Patients with hypothyroidism or Hashimoto’s Autoimmune Disease struggle with low-thyroid symptoms even after being prescribed thyroid-hormone therapy. When patients with Graves’ Disease or thyroid cancer have radioactive iodine ablation and/or a thyroidectomy, they face similar struggles with low-thyroid symptoms; and this struggle is often ignored or poorly handled by their physicians.
As a Functional Medicine doctor, my approach to patients with lingering low-thyroid symptoms is very different (see our Functional Medicine page). For patients who have undergone radioactive iodine ablation or a thyroidectomy, a prescription for either synthetic or natural thyroid hormone alone is far less effective than augmenting thyroid-hormone therapy with a whole-body approach to autoimmunity and inflammation.
For anyone already on thyroid-replacement medication but still dealing with low-thyroid (hypothyroid) symptoms, I do thorough diagnostic testing and tailored natural treatments for patients locally and long-distance, with the United States. I also offer a free, 15-minute phone consultation to discuss health concerns. Scheduling a phone consultation is easy, on our Contact Us page.
Understanding Graves’ Disease
Characterized by overactivity of the entire thyroid gland, Graves’ Disease was first described in the nineteenth century by Dr. Robert Graves, an Irish physician. Like Hashimoto’s Hypothyroidism, Graves’ Disease is also an autoimmune disorder. The body’s lymphoctyes make antibodies against the body’s own tissues.
In Graves’ Disease, antibodies bind to the surface of thyroid cells, which causes these cells to overproduce thyroid hormones (called “hyperthyroidism”). Though not the only cause of hyperthyroidism, Graves’ Disease is the most common cause; and it often results in an enlarged thyroid gland. Patients with Graves’ Disease also have eye changes, called Graves’ opthalmopathy.
As an autoimmune disorder, Graves’ Disease requires an understanding of why the immune system is in overdrive. To treat the underlying disease itself, it’s necessary to know what dietary changes and natural supplementation will reduce the fiery inflammation caused by an immune system that won’t retreat and “be quiet.”
Common Treatments for Graves’ Disease
RADIOACTIVE IODINE ABLATION: For Graves’ Disease patients, radioactive iodine ablation is often used to treat hyperthyroid symptoms. The radioactive iodine shrinks the thyroid and eventually destroys the entire gland. For some Graves’ patients, destroying the entire gland might not be necessary; but usually the destruction of the whole thyroid occurs.
ANTI-THYROID MEDICATION: Another option for Graves’ patients is the use of antithyroid medications, such as propylthiouracil (PTU) and methimazole (Tapazole). They stop the thyroid from producing T3 and T4 hormones. These drugs are expected to lower excess thyroid-hormone production within six-to-twelve weeks. Though it’s true that these medications lessen the chance of developing hyperthyroidism again, they area not a cure, and they don’t address the underlying autoimmunity in the disease.
THYROIDECTOMY: Some Graves’ Disease patients choose a thyroidectomy to eliminate hyperthyroid symptoms permanently. A thyroidectomy is the surgical removal of the thyroid gland, due to thyroid cancer or to Graves’ Disease.
All three of these treatments for Graves’ Disease do not address the underlying autoimmune problem, unfortunately. Also, for these patients, their subsequent low-thyroid symptoms are rarely completely alleviated by thyroid-hormone therapy alone.
Hyperthyroid symptoms include the following: weight loss, hair loss, protrusion of eyes or puffy eyes, nervousness, tremors, insomnia, irregular or light menstruation, panic attacks or mood swings, a fast heart rate or abnormal heart rhythm, excessive sweating and heat intolerance, excessive hunger, and restlessness.
After radioactive iodine ablation or a thyroidectomy, Graves’ patients are prescribed thyroid hormone, which is supposed to eliminate hypothyroid symptoms, such as the following: extreme fatigue, brain fog and forgetfulness, depression, hair loss, dry skin, insomnia, constipation, etc. Unfortunately, these patients rarely experience the absence of low-thyroid symptoms, and simply increasing the thyroid-hormone dosage is not the answer.
Lab tests might indicate the right (“normal”) level of thyroid hormone in the blood has been achieved, but these patients continue to face hypothyroid symptoms. It is discouraging for a Graves’ patient to go through the process of radioactive iodine ablation and/or thyroidectomy and then through months of tests to determine the right level of replacement hormone, only to find that she STILL has symptoms that interfere with daily life.
Functional Medicine: Finding the Inflammation
Treating the underlying autoimmune problem in Graves’ Disease requires careful diagnostic testing. Whole-body systems (nervous, gastrointestinal, and endocrine/hormonal) need to be examined for sources of inflammation. At Carolinas Thyroid Institute, our Functional Medicine approach reveals and removes triggers that cause the immune system to rage.
We determine if the patient has food allergies or sensitivities to gluten and other foods. For autoimmune patients, in particular, gluten should be avoided. We also look for other sources of inflammation, such as adrenal stress, hormonal imbalances, hidden infections, heavy-metal toxicity and weak blood-sugar control. Both hypoglycemia and insulin resistance contribute to a raging immune system.
In addition to factors that worsen autoimmunity, Functional Medicine considers the many reasons a patient with hypothyroid symptoms (already on thyroid-hormone medication) might have thyroid lab results that are in normal range. The following possible reasons are just a few:
- The kidneys and liver need to be healthy, in order to convert the inactive form of thyroid hormone (T4) into the active form (T3);
- A healthy digestive tract is necessary, because 20% of T4 is converted into T3 in the “gut,” and probiotics (helpful bacteria) are crucial for this process;
- Cortisol is produced during times of stress, and cortisol prevents thyroid receptor sites in cells from “taking in” thyroid hormone from the blood.
Clearly, examining the cause of low-thyroid symptoms is much more involved than simply giving a patient thyroid-hormone medication. For those Graves’ patients (already on thyroid medication and with normal thyroid test results) who still have low-thyroid symptoms, a Functional Medicine approach is absolutely crucial for a healthy immune system and a better life.
For more information, I offer a free, 15-minute consultation. Call Carolinas Thyroid Institute at (704) 853-8000, or schedule easily on our Contact Us page.
For information about detailed testing and treatment for long-distance patients within the United States, see Nationwide Treatment.