What Are Thyroid Antibodies?

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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

 

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How To Exercise For Your Thyroid

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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

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Three reasons you still have symptoms on Synthroid

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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

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Desiccated Thyroid: An Update

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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

 

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

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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.

Screen Shot 2016-03-14 at 9.30.37 PM
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

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Hypothyroid affects fertility

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Our fertility patients often arrive at our office already knowing that there is a link to hypothyroid and infertility. The frustration usually comes from having some thyroid tests done, typically TSH and maybe T4, and it coming back within normal range and then doctors investigating any further and don’t consider treatment necessary.

Here is a study published in Endocrinology that explains why more testing is warranted, and maybe even treatment. This study found:

  • Infertile women with subclinical hypothyroidism treated with T4 Thyroxine had a shorter duration of infertility
  • 84.1% of they thyroxine group became pregnant while the untreated group remained infertile
  • 42% of all patients had anti-thyroid antibodies identified
  • TSH values ranged from 3.1 – 13.3 before treatment and were reduced to 0.02-3.75 after treatment (median values of 5.46 pre treatment and 1.25 post treatment)

In another study investigating subclinical hypothyroidism, thyroid autoimmunity and miscarriage rates, subclinical hypothyroidism was defined as a TSH higher than 2.5.

What does this mean for you?

Ask for further investigation with regards to your thyroid antibodies if you are struggling to become pregnant. If you TSH values are at the high end of normal, ask your doctor to try a course of thyroxine with you.

An Ontario ND can do further blood work for you if you cannot get it done through your regular doctor but cannot prescribe thyroxine.

Print off the study and ask your doctor to take a look at it for you.

Want to learn more about how we can help you? Book a free fertility assessment today.

Yours in Health,

Dr. Kerri Fullerton ND & Dr. Whitney Young ND

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