There are over 25 million people in the US alone who have hypothyroidism. The majority of them don’t even know it. Would you be able to notice if your thyroid gradually slowed down and started to produce less and less thyroid hormones? It usually takes months or even years to develop hypothyroidism, and decoding the symptoms can be challenging. One of the most common complaints is fatigue. But then again who isn’t tired in this day and age? We’ve come to accept being tired as the new normal. With taking care of our kids, our jobs and housework we have more on our plate than ever before, it seems.
The thyroid is a small gland located in the neck, and it’s responsible for so many functions in the body – it affects your metabolism, mood, energy, body temperature, weight, heart, cholesterol levels and more. Hypothyroidism mostly affects women but men and children can get it also.
I was diagnosed with hypothyroidism and more specifically with Hashimoto’s Thyroiditis in 2010. I was very disappointed with the lack of experience and care from the doctors I visited so I decided to look for answers myself. That’s how The Thyroid Disease Support Center was created. Hopefully you’ll find the information on this website helpful.
I often come across various “crazy” hypothyroidism treatment opinions online, whether from doctors or other healthcare professionals so I decided to make this blog post to clear up some myths when it comes to hypothyroidism treatment as experienced from a patient’s point of view.
Myth #1: Hypothyroidism treatment is easy – you just take 1 pill a day and you’re fine
When I was first diagnosed, I was told by my doctor at the time that hypothyroidism was no big deal. You just have to take synthroid/levothyroxine once a day and you’ll be back to normal in 4-6 weeks. I wish it was that easy! My symptoms persisted even after hormone replacement therapy (levothyroxine) and I even felt worse. Obviously something was wrong, something that simple T4 replacement medication couldn’t fix. What my doctor didn’t tell me was that my form of hypothyroidism is Hashimoto’s or auto-immune thyroiditis.
This form of hypothyroidism cannot be treated solely with synthroid because it’s the immune system that’s affected and that’s causing the thyroid problem. In reality, 90% of hypothyroidism patients have Hashimoto’s but they don’t know it because their doctor probably didn’t run the right tests. To diagnose Hashimoto’s you need to check your TPO-ab (Thyroid peroxidase antibody) and Tg-ab (Thyroglobulin auto antibodies) levels. If these are above normal ranges you’ll be diagnosed with Hashimoto’s disease.
There’s so much more to the treatment of Hashimoto’s than taking T4 hormones. There’s a diet that needs to be followed (check out our Nutrition Center for more information), and certain lifestyle changes.
Some patients do better with natural thyroid hormones like Armour – desiccated (dried and powdered) animal thyroid, mainly obtained from pigs, was the most common form of hypothyroidism treatment before the individual active thyroid hormones were identified. The reason why some patients prefer the natural thyroid hormones over the synthetic ones are that the natural hormones contain both T4 and T3, while the synthetic hormone medication only contains T4. I should mention, however, that the balance of T4 and T3 in animals is not the same as in humans, therefore the hormones in animal thyroid pills aren’t necessarily “natural” for the human body. Another point to keep in mind is that the amounts of T3 and T4 may vary from batch to batch with the desiccated thyroid, and that makes it harder to keep blood levels controlled. According to Thyroid.org “desiccated animal thyroid is rarely prescribed today, and there is no evidence that desiccated thyroid has any advantage over synthetic T4″ however some patients swear by it.
Trying out both types of thyroid hormone replacements for minimum of 6 weeks each can help hypothyroid patients determine which one makes them feel better in terms of decrease in their hypothyroidism symptoms.
Myth #2: Thyroidectomy (removal of the thyroid) will resolve your thyroid problems and make you feel better
While sometimes a thyroidectomy is necessary such as in patients with thyroid cancer, oftentimes doctors suggest thyroidectomy as a preventative measure. This is a very serious decision that shouldn’t be taken lightly. The thyroid is a major gland in your body, responsible for so many functions in the body! While some people experience improvement in their symptoms after removal of their thyroid, others just never go back to feeling like their normal self again, ending up with mild to severe hypothyroidism symptoms in spite of taking synthetic thyroid hormones normal blood test results. The road to recovery without a thyroid is not an easy one so take the time to carefully consider all your options before deciding to go with thyroidectomy.
Myth #3: Supplement with iodine or eat plenty of iodine-rich foods
When scientists realized that iodine deficiency is the main cause of hypothyroidism in the world, health authorities decided to start adding iodine to table salt. And while this strategy was successful in fixing iodine deficiency, it had a rather unexpected and even opposite effect. When iodine was added to table salt, the cases of autoimmune thyroid disease skyrocketed. There were studies done in many countries, proving it: Turkey, China, Brazil, Sri Lanka and Greece among others.
But how did this happen? The reason is that higher iodine intake, and more specifically in supplement form, jumpstarts or increases the autoimmune process that destroys the thyroid. The way it works is iodine reduces the activity of TPO – thyroid peroxidase – an enzyme essential for correct thyroid hormone production, and leads to the production of TPO antibodies.
