If you don’t want to be the horses’ hoofprints, you got to be the hooves.
—BRUCE COCKBURN
For some of you, just recognizing the symptoms of a thyroid problem will trigger a visit to the doctor, conventional tests will reveal your thyroid problem, the doctor will give you a prescription, and you’ll be on your way to feeling better and normalizing your metabolism and weight. Unfortunately, for some of you, getting a doctor who will test, diagnose, and properly treat your thyroid condition may not be as smooth a process as you’d hope, for a number of reasons.
CHALLENGES TO DIAGNOSIS
Inability to Get Tested or Diagnosed
You may find that your doctor isn’t willing to test your thyroid. Sometimes it’s because the test was your idea, which can threaten a doctor’s ego or sense of control. Or your doctor may be afraid that you want thyroid drugs as weight-loss aids. Some HMO doctors face restrictions or financial disincentives to order laboratory tests. Finally, some doctors are simply not particularly aware of or informed about thyroid disease. Some patients have even reported that their doctors refused to perform thyroid tests, saying totally off-base things such as
In other cases, you may describe your thyroid symptoms but end up with another diagnosis. Say fatigue, weight gain, and moodiness to many doctors, and you’ll leave the office not with a thyroid test but with a prescription for an antidepressant. Some researchers estimate that at least 15% of those diagnosed with depression are actually suffering from undiagnosed hypothyroidism.
Or you may be told that it’s your hormones (which in essence it is, but they’re talking about the wrong hormones here!). Or you may be told you’re experiencing the effects of getting older, working too hard, normal postpartum symptoms, or lack of exercise. If you describe feelings of anxiety and weight loss, you may, as some young women with hyperthyroidism have experienced, be labeled as anorexic or bulimic.
When faced with a doctor who is oblivious or resistant to what may be very obvious thyroid symptoms, or won’t test when asked, the best option is to find another doctor, even if you have to pay for it yourself. But if you have no options, here are a few tips:
In today’s lawsuit-laden environment, doctors are especially concerned about officially documenting controversial medical decisions, so you’ll probably get the tests you need. It may seem ridiculous that you have to struggle to get standard medical tests and treatment, but it’s your health that is at stake, so keep fighting.
Test Value Changes
Your doctor may not be up on the latest thyroid recommendations regarding revised lab standards for the thyroid-stimulating hormone (TSH) test, which is considered by most conventional doctors to be the primary diagnostic tool. In late 2002, the National Academy of Clinical Biochemistry, which is part of the Academy of the American Association for Clinical Chemistry (AACC), issued new Laboratory Medicine Practice Guidelines for thyroid testing. These guidelines made a fairly dramatic change in the normal range for TSH testing. Of specific interest are the following findings from the guidelines:
In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because >95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L.
A serum TSH result between 0.5 and 2.0 mIU/L is generally considered the therapeutic target for a standard L-T4 replacement dose for primary hypothyroidism.
What this means is that, while the so-called “normal” range at many labs may be listed as .5 to 5.5, and the endocrinologists now recommend narrowing the normal range to .3 to 3.0, there are experts who believe that the range should be lowered even further, to 2.5. This would mean that millions more people would be considered hypothyroid, and qualify for treatment. This also means that people who are receiving treatment but who have TSH levels in the “high-normal range”—above 2.5—may in fact exhibit hypothyroid symptoms.
Many doctors are still operating according to the old “normal” range and therefore will inaccurately rule out thyroid conditions. Get a copy of the guidelines online at http://www.nacb.org/lmpg/ thyroid_LMPG_PDF.stm and share them with your doctor.
Borderline Levels
Your TSH level may be borderline. In that situation, despite your symptoms, your doctor may refuse to treat you. Don’t accept a response of wait-and-see. Ask for the actual number, and ask for the normal range for the lab where your blood was tested. Show your doctor your Risks and Symptoms Checklist and ask about a trial course of treatment to see if your symptoms improve. If your doctor is so number obsessed that it’s like talking to an accountant instead of a health care practitioner, start looking for a new doctor.
