Dr. Chris Heimlich, DC, DACNB, Scottsdale Thyroid Doctor Comments:
Although I have written posts about blood sugar and low thyroid symptoms in the past, I came across a recent article the other day that I wanted to share with you that links thyroid disorders and diabetes. The article states that Diabetes and Thyroid Disease appear to be closely linked. They also stated that the data did not differ between type 1 and type 2 Diabetes.
The article also suggested a common genetic background for both thyroid disease and diabetes. They also link the conditions to autoimmunity.
What most people do not realize is that type 1 Diabetes is an autoimmune disease, just like Hashimoto’s Thyroiditis (low thyroid) and Grave’s Disease. Type 2 Diabetes is also connected to autoimmunity at least 20% of the time. Research shows, just like this article does, that if you have one autoimmune condition, you have a higher chance of having another. I have also found this clinically.
The article, as do most texts, considers low thyroid synonymous with Hashimoto’s Thyroiditis.
That is a huge take home message for you. According to the literature, when you have hypothyroid or low thyroid symptoms, it is synonymous with the autoimmune condition Hashimoto’s Thyroiditis. As you know from reading my other blogs and watching my videos, just taking thyroid hormones is not the answer to getting your maximal health back when you have an autoimmune condition.
The summary of the article stated that there is an increasing body of evidence suggesting that insulin sensitivity, or drugs used to modulate it, will also affect thyroid growth and function. It also stated that a better definition of the interactions between Diabetes and thyroid hormones is necessary to optimize treatment of patients with diabietes mellitus. They also stated the high prevalence of thyroid dysfunction should result in regular screening of the thyroid function. I suggest get screened for thyroid function regularly even if you have not been diagnosed with diabetes. Of course like I have said on many different occasions, make sure you get complete testing, not just the TSH.
Being treated for an underactive thyroid, but still suffering with thyroid symptoms…is a surprisingly common occurrence in people with low thyroid conditions and it can be extremely frustrating.
Most of our patients that come in with complaints of low thyroid symptoms are already on medication for their low thyroid condition. They had a blood test that came back with a high TSH, meaning low thyroid function, and they were put on thyroid medication. Some felt better for a little while, then the symptoms came back. (We call this the hormone honeymoon) Others never felt any better and continue to suffer with the fatigue, constipation, anxiety, brain fog, depression, weight gain, and all the other symptoms that go along with thyroid disorders.
This may sound familiar to you. You go in and complain you still feel like crud, and the doctor tells you that your thyroid is fine because the labs now tell them it is OK. But you don’t feel OK. You are still suffering, and frustrated.
Yes frustrated, but your doctor thinks it is depression, and suggests anti-depressants. (If you have not already been prescribed them) In your heart though, you know all these symptoms are not from being depressed.
Symptoms of an underactive thyroid that persist even after given thyroid medication is a red flag that something is still going on underneath the surface.
It means you need to find a doctor that will listen to you, and has the knowledge to dig deeper and find the root cause of why you are still feeling crummy.
There are many reasons why you can still feel crummy. The #1 cause of still feeling that was is a condition called Hashimoto’s Thyroiditis.
This means that the number one cause for low thyroid n America is an autoimmune attack. Here are some examples of other autoimmune conditions: MS, rheumatoid arthritis, Lupus.
Meaning—your immune system has turned on you and is targeting your thyroid…and is killing it…. and that’s what’s causing you to be low thyroid.
And taking thyroid hormones will NOT do anything for this attack. You will continue to lose more and more of your thyroid.
But the standard of care for that is giving you thyroid hormones. I think you probably understand now that this not a thyroid hormone problem. That’s not the battle. The battle is an immune system battle; an autoimmune battle.
What most doctors are going to do for Hashimoto’s is monitor your TSH–thyroid stimulating hormone –level. They’re going to try to make it stay within a certain numerical range,—but that’s going to fluctuate all over the place and it’s not really getting to the problem.
The immune system will NOT only attack the thyroid, but it will start attacking the cells in the lining of your stomach that help you to be able to absorb B-12. When this happens you’ll end up getting pernicious anemia. Since 80% of neurotransmitters are created in the stomach, you can also get brain fog, memory loss, and other neurological symptoms.
The brain is also targeted by the immune system. It likes to attack the cerebellum. You can end up having vertigo, dizziness, and balance problems.
The immune system also attacks your pancreas and can make you start having diabetic symptoms, insulin problems, and adrenal issues.
Since every cell in the body has a thyroid receptor site, any part of your body can be attacked when the immune system no longer can tell what is friend and what it foe.
