The Thyroid

The thyroid is a small, butterfly-shaped gland located at the front of your neck, as shown in the photo below. I understand that some of you may already be familiar with this information, but I know others may find it new and enlightening.

I’m Sakhile Ndlalane, commonly known as DocSakhi. I wear many hats and hold a diverse range of qualifications, but today, I’m here as the curator of this newsletter. My passion lies in writing and sharing knowledge for the benefit of all, and I confidently draw on my medical background whenever appropriate.

Welcome to the Ndlalane Health newsletter! I’m thrilled to have you here today. Without any further ado! Let’s dive right in before I bore you with my accolades.

There are two types of thyroid problems:

• Hypothyroidism

• Hyperthyroidism

Hypothyroidism is the underproduction of the thyroid hormones. Hyperthyroidism is the opposite—overproduction...

From my experience in treating thyroid issues, the common symptoms are: 

• Fatigue

• Dry skin

• Tiredness

• Puffy face

• Depression

• Constipation

• More sensitivity to cold 

Today, many people have thyroid problems, but these are often secondary to other issues.

To solve thyroid issues, you must first understand their root cause and the underlying mechanism. I’ve tried to simplify this as best as possible, but some medical jargon could not be avoided. I apologize in advance for that. The idea is not to teach a medical school class but to make the lay person understand complex matters at a really basic level.

In the brain, there is a part called the hypothalamus. It is known as the master regulator of all the glands in the body. In the case of the thyroid, the hypothalamus will release a hormone called the Thyrotropin-Releasing Hormone (TRH) which will instruct another gland in the brain called the pituitary gland to release a hormone called thyroid-stimulating hormone (TSH), this then does what its name implies. It stimulates the thyroid to produce a hormone called Thyroxine (T4), this is made possible by iodine in the thyroid which the body gets from our diet. This hormone is not active yet as it still needs to be activated.

I hope I haven’t lost anyone in this complex but simple process. You must understand this part because if the process doesn’t happen as I just explained, we will start to see sickness and other unwanted symptoms. You can read it again if you want to comprehend it better.

Now we are at the point where the thyroid has listened to instructions of TSH and used iodine in a complex process and has created the T4. Next step is, how do we activate it?  

This T4 hormone then travels from the thyroid gland through blood to the liver, where it is primarily activated. The kidneys also help to activate it but it is mostly the liver that is responsible... the activated version of the hormone changes name and becomes Triiodothyronine(T3),

T3 is very very very important in the body as it is responsible for regulating metabolism and other physiological processes.

When diagnosing the problem, most doctors only look at TSH, but it's important to consider the holistic view of the body.

Getting an idea of how things work inside your body also helps you as the patient to imagine the bigger picture of what is happening inside your body for you to be actively involved in your treatment process and root cause finding.

Let’s explore the first possible root cause ↓

The liver converts the thyroid hormone T4 from its inactive form by activating it to T3 as we have discussed. This means that 80% of the thyroid function occurs through your liver. Thus, damage to the liver may be one cause of your thyroid problems. Excessive alcohol consumption can impact the health of the liver. Abusing medications like paracetamol can also affect the liver.

So one of the tests to request from your physician is a liver function test if you are experiencing any of the symptoms I mentioned earlier or you are told that you might be having trouble with your thyroid.

I would also recommend making it common practice to Perform a liver detox now and again.  Since 80% of the conversion from T4 to T3 occurs in the liver, it must function properly. Speak to your doctor about the supplements you can use to achieve that.

The second problem we can consider is female-specific. There is a hormone in the female body that is called estrogen. This is quite interesting because estrogen has the power to influence / control the pituitary gland. How does that happen? I’ll tell you, try to follow through, and remember everything we just learnt above. So when estrogen levels are high in the body of the woman, it means that she is ovulating or ready to ovulate. This process requires a lot of body energy, to maintain her glow and ready the uterus for possible conception.

How does the body get its energy? By increasing its metabolism rate (metabolism is the rate at which cells create and use up energy). If you have been following, you will know that the thyroid hormone T3 is very very important because it regulates metabolism. 🤭

The estrogen is indeed female because its behaviour is truly that of a woman. Very easy to complain and want to speak to the manager 🤣, (jokes! But work with me). In that trail of thought, so the estrogen goes straight to the pituitary and tells it that it needs energy and that it must tell the thyroid to send some T4 to the liver. 🤷🏽‍♂️

So when does the problem occur? When a woman has very high estrogen, the estrogen promotes too much release of T4 resulting in hyperthyroidism. (See symptoms on photo above).

The matter becomes even more complicated because the very same estrogen up-regulates something called thyroid-binding globulin, in the blood, its idea is to try and rush the T4 into the liver, but the problem with that is that, once the T4 binds to the TBGs, the thyroid hormone markers start to think that, hey maybe there isn’t any T4, let’s make more.

When we test the patient for T4 in blood we find it sky high. If you are the patient in such an instance where your T4 test shows that it’s so high. Kindly ask your treating physician to consider checking your other hormone profiles especially, estrogen. It could be the underlying cause and in that way, we can start to treat accordingly.

In some cases, you can find that the thyroid even starts swelling up, because iodine is deficient in the thyroid as it keeps making too many T4s causing a condition known as goiter.

True healing of the thyroid is not the suppression of symptoms, but the addressing of the root cause and then giving your body the support it needs. Then it will perform miracles.

The thyroid is like an orchestra, and all the players need to be in harmony for optimal health.

There are other root causes, such as an autoimmune, but we will not talk about that for now. In an autoimmune case, your immune system starts killing your thyroid for no apparent reason.

Other factors include gut health and gallbladder health.. how does this help? Briefly, I’ll say, that bile helps to alleviate constipation and promotes a healthy gut which means a more free liver to perform other duties than to monitor the gut content.

We are wrapping up. I realized halfway through this article that, this is a very big topic.. and I might need to make it into a sequel.

Let’s end here for today and we shall continue again and hopefully add more clarity and disease-specific discussion.

Thank you for reading up this far, as always, you are welcome to respond to this email with your comments, questions and concerns.

If you wish to be part of the writing team, please also reach out to me on this email. [email protected] 

Cheers bye for now ✌🏽