Latest / Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease / What is the treatment for Hashimoto’s when your TSH is normal? ⎸ Ep. 224

Transcript

What is the treatment for Hashimoto’s when your TSH is normal? ⎸ Ep. 224 · Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease

• 0:00
  What is the treatment for Hashimoto's if you're diagnosed but your doctor says
• 0:04
  your TSH is fine? What then?
• 0:07
  First of all, congratulations that your doctor actually diagnosed you because
• 0:11
  most of them won't even see that you have antibodies until your TSH is way out of whack.
• 0:17
  But what if they did find it? That's what we're talking about today.
• 0:21
  What treatment options are there for Hashimoto's if your TSH is quote, fine.
• 0:28
  Maybe you got a prescription and a follow-up appointment for six weeks later,
• 0:32
  or maybe you got told that your
• 0:33
  numbers are fine for now and we're just going to keep an eye on things.
• 0:36
  Either way, your provider probably did not tell you that Hashimoto's is two things and not one.
• 0:41
  It's a thyroid that can't keep up because it's also an immune system that's attacking the thyroid.
• 0:47
  Medication can help handle the first, but the second one is all yours to work
• 0:51
  on. You are the CEO of your own health.
• 0:54
  You can start working on that immune system side before your labs say that you have to.
• 0:59
  Hi, I'm Esther Yunkin. I am a registered nurse. I've been a nurse for 25 years,
• 1:03
  and I am the host of the Health with Hashimoto's podcast.
• 1:06
  I am the nurse who helps you sort your Hashimoto's into thyroid or immune. Let's sort.
• 1:11
  So is there a treatment for Hashimoto's? That's kind of what this episode boils down to.
• 1:18
  What do you do? What do you do once you're diagnosed?
• 1:21
  Do you go on a medication? Is there a fix? Is there some way to reset your body
• 1:27
  so that you feel like yourself again?
• 1:29
  These are all valid questions, and it starts often with a diagnosis of Hashimoto's.
• 1:35
  So you go to see your doctor. Maybe this is like your fourth,
• 1:37
  fifth, seventh time going to see your doctor or any provider saying,
• 1:42
  I don't feel right. Please help me.
• 1:45
  Somebody finally finds that you have antibodies. You have thyroid antibodies.
• 1:51
  It might be your thyroglobulin, your TG antibody. It might be the TPO antibody,
• 1:56
  but your antibodies are elevated, which tells you and your provider that your
• 2:03
  immune system is attacking your thyroid.
• 2:06
  What is the diagnosis called for that? Hashimoto's thyroiditis.
• 2:10
  The thyroiditis means itis, means inflammation.
• 2:15
  Thyro means it's referring to your thyroid. So your thyroid is inflamed due
• 2:21
  to an attack of your own immune system on your thyroid.
• 2:26
  That is Hashimoto's. So your antibodies are elevated, but your doctor looks
• 2:31
  at the rest of your labs or, you know, your TSH and says your TSH is normal.
• 2:37
  What happens then?
• 2:40
  And you know what? It could be a different scenario too. Maybe you were diagnosed
• 2:45
  with Hashimoto's and your TSH is not normal.
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  And in that case, your doctor is going to say, most likely, here is a prescription
• 2:53
  for levothyroxine, Synthroid, some sort of T4 medication.
• 2:59
  And then they're going to say, take this, follow up. We want to see you back
• 3:03
  in probably six weeks so that we can recheck your labs and make sure that this
• 3:07
  medication is working for you. And it.
• 3:10
  I don't want to knock on doctors. They're doing the best they can with the information
• 3:15
  that they have been taught.
• 3:16
  But what they're probably going to do is just check your labs and see if your
• 3:20
  TSH is coming back into normal range.
• 3:23
  They probably, maybe I'm wrong, they probably will not ask about all of your
• 3:28
  symptoms and adjust your medications and,
• 3:32
  help you figure out conversion and all of that stuff that we have talked about in so many episodes.
• 3:39
  So today, I mean, I have like 220 something episodes that you can go back through.
• 3:45
  And I do have the most popular ones written out as blog posts at healthwithhashimodos.com.
• 3:52
  I also have two other resources. One of them is a PDF, and it is 10 questions to ask your provider.
• 3:58
  And that one is going to be coming in really handy if this is your scenario.
• 4:03
  You were diagnosed and you want to know what's next.
• 4:06
  That 10 questions, it's free.
