Navigating Thyroid Diagnoses
Pretty much every single thyroid patient I’ve worked with in clinic has said the same thing to me, they feel like they’ve been let down in their care. From a functional medicine perspective, individuals with thyroid disorders often find themselves let down by conventional medical approaches in many critical areas - including the accuracy of diagnosis, available treatment, lack of focus on the whole body and the investigation of primary underlying factors.
Let’s first take a look at why you may be feeling hopeless, or let down in your care.
1. Inadequate Testing:
Limited Range of Tests: Conventional medicine often relies on a narrow set of thyroid tests, typically TSH and sometimes T4. Functional medicine advocates for a more comprehensive panel, including free T3, reverse T3, and thyroid antibodies (TPO and TgAb) to get a complete picture of thyroid function and autoimmune activity.
Reference Ranges: The standard reference ranges used in conventional medicine may not capture subclinical thyroid issues. They focus on what the average person needs to be in order to not have a diagnoses, i.e damage to their thyroid. Functional medicine advocates the use of narrower optimal ranges to identify and address imbalances earlier.
2. Symptom Management:
Focus on Numbers, Not Symptoms: Conventional approaches may prioritise bringing lab values within the “normal” range, sometimes disregarding persistent symptoms. Functional medicine emphasises the importance of symptom resolution and quality of life alongside lab results. If your lab result is within the wide normal range, but you are still experiencing symptoms you are not ok and this is not ‘normal’ or just ‘to be accepted’
3. Root Cause Investigation:
Surface-Level Treatment: Conventional care often focuses on treating symptoms with medication (e.g., synthetic thyroid hormones) without exploring underlying causes. Functional medicine looks deeper into potential root causes, such as nutrient deficiencies, gut health issues, chronic infections, and environmental toxins. This is not to say you don’t need your medication, I work with many doctors on thyroid cases and many of my patients are on meds, what we are saying is it is one part of the picture and just because you are on medication it isn’t the end of your story.
Autoimmunity: Many thyroid issues, such as Hashimoto’s thyroiditis, have an autoimmune component that conventional medicine might not address. Functional medicine seeks to modulate the immune system and reduce autoimmune triggers. Your medication does not work on your autoimmunity at all. If you are just taking medication you are only looking at one part of the puzzle.
4. Holistic Approach:
Lifestyle Factors: Conventional medicine may not sufficiently address lifestyle factors like diet, stress, sleep, and exercise, which can significantly impact thyroid health. Functional medicine incorporates these elements into plans.
Individualised Care: Functional medicine provides a personalised approach based on the individual’s unique biochemistry, lifestyle, and health history, rather than a one-size-fits-all protocol. Your health history and story will be different to someone else’s with the same diagnosis, therefore the root cause of the problem may be different, therefore your plan for healing will be different. There is no ‘thyroid diet’.
5. Nutrition and Supplementation:
Dietary Interventions: Conventional care may not emphasise the role of diet in managing thyroid conditions. Functional medicine often recommends specific dietary changes, such as eliminating gluten or optimising intake of thyroid-supportive nutrients (e.g., selenium, zinc).
Targeted Supplements: Functional practitioners might use targeted supplements to support thyroid function and overall health, tailored to the patient’s specific needs. We also use them when we find specific root causes to bring your whole body back to balance.
6. Gut Health:
Microbiome Connection: There is growing evidence linking gut health to thyroid function. Functional medicine pays close attention to gut health, addressing dysbiosis, leaky gut, and other gastrointestinal issues that might impact thyroid function.
A lack of focus on many if not all of these areas can be the reason why you are not seeing the results you hoped for, or why you are feeling lost in your road to recovery.
If you’re struggling with ongoing thyroid issues, you might be grappling with a range of challenging emotions. Many of my patients have shared their experiences with me, and these stories often echo a common set of frustrations and feelings. Let's delve into some of these shared sentiments to better understand what you might be going through.
