To understand what triggers hypothyroidism and which micronutrients and hormones can be used to treat it, let's first take a closer look at how the thyroid gland works.

The protein thyroglobulin is stored in the thyroid cells. When iodine is delivered via the blood, it binds as iodide to the tyrosine amino acids in the thyroglobulin, and with the help of the enzyme TPO (thyroidal peroxidase) and iron as a cofactor, the thyroid hormones T4 (thyroxine, also called tetraiodothyronine) and T3 (triiodothyronine) are produced. In this process, the vast majority (93%) is converted into T4, and only 7% into T3.

D.hIron deficiency reduces TPO activity and thus limits the synthesis of T3 and T4!

T3 and T4 are then stored in the thyroid gland until the hormone TSH (thyroid-stimulating hormone), which originates from the pituitary gland, signals the release of T3 and T4 into the bloodstream. TSH travels through the blood to the thyroid gland and binds to TSH receptors. Once the receptors are bound, the thyroid gland releases T3 and T4 into the blood.

V.a. free T4 in turn inhibits the release of TSH, so that the amount of thyroid hormones in the blood normally regulates itself and a balance is established.

The production and release of TSH, in turn, depends on the TRH (thyrotropin-releasing hormone) level. TRH is produced by the hypothalamus, which sets the target value for thyroid hormones in the blood and constantly measures their actual levels.

TRH release is promoted by factors such as stress or cold, and inhibited by factors such as cortisol or T3. TSH release is also inhibited by cortisol; it is promoted, as explained, by TRH, but also by dopamine.

T3 is the active hormone, T4 the "storage hormone" and is slowly converted into T3 in the blood. The conversion of T4 to T3 occurs via deiodination by so-called deiodinases. These are selenoenzymes (d.h. require selenium as a cofactor), which activates T3 by removing an iodine atom. D.hA selenium deficiency reduces deiodinase activity and thus the conversion of T4 to more effective T3 in the liver and kidneys.

Since 60% of T4 is converted into T3 in the liver, normal thyroid function depends on a functioning liver. Therefore, we would like to draw your attention to the CLEAN preparation from QIDOSHA, which contains many ingredients to strengthen the liver, such as choline.

Deiodinases are distinguished as 5' and 5' deiodinase. The iodine atoms are located at T4. u.a...at the 5th position on the outer and inner rings. The iodine atoms at the 5th position on the outer ring are designated 5' and those on the inner ring as 5'. Only the 5' deiodinase leads to the conversion to T3. The 5' deiodinase leads to rT3; this is biologically inactive and has no mitochondrial activity. d.hIt does not contribute to cellular energy production. This unwanted 5-deiodinase leads to functional hypothyroidism, also known as "low T3 syndrome".

The unwanted 5-deiodinase can be triggered, for example, by stress, fasting, illness, or cortisol.

The cofactors required for the desired 5' deiodinase are, besides selenium, zinc and iron (for TPO/s.o.).

Hypothyroidism

Hypothyroidism (underactive thyroid) is rarely congenital, but rather i.d.RAcquired. Triggers for hypothyroidism can include, for example:

• Iodine deficiency
• Liver dysfunction
• Deficiency of the cofactors selenium, zinc and iron
• Autoimmune diseases (Hashimoto's thyroiditis)
• Hormonal imbalance in the sex hormone area, here v.a.progesterone (progesterone is a sex hormone that v.a(regulates processes in women such as the menstrual cycle, pregnancy, etc.)
• Prolonged stress

Typical symptoms that can indicate an underactive thyroid include:

• sensitivity to cold
• lethargy
• Swelling around the eye and face
• Thick tongue
• weight gain
• hoarseness
• Muscle weakness
• hair loss
• Loss of appetite
• Brittle nails

The consequences of hypothyroidism can include:

• Slowed metabolism
• Irregular cycle
• infertility
• Decline in progesterone sensitivity

