A Functional Medicine Approach to Hyperthyroidism

February 10th, 2014

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hyperthyroid

It seems that many of the articles regarding the thyroid gland tend to focus on the signs and symptoms of an under-active thyroid or hypothyroidism.  However, it’s estimated that between 3 and 10 million people actually suffer from an overactive thyroid, or hyperthyroidism.  I myself was diagnosed with the autoimmune form of hyperthyroidism called Graves’ disease during my second year of medical school.  You can listen to my podcast here, where I share my personal experience with Graves’ disease. I never want anyone to go through what I had to go through to treat my hyperthyroidism, so it is my mission to educate as many as I can that there is another, healthier and more natural way to recover from hyperthyroidism.

 

What is hyperthyroidism?

Your thyroid, the butterfly-shaped gland in the front of your neck, produces hormones to help regulate body temperature, heart rate, growth, energy production, and brain health. Hyperthyroidism is a condition that occurs when the thyroid is overactive and produces too much thyroid hormone. When thyroid hormones are too high, energy metabolism will speed up, causing the body to burn through nutrients too quickly. This can result in malnutrition, leading to a wide range of problems. I personally was eating everything in sight and went from a size 4 to a size 0 in a matter of months.  Trust me when I tell you it was not healthy!

How is it diagnosed?

Blood testing of your thyroid hormone levels is the first step.   In hyperthyroidism, the thyroid-stimulating hormone (TSH) will be very low and the Free T4 and Free T3 will be elevated.  In autoimmune conditions, you will see elevated levels of antibodies as well. To read more about optimal thyroid lab values you can read my article on the thyroid here.

Radioactive iodine uptake (RAIU) is the next step in diagnosing a thyroid imbalance. An RAIU using a small dose of I-131 will determine how much iodine the thyroid takes up. A high iodine uptake is indicative of Graves’ disease. This test can be helpful in ruling out other possible causes of overactive thyroid.

Ultrasound (US) of the thyroid is helpful to look at nodules on the thyroid, and your doctor may request you have a fine needle biopsy to confirm that the nodules are not cancerous.

Graves’ disease

There can be many reasons for the thyroid to be overactive, but this commonly occurs as a result of the autoimmune condition, known as Graves’ disease. Normally, thyroid function is regulated by the pituitary gland, a tiny gland responsible for secreting TSH, which signals the thyroid to produce thyroid hormones T3 and T4. In Graves’ disease, an antibody known as thyrotropin receptor antibody (TRAb) can mimic pituitary hormones and completely override the system, causing an overactive thyroid.  One may also develop Thyroid Peroxidase (TPO) antibodies or Antithyroglobulin antibodies. I personally did not have antibodies to TRAb, I only had antibodies to TPO.  I see this very frequently in my clinic as well.

Toxic Multi-nodular Goiter

Another form of hyperthyroidism is toxic multi-nodular goiter, which involves the growth of independently functioning nodules on the thyroid gland itself. These nodules are able to stimulate the thyroid without the use of TSH, thereby overriding the system and causing an overactive thyroid.

Signs of Hyperthyroidism

  • Hot flushes, sweating

  • Unintentional weight loss

  • Frequent stools, loose stool or diarrhea

  • Difficulty sleeping and insomnia

  • Anxiety, irritability, or constant fatigue

  • Elevated heart rate

  • Changes in menstrual cycles

  • Reduced libido

  • Bulging eyes

  • Thick red skin on shins or feet

  • Increased appetite

  • Osteoporosis

  • Hand tremor

  • Muscle weakness

 

Conventional treatment for hyperthyroidism

Conventional medicine is only focused on treating symptoms, not on getting to the root cause of the disease.  Medications, radiation and surgery only treat the overactive thyroid gland in hopes of reducing symptoms of the disease. In order to truly solve the problem and repair your thyroid and immune system, you must take a functional medicine approach and find the underlying cause of the imbalance. I personally tried two out of three of these treatments, and it’s honestly my only regret in life.  Please do not make the same mistake I did.

