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The Question #1
I work out and watch what I eat but every year, I gain weight. I can’t get rid of it. Is there anything I can do?
Yes. There is absolutely something that you can do! The first step is to get a clear picture of what’s going on with your thyroid levels. Make sure you get the full thyroid panel including TSH (which is where most tests stop), T 3, free T4, Free T3, and reverse T3. I also recommend testing thyroid antibodies and T3 uptake. For more on these tests and how to understand your results, you can download my FREE THYROID GUIDE
This has to do with unexplained weight gain because your levels may not be optimal (even if your doctor doesn’t note it). If you have Hashimoto’s, you may experience thyroid destruction so you need to make sure your levels are optimal
To improve weight loss, you will also want to balance inflammation and support your immune system. This could include eating anti-inflammatory foods and balancing blood sugar. Resist the urge to skip meals and avoid carb-loading. If you eat regular, balanced meals and your blood sugar is balanced you will have much more success.
Is it true that if you have Hashimoto’s, you can easily develop other autoimmune diseases?
Sadly, this is true. When we have an autoimmune disease like Hashimoto’s, the immune system has become confused about what it should be fighting against. In the case of Hashimoto’s the immune system is attacking the thyroid.
If the immune system stays confused and nothing is done to help balance and calm the system then it can attack other organs. And there’s something called cross-reactivity where antibodies of the thyroid can cross-react with other tissues and potentially cause another autoimmune disease.
This is all the more reason to balance inflammation and support the immune system, not just the thyroid with medication. I dive a little deeper into this in this episode but you can also find more information about solving the autoimmune mystery by listening to episode 32 of Health Mysteries Solved.
Can I have thyroid symptoms if my TSH is just a little bit outside of the reference range?
The answer is yes, especially if your other thyroid hormones (like T4 and T3) are low. This is why I always say that you have to look at the full thyroid panel because the TSH is not a clear enough indication of what’s really going on with your thyroid. You need thyroid hormone for everything in your body so you can definitely have symptoms if your levels are outside of optimal.
If you have Hashimoto’s, some symptoms could be due to the inflammation or your immune systems struggle to regulate.
How do you know if Synthroid is working or if you need to switch?
There are two key things you need to look at.
The first is to check your thyroid levels. If this is a new medication, you want to check all of your thyroid levels within the first 4-6 weeks to see how it is working. Synthroid isT4 so it does not give you any T3, the active hormone which your body needs so you want to check t3 to make sure you are able to convert it properly. For some people, this conversion is an issue. So, they may be taking Synthroid but the body is not converting it properly and they continue to have symptoms. This is why it’s so important to not rely solely on the TSH levels.
The second key thing is how you actually feel. Sometimes the labs are picture perfect but the person still doesn’t feel well. This could be for a couple of different reasons. One is that medications have fillers, excipients or colorings which can cause a reaction. There are other options and brands that are slightly different. For example, one is called Tirosint which is easy to absorb (it’s a gel cap) and it doesn’t contain any excipients or desiccated thyroid which works a little differently in the body and some people feel a difference with those.
Why does my thyroid medication stop working after several months?
If you have Hashimoto’s, you can experience flare-ups where the thyroid gland is under attack. Some people have more flare-ups than others. Over time, these flare-ups can destroy the gland itself so that it is less able to produce hormones requiring more medication. So, even if you’ve been on the same dose of medication for a long time, you may suddenly feel like it has stopped working but in actuality, you just need to adjust your dose.
There is a second possibility that has to do with absorption. Your body’s ability to absorb the medication can fluctuate depending on inflammation in the body, exposure to toxins especially things like plastics or pesticides. These can block the receptors so that even though the medication is coming in, your cells can’t absorb it.
In either of these cases, you will want to pay close attention to triggers. To help reduce triggers, focus on eating a clean diet (keeping it organic when you can), reducing stress, checking ingredients of personal care and clearing products. This should help reduce some of the triggers and inflammation.
Will I be on medication forever?
This depends on whether you have hypothyroidism or Hashimoto’s.
If it’s hypothyroidism not caused by Hashimoto’s, it could be due to some type of inflammation or it may have been triggered by toxin exposure or a virus in the thyroid. In those cases, it is possible for the thyroid function to return and for medication to be stopped.
In the case of Hashimoto’s, the thyroid gets destroyed over time. The goal here is not so much to get off the medication as it is to stop further attack on the thyroid. It is possible for the thyroid to regenerate but it is unknown if it can regenerate enough to no longer require medication.
Let me address something here because I know that a lot of people think medication is bad and that Synthroid is bad because it’s synthetic and unnatural. I try to get people to shift their thinking around this because thyroid is an essential hormone that you need for all of the cells in your body. So, this medication is replacing something that, for whatever reason, your body is not producing but absolutely needs. It’s essential. It’s much worse for your body to be deficient in thyroid hormone than to take the hormone.