The following section outlines negative influencing factors on the thyroid gland along the activation chain in order to highlight possible points of contact for micronutrients and hormones:

1. Hypothalamus --&Serotonin and dopamine deficiency, elevated prolactin --&progesterone deficiency
2. Pituitary gland --&elevated cortisol
3. Thyroid gland&iodine deficiency, Hashimoto's
4. T4/T3 synthesis --&Selenium, zinc, and iron deficiency; elevated cortisol; progesterone deficiency
5. T4/T3 Transport --&estrogen dominance, low TBG
6. SD receptor --&elevated cortisol, progesterone deficiency

Ad 2/6: One of the most common causes of hypothyroidism is lack of sleep: After just one night with too little sleep, the cortisol level does not drop sufficiently in the evenings in the following days, leading to a mild, persistent stress situation.

In summary, the following hormones and micronutrients are helpful in supporting thyroid function (source and recommended amounts: Dr. Robert Berger):

• Iron and vitamin B12 (ferritin) >100)
• Selenium (50-200 mcg)
• Bioidentical progesterone (25-200 mg)
• Zinc (10-30 mg)
• Vitamin B6 (20 mg)
• Iodine (500 mcg)
• Magnesium (400-1000 mg)
• Vitamin D (2000 IU)
• Melatonin (physiological melatonin replacement from middle age onwards counteracts age-related impairment of T3 production) (0.5-1 mg)
• Vitamin C (500 mg)

If hypothyroidism is suspected, the first step should be to determine the basal TSH level, which has a reference range of 0.4–2.5 mU/L. If the value is elevated, the next step is to determine the free T4 level: if this is low despite a high TSH level, then overt hypothyroidism is present. If the free T4 level is (still) normal, it is referred to as subclinical hypothyroidism.

If, on the other hand, the TSH level is too low and T3 and T4 are elevated at the same time, this is called hyperthyroidism.

EXCURSUS ON IODINE

What does iodine have to do with the healthiest people in the world?

The Japanese are considered the healthiest people in the world, with the highest life expectancy and the lowest infant mortality rate. Remarkably, the Japanese consume an average of 13.9–45 mg of iodine per day through their diet, which equates to 13,900–45,000 mcg! For comparison, the German Nutrition Society (DGE) recommends a daily iodine intake of just 200 mcg for healthy, non-pregnant adults!

Germany is now considered an iodine-deficient region, due to the low iodine levels in both soil and groundwater, as well as in animal and plant-based foods. Increased demand, for example, from certain lifestyles, also contributes to the deficiency.Pregnancy or growth spurts can cause iodine deficiency. Only about 9% of the population has sufficient iodine intake; approximately 15% of adults suffer from a true iodine deficiency.

Official intake recommendations from DGE and BfR:

• infants 50-80 mcg iodine/day
• Children 100-140 mcg iodine/day
• youth && Adults     180-200 mcg iodine/day
• Pregnant women && breastfeeding       200-300 mcg iodine/day

In contrast, the upper recommended limit in the USA is 1.1 mg and in Japan even 3 mg (d.h3000 mcg!) per day!

However, in order to reach the officially valid intake of 200 mcg of iodine in Germany, one would have to eat, for example, 1 kg of spinach, 154 g of mussels, 340 g of oysters or 104 g of plaice daily. It should be noted that iodine is a volatile element that evaporates even at low temperatures. D.h. the iodized salt used by many households provides v.aThe extractor hood contains sufficient iodine, but not necessarily the body.

Approximately 70-80% of the body's total iodine is found in the thyroid gland. The remainder is distributed among muscles, bile, the pituitary gland, salivary and mammary glands, eyes, spleen, and adrenal glands, as well as exposed mucous membranes. Besides its role in the production of thyroid hormones, iodine has other important functions, such as acting as an antioxidant (protecting cell membranes, fats, proteins, and DNA from free radicals  iodolipids), possessing antiviral and antibacterial properties, lowering cholesterol, being necessary for protein synthesis, and inducing antiproliferative and apoptotic effects via iodolactones and thiol depletion.