Overreliance on the TSH Test
Some doctors believe that only the TSH test is necessary and refuse to order free T4 or free T3 tests. The problem is that some people who have a borderline TSH level may have changes to free T4 and free T3 that point to a diagnosable thyroid problem. Without those additional numbers, however, a normal or borderline TSH will not reveal the underlying problem. Push for additional testing, or consider finding a doctor who will order the tests for you.
Alternatively, you can order TSH, free T3, and free T4 testing, known collectively as the Comprehensive Thyroid Profile II, from HealthCheckUSA. This panel usually runs less than $100 and does not require a doctor’s prescription. See http://www.goodmetabolism.com for details.
Failure to Test for Antibodies
Even though autoimmune problems are most frequently the cause of thyroid conditions, many physicians do not routinely conduct the antibody tests that diagnose autoimmune thyroid disease. This presents a problem because elevated thyroid antibodies even in the presence of normal TSH levels mean that you have autoimmune thyroid disease and that your thyroid is in the process of autoimmune dysfunction. The dysfunction may not be significant enough to register as an abnormal TSH level, but the presence of antibodies may generate symptoms and is predictive of thyroid problems down the road.
The practice of treating patients who have Hashimoto’s thyroiditis but normal-range TSH levels is supported by a study reported in the March 2001 issue of the journal Thyroid. In this study, German researchers found that treatment with levothyroxine for Hashimoto’s autoimmune thyroiditis—where TSH had not yet elevated beyond normal range—could actually reduce the chance and severity of autoimmune disease progression. The researchers speculated that such treatment might even be able to stop the progression of Hashimoto’s disease or prevent the development of hypothyroidism.
Many doctors will not, however, treat patients who present clinical symptoms of hypothyroidism and test positive for Hashimoto’s antibodies but have a normal TSH level. You may have to actively interview endocrinologists, as well as holistic doctors, osteopaths, and other practitioners, to find one who will treat you if you have a normal TSH level, with thyroid antibodies and symptoms.
Normal Levels but Low T3/ T4/T3 Conversion Problems
One of the most difficult situations is having an underlying thyroid problem that does not show up on standard thyroid blood tests. You may have a family history of thyroid disease or a number of thyroid symptoms—even a low basal body temperature—but you have TSH, free T4, free T3 and antibody levels that are normal. What you may be experiencing is thyroid hormone resistance, where your body is capable of producing thyroid hormone, but nutritional and metabolic dysfunctions have made your tissues resistant to that hormone. This is similar to the better-known concept of insulin resistance, where your body produces enough insulin, but your cells become resistant to it, so your body loses its ability to respond to it.
You may also have thyroid hormone conversion problems, where you have enough T4 and T3 in the bloodstream, but the organs and tissues are not effectively converting the inactive T4 into the active T3 that you need at the cellular level. In both cases, you may show normal circulating levels, but you are hypothyroid at the level of your tissues, organs, and cells.
Thyroid hormone resistance and conversion problems are very difficult to diagnose with blood tests. The thyrotropin-releasing hormone (TRH) test—the one laboratory test typically able to detect this sort of dysfunction—is generally not being done anymore. Some practitioners perform a reverse T3 test that measures the conversion of T4 to reverse T3—an inactive form of T3. This typically occurs when the body is under stress and is cause for treatment according to some practitioners. This test is considered irrelevant by many mainstream practitioners, however.
The bottom line is that if you suspect thyroid resistance or conversion problems, you will need a practitioner who is skilled in clinical, observational diagnosis, and who, in the face of normal blood test values, will still be willing to try you on a course of thyroid treatment if you have observable signs of hypothyroidism. Typically, this would be a holistic or alternative medicine physician with expertise working with thyroid disease and other difficult-to-diagnose conditions.
OPTIMIZING YOUR THYROID TREATMENT
If I seem to be focusing on hypothyroidism, it’s because it’s ultimately the end result for most thyroid patients. For example, with Hashimoto’s thyroiditis patients, the thyroid typically burns itself out over time, becoming less able to produce thyroid hormone, thus leaving most patients hypothyroid. With Graves’ disease and hyperthyroidism, most doctors in the United States, rush to administer radioactive iodine (RAI), which leaves patients without a functional thyroid. They end up hypothyroid even if they started out with an overactive gland. Many doctors do not explain this fully to patients when they recommend RAI treatment.
