Hashimoto’s Diagnosis and Treatment: The New Normal

When it comes to listening to women articulate feeling less than their best, Edmund Rhett, MD is a master. He considers the patient’s input when designing an individualized treatment plan. His desire to continue to provide more comprehensive care to his patients at Rhett Women’s Center has led him to the Functional Medicine approach. Functional Medicine marries the best of conventional and naturopathic, evidence-based medicine to offer a systematic approach to healing the patient. At Rhett Women’s Center, Gene Blake, NP and Erin Copenhaver, PA-C specialize in this integrative model of care. In honor of World Thyroid Day, May 25th, we are highlighting Hashimoto’s Disease, a common condition that can often be improved with the Functional Medicine methodology.

Hashimoto’s thyroiditis, also known as autoimmune thyroiditis and Hashimoto’s Disease, is a progressive disease of the thyroid gland causing a decreased ability to make thyroid hormones. It is caused by antibodies, or immune cells, that attack the thyroid and destroy it. Hashimoto’s is the most common cause of hypothyroidism in North America and Europe; it more commonly affects women and tends to run in families. The incidence of the disease is rising, and it can be hard to diagnose given the wide range of associated symptoms.

Erin Copenhaver, PA-C shared why Rhett Women’s Center is an important resource for people seeking relief from Hashimoto’s symptoms. “We know what it is, and we know what to do with it. Frequently, we see patients resigned to feeling unwell. By looking for the root causes to see what has triggered the disease in the first place, we can help abate the symptoms,” explains Copenhaver. “Many patients have seen other doctors who often focus solely on managing thyroid labs. This is not enough. If you don’t address the autoimmune part of the disease, then it can be hard to feel better. Additionally, if one autoimmune condition goes unchecked then there is risk for developing a second and third autoimmune condition over time. By identifying the reasons for the body to be in ‘attack’ mode – which are different for each individual – we help the patient to feel better and reduce the risk of other disease.”

What should you expect from your thyroid related visit? It begins with a thorough lab evaluation, not only for thyroid but for other related deficiencies. The clinician also takes into consideration that the lab normals listed for thyroid may not be accurate. Review of studies by endocrinologists years ago, led to the recommendation to narrow the reference ranges. However, most lab companies have not followed suit, meaning that many with hypothyroidism and subclinical hypothyroidism fall through the cracks.

Rhett Women’s Center uses a narrower range when assessing lab results based on research as well as the understanding that “normal is not optimal,” Copenhaver explains. “When you look at optimally healthy people and study what their normal lab ranges are then those levels become our goal in optimizing a person’s health.”

Another big piece of the puzzle is addressing the ‘roots’ of all health: nutrition, sleep, exercise, stress management, and relationships. It’s amazing what progress can be made when simply addressing those basics. Gut health and hormone balance are two of the main aspects Rhett Women’s Center addresses in Hashimoto’s patients. The thyroid gland is highly susceptible to environmental exposures such as inflammatory foods, mold, metals, toxins, and viruses such as Epstein-Bar, which causes mononucleosis and can later trigger autoimmune thyroiditis. Copenhaver explains, “the gut microbiome and hormones are important immune modulators. When they are out of balance it’s difficult to calm the autoimmune attack. Unless you are looking at those factors and trying to reverse them, a lot of people don’t get better.”

The thyroid produces hormones that help regulate a wide variety of critical body functions. For example, thyroid hormones influence growth and development, body temperature, heart rate, menstrual cycles, and weight*. Hashimoto’s symptoms may vary from one affected individual to another. Some common symptoms include:

  • Excessive tiredness (fatigue)
  • Weight gain or difficulty losing weight
  • Thin or dry hair, dry skin, hair loss
  • Slow heart rate
  • Joint or muscle pain
  • Constipation
  • Heavy period/period issues
  • Brain fog
  • Depression and anxiety
  • Feeling cold often
  • Pale, puffy face
  • Difficulty conceiving, multiple miscarriages

Effected women can have heavy or irregular menstrual periods and Polycystic Ovarian Syndrome (PCOS) is commonly a problem for thyroid patients. “Hashimoto’s symptoms vary greatly and are not only the classic ‘gaining weight and tired’ that most people think of. Difficulty concentrating and poor word recall can also be signs of a shortage of thyroid hormones,” says Copenhaver. “This is an inherited disease and can manifest itself throughout families. The good news is that when you heal women, you often heal families.”

If you think you may be suffering from Hashimoto’s we invite you to visit Rhett Women’s Center to find out how the Functional Medicine approach can start you on your healing journey.

*Genetics home reference. US National Library of Medicine.