1. Medications

Propylthiouracil (PTU) is an anti-thyroid drug that interferes with the production of thyroid hormones. Simply google these medications and you will see a long list of dangerous side effects, one being destruction of your liver.  I took PTU when I had Graves’, and that’s exactly what happened to me.  I was confined to bedrest until my liver healed, which nearly caused me my life and medical school.

Methamazole is another anti-thyroid drug administered for hyperthyroidism. As a result, this drug can actually cause hypothyroidism, requiring the careful monitoring of TSH and Free T4 levels. Side effects include rash, hair loss, vertigo, jaundice, aplastic anemia, lupus-like syndrome, and hepatitis.

2. Radiation/Ablation

This approach uses a large dose of radioactive iodine (I-131) to permanently destroy thyroid gland cells. After this procedure, you are destined to a life of manufactured thyroid hormone medication. After getting toxic hepatitis from the PTU, I had no other choice but to do this treatment myself. I truly believe that if I had discovered functional medicine sooner, I would have been able to reverse my condition and save my thyroid from destruction as I have done with numerous patients in my clinic.

3. Surgery

When antithyroid medications and radioactive treatments are not viable options, doctors may recommend a partial thyroidectomy, in which part of the thyroid gland is surgically removed.  This is actually the option I recommend as a last resort if someone is not able to reverse their hyperthyroidism using a  functional medicine approach.

 

Underlying causes of hyperthyroidism

1. Gluten

Gluten is a huge problem for most people these days because we hybridized it, modified it and it’s in everything!  Worst of all it can wreak havoc on your gut and set you up for a leaky gut.  Once the gut is leaky, gluten can get into your bloodstream and confuse your immune system. Since the building blocks of gluten share a similar molecular structure with building blocks of your thyroid gland, the immune system can get confused and accidentally attack your thyroid gland. This process is called molecular mimicry.

2. Leaky gut

In order to absorb nutrients, the gut is somewhat permeable to very small molecules. Many things including, gluten, infections, medications and stress can damage the gut, allowing toxins, microbes and undigested food particles – among other things – directly into your bloodstream. Leaky gut is the gateway for theses infections, toxins and foods like gluten to begin to cause systemic inflammation that leads to autoimmunity.  You must heal your gut before you can heal yourself.

3. Mercury

Mercury is a heavy metal that is capable of altering or damaging the cells of various bodily tissues. When cells are damaged, your immune system can mistake them as foreign invaders and begin attacking its own organs. Studies show that individuals with higher mercury exposures have an increased risk of getting an autoimmune thyroid disease.

4. Infections

Infections such as the herpes family of viruses (HSV) and Epstein-Barr virus (EBV) have been implicated as a potential cause of autoimmune thyroid disease through inflammation and molecular mimicry.

5. Iodine

Iodine status is a bit controversial.  It seems that too little iodine can cause goiter and hypothyroidism and too much can cause hyperthyroidism.  When the body detects an increased availability of iodine, this can trigger the thyroid to produce more thyroid hormone. If someone with a relatively low intake of iodine suddenly consumes a very iodine-rich diet, then over time that individual can produce an excessive amount of thyroid hormone, resulting in an overactive thyroid.

 

Functional medicine approach to hyperthyroidism

1. Remove gluten from diet

I recommend that all of my patients remove gluten from their diets because it’s simply an inflammatory food. For my patients with autoimmune diseases, like Graves’ or Hashimoto’s thyroiditis, I highly recommend removing all grains and legumes from the diet as well. These foods contain proteins known as lectins, which act as a natural pesticide for crops and can wreak havoc on the lining of your gut.  Changing your diet is the first step in getting well.  I created The Myers Way Comprehensive Elimination Diet eCourse which you can do at home, and it’s the foundation that I use with my patients to begin recovering from illnesses.

