Help For Hashimoto's

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What is Hashimoto's? Episode 27.

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What is Hashimoto's? Stephanie Ewals, NTP

Welcome to Episode 27 of Help For Hashimoto’s. I’ve got some lab work to share with you today. In the past weeks I had been talking about how I went off my medication and had been feeling pretty good. That feeling lasted for only a couple of weeks. Last week I started to feel slow. I could feel my muscles having to work extra hard just to walk or write. I didn’t have a lot of energy. I pushed my lab appointment up by a week because I knew things were not okay. I started to feel like I could just lay in bed all day.

My digestion also had virtually stopped working. I felt bloated and was gassy and was not having eliminations at all. So then I didn’t feel like eating because I was so plugged up which affected my energy levels as well. I’m sure if you have dealt with or are dealing with hypothyroid symptoms, you can relate.

Some of you may be very sensitive to your medication or to a higher than normal and if you have a TSH that is 4, 5 or 7 or 9 and your doctor is telling you that you are fine but you are having symptoms like I just described then you are not fine. Maybe you can manage things with diet alone- that is possible.

Clearly for me, that was not possible. So either, I was dealing with way too much stress over the last nine weeks or there has been too much damage to my thyroid gland and I will always need medication. For now, I am back on medication and starting to feel a lot better. 

My TSH went from being suppressed at below 1 to being 119 in just eight weeks after being off all medication completely. I will have my actual lab results posted in the show notes for this episode on my website. Taking the Biotics Research GTA supplement had suppressed my TSH and so we could not get an accurate reading of where my body was at. I decided on my own to go off all medication to see if my body could do it on its own after all these years. 

Clearly it cannot. I need the medication.  There was some talk with Aimee Raup in the episode on her book Body Belief about believing you can feel well. I want to be clear that you cannot think yourself in to remission but what you believe about your body’s ability to be well can affect how well you feel. I hope that makes sense. Even at a TSH of 119, feeling sluggish, and tired and like I didn’t want to get out of bed I remained positive about what this meant. I truly wanted to be able to tell you I didn’t need my medication any more. For now, that is just not the case. I need it and I am okay with that.

 I don’t like feeling like I am walking through sludge with 100 pound pack on my back all day long. I don’t like only having enough energy to get dressed and then need to take a nap. So, if medication helps me feel at my best everyday along with a continued clean diet and good lifestyle management then this is how it is. I will make the best of it and live my best life because I am not going to let Hashimoto’s control my life. You don’t have to either. 

With that said, let’s dive in to the topic of Hashimoto’s and what that really means. I talked about hypothyroidism last week and how that is a symptoms of Hashimoto’s which is an immune system problem first. 

What exactly does this mean? 

When you have a diagnosis of Hashimoto’s this means that your immune system has launched an attack on your thyroid gland and is destroying it. It is the most common cause of hypothyroidism in the United States. Usually you have to fight for it to be tested mostly because the treatment of the disease is the same as it is for hypothyroidism. It is expected by your doctor that your thyroid will continue to be killed off with the immune attack so your medication will be adjusted over time as the thyroid is destroyed. 

Over the years as you continue to feel bad, you may be offered antidepressants as I was or you may be offered pharmaceutical solutions to your racing heart or treatment for your high cortisol output or lack of cortisol output. Maybe you will be offered the option of removing the thyroid altogether. 

These treatment options are frustrating for us, the patient, at best. You may be told there is nothing you can do. That a gluten free diet will leave you nutrient deprived or that it won’t help you. 

Here is the thing. Doctors receive about 40 hours or less of nutrition training in medical school. If they get extra training in nutrition they will be taught what the government and the USDA food pyramid teaches. They are not trained to look any further for answers to your problems when it comes to chronic health conditions. It isn’t their fault. It is frustrating, but it isn’t their fault. So your doctor is doing what he or she thinks is best for you. I want to be clear on that. I am not bashing them. I am frustrated with the way we are treated in our current health care system and things do need to change but that is for another episode. 

Okay. You may or may not have a Hashimoto’s diagnosis but you have gotten a hypothyroid diagnosis and they are not testing for thyroglobulin or thyroid peroxidase antibodies because the treatment for you is no different. 

Common treatment for other autoimmune diseases is to be put on an immune system suppressing drug like prednisone. Hashimoto’s isn’t aggressive enough of an autoimmune disease to warrant being on a drug like that- and frankly, you should not want to use that as your treatment. It is a bandaid. This disease and most other autoimmune diseases are very well managed through diet and lifestyle. 

If you are looking for a bandaid as a permanent fix for your autoimmune disease, this is not the place to get it. 

I don’t want to go through the rest of my life with a bandaid that doesn’t really make me feel good. Prednisone’s side effects are things like insomnia, mood changes, increased appetite, gradual weight gain, acne, dry skin, slow wound healing, headache, dizziness, nausea, stomach pain and the list goes on. 

Doesn’t sound fun- in fact is sounds like more crappy symptoms on top of all the crappy symptoms that come with a mismanaged thyroid condition. 

Even if you are put on thyroid medication, like me, with a combo of T4 and T3 and even the supplement with the porcine glandular in it- the immune system is not being addressed.

Hashimoto’s disease is named after the Japanese doctor, Hakuro Hashimoto who was the first to describe the disease in 1912. Our autoimmune disease was the first ever to be recognized as an autoimmune disease. 

About 50 million people suffer from some kind of autoimmune disease in the US and about 30 million of those people are women. Hashimoto’s and Graves disease are some of the most common autoimmune diseases with about 8% of the US population having a diagnosis. Most of the cases of hypothyroidism are due to Hashimoto’s. 