When most patients suffering from low thyroid symptoms learn about the autoimmune attack on the body, it makes perfect sense to them. It makes sense because that is how they feel. Like their body is being attacked.
Focusing the clinical management on slowing and modulating the autoimmune attack is crucial in Hashimoto’s Disease. How can you have a properly functioning thyroid if the body is continually attacking and killing it?
A functional approach to naturally supporting and modulating the immune system in autoimmune cases is the best way to help the body slow down or stop the attack on itself. Natural management of autoimmune conditions is complex. Support that is specific to the individual immune system is essential if you truly want to help Hashimoto’s Disease.
You have to find out how their immune system has shifted. Our immune systems have two parts: TH-1 and a TH-2. They are supposed to be balanced. If they are not, then we have a problem.
You have to find out which one of those has become abnormally dominant and why.
Is it because of an antigen? –something that the immune system has been trying to kill for so long that it’s increased its immune attack on this antigen and then it flipped the scales and now we have an autoimmune condition.
Or has the immune system become imbalanced because of disregulation. Hormonal surges can do this. Stress can do this. Blood sugar problems. Inflammation can do this.
So if you know someone that’s suffering with Hashimoto’s, or with low thyroid, and they don’t feel any better – even with thyroid medication – it is time to get them some help.
It’s time to find someone who can investigate this further.
There are millions of you out there right now that have this problem and you don’t know it.
It’s why you still have thyroid symptoms even though you’re taking medication–you have an autoimmune condition (whether diagnosed correctly or not).
If you’re still suffering from underactive thyroid symptoms even though you’re being treated and told by your doctor that your thyroid is fine, there’s a high probability that something’s been missed in your diagnosis. The only way to discover what is “missing” with your diagnosis is through a comprehensive reevaluation.
Don’t suffer any more. Find a doctor that knows what we just talked about.
Without a doubt the most common question that I get on a day to day basis is:
“My thyroid was removed by my doctor X number of years ago but I still have symptoms. Is there any way you can help me?”
There are two reasons why people typically have their thyroid removed:
Graves Disease (autoimmune Hyperthyroidism)
Regardless of why the thyroid gland was removed what happens is that you immediately become hypothyroid after the surgery or radioactive iodine treatment.
You no longer have a gland to produce hormones on your own so you would forever be dependent on external thyroid hormones like Synthroid or Armour. That is a fact and there is nothing that can be done to change THAT aspect.
But what happens when taking the hormone doesn’t resolve the symptoms of low thyroid?
What if you continue to have weight and metabolism issues, hair loss, brain fog, and fatigue no matter how much or which thyroid hormone you take?
If you still have low thyroid symptoms then we know that there is another culprit that is affecting your ability to use those hormones. Until we discover what that culprit is and change/fix it, you will always struggle with those symptoms.
So if you have had your thyroid removed and you still have symptoms then you need our type of functional approach more than anybody.
Our functional approach gets to the root causes of the symptoms and will help you feel and function better. We will discover what is interfering with you ability to use the thyroid hormone that you are taking every day.
Unfortunately, it is very common to have symptoms of underactive thyroid, but not be diagnosed.
I just had another patient come in and ask me why that was. She is a 70 year old female, that after 8 years of complaining to her doctors, decided to make a change an “alternative” healthcare practitioner and get diagnosed.
She, like you probably, had done some research on low thyroid or come across some information on this health condition while researching for why she had these symptoms.
Underactive or low thyroid symptoms include: depression, low energy levels or extreme fatigue, an inability to lose weight, feeling sluggish, hair loss, and depression. People with low thyroid can also suffer from gas, diarrhea, headaches, dry skin, constipation or other symptoms.If you have these underactive thyroid symptoms and visit your practitioner, they will probably run a blood test called TSH. TSH stands for thyroid stimulating hormone. I have talked about it in prior blogs, but it is just one single marker of how the thyroid is functioning.
If you have a high TSH level, you’ll be diagnosed with low thyroid.
If you do not have a high TSH level, you will most likely not be diagnosed, even if you continue to suffer with symptoms that seem to match perfectly with low thyroid!
There are at least six major ways the thyroid can have dysfunction.
To figure out which of these is the problem, the doctor has to run more than just the TSH. In fact, you have to look at more than just a complete thyroid panel. As we have discussed in previous blog posts, to asses a patient completely, you need to look at the blood sugar, lipid panel, metabolic panel, CBC, vitamin D’s, and iron panel.
Listening to the patient – including a detailed history (consultation), examining the patient – yes examining the patient- is equally important as the blood labs.
