the thyroid is small but powerful and plays a vital role in maintaining our physical and mental well-being. This butterfly-shaped gland located under the Adam’s apple secretes and releases hormones that travel to all cells and organs – and therefore impacts processes such as breathing, heart rate, digestion, mood and body temperature.
the two hormones produced by the thyroid are thyroxine, also known as T4, and triiodothyronine, or T3. When the thyroid is not working properly, it can have serious negative health effects. Up to approx. 30 million Americans are affected by some form of thyroid disease – but more than half cases go undiagnosed.
One size does not fit all
A low intake of important thyroid hormones causes a condition called hypothyroidwhile too much causes hyperthyroid. Both are sometimes considered a form of autoimmune disease. In fact, autoimmune thyroid disease (AITD) affects between 2 and 5 percent of the world’s western population. This condition often takes the form of Hashimoto’s thyroiditisfirst identified in 1912 by Japanese physician Hakaru Hashimoto.
People with hyperthyroidism usually take a medicine called methimazole to lower their hormone levels. Sometimes doctors recommend radioactive iodine treatment or transaction. But when you lack sufficient levels of thyroid hormones, they need to be replaced in order to maintain healthy function. There are a surprising number of options for doing this, but most doctors don’t recommend a: synthetic T4 replacement, known as levothyroxine.
This treatment is the predominant approach because it is recommended by the American Thyroid Association (ATA). Unfortunately, many patients remain dissatisfied: Up to 40% of levothyroxine recipients still have symptoms of hypothyroidism. Medicine can also cause insomnia, irregular heartbeat and reduced bone density. Yet people often do not know which alternatives to pursue.
A “normal” test result can be misleading
The thyroid-stimulating hormone, or TSH, test has always been the gold standard for detecting thyroid disease, says endocrinologist and thyroid expert, Brittany Henderson. (For full disclosure, I previously collaborated with Henderson on a 2018 book on Hashimoto.) “It’s a useful initial screening tool, but people can have a normal result and still have an autoimmune disease.” , she says. you make a full panel testing is available.
What’s even more concerning: Most medical providers aren’t aware of these tests, don’t understand the value of ordering them, or don’t know how to interpret them.
Finding a treatment can be challenging
Henderson has worked to raise awareness of the limitations of conventional treatments for thyroid disease. By the time she sees a patient, he has usually seen several other doctors and spent up to a decade seeking help. “Their symptoms were ruled out,” she says. If their TSH result is normal, she notes that they are told there is nothing wrong with them. Other times, Henderson observes how patients have been misdiagnosed with depression or anxiety.
Although these conditions can be caused by thyroid problems, they are not always the underlying issues. From diagnosis to treatment, physicians are largely misinformed when it comes to treating these patients. “What endocrinologists learn in residency and training, and much of the research they know about, is outdated when it comes to treating thyroid disease,” Henderson says. “They’re rooted to follow guidelines, even when those guidelines are 10 to 15 years behind the current state of knowledge.”
You can look past food myths
A common misconception about thyroid disease is that a wide range of foods must be eliminated from patients’ diets to alleviate symptoms. People are often told that they need to eliminate gluten to reduce inflammation. Unless you have celiac disease, gluten sensitivity, or other gastrointestinal issues such as leaky gut, you may not need to avoid it. Indeed, eliminating gluten may have pitfallsincluding lack of important nutrients.
People with thyroid disorders are also often told that they need avoid cruciferous vegetables such as broccoli, cauliflower, spinach and kale. This belief stems from the fact that these foods can be goitrogenic, meaning they can interfere with thyroid function. But they are actually an important part of a healthy diet and are beneficial when eaten in moderation.
Nightshade vegetables like tomatoes and eggplant also get a bad rap. It has been postulated that they may increase inflammation in certain autoimmune conditions, but that is unestablished science. In his practice, Henderson finds that these healthy vegetables are well tolerated by many thyroid patients, while a certain subset of the thyroid population may find them problematic. While certain foods may cause discomfort, Henderson suggests a elimination diet or food sensitivity tests.
Effective care is possible
Balancing your thyroid hormones often requires a multi-pronged approach, which may include exploring options beyond T4 treatment. In response to patient calls for change, the European Thyroid Association (ETA) recommended areas for future research on combination therapy that administers both T4 and T3. Even though the suggestions were made in 2012, none of the promised studies had been published in 2019.
In the middle of the important need for research on combination therapies, patients suffer. Despite growing patient dissatisfaction with T4 supplementation and growth anecdotal evidence in support of combination therapy, the American Thyroid Association (ATA) continues recommended against. Since the ATA sets guidelines for providers, physicians are unlikely to deviate from these recommendations. But as a sign of progress, the ATA and ETA collaborated on a 2019 symposium to explore combination therapy research.
As countless people have been told they need to learn to live with thyroid disease, the treatment landscape is beginning to change. Integrative medicine providers and researchers, for example, take a more comprehensive approach to thyroid management. “In reality, most people benefit from combination treatment, some even reverse their disease,” Henderson says.
After successfully working with thousands of patients, she is trying to change the paradigm of thyroid care. To this end, she co-founded the American College of Thyroidology (ACT). “We want to train providers to properly diagnose and treat patients — and open communication between conventional and complementary medicine for any provider who touches a thyroid patient,” she says. “Patients can be helped and they can get better.”