Meanwhile cutting down on iodine may significantly improve and even reverse hypothyroidism. In a study 78% of Hashimoto’s patients were able to reverse their hypothyroidism and regain normal thyroid function by restricting iodine intake.
Having said that, it’s important to note that studies show that excess iodine can only cause problems for patients with autoimmune thyroid disorders when there’s also selenium deficiency present.
A study was done where rats received increased iodine – they developed goiter-like condition. However, the rats that were given selenium supplement in addition to iodine did not develop goiter. Other studies have proven that while excess iodine does trigger/flare autoimmune thyroid disease, selenium has a protective property against the effects of excess iodine. This is very important for hypothyroidism patients in countries where autoimmune thyroid disease not iodine deficiency is the primary cause of hypothyroidism (that includes the US).
Foods rich in selenium include Brazil nuts, sunflower seeds, fish (tuna, halibut, sardines, flounder, salmon). shellfish (oysters, mussels, shrimp, clams, scallops), meat (beef, liver, lamb, pork), poultry (chicken, turkey), eggs, mushrooms (button, crimini, shiitake), grains (wheat germ, barley, brown rice, oats) and onions.
The recommended daily amount of selenium for adults with hypothyroidism is 200 mcg. You can find it in the vitamin isle of your local store or health food stores. You can also order it online – Natures Way Selenium, 200mcg
So if you decide to supplement with iodine, make sure you also take selenium – some patients see improvements while others have hard time tolerating even small amounts of iodine. Remember, patients who have hypothyroidism caused by iodine deficiency can benefit greatly from supplementing with iodine but patients who have Hashimito’s should exercise caution with iodine supplementation. That’s one of the reasons why it’s really important to get a correct diagnosis – so that you could determine the right treatment for you.
Myth #4: You can diagnose hypothyroidism and determine treatment by solely running a TSH (Thyroid-stimulating hormone) test
Many doctors rely solely on THS to diagnose thyroid disease. There are 2 big problems with this practice.
First, many labs still use outdated TSH level ranges. The target range TSH level for patients on treatment ranges between 0.3 to 3.0 μIU/mL. The National Academy of Clinical Biochemistry (NACB) has stated that it expects the normal range for adults to be reduced to 0.4–2.5 µIU/mL, because research has shown that adults with an initially measured TSH level of over 2.0 µIU/mL have “an increased odds ratio of developing hypothyroidism over the following 20 years, especially if thyroid antibodies were elevated”. Many labs use old standards where your TSH could be as high as 5 and considered “Normal”. Your doctor looks at the test, sees it says “within normal range” and doesn’t think any further testing is needed.
Second, by only testing TSH levels it’s very difficult to see the whole picture. There are many other hormones involved, and many other factors to consider. For example, testing for the above-mentioned auto-antibodies (TPO-ab and Tg-ab) could help your doctor determine whether you’re suffering from Hashimoto’s – the autoimmune form of the disease which is significant in determining the right hypothyroidism treatment course.
This is how it works (very short explanation): Your pituitary gland releases TSH which in turn stimulates the thyroid gland to secrete the hormone thyroxine (T4); T4 is then converted to triiodothyronine (T3), which is the active hormone that stimulates metabolism. About 80% of this conversion is in the liver and other organs, and 20% in the thyroid itself.
So at minimum your doctor should test your TSH, T4, T3, TPO-ab, Tg-ab, vitamin D and B12, and iron levels.
Myth #5: Hypothyroidism cannot be cured, only managed
Unfortunately in the Western world many doctors are concerned with treating symptoms, I call it covering up symptoms. You cannot truly improve your condition until you find out what caused it in the first place. For example, levothyroxine/synthroid does correct the hormone deficiency in patients with Hashimoto’s but does nothing to address the primary cause of the disease which is auto-immune activity. If you don’t address your auto-immunity you cannot regain thyroid health completely. So they’re right to an extent when they say that hypothyroidism and more specifically Hashimoto’s cannot be cured – that’s because the treatment offered (hormone replacement therapy) doesn’t address the cause of the disease.
But what happens if in addition to hormone replacement you address your auto-immunity? That’s when you can make a real change not only in your thyroid health but in your overall health as well. That’s a very broad subject, one I’m not going to go into detail here because it’s a whole different topic but here are some suggestions that may help alleviate your symptoms:
Some foods can help relieve inflammation in conditions like Hashimoto’s, reducing flare-ups and painful symptoms while others can exasperate your condition. You’ll need to avoid any foods you’re allergic to – consuming such foods would cause flare-ups and worsen your symptoms. Also avoid soft drinks, caffeine, alcohol, sugar and especially artificial sweeteners, foods containing gluten (studies have shown that removing gluten from your diet may significantly improve your condition), products containing fluoride and foods containing goitrogens. Examples of such foods are cruciferous vegetables like:
- Brussel sprouts
Get at least 30 minutes of fresh air and exercise each day. Great exercise ideas for hypothyroidism patients are walking, yoga, tai chi and swimming.
Many patients are able to reverse their hypothyroidism by implementing the right hypothyroidism treatment as well as lifestyle and dietary changes in spite of being told by their doctors that it’s impossible.