The Effects of Integrative Medicine in Treating Hashimoto’s Thyroiditis Symptoms
This paper offers an extensive analysis of Hashimoto’s disease, doctor patient relationships, medical treatments for Hashimoto’s symptoms, elimination diets, available drugs for hypothyroid thyroid patients, and my own personal experiences battling this illness. Proving my hypothesis that, “Integrative medicine is a reliable source of medical treatment when it comes to relieving the symptoms of Hashimoto’s Thyroiditis.” The purpose of this paper is to provide the Hashimoto’s community with alternative medical options to mainstream medicine which has deemed itself relatively unsuccessful in treating autoimmune conditions. In the duration of this essay I have used studys from a broad range of doctors and medical professionals as evidence of the effects integrative treatments have of Hashimoto’s Thyroiditis patients. The results of the gathered and analyzed evidence list and explained below shows us that Integrative treating Hashimoto’s provides patients with relief of pain and is a more effective treatment option than conventional medicine.
I was diagnosed with Hashimoto’s Thyroiditis one year ago. I was 15 years old and had been struggling with my health for four years. Not one doctor thought it was strange that a seemingly fine teenager could not get out of bed, even with the most fierce determination to survive another day. I lost control of my life as my condition deteriorated to a point where I could hardly walk five minutes without a break. I refused to show my weaknesses to my friends, teachers, and peers and I persevered through all the pain I was experiencing.
My system was simple: Wake up. Get out of bed. Take some excedrin before the pain hit. Throw on whatever clothes I could find. Head to school, take another dose of excedrin before class starts, and another at lunch. Come home, sleep anywhere from 2-3 hours (because of constant fatigue), do homework and hopefully get to bed before midnight. The next day it would all start over. No one knew, and that meant I could pretend I was fine. Then my grades started dropping, I was constantly depressed and self-medicating three or four times a day while isolating myself from people I cared about and getting sicker. This was my life.
I saw a few different pediatricians who told me it was stress. There were trips to the urgent care where they told me it was hormones and It was all in my head. I saw a neurologist for a year and she said it was just school and the teenage life but we should order an MRI, just to be safe. By then, I needed a break. After the first run of five or six doctors I decided I needed some time to not think about being chronically in pain. I went back to self-medicating and feeling like I was crazy.
Then we started over. As is true for many who have autoimmune, in spite of symptoms that would not go away, I went undiagnosed, with most medical professionals attributing everything I was going through to anxiety.
Next we tried out alternative medicine. There was acupuncture and then therapy. Maybe everyone was right – I was making it up, it was all in my head, and I was just too stressed. I visited a chiropractor and then another pediatrician, and then another break and another dose of excedrin.
I was diagnosed with Hashimoto’s through a phone call that came from a pharmacy calling to let me know my prescription for levothyroxine was ready. Without so much as a call from the doctor, I felt alone, ignored, and like no one cared. I was then referred to a pediatric endocrinologist who wouldn’t spend more than 5 minutes talking to me. Getting diagnosed felt like I could finally breathe and at the same time it felt like I was drowning. I wasn’t crazy, I was sick.
The endocrinologist refused to talk to us about options other than medication, insisting that nothing would help me. I now know that this is a common story for people with Hashimoto. I starting seeing an integrative physician, she was a naturopath. I told the new doctor my story and she could see what I had been through. She told me she could fix me, this was what she did for a living; she worked with people who had my disease and got them to a better place in their life. She was my doctor for seven months before realizing she had put me on a dangerously low dose of medicine because she was not reading my lab work. Her mistake cost me all the progress I had made since I began treating my disease, throwing out everything I had done to get better. Everything I had worked towards was gone.
I know all of this sounds like a lot of failure, but this is the challenge that people with autoimmune face on a daily basis. Being undiagnosed, misdiagnosed, and being told the are crazy. I did however get a lot of pointers from doctors to ease pain and get reduce my symptoms, especially after I was diagnosed. My mom always reminds me that people will always have a lot to say so, “take what work for you and leave what doesn’t.” Over time, I have gradually had some success in reducing my symptoms with practices like: Meditation, The Autoimmune Protocol Diet, Natural Dessicated Thyroid Medicine, and Supplements.
