Three reasons you still have symptoms on Synthroid

sick on synthroid

Synthroid (also know as levothyroxine) is a synthetic form of T4 and the most common medication prescribed for hypothyroidism. Unfortunately, many people continue to experience chronic and debilitating symptoms of hypothyroidism on Synthroid, including:
– fatigue
– weight gain
– brain fog
– hair loss
– low mood
– and more…

There are three BIG reasons why you still might have symptoms on Synthroid.

1. Your body isn’t using the medication efficiently.

While T4 is the most abundant hormone the thyroid produces, T3 is the most active form. T3 is the hormone that acts on all the cells in your body to create positive changes in energy and metabolism. In healthy persons, T4 is converted to T3 in the body naturally. However, for many people (especially with hypothyroidism or Hashimoto’s disease) this doesn’t happen properly.

Want to know if you’re producing T3 in proper amounts? Have your FT4 and FT3 tested, and then do this simple calculation: FT4 divided by FT3

An optimal result should be around 3, which means your body is efficiently producing T3.

Results over 3 indicate what thyroid experts call a “conversion issue”. This is a very common roadblock to feeling better on Synthroid but don’t worry, it can easily be improved.

Bottom line: You can have all the T4 in the world, but if your body isn’t converting it to T3, you may still feel hypothyroid.

2. You’re not addressing the root cause

The most common cause of hypothyroidism in North America is an autoimmune condition called Hashimoto’s Disease. This occurs when the body begins to attack the thyroid and slowly destroys the thyroid tissue, making it impossible to produce adequate hormone amounts naturally.

While medication can be an important part of feeling better with Hashimoto’s, it’s not enough. You need to address the inflammation and autoimmune process that created your thyroid problem in the first place.

If you have symptoms like joint pain, hives, chronic digestive concerns, or already have an autoimmune disease, you need to be properly assessed for Hashimoto’s. Read about The Seven Signs This Common Condition is Causing Your Thyroid Disorder for more information about Hashimoto’s Disease.

3. You have nutrient deficiencies

Low nutrient levels are very common with low thyroid function and can leave you with lingering symptoms of fatigue, hair loss, brain fog and more. I talk about the most common nutrients deficiencies and how to test for them in another blog post entitled The 3 Nutrients I Check in Every Single Thyroid Patient

What can you do?

  • Talk to your Naturopathic Doctor about how to support optimal T3 levels with nutrient therapy that helps the body use Synthroid more effectively. You can also consider a thyroid medication that already contains T3. While Synthroid works well for some, others finally find symptom relief once switching to a different form medication.
  • Assess for Hashimoto’s Disease by asking for your thyroid antibodies (AntiTPO and TgAb) to be tested at your next lab work. If positive, get to work addressing your root cause to decrease inflammation and the autoimmune process.
  • Check your nutrient levels and supplement accordingly under the advice and care of your healthcare professional.

Have questions? We’re here to help!

Dr. Katie Rothwell, ND

Seven Signs This Common Condition Is Causing Your Thyroid Disorder

Hypothyroidism (or low thyroid function) is on the rise and affects 1 in 10 women in North America. The most common cause of hypothyroidism? You may be surprised to know that it’s an autoimmune condition called Hashimoto’s Disease.

In Hashimoto’s disease, the immune system produces antibodies against the thyroid. Overtime, this causes damage to the thyroid gland and eventually hypothyroidism. While Hashimoto’s affects primarily the thyroid, it’s not just a thyroid condition – it’s an autoimmune condition.

Testing for thyroid antibodies is the only way to truly know if you have Hashimoto’s disease. However, these are some of the signs and symptoms I see in people who have an autoimmune thyroid condition. These are usually in addition to the ‘regular’ or classic symptoms of hypothyroidism such as fatigue, trouble losing weight, cold body temperature and constipation.

1. You still feel like $h*t on Synthroid
Maybe you’ve been on thyroid medication for years (or decades!) but have never felt quite right. While thyroid medication can improve the hormone levels in your blood, it doesn’t address the inflammation and autoimmune process that happens with Hashimoto’s Disease. Without treating the inflammation your symptoms can continue to worsen over time even with “normal” thyroid tests.

2. You have digestive symptoms like bloating, gas, heartburn, diarrhea/constipation OR have been previously diagnosed with IBS
What does the gut have to do with our thyroid? A healthy digestive system is key to proper immune function. If you’ve experienced long-term gut issues, have been previously diagnosed with “IBS” or have never been well since something like food poisoning, Hashimoto’s should be on your radar.

