See Rebecca’s Top Takeaways

Like many people, I used to drink coffee to start my day. It was the first thing I put in my body before my early morning workouts. I loved the smell — I still do. But to make my coffee more palatable, I loaded each cup with cream and sugar. I had no idea the concoction had the potential to hinder my health and fitness.

I’ve been dedicated to exercise since I discovered its ability to help me cope with the stress of a divorce in my early 20s. At the time, the tension relief and physical outlet it provided were so valuable that working out became an essential part of my life.

Over the following three decades, I continued to prioritize my mental, physical, and spiritual well-being through exercise. But in early 2022, I started to feel curiously sluggish during my workouts — no matter how much coffee I consumed.

I was particularly sensitive to this fatigue because it’s a common symptom of Hashimoto’s disease, an autoimmune condition I contracted in my late 20s. But because I thought I was managing my illness, I didn’t know how to explain my fatigue, headaches, and indigestion. Only later did I realize how much my dietary choices were sabotaging my well-being and how much I needed a nutritional reset.

Experimenting With Nutrition

I regularly attended classes taught by Life Time trainer and nutrition coach Brigitt Castille at my club in Gilbert, Ariz. When Castille shared her positive experience with a detox program, I was inspired. I couldn’t figure out what was causing the symptoms I’d been experiencing, but I knew I needed to switch something up. Nutrition seemed like a great place to start.

Although I believed I followed a pretty healthy diet, which featured a lot of carbs for energy, I wondered how much protein I should eat. I also wanted to understand the effects of inflammatory foods, because they can be particularly problematic for those with autoimmune disorders.

In September 2022, I began the Life Time D.TOX program. It’s designed to support the body’s natural detoxification system by eliminating potentially inflammatory foods — including gluten, highly processed foods, dairy, soy, eggs, peanuts, and caffeine — that may be problematic for people with sensitivities. The program has three phases: roughly one week of preparation, two weeks of detoxification, and a period of restoration, during which participants slowly reintroduce foods and see how their bodies react.

The first few days of the preparation period were the most difficult. It was tough to wean myself from coffee, and grocery runs took longer than usual because I had to closely read labels to make sure to avoid elimination foods. The hardest ingredient to steer around was soy because it’s so often found in foods like protein bars, baked goods, and sauces.

At first, I assumed that giving up certain foods meant I would eat less. But plenty of options were still on the table, including many vegetables and fruits (primarily organic to avoid the toxin residue on conventionally grown produce), wild-caught fish, organic or pasture-raised poultry, raw nuts (no peanuts), and starches like rice, potatoes, and quinoa. I was encouraged to eat as much as my body needed.

I kept my menu as simple as possible, eating mostly ground turkey in different ways for protein because I don’t like beef. I mixed the turkey with brown rice or put it in lettuce as a wrap. I also ate a lot of salads and snacked on mangoes, blackberries, raspberries, and strawberries.

Over time, I realized I tended to overeat, which may have contributed to indigestion and bloat. Those symptoms resolved as I began eating more intuitively — paying attention to hunger and satiety. I found that I functioned better when I ate smaller portions more frequently.

After the detox phase, I started feeling lighter. I didn’t lose weight, but my shape changed; my muscles became more defined. I didn’t even realize I had been experiencing chronic headaches until they disappeared. I had renewed energy.

What’s more, I didn’t crave sugar or highly processed foods. Eating more protein and whole foods gave me a sense of satiety more quickly, so I didn’t feel the need to seek out quick sources of energy.

One Step Back

During the restoration phase, I reintroduced foods as recommended. Doing this allows you to recognize how your body responds to different things. I learned that for me, eating soy and gluten led to inflammation, bloating, headaches, and a midday crash.

I stuck to eating only the program’s approved foods for a while, but I eventually became less disciplined. By the end of the year I was eating more ultraprocessed foods, including pizza, and my beloved deep-fried tacos. My cravings returned, and with them came more food headaches, which I noticed after eating too much salt or soy.

Feeling the need to get nutritionally realigned, I signed up for a second round of D.TOX at the beginning of 2023. I expected to jump back in, but my body didn’t respond positively at all. I suffered more frequent headaches and constantly felt hungry and cold.

In addition to these symptoms, I was also choking on food and having trouble breathing, which encouraged me to check in with a doctor. An MRI showed my thyroid had swelled to three times its normal size. An enlarged thyroid is a common symptom of Hashimoto’s; although it isn’t usually painful, mine was partially obstructing my airway. When my doctor recommended removing my thyroid, I didn’t hesitate. I underwent surgery to remove it that February.

My recovery was relatively easy, and by the fall of 2023, I was healthy and ready to give the detox program another go. This time I understood what was involved and how to prepare more efficiently. I felt ready.

Third Time’s a Charm

My third time through the program was the most positive. I didn’t fight through food cravings in the beginning or think about foods I was avoiding. Being prepared allowed me to try more recipes with the approved foods.

When the time came to slowly reintroduce restricted foods into my diet, I already had a good idea of what I needed to avoid, like soy and gluten, which caused bloating and terrible headaches. But this time, I also found I could not eat sausage — even turkey sausage — likely because of the nitrates used as preservatives and for coloring.

I’ve been able to manage the symptoms of my Hashimoto’s disease, too. Despite having my thyroid removed, my medical team hasn’t needed to adjust the medication I use for treatment, which is a good sign that my lifestyle habits are supporting my well-being.

Moving forward, I plan to prioritize protein and organic whole foods, honor portion sizes, and avoid foods that cause adverse reactions. My commitment to exercise has also remained steadfast, especially now that my diet is more supportive of my goals.

That’s why I’m over my emotional attachment to coffee (and the headaches and indigestion that I learned came with it). After the first detox, I switched to decaf but eventually weaned off coffee altogether. I finally learned that my life and fitness are better off without it.