With thyroid nodules and goiter, surgery may be performed to remove all or part of the thyroid. The end result is often hypothyroidism. And for thyroid cancer, almost all patients have their thyroid removed entirely, leaving them completely hypothyroid and reliant on outside thyroid hormone replacement.
However you have gotten there, if you are battling weight issues, once you become hypothyroid, it’s a shared battle. After getting diagnosed and treated, the first step is to optimize your thyroid hormone replacement treatment.
If you are still suffering from thyroid symptoms and finding it difficult or impossible to lose weight, or you’re gaining weight even though you’re on a healthy diet and exercise program, there’s a good chance that your thyroid treatment is not optimized. A number of situations can contribute to less than optimal thyroid treatment:
Any of these problems can interfere with optimal thyroid function and disrupt metabolism. Here are some questions you can consider that address the various concerns relating to optimal thyroid function.
Are you on the right brand of levothyroxine for you?
Most people start out taking levothyroxine. But some people simply do not feel well on one brand of levothyroxine, and changing brands seems to help. With several FDA-approved brands (Unithroid, Levoxyl, and Synthroid, among others) available, you may wish to discuss a change with your physician. Do stick with a brand name, however, and not a generic, to ensure consistency. (Every time you refill a generic prescription, you can get a different manufacturer’s product.)
Do you need the addition of T3?
Some people do not feel their best and find it difficult to lose weight without the addition of a second thyroid hormone known as T3. T3 is the active thyroid hormone. Usually, the body converts T4 to T3, but nutritional deficiencies, toxins, and a variety of other physiological factors may prevent the body from accomplishing that conversion process properly, leaving you deficient in this most important thyroid hormone. In one research study, experts found that among a group of 100 obese patients, more than 90% of those studied had T3 levels that were below the mean. So it’s clear that low T3 or inability to convert T4 to T3 may contribute to weight gain or difficulty losing weight.
While it’s a controversial topic that is under increasing study by various experts, some physicians believe that supplemental T3 may be a solution to help optimize thyroid treatment for some patients. They add T3 in one of several ways:
Key point? Check with your physician about whether supplemental T3 might be helpful for you.
Would natural thyroid help?
Some practitioners believe that certain patients simply do best on natural desiccated thyroid derived from the thyroid gland of pigs. These products, including Armour and Nature-throid, are prescription thyroid drugs that have been in use for a century. Alternative experts believe that these drugs, which provide T4, T3, T2, T1, and other thyroid hormones and nutritional elements, more closely resemble human thyroid hormone than the synthetics and report that their patients feel better on them. Keep in mind that many conventional physicians feel that these drugs are out of date and won’t prescribe them, so you may need to find a holistic or alternative physician.
Kim describes her experiences with natural thyroid:
I convinced my doctor to put me on the natural thyroid medication rather than the synthetic that I had been on for years. The very first day with the natural, I felt so much better; I felt I could actually open my eyes. I also had more energy, and after not being able to lose weight and knowing I was eating properly, the first month I lost 16 pounds, doing the same things and eating the same things that I had done before. When my doctor saw the results from my blood test, and my weight loss and my blood pressure, he was very impressed and very proud of me. He said he would definitely keep me on the natural and that I am just one of the people that it works better for.
Are you at the optimal dosage/TSH for you?
While the normal range for TSH lab tests is established for each lab, where you personally feel best will vary. A study reported in the Journal of Clinical Endocrinology and Metabolism found that the mean TSH level for people who don’t have a thyroid condition is 1.5. And the American Association of Clinical Endocrinologists has stated that TSH levels above 3 would be considered potential evidence of a developing thyroid problem. So it’s no wonder that if your TSH is on the higher end of normal for you, you may find it hard to lose weight. Check your most recent blood test results and consult with your physician about whether a slight increase in medication dosage and a reduction in TSH would be better for your health.
