Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause

Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause by Izabella Wentz, Pharm.D., FASCP with Marta Nowosadzka, MD has a wealth of credible information on thyroid basics, symptoms, tests, and treatment. Izabella Wentz, a pharmacist and Hashimoto’s patient, has summarized three years of research in her book. I highly recommend her book, and I have attempted to summarize some of this information that I believe is crucial for every thyroid patient should know. Thyroid Symptoms As many thyroid symptoms are very non-specific they are often disregarded by the medical community in the initial stages. Patients are dismissed with having depression, stress or anxiety. Thyroid patients are prescribed anti-depressants or anti-anxiety medications without consideration of thyroid function. Medical studies have shown that up to one-third of people who fail antidepressants report feeling better once started on Cytomel (a T3 thyroid hormone). Some patients have even been hospitalized and misdiagnosed as having bipolar disorder or schizophrenia when in fact they were suffering from thyroid imbalances. People with anxiety, depression or other mood disorders should have their thyroid function checked, especially TPO antibodies. Some individuals with lifelong psychiatric diagnoses have been able to recover after receiving proper thyroid care. Thyroid Basics The thyroid produces thyroid hormones that affect the function of just about every organ system in the human body. Thyroid hormones are responsible for stimulating the metabolism of the foods we eat, extracting vitamins, and producing energy from food. They are also vital to the production of other hormones as well as the growth and development of our nervous system. The thyroid also maintains our temperature. Indirectly, thyroid function affects every reaction in the human body, as the temperature has to be just right for these reactions to take place properly. T4 (Thyroxine) and T3 (Triiodothyronine) are the two main thyroid hormones. Only T4 and T3 are considered to be biologically active in the body, and T4 is 300% less active than T3. Twenty percent of T3 comes from thyroid secretion, while the remaining 80% comes from T4 when T4 is converted to T3 through the deiodination process (which removes on iodine molecule) in peripheral organs like the liver and kidney. However, stress, nutritional deficiencies, or other issues can impair the thyroid’s ability to function. Instead of converting T4 to T3, the body conserves energy by converting T3 into an inactive form of T3 know as reverse T3 (rT3). Reverse T3 is able to bind the receptor sites on the cell that T3 normally occupies, but it does not have the ability to unlock these receptors and enter the cell, thus not allowing the necessary reactions inside the cell to take place. Total T4 includes: • T4 hormones bound to protein. When bound to protein, thyroid hormone is not available to the cells and therefore can’t do its job in the body. • FreeT4, which are T4 hormones that are free or unbound to protein. Total T3 includes: • T3 hormones that are bound to protein, and are not available to the cells and therefore can’t do its job in the body. • Free T3, which are T3 hormones that are free or unbound to protein. Free T3 Includes reverse T3 (rT3) hormones that cannot enter the cells and therefore can’t do its job in the body. So, the only T3 that is beneficial to the body for thyroid function is Free T3 minus rT3. Recommended Thyroid Functions Tests • TSH Test: Low levels of T4 and T3 circulating in the blood signal the release of TSH (Thyroid Stimulating Hormone), while high levels of circulating T4 and T3 stop the release of TSH. The problem with using the TSH test to diagnose and treat thyroid function is that the amount of T3 and T4 circulating in the bloodstream does not address the issue of how much Free T4 and Free T3 is actually available in the cells to ensure proper thyroid function required to produce hormones, enzymes, neurotransmitter, and muscle tissue, and have a healthy metabolism. • Free T4 • Free T3 • rT3: TSH, Free T3, and Free T4 tests may be normal, but without factoring in the amount of rT3, patients may be suffering with thyroid symptoms. Hashimoto’s Thyroiditis and Recommended Tests Hashimoto’s Thyroiditis is an autoimmune condition that results in destruction of the thyroid gland. Hashimoto’s is the most common cause of hypothyroidism in the United States, and accounts for 90% of cases of hypothyroidism. In most cases of Hashimoto’s thyroiditis, blood tests will reveal one or two types of anti-thyroid antibodies. Thyroid peroxidase antibody (TPOab) is the most common antibody present, and often antibodies against thyroglobulin (TGab) are found as well. These antibodies may appear decades before a change in TSH is detected. For this reason, TPO antibody screening is always crucial in suspected thyroid disease. Recommended tests are: • TPOab: Antibodies above 500 kU/L are considered aggressive, while antibodies of less than 100 kU/L are associated with a reduced risk of progressing to hypothyroidism. • Thyroglobulin Antibodies Why Are So Many Thyroid Patients Suffering with Thyroid Symptoms? Izabella Wentz’s research completely discredits the research currently used by traditional medicine. Traditional medicine’s diagnosis and treatment of thyroid function determines that any suppression of TSH, in spite of all other thyroid test results, indicates that the patient is hyperthyroid. This misuse of the TSH test results in a false diagnosis of hyperthyroidism; therefore, all the health risks they attribute to this erroneous diagnosis of hyperthyroidism are not valid. And could they defend their preference for T4 only medication if the patient’s medication was based on the results of all the lab work required to determine healthy thyroid function instead of basing it on their flawed research? Some of traditional medicines research is as follows: • Overreplacement – Overreplacement with T4 should be discouraged. Overreplacement causes subclinical hyperthyroidism (normal serum T4 and T3 and low serum TSH concentrations), or even overt hyperthyroidism. The main risk of subclinical hyperthyroidism is atrial fibrillation, which occurs three time more often in older patients with serum TSH concentration < 0.1 mU/L than in normal subjects. Patents with subclinical hyperthyroidism, particularly postmenopausal women, may also have accelerated bone loss. It is therefore important to educate patients about the potential adverse effects of overtreatment with T4. • Combination T4 and T3 therapy – Some hypothyroid patients remain symptomatic in spite of T4 replacement and normal serum TSH concentrations. As an example, in a large community-based questionnaire study of patients taking T4 who had normal serum TSH concentrations, 9 to 13 percent hypothyroid patients might benefit from substitution of some T3 for T4, an idea that has now been evaluated in multiple randomized trial, almost all of which showed that combination T4-T3 therapy does not appear to be superior to T4 monotherapy for the management of hypothyroid symptoms. In some trials, patients preferred combined therapy to T4 monotherapy; however, in one of those studies, patients were given overzealous doses of thyroid hormone resulting in mild hyperthyroidism. In general, clinical trials of combination T4-T3 therapy have not successfully replicated physiologic T4-T3 production. The Future for Thyroid Patients The truth about the current diagnosis and treatment based on the TSH test is that it has caused thyroid patients years, if not a lifetime, of suffering. By treating many thyroid symptoms, such as depression, fibromyalgia, CFS, stress and anxiety, etc. as separate illnesses, the medical profession and the pharmaceutical industry are the only ones who benefit. And the scary thing that I am now noticing is that as older doctors retire, the younger doctors taking their place have been trained to diagnose and treat thyroid function based on traditional medicine’s research as if it is sacred scripture. The only hope that thyroid patients have now are alternative medicine doctors who understand thyroid function and know and use the correct lab tests. I was informed this year (2017) that the lab tests ordered by my Naturopathic doctor are no longer covered by Medicare and Medicaid insurance. Are these doctors being targeted to be phased out? What does the future hold for thyroid patients? For additional information on why the medical profession should reassess the validity of using the TSH test and their preference for T4 only medications, read my review on Living Well with Hypothyroidism by Mary Shomon.

