An interview with Dr. Frank Aieta (West Hartford), a Licensed Naturopathic Physician;
Dr. Ann Aresco (Kensington), a Licensed Naturopathic Physician;
Dr. Deanna Cherrone(Avon), a board certified Internal Medicine physician who has changed the focus of her practice from traditional Internal Medicine to Functional Medicine; and
Dr. Tom Moorcroft (Glastonbury), an Osteopathic Family Medicine Physician.
If you knew that one gland in your body affected almost every aspect of your health, would you take care of it? If you knew that not caring for it could at best lessen your enjoyment of life, and at worst be fatal, would you take a few minutes to learn more?
Tens of millions of Americans have thyroid disease, and it’s estimated that more than half don’t know it. Thyroid disease is frequently overlooked and commonly misdiagnosed.
Your thyroid – a small gland located in the front of your neck – affects the functioning of almost every part of your body. It is responsible for metabolism and energy, managing the utilization of cholesterol, fats, proteins and carbohydrates, and can control your heart rate, digestion, skin, body temperature, and state of mind.
“Your thyroid affects your energy levels, your weight, your heart, your mood, and much more,” said Dr. Cherrone.
It’s easy to see that when your thyroid’s out of whack, you’re out of whack. So you go to your family doctor with a symptom or two, and end up being misdiagnosed and are put on antidepressants, cortisone creams, high blood pressure pills, Rogaine®, and other medications, when what was needed was treatment to restore the thyroid hormones.
“Conventional doctors tend to look at the constellation of symptoms as individual symptoms,” said Dr. Aieta. “Consequently, they treat individual symptoms.”
“As holistic physicians, we look at the constellation – the whole person,” said Dr. Aresco. That’s how we find the root cause.” “
Holistic physicians typically will test TSH, Free T3, Free T4, reverse T3 and thyroid antibodies,” said Dr. Moorcroft. “In addition, they might assess adrenal function and nutrient status.”
Conventional Medicine
The ‘gold standard’ in conventional medicine for detecting thyroid disease is drawing blood and measuring the Thyroid Stimulating Hormone (TSH). If it falls within the ‘normal’ range (which is a highly disputed range among doctors – they don’t all use the same numbers) you are likely to be deemed thyroid-disease free, even though you have several of the symptoms. In other words, you might actually have thyroid disease, but because you don’t fall into a rather arbitrary and changing range, conventional medicine could send you off with a non-diagnosis or a misdiagnosis.
“TSH is just one marker, and it’s actually a pituitary marker” said Aresco. “Even if it’s dead center in the ‘perfect’ range, it’s meaningless on its own.”
Thyroid issues become more complicated and harder to remedy as time passes. Additionally, one metabolic disorder increases your risk of experiencing others, and, in the case of hyperthyroidism, life-threatening arrhythmia and tachycardia can result. With untreated hypothyroidism myxedema coma, while rare, can be life-threatening.
The best way to manage your thyroid health is to learn what your thyroid does, how to protect it, how to know when you need a doctor’s opinion, and how to find a doctor who is familiar with thyroid disease and has a track record of helping people with thyroid problems return to wellness.
Hypothyroidism
Hypothyroidism, or underactive thyroid, is far more common than hyperthyroidism. Incidence is highest in women, seniors, and diabetics. Women and their doctors frequently dismiss hypothyroid symptoms as part of puberty, pregnancy, menopause, (which can all disrupt thyroid function) or aging. Seniors have the second highest incidence, and frequently attribute symptoms to age. Men and children also suffer, in fewer numbers.
Here are some of the common symptoms. There are many others – see the links to checklists, below.
Low thyroid hormone levels may be responsible for everything from unexplained weight gain or an inability to lose weight to cold intolerance, hair loss, dry skin, brain fog, a goiter, thinning eyebrows, chronic fatigue, puffy eyes, orange palms, depression, hypoglycemia, muscle aches, joint pains, constipation, high cholesterol, infertility, fibromyalgia, bad PMS, low libido, anemia, sleep apnea, endometriosis, uterine fibroids, and osteoporosis.
