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 

 

The Thyroid Tests You Need (and what they mean!)

The thyroid Tests You Need (2)

Last week I had a patient come in with a story that I hear way too often. She had recently been to her family doc for a number of concerns including fatigue, weight gain, and constipation. She has a history of hypothyroidism and so had some blood work done to test her hormone levels. However, when her blood work came back everything was reported as normal. Understandably, she was both frustrated and confused about what was going on in her body. Sound familiar?

If you’re convinced your thyroid isn’t functioning properly but all your lab work comes back “normal”, you might not be getting the whole picture! These are the thyroid tests you need to fully assess thyroid function.


TSH (Thyroid Stimulating Hormone)
What it is: TSH is the most common hormone that is tested to assess thyroid function. Often this is the only test done which is just not sufficient, especially if you are experiencing symptoms of low thyroid function.

What it does: TSH is produced by the pituitary gland in the brain and tells our thyroid to secrete more thyroid hormones (T4 and T3)

Why it’s important: TSH is a general measure of thyroid function. NDs like to see this value in a very narrow range, from about 1.0-2.0. The conventional medical system uses a range from 0.30 – 4.0, but we often see people with symptoms of thyroid dysfunction within this range.

Free T4 (Thyroxine)

What it is: T4 is the main hormone produce by the thyroid gland. Free T4 is the amount of available or ‘active’ T4 in the body. Although there is more T4 in the body than T3, only around 10% of the T4 we have is metabolically active.

What it does: T4 is converted to T3, which is used by the cells of our body to increase metabolism and energy.

Why it’s important: Indicates if the thyroid is producing hormones at the right level.

Free T3 (Triiodothyronine)
What it is: The most active thyroid hormone and the best marker for monitoring thyroid function, clinical symptoms, and treatment.

What it does: T3 is “the gas” that acts on the cells of the body to increase metabolism, energy, and growth. When your T3 is low, you will likely be feeling symptoms of hypothyroidism regardless of what your T4 and TSH levels are.

Why it’s important: Indicates if T4 is converting properly to T3, and if there are high enough levels of active thyroid hormones present in our cells. This is a widely overlooked test that absolutely needs to be included as part as a thorough thyroid panel. I find this lab value best correlates to how patients are feeling day to day.

Reverse T3 (RT3)
What it is: RT3 is the inactive form of T3, which is formed from T4 under certain conditions (such as stress)

What it does: This is “the break”, as it blocks T3 from doing its job correctly.

Why it’s important: Can be increased due to factors such as stress, obesity and inflammation. If RT3 is high, other thyroid lab values can be normal but you can still be symptomatic.

Thyroid Antibodies (TPOAb, TGBAb, TSI)
What they are: Antibodies are produced by our immune system and attack the thyroid gland directly, affecting its ability to function. These include Thyroid Peroxidase Antibodies (TPO Ab), Thyroid Stimulating Immunoglobulin (TSI), and Thyroglobulin Antibodies (TGB Ab).

What it does: The presence of these suggest inflammation and destruction of the thyroid gland, as part of an autoimmune thyroid condition, such as Hashimoto’s or Grave’s disease.

Why it’s important: The presence of antibodies indicates an autoimmune (and therefore, inflammatory) process. Current statistics state that autoimmune hypothyroidism is responsible for up to 90% of all cases of hypothyroidism in women! Autoimmunity is essential to rule in or out, as this greatly changes the way we as Naturopathic Doctors treat thyroid conditions.

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Our Thyroid Hormones

Other:
The thyroid is greatly affected by other hormones, nutrients, and vitamins. Other lab tests that may be important include Vitamin D, ferritin (iron stores), estrogen, progesterone, and cortisol. Stay tuned for future posts on how these factors directly affect thyroid function.

If you suspect your thyroid isn’t functioning properly or are currently on thyroid medication but still aren’t feeling well, a full thyroid panel investigating all of the above values can not only help reveal what’s really going on but can also guide the best treatment protocol for you and your body.

Got questions? We’re here to help.

Dr. Katie

Confused about Food Sensitivities? Here’s the Deal…

Food allergies vs. intolerances vs. sensitivities. What’s the difference and why does it matter?

The terms food sensitivities, intolerances and allergies are often confused or (incorrectly) used interchangeably. When Naturopathic Doctors are investigating digestive concerns, we use all three of these terms to determine what might be causing your symptoms and how to best to test for and treat them.

food-breakfast-egg-milk

Eggs, dairy, and wheat are three of the most common food sensitivities we see clinically!

Food Allergies
A true food allergy occurs when the immune system responds immediately to a particular food. Common food allergies include peanuts or shellfish. Symptoms can include hives, shortness of breath, or anaphylaxis and typically present within minutes after ingestion. Testing for immediate-type food allergies is typically unnecessary as it is usually readily apparent which food caused the problem. If testing is needed it is done via skin prick or blood testing. Food allergies usually need to be avoided life long, however some children do out grow them over time.

Food Sensitivities
Food sensitivities are also caused by an immune system reaction, but instead of an immediate reaction they cause delayed symptoms which can appear anywhere from hours to days after ingestion. These symptoms can include digestive complaints such as bloating and constipation, as well as non-digestive complaints such as headaches, fatigue, skin concerns, and joint pain. Identifying food sensitivities can be difficult due to the delayed nature of their symptoms. A supervised elimination type diet or specialized blood testing through your naturopathic doctor are the most effective ways to identify food sensitivities. Generally, food sensitivities are avoided or eliminated from the diet for several months and then gradually reintroduced following a gut-healing protocol.

Food Intolerances
Intolerances (unlike allergies and sensitivities) are NOT due to the immune system reacting to food. Instead, they are typically due to the body not being able to properly digest, absorb, or metabolize certain foods. The most common example of this is a lactose intolerance, in which the body does not produce the lactase enzyme. This stops the body from breaking down and digesting lactose or milk products and results in symptoms like bloating, flatulence, cramping, pain and diarrhea. You can reduce the uncomfortable symptoms of food intolerances by supplementing with the enzymes your body is lacking (for example: lactase pills) or avoiding the food all together.

The digestive system (or ‘the gut’ as we fondly refer to it as) is vital to overall health. As many of our patients can attest to, a poorly functioning gut can result in a variety of health concerns and chronic complaints down the line. 

If you’re frustrated with confusing food reactions, random symptoms, and can’t seem to identify what the problem is, it is important to have yourself properly assessed and tested by a qualified professional. You could have an allergy, sensitivity, intolerance, or any combination of the three!

Still have questions? Let us know, we’re here to help!

Dr. Katie