Thank you Izabella Wentz! This book has been an absolute lifeline for me as I've struggled with thyroid-related symptoms and been told repeatedly by drs. that I was fine. She explains the science behind what's going on in Hashimotos in-depth, but in a digestible way. I often even want to recommend it to anyone looking to learn more about autoimmune diseases because she explains so well what's going on in the autoimmune process, the different triggers to investigate, and emerging theories of autoimmunity. This book is much more in-depth than others I've read, and Izabella lays out her research in an unbiased way. She's not picking out research that supports her point, like some others do, but instead summarizes the research that exists, making points about its strengths, limitations or shortcomings. This book has really helped me communicate with my drs., know what tests to ask for, and understand why my drs. are running certain tests/using certain protocols, etc. I had a very sudden worsening of symptoms that seemed, primarily, like reactive hypoglycemia (blood sugar drops suddenly within a few hours of eating), though when I tested my blood sugar levels, most readings were normal. And it would take me hours to recover from a crash, leaving me feeling fried. I had faintness, dizziness, fatigue, poor memory, poor concentration, hair loss, rapid heart rate at random times, would get very cold, felt tired and wired, often couldn't sleep, depression, anxiety, overwhelm, dehydration despite drinking a lot of water, and other strange symptoms that would come and go. My symptoms were bad enough that I had to stop working after about a month. I was diagnosed with Hashimotos based on an antibody test and sonogram (my TSH, T3 and T4 were normal initially, even by functional medicine standards, though I was so symptomatic). But I was told that I didn't need thyroid medication and not given any guidance other than to eat every 2-3 hours. This book explained why so many of these strange things were happening and how to begin healing my body. It's the only place where I've been able to learn many things, such as why I get reactive hypoglycemic symptoms when my blood sugar isn't particularly low (my adrenals are severely burned out). I even went to the Mayo Clinic and was told, essentially, that I was fine, that I didn't even need thyroid medication, although at that point my TSH was barely within their "normal" range, and had risen dramatically. Using this book, I was able to advocate strongly for myself, ask for certain tests and challenge the drs. One Mayo dr. even told me that I'd done more research than his medical students, based on my questions that I have Izabella to thank for. Luckily I now have found a function medicine dr. to work with, who uses a similar process and protocol, and I encourage everyone to find a function medicine dr. It's worth every penny. I've improved drastically since working with mine, and although Izabella's book got me on the right path before I found my dr., it helps immensely to have the guidance of someone trained in function medicine. It's now been 4 months since my sudden onset of symptoms (though for years I had some symptoms), and two months since working with my functional dr., and I'm getting so much better, though I still have a ways to go. The AIP (autoimmuine paleo) diet, digestive enzymes, a number of other vitamins/supplements, and meditation have really turned around my health. I feel I can't do this book justice in this review, it has been so critical to my process of figuring out what was going on with my body and how to heal, and I'm endlessly grateful to Izabella. This is the first book I recommend to anyone with Hashimotos. I also recommend The Adrenal-Thyroid Revolution by Aviva Romm, and Aviva Romm's podcast; A Mind of Your Own by Kelly Brogan for mental health; 10% Human and The Good Gut to learn more about the microbiome, which I've learned is critical to healing.

