This article is part of a special report on Thyroid Disorders. To see a comprehensive eBook on thyroid health, click here.
An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime. The number of people suffering from thyroid disorders continues to rise each year. (1)
Hypothyroidism is one of the most common thyroid disorders. It’s estimated that nearly 5 percent of Americans age 12 and up have hypothyroidism. (2) It is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other not-so-fun symptoms.
Every cell in the body has receptors for thyroid hormone. These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body.
You can think of the thyroid as the central gear in a sophisticated engine. If that gear breaks, the entire engine goes down with it.
That’s why people with hypothyroidism experience everything from weight gain and depression to infertility, bone fractures and hair loss.
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One of the biggest challenges facing those with hypothyroidism is that the standard of care for thyroid disorders in both conventional and alternative medicine is hopelessly inadequate.
The dream of patients with thyroid disorders and the practitioners who treat them is to find that single substance that will magically reverse the course of the disease. For doctors, this is either synthetic or bio-identical thyroid hormone. For the alternative types, this is iodine.
Unfortunately, in the vast majority of cases neither approach is effective. Patients may get relief for a short period of time, but inevitably symptoms return or the disease progresses.
So what’s the problem? Why have replacement hormones and supplemental iodine been such dismal failures?
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Because Hypothyroidism Is Caused by an Autoimmune Disease
Studies show that 90 percent of people with hypothyroidism are producing antibodies to thyroid tissue. (3) This causes the immune system to attack and destroy the thyroid, which over time causes a decline in thyroid hormone levels.
This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the United States. (4) While not all people with Hashimoto’s have hypothyroid symptoms, thyroid antibodies have been found to be a marker for future thyroid disease.
Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors don’t tell their patients is simple: it doesn’t affect their treatment plan.
But in the case of Hashimoto’s, the consequences—i.e. side effects and complications—of using immunosuppressive drugs are believed to outweigh the potential benefits. (Thanks to conventional medicine for a relative moment of sanity here.)
So the standard of care for a Hashimoto’s patient is to simply wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid, and then give them thyroid hormone replacement. If they start to exhibit other symptoms commonly associated with their condition, like depression or insulin resistance, they’ll get additional drugs for those problems.
The obvious shortcoming of this approach is that it doesn’t address the underlying cause of the problem, which is the immune system attacking the thyroid gland. And if the underlying cause isn’t addressed, the treatment isn’t going to work very well—or for very long.
If you’re in a leaky rowboat, bailing water will only get you so far. If you want to stop the boat from sinking, you’ve got to plug the leaks.
Extending this metaphor to Hashimoto’s disease, thyroid hormones are like bailing water. They may be a necessary part of the treatment. But unless the immune dysregulation is addressed (plugging the leaks), whoever is in that boat will be fighting a losing battle to keep it from sinking.
Hashimoto’s often manifests as a “polyendocrine autoimmune pattern.” This means that in addition to having antibodies to thyroid tissue, it’s not uncommon for Hashimoto’s patients to have antibodies to other tissues or enzymes as well. The most common are transglutaminase (Celiac disease), the cerebellum (neurological disorders), intrinsic factor (pernicious anemia), glutamic acid decarboxylase (anxiety/panic attacks and late onset type 1 diabetes).
For more on how to balance the immune system and treat Hashimoto’s, check out this article.
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Thank you again for mentioning the transdermal LDN (above) – I am pleased to say that it’s now available in the UK too via Dicksons pharmacy. I started using it on Saturday, and so far, so good! Also my recent annual thyroid results are already moving in the right direction, so maybe a year’s acupuncture has helped too, along with the better diet.
Hi,
I’ve read your posts on iodine and selenium. I have come across this research (see link below) that suggests that iodine and selenium have no combined effect (although I may have grossly misinterpreted this). Would you care to comment?
http://www.ajcn.org/content/90/4/1038.abstract
My interest in iodine is not in using it for thyroid problems (although from what you and others say I will have problems if I take it with too high a dose). I have a few cherry angiomas, I’ve seen that this may be caused by bromine poisoning which iodine supplementation can help:
http://www.iodine-resource.com/cherry-angiomas.html
However, I suspect that we may be getting into the realms of snake oil here…
Thanks in advance for any reply.