Inorganic iodide (the main form in food) is absorbed by the small intestine at a rate of 90-100%, while protein-bound iodine is absorbed at only 40-70%. Obstacles to iodine absorption include: v.a. large amounts of chlorine, fluorine, lithium and bromine, which may be found in pesticides or even food.

Up to 70% of ingested iodine reaches the thyroid gland on day 1 of intake. Absorption is inhibited there. v.a. through cabbage, beets (oxazolidin-2-thiones), rapeseed and soy (goitrogens).

EXCURSUS SELEN

Why can't the thyroid gland do without selenium?

Selenium is a trace element and can be ingested in both organic (food proteins) and inorganic forms (e.g., in drinking water or through supplements):

Organic

Plant-based: Seleno-methionine - is incorporated non-specifically into all proteins

Animal-derived: Seleno-cysteine - is specifically incorporated into selenoproteins

Inorganic

Selenite (SeO3)/Redox status+4 - is specifically incorporated into selenoproteins/Caution: do not take vitamin C at the same time, as selenite (usually sodium selenite in supplements) would then be reduced to elemental and inactive selenium; Recommendation: 1 hour interval between taking vitamin C and sodium selenite

Selenate (SeO4)/Redox status+6 - is specifically incorporated into selenoproteins

Selenium is absorbed in the upper small intestine at a rate of approximately 80-90%. The absorption of organic selenium is better, but slower, than that of inorganic selenium.Within the group of organic selenium, the availability of seleno-cysteine ​​is faster than that of seleno-methionine.

After absorption, selenium enters the erythrocytes and binds to plasma proteins there. Selenium also reaches the organs and binds to them. u.a. to metal chelates; therefore, selenium also plays a role in detoxification (s.u.) a major role.

The most important selenoproteins (containing selenium as selenocysteine) include:

• Iodothyronine deiodinases: Deiodination of T4 to active T3 and vice versa
• Glutathione peroxidases: Degradation of peroxides
• Thioredoxin reductases: Control of the intracellular redox status (essential for cell division and differentiation) as well as regulation of transcription factors (e.g. NF-κB)

Effects of selenium:

• Thyroid hormone metabolism (iodothyronine deiodinases/s.o.)
• Detoxification: Detoxification of heavy metals (z.BMercury, cadmium, lead, arsenic) by forming inactive selenium compounds, which can then be excreted in the urine. Example: Hg2+ + Se --> HgSe
• Immunocompetent: Selenium improves/increases apoptosis in tumors, interferon-gamma (marks antigen-presenting cells), the activity of T cells, NK cells, cytotoxic cells and macrophages.
• Anticancer agent (inactivation of oncogenic gene segments): Selenium protects healthy cells, but not cancer cells (since selenium only forms selenium disulfide in tumor cells with high glutathione concentrations, which reduces the antioxidant protection of the tumor cell) from free radicals. Furthermore, selenium is involved in DNA repair of damaged "normal" cells and acts as a trigger for apoptosis and growth arrest in cancer cells (e.g., via transcription factor p53).
• Cell proliferation and cell differentiation (thioredoxin reductases)
• Antioxidant (cofactor of glutathione peroxidases) in erythrocytes, fatty acids, cell organelles, phospholipid membranes; selenite binds organic oxyl and hydroxyl radicals.
• Anti-inflammatory effect through inhibition of redox-sensitive transcription factors NFkB (thioredoxin reductases), which promote inflammation.

How can I naturally raise my selenium levels?

The recommended daily intake of selenium is 20-100 mcg, depending on the individual's starting point. However, the actual intake for men in Germany is only 47 mcg/day, and for women even less, at just 38 mcg/day.

Approximately 85% of selenium intake in adults comes from meat. A notable exception is Brazil nuts, which contain a very high amount of selenium.

