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MYSTERY BOX next tab
The following is information I have sent to friends in the past when/if they are not feeling well, have been diagnosed with thyroid issues, or any autoimmune disease.
The key with this information is to take this information as it works for you, and not to over-consume. Reading this list is great, but going down a rabbit hole is not helpful when finding root causes if you have not yet first stepped back to take care of yourself; slow down, relax, drink water and go for a walk, and meditate.
Below is a lot of information, but it is condensed information I have pulled together from books, articles, etc. I have read from others trying to sell "protocols". Keep it simple.
*Information I have below is good for Hypothyroidism, Hashimotos and managing the thyroid in general. I tried not to include Hashimotos specific things, but what can be applied to both, and information on managing the thyroid and your health in addition to/beyond medication. These are just starting points, there is so much more out there depending on what you are looking for and need help with.
First things to consider: Labs, Medication, then once started on medication, explore Symptoms beyond Medication, Lifestyle, Inflammation, Root Causes
Linked Reads: I colored the ones I think are best to read- Green, the others are good insight.
*Areas 1-3 are most important for now, just being diagnosed. 3-6 are there for you when/if you ever want to explore further, but I did link some insightful fertility info on #4.
1. Labs: Make sure you have ALL your bloodwork done. This is so important. If you're going to treat hypothyroidism when you may actually have Hashimotos, your care plan will look different. About 90% of people with Hashimotos were misdiagnosed with Hypothyroidism prior Hashimotos. Because, for whatever reason, medical practitioners only check your TSH levels (which indicate a thyroid issue) but not TPO (antibodies, which confirms Hashimotos or not).
Below is the basic panel you should start with. Make sure you know your levels on the following labs (ask your doctor for a copy and make sure it has the following tests)
a. TSH: Basically the main thing doctors look at to see if you have thyroid problems and is the sole number doctors use to determine your dose of medication. It is the golden number that indicates if you have HYPO or HYPER. Low=Hyper, High=hypo. You have HYPO, so your levels were high. Normal ranges of TSH are .35 - 5.0, but you should shoot to be 1.0 – 3.0
- My levels started at 8.9 (very high, hypothyroid) after medication they dropped to .1, very low and caused me to become hyper thyroid. I had to change my dose, and you may have to once you start.
Medication for this is primarily Levothyroxine (Synthroid), but there are other options as it doesn’t work for everyone- I’ll list more in #2.
b. Free T3 and Free T4: You need both of these in your body to feel like a normal human. However, to get T3, your body has to convert T4 into T3 and for people with thyroid issues, this doesn’t always happen. If you are feeling sluggish, low, down, tired, it is usually because your T3 levels are low as a result of your body not converting T4 into T3. Of course, you could also have low T4! Your TSH levels could be totally normal, but if you have low T4 and/or T3, you could still feel sick. Some doctors prescribe a pill for T3- I have personally taken it, didn’t think it helped and caused sleep issues, so I stopped. Everyone is different!
Medication for low T3 is Liothyronine (Cytomel), and is usually only prescribed by more modern, advanced Endocrinologists (I would research this more if you decide to take it)
c. Reverse T3 (optional): Measures how much of the free active T3 you have. Most importantly, this test is used to identify conversion of T4 to T3 (above), or thyroid issues that are due to adrenal stress, etc. Optional test because testing T3 and T4 is usually enough to indicate what your body needs.
d. *Thyroid Antibodies- TPO Antibody & TG: This is the lab doctors usually don’t do (hopefully yours did). If you have more than 0 thyroid antibodies in your body, you likely have Hashimotos. Thyroid antibodies indicate that the thyroid gland has been recognized as a foreign invader by the immune system and that your thyroid gland is being attacked. Ps. You can have normal TSH and antibodies.
Medication: There is no medication to reduce Antibodies. This reduction can be done, however, through lifestyle changes. People “reverse” their hypo & hashi diagnosis all the time or go into remission!
*Below is a link to an article about the first thyroid panel you should, if you do not already have it. This article is from Dr. Izabella Wentz- I find myself reading a lot of her stuff probably more than most other thyroid experts. She just has good sources and thorough research on all various thyroid issues. Pharmacists are pretty much always super thorough, detailed and TYPE A- A perfect combo for finding trustworthy info! She also has hypo and is a mom!
Reads: Full Thyroid Panel: https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
OPTIONAL, EXTRA LABS: After your first thyroid tests, I would recommend doing a much larger panel to check other areas of your body. It may help you to identify what is causing your body to be hypothyroid or to feel better in general (i.e, food sensitivities, stress, metal exposures, genetics, etc.).
I have attached a more thorough panel you can do, not usually covered by insurance but SO SO SO helpful to get these done. I can’t say how helpful enough! I wish I had done them sooner. If you decide to test all of these, I would start working with a nutritionist or holistic doctor. *If you’re only hypo, I think this is more of an option but could really help with fertility. I linked this article further below about why this is so important. *This is an investment, and I think it is worth it when you are ready.
2. Medication: Take it. Find a good Endo or Holistic Doctor and get your levels checked regularly. At first, you will likely need to check them more frequently (every 3 months) but once stabilized, I think the recommendation is every 6 months. If you have hypothyroid, leveling your hormones with medication will likely be pretty easy and won’t need extra intervention. I have had basically no issues with Levothyroxine. However, if your levels are normal but you still feel symptoms, you can look at changing your medication. A LOT of people start on Levothyroxine and then switch over to a different medication. There are medications that combine T4/T3 that I have seen people switch to (like Hillary Clinton, ha)!