Hashimoto’s Thyroiditis, or Hashi’s, is an autoimmune disease that targets the thyroid gland. The disease causes the body to recognise your thyroid gland as a foreign object in the body. When the body believes the thyroid is a foreign object it triggers the immune system response, producing and sending antibodies to destroy the thyroid gland. Destruction of the thyroid gland throws off the production and distribution of thyroid hormones and causes the body to go into distress, halting the function of other body systems.
When the body attacks itself it is called autoimmune, there are over 100 different autoimmune diseases according to the American Autoimmune Related Diseases Association. Each autoimmune disease is different based on what the disease targets. Some autoimmune diseases you may be familiar with are: Lupus, Crohn’s Disease, PANDAS (children with obsessive compulsive disorder), Rheumatoid Arthritis, Celiac, and Type One Diabetes.
Integrative medicine is a holistic view of the body. This means rather than treating symptoms you search for the root cause of the illness. There has been a lot more success with integrative medicine and autoimmune diseases because it can be so difficult to diagnose the symptoms of autoimmune. The Symptoms of any autoimmune disease are often very broad and inconsistent; symptoms can also be very scattered and there are usually a lot of them.
If I told the doctor I had constant headaches and ran a consistent low grade fever the doctor might write me a prescription for Sumatriptan and provide a final diagnosis of being hormonal. Teens can temporarily run a higher temperature because they have more hormones which increase body temperature.
An integrative doctor is trained to ask the question, “why?” The integrative doctor may ask, “why does a fifteen year old have chronic headaches?” Then they might check hormone levels with labs and come to the conclusion that there was an extremely depleted level of hormones. The doctor would know a low grade fever over a prolonged time is not normal and look for a long standing infection like an unhealthy gut or active epstein-barr. The doctor could then look for the connection between the two; if the patient tested positive for the Epstein-barr virus the doctor would ask why would the body put off hormone production and how does that relate to Epstein-barr? They could then come to the conclusion that the patient had and autoimmune disease.
Integrative medicine looks at the body from a different perspective, it recognizes that the systems of the body work together and not independently. Integrative medicine is a viable approach in treating the symptoms of Hashimoto’s Thyroiditis by looking at the body holistically through targeting the causes and effects of the disease.
According to the American Autoimmune Related Disease Association, autoimmune diseases are a selection of diseases categorized as mistakes made by the immune system (AARDA 2018). These diseases happen in the body when the immune system mistakes your own healthy cells as intruders; the system thinks the healthy cells are threatening microorganisms. When this happens the body creates an immune system response sending hundreds of antibodies to destroy and carry the antigen (an antigen is a molecule the body recognises as foreign) out of the body. In the case of autoimmune, antibodies target the healthy cells, destroying healthy tissue.
In research conducted by the American Autoimmune Related Disease Association a total of 75% of all autoimmune patients are women (AARDA 2018). Different autoimmune disease are more or less common amongst people of different races. For example, research has shown us that lupus is more likely to affect young African American women, Hispanic woman, Asian women, and Native American women than to affect White women (AARDA 2018). These diseases are difficult to understand and their patterns take decades to discover. It takes a perfect storm of genetics, triggers, and environmental factors to create autoimmunity, yet more people have it today than ever before (AARDA 2018). Autoimmunity affects all kinds of people and usually has a genetic link; that is why it’s found clustered in families (AARDA 2018).
There are many different types of autoimmune, some are more common and well know than others are. The characteristic that defines what autoimmune disease someone has is what tissue or organ the antibodies target and how the immune system responds. For example, in rheumatoid arthritis the antibodies target joints; in hashimoto’s thyroiditis the antibodies target the thyroid gland, diabetes antibodies targets the pancreas, and in Addison’s disease antibodies deteriorate the function of the adrenal wall (AARDA 2018). There are over 100 autoimmune diseases and they are all unique and affect the body differently (AARDA 2018).