Rebecca’s Top Takeaways

1. Mentally prepare. After you decide to start, she advises, “commit to it 100 percent.” Sticking to a detox program can be more difficult if you’re not wholly committed.
2. Follow a plan for achieving wellness objectives. It’s important to have wellness goals, Rebecca notes, but it is equally vital to develop a solid plan to achieve them.
3. Inform close friends and family. “Going out to eat was a big challenge,” she recalls. Let people know what you’re doing to give them the opportunity to be more supportive. That way, “they won’t wonder why you’re choosing not to eat certain things or try to coerce you to eat them anyway.”

Tell Us Your Story! Have a transformational healthy-living tale of your own? Share it with us!

Lack of energy was never a concern for Heidi Raschke. As an undergraduate at the University of Minnesota, Raschke easily juggled a full course load with a part-time job and an internship at the campus newspaper. Then, in her senior year, her reserves started to run low. Normally an “A” student, Raschke couldn’t concentrate and her grades slipped. “I felt overwhelmed,” she remembers. “I was tired all the time.” Raschke’s mood wasn’t helped by the fact that she was suddenly carrying extra weight. “I’d run six miles several times a week and bike to school every day,” she says. “Nothing helped.”

At first Raschke assumed that depression was the root cause of her problems. A therapist prescribed Prozac, and both the medication and therapy seemed to help initially. But just over a year later, her physical symptoms returned with a vengeance. One night she slept for 19 hours straight. “That scared the hell out of me,” she says.

Raschke made an appointment with her doctor, who immediately ordered a blood test. The results confirmed she was suffering from Hashimoto’s Thyroiditis, an autoimmune disease that had damaged her thyroid gland. Raschke’s thyroid function was depressed – a condition, called hypothyroidism, that her doctor said was likely irreversible.

Until her diagnosis, Raschke had never even thought about her thyroid. Suddenly, it seemed to have control over every part of her life. This led Raschke to ponder a question that will likely be posed by a growing number of Americans in coming years: How can such a comparatively tiny gland have such a giant impact?

The Body’s Gas Pedal

A healthy thyroid is important to everyone’s well-being. A butterfly-shaped gland located at the front of the neck between the Adam’s apple and the collarbone, the thyroid produces several hormones, two of which – triiodothyronine (T3) and thyroxine (T4) – are vital to a person’s health. These hormones help oxygen get into cells and make your thyroid the master gland of your body’s metabolism.

“The thyroid is the gas pedal for distributing energy throughout the body,” says Richard L. Shames, MD, coauthor, with his wife, Karilee Halo Shames, RN, PhD, of Thyroid Power: 10 Steps to Total Health. “Thyroid hormone keeps the body working at the right speed.”

When an individual’s thyroid hormone levels decrease, explains Shames, the activity in his or her body’s cells decreases, too. As a result, the person may feel emotionally and physically drained and may also gain weight, even as his or her appetite wanes.

Hypothyroid disorders are extremely common. According to the American Association of Clinical Endocrinologists (AACE), one in 10 Americans – more than the number of Americans with diabetes and cancer combined – suffer from thyroid disease, more than half of them undiagnosed.

The most common cause of thyroid disease in the United States is Hashimoto’s Thyroiditis, a chronic autoimmune condition that results when the immune system mistakenly attacks the body’s own tissues. The thyroid can also produce elevated levels of thyroid hormones (hyperthyroidism), usually as the result of a less-common autoimmune condition known as Graves’ disease.

In the case of Hashimoto’s Thyroiditis, the immune cells that usually fight off infection and colds attack the thyroid instead. The damaged thyroid loses function, resulting in a variety of symptoms including fatigue, weight gain, forgetfulness, depression, constipation, dry skin, and cold hands and feet. Left untreated, hypothyroidism can lead to more serious health consequences, such as elevated cholesterol, heart disease, osteoporosis and infertility.

“There is a huge population of people who are gaining weight and are depressed and exhausted, and they aren’t being treated properly.”

Hypothyroidism runs in families and is five to eight times more common in women than in men. The elderly are also at increased risk for the disease. The AACE estimates that by age 60, as many as 17 percent of women and 9 percent of men have an underactive thyroid.

“There is a huge population of people who are gaining weight and are depressed and exhausted, and they aren’t being treated properly,” says Mary Shomon, who was diagnosed with hypothyroidism in 1995 and is today a patient advocate and the author of Living Well With Hypothyroidism: What Your Doctor Doesn’t Tell You That You Need to Know. Shomon and other advocates, including many doctors, want more attention paid to thyroid disorders, including treatment options for people with low, but not necessarily disease-level, thyroid function.

“Something doesn’t have to be at the level of a disease for it to be a problem,” says Laura Thompson, PhD, a naturopathic endocrinologist and director of the Southern California Institute of Clinical Nutrition. “There tend to be a lot of mysterious symptoms that people can’t explain that turn out to be subclinical thyroid imbalances. Inability to lose weight, depression, irregular menstrual cycles, severe PMS, menopause problems – all can be related to the thyroid.”

Recently, official hypothyroid diagnosis guidelines were adjusted downward (see “The Numbers Game” below). The change, which received a great deal of media coverage, was designed to help doctors more accurately identify and treat the large number of hypothyroid sufferers whose conditions were previously considered “subclinical.”

How to Treat Thyroid Issues Naturally

Why are so many people’s thyroids under siege? It all depends on whom you ask. A nutritionist might blame our unhealthy addiction to processed foods, while an environmental scientist will cite research that links toxins in the water supply to weakened immune systems. Still others will caution that our overly stressed lifestyles and lack of sleep are throwing our thyroids off kilter.

