Help For Hashimoto's Episode 17

ITunes Review: 

Stephanie, Thank you so much for a wonderful podcast. I love that you keep it real while answering difficult questions for us. You have a very calming and peaceful voice and I am always so encouraged listening to your podcasts. Keep them coming. We are listening and learning. 


What do you do if you forget to take your medication? 

Half life- a half life in the world of medications means the amount of time it takes for the concentration of the medication in your blood plasma to reduce by half.  Said another way- it is how long a drug stays in your system or the amount of time it takes for the effectiveness of a drug to reduce by half. 

If you are taking levothyroxine, the half life is 6-7 days and up to 9 or 10 days if you are dealing with hypothyroid conditions. If you have hyperthyroid conditions then it can be as little as three days. Nothing seems to be easy with this disease. 

Levothyroixine is a common treatment and most likely what your doctor will prescribe unless you have a doctor open or more knowledgeable in thyroid health. 

For practical purposes we will go with a 7 day half life for levothyroxine. When you take this medication, around 80% of it goes through your system over a longer period of time, like several hours. 

According to the Williams Textbook of Endocrinology, missing a day shouldn’t have a big effect on you. They also say that T4 is absorbed very well by the body so waiting an hour to take your medication before eating might not necessarily be required. Taking it on an empty stomach will give you a more stable TSH reading though. But since we all know that TSH should not be the gold standard, that maybe shouldn’t matter. 

The reason you usually have to wait 6 weeks to have your labs tested is because of this long half life. It takes about 6 weeks before your body has adjusted to a dose. 

However, if your digestion is not working well and we are going to talk about that in a minute, then you may have issues with absorption and of creation of T3 from your T4 only medication. 

There can be an issue in concentration of medication between manufacturers which can mess with your body. So, be proactive and let your pharmacy know that you do not want them to switch your medication without your knowledge. Remember that getting this dose right is like goldilocks- it needs to be just right. 

This same textbook also says that NDT is not a good choice for treatment and that TSH is the gold standard so- take it for what it is worth. 

A NDT like Armour has a half life of 2-7 days with the T3 having a half life of 4-6 hours. So if you take your medication with T3 in it at 8am then sometime between 12pm and 2pm you have about half of the original dose of medication in your system. Your cells will have used the rest of it. But it should last you about a day. This means half is gone in 4-6 hours, another half of the half (a quarter more ) will be used in another 4-6 hours and so on. 

T3 is used up faster because your body doesn’t have to convert it like it does T4. This is why it is a good idea to take a partial dose in the morning and a partial dose in the afternoon. 

Now let’s talk about what happens when our digestion isn’t working well because this is very important for our thyroid to work well. 

Thyroid peroxidase is an enzyme. It makes thyroid hormones by cleaving off an iodine molecule and adding it to the amino acid tyrosine on thyroglobulin which then makes T4 and T3. In order for this to happen, we need to have available to us: selenium, copper, magnesium, B vitamins, zinc, vitamin A. 

You should not just go and willy nilly supplement with these vitamins and minerals. There are many factors involved here and supplementing with some of these may make things worse in the long run. So it is a good idea to either do a lot of your own research or work with someone who knows how to work with your condition. 

Our gut or gastro intestinal tract is an important factor in our thyroid health but even before that, what we eat and how we break it down in our stomach is a key factor. 

Before we even talk about what you are eating, let’s talk about how you are eating it. Are you running through the drive through before or after your kids activities? Are you eating in the car or eating while you are doing something else?  Are you relaxed or stressed while you are eating?

Any of those scenarios will mean you are going to struggle with breaking down your meal before it even gets to your small intestine where most of the nutrients are absorbed. 

Digestion actually starts in the brain. We smell our food cooking and our brain signals the production of saliva so we can break down some of that food in our mouth while chewing. Are you chewing your food well? Like 20-30 chews per bite? Really breaking it down so the enzymes in your saliva can begin digesting the carbohydrates in your meal?

