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Patient-Centered, Whole-Person, Functional Metabolic Care For Hashimoto's and Low Thyroid

Why Proper Stomach and GI System Function is Critical for Thyroid Function

Why Proper Stomach and GI System Function is Critical for Thyroid Function

Most patients that I see have a few things in common.

1. They were diagnosed with hypothyroidism.
2. They take some form of thyroid hormone replacement.
3. They continue to experience some degree of thyroid symptoms despite conventional treatment.

Just like you, if they were not having symptoms, they would not be investing their precious time trying to educate themselves on what their doctor should already know.

When I consult with a patient with ongoing thyroid symptoms I know I must start searching and begin putting the pieces together if I am going to help that person.  This can be hard for most patients to understand at first because they have been told to just take this thyroid medication and problem solved.

For most patients, that advice is dead wrong.

Sure, it is going to replace the hormone your body no longer can create, but it usually does not address the underlying condition and factors that play a huge role in the patient’s health.  Taking some form of thyroid replacement is just the first step. It does not consider other possible mechanisms that could be contributing to your problem and symptoms.

Although I have talked about the gut-brain-thyroid connection in the past, I thought I should write another blog going over the stomach and GI connection again because it is critical to the improvement of your symptoms.

Gut microorganisms can affect thyroid function at all levels including:

  1. Thyroid receptor site resistance – where your hormone can’t actually bind to your receptors. This creates a classic presentation of ongoing thyroid symptoms despite being able to see normal amounts of hormone in the blood stream.
  2. Decreased T3 production
  3. Increased reverse T3
  4. Decreased TSH secretion from your pituitary

What does all of that mean?   It means you have to look at more than just a patient’s TSH if get to the bottom of why they are having low thyroid symptoms.

If you ever experience bloating, gas, constipation, or diarrhea and you also have thyroid symptoms then you have to consider the impact that gut microorganisms are affecting your thyroid. Dealing with the gut issue is a necessity if you want to feel good again.

How Can a Thyroid Specialist Help Me If I Had My Thyroid Removed?

Every week I get several emails asking me that question.  I usually respond by telling them that to start off with, I am not a Thyroid Doctor or Specialist.  If I was, then we would not have the success with our patients that we have and we would not have all the testimonials if we only looked at the Thyroid.  Instead, we look at the entire person as a whole, not just parts, and try to figure out why their body is not healing itself the way it was designed to do.

Many patients with autoimmune thyroid have their gland removed surgically.  The problem is that the underlying immune dysfunction is still there.  This often results in patients having difficulty utilizing their hormone replacement and as a result they continue to have the same thyroid symptoms.  If this sounds familiar, there is hope.

Our approach is to focus on the immune aspect of this so that you can actually get relief of your thyroid symptoms.

So Where Do You Start?

1.   Identify and remove the trigger(s) that aggravate the immune system (foods, chemicals, hormonal imbalance, etc.).

2.  Quench the existing body-wide inflammatory cascade (with diet & lifestyle changes and specific supplements that down regulate pro-inflammatory processes and up-regulate anti-inflammatory processes).

3.  Aid in the repair the GI tract barrier

4.  Support the damaged autoimmune target with specific supplements and/or medical hormone replacement therapy (as in the case of thyroid and pancreas damage by co-managing the illness with your medical doctor)

5.  Re-mediate any abnormal brain and nervous system function with Brain Based Therapy

It is important to consider that the thyroid gland has major influence in all of these areas:

  • Enhances a portion of the nervous system called the sympathetic nervous system.
  • Promotes breakdown of blood sugar, mobilizes fats, essential for protein synthesis, and enhances the liver’s synthesis of cholesterol.
  • Promotes normal adult nervous system function and mood.
  • Promotes normal functioning of the heart.
  • Promotes normal muscular growth and function.
  • Promotes normal GI motility and tone; increases secretion of digestive juices, particularly that of the gallbladder and the stomach.
  • Promotes normal female reproductive ability and lactation.
  • Promotes normal hydration and secretory activity of the skin.

Here are a few more key things to remember:

Bone:  Deficiency of thyroid hormones lead to a decrease in bone development and an abnormal architecture of the bone that is created.  Generally, a functionally low (which means low but not flagged as of yet) serum calcium is noted in hypothyroidism.  Elevated thyroid hormones causes an increased serum calcium, as it pulls calcium from the bone, leading to increased risk of pathological fractures of the spine and weight bearing joints.

