Thyroid Management Program

Safe THYROID Management

Generally any issue with abnormalities in thyroid is not noticed unless you regularly do your preventive health. Thyroid disorders are widely seen among both men and women right from adolescence.

Treating HYPOTHYROIDISM

As always with integrative medicine, doctors do not treat the symptoms, they do not even treat the disease. They treat the cause. So, first, they have to figure out the cause. This can take time and usually requires in depth lab investigations that screens hormones, micronutrients, gut bacteria, inflammation, and more. Sometimes, your symptoms can help the doctors

Depending on the cause, treatment may involve use of thyroid hormones (natural or synthetic), vitamins, minerals, herbs, diet changes, stress management, and other lifestyle changes.

The treatment plan for hyperthyroidism in integrative & functional medicine approach includes a careful detailed screening. Addressing the causing factors is the prime focus. Step wise approach of Removal of gluten from the diet, healing the gut, testing for heavy metals, treating the infections post screening, supporting the immune systems strongly by specific supplements such as omega, glutathione, etc. that are powerful antioxidants which helps reduce inflammatory effects on glands and improve detoxification. Few thyroid-calming herbs / natural food are very useful.

Depending on the patient – hyper / hypo, thyroid supporting minerals such as zinc, selenium, and iodine, alongside antioxidants like vitamins C and E are recommended to support thyroid function for its optimum. Since these multi vitamins and minerals are required in small quantities, a clear understanding of its deficiencies are important, which are determined by our functional medicine experts, by conducting various type of screening.

The team of doctors at wellbeeing have developed various protocols to address the cause of hypothyroid

1. We address the stress, the first factor for thyroid imbalance
Our hormones interact and interfere with each other. Stress hormones can interfere with the thyroid gland and thyroid hormones, which results in hypothyroidism. Stress hormones, through the inflammation can stop the brain cells from sending signals to the thyroid, which in turn can stop the conversion of T4 to T3, and interfere with how cells respond to T3.Getting adrenal glands and stress hormones evaluation is very ideal if you have a thyroid dysfunction. Other hormones, such as estrogen, can also interfere with the thyroid. High levels of estrogen increases the protein that binds the thyroid hormones in the blood. When thyroid hormone is bound to this protein, it is inactive.

2. Replenish with nutrition supplements that are a deficient.
In order to make and activate thyroid hormones, your body needs tyrosine, iodine, iron, selenium, zinc, and methylfolate. If you are not getting enough of these nutrients in your diet or you have digestive issues preventing absorption of nutrients, you may be functionally deficient resulting in low T3. Also, if you have genetic mutations in the enzymes that use and activate these nutrients (such as in MTHFR gene), your body may struggle to make enough active T3. 

3. Addressing the trigger factor for autoimmune reaction in the body
The most common cause of hypothyroidism is Hashimoto's, an autoimmune disease where your body attacks your thyroid. There are multiple factors that lead to the development of this autoimmune disease, which means there are many ways to address and reverse this disease. Factors to consider include gluten cross-reactivity, imbalances in gut bacteria, increased intestinal permeability, chronic viral infections, and heavy metal toxicity. This model provides a lot more treatment options and therefore, a greater chance of healing your body. Some of these are addressed very well by Ayurveda body analysis of the person. It explains the genetics and epigenetics load on the body. Careful planning of the diet, lifestyle, and environment can impact what genes our body turns on and what genes are body turns off. Understanding this is most important for preventing an autoimmune disease.

Treating hypothyroid encompasses a multidisciplinary approach of detailed screening of the blood parameters and assessing the symptoms, detoxing the body, metabolic corrective steps, addressing the nutrient deficiencies, mobilization therapies for managing the energy levels, stress management and handling emotions and environment that may be the triggering factors for long, diet & nutrition therapy, backed with active fitness and stimulation through thyroid packs. Regular follow up, evaluation and monitoring of thyroid levels & tapering of medications and monitoring for a longer period is the approach that we believe is an ideal treatment protocol.

However, our on line program focuses more on the non-therapy based interventions, while our OPD (outpatient department) or day care clinic addresses the same by combining select therapies of Ayurveda and Naturopathy to influence a change in the physiological environment. Ayurveda’s focus is to correct the structural damage of various tissues related to gland function, functional aspects of the hormones and balancing the kinetic energy flow (nerve impulse) or energy and emotional balance. Thus the three pronged effort of principles of nutrition deficiencies, corrections in the metabolic system and influencing the mental balance helps reverse this autoimmune disorders with better outcomes.