Once you have chewed well, you swallow and that ball of food goes in to your stomach and stomach acid and pepsin get to work digesting or breaking down proteins. 

Do you have acid reflux after eating? (there is more about this in the audio)

Once it is broken down in the stomach and reaches the right pH then the valve between your stomach and your small intestine opens and fats are broken down by the release of bile and nutrients are extracted in the small intestine and absorbed in to the blood stream. 

Here is where your gut health comes in to play since leaky gut or Intestinal Permeability are what contributes to autoimmunity. 

We need a balance of gut bacteria in our intestines to help us convert T4 to T3 there. If we are not eating right or digesting well then we will have an imbalance of bacteria and intestinal permeability. 

We can end up with parasites, overgrowth of candida and constipation- all with their own contributions to our failing health. 

When we have hypothyroid- we have a sluggish gallbladder which means we might struggle to digest our dietary fats and then we are making thick and viscous bile which further messes up the gallbladder function. When this is not working well, we are not detoxifying as well either. so we can’t break down hormones or toxins from our environment. 

How are you pooping? No one wants to talk about it but you must be moving stool through your body and going every 16-24 hours. Your BM should be the size of your forearm from your wrist to your elbow, it should come out with ease and you should feel relieved when you are done and not like you still have to go. 

Being constipated further contributes to the “bad guys” overgrowing in your Small Intestine and causing bacterial infections, you may experience chronic pain, inflammation, digestive issues, food intolerances and Hashimoto’s. 

With all of this happening, we can also have issues dumping estrogen and so it can accumulate. This can cause hypothyroidism that you won’t see on a blood test according to Datis Kharrazian in Why Do I Still Have Thyroid Symptoms. This excess estrogen will keep the thyroid hormones from getting to the cells- causing hypothyroid symptoms. 

So you see, taking supplements without first healing the gut is pointless. It is a band aid at best. The only supplement you may need at this point is some stomach acid- Betaine HCl so you can start to break down your food and get those nutrients to your cells, kill off some of the bad guys and bring things back in balance. 

You will see improvement in chronic inflammation from changing what you eat and the way you eat it. Start with your plate. With breakfast. Make some bone broth. That is the next recipe to go out in my newsletter so sign up for that. 

So reduce inflammation by cutting out gluten, dairy products, eggs, most other grains, soy products and yeast. Yeast can feed an already out of control candida overgrowth. These are some of the big allergens, in other grains it is best to avoid corn for sure. 

This gives your body a chance to calm down so it can properly react to foods. 

You need to be on an elimination diet for 3 weeks to 3 months depending on how sick you are, how inflamed, or how long you went untreated for Hashimoto’s. In addition to this, you can do something called a FIT test

What can you eat?  There are no notes for this. It’s only on the audio. 


Why Do I Still Have Thyroid Symptoms?

Against All Grain

Meals Made Simple


Help for Hashimoto's Episode 9

Help for Hashimoto's Episode 9

So today I had my 3rd consultant appointment to tell me I have hashimotos disease. (I got told this by the doctor 3 months ago) all he said was, its fine, Nothing to worry about and its very common in women, thyroid is fine, no need for anything else other than ill see you in 9 months time......now i feel like an idiot for having bad days of constant tiredness and pain.

After receiving the results from my full thyroid panel that was ran by my gynecologist, she referred me back to my regular doctor. She spent 10 minutes confirming that I do have Hashimoto thyroiditis and hypothyroidism. She said that I need synthroid and I should follow-up in 3 months. Nothing was explained to me. No recommendations for supplements. No recommendations for diet. I had to request an endocrinologist referral, which will take weeks. So my question here is should I begin the synthroid, figure out what supplements I need, diet, etc or wait to start synthroid until I meet with endo? I’m lost. Also, the closest functional medicine doc is 2 hours from me and doesn’t take insurance.