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  The last page is printable, so you could take it with you to the doctor's office
• 4:13
  or your nurse practitioner's office or whoever you see.
• 4:15
  The other resource I have for you explains everything. It is called Hashimoto's Decoded.
• 4:21
  And just like the title suggests, I will help you figure it out.
• 4:26
  I will help you decode what's going on.
• 4:28
  And that one is $27. All of the links will be down in the show notes,
• 4:32
  but we want to get to what treatment options are there for Hashimoto's,
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  especially if your TSH is fine.
• 4:41
  Well, to answer that question, we have to talk about what Hashimoto's is.
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  Hashimoto's is two things.
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  It is your immune system attacking your thyroid.
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  Hashimoto's is also your thyroid reacting to that attack and usually not being
• 4:56
  able to keep up with what your body needs.
• 5:00
  Your thyroid produces thyroid hormone. Typically, your thyroid produces T4.
• 5:06
  That's like the storage hormone. It's like you get a whole bunch of boxes of
• 5:11
  supplies and you have them in the closet ready to go when you need them. That's a T4.
• 5:16
  And then your body converts that to T3, which is the ignition keys for every
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  single cell in your body.
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  Of course, if you want your cells to work, they need to be turning on, right?
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  Your body is made up of trillions of cells. Every single cell has a job.
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  You don't function if your cells are not working well. So every cell needs an ignition key.
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  And that is your thyroid hormone.
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  So your thyroid function is crucial for everything.
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  You need good thyroid function and good thyroid hormones for your brain to work well.
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  You need good thyroid function and thyroid hormones for your digestion,
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  for your metabolism, for every single aspect of life because you are made up of trillions of cells.
• 6:08
  And every single one of those cells needs thyroid hormone.
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  So typically at a doctor's appointment, they will check your TSH.
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  Your TSH is the lab value that tells you and your provider how much your brain
• 6:21
  is asking for more thyroid hormone.
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  If your brain is asking a lot, asking, asking, asking, your TSH is going to
• 6:29
  be high because it gets a lot of requests.
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  That means that it needs more thyroid hormone.
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  So if your TSH is normal, that indicates to your provider that your brain isn't
• 6:42
  really asking for more thyroid hormone.
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  Therefore, your thyroid is obviously doing fine.
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  So we do not need to address it.
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  Now here is where the problem comes in.
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  Like I said, Hashimoto's is two different things. It's your immune system attacking
• 6:59
  your own self. In this case, your thyroid.
• 7:02
  Hashimoto's is also your thyroid responding to that attack and being unable
• 7:07
  to keep up with the demands.
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  So if your thyroid is still keeping up with the demands, your doctor might think
• 7:14
  everything is a-okay, we don't have to do anything because your doctor is not
• 7:18
  looking at the other half of Hashimoto's.
• 7:22
  The other half of Hashimoto's is your immune system attacking yourself.
• 7:27
  There is no medication that, quote, fixes that. There is nothing to heal that.
• 7:34
  That is not a pharmaceutical thing. Now, there are pharmaceuticals that address
• 7:40
  the immune system and that are created for autoimmune issues.
• 7:46
  In general, those medications suppress the immune system. They, like, turn it down.
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  Because if your immune system is going haywire, if it's attacking too many things,
• 7:57
  then, you know, it would kind of make sense to turn it down.
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  But your immune system, your entire body is created so intricately.
• 8:08
  Everything has a purpose and a design.
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  And if you suppress the immune system, you're going to have problems,
• 8:16
  even if your immune system is being overreactive.
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  So some people do benefit from that with some autoimmune conditions,
• 8:24
  but that is not what I want you to do as the CEO of your own health.
• 8:30
  You get to look at the whole picture and say, okay, what's going on and what can I do?
• 8:35
  So if your doctor said your TSH is fine, typically if your TSH is fine,
• 8:40
  they will have you come in in a full year. So 12 months from now.
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  If you were diagnosed with Hashimoto's,
• 8:47
  that means that they saw your antibodies are already elevated.
• 8:51
  That means there is an attack going on on your thyroid.
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  We do not want 12 more months of an attack before we decide to do something.
• 9:03
  If your kids are fighting and you like sense that one of them is going to get
• 9:10
  injured, you're going to stop them fighting, right?
• 9:13
  You're not going to say, oh, you guys can keep fighting until one of you is seriously injured.
• 9:18
  Well, that would be horrible parenting, right? You're not going to do that.
