Difficult thyroid disease

In the minds of most endocrinologists, hypothyroidism is easy.

Unlike adrenal disease, where making a diagnosis of, say, Cushing’s Disease, can be a long and complex process, thyroid blood tests are precise, simple, and clear cut. The treatment is straightforward and completely effective – in the minds of most endocrinologists.  I know this, because I’ve been there.

Thirty years ago I worked in the endocrine unit at St Thomas Hospital. GPs referred hypothyroid patients to us for specialist investigation. Either the doctors were not sure whether the patients actually had thyroid disease, or there were unusual test results, or the patients were not satisfied with being told ‘Your tests are normal’. They were dissatisfied for the simple reason that they still felt unwell.

We did all the necessary tests, either confirmed the diagnosis and gave them thyroxin until the tests were satisfactory, or told them that their tests were normal and sent them off. They were seldom the subject of high-powered meetings and case discussions like the patients with adrenal or reproductive disease. Even when they still felt unwell.

It is true that some people, perhaps a bit more than half of the patients,  responded perfectly; they improved quickly, felt good on thyroxin, and stayed fine on a stable dose for years. Others, however, probably a third, felt little better despite the thyroxin. We sent them back to their doctors satisfied that we had done a good job, because we had done all the right tests, and we had returned any abnormal results to the normal range. Any remaining symptoms had to be ‘all in their heads’. It was not our fault that they still felt unwell – and not our job to make them better!

Had we done a good job for these people? Had we actually helped them? Had we solved – or even diminished their problems? Our whole department was very satisfied that we had. We were a centre of clinical excellence!

These questions, among others, drove me to leave hospital medicine, and in 1988 I started a practice with the intention of improving people’s health to its highest state – whatever it took. I defined my role as helping people to feel really well.

Today my aim is the same (I have redefined my job to include generating self-sustaining health for people), and with the benefit of 27 years’ experience, I can tell you that hypothyroidism can be a very complex condition, a master of disguise, a symptom screen that can hide many other disorders – it is not a one-trick pony!

The biggest lesson I have learned is that hypothyroidism almost never exists on its own. It is usually the result of non-thyroid imbalances and disorders in the body. In Hashimoto’s Thyroiditis an autoimmune disorder, there are always other organs and systems involved.

• Did you know that hypothyroidism can present as hypertension, or as atrial fibrillation?
• Did you know that anything from heavy metal toxicity to intestinal dysbiosis, from chronic inflammation to chronic viral illness can masquerade behind hypothyroidism?
• Did you realise that poor adrenal function and food sensitivities are among the many confounding and contributing factors that stop people feeling well when their thyroid hormone levels are ‘normal’?

When these problems exist, thyroid hormone replacement, even with the most individually compatible product, will often produce only a partial response. You may feel better, even much better than you did, yet you are not 100 per cent and you know it.

‘I’m so much better than I was! I can function! If this is as good as it gets, I can live with it.’ Many people think this way, not realising how much they are missing.

Excellent health feels really great, and you may have forgotten just how good it feels. The good feeling comes from  your genes, which are rewarding you for treating them properly.
Feeling good is an inducement to stay totally well, so that you have maximum resistance against all illnesses, even those that ‘run in the family’.

Getting on to the right dose of the right thyroid hormone product for your unique system is an essential step in restoring good health. Some people do best on thyroid extracts (NDT), some do best on T4 plus T3 (purified, compounded versions) and many people are perfectly fine on ordinary thyroxin alone – once all the non-thyroid factors have been corrected.

But thyroid hormone is only the first step. Finding the non-thyroid root causes of the problem, and treating them with personalised lifestyle medicine completes the recovery. This is the process that leads you to self-sustaining wellness.

In health, as in so many other areas, it is important not to be satisfied with less than the best you can achieve!

Most thyroid problems can be fully solved, leading you to excellent good health!

 

Dr Rodney Adeniyi-Jones