It seems this is quite common for a lot of us. We go to the doctor and they tell us to take the medicine and come back in three months or so to be tested to see if we are at the right dosage.  I personally got nothing at all from an endocrinologist. I had to pay out of pocket to see him and he was worthless to me. Just because your thyroid is a part of the endocrine system does not mean you will get the proper care from an endocrinologist. I am sure there are great ones out there but I have found they are particularly difficult to work with you on treating symptoms and not just your labs. Plus they have a standard for their labs and they will go by that and nothing else. If you are lucky to find an endocrinologist who will work with, great. If not, fire them and keep looking. You are the customer in this situation. You have a right to find someone who will listen. Unfortunately I realize that some of you have horrible health insurance and don’t have the ability to look around much so I have a plan for you! 

First of all, you have to

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Help For Hashimoto's Episode 6

I have Hashimotos and recently my hair has turned extremely dry and brittle. My doctor increased my medication a month ago, but still no change in my hair. I definitely feel as though it’s caused by something with in me as opposed to any products I may be using on my hair since those have not changed. Any suggestions would be sincerely appreciated!

Jody

Losing your hair and or having dry brittle hair are common symptoms in hypothyroidism. Some things that might be causing this for you are: 

  1. is your thyroid medication/treatment optimal?
    1. all the cells in our body need thyroid hormones to function properly. T4 only medications like levothyroxine and synthroid might not be working well for you. Maybe your body doesn’t do well converting t4 to t3 which is what your cells use.  You might need a T4/T3 combo medication. 
    2. Make sure your doctor is testing TSH, Free T3, Free T4, Reverse T3 and the antibodies- TPO and TgAb. Functional medicine lab ranges according to Datis Kharrazian for TSH are 1.8-3.0 mU/L (milliunits per liter). Personally, I have felt best when mine is a bit below 1.0 which is common for those of us on Natural desiccated thyroid hormone.  Free T3 functional range is 1.2-4.9 mg per deciliter, free t4 functional range is 1.0-1.5 ng/dL (nanograms per deciliter. If you lab results are not in these measurements, you can google how to convert them in to these numbers. Don’t worry about taking notes on this either, all of this will be on my website at out of the woods nutrition dot com.  The antibodies should be at zero but that doesn’t mean you don’t have the autoimmune thyroid conditions of hashimoto’s or graves disease. Our immune systems fluctuate- when you have your blood test they might be considered within range- so don’t rely on antibodies testing alone to mean you do or do not have the disease. 
    3. What are your iron levels like?  Ferritin is our storage iron. If that is low it can result in hair loss and probably are related to dry hair too but more so hair that is falling out. Having good ferritin levels encourages hair growth and having low levels means your body will put hair and nail health on the back burner to ensure that the tissues that really need iron get it first. Liver is a great way to get your iron. Personally I can’t stand liver in the form of pate or cooked so I take either an iron supplement occasionally or I take Vital Proteins liver capsules which are not cheap. I have liver in my freezer and have not taken the time to dehydrate it and put it in capsules which would be way more cost effective. 
    4. If you are not making enough stomach acid, you will not be breaking down your food, protein in particular, so you will not be getting all the nutrients you need from your diet which will affect how supple your hair is. Are you eating enough protein? Hair and nails are made of protein. If you are deficient either because you are not eating enough or because you are not breaking down your food well enough you will be deficient and your hair will pay the price. I recommend starting out on a low dose of HCl aka Betaine Hydrochloric Acid with Pepsin to help you break down your food. Something like 150mg to start with and go up from there………..
    5. Something your pharmacist won’t tell you- some thyroid medications can cause hair loss. So, the very thing you are depending on to feel well is causing your hair to fall out. The package insert for your medication will also tell you that you should not be taking it if you are suffering with adrenal insufficiency- adrenal fatigue. 
    6. If you have hashimoto’s you have an autoimmune disease and that means you are likely susceptible to having more than one autoimmune disease- most commonly 3 AID and the likelihood of having a total of 7 over your lifetime. These things don’t happen overnight either. Your body suffers internally for years before another disease becomes symptomatic.  This is why it is soooo important to address diet and lifestyle issues. We don’t just all of a sudden get sick overnight. Our body is like a car- pick your dream car or even the one you are driving now. How you care for that car today and for the time you drive it will determine just how long that car runs well for you. You have to put the right kind of fuel in to it. You have to change the oil and have other fluids checked. Your car wants to run well for you but it will break down if you don’t give it what it needs to run properly. Our bodies are the same. You only get this one chance to be here now. Your body does what it can daily to maintain homeostasis or balance. It works really hard to keep us alive and running well. What we fuel it with really does matter. A calorie is not just a calorie. You will get so much more out of 100 calories of veggies vs. 100 calories of cookies. 
    7. Speaking of fuel- how is your blood sugar? According to Izabella Wentz: Blood sugar swings- due to high refined carbohydrates and not enough good quality protein and fats will cause T4 to be converted to Reverse T3 which keeps T3 bound up so the body and the cells can’t use it. This can cause us to lose hair too. Again, I know you were more concerned about dry brittle hair but the two go together. 
    8. Are you digesting your fat well? Are you eating a good balance of omega 3 and omega 6 fats? Get a high quality fish oil and eat some healthy fats like olive oil, avocados and coconut oil to get a good mix of omega 3 and omega 6. The ratio of those should be around 1:1 and most of us get about 1:20 with omega 6 being the 20 because it is in a lot of processed foods and restaurant foods in the form of canola oil and soybean oil. 
    9. Some people believe that supplementing with collagen can help your hair. We make less of this protein as we get older so you can try it to see if it helps. I would give it about a month. 
    10. I would lastly look at your hair products. It doesn’t sound like this is an issue for you as you said you didn’t have a problem before and you had not switched products. My favorite hair products are Intelligent Nutrients- they are good for your hair and for the environment. I do think you are right though, your hair problem is internal. I would encourage you to use a food journal to keep track of what you are eating and how you feel and you may notice that you might need to change some things. 

