Thyroid Disease: One Size Fits All Does not Serve For All
When it comes to giving guidance around an illness, it must be clear that “one size fits all” does not work. But when the topic under consideration is thyroid diseases, what does it really mean?
Table of Contents
- 1 The concept of thyroid diseases
- 2 Diagnosis of thyroid diseases
- 3 End of discussion!
- 4 Treatment of thyroid diseases
- 5 Functional medicine and its treatment vision
- 6 Final words about thyroid diseases
The concept of thyroid diseases
First, it means that “one size fits all” does not apply in general to the concept of thyroid diseases.
- Hyperthyroidism: It is an overactive thyroid, often accompanied by anxiety and weight loss. Hyperthyroidism can range from extreme/subclinical to thyroid crisis or storm. One of the diseases of the thyroid, whose consequence is deadly if the patient is not taken care of
- Hypothyroidism – Hypoactive thyroid– Often characterized by weight gain, fatigue, and depression. In some people, it is a mild discomfort easily treated. For others, however, it is a debilitating chronic disease, a life changes difficult to treat and to accept.
- Goiter and/or nodules: They may be small, asymptomatic, very slow growing or rapidly growing, and interfere with breathing and swallowing.
- Thyroid cancer: it is often diagnosed without symptoms. For thyroid cancer, the prognosis is small in size and encapsulated. Papillary thyroid cancer has one of the highest survival rates. In contrast, advanced medullary or anaplastic thyroid cancers are difficult to treat and can be fatal. Also, keep in mind that some patients are discharged one day after thyroid surgery. While others have complications, damage to the laryngeal nerve and longer recovery periods.
The point is, that many and different conditions are grouped under the term thyroid diseases, which in fact are very different:
- Hashimoto’s hypothyroidism.
- Graves’ disease.
- Thyroid nodules.
- Thyroid cancer.
Diagnosis of thyroid diseases
Second, while the treatment is a problem for some conventional endocrinologists, for many patients and professionals, it is clear that “one treatment is not good for everyone” in the diagnosis of thyroid diseases. Official “guidelines” for the diagnosis of thyroid problems, either by overproduction or by the deficit, for example, rely almost exclusively on thyroid stimulating hormone (TSH) levels.
In short, conventional wisdom assumes that TSH above 5.0 is “subclinical hypothyroidism” (which may or may not warrant treatment) and TSH above 10.0 constitutes overt hypothyroidism and warrants treatment. A TSH below 0.5 is hyperthyroidism and may warrant treatment.
End of discussion!
This one-size-fits-all approach is leaving millions undiagnosed. The American Thyroid Association estimates that 12 million Americans are left undiagnosed for their thyroid disorders. Even among conventional endocrinologists who consider TSH the “gold standard”, there is still a high degree of variability in the way they diagnose thyroid diseases.
Some of these physicians consider that the reference range for the TSH test should be narrower, with diagnosis and treatment according to lower values. In fact, this issue has been the subject of controversy for more than a decade.
Tests to detect thyroid diseases
Some doctors believe that the cause of thyroid imbalance may be an underlying disease. Hence they ask for antithyroid antibody tests to identify Hashimoto’s disease and Graves’ disease, which can cause symptoms before TSH, T4, and T3 reflect thyroid dysfunction.
There is also evidence that treatment of Hashimoto’s autoimmune thyroiditis – with normal levels of TSH but with elevated thyroid peroxidase (TPO) antibodies – may help prevent progression to manifest hypothyroidism.
With the help of imaging, some doctors also routinely order a thyroid ultrasound for people with autoimmune thyroid disease, looking for:
- Goiter (enlarged thyroid).
- Irregularity in the thyroid gland.
- The existence of thyroid nodules.
Functional medicine and thyroid disease screening
Functional physicians and hormone experts often use a much more complex approach to the diagnosis of thyroid problems. They believe that the TSH test can sometimes be imperfect (due to testing, storage, and distribution conditions).