Treating HYPERTHYROIDISM

An integrative and Functional Medicine Approach to Hyperthyroidism

The treatment plan for hyperthyroidism includes a careful detailed screening, addressing the causing factors is the prime focus. Step wise approach of Removal of gluten from the diet, healing the gut, testing for heavy metals, treating the infections post screening, supporting the immune systems strongly by specific supplements such as Omega 3, glutathione, etc. that are powerful antioxidants which helps reduce inflammatory effects on glands and improve detoxification. Few thyroid-calming herbs / natural food are very useful

Many thyroid supporting minerals such as zinc, selenium, and iodine, alongside antioxidants like vitamins C and E are recommended to support thyroid function for its optimum. Since these multi vitamins and minerals are required in small quantities, a clear understanding of its deficiencies are important, which are determined by our functional medicine experts.

High fiber diet, select amino acids and other supplements, along with regular yoga practice that helps in rejuvenating the body helps in reversing muscle weakness, combat sleeplessness, nervousness ad tremors. Therapeutic yoga is an effective form of stretching, breathing and strengthening the body, that regulates the union of mind and body, helps in regaining more energy, and brings thyroid function in equilibrium, and thus ensures you feel like yourself again. For off-line programs, we encourage select Ayurveda therapies to reduce stress and detox the body, which overall enhances the immunity.

Conventional approach vs Integrative-Functional Medicine Approach for treating HYPERTHYROIDISM

HYPERTHYROIDISM is a condition that occurs when the thyroid is overactive and produces too much thyroid hormone. When thyroid hormones are too high, energy metabolism will speed up, causing the body to burn through nutrients too quickly. This can result in malnutrition and lead to a wide range of problems. One of the common problem is loss of weight which is not healthy.

Cause of HYPERTHYROIDISM

There can be many reasons for the thyroid to be overactive, but one common reason is autoimmune condition, known as Graves’ disease.

Normally, thyroid function is regulated by the pituitary gland, a tiny gland responsible for secreting TSH, which signals the thyroid to produce thyroid hormones T3 and T4. In Graves’ disease, an antibody known as thyrotropin receptor antibody (TRAb) can mimic pituitary hormones and completely override the system, causing an overactive thyroid. You can also develop Thyroid Peroxidase (TPO) antibodies or Antithyroglobulin antibodies.

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

Diagnosis of HYPERTHYROIDISM

Blood testing your thyroid hormone levels is the first step. In HYPERTHYROIDISM , the thyroid- stimulating hormone (TSH) will be very low and the Free T4 and Free T3 will be elevated. In autoimmune conditions, antibodies too would be elivated.

Radioactive iodine uptake (RAIU) is the next step in diagnosing a thyroid imbalance. An RAIU will determine how much iodine the thyroid takes up. A high iodine uptake is indicative of Graves’ disease. This test helps to rule out other possible causes of an overactive thyroid.

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

Conventional Treatment for HYPERTHYROIDISM

Conventional medicine is focused on treating symptoms, not on getting to the root cause of the disease. Medications, radiation, and surgery the options available in this approach can only treat the overactive thyroid gland with a hope of reducing symptoms of the disease.

Adverse effects of the treatments

1. Medications
Propylthiouracil (PTU) is an anti-thyroid drug known to interfere with the production of thyroid hormones, and increases the load on liver function, Long-term usage of this medicine weakens the body. Methamazole is another anti-thyroid drug administered for HYPERTHYROIDISM, whose side effects could cause HYPERTHYROIDISM . Hence requires careful monitoring of TSH and Free T4 levels.

2. Radiation/Ablation
This approach uses a large dose of radioactive iodine, which has high risk of affecting or permanent destruction of thyroid gland cells. After this procedure, often, patients are destined for a life-long thyroid hormone medication.

3. Surgery
When anti-thyroid medications and radioactive treatments are not viable options, doctors may recommend a partial thyroidectomy, which is when part of the thyroid gland is surgically removed. This could be the best option when finally.

In order to truly solve the problem and repair the thyroid and immune system, the integrative & functional medicine approach in hyperthyroidism recommends to identify and evaluate the underlying cause, and address them systematically, with regular monitoring and evaluation of blood parameters.

1. Gluten’s molecular mimicry characteristic are harmful
Gluten is a huge problem since it’s a process ingredient. It has harmful effect on your gut and set you up for a leaky gut. Gluten can get into your bloodstream and confuse your immune system (Gluten’s molecular structure is similar to thyroid’s molecular structure. Hence, the immune system can get confused and accidentally attack your thyroid gland).

2. Leaky gut due to infections or medications leads to auto immunity
Many things including, gluten, infections, medications, and stress can damage the gut, allowing toxins, microbes, and undigested food particles – among other things – to enter directly into your bloodstream causing the systemic inflammation, which leads to autoimmunity.

