The disease process for Hashimoto’s is a spectrum, and not all patients require treatment. Some patients have autoimmune antibodies but retain enough thyroid function without the need for intervention for years. Generally, once the body can no longer produce an adequate amount of thyroid hormone for necessary physiological functions, thyroid replacement medication is necessary to correct the hormonal imbalances associated with hypothyroidism.

Other noticeable effects of hypothyroidism include moodiness and a sluggish metabolism. Essentially when your thyroid is underactive your metabolism will slow down, which might mean you always feel tired or struggle to keep off weight. Your mood is especially susceptible to changes in hormone levels, so some people with hypothyroidism wind up dealing with depression, anxiety, trouble getting good sleep, and low immunity. The thyroid gland helps regulate chemical messengers called neurotransmitters that control your emotions and nerve signaling, which is the reason an out-of-balance thyroid can mean drastic emotional changes at times.


Hypothyroidism can be easily treated with thyroid hormone replacement. The preferred treatment for most people with an underactive thyroid is levothyroxine sodium (Levoxyl, Synthroid). This is a more stable form of thyroid hormone and requires once a day dosing.Liothyronine sodium (Cytomel) also may be prescribed to treat hypothyroidism under certain conditions.
l-Thyroxine was the first synthetic molecule used to treat hypothyroidism (23) and was shown to be efficacious as monotherapy for myxedema (24). Around that time, serum protein-bound iodine (PBI) emerged as a diagnostic test and therapeutic marker; serum PBI quantitation was the only valid way to biochemically assess thyroid hormone status (25). This tool was limited in terms of treatment monitoring because the effect on serum PBI varied by agent (26). For example, l-triiodothyronine corrected BMR without much increase in serum PBI, l-thyroxine increased serum PBI sometimes to above normal, and combination l-thyroxine and l-triiodothyronine and desiccated thyroid had the advantage of normalizing serum PBI (27). In addition to BMR and serum PBI, other surrogates for treatment response included cholesterol levels, symptoms, and deep tendon reflexes, but their lack of sensitivity was always recognized (28).
Lifeworks Wellness Center is long recognized as one of the foremost natural health clinics in the US. At our Tampa Bay, Florida alternative medicine office we have been offering treatment for underactive thyroid for a long time and many of our patients have benefitted from it. The patients fly in from all over the world because they simply can’t find clinics offering natural treatments for underactive thyroid and natural medicine for low thyroid where they live.
l-Thyroxine was the first synthetic molecule used to treat hypothyroidism (23) and was shown to be efficacious as monotherapy for myxedema (24). Around that time, serum protein-bound iodine (PBI) emerged as a diagnostic test and therapeutic marker; serum PBI quantitation was the only valid way to biochemically assess thyroid hormone status (25). This tool was limited in terms of treatment monitoring because the effect on serum PBI varied by agent (26). For example, l-triiodothyronine corrected BMR without much increase in serum PBI, l-thyroxine increased serum PBI sometimes to above normal, and combination l-thyroxine and l-triiodothyronine and desiccated thyroid had the advantage of normalizing serum PBI (27). In addition to BMR and serum PBI, other surrogates for treatment response included cholesterol levels, symptoms, and deep tendon reflexes, but their lack of sensitivity was always recognized (28).
A clinical trial investigating symptoms found that patients receiving l-thyroxine monotherapy, even with a normal TSH, displayed substantial impairment in psychological well-being compared with controls of similar age and sex (3). Because some hypothesized that this phenomenon came about only after adoption of l-thyroxine monotherapy, a study assessed combination therapy with l-thyroxine and l-triiodothyronine. Remarkably, the latter study showed that psychological measures improve in patients receiving combination therapy until serum TSH level is normal (6). In another study comparing l-thyroxine monotherapy versus desiccated thyroid, in which both groups had a normal TSH, many patients preferred desiccated thyroid and lost weight (60). Unfortunately, the solution to this complex problem is not as simple as reverting to combination therapy; the more than a dozen clinical trials on the subject have not shown benefit of superiority and preference for combination therapy, as previously reviewed (1, 3, 70).
Characteristic symptoms and physical signs, which can be detected by a physician, can signal hypothyroidism. However, the condition may develop so slowly that many patients do not realize that their body has changed, so it is critically important to perform diagnostic laboratory tests to confirm the diagnosis and to determine the cause of hypothyroidism. A primary care physician may make the diagnosis of hypothyroidism, but assistance is often needed from an endocrinologist, a physician who is a specialist in thyroid diseases.
Dr. Josh Axe is a certified doctor of natural medicine, doctor of chiropractic, and clinical nutritionist with a passion to help people get healthy by using food as medicine. Dr. Axe has created one of the top 10 most visited natural health websites in the world at www.DrAxe.com which has over 15 million monthly visitors. Dr. Axe has been a physician for many professional athletes. In 2009, he began working with the Wellness Advisory Council and Professional Swim Teams. He worked with professional swimmers, including Ryan Lochte and Peter Vanderkaay, providing nutritional advice and musculoskeletal work on the athletes to increase their performance. He also traveled to the 2012 Games in London to work with USA athletes. Dr. Axe has authored several books including his new book Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems and 5 Surprising Steps to Cure It.
If you have been diagnosed with both hypothyroidism and iodine deficiency, there are some things you can do to make these vegetables less harmful. Cooking them can reduce the effect that cruciferous vegetables have on the thyroid gland, and limiting your intake of these (cooked) vegetables to 5 ounces a day may help as well, since that amount appears to have no adverse effect on thyroid function.

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