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Overactive, underactive, Hashimoto's... learn to understand the thyroid

In order to understand what causes an underactive thyroid (hypothyroidism) and which micronutrients and hormones can be used to treat it, let's first take a closer look at how the thyroid works.

The protein thyroglobulin is stored in the thyroid cells. When iodine is delivered through the blood, it binds as iodide to the thyrosine amino acids in 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 formed ). The significantly larger part, 93%, is converted into T4 and only 7% into T3.

D.H An iron deficiency reduces TPO activity and thus limits the synthesis of T3 and T4!

T3 and T4 are then stored in the thyroid until the hormone TSH (“thyroid stimulating hormone”), which comes from the pituitary gland, gives the signal to release T3 and T4 into the blood. TSH reaches the thyroid via the blood and binds to so-called TSH receptors. After receptor binding, the thyroid releases T3 and T4 into the blood.

V.a The 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 achieved.

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

TRH release is promoted, for example. It is inhibited by stress or cold, for example. through cortisol or T3. TSH release is also inhibited by cortisol; As explained, it is promoted by the TRH, but also by dopamine.

T3 is the active hormone, T4 is the “storage hormone” and is slowly converted into T3 in the blood. The conversion of T4 into T3 takes place via deiodination by the so-called Deiodase. These are selenoenzymes (i.e.H require selenium as a cofactor), which activates T3 by removing an iodine atom. D.H A selenium deficiency reduces deiodase activity and thus the conversion of T4 into more effective T3 in the liver and kidneys.

Since 60% of T4 is converted into T3 in the liver, normal thyroid activity depends on a functioning liver. Therefore, at this point we would like to refer to the CLEAN preparation from QIDOSHA, which contains many ingredients to strengthen the liver, such as: Choline.

When it comes to deiodase, a distinction is made between 5' and 5' deiodase. The iodine atoms are located at T4 anda on the 5th Position on the outer and inner ring. The iodine atoms of the 5th Positions on the outer ring are referred to as 5' and those on the inner ring as 5. Only the 5' deiodase leads to conversion to T3. The 5 deiodase leads to rT3; this is biologically inactive and has no mitochondrial effect, i.e.H does not contribute to cellular energy production. This undesirable 5 deiodase leads to functional hypothyroidism, also called “low T3 syndrome”.

The undesirable 5 deiodase can, for example, are triggered by stress, fasting, illness or cortisol.

The cofactors required for the desired 5' deiodase are, in addition to selenium, zinc and iron (for TPO / s.O)

Underactive thyroid

Hypothyroidism (underactive thyroid) is rarely congenital, but rather i.dR acquired. Triggers for hypothyroidism can be, for example:

  • Iodine deficiency
  • Liver malfunction
  • Lack of the cofactors selenium, zinc and iron
  • Autoimmune diseases (Hashimoto)
  • Hormonal imbalance in the sex hormone area, here especially.a progesterone (progesterone is a sex hormone that is mainlya in women, processes such as menstrual cycle, pregnancy, etc. regulated)
  • Long-term stress


Typical symptoms by which hypothyroidism can be recognized are, for example:

  • Sensitivity to cold
  • Lethargy
  • Swelling of the eyes and face
  • Thick tongue
  • Weight gain
  • Hoarseness
  • Muscle weakness
  • Hair loss
  • Loss of appetite
  • Brittle nails


Consequences of hypothyroidism can be:

  • Slowed metabolism
  • Irregular cycle
  • Infertility
  • Decrease in progesterone sensitivity


In the following, negative influencing factors on the thyroid along the activation chain will be presented in order to clarify possible connection points for micronutrients and hormones:

  1. Hypothalamus --> serotonin, dopamine deficiency, increased prolactin --> progesterone deficiency
  2. Pituitary gland --> increased cortisol
  3. Thyroid --> Iodine deficiency, Hashimoto
  4. T4/T3 synthesis --> selenium, zinc, iron deficiency, increased cortisol, progesterone deficiency
  5. T4/T3 transport --> estrogen dominance, low TBG
  6. SD receptor --> increased cortisol, progesterone deficiency

Ad 2/6: One of the most common causes of hypothyroidism is a lack of sleep: after just one night with too little sleep, the cortisol level does not fall sufficiently in the evening in the following days, which leads to a slight constant stress situation.