I do get it. I struggled with this for a long time but was able to reframe my thinking around it because for me, it is something my body really needs. I think that especially with Hashimoto’s, it’s about keeping things balanced to prevent more attack and the need to increase the medication. If you can do that and keep your medication at the same dose without the need to increase each year, you are doing a great job!
At my last check, my TSH was where we wanted it to be and I’m doing well and losing weight. However, I have hair loss. Why is that still the case?
It’s true that your thyroid plays an important role in your hair health but it’s not solely responsible! There are a lot of other things at play when it comes to your hair.
The first thing you want to check are your iron levels (not just your hemoglobin – check iron saturation and ferritin) to make sure those are in range. Note that ferritin will fluctuate a little with your menstrual cycle so if it’s low but everything else looks good, you should be okay. If you are low in iron, you’ll want to look into dietary changes and supplements.
The other big thing that people don’t often realize affects hair health is blood sugar. If you’re skipping means or your meals aren’t balanced, you may be experiencing insulin spikes. That can influence polycystic ovarian syndrome and which can affect your estrogen and testosterone levels. This can directly affect the hair.
I understand that gluten and dairy can be issues for those with Hashimoto’s but what about coffee or tea, can those aggravate it?
Yes, they possibly can.
Some people who have thyroid issues also have sensitive adrenal glands. Coffee has caffeine which can overstimulate the adrenal glands. The thyroid and adrenals work closely together so if the adrenals are overstimulated, the thyroid can suffer.
Additionally, coffee can cross-react with gluten, so if you have an issue with gluten, there is a possibility that it could also be an issue with coffee. To be sure, you can do a food sensitivity test to see if coffee is an issue.
Finally, be aware that green tea, specifically, can overstimulate the immune system which can cause problems for those with Hashimoto’s.
I have double-vision from Hashimoto’s. Should I see an eye specialist?
An eye specialist is always helpful but it’s important that you address your immune system. There is definitely a relationship between autoimmunity and the inflammatory process. In the case of Hashimoto’s, it attacks the thyroid but it can also attack other tissues like those in the eyes. So, yes, definitely see a specialist but also look at your Hashimoto triggers and anything that might be causing inflammation to try to reduce flare-ups.
What are the chances of getting pregnant with Hashimoto’s?
The chances are very, very good – I’m living proof with two kids. I have hundreds and hundreds of clients with Hashimoto’s who have gotten pregnant.
To increase your chances, make sure to support the immune system and that all of your thyroid levels are where they should be. If you don’t have enough thyroid hormone, it can cause issues with conception and increase the chance of a miscarriage.
Is it safe to take Levothyroxine or Synthroid while pregnant?
Yes, yes, yes! Not only is it safe, it’s absolutely needed if your TSH is high and your hormones are low. For the first 8 weeks, the baby is actually relying on your thyroid hormone before their thyroid gland forms. So, yes it is extremely safe and extremely important for you to support your thyroid during pregnancy if you don’t have enough naturally.
What are the root causes of a goiter (aside from iodine deficiency)?
This may surprise you but iodine deficiency is not actually that big of a cause of goiters in the USA. Most people are not that iodine deficient because your thyroid only needs a very small amount of iodine because it can store it.
Goiter is typically caused by an elevated TSH more so than a deficiency in iodine. There are chemicals that are considered goitrogens that can block the hormones and elevate TSH. When the TSH is elevated for an extended period of time, it creates a build up in the growth of the thyroid tissue resulting in a goiter. Goitrogens are found in things like pesticides and plastics.
My naturopath said that I have Hashimoto’s but my endocrinologist says that I don’t. My antibodies are there but below the reference range. Do I have it or don’t I?
I get this question a lot and unfortunately, it’s a bit of a gray area. The way I look at it is that something is forming, but it may not be official because the antibodies are not above the reference range.
From a functional, holistic perspective, there shouldn’t be any antibodies against the thyroid so we shouldn’t ignore that they are there. Something is forming and it could take 5 or 50 years to develop. I would be mindful and look at triggers. I would do a food sensitivity test, check for Celiac genes, and consider removing gluten because it can be such a biggie. Also reduce your stress and exposure to toxins. Basically, do everything you can to help calm the body and immune system while also increasing your intake of anti-inflammatory foods.
Check your antibody level regularly to see if it’s going up or down. You may not officially have Hashimoto’s but I wouldn’t ignore it either.
If you have Hashimoto’s be sure to tune in to the 100th episode of Health Mysteries Solved. It’s an entire show dedicated to navigating the symptoms of Hashimoto’s.
Eliminating Health Mysteries
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