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Category: Medications for Hashimoto’s

Doctors and Hashimoto’s

Doctors and Hashimoto’s

If you’ve been struggling with this diagnosis for any time at all, you’ve probably figured out that most doctors out there are not very well informed when it comes to this condition. I have realized through the years that most doctors respond according to the way they were trained and they tend not to question that process, even when confronted by patients with failing health. A lot of them simply do not have the time to do outside research (especially primary care doctors), but many of them just cannot find it in themselves to be flexible enough to go outside their traditional medical training.

A prime example of this problem lies in the choice of thyroid medication usually prescribed for Hashimoto’s. If you go to a traditional endocrinologist or even your primary care doctor, they will, more than likely, put you on Synthroid or Levothyroxin, even though there are thousands of patient reports stating that Natural Desiccated Thyroid (NDT) works better for many, many people. 

Because big pharma has such an enormous influence on what doctors ultimately decide to prescribe for many conditions, treatments such as NDT, which proved its efficacy long ago in the latter part of the 19th and first part of the 20th centuries, are considered “antiquated” and/or “bizarre”.

If you’d like to read an interesting history of NDT, click here.

Don’t get me wrong – there are people out there who do just fine on these medications, but most of them are dealing with simple hypothyroidism, not Hashimoto’s. If you would like to know why Synthroid and Levothyroxin generally do not work well for Hashi’s, click here. 

Whatever happened to “Do No Harm”??

I don’t believe that doctors set out to harm their patients. But I do believe the medical community, as a whole, exerts a ton of pressure on conventional doctors to stick to traditional approaches to treatment, regardless of outcome. It’s difficult for me to understand how they can continue to do this, when it’s pretty obvious that their patients are not getting better. This approach harms everyone – the patient gets sicker and angrier at a system that seems to have no interest in learning new approaches that might help, and the doctor gets angry at patients who come to appointments and question them about everything. But, I will say this:

It is your right to question your treatment. You are paying for it.

Ultimately, with today’s insurance restrictions requiring one to stay inside provider networks, the best I have been able to do for myself is to find a primary care doctor who is willing to support the work of my functional medicine doctor, for whom I have to pay out of pocket. I’m fortunate enough to be able to do that. A lot of people are not. However, there does seem to be a small trend toward more integrative and functional medicine doctors taking insurance.

Where to start when looking for a thyroid/Hashi’s doctor?

Mary Shomon has a page on her site where you can look for thyroid doctors that have been recommended by thyroid patients. You can find that here. Keep in mind that not all thyroid doctors are experienced or knowledgeable about Hashimoto’s. There’s a lot of difference between hypo/hyper-thyroid conditions and an autoimmune condition that affects the thyroid gland.

The first rule of finding a supportive thyroid doctor: don’t give up. An individual looking for a new doctor has to approach this problem as an employer.

You are literally looking for the right person to “hire” for your care.

As I said before, you are paying for this care, and you have a right to determine whether or not the doctor is meeting your standards.

When I tell people this, I usually get very strange looks. But, it’s true. We are consumers and we are paying for a service. For too long, doctors have treated themselves as experts who cannot be questioned by “uninformed” patients. Those years are long gone with the advent of the internet because we ALL have access to a lot of information now, good and bad.

It will be up to you to do proper research and educate yourself about this condition so that you understand what kind of care you need. This can be hard, because a lot of us with Hashi’s just don’t feel up to doing much of anything a lot of the time. If you’re currently dealing with a lot of fatigue, you will have to decide how long you can stand to do this kind of research every day. But you will need to do it if you have any hope of finding a practitioner who can help you to heal.

I have personally found that the doctors who are best equipped to deal with Hashi’s are usually doctors of integrative medicine or functional medicine. These are practitioners who are willing to look outside traditional medical treatments and add alternative treatments to their practices because they feel that is the only way they can truly help their patients. The doctor I’m seeing now told me that the reason he went into functional medicine was because he was tired of feeling totally powerless in the face of patients who were becoming sicker every day.

What is the difference between integrative and functional medicine, you ask?

As taken from The Institute for Functional Medicine’s website:

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

The Functional Medicine model considers the diagnosis, of course, but also seeks to answer the question, “Why does this person have this illness?” The answer to this question is revealed by discovering the antecedents, triggers, and mediators that underlie symptoms, signs, illness behaviors, and demonstrable pathology. 

You can look for a functional medicine practitioner here or here.

You can search for an integrative medicine practitioner here.

Dr. Kharrazian, who is one of the foremost practitioners specializing in Hashimoto’s, also has links on his site to assist in finding a practitioner here.