Regardless of the reasons, all experts agree that the best way to treat a thyroid problem is to prevent it from developing in the first place. Diet is a good place to start.

“Iodine is the most important mineral for production of thyroid hormone.”

The first thing to look for: iodine deficiency. “Iodine is the most important mineral for production of thyroid hormone,” Thompson explains, “and many people don’t get enough of it.” (Learn more about this essential micronutrient at “Why Iodine Is Important for Your Health.”)

In 1924, U.S. salt companies iodized salt in an effort to eliminate iodine deficiencies. Today iodizing salt is mandatory in 120 countries but is voluntary in the United States. While ordinary table salts still contain iodine, kosher salt and some gourmet sea salts do not. Nor do the majority of salts that end up in processed or fast foods.

Over the past 20 years, the percentage of Americans with low iodine levels has quadrupled. In a National Health and Nutrition Examination Survey, the Centers for Disease Control and Prevention found that more than one in 10 Americans are deficient in iodine.

To boost iodine levels, Thompson suggests you use iodized sea salt for seasoning. She also advises eating more seafood and sea vegetables, such as kelp, nori and wakame (these are featured in sushi, soups and many other Asian dishes and are widely available in health-food stores and larger markets).

Many nutritional experts advise people who suspect or know they have thyroid problems to avoid eating large amounts of cruciferous vegetables, such as broccoli, cabbage, cauliflower and Brussels sprouts, especially when raw. These vegetables can have a depressive effect on thyroid function. (See “Can People With Thyroid Conditions Eat Cruciferous Vegetables?” for more on this topic.)

Another food that may depress the thyroid is soy. While soy can be an important protein source, it is not your thyroid’s favorite food. “In high quantities, soy depresses thyroid function,” says Shomon. Eating soy in moderation is fine, but if you have soymilk for breakfast, a soy smoothie for lunch, a soy burger for dinner and take soy supplements to protect against heart disease or hot flashes, it may be time to cut back.

There is a wide array of nutrients helpful in promoting healthy thyroid function. At the top of Thompson’s list are gamma linoleic acids (GLAs), such as:

• Evening primrose oil and black currant oil, both of which help the thyroid produce hormones.
• The mineral selenium and the amino acid tyrosine help convert the inactive T3 thyroid hormone to the active T4 version. Thompson suggests a selenium supplement or a supplement that combines selenium with iodine and tyrosine.

Because an inflamed or swollen gland often accompanies thyroid problems, it’s also important to include anti-inflammatory foods in your diet, such as the essential fatty acids omega-6 and omega-3.

Finally, water is essential for proper immune-system function, so whenever possible, choose filtered or pure spring water over sodas and other drinks. Sip water throughout the day, not just when you become thirsty (a sign you are already dehydrated).

You can also support your thyroid by minimizing sugar, artificial sweeteners, caffeine, dairy and wheat as well as flavor and color additives, as these foods pose a challenge to many people’s immune systems, says Thompson.

How Chemicals and Toxins Can Affect Thyroid Health

Getting the right food and nutrients is just the start of your thyroid challenge.

Environmental scientists are pointing to a growing body of research that suggests the chemicals in our air, water and food supply may be confusing and taxing our immune systems. According to Paul Connett, professor of chemistry at St. Lawrence University in Canton, N.Y., the fluoride we ingest through tap water, processed foods, toothpaste and mouthwash suppresses thyroid function.

The fluoride we ingest through tap water, processed foods, toothpaste and mouthwash suppresses thyroid function.

“In the 1950s, doctors in Europe treated patients with hyperthyroidism with sodium fluoride tablets,” he explains. “The doses they were using are within the range of what we get in people living in fluoridated communities.” Connett suggests that fluoride may cause problems for those with hypothyroid disorders because it mimics the action of thyroid-stimulating hormone (TSH), the hormone that catalyzes the release of hormones from the thyroid, and desensitizes the protein receptors that receive TSH.

Connett and others believe that people concerned about their thyroid health should not only filter their tap water or drink bottled water, but also avoid fluoridated toothpastes and mouthwashes, as well as processed foods (which may be made with fluoridated water) and fluoride-rich foods such as sardines and cooked spinach. (Connett is among a group of scientists and alternative practitioners who reject the notion that fluoride has dental health benefits; most conventional dentists disagree and continue to support fluoridation.)

How Stress Affects the Thyroid

While the idea of chemical stressors is daunting, emotional and mental stress may be an even bigger concern. Some doctors believe that serious physical or mental stress can trigger the immune system to attack the thyroid, especially if you have a family history of low thyroid, diabetes, or other rheumatic or autoimmune illnesses. But even if you don’t have a family history of autoimmune diseases, it’s still important to make sure that your stress levels aren’t weakening your thyroid or getting in the way of your body’s healing processes.

“There is a tremendous amount of frustration built into our everyday lives,” says Shames, “all of which has a negative impact on our biochemistry. Plus our rapid pace of life leaves little time for immune-restoring activities such as exercise and a solid night’s sleep.”

“When you are going through a difficult time or a chronically stressful situation,” advises Shames, “utilize every good stress-reduction technique available to you. If you don’t know any, get some training and try a few out. You could choose meditation, self-hypnosis, or specific relaxation exercises from biofeedback or yoga.”

Shames also advises his thyroid patients to exercise, to stay connected with friends and, if they need it, to seek out professional counseling. But the basic message is simple: When your body starts breaking down or getting overwhelmed, it’s a clear sign you need to take better care of yourself. Go easy, advises Shames. Back off from overly ambitious plans. “If you’ve been working without a break for months on end, schedule a vacation. Get out of your body’s way and let it heal.”

