Have you ever noticed that levothyroxine always seems to make it onto the top-ten most prescribed medications list? Of course, that's only one of the many thyroid hormone drugs on the market, but the popularity of thyroid hormones does demonstrate that hypothyroidism is a common problem in the US.
Here are a few things to know about our friend the thyroid gland and hypothyroidism, as well as how I work with it:
1. A bunch of different things can cause you to feel, and functionally be, hypothyroid. This may or may not be reflected in your TSH- the one and only lab test 99% of doctors look at when assessing the thyroid.
As is always the case in my practice, my first job as your doctor is to find out why you are hypothyroid. Autoimmunity, inflammation, birth control pills, and certain medications can all cause one to become hypothyroid. Once we know the cause we can (hopefully) try to identify what we can work with naturally, and refer to an MD or DO should the need arise for drugs
2. Autoimmune disease (Hashimoto's) is the number 1 cause of hypothyroidism in the USA and accounts for about 90% of hypothyroid cases. Furthermore, it has been estimated that about 8% of the US population has antibodies to their thyroid. This is tremendously important, as it should (but often does not) change the way these patients are treated and monitored. The vast majority of doctors (endocrinologists alike) simply replace the thyroid hormone that is lost without doing anything to treat the underlying issue: the immune system. For further reading on my approach to managing autoimmune conditions see my previous blog post here.
3. Many people who are getting their thyroid treated still have thyroid symptoms. This is most likely due to what I mentioned above- most of these people are autoimmune patients and their immune system has gone untreated for years. Examples of hypothyroid symptoms that hang around are constipation, skin problems, thinning hair, cold hands and feet, and fatigue and depression. To learn more about this topic, check out this book on amazon by Datis Kharrazian.
4. Iodine is almost never the problem in the United States. This is important, because almost all "holistic" and alternative medicine practitioners just give a ton of Iodine to their thyroid patients. This might be a good bet if we lived in rural Africa, but here in the United States with our love-affair with iodized salt it's virtually a non-issue in regards to the thyroid. For that matter, many autoimmune thyroid patients do worse when they are given Iodine.
5. TSH is not enough to fully assess thyroid function. Ideally, a full thyroid panel should include at least TSH, TPO antibodies, Thyroglobulin antibodies, T3 uptake, Free T3, Reverse T3, and Total T4.
6. Thyroid hormone is critical to the health and metabolism of every single cell in your body. Everything from your brain and your gut, to your skin and your immune system need proper amounts of thyroid hormones to function. If you suspect that you or someone you love is hypothyroid please get the above blood work done and interpreted by a functional medicine doctor ASAP.
7. Not everybody who works with the thyroid is trained equally. Commonly general practitioners and endocrinologists manage your thyroid hormone levels by monitoring TSH. Chiropractors, nutritionists, naturopaths, and other alternative medicine practitioners often load thyroid patients up with Iodine. Neither of these scenarios serve thyroid patients well. Functional medicine doctors are usually a good bet, but ideally you want to find somebody who has received training from Datis Kharrazian. I have had the privilege of taking all of Dr. Kharrazian's courses, including his thyroid course several times.
8. You may need thyroid hormones for the rest of your life. As a chiropractor, it is not uncommon for patients to come to me and ask if I can help them get off their medications. Don't get me wrong, I'm all in favor of living a lifestyle that does not necessitate that you rely on medications, but this is one area where even I have to say that you might just need that pill for the rest of your life. It really depends on two things: 1. What is causing you to be hypothyroid and 2. How long has it been going on.
If you're one of the numerous Hashimoto's cases out there who have been undiagnosed and/or mismanaged for years, you've probably destroyed enough of your thyroid gland that you can't make as much thyroid hormone anymore. Years of an unchecked autoimmune attack means that you've been waging war on your poor, little thyroid for a long, long time, and to my knowledge there is no amount of supplements that will ever bring it back. If, however, you are a relatively "fresh" autoimmune person and we catch you before you shred the poor little thyroid to ribbons we might be able to get you to the point where you no longer need additional hormone support. Now, that's not to say that you won't feel much better with this type of treatment- I'm just saying that we might not be able to ever get you off your pills and you need to be okay with that.
If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.