Feeling Unheard and Dismissed
This is a recurring theme among my patients. Many express that their persistent symptoms are often overlooked or not taken seriously, especially if their lab results appear to be within the 'normal' range. This dismissal can leave them feeling invalidated and unheard, as if their experiences and concerns are being disregarded. Additionally, rushed appointments only add to this sentiment, as short and hurried consultations can prevent a thorough discussion of their issues, making patients feel that their worries are not fully addressed.
Experiencing Frustration and Hopelessness
Living with continuous symptoms despite receiving treatment can lead to immense frustration and a sense of hopelessness. Patients often describe feeling trapped in a cycle of inadequate care, with little to no improvement over time. This lack of progress can be deeply discouraging, eroding their confidence in their prospects for recovery and making them feel stuck in a seemingly unending struggle with their health.
Feeling Confused and Overwhelmed
Navigating the complexities of thyroid conditions can be incredibly confusing, especially when patients receive conflicting advice from different healthcare providers, this is something I hear regularly from my patients they’ve just not known where to turn or what to do next. This inconsistency in information can be overwhelming, leaving you uncertain about the best course of action. Additionally, the intricate nature of thyroid diagnoses, combined with a lack of clear understanding or comprehensive support, can add to your sense of bewilderment and stress.
Experiencing Isolation and Loneliness
The lack of adequate support from the healthcare system can lead patients to feel isolated and alone in managing their condition. This sense of isolation is often compounded by the social impacts of their symptoms. Fatigue, weight changes, and mood swings can make social interactions challenging, further deepening their feelings of loneliness and disconnect from others. Many of my patients also describe their family or friends not really understanding their symptoms, it can be hugely beneficial just to have someone on your side who knows what you are going through. Functional medicine focuses in on this support, my programmes are designed to give you ongoing support.
Grappling with Anxiety and Uncertainty
The uncertainty surrounding their health and future can be a significant source of anxiety for patients. The fear of the unknown, coupled with inadequate explanations and superficial treatments, can leave them feeling uncertain about the true nature of their condition and its long-term management. This pervasive anxiety can overshadow their daily lives, making it difficult to find peace and clarity.
Feeling Physically and Emotionally Drained
Persistent symptoms like chronic fatigue and pain can deplete a patient's physical and emotional energy, leaving them feeling drained. The impact on their daily lives can be profound, as they struggle to manage everyday activities and responsibilities. This relentless battle can lead to burnout and emotional exhaustion, making it difficult to find the strength to keep pushing forward. Again we can support this by supporting your whole body, the adrenals are very heavily linked to the thyroid as is the mitochondria, your energy producers in every cell of your body, I always work on these areas with my thyroid patients.
The Functional Medicine Approach
In functional medicine, every symptom is taken seriously, not just dismissed if standard lab results fall within the normal range. This detailed attention validates the patient's experiences and makes them feel genuinely heard and understood. Extended consultations delve deeply into their health history, symptoms, and lifestyle factors, ensuring that every concern is fully considered and addressed. This comprehensive approach contrasts sharply with the rushed, superficial interactions many patients have previously endured, providing them with a much-needed sense of validation and understanding.
Functional medicine’s personalised care model empowers patients to become active participants in their health journey. By tailoring treatment plans to each individual, patients gain a deeper understanding of their condition and the factors influencing it. Education is a cornerstone of this approach; patients are equipped with knowledge about their thyroid condition, various treatment options, and necessary lifestyle modifications. This empowerment through education enables them to make informed decisions and take charge of their health, fostering a sense of control and agency that is often lacking in conventional care.
Focusing on identifying and addressing the root causes of thyroid issues can inspire hope for lasting improvements. Instead of merely managing symptoms, patients can look forward to substantial and enduring health benefits. Holistic treatment plans that consider all aspects of their well-being—diet, stress, sleep, and more—give patients confidence in achieving better health outcomes. This comprehensive and tailored approach brings a renewed sense of optimism and a clear path toward improved health.