If you have hypothyroidism and are on medication but still feel symptoms or you continue to feel worse over time, then you are probably dealing with Hashimoto’s disease. You might be showing lab tests of normal TSH because you are on medication but your immune system may be on fire and so you present with symptoms. 

You also might be having symptoms of both hypothyroidism and hyperthyroidism which can fluctuate from week to week, day to day or month to month. This is a clue that your immune system is needing attention. Your TSH levels can be all over the place so if you happen to go in for your labs at a time when your TSH is in the normal range- you will not be given medication. In the case with Hashimoto’s medication in the form of thyroid hormone replacement is a band aid. You may need it for a time period until you get things under control but you may not need to be dependent on it for the rest of your life. There is even some evidence to show that it might be possible for your thyroid to regenerate once you get the immune system calmed down. 

In my case, I probably had Hashimoto’s when I was first diagnosed with hypothyroidism in 2002 but because I went for 8 years thinking all I needed was to take my levothyroxine there was probably enough damage to my thyroid that I will likely need medication for the rest of my life. Who knows. I’m still hopeful. I went through times of having hypo and hyper symptoms and could not figure out what was going on. One of those times was when I was pregnant in 2004 and lost my baby at 34 weeks. You can read more about that in Five Things Your Doctor Won’t Tell You About Hypothyroidism which you can get from my website when you sign up for my newsletter. 

What is happening in your body when you have those hypo/hyper symptoms? Essentially the immune system is attacking your thyroid, killing off some tissue. As that tissue dies, the thyroid hormone is released in the blood stream giving you symptoms of hyperthyroidism such as heart palpitations or racing heartbeat, you may have this feeling of inward trembling, you may feel nervous or moody/emotional, you can have insomnia and night sweats (I had night sweats for years), you may be losing weight for no reason at all. 

You can confirm you have Hashimoto’s by asking for a Thyroid Peroxidase Antibodies test (TPO Ab). This will verify that your immune system is attacking the enzyme that allows your body to produce T4 and T3. 

You can also ask for a Thyroglobulin Antibodies test (TGB Ab). Thyroglobulin is what your thyroid uses to make thyroid hormone. You can have a negative antibodies test. This is common because as with everything else in the body, your immune system can yo-yo. It may not be acting up at the time of your test. So you either have to go in and ask for the test when you know you're in a flare (having symptoms). 

What are the triggers for Hashimoto’s or autoimmune disease in general?

As has been said, “Your genes load the gun and your environment pulls the trigger”. 

You may be genetically predisposed to your disease- like me. My mom, her siblings and their mother all had or have some kind of thyroid condition. One of my Aunts and my Uncle have Grave’s disease. My Uncle also has an autoimmune kidney disease for which he is on an immune suppressant. My other Aunt has hyperthyroid symptoms and my mom has hypothyroidism. I’m pretty sure she has Hashimoto’s because she has spent her whole life not really feeling well. She has never been tested. 

So, genetics were there for me and I pulled the proverbial trigger of that genetic gun with my lifestyle and environmental factors. 

Things like gluten intolerance, estrogen dominance, blood sugar dysregulation, PCOS, being deficient in vitamin D and other nutrients, toxicity in the body from environment or heavy metals, chronic infections or inflammation, stress in any form. All of these or any one of these can lead to the breakdown of your body and the beginning of autoimmune disease. 

The good news is that you can definitely control your disease with diet and lifestyle. You maybe have figured that out already and that is why you are here. If not, you are in the right place to learn about how you can manage your disease and feel your best. 

If you are on medication, you need to start paying attention to how you feel on it. You may need to have it adjusted and hopefully you have a doctor who is willing to treat you by your symptoms and adjust or switch your medication as needed. The medication is kind of a Goldilocks type medication. It can take some time to find what is just right for you. Some people do fine on synthetic medications that are T4 only like Synthroid or Levothyroxine. Some people do better on Natural Desiccated Thyroid Hormone like Armour, Naturethroid, WP Thyroid or compounded thyroid powder.  If you don’t feel well on one type of medication ask to try a different one. 

One thing all autoimmune conditions have in common is intestinal permeability or what you may have heard of as leaky gut. Your intestinal wall is the only thing protecting your body from the outside world. It’s entrance is essentially your mouth and its exit is your anus. If it becomes permeable or leaky- having tiny microscopic openings in it- then the outside has access to your insides where your immune system is ready to protect you at all costs. 

We have a protein called zonulin which allows our intestinal wall to become permeable or causes the tight junctions in our intestinal wall to open which will allow proteins and bacterias to have access to our insides- our blood stream. This causes our immune system to go on high alert and launch an attack on these so called invaders. 

One of the bigger triggers for this in autoimmune disease can be gluten- the protein found in larger amounts in wheat, barley, rye and other grains. This is why you hear so many practitioners talking about being on a gluten free diet. It can help your immune system calm down. Next dietary change would be to take dairy out. It has proteins similar to gluten and can confuse your immune system and remember we are trying to calm the immune system. 

You also need to look at other factors like stress, sleep, nutrient deficiencies like vitamin D and healing the gut is a must. You can’t absorb nutrients if you are not first digesting your meals well and have a healthy gut. Gut means your small intestines. That is where about 80% of your immune system lies and that is where the majority of your nutrient absorption is. 

This is a lot of information and hopefully not too overwhelming. If you have questions or want something covered in more detail, please drop me a note at helpforhashimotos@gmail.com or go to my website and fill out the contact form. I’m here for you and want to help so send me your questions. 

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Thanks so much for listening. See you next week.