Hi. I posted a couple months ago up there and was things are only getting worse. I’ve been getting more and more fatigued, and my memory seems to be going. More of an absent-mindedness, but I feel like I can’t remember anything unless I write it down, and even then, sometimes I forget to look at the paper I wrote it down on to remember what was written.
Please, if you could offer some advice to me. As I said in my last post, because everything started to go wrong when I had an enlarged thyroid and my doctors decided to remove half of it instead of find the cause of they hyperthyroidism, I really wonder if this is now one of two things. 1) whatever was wrong in the first place finding a new way out since the thyroid was partially removed or 2) negative/downfalls or continuing problems related to hypothyroidism caused by the thyroid removal.
Thank you Chris – I really appreciate your response. I did not know of the transdermal LDN and I am now looking into that possibility.
I wish I had known what I know now (I am almost 60) when I was your age, but I probably wouldn’t have listened then! I suspect that my autoimmune issues were triggered by my last pregnancy when I had Immune Thrombocytopenic Purpura, though luckily not until the last few weeks. My Hashimotos didn’t appear until around 10 yrs later. I also have had issues with Lichen Planus since then, also thought to be autoimmune.
Looking back I can track the medical history now, (also have had gastritis now healed by the diet), but at least I can do my best for my old age. I was into healthy eating too, and thought I was doing the right thing, but the gluten was probably the worst thing I was eating then without knowing it.
I have just found this wonderful website. I have ME/CFS as well as hypothyroidism (Hashimotos I assume though I am in the UK and it’s never been called that to me).
I have taken synthetic Thyroxine for nearly 20 years so is it too late for any improvement now? I have changed my diet in the last 2 yrs (to try and improve the ME/CFS), and on reading the articles it seems I am doing it almost as well as I can already as I am on a Paleo(ish) diet, and gave up gluten a year ago, which has ended my horrible stomach pain, and have solved my acid issues with kefir. I have even been to acupuncture weekly for a year.
I have just started on LDN ….. more to help with the ME/CFS than the thyroid though it seems it could help with that too. Sadly, I have sensitivity issues and get terrible stomach pain on it, so can only tolerate a tiny dose every other night at present.
Would be grateful for your view if it’s all too late for me having been on the synthetic Thyroxine for 20 yrs, and if my ME/CFS and thyroid is likely to be improved too with what I am doing?
There is no advice via my GP in the UK – they have no understanding of these things at all. I am getting a little help with a private GP who specialises in ME/CFS and who has prescribed the LDN for me.
Elaine: there’s another way of administering LDN that you might want to look into. You can take it in transdermal form as a cream. Skip’s Pharmacy in Florida can prepare it that way. I’m not sure if you can get order it from Florida since you’re in the UK, but you may want to consider that. I don’t think it’s too late for improvement, and I think LDN will probably be helpful for both your thyroid and ME/CFS if you can get on a solid dose.
I wish I’d known all this a long time ago. I was diagnosed with hypothyroidism at age 4 with a bone age of 9 months. My TSH test came back borderline, and apparently a low-grade deficiency was enough to retard my growth that much. My doctor pretty much guessed that maybe a low dose of Synthroid would help, and with that I grew twelve inches in twelve months. Throughout the years afterward, though, as long as my TSH test came back “normal” I was told I was fine, any residual fatigue, depression, malaise, whatever was in my head or would pass soon enough. Or maybe, it was suggested, I should be on an antidepressant. I was on Lexapro for two and a half years, beginning with my third pregnancy. It didn’t help, and it took a long time to break free of it (several months to find a slow-enough tapering-off schedule and six months on that schedule). I don’t want to take another anti-depressant, but if it would help to take a supplemental dose of T3 (like Cytomel or its generic form) or a different thyroid medicine with T4 & T3 combined, I’m all for trying that.
Hi. I had some questions and was wondering if you had any insight as to what might be going on or some other things that I should be checking for. A few years ago, I had an enlarged thyroid. The doctors drained the fluid out, tested it, and when it filled back up decided that the best course of action was to send me straight to the surgeon. I didnt know any better so I had half my thyroid removed, and now have hypothroidism as a result. No doctor seemed to think it was important to find out why my thyroid was acting up in the first place. A little over a year later (had a child in that time) i started having a multitude of symptoms: fainting, dizziness/lightheadedness, chest pains, extreme fatigue, hard time loosing weight, tingling/numbing in hands/feet. for about the last 2.5 years now I have had all of these symptoms and have had just about every medical test known to man done, everything comes back normal. I have been a guinea pig for so many medicines because the doctors don’t know what else to do so they just throw medicines at me to try. Because my thryroid was the first thing to go wrong, i’ve begun to look into that more on my own and have really been wondering if that’s where everything went wrong, and because the doctors I had at the time decided to just cut out what was causing a problem instead of trying to fix the problem, it really didnt solve anything. Any help or tips or advice you can offer to me would be greatly appreciated. I am so tired figuratively and literally from doctors trying to tell me everything is fine because the tests come back ‘normal’. Thank you.