Ongoing monitoring and regular follow-ups are integral to the functional medicine approach, ensuring that patients feel supported throughout their health journey. Adjustments based on their progress reinforce that they are not alone in this process. Functional medicine also provides multi-faceted support that extends beyond medication, addressing crucial lifestyle factors such as diet, stress, and sleep. This all-encompassing care fosters a profound sense of being genuinely cared for and supported, which is often missing in conventional care settings.
Effective symptom management and overall health improvements are tangible benefits of functional medicine. Patients often report enhanced physical and emotional well-being as their symptoms are effectively managed. This leads to significant improvements in energy levels, mood, and daily functioning, contributing to a markedly better quality of life. As they regain their health, patients can experience renewed vitality and engagement with life.
The Roadblocks with Hashimoto’s Thyroiditis
Hashimoto’s is the most common thyroid condition. Patients with Hashimoto’s thyroiditis often encounter a myriad of obstacles that hinder effective management and recovery. These challenges are rooted in both the complex nature of the disease and systemic issues within the healthcare framework. Let’s explore some of the main roadblocks faced by individuals dealing with Hashimoto’s.
Delayed or Inaccurate Diagnosis
Hashimoto’s thyroiditis can present with a spectrum of nonspecific symptoms such as fatigue, weight gain, and depression. These symptoms are common to many conditions, often leading to misdiagnosis or a delay in identifying the true cause. Compounding this issue, conventional medical practices typically rely on basic thyroid-stimulating hormone (TSH) and T4 level tests, which may overlook the critical presence of thyroid antibodies (TPO and TgAb) that are indicative of Hashimoto’s. This limited testing can result in a significant delay in receiving a correct diagnosis.
Lack of Comprehensive Treatment
Once diagnosed, the treatment of Hashimoto’s often focuses narrowly on normalizing TSH levels, without addressing the underlying autoimmune activity or other contributing factors. Patients are frequently prescribed synthetic T4 (levothyroxine), which might not be sufficient for everyone. Alternatives like T3 or natural desiccated thyroid options, which can be more effective for some, are not always considered. This symptom-focused approach fails to provide a holistic treatment plan that fully addresses the complexities of the condition.
Dietary and Lifestyle Factors
Hashimoto’s patients frequently struggle with nutritional deficiencies in key elements such as selenium, zinc, and vitamin D, which are crucial for thyroid function and overall health. These deficiencies are often overlooked in standard care. Furthermore, dietary triggers like gluten and dairy can exacerbate symptoms, yet identifying and eliminating these without proper guidance can be daunting. Lifestyle factors, including stress management, sleep hygiene, and exercise, play a critical role in managing Hashimoto’s but are often neglected or inadequately supported in conventional care settings.
Gut Health Issues
Gut health is intricately linked to autoimmune conditions like Hashimoto’s. Many patients suffer from gut permeability issues, commonly known as leaky gut syndrome, which can intensify autoimmune responses. However, these gut-related factors are rarely addressed in conventional treatment protocols. Additionally, imbalances in gut microbiota, or dysbiosis, can contribute to inflammation and further autoimmune complications, yet this is another aspect of health that often goes unexamined in standard medical care.
Autoimmune Component
A significant challenge in managing Hashimoto’s lies in the autoimmune nature of the disease. Conventional treatments typically focus on hormone replacement without addressing the underlying autoimmune processes that drive the condition. Moreover, patients with Hashimoto’s are at an increased risk for developing additional autoimmune disorders, complicating their treatment and recovery further. This aspect of care is crucial but often ignored in the pursuit of merely balancing hormone levels.
Environmental Toxins
Exposure to environmental toxins such as pesticides, heavy metals, and endocrine disruptors can exacerbate thyroid dysfunction and autoimmune responses. Despite their significant impact, these factors are rarely considered or addressed in conventional care settings. Patients are often left to navigate these environmental challenges on their own, without guidance or support from their healthcare providers.
Healthcare System Limitations
The limitations of the healthcare system itself pose significant barriers to effective Hashimoto’s management. Short appointment times often prevent a thorough investigation into the patient’s condition and hinder the development of personalized treatment plans. Moreover, the fragmented nature of care, where different specialists may not communicate effectively, can lead to inconsistent and uncoordinated treatment. This lack of integration can leave patients feeling like they are piecing together their care without a cohesive strategy.
