against it.

In normal circumstances, our immune system functions as a fine-tuned system for detecting and neutralizing threats such as bacteria, viruses, and other harmful antigens. It keeps a patient vigil over our bodies, ensuring we stay healthy.

However, in the case of autoimmune disorders like Hashimoto's thyroiditis, this protective shield malfunctions and starts attacking the body's own cells.

Iodine Deficiency

Iodine is an indispensable micronutrient that plays a cardinal role in the synthesis of thyroid hormones. This often under-appreciated trace element is a vital building block for creating the hormones T4 and T3.

Without a regular and sufficient intake of iodine through diet, the thyroid gland falls short in its hormonal production, creating a scenario that paves the way for hypothyroidism. 

Sources of iodine that one can reach for are kelp, seaweed, seafood, and sea salt. 

Selenium Deficiency

Selenium, a vital trace element, plays a significant role in our thyroid function, particularly in the production and conversion of critical thyroid hormones. This noteworthy component is integral to the synthesis of tetraiodothyronine (T4), a principal thyroid hormone that bears much importance in regulating metabolic functions. But the critical role of selenium extends beyond the initial production of T4. Even after T4 synthesis, selenium remains in the spotlight, as it is quintessential for the subsequent transformation of T4 into the biologically active form of thyroid hormone, triiodothyronine (T3).

This important conversion process allows the body to efficiently utilize the thyroid hormone, further emphasizing the need for adequate selenium intake. 

Sources of selenium are brazil nuts, seafood and organ meats.

Thyroid Surgery or Radioactive Iodine Treatment

In certain circumstances, more aggressive measures such as thyroid gland surgery or radioactive iodine treatments may be required to manage severe thyroid conditions like thyroid cancer or hyperthyroidism—an overactive thyroid.

However, while these interventions can effectively counter the present ailment, they can potentially swing the pendulum in the opposite direction, creating another issue: hypothyroidism. Surgical removal of the thyroid gland, known as a thyroidectomy, eradicates the source of thyroid hormone production.

Similarly, radioactive iodine treatments are used to deliberately damage or kill thyroid cells, effectively reducing the overproduction of thyroid hormones in conditions like hyperthyroidism.

Yet, by reducing or eradicating hormone production from the thyroid gland, these treatments may inadvertently create a deficit, causing the individual to shift from an overactive to an underactive thyroid state.

In situations where these treatments are necessary, the onset of hypothyroidism is typically managed through lifelong thyroid hormone replacement therapy. This compensatory strategy involves administering synthetic thyroid hormone (Levothyroxine) to maintain normal hormone levels and metabolic activities.

While it may seem like a significant shift, with proper medical management and regular monitoring, individuals can seamlessly transition into a new, healthier equilibrium.

What Medications Affect The Thyroid?

It's crucial to understand that some medications, designed to treat various medical conditions, might inadvertently impact the functionality of the thyroid gland, occasionally leading to a condition known as hypothyroidism.

Hypothyroidism refers to the diminished production of thyroid hormones by the thyroid gland, which can have wide-ranging effects on the body's metabolic processes.

One of the common medicines that may influence the thyroid gland's performance is Lithium, often prescribed for patients dealing with bipolar disorder. While it's proven remarkably efficient for managing and reducing the severity of manic episodes, lithium can sometimes tamper with the thyroid hormone production.

Long-term lithium therapy causes reduced thyroxine (T4) secretion in patients, leading to hypothyroidism symptoms like weight gain, tiredness, and decreased body temperature. In the medical management of heart arrhythmias, a drug known as Amiodarone is commonly used.

Despite its significant benefits in regulating heart rhythm, amiodarone carries the possibility of causing thyroid imbalances due to its high iodine content. Since the thyroid gland uses iodine to produce its hormones, an excess amount of this element can either lead to hyperthyroidism (too much hormone) or hypothyroidism (too little hormone).

Anti-thyroid medications, prescribed to treat conditions like hyperthyroidism, can occasionally flip the problem and result in hypothyroidism. These drugs work by slowing down the thyroid gland's hormone production, which, when not carefully monitored, can overflow into limiting hormone production to the point of hypothyroidism. This underlines the importance of regular testing and adaptability within the treatment regimen to effectively manage thyroid hormone balance.