Dear Melissa, I really hope you find soon out what is wrong with you and your Tyroid. I can only write about myself and I still do not know if all what I have done was/is the right for me…. but since I am feeling well I do believe I did it right:
– cut off all grains and dairy;
– use only olive oil extra virgen over cooked veggies (I dio not heat oils)
– use ghee (Butterschmalz) as fat for almost everything;
– Eat eggs and meat (chicken, beef, duck, fish) in every meal
– Eat at least 200g veggies….better 300g for each meal (even mornings)
– avoid any industrialized product
– Eat fruits but not too many (2 a day)
One year has passed…. I can walk without problems again…. I could not so tired I was…. Now once in a while I use some butter, heavy cream and eat some rice (very seldom). I lost weight (10 kg) and feel great. I do hope that was the right thing I did…I am still a little afraid that the missing grains / dairy can harm my health…. but up to now…. it only made me feel better and better!
I wish you all the best! (I did not mentioned: I do have Hashi…. but even that is changing for better)
Hi Chris,
First off, thank you so much for your skeptical health blog. You are a rare voice in a field filled with superstition, miracle cures, and snake oil salesmen looking to make a quick buck on the vulnerable.
About me: I am 24 years old, just got diagnosed with hypothyroid after around 3-4 years of being “borderline.” I’ve had conflicted feelings about this diagnosis because in one way, it ties together all these other health problems that I have been having (and that I feel like I am too young to have 🙁 ), namely: polycystic ovaries/irregular menstruation, constant low energy and fatigue, serious anxiety/panic disorder, and what I recently found out was mild scoliosis (causing constant pain in the joints on my right side). Honestly, reading all this on your blog has made me feel rather hopeless…autoimmune diseases are so serious and I was unprepared for the thought that I will be dealing with a lifetime of serious problems.
I just wanted to find out from you if there is any hope in handling this disease. I haven’t yet found out if I have Hashimoto’s or not, but of course chances are that I do. I am at the point in my life where I am preparing for graduate school. Do you think that I need to take some time off to address these health problems before I get lost in the world of grad school (high stress, overwhelming responsibilities, little free time, etc)? I know this is a strange question, but this all really worries me. I’d appreciate your perspective on what it takes to begin managing it.
Eva: hypothyroidism (and Hashimoto’s) are treatable, and it’s entirely possible to live a full and happy live with the proper care. Identifying whether you have Hashimoto’s, or iodine deficiency, or both, or perhaps another cause of thyroid hypofunction is the most important step. From there, the next steps become more clear. Best of luck.
I have a question. I am currently waiting on another endo visit; but I have a month to wait. I have Hashimotos. I also developed a toxic adenoma (approx 3″ in diameter. I had both the adenoma and total Thyroid removed 1 year ago (I am 38). I actually tested negative for both hashi’s and Graves antibodies the day before my surgery (it was believed I had both? My mother has graves). I recently tested my antibodies and they were 2,300+. I feel horrible, and I feel like there is a new lump in my throat forming. Anyone ever experience a Hashi’s tumor post Thyroidectomy??? It feels very much the same; the weird pain at times in the mass. *sigh* Ideas? Tips? My doc tested many other antibodies and they were all negative. My insulin production is slightly elevated and I’m experiencing bouts of Hypoglycemia (my daughter is Type 1 Diabetic so we have meters everywhere).
**** Also autoimmune disorders are rampant in my family. Besides the diabetes with my child, and Hashi’s for me so far- my mother has Lupus, antiphospholipid syndrome, short bowl syndrome, Graves, and something with her bone marrow as well (not sure what, that’s a new development theory)
Please look into Low Dose Naltrexone and try to find a doctor that works with it in your area. http://ldninfo.org and then join the Yahoo LDN group for referrals.