Patient Education and Support
A common struggle among Hashimoto’s patients is the lack of comprehensive education about their condition and self-management strategies. Without adequate information, patients cannot fully understand or effectively manage their health. Additionally, limited access to support networks or resources can leave individuals feeling isolated and unsupported in their journey. The absence of these critical components can significantly impact their ability to cope with and manage their condition.
Emotional and Psychological Impact
The chronic nature of Hashimoto’s symptoms can take a toll on a patient’s emotional and psychological well-being. Persistent symptoms can lead to emotional distress, anxiety, and depression, which require management alongside the physical aspects of the disease. Additionally, the impact of these symptoms on daily life, work, and relationships can be profound, necessitating a holistic approach that addresses both the emotional and social dimensions of health.
Addressing these roadblocks effectively often necessitates a comprehensive, integrative approach. This includes detailed testing to uncover underlying issues, personalized treatment plans that go beyond hormone replacement, and lifestyle and dietary modifications supported by ongoing education and support. By adopting such an approach, patients with Hashimoto’s can better navigate the complexities of their condition and achieve more meaningful, lasting improvements in their health.
Persistent symptoms with Hashimoto’s
Patients with Hashimoto’s thyroiditis may find certain symptoms particularly stubborn and difficult to recover from. These symptoms can be persistent due to the chronic nature of the disease, the complexity of thyroid hormone regulation, and the autoimmune component of the condition. Some of the most challenging symptoms include:
1. Fatigue:
Persistent Tiredness: Chronic fatigue is one of the most common and debilitating symptoms of Hashimoto’s. It can persist even after thyroid hormone levels are normalised, often due to underlying issues like mitochondrial imbalances, adrenal fatigue, nutrient deficiencies, or ongoing inflammation.
2. Weight Gain:
Metabolic Slowdown: Difficulty losing weight or unexplained weight gain can be particularly stubborn, as hypothyroidism slows down metabolism. Even with optimal thyroid hormone replacement, some patients struggle to manage their weight due to metabolic and hormonal imbalances.
3. Brain Fog:
Cognitive Issues: Problems with concentration, memory, and mental clarity can persist despite treatment. Brain fog may be influenced by thyroid hormone levels, but also by inflammation, nutrient deficiencies, and gut health issues.
4. Depression and Anxiety:
Mood Disorders: Emotional symptoms such as depression and anxiety can be difficult to alleviate completely. These may be tied to thyroid hormone imbalances, but also to the stress of dealing with a chronic illness, changes in brain chemistry, and autoimmunity.
5. Hair Loss:
Thinning Hair: Hair loss or thinning can be distressing and slow to improve. Hair health is closely linked to thyroid function, and recovery can be prolonged, requiring optimal thyroid hormone levels and addressing any nutrient deficiencies.
6. Joint and Muscle Pain:
Musculoskeletal Discomfort: Pain and stiffness in muscles and joints can persist, often due to ongoing inflammation. This symptom may be exacerbated by other autoimmune conditions or by lifestyle factors.
7. Cold Intolerance:
Sensitivity to Cold: Many patients with Hashimoto’s experience cold intolerance, which can be slow to resolve even with adequate thyroid hormone replacement. This is related to the overall slowing of metabolism and impaired circulation.
8. Digestive Issues:
Gut Problems: Constipation, bloating, and other gastrointestinal issues can be persistent. These symptoms are often related to gut dysbiosis, leaky gut syndrome, and the effect of thyroid hormones on gut motility.
9. Sleep Disturbances:
Insomnia and Poor Sleep Quality: Sleep issues, including insomnia and restless sleep, can be particularly difficult to manage. These may be linked to hormonal imbalances, stress, and anxiety.
10. Swelling and Puffiness:
Oedema: Puffiness, particularly around the eyes and face, can be slow to improve. This symptom is often related to fluid retention and poor lymphatic drainage.