While no one autoimmune disease is the same, they all share certain characteristics. Every autoimmune disease has antibodies present that are affecting the targeted tissue. Each disease also causes extreme inflammation in the body that will only decrease when the level of antibodies decreases (Posselt, R. T., Coelho, V. N., & Skare, T. L. 2018). Antibodies can be decreased by diet (eliminating inflammatory foods like gluten, dairy, eggs, corn, and soy), by taking anti-inflammatory medications (immunosuppressants), by experimental treatments like Low Dose Naltrexone (blocks the opioid receptors at night so that in the morning you release two – three times the amount of endorphins and get a boost in mood and immune function), and with other holistic treatments.
Another common factor of autoimmune is inflammation. When the body thinks there is an intruder it produces an influx of chemicals and antibodies (little warriors that are suppose to neutralize the threat and carry it out of the body through the immune system) and sends them off to handle the foreign body (Posselt, R. T., Coelho, V. N., & Skare, T. L. 2018). At the site of the attack, the immune system has an inflammatory response to protect the rest of the body by producing inflammation (swelling) and heat to begin the recovery process (Posselt, R. T., Coelho, V. N., & Skare, T. L. 2018). However, when a whole organ is under attack this response happens on a much larger scale. The body can remain in an inflammatory state for years until you reach a point of remission with the disease. High amounts of inflammation in the body for a prolonged time can lead to the development of additional autoimmune disease, cancers, and other serious health problems (Posselt, R. T., Coelho, V. N., & Skare, T. L. 2018).
One more correlation between all autoimmune diseases is gut health. In the gut everyone has something called a microbiome, this is a community of bacteria and microorganism that are instrumental in the way your body functions. Research shows that the gut contributes to the immune system, brain function, mood, and other physical and mental conditions (Wyatt, D. A. 2017). When small perforations in the gut walls develop it is called leaky gut (Wyatt, D. A. 2017). This is when toxins and pathogens that the gut typically processes and dismisses from the body seep through the perforations and enter the bloodstream (Wyatt, D. A. 2017). Once the pathogens enter the bloodstream the gut no longer has control of it and it become the responsibility of the immune system and induces an immune system response (Wyatt, D. A. 2017). If you have leaky gut then you also have a consistently elevated rate of inflammation because you regularly have a pathogenic induced immune system response (Wyatt, D. A. 2017). This cycle is a breeding ground for the development of autoimmune diseases.
With autoimmune diseases there is a lot of opportunity for misdiagnosis and for going undiagnosed for an extended period of time. Unfortunately with an autoimmune disease it can be very tricky to diagnose for a few reasons. To start out, autoimmune disease are whole body diseases, this means that it can not simply be treated through medication or by one specific avenue of medicine. These disease are present in the entire body. Even if the antibodies are only targeting the thyroid, it is still affecting many other bodily systems. For example if you have Hashimoto’s thyroiditis your body is focused on destroying the thyroid gland, and because of this it is unable to produces and manage all of the hormones your body needs. This affects menstruation, fertility, neurological stability, central nervous system functions, adrenal function, bone and tissue growth, and more. Since autoimmune diseases affect more than the targeted tissue, it makes it difficult for traditional medicine to diagnose them because in traditional medicine doctors are taught to treat symptoms and not search for the root causes. This makes it easy for an autoimmune disease to be overlooked. When you tell the doctor you are depressed (a common autoimmune symptom), have chronic headaches, fatigued, and you are 15, they might prescribe you antidepressants. They’ll test your vitamin D levels and run other blood work, but miss the opportunity to look for a connection between how the systems of the body are interacting and presenting in the patient.
Looking holistically at the body you would ask, “how does this connect?” An integrative doctor also takes into account the patient’s lifestyle, diet, and environments. When these factors are not taken into account, autoimmune diseases can go undiagnosed or be misdiagnosed; leading to years of suffering with physical, mental, and emotional damage to patients.