Hyperthyroidism
Hyperthyroidism, or overactive thyroid, is less common than hypothyroidism. Symptoms may include anxiety, weight loss, increased perspiration, heart racing, hand tremors, difficulty sleeping, fine brittle hair, and muscular weakness, to name a few. Older sufferers may not experience many of these symptoms – they typically only have two – weight loss and depression. Be on the lookout, and, as mentioned above, don’t wait to see a doctor. Hyperthyroidism is more likely to be life threatening than hypothyroidism is.
On the Rise
The incidence of thyroid disease is increasing across all genders and ages. “This is probably as a result of the increase in environmental toxins,” says Dr. Aieta. Dr. Moorcroft chimed in, “We are meant to live in homeostasis – a state of balance – but the toxic burden we now carry has many people hanging on to homeostasis by their fingernails.”
Causes
Thyroid dysfunction doesn’t exist in a vacuum. As mentioned, environmental toxins play a significant role. Heavy metals and other toxins are prevalent in today’s air, soil and water, and they inflame the thyroid. According to all the doctors I spoke with, infectious agents, adrenal issues, processed foods, a vitamin D deficiency, an excess or deficiency of iodine, gluten intolerance, yeast, H.pylori, excessive raw cruciferous vegetables, exposure to radiation, the presence of fluoride (in toothpaste, for example), bromine in bread, chlorine in your pool, tap water or shower, mercury in dental fillings, vitamin and mineral deficiencies, some medications, hormones in meat, hormonal fluctuations, and even Mountain Dew have negative affects on your thyroid.
Complete Symptom Checklists
“This disease affects your whole body,” says Dr. Aresco. “If you’ve had your TSH tested, the results say it’s normal, but you have several hypo- or hyperthyroid symptoms, get yourself a checklist of symptoms and fill it out. No one has all the symptoms, but if you have several, take that list to a holistic doctor.”
“Don’t think it’s all in your head, or you’re just getting older,” adds Moorcroft. Left unchecked, thyroid disease can ruin – and in rare instances end – your life.
For a comprehensive hypothyroidism checklist, go to http://www.draieta.com/articles_thyroid.html
For a comprehensive hyperthyroidism checklist, go to http://thyroid.about.com/cs/basics_starthere/a/hyperchecklist.htm
If you don’t have symptoms, here are some ways to continue with that good track record!
Prevention
Taking care of your thyroid is synonymous with taking care of yourself. Eat whole foods and avoid processed foods, move your body, avoid toxins, manage stress. More specific prevention measures include not smoking, avoiding too much soy, filtering your water and/or having your water tested for perchlorate and chlorine, eliminating gluten from your diet, avoiding excessive x-rays, and use toothpaste that doesn’t have fluoride. Also watch out for fluoride in mouthwash, and skip a few fluoride treatments at the dentist. Ask for a thyroid shield before dental x-rays. Use only natural forms of soy, and use them in moderation (tofu, tempeh, miso, etc.)
If you have a family history of thyroid disease, diabetes, migraine, colitis, rheumatoid or other autimmune problems in your family, you may want to have your thyroid antibodies checked every year or two. This is especially true during menopause. The presence of anti-thyroid peroxidase (TPO) antibodies is especially helpful in predicting hypothyroidism and makes early detection and treatment is possible.
Who to See
If you do have symptoms, who do you see? Some people go to their family doctor. Some seek out endocrinologists, which seems like a logical choice, and sometimes it is. However most allopathic doctors and endocrinologists work under a structure that doesn’t allow enough time to really know each patient. They need to rely on test results – and the insurance industry supports that. Consequently, you could present with many classic symptoms, but if your numbers fall in the ‘normal’ range (which is a range that is disputed) you might not receive treatment that you need.
“When treatment is based on statistical ranges vs. science, many people suffer,” agreed the panel, all of whom reiterated that whole body symptoms are best treated by looking at the entire complex human organism. Drugs can treat symptoms without treating the thyroid – and, worse, drugs might not even alleviate the symptoms.
“We Are Patients, Not Lab Values.” – Mary Shomon, patient advocate, author of books on thyroid disease, and patient.
