What Are Thyroid Antibodies?

By //  by 

thyroid antibodies

What Are Thyroid Antibodies?

Unless you’ve been in a biology or immunology class recently, you may not be familiar with antibodies. Antibodies are a normal part of our immune system. Your body makes them in order to “tag” or “mark” foreign bacteria or viruses that are harmful. Once tagged, your immune system can recognize these foreign invaders and fight them off.

The antibodies that occur in Hashimoto’s Disease (or any other autoimmune disease) are different. They are AUTO-antibodies. Which means that they are ‘marking’ your own thyroid tissue. This isn’t good – we don’t want your immune system attacking your own body!

Essentially, elevated thyroid antibodies indicate that your immune system has targeted the thyroid gland for destruction. Over time, this can damage your thyroid tissue and make it impossible for your body to produce its own hormones.

What do Thyroid Antibodies Mean? 

Thyroid antibodies are the most important tests to diagnose Hashimoto’s disease. If you test positive for one or both of these antibodies, you have Hashimoto’s disease.

  1. Thyroid Peroxidase Antibodies (TPOAb) – present in approximately 90% of those with Hashimoto’s disease
  2. Thyroglobulin Antibodies (TgAb) – present in approximately 80% of those with Hashimoto’s disease.

If you haven’t already done so, I recommend testing your antibodies if you already have or suspect hypothyroidism. Hashimoto’s disease isn’t just hypothyroidism – it’s an autoimmune disease, and needs to be treated as an autoimmune disease!

The First Thing You Should Do When You Find Out You Have Thyroid Antibodies…

It’s important to know that Hashimoto’s disease does have a genetic link. So, it’s very common to see Hashimoto’s present in multiple family members (typically females). For that reason, when I have a patient with positive antibodies one of the first things I tell them is to talk to their family. Tell your mother, sisters, daughters, and aunts to have their thyroid antibodies tested as well, especially if they already know they have low thyroid function. The sooner we can identify antibodies and regulate the immune response, the more likely it is that we will be able to prevent damage to the thyroid gland. BUT, just because a relative has Hashimoto’s doesn’t mean you’re destined for it too. Genes only play a part of the picture!

Have more questions about thyroid antibodies? Let me know!

Dr. Katie Rothwell, ND

 

What Are Thyroid Antibodies?Read More

How To Exercise For Your Thyroid

By //  by 

how to exercise thyroid

Is your current exercise routine sabotaging your thyroid health?

If you have a thyroid condition, you may be experiencing one or more of the following when it comes to exercise:

  • You’re exhausted and can’t imagine attempting exercise or even making it to the gym
  • You’re making exercise a regular habit but you find that it takes you forever to recover and you experience lots of muscle or joint pain afterward
  • You’re working out like crazy and are beyond frustrated that your best efforts at the gym aren’t getting you any closer to your goals

If any of the above sounds familiar, read on!

Hypothyroidism or Hashimoto’s Disease can make exercise a challenge. Why? A low thyroid also means a low metabolism. Even if you’re taking medication and your thyroid labs are “normal” your metabolism could still be suffering.

First and foremost is to make sure your thyroid labs (especially your free T3) are optimal so you have the stamina and energy to make it through your day AND get some exercise in. With optimal labs you will also recover faster from exercise and experience less muscle and joint pain.

Secondly, (and this is the important part!) the type and length of exercise can make a big difference for hypothyroid folks.

Did you know that high intensity or extended periods of exercise can actually lower your Free T3 (your most active thyroid hormone) and increases your Reverse T3?

This combination is like a big brake pedal for your thyroid gland telling it so slooow down. For people with low thyroid function, this is the opposite of what we want!

Here are some questions to ask yourself to help decide if your current exercise plan is right for you:

  1. How do you feel during exercise?
    If at any time you feel dizzy, lightheaded or fatigued during exercise it may be too strenuous.
  2. How do you feel after?
    After exercise, you should feel energized and upbeat due to the positive endorphins that are released with physical activity. If you’re feeling sore, exhausted, or like you need a nap, you may need to dial back the intensity of your workouts.
  3. Could you do the same exercise again?
    If the answer is yes, you’re exercising at the sweet spot of intensity (not too low and not too high)
  4. Do you enjoy it?
    Please, pick something you actually enjoy! Exercise doesn’t have to mean slugging it out at the gym day after day. Walking, hiking, yoga, biking, karate, swimming or mowing the lawn are all wonderful ways to move your body.