I am not going to go over all six of the different ways you can have thyroid dysfunction. You shouldn’t have to spend your time learning about them. Your physician should. If you feel the need to learn more, just go to my previous blogs at scottsdalethyroiddoctor.com
So if you are suffering with underactive thyroid symptoms, but have yet to be diagnosed, you need a more thorough evaluation.
One of the most frequent questions I get asked by new patients suffering from low thyroid symptoms is why we do a functional neurological exam on them. There are several reasons why we do this. First, the brain directly communicates with the thyroid. The brain tells the pituitary to talk to the hypothalamus to tell the thyroid to release hormones. Kind of like a domino effect.
The brain also directly communicates with the stomach and intestines (which is what we call the gastrointestinal system) through the vagal nerve. In previous posts I have talked about how important the gastrointestinal system is in patients with low thyroid symptoms. If you have been reading or watching then you know the number one cause of low thyroid symptoms in the United States is an autoimmune condition called Hashimoto’s Thyroiditis. 85 to 95% of all low thyroid conditions in the United States as an autoimmune condition of the thyroid.
The liver and spleen have a huge effect on the immune system, and are also directly connected to the brain through the autonomic nervous system. Researchers have known for years that if you damage the vagus nerve, you will have dysfunction of the organs that we talked about. When those organs don’t function correctly, the thyroid health is directly and negatively impacted.
The gastrointestinal tract and liver also convert inactive thyroid hormones into active ones. So if they are not functioning correctly, you will not have enough active thyroid hormone to bind to the receptor sites. That will translate into low thyroid symptoms like brain fog, constipation, hair loss, weight gain, fatigue, insomnia, and all the other low thyroid symptoms.
Another important reason why we do function neurological exam on all patients complaining of low thyroid symptoms is because we want to check and see how the brain is functioning, particularly the cerebellum and the basal ganglia. Research has shown that these two areas in the brain can also be attacked just like the thyroid is attacked in people with Hashimoto’s Thyroiditis.
If you are still suffering with low thyroid symptoms, make sure you find a doctor that knows we’ve just talked about. You want to make sure that you get more than just your TSH and free T3 and free T4 checked when you are trying to find the cause of why you are still suffering with symptoms of hypothyroidism.
If you’re suffering from the thyroid problems and can’t get off the extra pounds, we may have a solution for you.
One of the most frustrating symptoms associated with low thyroid is weight gain. Although patients may have several symptoms associated with low thyroid, this is the one they often look most forward to resolving with help and support. It is extremely frustrating to eat like a bird, exercise like an athlete, and still not budge on the scales.
Here is a real conversation one of my patients had with her doctor. (not for the faint of heart)
Patient: “I can’t lose weight. I am exercising every day, watching what I eat, taking my thyroid medication, but still can’t make any progress. What can I do?”
Doctor: “Did you ever see anyone come out of a concentration camp that was fat?”
Doctor: “Did you ever see anyone come out of a concentration camp that was fat?”
Patient: “No. Are suggesting I starve myself? That isn’t healthy.”
Doctor: “You are probably just eating too much.”
How about that for bedside manner? That is the kind of recommendations that some patients are given.
I realize that this is probably an isolated case, but there are many women are told to starve themselves to achieve weight loss.
Now I am the first to admit, starting off in practice I did not pay too much attention to the weight issues of our patients. I felt it was more important to get the body to heal itself so it could get rid of the other symptoms associated with low thyroid, and the weight would take care of itself. My staff had told me that the weight was a very big issue and that I needed to be more sensitive to that aspect of the healing process. I would ask patients how they were doing, and the first thing they would talk about it the weight loss. After asking about their other symptoms, it was common to hear “oh I sleep better now, don’t have brain fog, my IBS is gone, not depressed, but I lost 18 pounds already.” They would forget about the other symptoms they used to have, and focus on the weight loss. It finally hit me, this is one symptom of major importance to the patient, and I needed to address it as such.
The inability to lose weight is often the symptom that prompts patients to seek out low thyroid treatment with their primary care physician. Unfortunately, the inability to lose weight isn’t always resolved once treatment begins.
If you’re in this situation, ask your physician or practitioner this question: why you are still having difficulty losing weight. If the answer is, “You just need to eat less,” or “You need to exercise more,” you should consider other support options and answers.
Although diet and exercise are important for everyone, there are many factors play a huge role in the weight issues.
Blood sugar, adrenal function, inflammation, GI function, and how the body is functionally working all could be contributing to your weight issue. If you are suffering with hypothyroid symptoms and still cannot lose the weight, find a doctor that will listen you, dig deep to find out what could be causing your symptoms, and will work with you to achieve your health goals.