3. Mercury can damage the cells
Mercury is a heavy metal that is capable of altering or damaging the cells of various bodily tissues. When cells are damaged, often immune system mistakes them as foreign invaders and begin attacking its own organs (called autoimmune disorders). Researches have shown that individuals with higher mercury exposures have an increased risk of getting an autoimmune thyroid disease.

4. Infections
Infections such as the herpes and other viral infections have been implicated as a potential cause of autoimmune thyroid disease through inflammation and molecular mimicry.

5. Iodine
When the body detects an increased availability of iodine, this can trigger the thyroid to produce more thyroid hormone. If someone with a relatively low intake of iodine suddenly consumes a very iodine-rich diet, then over time that individual can produce an excessive amount of thyroid hormone, resulting in an overactive thyroid.

Conventional approach vs Integrative-functional medicine approach to treat HYPOTHYROIDISM

Conventionally, only screening assessment will determine the disorders, and only when thyroid dysfunction is severe, conventional medicine treats it (with drugs and surgery).

The standard method to evaluate the thyroid is to test TSH only. If TSH is high, this means the brain sensed low T3 levels, so it is now shouting at the thyroid to make more. If TSH is low, this means that the brain senses a lot of T3 in the blood. When TSH comes back abnormal, doctors will then usually test for T4 levels.

In Integrative & Functional Medicine approach, we see this as a problem. The reference range for TSH is not accurate. According to the reference range, your thyroid function is normal if your TSH is anywhere between 0.5 to 8, which is a huge range of thyroid function.

Often people with thyroid feel satisfied if their TSH is between 1 and 2, and feel concerned if it is 4. When it is 8, it is considered as your thyroid is severely dysfunctional. Many doctors may not even further assess your thyroid function until your TSH is greater than 8, which is not alarming to them. It’s not considered as a big concern often.

However, you may be experiencing fatigue, stressed, digestive issues, depression, and hair loss. Why? Isn’t the body saying something to you? Trying to yell at you?

If your TSH is greater than 2, it is time to get further evaluation. We recommend complete thyroid evaluation through screening: free T4, free T3, anti-TPO, anti-TG & reverse T3 (optional)

Often individuals will have a TSH greater than 2 with free T4 and free T3 on the low end of normal. Most people feel the best when their thyroid hormones are on the upper end of the normal range. A free T4 around 1.5 and a free T3 around 3.5 is good.

When your TSH is elevated (this may mean above 2 or even above 8) and your free T4 and free T3 are normal, this is called subclinical HYPOTHYROIDISM. This is a bit of a misnomer because in this state, the labs are saying your thyroid is fine according to the reference ranges, but your body is telling a different story. You have all the signs and symptoms of HYPOTHYROIDISM, just not the lab values. If you have subclinical HYPOTHYROIDISM, many doctors wait or do not act until it gets worse.

What most doctors miss here is, that the story of the antibodies. Anti-TPO and anti-TG are antibodies that you’re the immune system prepares to attack the thyroid gland. This happens in an autoimmune disease called Hashimoto's, which is the most common cause of HYPOTHYROIDISM.

Most doctors never test for antibodies. Why? Because the presence of antibodies does not change their treatment approach. Whether you have Hashimoto's or plain HYPOTHYROIDISM, they will still treat with drugs.

In the approach we follow, we assess the subclinical HYPOTHYROIDISM which has elevated antibodies. This means Hashimoto's is caught at an early stage, which is treatable. Because we can now treat it and prevent damage to your thyroid gland that otherwise may be permanent.

Your thyroid is a small gland that is at the base of your throat. Thyroid makes thyroid hormones which are responsible for growth and energy production in the body, broadly speaking. Thyroid hormones regulate the basal metabolic rate (how much calories we burn each day), how we metabolize carbohydrates, proteins, and fat, and how hard our cardiovascular system works.

How the thyroid hormone works?

To help you understand your thyroid (a small, butterfly-shaped gland in the front of your neck), we first need to discuss a little bit of thyroid physiology.

The production of thyroid hormone by the thyroid gland is governed by the brain. When a gland in the brain, called the anterior pituitary, senses that there is not enough active thyroid hormone in the blood, it sends a messenger to tell the thyroid to make more hormone.

The messenger is called Thyroid Stimulating Hormone (TSH). This is the screening test that doctors use to evaluate thyroid function. In response to TSH, the thyroid makes more thyroid hormone, mostly in the form of the inactive hormone called T4. T4 is converted to the active hormone, T3, in the liver, kidneys, and brain. T3 then enters all different types of cells in the body to send messages about energy production and growth.