That the measurement of a pituitary hormone such as TSH does not necessarily reflect the actual circulating thyroid hormones (thyroxine / T4 and triiodothyronine / T3) whose excess or deficiencies cause the symptoms. To this end, they perform free T4 and free T3 tests to measure the unconsolidated, available amounts of these thyroid hormones. Many doctors also include antithyroid antibody tests to detect autoimmune diseases.
Others also include reverse T3. To assess the amount of T3 inactive in the bloodstream, it can block the body’s ability to properly use T3.
When it comes to identifying a thyroid nodule that may be cancerous, some cutting-edge professionals use thyroid analysis states from the company Veracyte, which can provide a definitive assessment of whether a lump is cancerous or not.
Others rely on the more traditional fine needle aspiration (FNAB) process, whose inconclusive or indeterminate rates are higher. Often, these inconclusive nodules end up in an unnecessary total thyroidectomy, because later it is demonstrated that there was no thyroid cancer. However, the patient is bitten to suffer permanent hypothyroidism.
Alternative Medicine and Tests for Thyroid Disease
However, in alternative medicine, there is an unhelpful trend towards a unique approach to the diagnosis of thyroid disease in some professionals. For example, some alternative doctors randomly diagnose thyroid diseases – in particular, hypothyroidism – without blood tests, medical history, or even a clinical thyroid exam.
Some rely on inconclusive controls such as “basal body temperature,” ridiculous tests like iodine paint on a patient’s arm, or the claim that anyone with fatigue and weight gain is due to hypothyroidism. And the idea that all overweight or tired people have hypothyroidism – regardless of blood tests – is a “one size fits all” idea from the world of alternative medicine that does not serve patients, Or to the credibility of these professionals.
Treatment of thyroid diseases
Treatment for hyperthyroidism
Third, as far as treatments, this is an area where definitely “one size fits all” does not fit all. No matter how much the experts insist on treating it like that. For hyperthyroidism and Graves ‘ disease, endocrinologists in the US Often recommend radioactive iodine ablation (RAI). A treatment that permanently removes the thyroid gland. Causing the patient to suffer hypothyroidism for life!
Open minded doctors consider the severity of the disease, symptoms and patient history, and usually include antithyroid drugs – especially methimazole (Tapazole) – as an option. A percentage of patients taking antithyroid medications have temporary or permanent remission of Graves’ disease and do not require RAI or surgery. Avoiding this, suffer hypothyroidism the rest of your life.
On the holistic front, some doctors are succeeding with supplements that slow down the thyroid or modulate the immune system, dietary changes (such as the gluten- free diet ), and even the use of low doses of drugs such as naltrexone. It has been shown to reduce antibodies in some thyroid patients.
Treatment of thyroid cancer
For thyroid cancer, there are also differences in terms of treatments. The typical treatment for most thyroid cancers is surgical removal of the entire gland. Secondly, the radioactive ablation, followed by an increase in the suppressive dose of the thyroid hormone replacement. And finally the periodic examinations – outside the thyroid medication – to detect possible recurrence.
But increasingly, for very small and encapsulated thyroid cancers, some doctors advise a “wait and see” follow-up approach, rather than the more invasive thyroidectomy. Or, depending on the nature and extent of cancer, thyroidectomy is performed, but without radioactive iodine (RAI) ablation.
There are also different ideas about whether suppressive doses of thyroid medications are needed. Or how often analysis is needed to assess the presence of a cancer recurrence.
Unique size for hypothyroidism?
In any disease, the ineffectiveness of the idea of ”one size fits all” is more evident than in the treatment of hypothyroidism. “One size fits all” guidelines prescribe levothyroxine (synthetic T4) for all standards as a treatment to reestablish the patient’s “normal reference range.” But even within this narrow framework of treatment, there are differences.
Some professionals prefer that patients use only one brand of levothyroxine (such as Synthroid, Levoxyl, Levothroid, etc.) and others believe that the drugs are mostly interchangeable. Many doctors are unaware of a new brand of levothyroxine, Tirosint, a hypoallergenic liquid form of levothyroxine.