Allie, who is 50, started having a weight problem around the time she hit 40. She also had a laundry list of symptoms, including dry skin, hot flashes, memory loss, and low sex drive. Her doctor decided it was menopause and depression. Allie kept insisting on a thyroid test. She was finally tested and diagnosed as hypothyroid at age 48. Her symptoms continued, and she insisted on more blood work. Her TSH level was 5.2, which according to Allie’s doctor was normal.
I insisted that, knowing my body, it was too high for me. He was quite adamant that my problem was not my thyroid, but that I needed to admit that it was depression and that I had all the symptoms. When I told him that all of my symptoms were from a low thyroid problem and that the latest count just wasn’t compatible with my body, and that I wasn’t depressed, his answer was “I’ll bet 95% of the people in the psychiatric ward say the same thing.”
Allie finally saw another physician, who said she was being undertreated and upped her dosage of thyroid hormone replacement. She’s feeling dramatically better.
One other little-known issue for thyroid patients is the seasonal variation in thyroid function. A number of studies show that TSH naturally rises during colder months and drops to a low normal or even a hyperthyroid level in the warmest months. Some doctors adjust for this by prescribing slightly increased dosages during colder months and reducing dosages during warm periods. Most, however, are not aware of this seasonal fluctuation, leaving patients suffering with worsening hypothyroidism symptoms during colder months, or going through warmer months suffering with hyperthyroidism symptoms due to slight overdosage. This seasonal fluctuation becomes more pronounced in older people, particularly in cold climates. Twice-yearly tests at minimum during winter and summer months can help assess fluctuations and guide seasonal dosage modifications if needed.
Are you taking your medication properly?
There are a number of guidelines on how to properly take thyroid hormone to ensure that you are absorbing the drug and receiving the maximum possible benefit.
NUTRITION AND SUPPLEMENTS FOR THYROID FUNCTION
Multivitamins
A high-potency multivitamin is essential for thyroid patients. Look for one that has high amounts of vitamins B, C, and E and a good range of minerals. One that I particularly like is Dr. Jacob Teitelbaum’s formulation known as Daily Energy Enfusion (see appendixA). Dr. Teitelbaum’s formula does contain some iodine, however, so you may want to slightly reduce your daily dosage if you are iodine sensitive. The vitamin comes as a flavorful powdered drink along with one B vitamin capsule, and this replaces more than 30 vitamins and supplement pills each day. Dr. Teitelbaum’s formula does not include iron or calcium, so it can be taken at the same time as thyroid pills.
Another good option if you want an iodine-and iron-free antioxidant multivitamin is Advanced Nutritional System’s Rainbow Light: Complete Antioxidant Multivitamin and Advanced Nutritional System’s Rainbow Light Iron-Free Complete Nutritional System Multivitamin. The first is a high-power multivitamin, and the second adds green foods, herbs, and enzymes.
Probiotics
Probiotics are supplements that contain live bacteria—the “good” bacteria found in fermented foods such as miso and dairy products such as yogurt and some cheeses—that we are meant to have in sufficient quantities in our intestinal system. One of the more well-known probiotic bacterium is acidophilus, the live cultures found in yogurt. According to a report in the European Journal of Clinical Nutrition, the probiotic bacteria known as Bifidobacterium lactis HN019 boosts the activity of various disease-killing immune system cells in healthy adults. Probiotics help proper digestive functioning, which enhances the immune system. They also kill off harmful bacteria, having an antibiotic effect by fighting off various types of infection. You can take yogurt, but the concentration of live cultures in yogurt is not high enough to get a substantial effect, so a probiotic supplement is your best option. Some probiotic supplements can be expensive and require refrigeration, but I recommend a patented formula from Enzymatic Therapies, the Probiotic Pearl. This tiny pearl-shaped supplement contains a guaranteed level of live bacteria in the millions, is very inexpensive, and requires no refrigeration.
Zinc
Zinc is important for thyroid hormone production and conversion, and 15 to 25 milligrams of zinc a day can help ensure optimum zinc delivery to the thyroid. Zinc, along with selenium, can also help prevent the decline of T3 when you are on a lower-calorie diet.