Malheureusement la prise en charge globale du Hashimoto est peu connue par les medecins francais, ce guide en anglais vous apporte une connaissance tres importante pour reprendre votre sante en main

It’s a very dry read (a dictionary has more plot twists) but absolutely worth it. I have learned so much and I am getting great results.

Es un libro excelente para quienes buscan conocer más acerca del tratamiento de esta enfermedad, sus efectos en los pacientes y los cambios en el estilo de vida que pueden contribuir a mejorar la salud.

Item arrived next day read up to chapter 2 ,very interesting

I was diagnosed with Hashimoto's thyroiditis about 20 years ago. At the time there was very little out there on this disease. I was shocked to find that symptoms which I had presented for years finally had a name. I researched every book I could find. I went on-line looking for help. I must say I found some excellent help for thyoid- both hyper and hypo which this illness encompasses. However, after visiting the endo, I was still unsure what I should do. Yes, of course take the thyroid meds but what else could I modify. Although I was extremely fatigued at all times, I still pushed myself to exercise a lot. My eating habits were good although I had always had a tiny appetite. I had been extremely thin all my life, but overnight I became very heavy. Of course the ridicule from "family and friends" only exacerbated by anxieties. With the help of a metabolic doctor, I lost most of the weight Sleep was non existent. This wonderful book explained to me the causes of my illness and gave excellent suggestions on how to live better. Although I have only had the book for a short time and have read it cover to cover, I found excellent advice on how to improve my quality of life..........................yes......I urge you to read this highly informative book and as another reviewer has said save yourself the time it takes to research this information. You and your health deserve it!!