• 9:23
  If your kids are fighting, and you think that one of them is going to get hurt,
• 9:27
  emotionally or physically or whatever, you're going to step in.
• 9:31
  Obviously, you're going to teach your kids or tell them again,
• 9:35
  yet again and again and again, to show each other respect and love and, you know, be civilized.
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  Kids have to learn that.
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  I'm not saying that my kids have learned it 100%. They're kids.
• 9:50
  But that's my job as a parent. If I see something coming, I need to step in
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  and teach them how to deal with it in an appropriate manner.
• 10:00
  And so that is your job as someone with an immune system.
• 10:04
  If you see that it's going haywire and it's starting to fight,
• 10:07
  it's starting to attack, you get to look at that immune system and say, okay, let's chill out.
• 10:13
  Let's figure out an appropriate way to react.
• 10:17
  Let's talk about what's going on. Now, obviously, your immune system cannot talk to you.
• 10:24
  Your immune system isn't going to, you know, pull up a text message and reply
• 10:29
  to you and say, this is what's going on.
• 10:32
  These are all the things that are stressing me out. And these are the things that you can do.
• 10:37
  You're not going to have a one-on-one conversation with your immune system.
• 10:40
  It would be so nice if we could.
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  If you could just ask your immune system and then your immune system just pops
• 10:48
  up this list of here's what's bothering me. What can you address?
• 10:51
  You would be able to look at that list and say, oh, okay, well,
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  I understand that I really love to run, you know, or I love to exercise hard.
• 11:01
  Those HIIT workouts, they really relieve my mental stress.
• 11:04
  But I see on your list here that that physical stressor is stressing you out.
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  More than the mental stress.
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  So I need to figure out something different to exercise so that I can still
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  relieve that mental stress, but not cause you a whole bunch of additional stress
• 11:22
  with a physical stressor.
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  You could look at that list and say, okay, I can adjust this.
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  But since our immune system doesn't sit down one-on-one with us and explain
• 11:31
  all of that to you, you get to leave your doctor's office with this new diagnosis
• 11:36
  of Hashimoto's, and then you get to figure out what's going on.
• 11:40
  How can you help your immune system?
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  Because your immune system is crying out for help. There is an attack going on. It's fighting.
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  And you get to figure out how to.
• 11:53
  To calm it down. And there is not one right answer for that.
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  It would be so nice if you could push play on this episode, and I would just
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  pop on the microphone and I would say, okay, here is step A, step B, step C.
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  These are exactly the things that you need to do.
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  And every single person with a Hashimoto's diagnosis, if you do A,
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  B, and C, you're going to be fine.
• 12:16
  But that's not how it works. Because you are a bio-individual.
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  There is nobody on earth exactly like you.
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  There is nobody with all of the same history, the same present circumstances,
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  the same diet, the same stressors, the same everything. You are unique.
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  And that means that your solutions are also going to be unique to you.
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  And that is both a privilege and a responsibility. So where are you going to
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  start? Number one, you're going to start out with that level of hope.
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  You went to your doctor, they checked your labs, your TSH is quote normal,
• 12:55
  and so you can breathe deeply and know that your thyroid is still doing its job.
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  Now we also have to talk about what normal is. Normal is in quotes because that initial
• 13:09
  lab value, the norms, you know, what they consider normal, was based on a population
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  that included a lot of healthy people, but also included some sick people.
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  So when they figured out what was average, there were people with hypothyroidism in that average.
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  And so the quote norms, the normal lab values might be off.
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  And that is why whenever I get my labs done, I don't have them all memorized.
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  There are way too many lab values in medicine to memorize everything.
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  And so I pull up the search engine and I say, what are the functional medicine norms or normals?
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  Lab values for whatever lab I'm looking at for TSH.
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  The functional medicine lab values are going to differ from the quote regular,
• 14:05
  the Western medicine normal lab values.
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  And then even the functional medicine lab values might differ from what an OBGYN
• 14:18
  wants to see when you're pregnant, because that has to be even more narrowly
• 14:23
  maintained for a healthy baby.
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  So a functional medicine range for TSH is 1.5 to 3.
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  So if your Western medicine conventional doctor said your TSH is quote normal,
• 14:40
  but it's outside of that range, then you might need to look for a different
• 14:45
  provider, one that looks at functional medicine ranges.
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  Because we don't want to look at the sick population of what's normal for everybody
• 14:51
  who's sick. We want to look at what's normal for everybody.