Selenium
Research has shown that selenium is an important mineral for thyroid function. It activates an enzyme responsible for controlling thyroid function by the conversion of T4 to T3. Stress and injury appear to make the body particularly thyroid responsive and selenium deficient. Supplemental selenium appears to offset the effect of high iodine intake on thyroid function. A 1997 study suggested that high intake of iodine when selenium is deficient may permit thyroid damage. Selenium supplementation has been shown to reduce inflammation in patients with autoimmune thyroiditis. Too much selenium can be dangerous, so multivitamin and additional supplementation should not exceed 400 micrograms per day.
L-tyrosine
L-tyrosine is a known precursor to thyroid hormone, and low levels can make it difficult for the thyroid to function properly. It is a common component of many thyroid support supplements that combine several supplements into one capsule. Tyrosine supplements at the level of 85 to 170 milligrams a day may be helpful to the thyroid.
Guggul
Z-guggulsterone—known as guggul—is derived from the plant commiphora mukul and has been used in Ayurvedic medicine as an antiinflammatory, antiobesity, thyroid-stimulating, and cholesterol-lowering agent. Guggul is considered particularly important for prevention of a sluggish metabolism, and studies have shown that Z-guggulsterone has the ability to increase the thyroid’s ability to take up the enzymes it needs for effective hormone conversion. It also increases the oxygen uptake in muscles. Some people find that guggul is overstimulating, so you need to be careful with this supplement.
Essential Fatty Acids
Essential fatty acids (EFAs) cannot be produced in the body, so you must get them through diet or supplements. The key essential fatty acids include
According to Dr. Udo Erasmus, author of Fats That Heal, Fats That Kill, imbalances and deficiencies in essential fatty acids are the cause, a trigger, or a contributing factor to many diseases and conditions, and addressing those deficiencies through proper foods or use of healthy oils can have huge implications for health. He believes that essential fatty acids are critical to thyroid function because (1) they are required for the integrity of the structure for every membrane of every cell, (2) they increase energy levels in the cell, and (3) there is some evidence that essential fatty acids, especially omega-3s, improve the body’s ability to detect and respond to thyroid hormone effectively.
Erasmus also points to the role that EFAs play in preventing and reducing inflammation. In particular, essential fatty acids make hormone-like eicosanoids that regulate immune and inflammatory responses, and omega 3s in particular have antiinflammatory effects that can slow autoimmune damage. Inflammation of the thyroid—known as goiter—is central to many cases of autoimmune thyroid disease, and inflammation is generally seen in almost all autoimmune diseases.
Erasmus believes that if proteins are the juice, fats are the insulators, not just of nerves but of cells and membranes. Protein reactions lead to inflammation, allergies, and autoimmune disease. Essential fatty acids seem to help prevent the proteins from becoming hyperactive and triggering these various immune reactions.
Nutritional expert Ann Louise Gittleman, author of Eat Fat, Lose Weight and the best-selling book The Fat Flush Plan, believes that good fats are essential to good health and weight loss, and that today’s low-fat diets are counterproductive. Gittleman says, “Even as we have cut back on fat in the last decade, weight has steadily increased, an average of 8 pounds per person. We may be eating less fat, but we are eating more calories.” Ultimately, Gittleman, like many other nutritional experts, believes that if you include good fats in the diet, you rev up the body’s fat-burning potential and you stay full longer, so you eat fewer calories without feeling hungry.
Overall, EFA supplements appear to be an important part of any weight-loss effort for the following reasons:
In addition to adding more of the foods that contain these essential fatty acids, some of the ways you can add EFAs to your diet include
Gittleman is an advocate of evening primrose oil.
In my private practice, I have seen women and men benefit time and time again from the addition of omega fats to their weight-loss plans. Many of my clients who have had at least 10 pounds or more of weight to lose have reported staggeringly dramatic results with four to eight capsules of 500 mg evening primrose oil.
If you want to include a healthy balance of EFAs, think about a product that includes a balance of oils, such as the Atkins formulated Essential Oils Supplement, or Udo Erasmus’s Udo’s Oil products.
