Autoimmune & Thyroid

Diagnosis

Thyroid disorders are often the most difficult to diagnose; as the symptoms are often confused with other illnesses. It is therefore very important to work with a physician or health practitioner who will take your symptoms seriously and be willing to work with you in partnership. It also is very helpful if you are prepared to advocate for yourself.

Contributing Factors To Thyroid Disease

Often someone feels “fine” until they undergo a stressor. There are three main factors, which can push you into active thyroid disease.

  • This could be high stress from a job, college, move to a new city, or family illness. Autoimmune disease can also appear with pregnancy or post partum.
  • Genetics contribute to the development of thyroid disease; there is an increase chance of developing the disease if a woman in your family history has thyroid disease. Environmental factors can cause the genes to become active.
  • Lastly, gut imbalance or intestinal permeability, contributes to the development of autoimmune disease and thyroid disorders.

Inflammation is intrinsic to autoimmune disease and contributes directly to thyroid imbalance.

Symptoms of Autoimmune or Thyroid Disease

    • Fatigue, weakness, sluggishness, feeling run down all the time
    • Depression, anxiety or other mood disorders
    • Loss of hair, thin eyebrows
    • Weight gain and inability to loose weight
    • Abdominal bloating, pear shaped body
    • Insulin resistance or Syndrome X
    • Muscle and bone aching
    • Joint pain and stiffness
    • Fibromyalgia
      • Sleep disturbance
      • Restless legs
      • Constipation
      • Menstrual irregularity
      • Infertility
      • Memory problems, poor concentration
      • Dry skin, eczema
      • Frequent infections, catch colds easily
      • Neurological symptoms such as cold hands and feet, tingling in your hands and feet, slow reflex response

Testing

Many times a patient will be in my office, have a family history of thyroid disease, present with clear thyroid symptoms, but tell me “My doctor said there’s nothing wrong with my thyroid because my laboratory work was normal.”

I don’t let the number dictate diagnosis of thyroid disease. If a patient has a family history of thyroid disease and presents with clear thyroid symptoms, hypo and/or Hashimoto’s thyroiditis, or hyperthyroid, and their blood work up is not yet in the abnormal range, I will treat them as if they are experiencing a thyroid problem, ruling out other possible diagnoses, of course.

Incomplete Blood Workup

Unfortunately, this is because many times, doctors only order the screening test for thyroid disease, NOT the test for Hashimoto’s, and Hashimoto’s Thyroiditis is much more than a thyroid disease; it is an inflammatory process that is mainly targeting the thyroid.

What Constitutes a Complete Thyroid Workup?

Antibody Tests
These tests measure the immune response of your body towards your thyroid gland. These numbers can change with nutritional support, and lifestyle changes, so it’s a good idea to ask your practitioner to repeat these tests every six to eight months. These are often the tests that are not performed, but the information they provide can confirm a diagnosis of Hashimoto’s Thyroiditis or Graves’ Disease (hyperthyroidism).

Thyroid Peroxidase or TPO
Thyroid peroxidase is an enzyme made in the thyroid gland this is important in the production of thyroid hormone. TPO is found in thyroid follicle cells, where it converts the thyroid hormone T4 to T3. Thyroid peroxidase is a test that measures the level of an antibody that is directed against thyroid peroxidase. Autoantibodies to thyroid peroxidase are produced within the body and their presence in the blood reflect an attack on the thyroid tissue by the body’s immune system.

Thyroglobulin Antibodies or TgAB
Antithyroglobulin antibody measure antibodies to a protein called thyroglobulin, which is found in thyroid cells and plays a crucial role in hormone synthesis, storage and release. It is not secreted into the systemic circulation unless there has been follicular inflammation, as seen with thyroiditis and autoimmune hypothyroidism.

TSH
Thyroid Stimulating Hormone is produced by the pituitary gland and signals the thyroid glad to release the hormone T4 and T3. Functional Medicine™ practitioners have further defined normal reference ranges as being between 1 and 2μIU/ml for a healthy person not taking thyroid medications.

Reverse T3 or rT3
This molecule acts to slow down the energy production of T3.

Free T4
T4 is converted to T3 in our body, and this test measures the unbound form. But there are many biochemical imbalances that can contribute to this not being a full conversion. So it is possible to continue to experience extreme fatigue, even with a T4 in the “normal” range.

Free T3
This is the primary hormone produced by your thyroid and this test measures the unbound or active form of T3. It is representative of the amount of energy you have to provide to your cells.

Treatment

Functional Medicine™ is the basis for the treatment approach for recovery from thyroid disease.

      • A Gluten Free and Allergy Free diet form the foundation for recovery from thyroid disease.
      • The health of your digestive tract also contributes to the health of your immune system and thus, your thyroid.
      • Stress Reduction — It may sound simple enough, but it’s not always easy to identify, and then remove, people or situations that cause you stress in your life. Emotional stress has been shown to affect your cortisol levels, which affect your ability to sleep, all of which negatively impact your immune system. Taking charge of personal relationships that cause an emotional drain, getting on top of your spending habits, figuring out how to decrease the pressure at work can all make a difference in your emotional health and stress reduction. The important thing is to feel like you have options and breathing room, even if it’s only a small amount. Exercise, even a 15 minute walk, yoga, meditation, hanging out with friends, all have a positive affect on your immune health.
      • Functional Medicine™ Testing — We utilize Functional Medicine™ testing to discover the root cause contributing to your thyroid imbalance. We then use targeted supplementation to address the imbalances clarified through this advanced testing.

If you would like further detailed information on thyroid and autoimmune disease, here are three excellent books on the subject.

Resources

      • The Thyroid Cure by Michelle Corey
      • Hashimoto’s Thyroiditis by Izabella Wentz
      • The AutoImmune Solution by Amy Myers

Thyroid disorders require a commitment from the practitioner and patient to work as a team. “Get to the root of your chronic health problems and restore your health!”

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