1 – Thyroid disease is primarily a thyroid disorder
It can be incredibly confusing and frustrating for anyone suffering from thyroid symptoms to go for years if not decades without a proper diagnosis. Did you know that 95% of people with thyroid disease have a history of a gastrointestinal disorder called “leaky gut” that is the precursor to the body producing antibodies against their thyroid? As these antibodies form and bind to the thyroid they slowly start to destroy the thyroid, which eventually impacts the ability to make thyroid hormones. This is why TSH eventually goes up although it can take decades. Although it may be a relief to finally get a diagnosis, the common medications do not stop the disease from destroying the thyroid and medications frequently need to be adjusted. If you have a thyroid disease, it is most likely auto-immune in nature. As a result, the immune system needs to be addressed in order to truly address the underlying causes of your thyroid disease. Supporting your triggers, genetics, and environment through a customized approach is essential to regaining your health!
2 – You need medication or one kind of medication is superior to another
Once diagnosed with Hashimoto’s the risk is quite high that without proper intervention you will at some point in your life struggle to make thyroid hormones and become hypothyroid. But, just because you had a diagnosis does not mean you immediately need thyroid hormones (I would add that they can absolutely be helpful with true hypothyroidism as defined by elevated TSH and low T4). In fact, one of the most challenging gut problems related to thyroid disease is something called small intestinal bacterial overgrowth (SIBO), which according to a February 2017 medical article published in World Journal Gastroenterology is exacerbated or initiated by levothyroxine (thyroid hormone replacement) medication. Also, I’ve worked with over 2,000 hypothyroid cases and everyone responds differently to different medications. I have seen dramatic improvements when someone has switched from Armour and other porcine T4/T3 combo drugs to synthetic medications and I have seen the binders in synthetic hormones cause severe flares in autoimmune symptoms. Bottom line, if you can afford it custom compounded (pharmacist) T4/T3 is best (unless you are sensitive to T3 and get hyperthyroid symptoms), WP Armour is my second choice and Tyrosint is my first choice for synthetics.
3 – Once diagnosed, my thyroid will only get worse
When you are diagnosed a classically trained MD is going to drop the bomb on you that you will need thyroid hormone replacement the rest of your life. At that point, you may really need the hormone if you are in bad shape and it can help you pull yourself out of a serious funk! But, what they are not telling you is multiple medical trials have shown that thyroid tissue can heal with the assistance of low-level laser therapy (cold laser). As I’ve explained before your thyroid is similar to cartilage and with enough cold laser treatment it is possible to regenerate. This can drop TSH, improve T4 production and remove thyroid peroxidase antibodies from your thyroid tissue! Bottom line is that even if you have had a thyroid disorder for decades, there are ways to address the root cause and rehabilitate the damage so that you never feel like you have a thyroid disorder.
4 – Foods like Cabbage, Broccoli and Brussel sprouts are harmful
I feel so bad for these poor foods! They are maligned throughout the internet and very commonly seen as one of the boogeymen to your thyroid. However, multiple medical trials show protective effects from thyroid cancer with goitrogenic foods! The confusion started in the 1950’s when we had a nationwide epidemic of iodine deficiency and research done on rats showed that extremely high doses of extracts from goitrogenic foods like broccoli, kale, etc. created nodules and goiters on their thyroid. This has been extrapolated as evidence we should not consume these powerful foods. Interestingly, the doses they gave are typically around 20-50 heads of cabbage or broccoli. How would you feel if someone injected you with a dose of anything that high? We now know that most Americans are iodine-replete. This iodine protects the thyroid from goitrogens. Bottom line, eat these foods liberally and if you are still worried go ahead and cook the vegetables (not to long please!) as this will remove any anti-nutrients that could affect your thyroid tissue.
5 – Once you have one autoimmune disease you will develop others
This is unfortunately true for those that do not dig in and find the root causes of their autoimmune condition. Research indicates that after someone is diagnosed with one autoimmune disease they have a 50% chance of already having a second autoimmune condition. And the likelihood of developing another, increases. But, autoimmune progression does not have to be your destiny! Polyautoimmune disease is a reality for many of my clients and can be tested numerous ways. Anti-Nuclear Antibodies (ANA) are a way to detect multiple autoimmune conditions and anyone with Hashimoto’s hypothyroid or Graves disease should have this basic screening test. But, there are another 175 known tissue antibodies and it can be difficult and expensive trying to hunt down the positive markers! The truth is that with the right changes to the environment, lifestyle and elimination of triggers you can start to heal your body and watch your antibody counts drop! This is very exciting as I work with clients and we get them closer to remission and towards optimal health!
6 – My Dr’s test said I didn’t have a problem with gluten so I can eat it right?
I wish! When you consult with your medical doctor, and I recommend you have a relationship with one, they are taught a model that specific gastrointestinal antibodies like IgA anti-transglutaminase or anti-endomysial antibodies should be positive and a confirmation biopsy showing villous atrophy in your intestines must be confirmed to go on a gluten-free diet. Unfortunately, for anyone with an autoimmune disease, gluten causes the body to increase current antibody production and increase the attack on the affected tissues. Thus, eating gluten when diagnosed with Hashimoto’s escalates the attack on your thyroid. We also know that there are at least 24 different antibodies you can react to. Gluten sensitivity and Celiac disease are only two manifestations of a larger problem with the protein. Avoiding foods containing wheat, barley, rye, and spelt are essential with any autoimmune condition. Additionally, gluten sensitivity may not be causing gastrointestinal disease or even GI symptoms. In 2001, a preeminent neurologist published an article saying “That gluten sensitivity is regarded as principally a disease of the small bowel is a historical misconception.” Unfortunately, most Western-trained medical professionals may not look to give you proper screening if you do not have GI symptoms, or if they do it may be lacking in what markers are administered. Going gluten-free should be one of the first steps after you are diagnosed. Bottom line, don’t believe that feeling crummy is a product of stress or your thyroid hormones just need adjustment – good chance it’s that bagel you just ordered!