Good luck Jody, and please let me know if any of these suggestions helped you! 

 

Hi! Your podcasts have been great so far...thank you, thank you, thank you. I have been diagnosed with hashimotos for the past two years. I am 34 years old.

I decided to visit the doctor two years ago when I started having body aches and unusually dry skin. I was extremely tired all the time, however I thought that was natural due to having a newborn. I soon realized it was much more than being a “tired mom”.

I was put on levothyroxin. Seemed to even my levels out until recently. Started having stronger symptoms again and revisited the doctor. Taken off of levothyroxin (synthetic thyroid medication) and placed on nature throid (natural thyroid medication). What do you believe are major differences in a synthetic vs natural thyroid prescription?

Thank you again for all of your honest, transparent, and giving information.

CM

 

We have a similar story. I was diagnosed after my second child was born. I went in for a literal pain in my behind which turned out to be sciatica and when the doctor asked me if I needed anything else I told him I felt extra tired but thought it was because I had a toddler and an infant. He did a TSH test- standard for conventional medicine and my TSH was at 150- so clearly I had an issue with hypothyroidism. He put me on levothyroxine and I never felt good after that. My periods were heavy, I was cold all the time- like chilled to the bone and my adrenals were shot. 

Your question is about the differences between synthetic medication like levothyroxine and natural desiccated thyroid hormones like Naturethroid. I will get to that but I want to first address why things leveled off for awhile but got worse and your medication had to be adjusted. 