Meg you sent me a message about the LGS diet. I don’t see your comment here. If you are still interested I can email it to you. There is a PDF file that is too large to post here.
would love it!
[email protected]
thanks!
renee d. I have just been reading all your posts,a great help, and all very relevant to me, would it be too much trouble for you to email me this LGS diet too.
Many thanks in advance,
[email protected]
Renee d.
I would really like to see this diet. Please email to me if you get this request. [email protected]
When I was first diagnosis my tsh was over 100.
Bejeesus! A TSH of 47.60…I hope the decimal point’s in the wrong place. Everyone seems to be using the same unit of measure (mU/L) so I guess it’s has high as it sounds.
Jennifer your doctor should be testing more than your TSH level. What meds are you taking? If you are on Synthroid, that is synthetic and is only T4. If you are hypo, you aren’t converting T4 to T3 so you need a med that will provide you w/ T3 as well. I am talking out of experience as Synthroid was NOT the drug for me. I did my research and insisted that my doc write me a script for Nature Throid which has T4 and T3. I feel like my old self again! Also, watch what you eat as you could be insulin resistant. Cut out any refined sugar which is in just about everything, eat low glycemic fruit if you have a sweet tooth and stay away from rice, pasta, bread and potato’s. An organic diet consiting of veggies, lean meat or beans [for protein] is a good way to help you feel better too. Also, have your Vit. D level checked as it is a hormone not a vitamin. I hope that helps. I went thru hell before I started my research. Good luck and if I can help…………
Hi Iam 29 yrs old in 2009 had thyroid cancer followed by radioactive iodine and total thyroidectomy . Tsh has been normal last 2 months have felt awful have no energy and excessive sleepiness. Tsh was just checked last week now is 47.60 Have been on same doage for a year. What could be the problem
Hi Chris –
I am getting a prescription for LDN thanks to your informative podcasts. In researching LDN in various user groups, some people talk about LDN not being as effective if you have candida overgrowth. Have you found this to be the case with your patients? Have you seen anything about it in your research?
Thanks! Pam
I’ve heard that, but I haven’t observed it in my practice – and I think candida is often misdiagnosed or overdiagnosed.
There is a way to treat hipothyroidism without drugs doc, have you herad of this?
Hi
Just discovered your forum. Great info! I was diagnosed with celiac 2 yrs ago and have been on a strict gluten free diet. I had adrenal fatigue (low cortisol levels about 7 for 8 am) and fluctuating high TSH levels. My free t3 and free t 4 have always been in upper 1/3 and 1/2 of range respectively. Antibodies have always been negative. Recently again my TSH is 4.53 free t4 1.1 (range .74-1.83) and free t3 3.74 (range 2.28 -4.81). SO since free t3 and free 4 seems to be ok but TSH is high, should I try .5 grain armour to see if I feel better? The thyroid is working hard to keep levels normal but why is this happening?
On a side note my liver enzymes have been in upper limit AST is 41 (range 8-39)ALT 48 (range 9-52).
I have been struggling with low motivation and energy for 3 years now..any feedback would be greatly appreciated!
Hi Chris –
I have Hashimoto’s and have had it most of my life. I was always told that my enlarged red blood cells were due to my thyroid problems and that there was nothing I could do about it. Is that true? Is this a type of anemia? I am curious if this is a common symptom you have seen in your research and if there is anything I can do about it.
Thanks, Pam
PS I also posted this on your podcast questions
Macrocytosis is a common complication of Hashimoto’s. To treat it, you need to treat the Hashimoto’s itself, which means addressing the immune dysregulation. Thyroid medication only replaces the thyroid hormone. It doesn’t address the immune issues.
I had a total thyroidectomy due to hyperthyroidsm and graves disease in August 2010. I take 150mg Eltroxin daily. I am tired 24-7 my arms ache and I generally feel bad. Are there any energy supplements I should be taking?
Try going Gluten-Free. I have Hashimotos and Graves disease, take thyroxin and had these same symptoms among others, since going GF the pains in my arms have dissappeared (after only a few days), I have much more energy and generally feel very much better. Other symptoms, (IBS type) have also gone, going GF was meant to be only a trial, its not been 6 weeks yet since I started, but I will definately be keeping it up, even though its a nuisance having to read all the food packets and trying to find a decent bread I can eat, i’m going to stick with it. I hope it helps you too.