3. You experience random skin rashes or hives 
This is another sign that the immune system is out of control and reacting to things it shouldn’t be. It is also a tell-tale sign that the gut isn’t working properly (see above!)

4. You have joint pain or feel puffy all the time
Autoimmune conditions often affect muscles and joints and can lead to constant aches and pains. Swelling, redness, and pain are all signs of inflammation, which goes hand-in-hand with autoimmune conditions and Hashimoto’s disease.

5. You already have an autoimmune condition
Having one autoimmune condition increases your risk for developing others. Autoimmune conditions seen frequently with Hashimoto’s include Rheumatoid Arthritis, Celiac disease, Crohn’s Disease, Ulcerative Colitis, Pernicious anemia, Vitiligo, and more.

6. Other members of your family have a thyroid condition
There is also a strong genetic link to Hashimoto’s and other autoimmune conditions. I often see autoimmune conditions being present in multiple members of the same family such as sisters, mothers and daughters. Remember, Hashimoto’s is much more common in females! If your family has a strong history of thyroid conditions, or a relative has been diagnosed with Hashimoto’s or other autoimmune condition, you’ll definitely want to pursue testing.

6. Your thyroid condition was first diagnosed at a young age or after the birth of a child
I often see Hashimoto’s being diagnosed more commonly in young women between 20 and 30 years old. Pregnancy and postpartum is another time where a change in hormones and the immune system can ignite an autoimmune thyroid condition.

The Bottom Line
If you have been previously diagnosed with hypothyroidism I encourage you to also have your thyroid antibodies checked to rule out Hashimoto’s Disease (Your MD or ND can do this). You’ll want to ask specifically for Thyroid Peroxidase Antibodies (AntiTPO) and Thyroglobulin Antibodies (TgAb).

You can also check out my other blog post here on what tests you need for a complete thyroid assessment.

Have questions? We’re here to help!

Dr. Katie Rothwell, ND

The 3 Thyroid Nutrients I Check In Every Single Patient

nutrient deficiency thyroid

Today I want to share 3 specific nutrients that I make sure to check in every single thyroid patient I see. These nutrients tend to be chronically low in most people with thyroid conditions and this alone can be a major contributing factor to symptoms like fatigue, brain fog, hair loss, muscle aches and more. The first step in many of my treatment plans is to improve these nutrients to optimal levels as it often gets people feeling better than they have in a long time!

1. Ferritin (Iron levels)

Hypothyroidism and low iron often go hand in hand. We can test your iron levels by looking at ferritin, a measure of iron stores in your body. The most common signs of low iron include fatigue, hair loss, feeling cold, weak or brittle nails, and palpitations or shortness of breath. Your thyroid also requires adequate iron levels for two key enzymes that are vital to thyroid hormone production and activation. Without iron, your thyroid just can’t function properly.

If you experience heavy menstrual periods (common with low thyroid function), are vegan/vegetarian, or have a chronic digestive disorder it’s even more important to have your ferritin assessed on a regular basis.

2. Vitamin B12

Vitamin B12 deficiency is frequently reported in those with thyroid conditions and I certainly see this in practice. A 2014 study stated that over 55% of patients with an autoimmune thyroid condition had low B12 levels. A series of Vitamin B12 injections often does wonders for thyroid patients in terms of energy levels, memory and concentration, as well as aches and pains.

We get most of our B12 from our diet in the form of animal products, so if you are vegan or vegetarian you should definitely have your B12 checked more often.

Another condition called Pernicious Anemia commonly co-exists with autoimmune thyroid disorders. If you have pernicious anemia your body is unable to absorb B12 from food sources and you will require supplementation long term.

3. Vitamin D

Most of us know that Vitamin D can be helpful for our immune system, but did you know that it is also an essential vitamin for preventing and healing thyroid conditions?

Low vitamin D levels have been implicated in the development, severity, AND progression of autoimmune thyroid conditions such as Hashimoto’s Disease and Grave’s disease. Vitamin D can also be anti-inflammatory for the thyroid and has a role in reducing thyroid specific antibodies.

Symptoms of Vitamin D deficiency include fatigue, muscle/joint pain, and frequent colds and infections. Our body makes its own Vitamin D but only with exposure to the sun. Many of us (especially as Canadians) are vitamin D deficient and require supplementation.

Test, don’t guess!
All of these important nutrients can be tested accurately with a simple blood test. Remember to check your labs carefully or review them with a knowledgeable health professional to make sure they are optimal, and not just falling within the ‘normal’ range. Your Medical Doctor or Naturopathic Doctor can run these tests, ideally alongside a full thyroid panel, which I talk about HERE.