Alternatively, you can just do a search for “functional medicine” or “integrative medicine” plus the name of the city/town where you live and see what comes up.

It can be really easy to lose hope in this quest for a good doctor, especially if you’re not located in a large metropolitan area. But, you will find someone eventually, even if you end up doing treatment long distance over the internet. There are several good practitioners out there offering long distance consultations and treatment programs and a lot of people are doing this now because it’s the only way they can access care from people who know about this condition. Here is a short list of people I have run across who are offering long distance consults:

Marc Ryan, L.Ac. – Marc is a licensed acupuncturist and has Hashi’s himself. He has an enormously informational site at Hashimotoshealing.com.

Eric Osansky, D.C. – Eric is a chiropractic physician who specializes in natural treatments for endocrine problems. You can find him at Naturalendocrinesolutions.com.

Dr. Isabella Wentz – Dr. Wentz is a pharmacist with Hashi’s. Her site has a ton of useful information at Thyroidpharmacist.com.

Dr. Sarah Ballantyne has assembled a stellar group of people with whom you can make appointments and get guidance. You can find them here.

Amy Myers, MD – Amy practices functional medicine and has several online programs that you can choose from here.

This list is by no means exhaustive. If you have had a good experience with an online practitioner whom I haven’t mentioned, I would love to hear from you!

Hang in there, keep looking and don’t settle until you find someone who will work with you as a team and listen to you and your symptoms.

My best hopes for you all,

Vanessa

Vanessa Gunter, D.M.A., M.A.

 

Medications Often Associated with Hashimoto’s Disease

Medications Often Associated with Hashimoto’s Disease

There are various approaches to medications that may or may not be helpful with Hashimoto’s. I will attempt to give you an overview here.

Synthroid/Levothyroxin

As I stated in a another post, the “go to” medication for Hashimoto’s is often a T4-only medication like Synthroid or Levothyroxin, unless you’re fortunate enough to be seeing a holistic practitioner when you’re diagnosed. Some people do fine on this, but many people do not, mainly because it does nothing to address the autoimmune component of the problem and it only provides one of the five hormones that the thyroid needs to function.

I was on Synthroid for a little over 10 years, but I started feeling really lousy (translates as: always tired, sick a lot) about 6 years after starting it. When I started trying to talk with doctors about this problem, they usually just wanted to increase my dose. When I would try this, my heart rate would go up, along with  my anxiety levels, and I just generally did not feel right. I knew that something else was amiss, so I began to seek out practitioners with a more holistic approach. I was on Synthroid plus Armour for a while (strange combo and not recommended), and it did increase my energy, but only at very high doses, which was really ramping up my heart. I was told I had adrenal fatigue, but was not given any direction as to what to do about this. Finally, I found a doctor with experience with this and he prescribed cortisol and took me off of Armour.

Then, of course, we moved to another state and I had to start all over again finding practitioners who were knowledgeable about any of this. For a time, I was on Synthroid plus Cytomel (a T3-only medication), which did help my energy levels, but, without any support for my adrenals, I was still exhausted and depressed most of the time.

For a more detailed discussion of why these meds don’t work well for Hashi’s, click here.

Natural Desiccated Thyroid (NDT)

During all of this time, I was doing a lot of reading and research, trying to figure things out on my own. As I continued to search for knowledgeable practitioners, initial appointments with these people became interviews because I was, in fact, interviewing them for a job as my doctor. I will talk more about “hiring” doctors in another post.

I finally found someone who was willing to work with me as a team to try to figure things out. It was at this point that I decided to try natural dessicated thyroid (NDT). I have been on it since and have found it to be very helpful in combination with other supports. Since it is made from thyroid tissue, it has all the thyroid hormones in it, which we all need. There are several “flavors” of NDT out there. I happen to use Nature-throid. For a thorough discussion of what’s available in the category of NDT, click here.

Adrenal Support

Now, all this time, my poor adrenals were completely ignored when, in fact, they probably pooped out before my immune system went kerflooey. One of the most frustrating things I have discovered about this is that before a doctor prescribes Synthroid to anyone, he/she is supposed to determine if the adrenals are faltering, because prescribing Synthroid in the presence of weak adrenals can worsen the problem. Well, based on patient report and conversations on forums, I can tell you this just is not happening very often. So, a lot of people are ending up with adrenal fatigue when it could have been avoided. Grrrrrrr.

I use a combo of low dose cortisol and adrenal cortex to support my adrenals. There is still a lot of controversy out there regarding the use of cortisol, but I have found it to be very helpful. Many conventional docs won’t prescribe it based on a history of horrible side effects at high doses. But only physiologic doses (up to 30 mg a day) are typically used to treat tired adrenals. I did wean myself off of it at one point at the direction of a naturopath with whom I was working, but I found that I was, once again, tired all the time and couldn’t think well. When another doctor prescribed it for me later, the relief I felt was almost instantaneous.