Testing for thyroid disease and regulating the thyroid are controversial subjects between natural medicine and conventional medicine. “Holistic doctors conduct more tests than most conventional doctors and endocrinologists do,” said Dr. Cherrone. “This minimizes the chance of overlooking thyroid disease, or treating one symptom and missing the big picture.”
“In many instances we find that natural solutions can both restore our patients’ health and keep them off medications,” added Dr. Aieta.
“We don’t base treatment on highly disputed lab numbers on a piece of paper,” says Dr. Cherrone. “We base treatment on you feeling better. The numbers are just tools, and every patient is different.”
Testing
A holistic practitioner will generally begin by asking about symptoms. “And listening,” said Dr. Aresco. They might palpate (feel) the front of your neck.
“One of the first things I do when I suspect thyroid problems is test the Achilles tendon reflex,” said Dr. Aieta. “It’s almost always delayed in hypothyroid cases.” In some cases the physician will prescribe a baseline ultrasound. Blood tests are generally the next step, and perhaps a urinalysis to check iodine and zinc levels, and more.
The thyroid works in concert with the pituitary gland, and it’s the latter gland that produces TSH. The conventional wisdom of testing only TSH has long-since been found to be woefully inadequate. One problem is that it takes several years for TSH to catch up to clinical symptoms. You can be symptomatic for years and have TSH fall in the normal range.
Today, the following hormones and antibodies are commonly tested: the hormone Thyroxine, also called Tetraiodothyronine (T4); the hormone Triiodothyronine (T3), and the Antithyroid Antibodies (ATA) Antithyroglobulin (anti-TG) and Antithyroid Peroxidase (anti-TPO).
T4 is the storage form of thyroid hormone. Its main function is to be converted into T3. Some T4 is not available for conversion, so testing overall T4 can be misleading. It is more useful to test for Free T4 – the T4 that is available for conversion to T3. T3 is critical – it’s the body’s gas pedal, entering cells and regulating functions. There are two types of T3 – Free T3 (available for use) and Reverse T3, or RT3 (unavailable).
“Often times I will find that a person tests normal on their TSH test but they are exhibiting symptoms of hypothyroidism and have a corresponding low level of Free T3 in their blood,” said Dr. Cherrone. “That means the T4 is not converting to T3. There can be several reasons for this.”
Some reasons for low T3 are deficiencies in zinc, copper, vitamins A, B2, B3, B6, and C. These deficiencies can be caused by nutrients, medications, diet, and more.
For example, in times of stress (mental or physical), the body wants to slow down metabolism and conserve energy. It does this by taking its foot off the gas pedal – by converting some T4 to unusable reverse T3. This would be useful during a famine, but most of us are lucky enough to have enough food, and don’t need or want to be in slowdown mode.
What if a physician only tested for T4 and decided that supplementation was needed, but didn’t test for Free T3? Giving more T4 wouldn’t do any good if it wasn’t converting to T3. If it converts to reverse T3 it actually makes the patient more hypothyroid.
Other reasons excessive reverse T3 include undiagnosed or undertreated problems with low ferriten, cortisol/adrenal problems, or infection. (In these instances the logical remedy is to treat the cause, and see if that corrects the thyroid and alleviates symptoms.)
You can begin to see why measuring one hormone and/or treating one symptom is only enough if you get lucky! The panel of doctors all emphasized that it is not possible to know the true cause of hyper- or hypothryroidism without getting a good picture of the entire, complex person.
Many factors affect how your body produces T3 and T4. Some factors that cause decreased production of T3 include a deficiency in zinc, copper, vitamins A, B2, B3, B6, and C. So it becomes important to test for these nutrients and supplement with adequate amounts. Furthermore, your body needs to be able to convert T4 to T3, the more active form. The conversion can be hindered by elements, nutrients, medications, diet, and more.
Synthetic Hormone Replacement
Even when properly diagnosed, Synthroid, which is, as the name implies, a synthetic thyroid, is commonly prescribed by conventional doctors and endocrinologists. Synthroid is basically synthetic T4. There also is a synthetic T3.
“Synthetic remedies are rarely accepted by our bodies as well as natural remedies are,” said Dr. Moorcroft.
“Many of my patients are on Synthroid when them come to me,” said Dr. Aieta. “They seek alternative care because they still have hypothyroid symptoms – they don’t feel good. And when we get their free T3 test back it usually shows that the levels are too low.