From personal experience I can testify to the damaging effects that going undiagnosed for a long period of time has on a person’s mental and physical being. When something is truly wrong in your body, you know. You need a doctor to spend more than five seconds with you. You want to be heard. You want them to see you and your pain. The doctor gives you some explanation for your bucket full of symptoms like stress, hormones, or depression and sends you on your way. You wake up the next day feeling the same. Weeks pass and nothing has changed. Suddenly you’ve been sick for years and still they say nothing is wrong. You start to doubt yourself. You’ve exhausted the internet’s suggestions and there is no explanation for your pain other than that it is all in your head. These experiences caused me to give up hope on finding help, increased my depression, and put cracks in my support system. I can only imagine watching someone you love, so frail and fragile, get sicker and being with them on their journey. People tell you that they are crazy, their illness is in their head; you can’t feel what they feel. How can you know it is real? I would doubt it too.
Hashimoto’s is a disease that targets the thyroid but it affect the whole body and that is evident in the broad range of symptoms people with this disease have. Some the most universal and increasingly debilitating symptoms according to (Mayo Clinic 2016) include: fatigue, depression, muscle weaknesses, joint stiffness, and extreme sensitivity to cold. Some of the less prominent symptoms consist of: weight loss and/or gain, hair loss, brittle nails, memory lapse, inflammation, and swollen thyroid gland.
When you have Hashimoto’s thyroiditis the symptoms you experience change often due to instability in thyroid hormones and inflammation markers in the body (Dach 2017). If your body is not responding to medication or you are not being treated then there is no way for your inflammation to go down, The more inflamation you have, the more reactive and unpredictable your body will be. For example if your inflammation is particularly high one month then you may have more or stronger symptoms than normal. The body is always fluctuating, trying to get as close to homeostasis as possible so things are rarely the same, even if you are not fighting a chronic illness (Dach 2017). You may experience headaches and joint pain for a few months and then severe fatigue and swelling the next couple months.
Since fluctuation causes continuous change, if you are not seeing a regular doctor (same doctor everytime), which most of us don’t anymore due to challenges with health insurance or lack of health insurance, then it is difficult to keep track of your symptom history and important factors may be overlooked. If you have new symptoms each time you see a doctor there is no continuity in your care and patterns are hard to find. It’s like starting from square one each time and it becomes difficult for medical professionals to diagnose Hashimoto’s patients.
Many factors contribute to having this disease; there are triggers, mistakes by doctors, and lifestyle elements that can make it worse. It takes a physical and mental toll and takes years to recover in just the smallest ways. However not everyone is lucky enough to recover. Many people never even find out they have Hashimoto’s until it has taken them over and transformed into an illness even more dramatic and life threatening.
Over time if left untreated Hashimoto’s thyroiditis can develop into papillary thyroid carcinoma, a type of common thyroid cancer (Okani 2015). The disease can also affect fertility in a major way. Fertility is always high risk with autoimmune patients but according to (Gomes, Mesquita, & Capela 2015) it is especially a risk in hashimoto’s patients. Fluctuation in hormones and the power of antibodies can impact a woman’s ability to conceive, cause a miscarriage, and cause pregnancy complications. Women with this disease have a more likely chance of an early miscarriage and infertility due to the hormonal instability already being managed by the thyroid and then the increase in hormones due to pregnancy.
Hashimoto’s also impacts mental stability and can have serious effects on the brain that are both long term and short term, including depression, anxiety and brain fog according to (Hoeffding, L. K., Rosengren, A., Thygesen, J. H., Schmock, H., Werge, T., & Hansen, T. 2017) There is a strong connection between schizophrenia and autoimmune diseases. Leaky brain is another mental effect from Hashimoto’s, it is the same concept as leaky gut (perforation in blood vessels cause toxins and pathogens to leak into the brain) and causes clouding in the brain and prevents focus.
Good quality of life can be difficult to find with an autoimmune disease; there are many factors that affect life quality and successful treatment. One of the most prevalent factors in life quality with an autoimmune disease is the financial ability to seek treatment. Medical care is expensive and with active hashimoto’s you have monthly labs, doctor visits, medications, the diet, and symptom treatments, to think about. In a country with a system so rigged, where medical care is difficult to afford for most families and high insurance prices are often paired with low coverage, patients sometimes end up paying out of pocket to get what they need in terms of treatment and testing. Access to different degrees of health care plays a part in a patient’s outcome. Patients with access to plenty of resources are going to have a better chance at getting the care they need.
