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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The 3 Thyroid Nutrients I Check In Every Single Patient

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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

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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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High Cholesterol? It Could Be Your Thyroid.

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Cholesterol thyroid

Do you have high cholesterol? You may want to check your thyroid levels!

Earlier this year the U.S. Secretaries of Health and Agriculture joined the American Health Association in stating that dietary cholesterol (the kind we get from eggs and meat products, for example) is no longer a nutrient of concern. After 50 years of guidelines advising to reduce dietary cholesterol, there is simply no good research to suggest that there is a link between the cholesterol we eat and our blood cholesterol levels.

So, if our dietary intake of cholesterol doesn’t affect our levels, what does? While other foods are certainly worth investigating (like sugar!), your thyroid can also play a role.

Hypothyroidism (or low thyroid function) is a very common, but usually unrecognized cause of high cholesterol levels. Low thyroid function affects our ability to produce and metabolize fats in proper levels and can ultimately lead to elevated triglycerides, cholesterol, and LDL (the “bad” cholesterol). There is a clear relationship between thyroid function and cholesterol levels that has been reproduced in many clinical studies.


As thyroid function decreases, cholesterol levels increase


Why is this important?
Well for one, you may be unnecessarily prescribed statins or cholesterol-lowering medication when the root cause is actually your thyroid.

Once thyroid function is addressed and your labs are optimal (TSH, FT3 and FT4), cholesterol levels often return to normal and no further medication is required.

If your latest lab work reveals high cholesterol, have a complete thyroid panel run (NDs can do this!) to rule out low thyroid function, especially if you are experiencing any of the following symptoms:

  • Fatigue
  • Weight gain
  • Constipation
  • Feeling cold
  • Changes in hair, nails and/or skin
  • Brain fog or low mood

If you are already on thyroid medication and are having problems with high cholesterol, you may want to speak with your health professional to ensure that your medication type and dosage is right for you AND that it is resulting in proper levels of thyroid hormones in the body.

Check out my previous blog post here for more information on thyroid lab testing.

Questions? We’re here to help,

Dr. Katie Rothwell, ND

Resources
C.V Rizos, M.S Elisaf, and E.N Liberopoulos Effects of Thyroid Dysfunction on Lipid Profile. Open Cardiovasc Med J. 2011; 5: 76–84. Published online 2011 Feb

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Are Low Iron Levels Sabotaging Your Thyroid Hormones?

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Low iron thyroid

Iron Basics
Low iron is one of the most common things I see in women who walk through my door. It’s also one of the most common tests we run and we do this by looking at ferritin levels (a measure of iron stores in your body). The normal reference range for ferritin is anywhere from 10-291 ng/mL for women. Most often, if you’re not clinically anemic and your ferritin is within this range, you won’t be alerted to abnormal ferritin levels (even if they as low as 12, for example). However, recent studies show that women have improved energy and feel best with ferritin levels > 50, even if they’re not anemic.

Symptoms of Low Iron
Symptoms of low iron can include fatigue, low energy, hair loss, feeling cold, weak or brittle nails, palpitations or shortness of breath, brain fog and more. Many of these symptoms are also symptoms of low thyroid function or hypothyroidism. If you’ve been previously diagnosed with hypothyroidism and are still experiencing many of these symptoms, take the guess work out and have your ferritin levels checked.

Side note: If you experience heavy menstrual periods, are vegan/vegetarian, or have digestive disorders (such as celiac disease) that affect nutrient absorption, it’s also important to have your ferritin assessed on a regular basis.

The Iron-Thyroid Connection
Women are more likely to have low iron levels and we’re also more likely to have hypothyroidism or Hashimoto’s Disease (Lucky us!). We don’t usually think of iron as being essential to thyroid function, but it is!

Our thyroid needs adequate iron levels to produce the active hormones T4 and T3. If our body is low in iron, the enzyme responsible for this can be reduced in activity up to 50%. Iron is also essential to another key enzyme, which converts T4 into T3. (T3 is our most active thyroid hormone). If you are already on medication for your thyroid (such as Synthroid) having adequate iron levels is still important for converting the medication into active, usable, thyroid hormone.

There’s more: a very common symptom of hypothyroidism is low stomach acid, which decreases our ability to break down foods and absorb nutrients. Thus, a very common symptom of hypothyroidism is (you guessed it) low iron levels!

Low iron –> hypothyroidism –> low iron –> vicious cycle

So What Should My Ferritin Be?
For optimal energy and thyroid function, ferritin levels should be at or above 80 ng/mL. Hair loss or thinning can occur at levels less than 40. Anything below 30 is what I call “scraping the bottom of the iron bucket”. If your ferritin is really low, your thyroid won’t be functioning properly no matter what other medications or supplements you are taking. Most women I test ferritin levels on are somewhere between 20-50, and many are in need of some sort of iron support or supplementation. If you’ve been on iron in the past and have experienced digestive upset, constipation, or nausea, there are better supplements out there that don’t have these unwanted side effects and are more effective in bringing up iron levels.

That said, we also don’t want too much iron, as this can be harmful to the body. So supplement wisely and make sure to re-test your levels on a regular basis.

The Recap: 

  • Many symptoms of iron deficiency and hypothyroidism overlap. What you thought were low thyroid symptoms (such as fatigue and hair loss) could in fact, be due to low iron!
  • Your thyroid requires adequate iron levels for TWO key enzymes that are vital to hormone production and activation.
  • If you have low thyroid function or hypothyroidism, have your ferritin levels assessed and get a copy of the results. Use 80 ng/mL as a guide to optimal levels, although different people feel best at different levels.
  • Ask your Naturopathic Doctor about testing your ferritin levels and if needed, the best iron supplements to increase your levels quickly without causing you digestive upset.

Want more info on the thyroid tests you need? Check out my last blog post here

Take care!

Dr. Katie

 

 

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