Radiation Therapy

Radiation therapy is a vital component in the battle against several forms of cancer, including those located in the head and neck.

Although it plays a significant role in debilitating or eliminating cancer cells, it may inadvertently affect the thyroid gland leading to a condition known as hypothyroidism.

Radiation therapy, specifically in the neck or head regions, forms an integral part of the treatment strategy for various head and neck cancers.

However, this particular treatment can sometimes showcase a double-edged nature due to its potential impact on the thyroid gland. The gland, located in the neck, can be caught in the radiation field during treatment, which could inflict unintended harm.

Hypothyroidism embodies a condition where the thyroid does not produce adequate thyroid hormones, impacting numerous metabolic functions within the body. When the thyroid gland is exposed to radiation during therapy, the gland cells can sustain damage affecting their ability to produce these essential hormones, thus inducing hypothyroidism. Symptoms can range from fatigue and weight gain to more severe signs such as depression and persistent feelings of cold. It is crucial to comprehend the significance of radiation-induced hypothyroidism, as it quickly becomes an understated burden for patients who have undergone head and neck radiation therapy. It is, therefore, crucial to monitor thyroid function in patients who have undergone such therapy. Regular thyroid function tests can ensure timely diagnosis and prompt treatment, minimizing the overall impact on patients.

Congenital Hypothyroidism

Congenital hypothyroidism is a condition in which an individual is born with a thyroid gland that doesn't produce enough thyroid hormones. This condition arises due to the thyroid gland failing to develop correctly or working inefficiently from birth. Screening programs, typically undertaken shortly after birth, aid in early detection of this condition. These programs employ tests that determine the levels of thyroid-stimulating hormone (TSH) and thyroxine (T4). An increased level of TSH and/or decreased T4 level could indicate the presence of congenital hypothyroidism.

When diagnosed early through newborn screening programs, the treatment administered promptly leads to generally normal neurocognitive outcomes as the child develops into adulthood.

However, it's noteworthy that newborn screening for hypothyroidism is not practiced universally, with a significant percentage of neonates worldwide (approximately 70%) not undergoing such testing.

The management of congenital hypothyroidism typically necessitates lifelong thyroid hormone replacement therapy. The aim of this treatment is to compensate for the deficient production of thyroid hormones, effectively mitigating the potential impact on the body's metabolic processes.

Pituitary or Hypothalamic Disorders

Certain conditions affecting the regulatory organs of the thyroid gland, specifically the pituitary gland and the hypothalamus, can instigate a form of hypothyroidism known as secondary or central hypothyroidism.

In such instances, the thyroid gland rarely exhibits inherent issues; the root of the problem instead lies in an interrupted communication pathway required for thyroid hormone production. The pituitary gland and hypothalamus operate as key overseers of the endocrine system, with the presiding responsibility of regulating hormone production from the thyroid gland.

These supervising entities wield decisive control over the body's hormonal balance via a set of signals that activate or inhibit the thyroid gland's functions as necessary.

Secondary hypothyroidism, also known as central hypothyroidism, develops when this closely coordinated system experiences disruption. Unlike primary hypothyroidism, where the thyroid gland itself is defective, secondary hypothyroidism arises from problems with either the pituitary gland or the hypothalamus.

The result is an impaired signal transmission to the thyroid gland, akin to a miscommunication causing the thyroid to decrease hormone production, even though it is structurally sound.

Common causes initiating secondary hypothyroidism may include specific diseases affecting pituitary function, such as a pituitary tumor or hypopituitarism. Inflammatory, infiltrative, or neoplastic diseases can influence the hypothalamus, leading to secondary hypothyroidism. Besides, medical interventions involving radiation therapy or surgery can inadvertently impact the hypothalamic-pituitary axis, disrupting the network that regulates thyroid function.

Other Autoimmune Conditions

Indeed, there's a fascinating interplay between autoimmune conditions like celiac disease, type 1 diabetes, and the risk of developing hypothyroidism.