Here are my general recommendations on how to exercise for your thyroid:

  • Keep your exercise at a low to moderate intensity (less than 75% of your maximum heart rate) for approximately 30-40 minutes.
  • Avoid high-intensity cardio or extended periods of exercise. Don’t over do it – your body will interpret this as stress and will slow down your metabolism even more to conserve energy. Exercises to think twice about would include marathons, high-intensity spinning, or aggressive HIIT training.
  • Build muscle! Cardio is not king in the thyroid world. More muscle = better metabolism.
  • Listen to your body. If you feel good both during and after exercise, it’s likely a good choice for you.

Have questions? Book your Free Thyroid Assessment to learn more!

Dr. Katie Rothwell, ND

References:
https://www.ncbi.nlm.nih.gov/pubmed/16175498

How To Exercise For Your ThyroidRead More

Three reasons you still have symptoms on Synthroid

By //  by 

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

Three reasons you still have symptoms on SynthroidRead More

Seven Signs This Common Condition Is Causing Your Thyroid Disorder

By //  by 

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

Seven Signs This Common Condition Is Causing Your Thyroid DisorderRead More

The 3 Thyroid Nutrients I Check In Every Single Patient

By //  by 

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

The 3 Thyroid Nutrients I Check In Every Single PatientRead More

Desiccated Thyroid: An Update

By //  by 

desiccated thyroid

Updated March 2019

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 are 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 and hypothyroidism. 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 some 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 T4 and T3 (which is our most metabolically active thyroid hormone). Many of the benefits of NDT come from the addition of the T3 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 also called armour thyroid or nature thyroid. In Canada, there are 2 sources of desiccated thyroid, ERFA Thyroid and Compounded Desiccated Thyroid. ERFA thyroid is produced in 30mg, 60mg, and 125mg tablets, is available at almost any pharmacy, and is considered the ‘generic’ form. Compounded desiccated thyroid is produced by Medisca and is only available through compounding pharmacies. It is a powdered form that can be made into any dosage and is prescribed in capsule form.

So what form is best? 
I use primarily compounded desiccated thyroid in my practice. This form has less fillers (like cornstarch) that are found in the generic brand. As well, Medisca provides a certificate of analysis with each produced batch, so I can guarantee my patients that they are getting a standardized and consistent dose. It also gives us dosing flexibility, so we can get creative and really fine tune doses if (for example) a patient needed 77.5mg of NDT – no problem!

4. My doctor says desiccated thyroid isn’t safe, is that true?
Historically there have 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 2 manufacturers in Canada and 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. As stated above, I monitor each ‘batch’ of compounded NDT to ensure my patients are getting the same standardized dosing.

5. Is desiccated thyroid better than Synthroid?
Well, it all depends on the person and their current state of health. Many people do feel better on NDT due to the addition of T3, our most active thyroid hormone. Others hypothesize that NDT is superior because it also contains two other lesser known thyroid hormones (T1 and T2). Unfortunately, quality research comparing NDT and other forms of T4 and T4/T3 combination medications is limited. A 2013 study compared levothyroxine to NDT and found that 49% preferred desiccated thyroid, 19% preferred levothyroxine, and 23% found no difference.

What I see in practice
After years of prescribing and working with desiccated thyroid, the vast majority of my patients feel superior on NDT. Improvements in energy, body temperature, hair growth, sleep, skin, mood, metabolism, and more have all been reported. Most of my patients notice a difference in as little as 1-2 weeks, and symptoms continue to improve over the course of 3-6 months while we finesse their dose.

Have more NDT questions? Book a free thyroid assessment with me here

– Your Thyroid ND
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

 

Desiccated Thyroid: An UpdateRead More