Hi Geliza,
I do have the same and I am going on GF almost one year so I found out how to make my own bread…. of course it is not the same… but it works very well:
– 500g Linseed (grinded)
– 5 eggs beaten
– 1 tsp. salt
– 1 tsp. baking powder or soda bicarbonate
– aprox. 300ml water
mix all and baked 375 F/180C for aprox. 30-45 minutes. Make the toothpick procedure to see if it is done.
Hope you enjoy like I do when I’m craving for a “bread”
Regards
Ingrid
Thanks very much for the recipe, I shall certainly try it, I am in the process of trying out different ones.
I found one that looked really good, on the net, but when I tried it out it didn’t quite work out, from the fotos its the nearest I have seen to real bread. I could give you the link but it is in spanish, suffice to say it’s bread made with mandioca, (yuca, tapioca) starch, and the process is much more complicated than your recipe.
Thank you Geliza – but I am so tired of trying recipes….. he he he…. now I found this and I think for me the Linseed is just perfect (until someone find out it is not good for your health…he he he) Thank you again! (PS no problems with spanish – I speak a little). Ingrid
Yeah the thyroid blinks in and out while in the process of completely not working so that is what you are feeling with the ups and downs. Believe it or not, eating oranges at my lows helped me a lot. Like I said you MUST find a good ENDO and what makes a good endo is one that listens and takes into account your input. Drinking cinnamon or coffee will help with the low blood pressure. Make cinnamon tea (use real cinnamon) 1 cup and see if that doesn’t help with the blood pressure. You need to leave the naturalpathic doc and find an endochrinologidt not just a reg. doc because they know nothing about thyroid. after my thyroid was taken out I had a lot of problems but ONLY because I couldnot tolerate synthroid and had to go to a natural thyroid hormone called Armour. Bother your doctors and don’t let them bully you. THIS IS YOUR LIFE AND YOUR BODY and they are there to help, so be strong even to the point of being obnoxious. ONce your thyroid is taken out and your hormones are level you will no longer have diareah since it is cause by your hyperthyroid state. YOU MUST drink a lot of water until this resolves so that you do not become dehydrated. Also, many of us are lactose intolerant to some degree or another. My GI issues went away somewhat when I started doing the towel thing that I mentioned earlier and they completely went away when I had to have my gallbladder removed aabout 6 yrs after my thyroid was removed. Once you are stable, many of the symptoms will just disappear and you will be healthy again. You need to keep a diary right now of what you are eating and pay attention to how your stomach and blood pressure reacts to them and eliminate them from your diet. I do not consume anything with milk. I do not eat beans. My diet right now is mostly protiens with a little carbs but since you are hyper right now it should be the other way around. More carbs than protien so you don’t lose an enormous amount of weight until you become healthy again. Don’t worry. This does not last forever even though it feels like an eternity for you right now. Everything will fall into place once you have the correct amount of thyroid hormone in your body. Don’t give up and don’t think that this is how you will feel forever because this is not true. You will be OK just pay attention even to the littlest symptom like your legs cramping or feeling like there are spiders crawling on your cheek. All of this, although little symptoms can drive you crazy. Write them down so you don’t forget to tell the doc. When you go see the ENDO, make sure you have a list written down of all your symptoms and when your feel them or what makes it worse or better. Just remember that you have to fight for your well being even if you have to change ENDO’s 3 times till you find one that will listen. Like I said before the best way to find an ENDO is by patient referral so use the website of Mary Shoman to help you in your search. my email is [email protected] and you can email me anytime for support. I will be happy to help in anyway I can.
Sisi, Thanks for the tip, I will definately take my temp everyday now. I have been questioning whether my thyroid was going back and forth everyday, I actually wonder if it does that throughout the day actually, because some days I’ll wake up feeling great but then by lunch or after feel like crap, and then other days it’s the opposite, i’ll wake up feeling like crap and then have a burst of energy for several hours and then feel like crap, but I always feel better everyday at about 9pm at night. It’s the weirdest thing. I did take my blood pressure this morning and it was 98 over 68, That is really low, and I don’t know what I should be doing. But I agree with you about how eventually it needs to just come out. I just hope my doctors listen to me, I get the worst luck with doctors. I have been seeing a natural path and she even has been a pain to deal with at times. So I might be switching general doctors again, we’ll see. Did your stomach issues go away after you had it taken out? I can handle everything else that is wrong with me, it’s my constant stomach issues that I am soooo sick of. Thanks