Celiac disease and type 1 diabetes are autoimmune conditions that share common susceptibility factors, notably HLA genetics. Both illnesses have seen increasing incidences worldwide, suggesting that, in addition to genetic factors, environmental influences play a significant role in disease pathogenesis.

Celiac disease, in particular, has been identified as a risk factor for autoimmune thyroid disease (ATD) in individuals with Type 1 Diabetes(T1D)2. This risk increases with the duration of Celiac disease, with the excess risk highest in those who had celiac disease for 10 years or more2.

To underscore the importance of these connections, medical professionals often take into account the autoimmune status and history of patients when treating each of these conditions. By doing so, they ensure a well-rounded therapeutic approach that acknowledges the impact and potential interplay of these autoimmune diseases.

Pregnancy

During pregnancy, some women may experience a temporary form of hypothyroidism termed gestational hypothyroidism. This condition arises due to a variety of reasons, such as the initial presentation of Hashimoto's thyroiditis, inadequate treatment of a woman known to have existing hypothyroidism, or over-treatment of a hyperthyroid woman with anti-thyroid medications. In certain cases, gestational hypothyroidism may resolve after childbirth.

Many symptoms of hypothyroidism, such as fatigue, weight gain, or abnormal menstruation, are similar to pregnancy symptoms, which may make diagnosing gestational hypothyroidism more challenging[^2^]. Low thyroid hormone levels during pregnancy may also interfere with the chances of becoming pregnant or cause other complications.

Liver, Gut, or Kidney Conversion Issues

The thyroid gland produces two forms of hormones: triiodothyronine (T3) and thyroxine (T4). The latter is often referred to as an inactive thyroid hormone, as it requires conversion to its active form, T3, to carry out its functions effectively. This crucial conversion process takes place predominantly in the liver and kidneys.

The liver plays an essential role in thyroid hormone activation, inactivation, transport, and metabolism. Additionally, D1 enzymes, largely expressed in the liver and kidneys, possess outer ring deiodinase activity, catalyzing the conversion of the prohormone T4 into active hormone T3.

Though often overlooked, the gut also plays a part in this conversion. Commensal gut microbiota can influence the availability of iodine for thyroid hormone synthesis and can modulate thyroid hormone’s enterohepatic circulation.

Heavy Metal Toxicity

Indeed, there is scientific consensus that heavy metals, including uranium, arsenic, mercury, and cadmium, can disrupt the normal functioning of the thyroid gland, potentially leading to hypothyroidism.

These toxic heavy metals expose the body, notably the thyroid gland, to undue stress by disrupting critical cellular events. This includes suppressing cell growth, differentiation, damage-repairing processes, and apoptosis.

Such disruptions can impede the thyroid's capability to produce adequate thyroid hormones.

The conversion of the inactive thyroid hormone T4 into its active form T3 is another crucial process that can be compromised by heavy metal exposure. Some metals can induce toxicity through pathways like ROS generation, weakening the antioxidant defense, and enzyme inactivation—processes implicated in the inactivation of thyroid hormones. Lastly, the body's sensitivity to thyroid hormones can be affected by these metals. For instance, mercury can bind to thyroid hormone receptors and disturb normal thyroid activities, having a profound effect on the body's ability to utilize these hormones appropriately.

What are the Signs and Symptoms of Hypothyroidism?

Understanding and recognizing the array of symptoms associated with hypothyroidism, an often underdiagnosed condition, is a vital aspect of proactive health management.

Hypothyroidism, characterized by an underactive thyroid gland, can manifest through a host of interrelated signs that may be easily mistaken for routine fatigue or stress. Notable symptoms can include persistent lethargy, increased body weight disproportionate to calorie intake, heightened sensitivity to cold, and skin that is unusually dry.

Other subtle but significant indicators can be hair loss, mood swings leaning towards depression or anxiety, blood pressure readings on the lower end of the scale, chronic constipation, and a diminished sexual drive.

While managing these signs, it's also essential not to lose sight of the valuable role specific minerals play in maintaining or restoring thyroid health.