Treatment for Life

The good news about hypothyroidism and other thyroid diseases is that they are treatable. When lifestyle changes fail to help (and in many cases, before they are tried), most doctors treat thyroid problems with both synthetic and natural prescription hormones.

The standard therapy for hypothyroidism is a synthetic hormone called thyroxine, sold under the brand name Synthroid. An alternative natural product, sold by prescription under the brand name Armour, is made of desiccated animal thyroid gland. It is popular among many alternative and complementary health practitioners because they believe it most closely resembles our body’s own natural thyroid hormone. There is little convincing evidence that one type of product is consistently better or more effective than the other: It just depends on the individual’s condition and body chemistry.

“There is no one best medicine for all low-thyroid sufferers,” says Shames. He explains that finding the right drug and the correct dosage can be a frustrating process of trial and error that can take doctor and patient months or longer to master. Sometimes a combination of two drugs is the optimal solution. Sometimes one drug works well for five years and then is no longer as effective.

There is one generalization that can be made, however: Once you start taking any prescription thyroid medication, you’ll probably have to keep on taking it. Most thyroid medications are designed to supplement or replace naturally occurring thyroid hormones – not to strengthen or “cure” the thyroid gland itself. Over time, thyroid medication effectively shuts down the thyroid gland, causing it to slow or halt production altogether, creating a lifelong dependence on supplemental hormones. This phenomenon has made thyroxine one of the most prescribed drugs in the United States. It’s also a consideration that encourages some hypothyroid patients to investigate alternative treatments, including naturopathic and Chinese medicine, before turning to prescription hormones.

In many cases, particularly when thyroid disorders are caught early enough, alternative and integrative methods prove very effective in rebalancing the body’s chemical and hormonal activity. In other cases, they don’t.

The key, according to Shames, is to listen to your body, respect your instincts and take charge of your health. “You need to be as active about your medical care as you are about going to the gym,” he says.

Shames encourages patients to do their research, weigh their options and come to their appointments prepared to talk openly about their concerns and priorities. “If you don’t feel like you are being listened to,” he insists, “fire your doctor!”

Fortunately, Heidi Raschke didn’t have to take Shames’s advice. After a few months of tinkering with her dosage, she found that Synthroid did the trick. Now an editor at a major metropolitan newspaper and the mother of a toddler, she’s busier than ever and feeling fine.

“It’s a minor issue in my life now,” she says. “Having a thyroid condition is awful when it’s not being properly treated. But for me, the medication was a miracle. It made me feel like myself again.”

What Are the Symptoms of Low Thyroid Function? A Self-Test

The symptoms below may indicate low thyroid function. If you experience any combination of these, you should talk to your doctor about getting a thyroid function test.

Do you …

• have unusual fatigue unrelated to exertion?
• feel cold constantly?
• have feelings of anxiety that sometimes lead to panic?
• have trouble with weight, often eating lightly, yet still not losing a pound?
• experience aches and pains in your muscles and joints unrelated to trauma or exercise?
• feel mentally sluggish, unfocused, or unusually forgetful?
• know of anyone in your family who has ever had a thyroid problem (even you at an earlier age)?
• suffer from dry skin, or are you prone to adult acne or eczema?
• go through periods of depression, and/or lowered sex drive, seemingly out of proportion to life events?
• have diabetes, anemia, rheumatoid arthritis, or early graying hair? Does anyone in your family?
• experience significant menopausal symptoms, including migraine headaches, which other therapies do not relieve?

Reprinted with permission from Thyroid Power: 10 Steps to Total Healthby Richard L. Shames, MD, and Karilee Halo Shames, RN, PhD. For more information, visit www.thyroidpower.com.

Be Kind To Your Thyroid

• Stop smoking. Smoking increases your risk of developing thyroid problems.
• Avoid fluoride. Fluoride depresses thyroid function.
• Go easy on soy and cabbage-family vegetables. They inhibit thyroid hormone function.
• Be careful about radiation. Avoid direct radiation to your neck. Make sure your dentist uses a thyroid shield when taking X-rays.
• Green up your cleaning supplies. Replace your “extra strength” cleansers with less toxic options. Because chlorine suppresses thyroid function, minimize cleansers with bleach and heavy-duty chemicals.
• Increase your iodine intake. Sushi and iodized salt are two good sources.
• Reduce stress. Exercise, sleep and reaching out to others can help ease stress. Build relaxation into your schedule.

The Numbers Game: How to Get an Accurate Thyroid Diagnosis

The consequences of a thyroid misdiagnosis can be huge, because the longer thyroid disease remains untreated, the more the metabolism gets out of whack. That means a person will not only be more depressed, more tired and gain more weight, he or she will also be increasingly susceptible to the severe effects of thyroid disease, such as heart disease and difficulties conceiving and bearing children.

Unfortunately, test results aren’t always clear. “When you have a thyroid situation, testing isn’t black and white,” says Richard Shames. “If you have a lot of symptoms, even if you test in midrange, you need to be suspicious.”

Here are a few suggestions to help you get the right diagnosis on the first try.

1. GET TESTED REGULARLY: The American Thyroid Association recommends that women over 35 get their thyroids tested every five years, and that people with a family history of thyroid disease or other autoimmune diseases get checked more regularly. A thyroid test should also be part of your prenatal plan. Not only can thyroid disease make it difficult to get pregnant, an undiagnosed thyroid problem in the mother can have severe consequences for a baby, including low birth weight, low IQ and stillbirth.

2. BE SPECIFIC ABOUT YOUR SYMPTOMS: “It’s more common for a hypothyroid person to go to a doctor and leave with a prescription for Prozac than with a thyroid treatment,” says Mary Shomon, who places part of the blame for improper treatment on the bureaucracies of managed healthcare. “It costs added money to order a blood test,” she says. “But it costs nothing to write a prescription for an antidepressant.”