There are many different treatments to help reduce symptoms and send Hashimoto’s patients into remission. A broad range of treatments targeting different aspects of the disease and helping the body to be healthy are exactly what the purpose of treating hashimoto’s integrative (treating the whole body) is. The very first treatment a Hashimoto’s Thyroiditis patient will likely begin is a thyroid hormone replacement to start providing the body with some of those important chemicals again.
When you have Hashimoto’s Thyroiditis there are two options in medication, synthetic or natural. Synthetic thyroid is called Levothyroxine and is compounded in a pharmacy to act as an identical thyroid hormone when you take it and contains only T4 or T3. Natural thyroid is made by compounding crushed thyroids from desiccated pigs and contains T1, T2, T3, T4 and calcitonin. Some patient are able to reverse their symptoms on Synthroid but there is a large community of people with thyroid issues who are not able to see improvement in their disease on synthetic hormones but instead benefits from natural thyroid which contains all of the thyroids natural hormones like T3, T2, and T1.
What you are prescribed has to do with your doctors preferences in natural or synthetic hormone replacement. Some doctors have concerns about prescribing natural drugs like Armour Thyroid because natural thyroid medications can be difficult to dose considering not every animal has the same hormone secretion in their thyroid gland. Considering this, if your medication has an unstable dose then you are causing hormone fluctuation, the exact thing you are trying to prevent, by taking it daily. However some doctors prefer natural thyroid for its broader range of thyroid hormones and the facts that patients can have serious side effects on synthetic hormones.
This controversy of natural versus synthetic drugs goes deeper than just doctor preference and how predictable dosage is. The dispute largely has to do with monopoly of the pharmaceutical market. This sort of competition for marketing drugs to patients largely affect the hashimoto’s community. This problem makes it difficult to receive access to the medication that will be best for patients and as demonstrated above, medication is a major part of successful integrative treatment.
Kickback is the involvement of third party providers in the relationship doctors have with patients by offering revenue for prescribing a certain drug enough times. This system creates many problems that affect patients, pharmacies, and doctors. First of all, doctors pushing one brand of medication for all patients because of perks they will receive leads to doctors forcing drugs that may not be right for a patient’s condition. Second, major synthetic thyroid hormone brands like Synthroid dominate the pharmaceutical market making millions by bribing doctors and unfairly marketing their product through false advertisement.
According to GoodRx, Synthroid’s Levothyroxine is the single most prescribed drug of 2017, with 21.5 million people in America holding a prescription to it (GoodRx 2017). That is not 21.5 million people suffering from hypothyroidism (an underperforming thyroid) that is medical abuse. In 2016 alone the brand Synthroid made over 900,000 payments to healthcare professionals (Research and Markets 2016). Synthroid is known as a medication called a “Designer Drug”, which is a part of a group of name brand drugs that are more expensive in cost than off brand drugs like Levothyroxine or Armour (natural thyroid). This is important since these drugs are pushed so much that patients end up thinking that those over marketed products will work better than other brands, which is in fact completely untrue According to Drugwatch, the pharmaceutical company AbbVie (formerly known as Abbott Laboratories, changing their name is 2013), Synthroid’s parent company, made $763 million dollars off of synthroid in 2016 alone. (Drugwatch, 2016) Alongside Synthroid sits the company’s Humira (the world’s top selling drug) bring in whopping $16 billion dollars in sales and Viekira (for hepatitis C) with a $1.5 billion in sales. This king of revenue comes from the company’s abuse of the medical industry and marketing industry.
Described by Washington Post in 2012, AbbVie is also known for fraudulent marketing of their product by advertising off label and unapproved usage of their drug Depakote to nursing homes in the 90’s. The clinical trial of Depakote was canceled after Abbott Laboratories admitted to targeting nursing homes but continued distributing the drug until 2006 and were then settled for with a criminal payout of $700 million and a government fine of $800 million.
As shown above, off label prescriptions can be dangerous and misused but they also play a major part in integratively treating Hashimoto’s Thyroiditis. Off label prescribing is a practice in the medical field which distributes drugs for treatment other than the FDA’s approved usage of the substance. According to (Henry 2003) an estimated 40-60% of Americans with prescriptions at the time held them for off label usage.