7 – Selenium from Brazil nuts is the best source of this nutrient for my thyroid
A lack of selenium is often shown as a common trigger for the onset of Hashimoto’s disease. The thyroid requires proper selenium levels to neutralize inflammation and for conversion of T4 to T3. It has also been shown to reduce thyroid antibodies. This nutrient is found in Brazil nuts but the selenium content can vary 10x depending on the source! What’s important about that fact is that selenium has a narrow spectrum of action. Meaning that doses below 200mcg did not show clinical benefit and extended doses above 900mcg can actually create toxicity! Bottom line, get a trustworthy pharmaceutical grade product and do not exceed 200mcg twice daily for more than three months!
8 – I must depend on my Doctor to optimize my thyroid condition
It is always wise to have an integrative doctor in your corner who can manage medications and help lend effective advice to keep you on the lowest medications possible. But, too long have we depended on professional medical advice as sacrosanct and impenetrable to doubt. The only person that is going to optimize their Thyroid condition is you. There are phenomenal resources out there including blogs, books, documentaries (Thyroid Secret Woot Woot!) and inspirational lectures (RTWC upcoming events) to help guide you through this complex process. You truly need a team if you want success! Optimizing thyroid function takes time, dedication and a great functional medicine practitioner to help navigate your unique triggers. Bottom line, get help but from someone who is knowledgeable various aspects of your thyroid condition and who has the compassion and knowledge to stick with you through this process.
9 – Iodine is a top supplement for thyroid disease
Iodine is a necessary nutrient for thyroid hormone production. We use this halogen for multiple purposes in the thyroid including the production of thyroid peroxidase, an enzyme critical for the production of T4 (4 = 4 iodine molecules, T3 = 3 iodine molecules, and thyroid peroxidase help catalyze this reaction). So, many well-intentioned health enthusiasts believe that higher doses of iodine can improve your bodies ability to produce thyroid hormones. The problem is that very high doses actually shut down a pump that brings nutrients to the thyroid (called a symporter) and levels of iodine >300mcg correlated with risk of developing Hashimoto’s hypothyroidism! This is a complex issue because iodine cuts both ways and it appears that if the tissue is already inflamed and with both low selenium and elevated iodine it creates a perfect storm for the creation of these aggressive thyroid antibodies! Bottom line, do not exceed 300mcg of iodine per day if you have thyroid peroxidase or anti-thyroglobulin antibodies which may include kelp, dulce, and seaweed!
10 – TSH is the only test you need for thyroid function
Thyroid Stimulating Hormone, TSH is a completely valid test to look at how the pituitary is receiving feedback from the thyroid for three things: thyroid peroxidase enzyme, iodine, and tyrosine. It does not accurately reflect iodine/tyrosine levels but these two are necessary for thyroid hormone production (buzz kill, please don’t run out and take tyrosine because I’ve never seen it help hypothyroid patients). There are 10 common patterns of thyroid dysfunction and 21 possible reasons for thyroid dysregulation. TSH only measures 3 of those 21 potential problems and yet providers are stuck on relying on this marker as the “be all, end all”. On top of that, the range of TSH is .6-4.6 in the Denver metro area so you may be at a 4.5 and are still considered “normal”. I always recommend the American Endocrine Society range of 1-2.5 and people typically feel the best when they are closer to 1.0. As part of an initial workup, we measure at least 9 markers for thyroid dysfunction. But cortisol, estrogen/progesterone, food sensitivities and dysbiosis (bacterial imbalances) all can contribute to the vicious circle you may find yourself in now. Bottom line, TSH is a valid test for the above mentioned but it is not comprehensive and you should ask your doctor for TSH, T4/T3 (total and free – 4 total), T3U, TPO/TBG Ab, and rT3.
I hope this short list gave you some insight into the complexity of endocrinology and how taking a critical eye towards many of the perceived truths may benefit your health. If you are struggling with fatigue, inability to lose weight, anxiety/depression, hair skin or nail problems, constipation or GI distress and sleep problems then you need to take a deeper look at your thyroid physiology through the lens of functional medicine. Keep learning and asking the hard questions to your providers and if they can’t answer them or guide you on the path towards remission or at least feeling great – find someone who can!
Sincerely, Dr. Ian Hollaman, D.C., MSc, IFMCP
Upcoming Dr. Autoimmune Thyroid Lectures
Lectures are held at Dr. Autoimmune in Boulder Colorado at 4520 N.Broadway. SPACE IS LIMITED!
Thursday, January 25th at 6:00 pm -FULL-
Saturday, January 27th at 10:00 am
Thursday, February 1st at 6:00 pm
Thursday, February 15th at 6:00 pm
If you or someone you know is interested in joining Dr. Ian Hollaman, D.C. for a free lecture please call 303.882.8447 OR register with the form below. Lecture attendees will also have access to exclusive, new patient pricing.