Addressing these stubborn symptoms often requires a multi-faceted approach:
Thorough Evaluation: Comprehensive testing to ensure optimal thyroid hormone levels, including TSH, free T3, free T4, and reverse T3.
Nutrient Support: Ensuring adequate levels of key nutrients such as selenium, zinc, vitamin D, B vitamins, and iron.
Dietary Changes: Adopting an anti-inflammatory diet, potentially eliminating gluten and other food sensitivities.
Gut Health: Supporting gut health through probiotics, prebiotics, and addressing any underlying infections or dysbiosis.
Stress Management: Incorporating stress-reduction techniques such as mindfulness, yoga, and adequate sleep.
Exercise: Engaging in regular physical activity to support metabolism, mood, and overall health.
Autoimmune Management: Modulating the immune system through lifestyle changes, dietary adjustments, and possibly low-dose naltrexone (LDN) or other interventions.
Patience and persistence are crucial, as it can take time for these interventions to yield significant improvements in chronic and stubborn symptoms.
The Importance of Being an Active Part of Your Healthcare
Being an active part of one’s healthcare can significantly empower a person in various ways, leading to better health outcomes and an improved overall quality of life. Here are some of the key benefits and powers gained from being actively involved in healthcare:
1. Increased Knowledge and Understanding:
Informed Decisions: Patients who actively engage in their healthcare often have a better understanding of their condition, treatment options, and the implications of different choices. This enables them to make informed decisions about their care.
Self-Education: Learning about their health conditions and treatment possibilities can empower patients to ask pertinent questions and seek the best possible care.
2. Improved Health Outcomes:
Adherence to Treatment: Active involvement typically leads to better adherence to treatment plans, including medication regimens, lifestyle changes, and follow-up appointments.
Early Detection: Being vigilant about changes in health and symptoms can lead to early detection of complications or new health issues, allowing for prompt intervention.
3. Enhanced Communication with Healthcare Providers:
Better Collaboration: Active patients often have more productive and collaborative relationships with their healthcare providers, leading to personalised and effective care plans.
Clearer Communication: Being informed helps patients communicate their symptoms, concerns, and preferences more clearly, ensuring that their needs are understood and addressed.
4. Greater Control and Autonomy:
Empowerment: Taking an active role fosters a sense of control and autonomy over one’s health, reducing feelings of helplessness and dependency.
Personal Responsibility: Patients who take responsibility for their health decisions often feel more empowered and motivated to adhere to their care plans and make healthy lifestyle choices.
5. Improved Mental and Emotional Well-being:
Reduced Anxiety: Understanding one’s condition and being involved in decision-making can reduce anxiety and stress related to health issues.
Confidence and Self-Efficacy: Active participation can boost confidence in managing one’s health and increase self-efficacy, the belief in one’s ability to achieve health goals.
6. Holistic and Personalised Care:
Customized Plans: Active patients are more likely to receive personalized care plans that consider their unique circumstances, preferences, and lifestyle.
Holistic Approach: Engaged patients often pursue holistic care approaches, integrating conventional medicine with complementary therapies, nutrition, and lifestyle changes.
7. Advocacy and Support:
Self-Advocacy: Being knowledgeable and involved allows patients to advocate for themselves more effectively within the healthcare system.
Support Networks: Active patients are more likely to seek out and engage with support networks, including patient advocacy groups and online communities, providing emotional support and shared experiences.
8. Prevention and Maintenance:
Preventive Measures: Active engagement encourages the adoption of preventive health measures, such as regular screenings, vaccinations, and healthy lifestyle practices.
Chronic Disease Management: For chronic conditions like Hashimoto’s thyroiditis, active involvement can lead to better management of the disease, minimizing flare-ups and complications.
In summary, being an active part of one’s healthcare empowers patients with knowledge, improves health outcomes, enhances communication with healthcare providers, increases control and autonomy, boosts mental and emotional well-being, enables holistic and personalized care, strengthens advocacy and support, and promotes preventive and maintenance strategies. This proactive approach can significantly enhance a person’s overall health and quality of life.
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