Gastrointestinal Function:  Transit time is affected directly by thyroid hormones as is absorption of nutrients.

Male Hormones:  Hypothyroidism has been linked to diminished libido and impotence.  Although this condition is rarer in men, it must be considered in treating these conditions.

Liver and Gallbladder Function:  Low thyroid function caused decreased liver clearance and gall bladder congestion through thickening of the bile, often also associated with an elevation of cholesterol.

Body Composition:  As you may know all too well, low thyroid function causes an inability to lose weight.  This is caused by a slowed conversion of glucose and fat into energy, and altering the way Human Growth Hormone (HGH) is metabolized in the body.

Blood Sugar Regulation:  Low thyroid slows the insulin response to glucose following eating carbohydrates or sugar and it also slows glucose uptake into cells and tissues, and slows absorption of glucose from the intestinal tract.  In other words, your entire energy production system is slowed.  It is quite confounding to your body and brain, in that the glucose is in the blood, but the tissues are not able to absorb it.  This really confuses the pituitary gland and adrenal glands, resulting in a “stress physiology,” even if life is good.

Cholesterol:  As mentioned earlier, low thyroid increases your cholesterol and triglycerides, so your doctor tells you your diet is poor.  You become even more strict in your diet, and the tissue starvation (low glucose, low energy) gets worse, which makes the stress physiology worse, which makes your cholesterol higher, which prompts your doctor to put you on cholesterol medication, which interferes with energy production, which further stresses your physiology…whew!  You are frustrated!

Depression:  Low thyroid impairs the production of stimulating neurotransmitters, which are the chemicals that antidepressants work on.  Low stimulating neurotransmitters leaves you, as one of my professors described, feeling “lower than a snakes belly.”

Female Hormones:  Low thyroid changes the way estrogen is metabolized in the body, shifting toward an estrogen metabolite that has been proven to increase the risk of breast cancer.

Stress:  Low thyroid slows the elimination of the stress hormone cortisol, which leaves you feeling stressed out, not because of “stress,” but because the stress hormone can’t be removed efficiently.

Detoxification:  Low thyroid slows an enzyme critical for metabolic biotransformation, or detoxification, the process by which the body binds and removes all environmental chemicals, and normal byproducts of metabolism, including hormones.  “Toxicity” further slows your metabolism, and leads to headaches and other toxic symptoms.

Digestion:  Low thyroid reduces the release of Gastrin, which determines the output of hydrochloric acid in the stomach, leading to poor protein digestion, sour stomach, and GERD.

Thermoregulation:  Regulation of body temperature is affected by low thyroid, resulting in hot flashes and night sweats, which is especially prominent in perimenopausal women.  This is often blamed on estrogen dropping, but may be directly caused by low thyroid.

PMS and Infertility:  Low thyroid affects the progesterone receptors, making them less sensitive to progesterone, which feels like low progesterone, although the progesterone levels may be normal.  Since the activity of progesterone is diminished, the health of the uterus is insufficient for implantation in the second half of the female cycle, leading to difficulties getting pregnant and PMS.  Low thyroid also reduces sex hormone binding proteins, leading to an increase in estrogen activity.

Anemia:  Low thyroid, as mentioned affects protein metabolism, which then lowers the red blood cell mass, which carries oxygen to tissues for metabolism of energy.  Yes, another mechanism for feeling lousy.

Homocysteine:  Low thyroid slows a process called methylation, often evidenced by elevated serum levels of homocysteine.  Elevated homocysteine in the blood has been proven as a risk factor for cardiovascular disease, Alzheimer’s and other neurodegenerative disorders, and cervical dysplasia.

So if you have had your thyroid removed because of an autoimmune condition, and are still suffering, there is hope for you to get your body to heal itself and get your vitality and zest for life back.  

It boils down to finding a doctor that knows what we just talked about and understands that you can still feel crummy, even though you have had your thyroid removed.  Find a doctor that knows there are many other factors that play into the health of your thyroid hormones.  One who is willing to examine you, look at all your health factors, and help you get your body to heal itself back up the way it was designed to.

Low Thyroid Symptoms and Vitamin D

Should you be supplementing with vitamin D?

Dr. Chris Heimlich DC, Director of the Arizona Thyroid Institute in Scottsdale, AZ Explains:

More and more people are taking vitamin D.  They have seen on the news or the web that it is good for them.  Taking vitamin D is good for you…IF YOU NEED IT.

