Note From Dr. BApril 23, 2018
The Iron ParadoxMay 7, 2018
When it comes to discussing how to reverse just about any disease, the optimal place to start is by investigating what contributed to the disease in the first place. If you are able to trace back how the disease manifested, you can start to develop a fuller story about how you can go about handling triggers and ultimately reversing the disease.
Thyroid Disease: Defined
When talking about thyroid disease, there are two key definitions to be clear about:
- Hypothyroidism – This is defined by the thyroid gland not producing enough hormone to meet the body’s needs.
- Hashimoto’s Thyroid Disease – This is a subset of hypothyroidism where your immune system is causing structural destruction and dysfunction of the gland itself.
There are simple diagnostics, including both simple blood tests and ultrasonography, in order to help determine if you may have Hashimoto’s thyroid disease. If so, this is where the true work begins.
Thyroid Disease: By The Numbers
Many patients that I work with come to me with a goal of:
- Healing Hashimoto’s
- Normalizing thyroid antibodies
- Getting off thyroid medications
Key Insight: Unfortunately, many are told that these goals are too lofty, that thyroid disease is irreversible, and that they should just go back to accepting the diagnosis and watch and see. But does that have to be the end of the story?
Ample data has looked into whether or not this is the case, and if thyroid disease can be reversed. What this data has found is that if a patient does nothing to change lifestyle or circumstance, there is a default progression of Hashimoto’s thyroid disease where:
- 25% of people experience self-resolution in time, regardless of what they do.
- 25% of people will have a slight decline in thyroid function that will then stabilize and remain that way.
- 25% of people will experience an initial slow in function (however slight), then additional slow with time and a final stabilization.
- 25% of people will have a slow progression of this disease until the gland completely shuts down.
It is important to understand that with those mentioned possibilities, individuals can do more than just wait and see where their fortunes lie. We have the unique opportunity to take action, and to dictate how this disease progresses or regresses, by undressing the underlying cause and root problems.
Let me share with you an exact conversation that I had with a new patient, one who had the goal of reversing her condition. She was a 48-year old female, diagnosed with Hashimoto’s thyroid disease (10 years prior), following the delivery of her third child.
At that time, she was experiencing many of the classic symptoms of Hashimoto’s including:
- Significant mood swings that were thought to be normal with postpartum circumstance
- Inability to lose weight
- Hair loss
- Brain fog
- Significant temperature fluctuations
She was placed on medication and told that she would need to continue to monitor her condition every year. At the time, no other substantive changes were presented to her as an option. Just to wait and see.
The smartest thing that she did was take matters into her own hands and began making changes in her life. She made a lot of progress in her overall quality of life but was still struggling with concerns of persistent weight gain, depression, hair thinning, significant fatigue, and elevated thyroid antibodies lab values.
The Causes of Hashimoto’s Thyroid disease
When it comes to triggers, we need to think about it in terms of triggers grouping together to encourage the onset of this disease. It is a combination and not just one single event.
I learned from Dr. Christianson the phrase “Hashimoto’s is born from a balance of susceptibility and exposure”. I find this to be a great way to articulate that genes alone do not lead to our fate with Hashimoto’s (or any health fate), but it has to do with the combination of our genetic makeup, our circumstances, and our environment. That said, understanding your family history can be very helpful in determining if you are possibly prone to developing Hashimoto’s.
Key Insight: Other triggers that can cause a higher likelihood of developing this disease include environmental toxins and immune stressors. With my patients, I often discuss diet and food sensitivities, investigating gut microbial diversity, evaluating adrenal function and stress response and testing for exposure to environmental toxins.
The truth is that these categories provide powerful insight into what may be an underlying culprit to this disease process. In addressing each, the disease process should halt in progression and ultimately regress until findings are within a normal range.
Remember the patient I mentioned above? She had originally arrived at Integrative Health with symptomatic concerns as well as elevated thyroid antibody lab values. Her ultimate goal, as she put it, was to “get off thyroid meds.”
After her initial visit, I commended her efforts with changing her diet as well as her overall lifestyle. She was previously a working mom of three, with a substantial amount of stress finding the balance between work and family life. She decided for her health that she would stop working and commit her energy to her family and help the family embrace a gluten-free lifestyle.
We proceeded to discuss her possible triggers in more detail, including:
- Food sensitivities
- Gut microbial imbalance due to her history of antibiotic use
- Her past history of Epstein Barr infection in college
- Dental fillings that she had removed 5 years prior and her maternal family history hypothyroidism
We jokingly tagged her as a “ticking time bomb” and discussed that her pregnancy likely served as the immune and hormonal trigger that tipped her off balance. After gathering objective markers, we initiated addressing her specific root causes and after one year, her antibody values had normalized and were no longer elevated. She continues to be on medication at this time with the goal to wean off of it in future.
Bottom Line: This case serves to inform our understanding that when it comes to reversing thyroid disease, it’s not simple, but it is possible. In any event, when we know what it possible we often set ourselves up for success. While I do tell my patients that it takes a lot of work – with both investigation and dedication – you can reverse your thyroid disease.