To Your Health

Q. I am in early menopause and recently was diagnosed as hyperthyroid. I would rather not have surgery or radioactive iodine treatment. Are there other options?

A. The thyroid gland, largest of the endocrine glands, is the body's metabolic thermostat. It regulates body temperature and the rate of energy production, which greatly influences the rate at which all body organs function. This butterfly-shaped gland, located close to the windpipe, secretes two hormones: thyroxine (T4) and tri-iodothyronine (T3). Approximately 93% of the thyroid gland production is T4 with 7% T3. Secretion of thyroid hormones is regulated by thyroid-stimulating hormone, secreted by the pituitary gland in the brain. The thyroid gland also secretes a hormone called calcitonin, involved in calcium metabolism.

Hyperthyroidism results from overactive thyroid gland function. Excessive amounts of thyroid hormones are secreted, resulting in an overactive metabolism, accelerating all the body's processes. Symptoms include constantly feeling hot, increased perspiration, nervousness, irritability, insomnia, increased frequency of bowel movements, hair loss, weight loss, rapid heartbeat, and sometimes protruding eyeballs.

Although all the body's hormones interact, there is a closer than usual relationship of thyroid to ovarian hormones. Most commonly, as a woman approaches menopause, estrogen excess or progesterone deficiency tends to cause a hypothyroid state. Most women find that replacement of progesterone, with its anti-inflammatory and protective effects, leads to a more comfortable menopause. However, progesterone also facilitates the release of hormones from the thyroid gland while estrogen blocks their release. An imbalance between progesterone and estrogen may cause changes in circulating thyroid hormone levels. A simple saliva test for the levels of estrogen and progesterone is available.

A more serious hazard is Graves' disease, an autoimmune disorder that accounts for 85% of all cases of hyperthyroidism. This immune system defect leads to the production of antibodies that attack the thyroid gland and eye muscle tissue. The cause of Graves' disease is not known, though research is focusing on genetic issues.

Hyperthyroidism is not a simple one-deficiency disease, but nutritional intervention may help. For instance, vitamin A supplements have been used for a long time for hyperthyroidism and vitamin A deficiency has recently been shown to increase T3 output, which could lead to hyperthyroidism. In laboratory animals, vitamin A deficiency also alters the structure of thyroglobulin, the protein that carries the thyroid hormone, and this may lead to changes in thyroid function.

Essential fatty acids also inhibit thyroid function at many levels but are subject to damage when not accompanied by antioxidants, coenzyme Q-10 in particular. It is also important to maintain a balance of omega-3 and omega-6 essential fatty acids.

Because of increased metabolism, hyperthyroidism increases nutrient requirements. You should be careful to get very good nutrition for a while, emphasizing fruits and vegetables, and eating very little junk food.