“Many patients experience great relief of symptoms when they switch from Synthroid to Armour thyroid, or another natural substance,” added Dr. Moorcroft.
Treatment
All four doctors agreed that in all but the most severe cases they start with gentle, natural treatments. “Many patients respond well to homeopathic and herbal remedies and never need thyroid medication,” said Dr. Aresco. Dr. Cherrone commented that many of her patients experienced a world of difference with diet and lifestyle changes, eliminating the need for even natural thyroid medications in some patients. Wish it was as simple as popping pills? The doctors lamented that some people have a hard time changing even small habits. If this is you, be sure to see the solution in Dr. Diane’s article, in this issue, on how to rewire your brain to achieve perfect health! You’ll still need some time, but not a lot of willpower, and your efforts will be rewarded with a life of energy, lived in balance.
Herbs, dietary modifications, and homeopathic remedies are all generally considered for the first line of defense. Detoxifying might be the solution, and can be accomplished in several ways, depending on symptoms. In some cases you might get your wish to fix things with a pill – iodine pills are sometimes all that’s needed. Glandulars and/or protomorphogens might be prescribed. Glandulars, also called Whole Gland Desiccated products, are whole organs that are dried at low temperatures and ground up then put into capsules. They are given for general support of various organs.
One advantage of glandulars over herbs is that they often contain enzymes that are identical to those in the human body, while herbs rarely do.
Protomorphogens are like homeopathics, supporting healing over time. Protomorph products are composed of nuclear proteins and are used to supply a better RNA/DNA template so that the body can assemble available nutrients to repair damaged tissue in the glands being treated. What differentiates protomorphogens from glandulars is the patented extraction process.
The next line of defense is natural hormone replacement for most patients. Holistic doctors generally prescribe porcine thyroid, a natural substance that contains all thyroid hormones, including T3 and T4, in a similar ratio to what the human body produces. They also may recommend natural compounded time-released T3. Research has shown that replacing T4 and T3 is more effective than replacing T4 only.
Keep in mind that there are at least five kinds of synthetic thyroid, and five kinds of natural thyroid. Dose, thyroid mix (T4 and T3), and “brand” can all be manipulated to find the best mix for each individual.
In all cases, there are a series of follow-up visits to see what’s working.
The hormonal system is at the center of regulation of all of our functions. It is often overlooked unless it has gone totally awry. Don’t wait for that to happen! Optimizing hormonal function can make truly dramatic differences in the way you feel, and bring more joy to your life.
Dr. Aieta is a board certified and licensed Naturopathic Physician with a private practice in West Hartford, Connecticut. He specializes in the treatment of disease, utilizing natural therapies such as acupuncture, homeopathy, spinal manipulation, clinical nutrition, herbal medicine and natural hormone balancing. He sees a wide range of patients and conditions from asthma and allergies to auto-immune diseases and cancer but specializes in adrenal, thyroid and other hormonal problems. Visit his website www.draieta.com to view his informative videos and articles on various health topics.
Dr. Aresco has a Doctorate in Naturopathic Medicine from Southwest College of Naturopathic Medicine (SCNM) in Tempe Arizona. Dr. Aresco first became interested in holistic medicine while pregnant with her first son. Needing treatment and not wanting to use invasive therapies, she turned to natural healing and was blessed with safe and curative results. The experience placed her on the path to becoming a Naturopathic Physician so she could offer safe and natural alternatives to others. Dr. Aresco’s family practice is located at 355 New Britain Rd., Kensington, CT 06037. Phone: 860-829-0707or visit her website www.KensingtonNaturopathic.com.
Dr. Cherrone
Dr. Moorcroft is a Family Medicine residency-trained Osteopathic Physician who specializes in the holistic treatment of chronic pain, fatigue, brain fog and other chronic medical dis-eases. Dr. Tom helps restore his patient’s hope by finding the root of their problem and creating a personalized treatment plan based upon his extensive experience so they are able to regain the life they want. He practices at Origins Of Health, 844 Hebron Ave. Glastonbury, CT. For more information please call 860-430-9790 or visit www.OriginsOfHealth.com