You can find a ton of info on cortisol, NDT and a million other things regarding thyroid treatment over at Stop The Thyroid Madness. Great site, great book!  The best reference I know on using cortisol safely is the book Safe Uses of Cortisol by Wm. Jeffries. Definitely worth a read. You can buy a copy here.

Low Dose Naltrexone (LDN)

A relatively new medication that is making major waves in the Hashi’s and autoimmune world is low dose naltrexone (LDN). I discovered this a few years ago only because the functional medicine doctor I was seeing knew about it and prescribed it for me. Wow! What a life-changer. By the time I started using this medication, I had been dealing with chronic pain for a long time. My pain always came as a result of knots and spasms in my muscles (usually in the neck and shoulders) and, as a I noted in another post, I thought that this was all connected to repetitive stress injuries from my 35+ years as a professional flutist. Well, about 2 weeks after I began taking LDN, I started noticing a decrease in pain and, after 5-6 weeks, the pain was greatly diminished. Unfortunately, I have never been able to get back to a place where I can play flute regularly again, but at least I’m not in constant pain all day. Of course, that isn’t the end of the story. In order to keep the pain at bay, you need more than just LDN. You can read more about that here.

LDN works by modulating the immune system through blocking opioid receptors, which forces more endorphins into the blood. You see, a common denominator with all autoimmune disease is a deficiency in endorphins. LDN actually assists the body in repairing itself by giving it what it lacks. It’s a great thing. For more detailed information, click here.

Lufenuron

Since so many people with Hashi’s have gut problems and many of those gut problems are related to things like parasites and Candida, I have noticed a lot of people turning to Lufenuron for help with this. Lufenuron works by preventing the chitin in the Candida and/or parasites from forming, thereby killing both. It is totally benign in the body and, in addition to taking care of these problems, it helps LDN to work more efficiently in the body. I tested negative for both Candida and parasites some time ago, but decided to do a course of Lufenuron anyway, just to be sure. I did feel better while taking it and it did seem as though my LDN was working better. For more information on Lufenuron, click here.

It’s important to keep in mind that medication choices are personal and should be tailored toward what works best for the individual. People with Hashimoto’s have a lot of symptoms in common, but we all experience this condition in a unique way according to our particular physiology. This is why it’s so important to find a practitioner knowledgeable in Hashimoto’s and all of the available approaches that may be useful.

Best,

Vanessa

Vanessa Gunter, D.M.A., M.A.

Disclaimer: This blog is a representation of my personal views and opinions and not those of any associations or organizations to which I may belong or with which I may volunteer. The contents of these pages are informational only and must not be construed as medical advice, opinion, diagnosis or treatment. The information provided here should not be used for diagnosing or treating a medical problem and should not be viewed as a substitute for professional care. If you feel or suspect that you have a medical problem, you should consult an appropriate health care provider.

 

Addressing Hashimoto’s Symptoms – Where to Start?

Addressing Hashimoto’s Symptoms – Where to Start?

Depending on how long you’ve been dealing with Hashimoto’s disease, you may have only a few symptoms or everything that was on the list in my earlier post. Obviously, it’s easier to manage if you have only a few, but it’s really important that those first symptoms are managed properly, so that your condition doesn’t worsen.

In my case, as I mentioned before, symptoms were ignored for literally decades until, finally, a thyroid antibody test (which no one had ever thought to do prior to that time) returned a positive result. People are now starting to talk about the fact that by the time you are actually diagnosed with this condition, it may have been around for a very long time and you may already be in a pretty severe stage of the disease.

Thyroid Meds

When you’re diagnosed with this condition, you are diagnosed as being hypothyroid (underactive thyroid). Conventional doctors will inevitably prescribe medications such as Synthroid or its generic equivalent Levothyroxin. Unfortunately, this approach simply attempts to support the thyroid gland without addressing any component of the autoimmune problem. This is why we all get sicker over time. For more on this issue and some alternatives, click here.

Digestive Issues

Digestion is a huge issue with a lot of people who have Hashi’s. Many of us have never had good digestion for whatever reason and some of us have created a hostile digestive environment through bad eating habits. In either case, the end result is usually leaky gut. There is still skepticism about this condition among many conventional doctors, but I am definitely a believer. Given my own struggles with digestive issues my entire life, I now firmly believe that this was the shaky foundation that helped to set me on a path to Hashimoto’s. Simply put, leaky gut allows food particles that would normally stay in your digestive tract to escape into your blood stream. This not only causes problems with nutrient absorption, but it causes your body to become sensitive to a wide variety of foods, since it is no longer being protected by the usual barrier between your gut and your bloodstream. This results in becoming allergic to a long list of foods and not being able to absorb nutrients from food, so you literally become malnourished. At my lowest point, my hair was falling out, I had become very thin, and my muscles were basically just hanging off of my bones because I was on a horribly restricted diet and I was absorbing very few nutrients from my food. For a detailed discussion of leaky gut, you can go here.