Thyroid disease occurs when the thyroid does not produce the right amount of thyroid hormone. So you can understand that if you have a problem with your thyroid, this will have a big impact on your overall health. 

Thyroid disease is a medical condition that affects the function of the thyroid gland. The most common thyroid disorders include hyperthyroidism and hypothyroidism. Having hyperthyroidism and hypothyroidism can be both unpleasant and uncomfortable, but these thyroid conditions can be managed if properly diagnosed and treated. The first step is checking thyroid function with checking free T4, free T3, reverse T3, TSH, total T3, and thyroid antibodies.

Types:

Hypothyroidism - when your thyroid gland does not make enough thyroid hormones Hyperthyroidism - when your thyroid gland makes more thyroid hormones than your body needs

Causes:

• Iodine deficiency
• Autoimmune diseases, in which the immune system attacks the thyroid, leading either to Hypothyroidism (caused by Graves’ disease) or Hypothyroidism (caused by Hashimoto's disease)
• Inflammation (which may or may not cause pain), caused by a virus or bacteria
• Nodules, or non-cancerous lumps
• Cancerous tumors
• Certain medical treatments, including radiation therapy, thyroid surgery, and some medicines
• Some genetic disorders

Symptoms:

HYPOTHYROIDISM can be considered as condition which results due to Agni Dushti and Vata Kapha dosha dushti. In Ayurveda Thyroid problem is co-related as Galaganda and Gandamala as nodular swelling in thyroid region is seen

As far as the management of HYPOTHYROIDISM through Ayurveda is concerned, hormonal replacement is not possible through drugs. However, one can interpret the pathogenesis of HYPOTHYROIDISM in the context of Ayurveda, in which role of Agni is foremost and through its management, wholesome normal activity of the thyroid gland may be achieved. The objective of treatment should be to address the problem at its root – causes (Vyadhi Pratyanika chikitsa & Dosha Pratyanika Chikitsa) i.e. reduced digestive fire and vata-kapha dosha vruddhi by regulating the immune system and decreasing inflammation. This is achieved by

• Cleansing of the macro and micro channels and digesting the toxins in the channels
• Stimulation of the digestion and metabolism. This is done by avoiding the causative agents, by following specific diet and oral medicines and by following some therapies.
• Digestion and Proper regulation of excretory system are the main principles of treatment.
• Palliative drugs is also used commonly after purification to control the remaining Dosha.
• Mind Tranquilizing diet, self-care and medicines are also explained to reduce the stress or mind agitating emotions so that the root cause of thyroid problem is addressed.

Thyroid disorders are conditions in which there is a change in the normal structure or function of the thyroid gland and can range from a small, harmless Goitre that needs no treatment to life threatening cancer. The most common thyroid problems are abnormal production of thyroid hormones

Naturopathy understands that any abnormalities in the functions of organs are due to toxemia resulting from enervation caused by the adoption of unhygienic habits of living. Thyroid dysfunction is also the result of such enervation which results in defective elimination. This results in accumulation of morbid matters, down regulation of thyroid function and alteration in plasma blood volumes of thyroid hormones. Other factors like stress, infection, trauma, radiation, and fluorides reduce vitality and promotes enervation and thereby thyroid dysfunction. In modern times improper lifestyle choices will lead to accumulation or diminution of zinc, selenium and fluoride, which will negatively or positively influence the feedback mechanism of the thyroid gland and lead to encumbrances. Naturopathic medicine intends to understand the healing mechanisms in the body and create strategies to maximize them so that the body can express health on its own it operates under the principle that the body is a self-healing, self-regulating organism. Counseling is a key element of naturopathic treatment as it endows individuals to take greater control of their own health, happiness. Understanding and educating the multi-faceted causation of thyroid disease is very essential in treating both HYPERTHYROIDISM as well as HYPOTHYROIDISM .

Yoga for Thyroid

Specific therapeutic yoga for thyroid includes asanas and poses that help normalize the secretion of thyroxin in the body, restoring metabolic balance and easing problems like anxiety, nervousness, and sleeplessness. They act like a massage of the thyroid gland, are restorative, and enhance its effectiveness. Yoga is the union of body and mind, hence helps keep you calm, balances your emotions and nerve impulse, which are most important for regulating hormonal balance. The practice of specific breathing exercises and Yoga create calm and relaxation, since these patients need emotional balance.

Thus, the treatment plan in thyroid involves diet modification, stress management through naturopathy therapies and packs and specific breathing and yoga, evaluated and monitored closely with various awareness and education programs for bringing the blood parameters to normal, and enhance the mental and emotional balance.