  1. You were diagnosed with hashimoto’s which is first an issue with your immune system and second and issue with your thyroid- likely hypothyroid symtoms.  When the autoimmune disease is not treated with diet and lifestyle modifications, your immune system can remain on high alert and can continue to attack your thyroid tissue killing it off. This often gives us the feeling of going between hypo and hyper symptoms. Maybe this has happened to you, maybe not. Anyway- one of the reasons for needing your dose to be increased is because more of your thyroid has been killed off. I guess you never said that your dose was increased but just changed to a different medication. Still, this is something to be mindful of. 
  2. Now, on to the differences between synthetic and natural hormone medications. 
    1. NDT was used in the 1800’s to treat patients with hypothyroid symptoms. The medication is made from pig thyroid glands and this is why it is called natural. It also contains all the thyroid hormones present in our own thyroid tissue. Desiccated means that the pigs are bred for the purpose of getting the thyroid. It is removed with a specific protocol, frozen, minced, dried and made into a fine powder. It is defatted and batches are combined to get a uniform mixture of T4 and T3. The benefit of the natural desiccated medications is that you get what your body would have normally provided for you had your own thyroid stopped working properly. This means the right ratios of T4 and T3, and T2, T1 and T0. There is not a lot of research on T2,1 and 0 but they are obviously there for a reason so this might be why some people really feel so much better on NDT.  The dosages are often referred to as grains. One grain equals 60 mg of NDT In Armour which is made up of 38mcg of T4 and 9mcg of T3. You can find conversion charts from manufacturers for most of the NDT medications on the market. 
      1. Armour, NatureThroid and Westhroid are the most common prescriptions. My favorite was WP thyroid until I couldn’t get it anymore but have found great success using a compounded thyroid medication which is just the thyroid powder and cellulose which I open the capsule and put under my tongue. This is called taking the medication sublingually. It bypasses your stomach, gut and liver and goes right in to the bloodstream. This works for me, but doesn’t mean it will work for you. You can try it and see how you feel after a week on it. I take my meds in divided doses. Half in the morning when I wake up and half in the late afternoon.  Western Research Labs or RLC labs is the manufacturer of your medication. You may be able to get all the ingredients of your medication on their site. Also be aware that your pharmacy can switch your medication without telling you if they run out of what is prescribed. You can ask your doctor to write your prescription to be dispensed as subscribed or you can let your pharmacist know that you do not want them to switch your meds. The main reason NDT meds are different is because they contain more than just T4. T3 plays a big role in cognitive abilities in the brain and how the brain functions. Got brain fog? Maybe you are not converting T4 to T3 or maybe you are lacking in T3.  NDT might be what is the key to your brain fog, depression and mood problems for us. If you don’t feel any changes in those things, maybe you are not on a high enough dose or your body isn’t using it well. This is where diet changes can help. T3 is supposed to be better absorbed by the gut than T4. Studies show that 95% of T3 is absorbed within the first 4 hours of taking it and will happen even faster on an empty stomach.   Back when Armour was first being used, they were making doses of medication based on symptoms and relief of those symptoms. Novel idea huh!? 
      2. In 1926 synthetic thyroxine was created. Synthroid was made. To market this great money making drug- the maufacturer sold physicians on the idea that it was better than NDT. Research was funded to prove it was better than NDT. Unfortunately the study didn’t show Synthroid to be better than NDT. The research study was not published and the Dr. performing the research was discredited. A journalist caught on and broke the story and there was a lot of trouble for the manufacturer in the 90’s. The FDA pulled the medication due to irregularities in formulation. It was even marketed and sold in the US without formal FDA approval. In 2013 28,000 bottles of 150 mcg of Synthroid were recalled due to being a lower dose than stated on the bottle. Your doctor likely is just used to prescribing this medication because that is what they are taught. They have been told that NDT causes heart problems which is really a load of crap. Too much can lead to atrial fibrillation, osteoporosis, insomnia, heat intolerance, tremors, and more. My body takes awhile to get used to a NDT Medication change and that is why dosing it twice a day is recommended. Fight for the chance to try this kind of medication if you don’t feel well on synthetic only medications. The synthetic medications are really about money. Synthroid is the 4th most prescribed medication in the US at 70 million prescriptions a year. The profit from Abbott Labs funds endocrinology groups and their meetings as well as clinical research grants. Do you think they are going to publish studies that show their medication doesn’t work as well? Probably not. Pharmaceutical companies have more to gain by you being on a synthetic medication that keeps you sick vs. the Natural medication that makes  you feel better. 