Selenium sources in mcg/100 g:

• Brazil nuts: up to 2550 (= up to 90 mcg selenium per nut)
• Offal: 60
• Seafood: 30-70
• Egg yolk: 30
• Mushrooms: 12-25
• Meat: 12-22
• Potatoes, vegetables, fruit: 0.5-1

Causes of selenium deficiency:

• Selenium-deficient soils
• Vegan diet
• Absorption disorders (v.a.in the small intestine)
• Increased selenium requirement depending on life situation

Consequences of selenium deficiency can include:

• Hypothyroidism
• Changes in skin, hair, nails
• Muscle diseases with muscle weakness
• Low HDL cholesterol
• Diseases of the heart muscle and hypertension
• Weakening of the immune system
• Joint pain
• Infertility in men
• Growth delays in children
• Cancer

HASHIMOTO

Hashimoto's thyroiditis is predominantly a women's disease, affecting approximately nine times as many women as men. Typical symptoms include sweating, lack of energy, and fatigue—the typical symptoms of menopause. It is noteworthy that Hashimoto's thyroiditis often coincides with hormonal changes such as menopause and childbirth, as well as with periods of particular stress.

Hashimoto's is a autoimmun A thyroid disease caused by the body producing antibodies against its own thyroid gland, leading to inflammation. After initial symptoms of hyperthyroidism (due to immunological destruction of hormone-storing thyroid tissue, d.hCell destruction triggers passive hormone release, leading to a transition to chronic hypothyroidism, and in the long term, inflammation causes organ destruction. Especially in the early stages of the disease, fluctuating hormone levels are occasionally possible. During this "rollercoaster ride" between hyper- and hypothyroidism, normal values ​​can occur depending on when the blood sample is taken, masking deviations in hypo- and hyperfunction.

Presumably, in individuals with a corresponding genetic predisposition, the immune system becomes unbalanced due to stress/adrenal dysfunction, infections, or other factors such as excessive iodine intake, and immune cells directed against the thyroid gland run amok. Free radicals and oxidative processes further fuel the immune response in the thyroid.

This chronic inflammation of the thyroid gland is incurable, but there are things that can be done to improve the condition. In this context, u.a. on Adaptogens referred to from phytotherapy, which immunomodulating effect have. D.h. in the case of an excessive immune response, as in o.gIn some cases, they contribute to a "downregulation" of the system. In Ayurveda, they are considered adaptogens. Ashwagandha, Shatavari and BrahmiIn Traditional Chinese Medicine (TCM) Reishi, Agaricus blazei (almond mushroom) and Hericium They represent particularly strong adaptogens.

To reduce the effects of free radicals, we have an enzymatic antioxidant system that, in case of overload, Antioxidants, which should be supported by dietary intake. Particularly potent antioxidants are considered to be u.a. Quercetin and OPC grape seed extractA combination of various, particularly potent antioxidants that z.T. synergistic effects, in that some substances reduce other antioxidants, can also be found in the ANTI-OX preparation from QIDOSHA.

Hashimoto's disease has been confirmed. v.a.using the following parameters:

• Microsomal antibodies (TPO-Ab) are elevated in approximately 90% of cases.
• Antibodies against thyroglobulin (Tg-Ab) are elevated in approximately 70% of cases.
• TSH receptor antibodies (TRAK) not elevated
• Inhomogeneous, hypoechoic ultrasound image

The primary therapy for Hashimoto's thyroiditis is the administration of thyroid hormones, for example, 50-100 mcg of levothyroxine. As a complementary therapy, additional progesterone is often recommended to replace thyroid hormones, which reduces anti-TPO levels (30-50% within 2-6 months). Sleep, mood, and physical and mental resilience also frequently improve as a result. It is also important to address any frequently occurring deficiencies in selenium, zinc, iron, and vitamin D (source: Schulte-Uebbing 2012). As explained, selenium, zinc, and iron are important cofactors; vitamin D is... v.a...for its immunomodulating and anti-inflammatory effect.