The importance of iodine and selenium, two markers of thyroid health, is well-established; they are quintessential to the production and function of thyroid hormones.

Yet, our focus should broaden to include other less-discussed but equally significant minerals. One such element is manganese, whose role in thyroid health remains noteworthy.

Manganese, though not as frequently discussed as iodine and selenium, plays a critical part in mitigating risks associated with hypothyroidism. Its vital role is illustrated in its function as a co-activator for various enzymes, including one that protects the thyroid gland from damage induced by oxidative stress.

Besides, manganese participates in the synthesis of thyroglobulin, a precursor necessary for the production of thyroid hormones T3 and T4. Importantly, manganese has also been suggested to assist the deiodinase activity, a vital process that converts the largely inactive T4 into the more potent T3.

Thus, in the symphony of minerals governing thyroid health, manganese clearly plays a substantially meaningful part.

Can Manganese Deficiency Cause Hypothyroidism?

Manganese, a critical trace mineral, holds an indispensable role in numerous biochemical processes pivotal to human health, a fact that often goes unsung.

Although it shares the stage with key players like iodine and selenium, its part in maintaining normal thyroid function is worth highlighting. While manganese may not be directly involved in thyroid hormone synthesis—roles primarily assumed by iodine and selenium—it indirectly holds influence over thyroid health.

Its significance extends to various dimensions of thyroid functionality and provides a much-needed balance, thus setting the stage for overall wellness.

It's important to understand that every element related to thyroid function often works in synergy, and manganese is no exception.

Its role, albeit less direct, is as critical as that of iodine and selenium, especially regarding the promotion of a well-functioning and healthy thyroid gland.

Manganese's Influence on Thyroid Function

As an architect of vital biochemical processes, manganese serves crucial roles that extend beyond its status as a trace mineral. Its significance reverberates across several areas, impacting thyroid hormone synthesis, antioxidant defense, and bone health.

Enzyme Activation

Manganese assumes a crucial role as a cofactor for various enzymes, notably those intertwined with the synthesis of thyroid hormones. One of its key responsibilities is activating thyroxine 5'-deiodinase, a specific enzyme responsible for catalyzing the conversion of the relatively inactive thyroid hormone, thyroxine (T4), into triiodothyronine (T3)—the active form.

This active thyroid hormone, T3, is primarily responsible for a multitude of biological effects across the body.

Antioxidant Defense

Moreover, manganese has a pivotal role in maintaining the body's antioxidant defense by actively participating in superoxide dismutase (SOD) enzyme activity. Antioxidants are important shields that protect the thyroid tissues from oxidative stress-induced damage, which could, if unchecked, impair thyroid function.

Thus, manganese fortifies the body's defenses, ensuring a healthy thyroid.

Bone Health

Manganese is equally essential to bone health and growth. It plays an instrumental role in bone metabolism—a cyclic process of bone formation and resorption, which is vital for maintaining healthy bones.

Notably, the health of the skeletal system and the function of the thyroid gland are intrinsically linked, primarily because thyroid hormones significantly influence bone density.

Therefore, the role of manganese here is two-fold, impacting both bone health and consequently, thyroid health.

What are the signs of Manganese Deficiency?

Manganese is an essential trace mineral required by the human body in relatively small quantities, and a balanced diet typically supplies an adequate amount. However, it's concerning that manganese deficiency, while technically rare, is becoming more common in contemporary times.

This increase in deficiency can be attributed to a combination of factors, including poor agricultural practices involving the excessive use of fertilizers and pesticides, as well as the widespread depletion and stress experienced by individuals, which can compromise their ability to absorb nutrients effectively.

Despite being less common than other nutritional deficiencies, a shortage of manganese can manifest in various subtle signs and symptoms, indicating the importance of addressing this issue:

Impaired Growth and Development

Manganese plays a pivotal role in promoting proper growth and development in the human body. In children, a deficiency can lead to growth retardation and the development of skeletal abnormalities, underscoring its significance for healthy childhood development.

Reproductive Issues

Manganese is crucial for the production and activation of specific enzymes involved in reproductive health.