Modern diets are lacking in Vitamin D rich foods.  What are Vitamin D rich foods?  Liver, organ meats, lard, many forms of seafood, butter and egg yolks.

The best-known function of active vitamin D is to help regulate blood levels of calcium and phosphorous. Vitamin D increases absorption of minerals from the gastrointestinal (GI) tract. In combination with parathyroid hormone, it enhances their reabsorption from the kidneys and their mobilization from bones into the blood. Vitamin D helps maintain calcium levels even if dietary intakes are not optimal. Calcitriol affects growth of normal cells and some cancer cells. Adequate vitamin-D status has been linked to a reduced risk of developing breast, colon, and prostrate cancers.

Sunlight is another important factor and source of Vitamin D.  BUT, you should NEVER take vitamin D without having your Vitamin D levels tested, specifically, 25 OHD and 1,25 OHD.  Most doctors only test 25 OHD.  I feel this is a mistake.  It is very important to have both levels tested.  I see at least one patient a week that comes in taking Vit D that have low or normal 25 OHD levels and high 1,25 OHD levels.

Why could it be bad a bad idea to take Vitamin D?  One reason is because it is a fat-soluble vitamin.  That means it is tougher for your body to get excess amounts out of your system.   Vitamin D is most likely to have toxic effects when consumed in excessive amounts through supplementation. Excess vitamin D raises blood calcium levels, resulting in calcium precipitation in soft tissues and stone formation in the kidneys, where calcium becomes concentrated in an effort to excrete it.

Why is Vitamin D so important with patients that have low thyroid symptoms like hair loss, depression, weight gain and fatigue?  Vitamin D deficiency is associated with many, many autoimmune conditions including Hashimoto’s Thyroiditis.  Autoimmune rates have been skyrocketing in the past 20 years and have been correlated with decreased levels of Vitamin D in the general population.

The number one cause of low thyroid in America is an autoimmune disease called Hashimoto’s.

Adequate Vitamin D levels help to keep the immune system balance so it doesn’t swing out of control into an autoimmune disease.  When it comes to Hashimoto’s Thyroiditis, the problems with Vitamin D deficiency is made worse by genetics.  There are studies that show that more than 90 percent of the people with an autoimmune thyroid or Hashimoto’s have a genetic defect affecting their ability to process Vitamin D.

The take home message here is to NOT just take vitamin D because you think it is good for you.  Find a thyroid doctor that can actually do the detective work and find out if it is something that you need.


Listen To The Audio:
Low Thyroid Symptoms and Vitamin D

The Hidden Connection Between Thyroid Disease and Diabetes

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.

 

#1 Reason to Still Have Symptoms While Being Treated for Low Thyroid with Medication

Dr. Chris Heimlich, DC, DACNB FIAMA Comments:

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.

[Did Your Doctor Consider This?] Part 2: High TSH With Normal T4 and T3

A research study published in December 2012 sheds some light on a phenomenon we see often …

A patient has elevated TSH but normal T4 and T3.

If that person also has symptoms of fatigue do they have hypothyroidism?

By standard definition any elevation of TSH indicates hypothyroidism. Usually this elevated level of TSH corresponds with a decrease in T4. That is the way it normally works in the body.

In this case it may not be a thyroid problem at all.

One of the things we look at in all our patients is dysglycemia (abnormal blood sugar).

Many thyroid patients have undiagnosed pre-diabetes and as this newly published article points out, pre-diabetes can lead to elevations in TSH.

And guess what?

Pre-diabetes causes many of the same symptoms as low thyroid.

So most patients that go to the doctor with fatigue and the doctor sees elevated TSH then they immediately get put on thyroid hormone.

The underlying blood sugar problem never gets fully investigated and the patient continues to suffer with symptoms because a lab marker was treated and not the patient.

That is why we take a whole person approach and make sure we understand the problems and mechanisms so we can help our patients feel and function well.

References:

Indian J Endocrinol Metab. 2012 Nov-Dec; 16(6): 958–961. doi: 10.4103/2230-8210.102999

Can You Help Me Even If My Thyroid Has Been Removed?

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:

    1. Graves Disease (autoimmune Hyperthyroidism)
    2. Cancer

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.

The first step is to schedule a consultation in our office to discuss the specifics of your case. Click Here to Schedule Now.

Thyroid Problems: Symptoms of Low Thyroid, But Haven’t Been Diagnosed or Given Medication because Labs are Normal

Dr. Chris Heimlich, DC, DACNB FIAMA Comments:

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.