Shomon also thinks that the communication style between patient and doctor is partly to blame. “Doctors don’t understand concepts like ‘I feel fat’ and ‘I feel tired’ because they don’t translate into actual symptoms.” What patients need to do, in Shomon’s view, is to quantify, quantify, quantify. “Instead of saying ‘I’m always sleepy,’ tell your doctor that you used to sleep eight hours a night and have energy throughout the day. Then explain that you now sleep 11 hours a night and feel like you are walking around half dead,” she says. “Give specific numbers for the calories you eat, the hours per week you exercise, the pounds you have gained in the last month or year.” (For more ideas on how to successfully work with your doctor, see the “Empowered Patient.”)

3. KNOW YOUR NUMBERS: The most common way that physicians diagnose hypothyroidism is with a blood test that measures thyroid-stimulating hormone (TSH), the messenger chemical that instructs the thyroid gland to produce the T4 thyroid hormone. Both the Shameses and Mary Shomon say that relying on a blood test alone is problematic. Not only can the results be misinterpreted, but blood tests often miss borderline low-thyroid sufferers who could be helped if properly diagnosed. Until recently, physicians accepted the normal TSH range of 0.5 to 5.0 mIU/L. But new clinical guidelines published in late 2002 by the American Association of Clinical Endocrinologists (AACE) call for the “normal” range to be between 0.3 and 3.04. AACE anticipates that the new guidelines will result in millions of new hypothyroid diagnoses.

This originally appeared at “Little Gland, Big Problems” in the April 2004 issue of Experience Life.

For much of my adult life, I’ve experienced mild fatigue. It never made me want to crawl under the covers and sleep all day, nor did it inhibit me from pursuing my interests. I’ve never suffered from depression, and until just a few years ago my metabolism burned hot.

During the worst of times, I just felt like I had one foot on the gas and one on the brakes. And with a spirited and seemingly energetic mother who experienced similar issues, I figured this was simply my lot in life.

During the worst of times, I just felt like I had one foot on the gas and one on the brakes.

In 2002, at the age of 32, I was told in a routine checkup that my thyroid was “borderline.” I knew that the thyroid was a butterfly-shaped gland in the neck that controls metabolism and energy, but with no further discussion or instruction from my doctor about what borderline meant, I didn’t give it much consideration. I later suffered from symptoms that were, unknown to me at the time, related to the diagnosis. I was chilled in 75-degree weather, had dry skin and itchy eyes, and at times would experience significant hair loss. I was also becoming increasingly restless and impatient.

It wasn’t until 2008 that I discovered I suffered from the most common cause of hypothyroidism, Hashimoto’s thyroiditis, an autoimmune condition that causes the body to attack its own thyroid tissue. (For more about autoimmunity, see “Autoimmune Disorders: When Your Body Turns on You“.)

Even though I was trained as a holistic nutrition coach, I knew little about Hashimoto’s. Confronted with the mysterious four-syllable verdict, I countered, “Um, no, I don’t have that, thank you.”

My labs told a different story. When my then-doctor asserted that I had to be on thyroid drugs for the rest of my life — drugs that can cause heart palpitations, shortness of breath, troubled sleep and a host of other side effects — I again blurted, “I don’t think so,” and my journey into sleuthing low thyroid function and autoimmunity began.

It’s estimated that hypothyroidism, or underactive thyroid, affects more than 30 million women and 15 million men. (Hyperthyroidism, or overactive thyroid, is much less common.) “Thyroid dysfunction affects our health systemically,” says family nutritionist and naturopathic endocrinologist Laura Thompson, PhD. “Since the endocrine system [which is made up of glands that produce our bodies’ hormones] is responsible for growth, repair, metabolism, energy and reproduction, any slowing of the thyroid can have significant implications for our overall health.”

It’s estimated that hypothyroidism, or underactive thyroid, affects more than 30 million women and 15 million men.

Datis Kharrazian, DHSc, DC, MS, a leading expert on autoimmunity, further points out in his book, Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?, that autoimmune disease accounts for a whopping 90 percent of Americans with hypothyroidism, mostly due to Hashimoto’s. The other 10 percent are afflicted with non-autoimmune hypothyroidism.

Unfortunately, patients with hypothyroidism suffer from symptoms that are rarely traced to a sluggish thyroid. If you’re feeling blue or unmotivated, you may be prescribed an antidepressant. If you’re constipated, you’re told to take a laxative. If you’re having difficulty sleeping, you’re given a sleeping aid. If you’re overweight and having trouble shedding pounds, you’re instructed to work harder at the gym or consume fewer calories (which can actually exact a greater toll on the thyroid gland). And even when conventional docs do diagnose hypothyroidism, the drug regimens they routinely prescribe don’t always do the trick.

The good news is that knowledge of proper diagnosis methods, dietary choices, lifestyle modifications and thyroid drug alternatives can help many people reclaim their health. That’s what happened to me.

I simply focused on whole-foods nutrition and some simple thyroid-friendly lifestyle modifications (see “Reclaim Your Health With the 7-Day UltraSimple Slimdown Plan” for more). I am thankfully now in remission from Hashimoto’s and, motivated by the mantra “We teach what we most need to learn,” I’ve changed the focus of my health-coaching business in hopes that those who have thyroid issues can benefit from my research.

What Is the Function of the Thyroid Gland?

The thyroid is hailed as “the master gland” of our complex and interdependent endocrine system. Put another way, it’s the spoon that stirs our hormonal soup. It produces several hormones that transport energy into every cell in the body and are vital for feeling happy, warm and lithe. The thyroid gland also acts as the boss of our metabolism. Which is why symptoms of hypothyroidism include weight gain and fatigue — as well as constipation, depression, low body temperature, sleep disturbances, difficulty concentrating, edema (fluid retention), hair loss, infertility, joint aches and light sensitivity.