In summary, the following hormones and micronutrients are helpful for supporting thyroid function (source and quantitative guidelines: 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 substitution from middle age counteracts the age-related disorder of T3 formation) (0.5-1 mg)
  • Vitamin C (500 mg)


If hypothyroidism is suspected, the basal TSH should first be determined, the reference range of which is 0.4-2.5 mU/l. If the value is increased, the free T4 must then be determined: if this is low despite a high TSH, then there is manifest hypothyroidism. If the free T4 is (still) normal, it is referred to as latent hypothyroidism.

If, on the other hand, the TSH value is too low and T3 and T4 are increased at the same time, this is referred to as hyperthyroidism, the so-called. Hyperthyroidism.


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 longest life expectancy and the lowest infant mortality rate. In this context, it is noteworthy that the Japanese consume an average of 13.9-45 mg of iodine per day through their diet, which is 13,900 mcg - 45.000 mcg! For comparison: the DGE recommends a daily iodine intake of just 200 mcg for healthy, non-pregnant adults!

Germany is now considered an iodine deficiency area, which is due to the iodine deficiency in soil and groundwater as well as in animal and plant foods. But also an increased need such as due to pregnancy or growth can be the cause of iodine deficiency. Only around 9% of the population has sufficient iodine intake; at approx. 15% of adults have a true iodine deficiency.

Official intake recommendations from DGE and BfR:

  • Infants                                      50-80 mcg iodine/day
  • Children                                          100-140 mcg iodine/day
  • Adolescents & adults         180-200 mcg iodine/day
  • Pregnant & breastfeeding women              200-300 mcg iodine/day


The upper recommendation limit in the USA, on the other hand, is 1.1 mg and in Japan even 3 mg (i.e.H 3000 mcg!) per day!

But in order to only achieve the intake amount of 200 mcg iodine that is officially valid in Germany, you would have to, for example: 1 kg of spinach, 154 g of mussels, 340 g of oysters or 104 g of plaice should be eaten daily. It should be noted that iodine is a volatile element that evaporates at low temperatures.DH The iodine salt used by many households supplies v.a The extractor hood has enough iodine, but not necessarily the body.

Approximately 70-80% of all iodine in the body is found in the thyroid. The rest is distributed among the muscles, gallbladder, pituitary gland, salivary and mammary glands, eyes, spleen and adrenal glands as well as exposed mucous membranes. In addition to its involvement in the production of thyroid hormones, it has other important functions such as: as an antioxidant (protects cell membranes, fats, proteins and THEN from radicals  iodolipids), has an antiviral and antibacterial effect, lowers cholesterol, is necessary for protein formation and induces antiproliferative and apoptotic effects via iodolactones and thiol depletion.

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

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


Why can't the thyroid do without selenium?

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


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

Animal: Seleno-cysteine - is specifically incorporated into selenoproteins


Selenite (SeO3) / Redox status: +4 - is specifically incorporated into selenoproteins / Attention: no simultaneous intake of vitamin C, as selenite (usually sodium selenite in supplements) would then be reduced to elemental and inactive selenium; Recommendation: 1 hour apart when taking vitamin C and sodium selenite

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

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

After absorption, the selenium enters the erythrocytes and is bound to plasma proteins there. Selenium also reaches the organs and binds there.a to metal chelates; Therefore, selenium also plays a role in detoxification (seeu) a major role.

The most important seleno-proteins (contain selenium as seleno-cysteine) include:

  • Iodothyronine deiodases: deiodination of T4 to active T3 and vice versa
  • Glutathione peroxidases: breakdown 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. NFkB)


Effects of Selenium:

  • Thyroid hormone metabolism (iodothyronine deiodases / s.O)
  • Detoxification: Detoxification of heavy metals (e.g.b Mercury, cadmium, lead, arsenic) by forming inactive selenium compounds, which can then be excreted in the urine. E.g.: 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
  • Anticarcinogenic (inactivation of oncogenic gene segments): Selenium protects healthy cells, but not cancer cells (since selenium only forms selenium disulfide in tumor cells with a high glutathione concentration, which reduces the antioxidant protection of the tumor cell) from radicals. In addition, selenium is involved in the DNA repair of damaged “normal” cells and acts as a trigger for apoptosis and growth arrest of cancer cells (e.g. via transcription factor p53)
  • Cell proliferation and 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 by inhibiting redox-sensitive transcription factors NFkB (thioredoxin reductases), which promote inflammation


How can I increase selenium levels naturally?

