FEATURE — When it comes to hypothyroid patients in the United States, approximately 80-90% of them have an autoimmune disease called Hashimoto’s thyroiditis.
With Hashimoto’s, an errant immune system attacks and “chews up” the thyroid gland to the point where it becomes inflamed, swollen, impaired and unable to produce the hormones it should to maintain health and quality of life. Sometimes during the typically long process of destruction that characterizes Hashimoto’s, the gland even dumps too much hormone for short periods of time, creating hyper/hypo cycles that can drive patients and their doctors to the end of their ropes.
Despite Hashimoto’s dominance in the thyroiditis category, doctors seldom diagnose it via lab tests because insurance companies are unwilling to pay for the tests. They know that conventional medical treatment for Hashimoto’s – hormone replacement therapy – is the same as the treatment for other forms of hypothyroidism.
The thinking goes like this: If the treatment is going to be the same no matter what, why pay for extra testing? Seems logical enough. But is it? Let’s explore.
A large number of my patients are middle-aged women who come to my office after having been told by doctors that they are hypothyroid. They have been taking various hormone replacement medications to get their laboratory numbers – especially their pituitary TSH and thyroid T4 levels – back into normal ranges.
Despite the treatment, including jumps in dosage, these women continue to exhibit many different symptoms, including symptoms of hypothyroidism that hormone replacement was supposed to alleviate.
When that approach failed to relieve symptoms for these women, another diagnosis often followed, usually from the following sickness menu: depression, cyclothymia, PMS, chronic fatigue syndrome, fibromyalgia and anxiety disorder. For these women, the additional diagnoses have meant more drugs and more side effects from those drugs yet little, if any, relief from the misery they suffer. What is going on?
The immune system has two sides. One side attacks invaders while the other side creates antibodies that tag invaders for later attack and removal. With Hashimoto’s, one side has gone hyper, tricking the body into attacking its own cells. Further, when a confused immune system creates errant antibodies that attack the thyroid, those inflammatory antibodies also convince other body cells to resist thyroid hormones present in the bloodstream.
That’s not good.
Thyroid hormones are meant to trigger important metabolic functions within cells. When the cells resist, the hormones already present don’t work well and energy levels tank. That is why a patient can have adequate levels of thyroid hormones in the bloodstream and still have symptoms of low thyroid.
The key to managing the immune system of a Hashimoto’s patient is to find out whether the patient indeed has Hashimoto’s. We then can find out what side of the immune system is out of kilter and bring it back into balance with the other. This doesn’t mean suppression, which is dangerous; it means modulation.
Once the proper laboratory panels are run – including a comprehensive thyroid panel – and after looking for blood sugar disorders, other hormone imbalances, anemia patterns and adrenal gland dysfunction, the needed approach usually becomes quite clear.
But that approach must be tailored to each individual. One size does not fit all because too many things are often out of kilter at the same time with Hashimoto’s. What’s more, doctors need time to truly listen to patients, a service that is in short supply under today’s insurance-driven health care system.
Treating Hashimoto’s, whether actively diagnosed or not, as a thyroid disease requiring only hormone replacement is fighting the wrong battle. Hashimoto’s thyroid is basically an immune system problem that just happens to be targeting the thyroid. Manage the immune system problem well and the thyroid gland will often recover stability.
Moreover, further damage – and continued symptoms – can usually be averted by finding out what triggered Hashimoto’s in the first place, managing the diet, evaluating GI function for issues, altering general lifestyle behavior and supplementing with immune-system modulating plant extracts commonly used in functional medicine.
Yes, hormone replacement may still be needed if too much damage has been done and the gland is no longer able to produce sufficient amounts. Although Hashimoto’s is the result of some form of genetic susceptibility to environmental and other triggers and can’t be reversed in the current science, it can be managed and held at bay very well to regain quality of life.
Written by East West Health Wellness Experts.
This article was first published in St. George Health and Wellness magazine.
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