Without a doubt the most common question that I get on a day to day basis is:
“My thyroid was removed by my doctor X number of years ago but I still have symptoms. Is there any way you can help me?”
There are two reasons why people typically have their thyroid removed:
Regardless of why the thyroid gland was removed what happens is that you immediately become hypothyroid after the surgery or radioactive iodine treatment.
You no longer have a gland to produce hormones on your own so you would forever be dependent on external thyroid hormones like Synthroid or Armour. That is a fact and there is nothing that can be done to change THAT aspect.
But what happens when taking the hormone doesn’t resolve the symptoms of low thyroid?
What if you continue to have weight and metabolism issues, hair loss, brain fog, and fatigue no matter how much or which thyroid hormone you take?
If you still have low thyroid symptoms then we know that there is another culprit that is affecting your ability to use those hormones. Until we discover what that culprit is and change/fix it, you will always struggle with those symptoms.
So if you have had your thyroid removed and you still have symptoms then you need our type of functional approach more than anybody.
Our functional approach gets to the root causes of the symptoms and will help you feel and function better. We will discover what is interfering with you ability to use the thyroid hormone that you are taking every day.
Most of the patients I consult with have a few things in common:
1. They were diagnosed with hypothyroidism at some point in their lives.
2. They take some form of thyroid hormone replacement.
3. They continue to experience some degree of thyroid symptoms despite conventional treatment.
That third factor is important because the patients that respond well to hormone replacement don’t continue to search for answers. Why would you pursue further treatment if simply taking a pill seems to take care of the problem?
Actually there is the rare patient that understands that getting to root causes and taking a functional approach is important and those patients are a pleasure to work with. So if you fall into that category don’t check out yet.
When I consult with a patient with ongoing thyroid symptoms I see a world of possibilities. There are so many things that can go wrong that could be creating the problem. I know I must start searching and begin putting the pieces together if I am going to help that person.
Sadly I think conventional medicine views most thyroid patients the same way. They see a patient with thyroid symptoms and prescribe thyroid hormones.
Problem solved! (except the patient still doesn’t feel good, and they still have no real understanding of what went wrong in the patient)
Taking some form of thyroid replacement is just the first step. But did they consider other possible mechanisms that could be contributing to your problem? Probably not.
Since no one has taken the reigns and helped you understand all of this I will teach you about some of these mechanisms so you can take some action on them or find somebody who will help you.
So here goes part 1. Did they consider that stomach and GI abnormalities can affect your thyroid in many ways?
It is uncommon for me to encounter a hypothyroid patient that doesn’t also have to stomach problems. Gut infections and a condition called dysbiosis, where there is an abnormal balance of normal flora in your gut, have the potential to release lipopolysaccharides (LPS).
These gut microorganisms can affect thyroid function at all levels including:
All of that from your stomach. Though you just had a thyroid problem didn’t you?
If you ever experience bloating, gas, constipation, or diarrhea and you also have thyroid symptoms then you have to consider the impact that gut microorganisms are affecting your thyroid. Dealing with the gut issue is a necessity if you want to feel good again.
1. Ritig MG. Smooth and rough lipopolysaccarides phenotype of Brucella induce different intracellular trafficking and cytokine/chemokine release in human monocytes. Journal of Leukocyte Biology. 2004; 5(4):196-200.
2. Van der Poll T, Endert E, Coyle SM, Agosti JM, Lowry SF. Neutralization of TNF does not influence endotoxin induced changes in thyroid hormone metabolism in humans. Am J Physiology. 1999; 276:357-62.
3. Van der Poll T, Van Zee KJ, Endert E, et al. Interleukin-1 receptor blockade does not affect endotoxin-induced changes in plasma thyroid hormone and thyrotropin concentrations in man. J Clinical Endocrinology Metabolism. 1995; 80(4):1341-1346.
A research study published in December 2012 sheds some light on a phenomenon we see often …
A patient has elevated TSH but normal T4 and T3.
If that person also has symptoms of fatigue do they have hypothyroidism?
By standard definition any elevation of TSH indicates hypothyroidism. Usually this elevated level of TSH corresponds with a decrease in T4. That is the way it normally works in the body.
In this case it may not be a thyroid problem at all.
One of the things we look at in all our patients is dysglycemia (abnormal blood sugar).
Many thyroid patients have undiagnosed pre-diabetes and as this newly published article points out, pre-diabetes can lead to elevations in TSH.
And guess what?
Pre-diabetes causes many of the same symptoms as low thyroid.
So most patients that go to the doctor with fatigue and the doctor sees elevated TSH then they immediately get put on thyroid hormone.
The underlying blood sugar problem never gets fully investigated and the patient continues to suffer with symptoms because a lab marker was treated and not the patient.
That is why we take a whole person approach and make sure we understand the problems and mechanisms so we can help our patients feel and function well.
Indian J Endocrinol Metab. 2012 Nov-Dec; 16(6): 958–961. doi: 10.4103/2230-8210.102999