When presented in capsule, it is believed that it is better absorbed than the tablets. As for the dose, some doctors prescribe doses to their patients with the goal of reaching half of the reference range of TSH. Others believe that what is best for the patient is the lower end of the range.
And others say that the controversial risk of osteoporosis ensures that patients stay at the upper end of the reference range.
Functional medicine and its treatment vision
Holistic practitioners here are somewhat ambivalent, while some consider that the mantra “one size fits all” does not work, others adopt it.
Holistic doctors who do not support the mantra
Professionals who have adopted the functional vision of medicine tend to be much more open to alternatives to prescribing – including T3 and naturally dried thyroid – to treat hypothyroidism. They generally consider that the ideal replacement thyroid hormone is the one that works best and safely for each patient.
This means that patients can receive prescriptions of:
- Levothyroxine-type medications.
- Levothyroxine with synthetic T3 included (Liothyronine, brand name Cytomel).
- Levothyroxine with natural desiccated thyroid (ie Armor Thyroid, Nature-Thyroid, or generic natural thyroid).
- Medications of the natural dried thyroid (ie Armor Thyroid, Nature-Thyroid, or generic natural thyroid).
- Natural dried thyroid (ie, Armor Thyroid, Nature-Thyroid, or generic natural thyroid), with synthetic T3 included (liothyronine, brand Cytomel).
- Free T3 regimen – liothyronine (brand name Cytomel), or combined.
- A custom formulation that includes any of the above drugs.
Functional physicians also often try to treat other deficiencies – including ferritin and vitamin D, for example – that may affect the thyroid or immune system.
Some doctors are succeeding with supplements that lower the antibodies or modulate the immune system (ie, selenium, anatabine). As well as changes in diet (such as the gluten-free diet), and even the use of low doses of drugs such as naltrexone, which has been shown to reduce antibodies and achieve Hashimoto remission in some patients.
Holistic doctors who give approval to “one size fits all”
However, the mantra “one size fits all” has an unwanted point of support between some holistic and comprehensive practitioners, and some patients. For example, some physicians automatically assume that anyone with thyroid disease – regardless of the type of problem – needs to take iodine supplements, sometimes even megadoses of iodine.
While iodine is a basic component of thyroid hormone, prescribing iodine to some thyroid patients can make your condition significantly worse.
Some other claims that practitioners and patients allege about the “one size fits all” include:
- Synthetic thyroid drugs are bad/dangerous / ineffective.
- All patients with hypothyroidism only improved with natural drugs dried for the thyroid.
- Anyone suffering from hypothyroidism also has adrenal insufficiency.
- All patients with hypothyroidism should take cortisol to the adrenal glands
- Anyone with hypothyroidism has candidiasis.
- All patients with hypothyroidism have toxic levels of heavy metals (eg, mercury).
- Anyone suffering from hypothyroidism should remove mercury fillings.
- Patients with hypothyroidism should make coffee enemas.
This list is just the tip of the iceberg. The truth is that each person has their own combination of underlying factors and issues, and, again, when it comes to diagnosing thyroid disease, treatment, and other related issues, “one size fits all” does not work for everybody! What works for one patient does not necessarily work for another.
Final words about thyroid diseases
Remember: Any person or thing – be it an endocrinologist, a holistic doctor, a chiropractor, the herbalist’s employee, a patient advocate, a Twitter tweet, a book, a blog, a seminar, a celebrity, Renowned magazine, the latest video for thyroid cure, an ebook, or even your best friend – that claims to have a diagnostic approach, a proven response, an incredible solution, a cure, a supplement, a diet Miracle, a diet plan, a food or a drug that works for everyone is simply…
…A big lie! Especially if it’s thyroid disease, “one size fits all” does not work.
I would appreciate it if you consider that the same treatment should be applied to thyroid diseases!
Thanks for the more than 2000 words you have read so you can get here !!!