A deficiency can result in fertility problems and complications with reproductive organs, highlighting its relevance for maintaining reproductive well-being.

Bone Health

Manganese is actively involved in the formation and maintenance of bones. A deficiency in this mineral may lead to weakened bones, thereby increasing the risk of fractures and conditions like osteoporosis.

Neurological Symptoms

Severe manganese deficiency can, in rare cases, lead to neurological symptoms, including altered mental states, tremors, and muscle contractions. Although such symptoms are infrequent and typically associated with severe deficiency, they emphasize the importance of maintaining adequate manganese levels for neurological health.

Impaired Glucose Metabolism

Manganese is essential for the metabolism of carbohydrates and contributes to the proper functioning of insulin. A deficiency can potentially disrupt glucose regulation and increase the risk of insulin resistance, which is a significant concern in the context of metabolic health.

Reduced Antioxidant Defense

Manganese acts as a cofactor for the antioxidant enzyme superoxide dismutase (SOD), which helps protect cells from oxidative stress. A deficiency in manganese can result in a reduced antioxidant defense, rendering cells more susceptible to damage from oxidative stress, a factor associated with various health issues.

What are the Factors that affect Manganese Absorption?

Considering this, it's essential to understand that, as with other nutrients, manganese interacts with both antagonists and synergists — substances that can either deplete it or enhance its absorption.

Certain minerals, such as iron, calcium, magnesium, copper, chromium, vanadium, and phosphorus, may act as manganese antagonists. Essentially, they can hinder or diminish the biological effects of manganese.

If you're consuming substantial amounts of these minerals, particularly in supplementary form, it's crucial to be aware that you might be reducing your manganese levels.

Another critical factor to be aware of is the presence of dietary phytates and fiber, which are predominantly found in plant-based diets. Phytates are compounds present in specific plant foods, including grains, seeds, and legumes.

They can interact with manganese, thereby lowering its bioavailability. Ways to mitigate the effect of phytates on manganese absorption include cooking, soaking, or fermenting these foods.

Although some dietary fibers can obstruct manganese absorption, this impact is generally considered less significant than the interference caused by minerals such as iron, calcium, and magnesium.

However, it's worth underlining that while these substances may hinder manganese absorption, they rarely pose a problem within a balanced eating regimen. Many of these so-called antagonists are, in fact, essential minerals and nutrients required by the body.

A well-rounded diet ensures the necessary nutrient intake while avoiding potential manganese deficiency.

On the other hand, synergists such as zinc, choline, and vitamin K can significantly enhance manganese absorption and utilization. Interestingly, these synergists are abundantly found in diets consisting of both plant and animal-derived foods, often referred to as omnivorous diets.

Conclusion

In conclusion, understanding the intricate web of factors influencing thyroid health is essential for maintaining overall well-being.

Hypothyroidism, characterized by an underactive thyroid gland, can result from various causes, including autoimmune conditions, iodine or selenium deficiency, medications, radiation therapy, congenital issues, and more. Recognizing the signs and symptoms of hypothyroidism, often mistaken for routine fatigue or stress, is crucial for timely diagnosis and management.

While iodine and selenium are well-known players in thyroid health, manganese, a trace mineral with a less direct but equally critical role, should not be overlooked. Manganese influences thyroid hormone synthesis, antioxidant defense, and bone health.

Manganese deficiency can lead to various health issues, underscoring the importance of maintaining a balanced diet and considering the impact of dietary factors on manganese absorption. In the symphony of minerals governing thyroid health, manganese plays a substantially meaningful part alongside iodine and selenium, ensuring a harmonious and well-functioning thyroid gland.

If you're uncertain about whether you have a manganese deficiency or if you're considering manganese supplementation, the most effective approach is to undergo a Hair Tissue Mineral Analysis with us.

This analysis will provide comprehensive information and insights into your mineral and heavy metal levels.

Once you have a clear understanding of your specific needs, you can explore our Upgraded Manganese supplement for a reliable solution.

Barbara Madimenos
Hair Tissue Mineral Analysis Practitoner
Functional Diagnostic Nutrition Practitioner
Integrative Nutrition Coach