Take good care!

Dr. Katie Rothwell, ND

 

References
https://www.ncbi.nlm.nih.gov/pubmed/24630032
https://www.ncbi.nlm.nih.gov/pubmed/19625225
https://www.ncbi.nlm.nih.gov/pubmed/19625225
https://www.ncbi.nlm.nih.gov/pubmed/25854833
https://www.ncbi.nlm.nih.gov/pubmed/24532520

Desiccated Thyroid: 5 Things You Need To Know

thermometer-temperature-fever-flu

Recently I’ve been getting a ton of questions about desiccated thyroid from my thyroid patients and as Naturopathic Doctors have recently gained access to the prescribing of this medication, it’s a great time to do some Q&A.

So, here’s the top 5 things you need to know about Natural Desiccated Thyroid (NDT)

1. What is desiccated thyroid? (NDT)
NDT is used for the treatment of low thyroid function. It’s considered a more natural form of thyroid medication and is sourced from porcine (pig) thyroid glands. NDT is NOT the same as natural thyroid “extracts” (the ones found online and in health food stores – these should be avoided!). NDT can be used in place of synthetic thyroid medications such as levothyroxine (T4) or cytomel (T3).

2. What is the difference between NDT and levothyroxine (Synthroid)?
Synthroid is the synthetic version of T4 which is only one of our thyroid hormones. NDT is sourced from actual thyroid glands and contains the full spectrum of thyroid hormones including T3, our most metabolically active thyroid hormone.

3. Where can I get desiccated thyroid?
NDT is available at most pharmacies by prescription only through your medical doctor or naturopathic doctor. In the US, desiccated thyroid is called armour thyroid or nature thyroid. Here in Canada, it’s referred to as desiccated thyroid, ERFA, or just plain ‘thyroid’. You don’t need to go to a compounded pharmacy to get desiccated thyroid.

4. My doctor says desiccated thyroid isn’t safe, is that true?
Historically there has been concerns about NDT doses not being standardized, meaning that one pill could have different amounts of hormone than the next. Because the thyroid gland is so sensitive to changes, this is definitely a serious concern! However, NDT is currently produced by only one manufacturer in Canada (a pharmaceutical company called ERFA) and is standardized to contain specific amounts of hormone in each tablet. Like any other pharmaceutical, it has a drug identification number (DIN) which means that it has been reviewed and approved by Health Canada. This also allows for quality control, inspections, and all the other regulations that go along with any pharmaceutical drug. In short, ERFA Thyroid is closely monitored for standardized dosing.

5. Is desiccated thyroid better than Synthroid?
This is a tough one and it really depends on the person and their current state of health. Some people do feel better on NDT due to the fact that it better represents our natural hormone production and contains T3, our most active thyroid hormone. There hasn’t been much research comparing the two, however a 2013 study compared levothyroxine to NDT and found that 49% preferred desiccated thyroid, 19% preferred levothyroxine, and 23% found no difference. So, while NDT may work well for many, it’s not for everyone.

Hope that helps!
Dr. Katie Rothwell, ND

Decode your Thyroid! Get your free guide to optimal thyroid hormones herePBOOK008

 

Resources:
Hoang TD et al Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: A randomized, double-blind, crossover study. J Clin Endo Metab 2013;98:1982-90. Epub March 28, 2013.

ERFA Pharmaceuticals www.eci2012.net/product/thyroid 

 

High Cholesterol? It Could Be Your Thyroid.

Cholesterol thyroid

Do you have high cholesterol? You may want to check your thyroid levels!

Earlier this year the U.S. Secretaries of Health and Agriculture joined the American Health Association in stating that dietary cholesterol (the kind we get from eggs and meat products, for example) is no longer a nutrient of concern. After 50 years of guidelines advising to reduce dietary cholesterol, there is simply no good research to suggest that there is a link between the cholesterol we eat and our blood cholesterol levels.

So, if our dietary intake of cholesterol doesn’t affect our levels, what does? While other foods are certainly worth investigating (like sugar!), your thyroid can also play a role.

Hypothyroidism (or low thyroid function) is a very common, but usually unrecognized cause of high cholesterol levels. Low thyroid function affects our ability to produce and metabolize fats in proper levels and can ultimately lead to elevated triglycerides, cholesterol, and LDL (the “bad” cholesterol). There is a clear relationship between thyroid function and cholesterol levels that has been reproduced in many clinical studies.


As thyroid function decreases, cholesterol levels increase


Why is this important?

Well for one, you may be unnecessarily prescribed statins or cholesterol-lowering medication when the root cause is actually your thyroid.

