By Amber Golshani, ND

January is thyroid awareness month. I am glad to see this small, unassuming gland getting it's time to shine. You probably won't see billboards, bumper stickers and celebrities reminding you to take care of your thyroid. That is a shame, because it is estimated that the majority of Americans with a thyroid problem don't even know it! Unfortunately, even those who are diagnosed often do not receive proper care. Some experts estimate that as many as 30 million to 50 million Americans have a thyroid disorder. Are you one of them?

The thyroid gland controls metabolism, which is the pace and process by which your body converts oxygen and food (calories) into energy for use by your cells, tissues and organs. It is a small butterfly-shaped gland on the front of your neck, below the Adam's apple. It secretes four hormones, the main two are triiodothyronine (T3) and thyroxine (T4). Thyroxine is often called inactive because most of the cells need it to be converted to T3 to be used. The hormones travel through the blood to be delivered to all parts of the body to keep things working at an appropriate pace.

The most common disorders of the thyroid include:
• Hypothyroidism. The gland produces less than optimal amounts of hormone. Symptoms include fatigue, weight gain, dry skin, constipation, thinning eyebrows, chilliness, foggy thinking, high cholesterol, low blood pressure and more.
• Hyperthyroidism. The gland is overactive, producing too much hormone. Symptoms include anxiety, weight loss, hot flashes, restlessness, irritation and racing heart.
• Autoimmune thyroiditis. The body's own immune system is attacking the gland. This can result in Hashimoto's thyroiditis, which causes hypothyroidism as the gland is destroyed, or Graves disease, which produces symptoms of hyperthyroidism.
• Thyroiditis, nodules, goiters and cancer are other disorders of the thyroid gland, which can occur.

A good doctor will do a thorough evaluation of your risk factors, family history, dietary intake, exposures to potential toxins. He or she will perform a physical exam of your thyroid and other areas for thyroid specific disorders and order lab tests and imaging, if necessary.

Which tests are ordered and how these lab tests are interpreted will depend on how up to date the practitioner is. There have been changes made to what is considered the normal range for the TSH (thyroid stimulating hormone) test. Despite the test having changed almost a decade ago, most doctors still rely on the old range, leaving many people feeling poorly and without treatment. Make sure your practitioner goes by the recommendations from the American Association of Clinical Endocrinologists. Be aware, however, that the TSH test may provide an incomplete picture of what is really happening. For symptomatic patients, I recommend at least these tests: a TSH, free T3 and total T3, a free T4 and total T4, and auto-antibodies to get an accurate idea of thyroid function.

To find a doctor that is up to date with thyroid diagnosis and treatment see www.aace.com or consult a licensed naturopathic doctor to explore the underlying cause of the problem and natural treatment at www.naturopathic.org.

Amber Golshani, ND, is a frequent contributor to the Konsyl Supplement.