The recommended selenium intake is 20-100 mcg/day - depending on the initial situation. The actual intake for men in Germany is only 47 mcg/day, and for women it is only 38 mcg/day.

Approximately 85% of the selenium intake in adults comes from meat. The notable exception are Brazil nuts, which contain a lot 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-poor soils
  • Vegan diet
  • Absorption disorders (v.a in the small intestine)
  • Increased selenium requirement depending on life situation


Consequences of selenium deficiency can be:

  • Underactive thyroid
  • Changes to skin, hair, nails
  • Muscular diseases with muscle weakness
  • Low HDL cholesterol
  • Diseases of the heart muscle and hypertension
  • Weakening of the immune system
  • Joint problems
  • Infertility in men
  • Growth delays in children
  • Cancer



Hashimoto's thyroiditis is primarily a female disease, as around 9 times as many women as men are affected. Typical symptoms are sweating, lack of motivation and fatigue - the typical climacteric symptoms. What is noteworthy in this context is the occurrence of Hashimoto's thyroiditis with hormonal changes such as menopause and childbirth as well as special stressful situations.

Hashimoto is an autoimmune thyroid disease in which the body produces antibodies against its own thyroid, which leads to its inflammation. After initial symptoms of hyperfunction (due to an immunological destruction of hormone-storing thyroid tissue, i.e.H the cell destruction triggers a passive hormone release), the transition to chronic hypofunction follows and in the long term the inflammation leads to the destruction of the organ. Courses with fluctuating hormone levels are occasionally possible, especially in the early phase of the disease. During this “rollercoaster ride” between hyperfunction and hypofunction, normal values ​​can also arise that conceal deviations in hypofunction and hyperfunction, depending on the time at which the blood is taken.

With the appropriate genetic predisposition, the immune system is probably affected by stress/adrenocortical dysfunction, infections or other factors such as: Excessive iodine intake becomes unbalanced and immune cells directed against your own thyroid get out of control. Free radicals and oxidative processes fuel the immune process in the thyroid.

This chronic inflammation of the thyroid cannot be cured, but there are things you can do to improve the condition. In this context u.a referred to adaptogens from phytotherapy, which have an immunomodulating effect . DH with an excessive immune response as in the above.G In this case, they contribute to a “down-regulation” of the system. Adaptogens in Ayurveda are Ashwaganda, Shatavari and Brahmi. In TCM, Reishi, Agaricus blazei (almond mushroom) and Hericium are particularly strong adaptogens.

To reduce the effects of free radicals, we have an enzymatic antioxidant system that should be supported in the event of an overload of antioxidants supplied through food. Particularly strong antioxidants include:a Quercetin and OPC grape seed extract. A combination of various, particularly strong antioxidants, e.g.T QIDOSHA's ANTI-OX preparation also works synergistically, with some substances reducing other antioxidants.

Hashimoto v. is proven.a using the following parameters:

  • Microsomal antibodies (TPO-Ab) increased in about 90%
  • Antibodies against thyroglobulin (Tg-Ab) increased in around 70%
  • TSH receptor antibodies (TRAK) not increased
  • Inhomogeneous, hypoechoic ultrasound image


The primary therapy for Hashimoto's is the administration of thyroid hormones, e.g. 50-100 mcg L-thyroxine. As a complementary therapy, an additional administration of progesterone to replace thyroid hormones is often recommended, which reduces anti-TPO (30-50% within 2-6 months). Sleep, mood and physical and mental resilience often improve as a result. It is also important to compensate for common selenium, zinc, iron and vitamin D deficiencies (source: Schulte-Uebbing 2012). As explained, selenium, zinc and iron are important cofactors; When it comes to vitamin D, it's mainlya about its immunomodulating and anti-inflammatory effects.


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