OTHER THYROID SUPPORT ALTERNATIVES
Watch Goitrogens
Goitrogens are products and foods that promote goiter formation and can act like antithyroid drugs in disabling the thyroid and causing hypothyroidism. Specifically, goitrogens inhibit the body’s ability to use iodine, block the process by which iodine becomes the thyroid hormones T4 and T3, inhibit the actual secretion of thyroid hormone, and disrupt the peripheral conversion of T4 to T3.
If you are hypothyroid due to thyroidectomy, you don’t have to be particularly concerned about goitrogens. If you still have a thyroid, however, you need to be careful not to eat goitrogens in large quantities. The enzymes involved in the formation of goitrogenic materials in plants can be partially destroyed by cooking. Eating moderate amounts of goitrogenic foods, raw or cooked, is probably not a problem for most people. The following list contains some of the more common and potent goitrogens (particularly when consumed raw):
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African cassava |
Babassu (palm-tree coconut fruit found in Brazil and Africa) |
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Broccoli |
|
|
Cabbage |
Brussels sprouts |
|
Kale |
Cauliflower |
|
Millet |
Kohlrabi |
|
Radishes |
Mustard |
|
Soy products |
Rutabaga |
|
Watercress |
Turnips |
Reduce Toxic Exposures
Fluoride has been used in the treatment of hyperthyroidism, meaning that it has the ability to suppress thyroid function. In one study, it was shown that 2.3 to 4.5 mg of fluoride per day was a successful treatment for hyperthyroidism. In areas where water is fluoridated, typical fluoride intake ranges from 1.6 to 6.6 mg/day, which in some cases exceeds the dosage used for medical treatment of hyperthyroidism. What can you do? Drink bottled water that is not fluoridated. Use a fluoride-free toothpaste. And do not get fluoride treatments at the dentist. These treatments have not been clearly demonstrated to be helpful in adults for reducing or preventing cavities.
The rocket fuel/explosives manufacturing by-product, perchlorate, a chemical that is known to disrupt thyroid function and cause other health problems, is increasingly the focus of public, media, and government attention. Perchlorate has contaminated areas of the U.S. water supply, most commonly in the western part of the country. Eating lettuce or other vegetables and fruits irrigated with perchlorate-contaminated water may expose some consumers to high levels of the toxin. Perchlorate is also a component of fertilizers and can contaminate foods grown with them. There’s not much you can do to avoid eating perchlorate-contaminated foods, except to grow your own produce and water it with water that you’ve had tested for perchlorate contamination. If you drink well water, you should also have that water tested, and if you live in an area near a current or former production facility for rockets, explosives, or fireworks, consider having your water independently tested. Most importantly, become aware of the issues, and monitor the status of perchlorate legislation by monitoring the comprehensive site: www.perchlorate.org.
Mercury exposure comes through dental fillings, and some fish concentrate high levels of mercury. Mercury levels can be tested by a holistic physician or nutritionist using hair analysis. If you have excessive levels of mercury, some experts recommend chelation—the process of helping the body excrete excess metals and minerals. This can be done through intravenous infusion or herbal supplements. In some cases, practitioners recommend removing mercury fillings and replacing them with composite materials that contain no mercury. This is controversial, because it can be very expensive. Some patients have reported that their thyroid problems and other symptoms were greatly relieved with removal of mercury fillings.
Treat Infections
Infection is also thought to be a trigger for some thyroid problems. The foodborne bacteria Yersinia enterocolitica, for example, has been associated with the production and elevated levels of thyroid antibodies, which is a sign of autoimmune thyroid disease.
A laboratory analysis by Great Smokies (see appendix A) can help detect intestinal bacterial overgrowth that could be contributing to underlying immune system problems that may be fueling your thyroid condition. Bacteria are typically treated with antibiotics, or a special diet, nutritional supplements, and herbs that function in an antibiotic-like capacity may be suggested by a holistic practitioner.