Which is why symptoms of hypothyroidism include weight gain and fatigue — as well as constipation, depression, low body temperature, sleep disturbances, difficulty concentrating, edema (fluid retention), hair loss, infertility, joint aches and light sensitivity.

In part because these symptoms are so common, the thyroid is too often the last place medical practitioners look for a problem. When doctors do choose to run labs, they routinely operate under the misguided conviction that hypothyroidism can be diagnosed via a single blood test of thyroid stimulating hormone (TSH), which ultimately reveals little about overall thyroid function. And even when a TSH test is relevant, the interpretation of the results is often incorrect.

Because TSH rises as thyroid function wanes, high TSH indicates that the thyroid is underperforming. But many doctors mistakenly believe that TSH over 5.0 is worth treating, when, according to most functional medicine doctors, anyone with TSH over 3.0 has hypothyroidism. (Harvard-educated integrative physician and gynecologist Sara Gottfried, MD, argues that women tend to feel best with TSH between 0.3 and 1.0.)

It’s no wonder thyroid patient and activist Janie Bowthorpe, MEd, author of Stop the Thyroid Madness, has nicknamed TSH “thyroid stimulating hooey.”

It’s estimated that millions more sufferers could be diagnosed if proper testing was commonplace for Hashimoto’s symptoms. Unfortunately, the antibodies that show the presence of Hashimoto’s — thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) — happen to be on the list of thyroid labs that most conventional docs don’t perform.

Because thyroid hormones directly act on so many parts of the body, though, it’s essential to follow up with proper lab tests if you self-identify a problem. (For more on lab testing, as well as a simple at-home test, see “Testing in the Lab” and “Testing at Home,” below.) When you’re tested, it’s also a good idea to be checked for adrenal fatigue, since those with hypothyroidism often have some level of the condition and it can be difficult to treat the thyroid without assessing both systems. (For more on adrenal fatigue, read “Pick Yourself Up.”)

Hashimoto’s Treatment

Hashimoto’s is one of the most common forms of autoimmune disease in the United States.

Other examples of autoimmune conditions include rheumatoid arthritis, type 1 diabetes, multiple sclerosis, lupus, celiac disease, Crohn’s disease and psoriasis. In the presence of autoimmunity, normal tissue is confused with a pathogen, and your body’s immune system mistakenly launches a seek-and-destroy mission against itself. When a person has Hashimoto’s, antibodies specifically attack and damage his or her thyroid tissue.

With the number of people suffering from an autoimmune disease increasing markedly in recent decades (50 million Americans are now affected), researchers are scrambling to find cures.

There are several theories about how autoimmunity is triggered, including childhood trauma, genetic predisposition and exposure to environmental toxins. But most conventional healthcare practitioners are unaware of how to manage it because there is no pharmaceutical for autoimmune diseases. There are only drugs to help ease the diseases’ symptoms. As a result, the underlying issues continue to smolder.

And although supplemental iodine is generally the correct regimen for those 10 percent of patients who have non-autoimmune hypothyroidism, it is not the treatment of choice for those with Hashimoto’s. Too much iodine can overstimulate the thyroid and cause anxiety and sleeplessness. Which is why, according to Kharrazian, if you have Hashimoto’s, taking supplemental iodine is “like throwing gasoline onto a fire.”

Hashimoto’s is one of the most common forms of autoimmune disease in the United States.

Instead, the first line of defense against Hashimoto’s is dietary change. There is a slew of nutritional recommendations you can follow — all of which helped me in my journey toward Hashimoto’s remission — but you should get started by completely removing gluten from your life, which has been shown to trigger a response from the immune systems of even those without digestive gluten sensitivity.

While many health experts suggest that none of us should be eating gluten lLearn about the latest research on gluten intolerance at “A Guide to Understanding Gluten and Gluten Sensitivity“), Hashimoto’s sufferers have a distinct reason to swear it off, according to Kharrazian. Because gluten protein closely resembles thyroid tissue, he says, eating it puts the immune system in attack mode, exacerbating the problem. There is no such thing as moderation when it comes to gluten and Hashimoto’s, he says, since even the smallest amount can trigger an autoimmune attack for several months.

Thyroid experts also advise eating foods with thyroid-friendly vitamins and minerals, such as vitamin D, iron, selenium and zinc, and avoiding foods that inhibit thyroid health, such as raw cruciferous vegetables, soy, sugar and caffeine. (See “Nutritional Dos and Don’ts” below for more.)

After changing dietary habits, some people have to turn to thyroid drugs to treat Hashimoto’s. In some cases, medication is required indefinitely, especially when Hashimoto’s has gone undiagnosed for a long time and the thyroid is damaged to the point that it can no longer produce hormones. In my situation, I halted the immune attack with good nutrition and self-care, and there was not so much damage to my thyroid that a replacement hormone was warranted.

I was lucky, but even if you do need thyroid drugs, it’s important to know that they are not always a lifelong sentence. “Often, patients can reduce their medication and sometimes even go off it entirely,” says Thompson. “It depends on the degree and duration of imbalance.”

“Finding the right thyroid drug is like trying on shoes,” and no matter what sort of treatment you may ultimately require, it’s all about experimentation, so don’t lose hope.

If you do need drugs, it’s important to work with a qualified doctor to find what type of medication, and what dosage, works well for you. As Gottfried puts it, “Finding the right thyroid drug is like trying on shoes,” and no matter what sort of treatment you may ultimately require, it’s all about experimentation, so don’t lose hope.

The specific hormones the thyroid produces that are most critical to our health are triiodothyronine (T3) and thyroxine (T4), both of which regulate metabolism. The most popular thyroid drug, Levothyroxine (most commonly known as Synthroid), is a synthetic T4-only drug.