As if this weren’t enough, many people also struggle with Candida, SIBO (small intestine bacterial overgrowth) and/or parasites. Any of these can cause brain fog and fatigue, along with digestive issues. You can find more info and resources on this topic here.

All this leads to the question: What can I eat?  I used to joke some years ago, when I was gradually eliminating first one food and then another and another and another, that by the time I was 60, I would be subsisting only on saltines and water. Well, that turned out not to be true, because I can’t even eat saltines!!  All joking aside, this is a serious issue, given the above-mentioned problems with malabsorption and malnutrition. For my take on this, go here.

Supplements become a primary concern for those of us struggling with this condition, usually because of malabsorption problems in the gut which can ultimately lead to malnutrition. However, you need to be very careful about the quality of the supplements you use and the extra ingredients that may be included. Sometimes these can worsen your condition, especially if you have multiple allergies and sensitivities. I have a post detailing the supplements and medications I use here. Please remember, these choices are very personal and I am listing mine simply to show you what has worked for me, not as medical advice.

Sleep…or the lack thereof

Most people with Hashimoto’s will deal with insomnia at some point. This can present in several ways. Sometimes people have difficulty falling asleep, sometimes it’s hard to stay asleep, and sometimes it can be both. Issues with falling asleep very often point to a badly regulated thyroid gland and issues with staying asleep can be related to adrenal, kidney, or liver issues. When you have both of these, then trying to get any decent sleep at all becomes a real challenge. Food sensitivities also play into this because if you’re eating foods that your body is having difficulty processing, then your body is probably going to wake you up in the middle of the night to let you know it is not happy. You can find an in-depth discussion of this problem here.

Chronic Pain (and Attempting to Exercise)

I didn’t know this until well after I was diagnosed, but chronic muscle and joint pain is also a common symptom of Hashimoto’s. For me, this presented as knots and spasms in my muscles which were incredibly painful, so much so that I have had to walk away from several jobs as a result. For now, my pain is pretty manageable, but I have found that removing stress is critical to keeping the pain at bay, along with taking copious amounts of magnesium and getting a prescription for low dose naltrexone (LDN). Read more about this here.

One of the most frustrating things for me about the muscle pain has been the inability to do much physical exercise. There are people out there who will advise certain things about Hashi’s and exercise, but the bottom line is, you can only do what you can do. So don’t push yourself to do exercises that are going to worsen your condition, regardless of what anyone says. I talk more about this here.

Brain Fog

Another common complaint among Hashi’s people is brain fog. If you’ve experienced this, you know. You can’t concentrate, you forget easily, you really feel like you can’t do anything but just sit in front of the TV, and, even then,  you can’t concentrate on what you’re watching. It’s a horrible feeling and it’s scary, especially with increases in diagnosed cases of Alzheimer’s and other forms of dementia. There seems to be a very strong connection between brain health and thyroid function, as well as a healthy gut. You can learn more about this here and here.

Depression and Anxiety

And lastly, I have to mention the emotional toll this condition takes on everyone who has it, because it is a large one. Depression and anxiety are common not only because you are constantly battling the various facets of this disease, but also because they are a physical part of this condition. Hashimoto’s screws mightily with your hormones and your hormones have a fundamental part to play in endocrine health, which regulates your emotions. So, it’s important to remember that these are symptoms, not some personal failing because you “can’t handle” your condition.

As I mentioned before, I have walked away from numerous jobs due to my Hashi’s and when/if you have to do this, it can bring all sorts of questions to your mind: What’s wrong with me? Why can’t I work like a normal person? Will I ever have a normal life again? How will I live? and the biggie, especially if you’ve been doing work you identify heavily with: Who am I now? Am I this disease? 

On top of this, you will inevitably encounter people who won’t believe you are struggling as much as you are because “you look fine”. This can be infuriating and hurtful, but just expect it, because it will happen. I will be devoting considerable resources to a discussion surrounding the psychology of Hashi’s.

So, this gives us a start at identifying core features of Hashimoto’s and a few resources with which to begin the journey of educating ourselves about this condition. More soon.

Best,

Vanessa

Vanessa Gunter, D.M.A., M.A.