Yoga
In addition to the overall health benefits of yoga, this ancient art and science of mind–body wellness offers several specific practices focused on the thyroid. A particular yoga breathing exercise is designed to help the thyroid and the throat chakra. Breathe in through your nose, focusing the inhalation toward the back of your throat. Your throat should feel slightly closed or blocked while you perform this breathing exercise. Mentally, you should try to feel as if you are taking in the air through the front of your throat. Do this several times a day but not for long periods, as it might make you dizzy.
A specific asana—or pose—is also thought to be of great benefit to the thyroid. The half-shoulder stand (viparit karani mudra) and shoulder stand (sarvangasan) positions both invert and stimulate the thyroid. The shoulder stand is considered one of the most powerful positions in yoga. In addition to helping the thyroid, it is thought to prolong life through its effect on the metabolism and pranic energy. In a shoulder stand, you lie flat on your back, keep your legs together, and raise them up until they are at a right angle to your shoulders/ neck, perpendicular to the floor, chin tucked into your chest, resting the weight of your body on your shoulders and elbows, arms supporting your hips. In a half-shoulder stand, the legs don’t need to be as straight as in a full shoulder stand. Work up to a daily session of a full 2 minutes by starting with two or three shorter sessions. As an alternative, you can support your legs on a wall or chair, if the shoulder stand position is too difficult.
Guided Chakra Visualization/Affirmation
In the area of energy work, there is a guided visualization and meditation that can be done to help tune and balance the thyroid. Sit in a comfortable upright position (in a chair or sofa, or cross-legged yoga lotus position), eyes closed. Take a few deep, cleansing breaths. The harmonic color for the thyroid is blue, so you should visualize a bright blue beam of light coming down through the top of your head and going right to your thyroid. Feel the blue energy infusing every cell of your thyroid, throat, and neck. Visualize the blue beam of energy enhancing the thyroid and curing its underactivity. Feel the blue light softly spreading all around your neck and throat. Now, say out loud, “My thyroid is energized and is working perfectly. I am safe, and loved, and filled with the energy of the Universe.”
CONTROVERSIES
The Iodine Controversy
Iodization of salt and foods has helped eliminate epidemic goiter and cretinism in areas that are iodine deficient, but excess inorganic iodine may contribute to thyroid imbalances in other areas where there is sufficient iodine. One gram of salt contains 76 micrograms of iodine, and we need approximately 100 micrograms of iodine per day. The average person in the United States, however, actually consumes as much as 3 grams of salt, so you may be overdosing on iodine.
Some alternative practitioners automatically recommend iodine or iodine-containing herbs or supplements such as bladder wrack and bugleweed supplementation when they hear “thyroid problem.” But do you need this supplemental iodine? In all likelihood, no. A study reported in the Journal of Clinical Endocrinology and Metabolism in late 1998 indicated that the percentage of Americans with a low intake of iodine has more than quadrupled since the 1970s, and currently around 12% of the U.S. population is iodine deficient, up from less than 3% in the early 1970s. Yet statistically only one in nine Americans is iodine deficient, so in all likelihood you are getting enough. It’s even more likely that you’re getting too much.
One way to cut back on iodine intake is to stop buying commercially iodized salt (salt that has potassium iodide) and use sea salt instead. An added plus is that sea salt tastes better!
However, if you are iodine deficient, this can factor into your thyroid problem. You can always have a doctor or nutritionist test for iodine deficiency, but a short course of iodine may be an adequate self-test to see whether you need this supplement. Or you can consider the input of Drs. Richard and Karilee Shames, authors of Thyroid Power, who say, “If you are a person who never consumes fast food, avoids salt like the plague, doesn’t eat much seafood, and feels that sea vegetables are for fish, and especially if you live more than 100 miles from any coast, then you might well consider supplementation with iodine.”
Some alternative and conventional practitioners have found that iodine or iodine-containing herbal products aggravate hypothyroid symptoms. I have tried iodine on numerous occasions, and within a day or two, I always feel exhausted, with a swollen, irritated neck, and after a week, barely functional. I can tolerate the small amount of iodine in a multivitamin, and I eat sea vegetables and iodine-rich foods like seaweed/sushi or shellfish without any problem, however, so perhaps the obstacle is a sensitivity to processed iodine rather than iodine in food.