In our bodies, T4 is a mostly inactive hormone and nicknamed “the storage closet” or “the lame duck.” It is the forerunner to T3, which is the predominant and active hormone and which has the greatest affect on our health and well-being. The body is designed to convert T4 to T3, but many people have trouble with this conversion, mostly due to stress, hormonal and gut imbalances, and nutritional deficiencies (to learn more on the importance of having a healthy gut, see “How to Heal a Leaky Gut“). In other words, if the body is to utilize a T4-only drug, the wheels that mobilize the T4 to T3 conversion need to be well oiled.

Some report a honeymoon period with Levothyroxine, where they feel better initially, only to revert to feeling unwell or have lingering symptoms. The continued health complaints often bring on increased dosages of thyroid meds and sometimes antidepressants or anti-anxiety prescriptions. Simply put, T4-only drugs fail many people.

What often works, however, is a combination T4-T3 medication. Biodentical T4-T3, known most commonly as Armour Thyroid, for example, comes from dried porcine thyroid. These natural hormones have been successfully used since the late 1800s and, after decades of the prevalence of T4-only prescriptions, are gaining use again. Switching from Levothyroxine to “tried and true” Armour Thyroid has proven extremely effective for many people.

Above all else, addressing hypothyroidism is an exercise in becoming a proactive patient. It’s imperative to approach a healthcare provider with informed confidence and to insist on proper testing. If your doctor uses outdated lab-reference ranges or doesn’t test for Hashimoto’s, don’t settle for a “you’re fine” diagnosis. Instead, try to find a functional medicine doctor who understands thyroid issues and knows that there’s rarely a silver-bullet solution.

It takes time and patience to heal, but I’m living proof that you can get there.

17 Symptoms of Thyroid Problems

The thyroid is a butterfly-shaped gland that controls our metabolism and energy and is critical to our overall health. Symptoms of hypothyroidism (underactive thyroid) include:

1. Weight gain or the inability to lose weight despite proper diet and exercise
2. Fatigue
3. Constipation
4. Edema (fluid retention)
5. Low body temperature
6. Infertility
7. Irregular menstrual cycles
8. Depression
9. Low stamina
10. Lack of motivation
11. Sleep disturbances
12. Difficulty concentrating
13. Joint aches
14. Poor ankle reflexes
15. Light sensitivity
16. Hair loss (including thinning of outer eyebrows — see “How to Reverse Female Hair Loss” for more)
17. Hoarseness upon waking

How to Test Your Thyroid At Home

Although lab testing is the best way to get an accurate sense of how well (or poorly) your thyroid is functioning, you can do a simple at-home test to get started. Keep a glass basal thermometer beside your bed. (A regular thermometer cannot assess minute temperature shifts.) When you wake up in the morning, at roughly the same time and before moving at all, tuck the thermometer snugly in your armpit and keep it in place for 10 minutes. Remain as still as possible. Remove, take a reading, and record the results. Follow this procedure for three days. If your average temperature is below 97.8 degrees F, you may have an underactive thyroid. (Women should begin testing on the second day of menstruation because mid-cycle, there is a natural rise in temperature with ovulation.)

Gender Gap

Why thyroid disorders affect women more often than men.

Although millions of men experience thyroid dysfunction, women are 10 times more likely to have a thyroid imbalance. The reasons are uncertain, but according to integrative physician and gynecologist Sara Gottfried, MD, the phenomenon is linked to female hormones, since estrogen dominance (a condition in which estrogen levels are high relative to progesterone) has been implicated as a contributing factor.

The interaction between the thyroid and a woman’s reproductive hormones is significant: Hypothyroidism can lead to infertility, miscarriage, premenstrual syndrome (PMS), osteoporosis, endometriosis, polycystic ovary syndrome (PCOS), irregular cycles, uterine fibroids, low libido and difficulty in menopause.

For many women, thyroid problems first arise during times of hormonal unrest, such as childbearing and periods of prolonged or intense emotional, physical and mental stress. According to Gottfried, “Women are most vulnerable after pregnancy and during perimenopause and menopause. Thyropause — a drop in reproductive hormones that often triggers hypothyroidism — is the main cause of fatigue, weight gain and depression.”

A woman’s hormonal matrix is a bit of a chicken-and-egg scenario. Boosting thyroid function has a beneficial effect on ovaries and adrenals, but the opposite is also true: Resolving estrogen dominance, low progesterone and adrenal fatigue can help rebalance thyroid hormones, too. All the organs and glands talk to each other; they also compensate for each other, explains family nutritionist and naturopathic endocrinologist Laura Thompson, PhD.

“All of these systems need to be aligned,” says Gottfried. “Otherwise, the thyroid can be sidetracked by the ovaries and adrenals, especially in the presence of estrogen dominance and adrenal burnout.”

Thompson agrees: “Estrogen dominance can contribute to hypothyroid conditions, especially in menopause. The use of high estradiol birth control pills can also contribute to low thyroid conditions.”

But men aren’t entirely immune to hormonally triggered hypothyroidism, she notes: “Low testosterone often accompanies low thyroid in both men and women.”

Testing in the Lab

Many doctors don’t test for thyroid dysfunction at all, and even when they do, they rely on only one blood test (for thyroid stimulating hormone, TSH) that reveals little about overall thyroid function. As a result, millions of people suffering from thyroid dysfunction are left undiagnosed. If you do go to the doctor for thyroid testing, be sure to be tested for Free T3 (FT3), Reverse T3 (RT3), and the presence of two thyroid antibodies, TPOAb and TgAb. The “Free” in front of T3 discloses what is unbound and usable by the body. Reverse T3 is just that — the opposite of T3 — and it blocks thyroid receptors and can cause patients to be unresponsive to any thyroid hormone.