One specific drug on the forefront of changing the way we treat autoimmune diseases and inflammation in the body is low dose naltrexone (LDN). Naltrexone is a drug used in high increments to reverse overdoses by blocking the opioid receptors to prevent damage of the drugs. Naltrexone works similarly in small doses between 1.5mg and 5mg taken before sleeping to block the opioid receptors overnight slowing the production of endorphins and so when you wake up and the LDN wears off, the body produces two to three time the amount of endorphins which then improves the immune system and the bodies’ function. LDN works by slowly bringing down inflammation, helping the immune system and steadily decreasing the presence of antibodies.
Food plays an important aspect in how your body functions. Some forms of medicine believe that food alone can heal people of autoimmune diseases. As stated by Dr. Patricia Rodgers, “Food allergy is an adverse reactions resulting from an inappropriate immunological response to a food antigen” (Rodgers 2011). Often when the immune system is weak or underdeveloped there is in increase in food related allergies and allergy symptoms (Rodger 2011). The compromised immune system can not process allergenic foods and has an immunological triggered response, this creates an inflammatory food allergy. The Autoimmune Protocol Diet was designed to help reduce immediate inflammation and begin controlling and de-escalating autoimmune diseases (Leech 2017). The purpose of this diet is to remove any possible gut contaminants or irritants that could be causing an immune response (which causes symptoms) in someone with autoimmune. Foods that are eliminated include: gluten, dairy, eggs, processed sugars, nightshade vegetables, legumes, all grains, coffee, cacao, nuts and seeds, and alcohol. The meal outline for this diet should look like 20% clean meats, 80% vegetables, and limited fruits throughout the day for three or four months to cleanse and heal the body. After three or four months on the diet the reintroduction phase starts. This is where you reintroduce each individual food one at a time over a series of months. Any foods that cause pain or discomfort after eating again are foods that are likely triggering an immune response and producing inflammation in the body. According to nutritionist Dr. Leech, by removing these reactive foods it gives the body a break to heal and can send autoimmune into remission (Leech 2017). When combined with other integrative treatments the Autoimmune Protocol Diet seems a viable choice of reducing autoimmune symptoms.
The eastern practice of meditation has been known to reduce stress and inflammatory triggers in the body making it a feasible treatment option for Hashimoto’s or any autoimmune disease. Evident through the findings of the science writer, Jo Marchant, “In some of the earliest research of this type, conducted on Buddhist monks who had spent tens of thousands of hours meditating, scientists observed high levels of activity in brain areas that control focus and positive emotions” (Marchant 2017). Meditation could be a valuable tool in treating the hashimoto’s symptom of depression by increasing positive emotions. Meditation decreases the size of the part of the brain that controls threats and increases the parts of the brain that is responsible for emotions, learning capabilities, and memory (Marchant 2017). By lowering activity in the area controlling threats the brain reduces the amount of times it sends itself into the flight or fight response which is known to be a large contributor to the production of inflammation (Marchant 2017). The very act or meditation could revolutionize levels of inflammation in Hashimoto’s and autoimmune patients.
Through extensive research we can conclude that integrative medicine makes for a better treatment option for Hashimoto’s patients because a holistic view allows for the treatment of multiple aspects of the disease at once. For example, when treating integratively we can combat inflammation with by reducing stress responses, prescribing Low Dose Naltrexone, and correcting diet. Looking at the body as a whole has more impact for sending Hashimoto’s into remission; options like thyroid replacement hormones, Autoimmune Protocol Diet, anti-inflammatory drugs, and meditation, are all viable effective treatments. By lowering inflammation and balancing out hormone levels Hashimoto’s can be corrected. However because of the limitations of traditional medicine, including: competitive pharmaceutical markets affecting drug availability, doctor payoffs restricting patients knowledge of medical options, underdeveloped doctor-patient relationships, and educational drop offs in autoimmune awareness, it can be extremely difficult to find proper treatment in mainstream medicine without an integrative perspective. The effects of treating Hashimoto Thyroiditis symptoms with integrative medicine has proven a viable and successful option and produces better results than treating symptoms with traditional medicine.
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