Soy
Experts can’t seem to agree on the subject, and there is a definite debate about the potentially harmful effects of overconsumption of isoflavone-intensive soy products. Soy is popular as a phytoestrogen for the same reason that it poses a danger to the thyroid, because in large enough quantities it functions as a hormone and antithyroid agent. The isoflavones in soy belong to the flavonoid chemical family, and flavonoids are considered endocrine disruptors—plants that act as hormones, disrupting the endocrine system. Flavonoids typically act against the thyroid by inhibition of thyroid peroxidase (TPO), which disturbs proper thyroid function.
There are concerns for adult consumption of soy products. One U.K. study involving premenopausal women gave 60 grams of soy protein per day for 1 month. This was found to disrupt the menstrual cycle, with the effects of the isoflavones continuing for a full 3 months after stopping the soy in the diet. Another study found that intake of soy over a long period causes enlargement of the thyroid and suppresses thyroid function. Isoflavones are also known to negatively affect fertility and sex hormones, and can have serious health effects in a number of mammals, including infertility, thyroid disease, and liver disease.
In a February 18, 1999, official letter of protest to the Food and Drug Administration, Doerge and Daniel Sheehan, who at that time were the FDA’s two key experts on soy, protested the health claims approved by the FDA on soy products, saying,
There is abundant evidence that some of the isoflavones found in soy, including genistein and equol, a metabolize of daidzen, demonstrate toxicity in estrogen-sensitive tissues and in the thyroid. This is true for a number of species, including humans. Additionally, isoflavones are inhibitors of the thyroid peroxidase, which makes T3 and T4. Inhibition can be expected to generate thyroid abnormalities, including goiter and autoimmune thyroiditis. There exists a significant body of animal data that demonstrates goitrogenic and even carcinogenic effects of soy products. Moreover, there are significant reports of goitrogenic effects from soy consumption in human infants and adults.
If you don’t have a thyroid, soy is not something you need to worry about. But if you still have a thyroid, be careful about using too much soy. Tempeh, soy sauce, and miso are far more easily digested and less likely to cause problems. Soy pills, powders, supplements, especially high-isoflavone supplements, and daily overconsumption of soy foods all may contribute to the worsening of your thyroid problem.
Coconut Oil/Medium-Chain Triglycerides
If you search the topic “thyroid” on the Internet or read some of the women’s magazines, you’ll find ads touting coconut oil as a cure for thyroid disease and a weight-loss miracle food and supplement. Coconut oil is controversial, however, and some experts believe it’s simply another oil.
Nutritionist Bruce Fife, author of The Healing Miracles of Coconut Oil, is a firm believer in coconut oil for thyroid patients. He says, “Coconut oil by itself is not a thyroid cure. But when used as part of a thyroid-enhancing program it can be invaluable in improving some forms of hypothyroidism and even bring about complete recovery.” Fife believes that coconut oil can rev up the metabolism, and he suggests replacing all refined vegetable oils with it, including margarine, shortening, and hydrogenated oils. He also recommends using coconut products and foods such as coconut milk as much as possible in cooking.
Coconut oil contains medium-chain triglycerides (MCTs), which are a special type of saturated fat. It’s theorized that MCTs may promote weight loss by increasing the burning of calories. Research recently conducted in Canada found that medium-chain fatty acids (MCFAs) such as those found in coconut oil are quickly oxidized in the liver, and this speed of oxidation leads to greater energy expenditure. No weight loss, however, was associated with the demonstrated increase in energy expenditure.
Research is contradictory on the topic. In one study, 66 women were put on a very low-carbohydrate diet for 4 weeks. Half received a regular fat supplement; the other half received an MCT supplement. Those on the MCT supplement had increased fat burning and less loss of muscle mass during the first 2 weeks, but these benefits declined during the last 2 weeks of the trial. Other trials showed that MCTs and coconut oil failed to enhance weight loss.
You can see if it works for you. And remember that the way to use coconut oil is not to add a few tablespoons to your diet on top of your regular foods, including fats. If you want to see if it’s going to help, you need to cut out most of your other fats and oils, and substitute coconut oil to see if you get any benefit.