There is some disagreement about what constitutes acceptable lab values, depending on the doctor and the lab. As a result of outdated ranges, borderline hypothyroid patients are often overlooked. Family nutritionist and naturopathic endocrinologist Laura Thompson, PhD, uses functional medicine thyroid-reference ranges. Optimal ranges for FT3 is 2.0–3.0 pg/ml; for RT3, it’s 90–350 pg/ml.

It’s also a good idea to get tested for celiac disease, as Hashimoto’s and celiac are often in cahoots, and to be on the lookout for gluten sensitivity. If your healthcare provider scoffs or tells you that these tests are unnecessary, consider finding a new doctor. In the meantime, you could also seek out comprehensive thyroid-panel testing through direct-to-consumer lab services, like HealthCheckUSA.com or DirectLabs.com.

Nutritional Dos and Don’ts

Autoimmunity or no autoimmunity, drugs or no drugs, it’s vital to treat the thyroid well by eating a thyroid-friendly diet. Here are some of the nutritional recommendations Minneapolis-based holistic nutrition coach Jill Grunewald recommends for her clients.

Macronutrients

The big three macronutrients — fat, protein and carbohydrates — all play key roles in regulating thyroid function.

• A low-fat or nonfat diet or a diet high in nasty trans fats will weaken your immune system and can wreak hormonal havoc. But cholesterol is the precursor to our hormonal pathways, so healthful fats are necessary for energy and hormone production. Quality sources of fat include olives and olive oil, avocados, flaxseeds, fish, nuts and nut butters, hormone- and antibiotic-free full-fat dairy, coconut oil, coconut milk products, grass-fed meats, and many types of wild fish.
• Protein is required for transporting thyroid hormone through the bloodstream to all your tissues. Protein sources include meat and fish, eggs, dairy, nuts and nut butters, legumes (lentils, beans, etc.), and quinoa.
• Low-carb diets are not a good choice for those suffering from impaired thyroid function. Decreasing carbohydrate intake leads to diminished levels of T3 hormones, crucial to your metabolism. Try the complex carbs found in vegetables, legumes, fruits and whole grains.

Micronutrients

Nutritional deficiencies play a significant role in thyroid dysfunction. While they aren’t the cause of hypothyroidism, not having enough of these micronutrients and minerals can exacerbate symptoms.

• Vitamin D — Egg yolks, fatty wild fish (salmon, mackerel, herring, halibut and sardines), fortified milk and yogurt, mushrooms, fish liver oils. It’s best to supplement with vitamin D, as since it’s nearly impossible to get everything we need from food sources. An adequate level of vitamin D is essential, as because it helps transport thyroid hormone into cells. (The standard minimum of 32 ng/mL won’t do it, as levels below this can contribute to disruption of hormonal pathways. Optimal vitamin D levels, I believe, are between 50–80 ng/mL.)
• Iron — Clams, oysters, spinach, white beans, blackstrap molasses, organ meats, pumpkin seeds, lentils
• Selenium — Brazil nuts, sunflower seeds, mushrooms, tuna, organ meats, halibut, beef
• Zinc — Oysters, sardines, gingerroot, whole grains, beef, lamb, turkey, split peas, sunflower seeds, pecans, Brazil nuts, almonds, walnuts, maple syrup
• Copper — Beef, oysters, lobster, crabmeat, mushrooms, tomato paste, dark chocolate, sunflower seeds, beans (white beans, chickpeas)
• Iodine — Primary sources: sea vegetables (kelp, dulse, hijiki, nori, arame, wakame, kombu), safe seafood; secondary sources: eggs, asparagus, lima beans, mushrooms, spinach, sesame seeds, summer squash, chard, garlic

For several dairy-free, gluten-free recipes that will nourish your thyroid, see “Essential Thyroid Recipes“.

Foods That Weaken Thyroid Function

Eating right for thyroid health also means avoiding these foods:

• By definition, goitrogens are foods that interfere with thyroid function and get their name from the term “goiter,” which means an enlargement of the thyroid gland. If the thyroid is having difficulty making thyroid hormone, it may enlarge as a way to compensate for its inadequate hormone production. Goitrogens include cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, kale, kohlrabi, rutabaga and turnips. Though research is limited, it appears cooking helps inactivate goitrogenic compounds, so don’t shun these foods, especially considering their cancer-fighting superpowers. Foods that are less goitrogenic are millet, spinach, strawberries, peaches, watercress, peanuts and soy.For an update on goitrogens, check out “Goitrogens: Thyroid Busters or Thyroid Boosters“
• Soy is one of the most controversial foods out there. Many believe that it is not fit to consume unless it’s fermented and only then in moderation. Fermented soy includes tempeh, natto (fermented soybeans), miso (fermented soybean paste), and shoyu and tamari (both types of soy sauce). Fermented soy doesn’t block protein digestion like unfermented soy and isn’t a menace to your thyroid. Unfermented soy contains goitrogens, which can stifle thyroid function. Unfermented soy products such as soymilk, soy ice cream, soy nuts and tofu, are reported endocrine disrupters and mimic hormones. Soy blocks the receptor sites in your cells for naturally produced hormones and interrupts the feedback loop throughout your endocrine system.
• Sugar and caffeine are the terrible twosome. These rascals can do a number on your thyroid by further stressing your system. When you have compromised glands, especially hypothyroidism and adrenal fatigue, the last thing you want to do is amp your system with sugar, caffeine and refined carbohydrates like flour-based products, which the body treats like refined sugar.

An In Depth Interview With Sara Gottfried, MD

This article has been updated. It was originally published in the November 2012 issue of Experience Life.