Thyroid disease is one of the most common conditions I see at my clinic. According to the Cleveland Clinic, over 20 million people in America have some sort of thyroid disease. In this post we will look at the different types of thyroid disease and dive into the integrative side of diagnosing and treating.
Types of Thyroid Disease:
Hypothyroid Disease: When the thyroid gland is under producing thyroid hormones. This often causes weight gain, constipation, fatigue, dry skin, memory problems, slow heart rate, depression and more.
Hyperthyroid Disease: When they thyroid gland is over producing thyroid hormones. This often causes anxiety, weight loss, thin/brittle nails and hair, increased sweating, irritability, diarrhea, bulging eyes, goiter, hand tremors, heart palpitations and more.
Hashimoto’s Thyroiditis: This is the most common thyroid disease, affecting 13 million Americans. This is when autoantibodies are produced and the body is mistaking good thyroid cells as foreign, causing an autoimmune type reaction. If caught and treated early, this can be reversed and person doesn’t have to go on medication (or doesn’t have to go on medication for a lifetime). People with Hashimoto’s can fluctuate between hyper and hypothyroid symptoms.
Grave’s Disease: This is an autoimmune thyroid disease that causes hyperthyroidism. The body attacks the gland and it produces increased thyroid hormone.
Testing for Thyroid Disease:
I often see patients that have chronic fatigue or have been on the most common thyroid medication (levothyroxine) for many years but still don’t feel well. They are told that their TSH (thyroid stimulating hormone) lab looks fine and that they must be okay.
In order to get a full picture of my patients thyroid, I run a full thyroid panel which includes: TSH, Free T3, Free T4, Reverse T3, TPO and thyroglobulin antibodies. Often times, the autoantibodies are the first to turn abnormal before the TSH or any other marker. When the autoantibodies are elevated, we take proactive measures with the patient so that they don’t end up with thyroid disease.
Checking infections is also important when someone presents with thyroid disease. Fatigue, sore muscles, painful joints, brain fog and sleeping issues are common symptoms and often times I find an underlying reactivated infection going on in the body (ie: Epstein Barr Virus or even parasites). When I treat underlying infections in the body, the patient’s symptoms improve.
Treating Thyroid Disease with Medications:
If the patient is currently being treated for thyroid disease and is on medications, we see what their labs are telling us. I like to see the TSH around 2.0 or less (even though the limits are higher), Free T3 around 3.0-3.5 and Reverse T3 less than 17. People just seem to feel best around these markers.
When choosing treatment options, I look at all the labs. Levothyroxine is a synthetic T4 hormone. Liothyronine is a synthetic T3 hormone. Natural thyroid is requested often among my patients. As the name implies, this is a type of natural hormone typically made from porcine (some bovine) thyroid. It has T4, T3, T2, T1 and other substances as well, more reflecting our own thyroid gland. If the autoantibodies are high in a patient, I will wait to prescribe the natural thyroid medications because as noted above, if there’s autoimmune issues to the thyroid such as hashimoto’s thyroiditis, then the body might not like the natural thyroid medication. In these patient’s I usually start with Liothyronine, because T3 is the most active thyroid hormone in the body.
Treating Thyroid with Diet:
Hashimoto’s Thyroiditis is an autoimmune reaction and can be constantly triggered by inflammatory foods. Gluten and dairy are the two biggest culprits that I see in my patients. I have patients remove these completely for a minimum of 4 weeks and I see how their body, mood and energy feels. Typically energy improves and their health and digestion are enhanced. I work closely with each patient to reintroduce foods back into their diet or continue to keep the foods out that are causing triggers to their thyroid.
Supplements for the Thyroid:
A good thyroid supplement regimen truly depends on what the patient is dealing with and what the root causes of their thyroid disease are. In general, the thyroid is most supported by common minerals:
- Zinc 25-30mg daily with food
- Selenium 200mcg daily
- Magnesium Glycinate 300-400mg in evening
- Thyroid Support: This contains the above minerals, some vitamins and actual thyroid and adrenal glandular, may or may not be recommended depending on symptoms
- Iodine may or may not be recommended depending on symptoms
Overall, I have seen patients decrease symptoms, improve their mood and decrease medication use by supporting their body and getting to the root cause. Like any autoimmune disease, genes may play a role, but environment is what triggers the cascade of disease. Decreasing toxins in the environment, decreasing stress and improving diet can help prevent these issues from occurring.
This blog post is not intended to replace medical advice. Work with a provider willing to work with you on root cause health and get your thyroid functioning optimally! If you have symptoms, continue to ask why, get to the root cause of your health.
Stephanie Grutz, ARNP, FNP-C
Owner Balance Integrative Health & Wellness