2. Heal the gut

Healing the gut is essential to healing yourself, as I mentioned before.  For this reason, I created The Myers Way Guide to the Gut eCourse to help guide you through the exact same steps I use with my patients to heal their guts. I also have many articles explaining my 4R approach to healing the gut and gut-healing supplements.

3. Find and treat infections

Have your doctor test for infections such as HSV and EBV.  Monolaurin from coconut oil can be very effective treatment for both HSV and EBV.  Lysine and a lysine-rich diet is effective at treating HSV infections.

4. Test for heavy metals

We are exposed to heavy metals in a number of different ways: amalgams, fish consumption, and the environment. I recommend having your MTHFR genes tested and doing a DMPS chelation challenge test through a functional medicine practitioner. to determine if mercury or other heavy metals are an issue for you.

5. Support the immune system

Supplements like vitamin D, omega-3 fish oils, and glutathione are powerful immune modulators, which means that they can help support your immune system. Vitamin D  has been shown to help regulate the immune system. Omega 3 fish oils help to reduce inflammation in the entire body. Glutathione is the most powerful antioxidant in the body which can help reduce inflammation and improve detoxification in the body.

 

If you need further assistance, find a functional medicine physician in your area to help you get to the root cause of your illness and to help you reverse your disease. It can be done.

 

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  • Julie Moore

    I believe I read in Dr Brownstein’s book on iodine –or maybe it’s the one on curing autoimmune disease –that taking selenium protects the thyroid gland from taking in too much iodine. What do you know about this?

  • gabrielamoore

    Hi Dr. Myers, I’m so happy you wrote this article. My story is very similar to yours — I had Grave’s disease and had radioactive iodine treatment because at the time I didn’t know any better. I’ve had hypothyroidism since then and take levothyroxine 150 daily. My question is, from a medical perspective should i still consider myself as someone with an autoimmune condition? And if so, should I follow the same protocol as someone with Grave’s who hasn’t had ROI treatment? I would imagine that since ROI doesn’t really treat the cause of Grave’s it is fairly possible that I still have thyroid antibodies in my system…

  • Phyllis Anderson

    Good Morning Dr. Myers,
    Thank you for this article. I was diagnosed with Grave’s Disease 8 years ago and the treatment choice has been to take Methimazole. I’ve also been diagnosed with Sjogren’s and Fibromyalgia. 3 years ago I had a pre-cancerous pancreatic tumor removed and now have a polyp in the gallbladder. Seems that once you have one AI issue, one continues to have more. I have tried everything from cutting out gluten, to becoming pretty much vegan in my eating habits. I continue to look for new methods of reducing symptoms.
    Thanks,
    Phyllis Anderson

    • You’re welcome, Phyllis! There’s lots of good info on this blog, especially about the thyroid, so I hope you can find some help here!

  • Michele Garrett Shirk

    Dr Myers, My sister-in-law was diagnosed with hyperthroidism and after much pleading from me (I have hashimotos) she went ahead and had the RAIU and has been very sick for the past 3 weeks. She did refuse to take the anithyroid medicine because of side effects. What can I suggest to her that would help her nausia and headache.? Michele

  • Cheryl Jacobson

    i have graves disease, i have had it for 17 years, i was told by my first endocrinologist that it was caused by a severe emotional trauma, i am now considering having the operation to remove most of my thyroid because it keeps flaring up (becoming overactive when usually 1 PTU a day keeps it at a good level for years). this most recent flare up was caused by taking amino acids. which i now know i can not take with graves disease. i have heard that thyroxine medication is not very good, so what would be better? i am sick of the side effects of graves, i have no muscle tone. i cant buy a multivitamin without iodine. should i have the operation or not?

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  • KellMass

    Dr. Myers. I have Graves’ disease and had a TT 4 years ago. I wish I knew then, what I know now. Although, I was eager to have children, and could not stay on antithyroid drugs. I have read some literature against NDT for Graves patients because it could cause an antibody flair up, and that synthetic t3 and t4 are the way to go. What are your thoughts? I’m curious as to what you have to say because you have Graves as well. Thanks 🙂