Additional medications are Armour, Nature-Throid, WP Thyroid.
If your labs and numbers indicate a normal range, but you still feel off, that is indicator that there is more you need to do with your body that medication isn’t fixing (extra labs I mentioned above , diet change, less exercise, more vitamin D or vitamin B12, stress management, etc.) OR needing a medication change.
3. Listen to your Body: Re-emphasize on above. You could have normal tests but still feel off. My hope for you is if you only have hypothyroidism, this won’t ever expand beyond your current symptoms or alleviating them via medication. If you’re not a fan of medication and believe there is more to illness than what is to be solved via a pill, read on!
Now that you have your labs and dx or working towards that, move on.
4. Lifestyle: Consider making lifestyle changes. Even with Hypothyroidism or no thyroid issues, as you of all people definitely know, this is just important. You’re not technically autoimmune with Hypothyroidism (I think) but you’re a higher risk. Once you have one autoimmune disease, it is easier to develop others. In my opinion and from how much I have read, the best thing to do is to manage your health beyond the medication. You’re already very active and healthy though so that is great! For me, even if I have the medication, I still want know what is causing my thyroid to attack itself so I can do my best to help reduce that inflammation.
I really like this article on what changes are important to make, scroll down to where she starts talking about fertility: https://thyroidpharmacist.com/articles/best-advice-hashimamas/
- Get full lab work done (the one I have attached, not starting labs)
- Eat whole foods
- Manage your medication
- Test and know your adrenals
- Keep active, but dependent on adrenals
- Mindset, so important. Thyroid is friend, and it needs help
- Self care, take care of your gut
- Avoid toxins
- Look into supplements
- Work with nutritionist, biological dentist
Reads: Linked above
5. Understand inflammation and explore leaky gut: This might help with your fatigue, brain fog. I thought inflammation would be more physical, but it can manifest in our brain functions- how fun! I still have yet to meet someone with as bad of brain inflammation as myself, but most people do get brain fog, like you mentioned. Pathogens enter the brain, leading to inflammation which damages brain tissue. Typically stems from leaky gut and causes typical thyroid symptoms.
6. Root causes:
*I would not start fully down this path until you have a better grip on how your medication is helping you. Best not to get overwhelmed with everything, but worth dipping into a little bit. The thing with finding root causes is it can be costly- the extra labs, working with a nutritionist, dental work, new doctors, etc. But, what is more important than your health? It is always worth it, in my opinion. Just do your research before.
If ever you feel overwhelmed, stop, step back and take a break. Your body won’t fail you.
I won’t get into this a whole lot because you might not be autoimmune. But (okay, maybe I will), every autoimmune condition has something that triggers it and/or makes it worse. If you’re not autoimmune, you still have things in your body that will trigger inflammation. So with my suggestion of getting full labs done, I think it is important to consider what could be a source of your hypothyroid and what helps/doesn’t help it.
a. Dental Work: I mentioned dental work last night (actually crazy how many people end up with thyroid issues that have had dental work or mercury in the mouth). I actually avoided this at first because it seemed weird and far-fetched to me. But now that I am in a place where I am getting my mouth checked for toxins, I wish I had done it sooner. Find a biological dentist in your area if you want to check this out. I have not found a lot of hard research on it, but I have found SO many articles about dental reversal linked to the thyroid and improvement of symptoms. Even a quick google search through these articles gives good insight. Doesn’t hurt to check it out.
b. Stress: A root cause for everything, right :/
c. Food: If you don’t notice improvements with medication, I’d start an elimination diet. I am 100% against diets but not when it comes to determining what makes you feel good/worse. It could be even the most subtle thing; for me, simply removing dairy from my diet, I went to having fainting spells almost every day to none at all- it was triggering inflammation for me (see #5). You can do this on your own or with a nutritionist. If you’re trying to get pregnant, I recommend working with a good nutritionist. I can point you to an INCREDIBLE one that has worked with several hypo individuals who have conceived with her guidance (like food guidance… ) Or your midwife! However, if she isn’t familiar or an expert with Hashimotos, I would ask her to research more or bring in a nutritionist to work with you.
- There are many autoimmune protocol diets if you go down this route
- Paleo (this is mostly what I do), Whole 30, Gluten Free, Dairy Free, it is really really really really hard to be vegan with thyroid issues, no processed foods, etc.
- Read: Autoimmune Diets
d. Hormonal imbalances, anxiety, too much/little exercise, poor conversion of T4 to T3. You can read more about this later, but know that there are many areas to explore!
More Reads: Good reads and places to start. I have read SO much on thyroid. Pub meds, research, blogs and experts who sell stuff for $. As I said above, I like Dr. Wentz’ stuff and not for lack of not finding great and diverse articles. You’ll find that information on thyroid issues is pretty consistent within and outside of the medical community, but variance when it comes to clinical or more holistic approaches. Dr. Wentz’ It is pretty straight forward and surface level with research behind it, or best practices. And if you want to dig deeper, you can.
Technically, most Endocrinologists will tell you medication is all you need for thyroid. And personally, I think that is mostly true- it will take you from feeling 10% to 90% and for some, 100%. But for the remaining +- 10%, there is more we can do. It just may take trial and error to find what works for you. I am hoping that your medication will be a great answer to your symptoms and fertility! But know that there is more you can do than just medication or to offset what medication doesn’t do. Obviously with or without thyroid issues, lifestyle is important.
Top Herbs for Autoimmune (ginger, turmeric)
This article on Hashimotos (but similar for hypothyroidism)