Once thyroid function is addressed and your labs are optimal (TSH, FT3 and FT4), cholesterol levels often return to normal and no further medication is required.

If your latest lab work reveals high cholesterol, have a complete thyroid panel run (NDs can do this!) to rule out low thyroid function, especially if you are experiencing any of the following symptoms:

  • Fatigue
  • Weight gain
  • Constipation
  • Feeling cold
  • Changes in hair, nails and/or skin
  • Brain fog or low mood

If you are already on thyroid medication and are having problems with high cholesterol, you may want to speak with your health professional to ensure that your medication type and dosage is right for you AND that it is resulting in proper levels of thyroid hormones in the body.

Check out my previous blog post here for more information on thyroid lab testing.

Questions? We’re here to help,

Dr. Katie Rothwell, ND

Resources
C.V RizosM.S Elisaf, and E.N Liberopoulos Effects of Thyroid Dysfunction on Lipid Profile. Open Cardiovasc Med J. 2011; 5: 76–84. Published online 2011 Feb

Are Low Iron Levels Sabotaging Your Thyroid Hormones?

Low iron thyroid

Iron Basics
Low iron is one of the most common things I see in women who walk through my door. It’s also one of the most common tests we run and we do this by looking at ferritin levels (a measure of iron stores in your body). The normal reference range for ferritin is anywhere from 10-291 ng/mL for women. Most often, if you’re not clinically anemic and your ferritin is within this range, you won’t be alerted to abnormal ferritin levels (even if they as low as 12, for example). However, recent studies show that women have improved energy and feel best with ferritin levels > 50, even if they’re not anemic.

Symptoms of Low Iron
Symptoms of low iron can include fatigue, low energy, hair loss, feeling cold, weak or brittle nails, palpitations or shortness of breath, brain fog and more. Many of these symptoms are also symptoms of low thyroid function or hypothyroidism. If you’ve been previously diagnosed with hypothyroidism and are still experiencing many of these symptoms, take the guess work out and have your ferritin levels checked.

Side note: If you experience heavy menstrual periods, are vegan/vegetarian, or have digestive disorders (such as celiac disease) that affect nutrient absorption, it’s also important to have your ferritin assessed on a regular basis.

The Iron-Thyroid Connection
Women are more likely to have low iron levels and we’re also more likely to have hypothyroidism or Hashimoto’s Disease (Lucky us!). We don’t usually think of iron as being essential to thyroid function, but it is!

Our thyroid needs adequate iron levels to produce the active hormones T4 and T3. If our body is low in iron, the enzyme responsible for this can be reduced in activity up to 50%. Iron is also essential to another key enzyme, which converts T4 into T3. (T3 is our most active thyroid hormone). If you are already on medication for your thyroid (such as Synthroid) having adequate iron levels is still important for converting the medication into active, usable, thyroid hormone.

There’s more: a very common symptom of hypothyroidism is low stomach acid, which decreases our ability to break down foods and absorb nutrients. Thus, a very common symptom of hypothyroidism is (you guessed it) low iron levels!

Low iron –> hypothyroidism –> low iron –> vicious cycle

So What Should My Ferritin Be?
For optimal energy and thyroid function, ferritin levels should be at or above 80 ng/mL. Hair loss or thinning can occur at levels less than 40. Anything below 30 is what I call “scraping the bottom of the iron bucket”. If your ferritin is really low, your thyroid won’t be functioning properly no matter what other medications or supplements you are taking. Most women I test ferritin levels on are somewhere between 20-50, and many are in need of some sort of iron support or supplementation. If you’ve been on iron in the past and have experienced digestive upset, constipation, or nausea, there are better supplements out there that don’t have these unwanted side effects and are more effective in bringing up iron levels.

That said, we also don’t want too much iron, as this can be harmful to the body. So supplement wisely and make sure to re-test your levels on a regular basis.

The Recap: 

  • Many symptoms of iron deficiency and hypothyroidism overlap. What you thought were low thyroid symptoms (such as fatigue and hair loss) could in fact, be due to low iron!
  • Your thyroid requires adequate iron levels for TWO key enzymes that are vital to hormone production and activation.
  • If you have low thyroid function or hypothyroidism, have your ferritin levels assessed and get a copy of the results. Use 80 ng/mL as a guide to optimal levels, although different people feel best at different levels.
  • Ask your Naturopathic Doctor about testing your ferritin levels and if needed, the best iron supplements to increase your levels quickly without causing you digestive upset.

Want more info on the thyroid tests you need? Check out my last blog post here

Take care!

Dr. Katie