 

I want to also talk about how it feels to have a disease that isn’t visible. I was talking with my niece and her husband last weekend about thyroid. Somehow the subject came up and my nieces husband said something about if your thyroid isn’t working right you are basically screwed or something like that. I had to laugh because he is so right. We don’t look sick but some days we just feel terrible. It is hard on us and hard on our families. My parents don’t understand, especially my dietary restrictions. They quit inviting my family over for dinner. My mom never makes an effort to understand how this has affected me. I don’t hold that against her- she is doing the best she can with the tools she has. So she says things like, let’s go out for pizza- you can eat a salad. Oh that sounds like so much fun to eat a salad while everyone else is enjoying pizza. It’s never- “let’s go to a restaurant where you can really enjoy the food”. She has thyroid problems too but all I ever hear is “I am so glad I feel so good”- what is normal for her is to feel tired and have a headache or just say she doesn’t feel good. She lays on the couch most afternoons and she had a headache everyday of my life in the morning. Sometimes we think we feel good because normal is to feel bad. 

Here are what some people are saying about what they want people to know about hashimoto’s. 

BA says:  In my case support... You don't "look" sick... My husband truly truly is trying to understand it all. He sees what it does to me but doesn't understand why. Thinks with diet and exercise I'll be just fine...

LH says:  Digestive issues, fatigue, stress,

GH says:  That everything can be great and you look and feel wonderful then you suddenly crash and feel like death. For weeks.

TF says:  Like one minute I lost 60 pounds, was working out every day at the age of 50 and living my best life and out of nowhere this monster hits me and now it’s horrible. I don’t know from one day to the next what is coming. I don’t even understand most of it. this disease is so extensive and complicated

TC says:  Why food makes us sick? Hurt? Not sleep?

KT says:  Always test your thyroid ANTIBODIES! All my “usual” thyroid labs were in the normal range, but antibodies off the charts... so grateful I finally had a doc test them!

TW says:  The fatigue is real, I’m not lazy. I don’t “want” to take a nap, I have no choice. What is needed? Research. Education of MDs and endocrinologists.

SJ says:  Extreme fatigue, and excessive weight gain ! 100 lbs, which I've been unable to loose for 20 years. Insomnia as well , and digestive issues ( gluten intolerant ). HASHIMOTO'S IS A BEAST !

TB says:  Research to determine which diet is the best for Hashimoto's. Extreme fatigue and brain fog are real!

SD says:  Educating MD's who are still treating all of our symptoms seperately, telling patients they are overweight because they eat too much and don’t exercise enough, and prescribing thyroid replacement that is man made instead of natural desiccated thyroid (NDT). Quit my doctor of 21 years 8 years ago and found a naturopath. Best decision of my life!!!

MH says:  More education, more testing. Doctors to understand test results vs symptoms and please don’t say” well you are  borderline even though you have these symptoms, so we will not treat you.”

TM says: Our tired is not their tired , it’s not even in the same realm . Our weight gain is not our fault . We are not lazy, we’re tired.

CE says:  Our inflammation is unlike others due to the constant aches we endure along with insomnia, depletion of vital nutrients, and gut problems.

AO says:  It may seem invisible but our body is having a nuclear war. New symptoms and concurrent disorders are constantly showing up, that don't seem to be related sometimes, and there hasn't been enough research to do anything but regulate diet and control some symptoms. It IS disabling for a large amount of people. With mine I had to quit work and can only last 2-4 hours of any type of work before I am too exhausted/weak/ill to function.

RS says:  More knowledge/awareness for everyone...So doctors stop running basic labs, so that people are more aware of symptoms and can ask for the correct labs, so loved ones can be more supportive of those with AI diseases, and so everyone realizes how vastly important our diets effect our health. The majority of people who find out I have Hashi’s have no clue what it is. I don’t look sick, so they don’t understand how I can go from 100 to bed ridden for days, or understand why I eat the way I do if I don’t have “food allergies.” People just don’t understand any of it, even my family and closest friends.