• 14:55
  Healthy. So the first thing that we think when we hear that the TSH is normal
• 15:01
  is, okay, great, my thyroid is doing its job.
• 15:06
  And then like I said, you have to look into the nuance. Is it actually normal
• 15:09
  or is it sick normal when you need to like take another step?
• 15:14
  Then the second thing that you get to do is look at your immune system.
• 15:19
  Why is it attacking your thyroid?
• 15:22
  There is too much to go into to cover all of that. I put that in Hashimoto's
• 15:28
  Decoded. I talk about thyroid or immune.
• 15:31
  I explain it all. We go through the root causes. We go through the eight most common triggers.
• 15:35
  And by the end of that, usually less than an hour, you know exactly what you can do next.
• 15:42
  If you go through Hashimoto's Decoded and you're like, okay,
• 15:45
  I understand thyroid or immune.
• 15:48
  I understand what my root causes most likely are, but I need help. I still feel stuck.
• 15:54
  I have a couple options for you. Number one, I have single Hashimoto's health sessions.
• 16:00
  If you want to hire me and do a consult for just one session.
• 16:05
  We can call it a get unstuck session, if that's what you prefer.
• 16:09
  We can talk together and you can get unstuck. You can figure out the exact next
• 16:13
  thing that you need to do.
• 16:14
  I also have Hashimoto's discernment, where I teach you how to be discerning.
• 16:20
  And so you can learn, you know, how to go forward because you're not always
• 16:25
  going to have me with you.
• 16:26
  So there are a couple, you know, options. But your first step is number one,
• 16:31
  is your TSH normal for a sick population or actually normal?
• 16:36
  And then second step is, what do I need to do for my immune system?
• 16:40
  And go through Hashimoto's Decoded if you want to learn all about that.
• 16:46
  I already alluded to it a couple times though.
• 16:51
  One of the biggest things, one of the biggest triggers for autoimmune conditions is stress.
• 16:57
  Now, I cannot tell you to change everything that stresses you out right now
• 17:02
  because that would be stressful. That would be kind of impossible.
• 17:06
  What you can do today, right now, while you are listening to my voice,
• 17:12
  is you can take a deep breath.
• 17:14
  Put one hand on your chest, one hand on your belly, and take a deep breath in and a deep breath out.
• 17:21
  Now do it again and pay attention to which hand went up and down.
• 17:26
  Was it the hand on your chest or was it the hand on your belly?
• 17:29
  Or maybe your shoulders went up and down.
• 17:31
  What moves as you breathe?
• 17:34
  If you can switch into diaphragmatic breathing, breathing with your diaphragm,
• 17:40
  with your belly, that tells every single cell in your body that everything's cool. You're safe.
• 17:47
  You can relax. Diaphragmatic breathing is one of the fastest and simplest ways
• 17:53
  to switch from fight and flight, that stressed out nervous system,
• 17:58
  into rest and digest, which is your parasympathetic or your relaxed nervous system.
• 18:04
  Whatever is going on in life, no matter the stressors, you can control your
• 18:10
  breathing. You can take a deep breath or five or ten with your diaphragm and
• 18:17
  reset your nervous system.
• 18:19
  You can't always change the things that are stressing you out,
• 18:22
  but you can change your reaction to it and how you are surviving through it.
• 18:29
  So yes, absolutely address the root causes and all of the triggers.
• 18:35
  Do it in a way that is maintainable for you.
• 18:38
  Some people want to take like 10 steps all at once. They want to change their
• 18:43
  diet. They want to change all the personal care products and the toxins in their environment.
• 18:48
  They want to mitigate their stress. They want to do so many things and they
• 18:52
  have the bandwidth to do that.
• 18:54
  And it's awesome. And they do it and they maintain it.
• 18:57
  Other people, they are like at the end of their rope, they say,
• 19:00
  I just need one simple thing today.
• 19:03
  What is it for you? Can you do five things?
• 19:07
  Do you just need one thing? If you just need one thing, I encourage you to start with breathing.
• 19:13
  You can do it anytime, anywhere. And that one simple thing of breathing with
• 19:18
  your diaphragm can help switch you into that rest and digest mode instead of fight and flight mode.
• 19:25
  But no matter what, if your TSH is normal, but you have a diagnosis of Hashimoto's,
• 19:32
  I encourage you, don't wait.
• 19:35
  Your doctor probably say, come back in 12 months. Let's recheck your labs because
• 19:41
  your doctor is waiting for your TSH to be out of the normal range so that you can get medication.
• 19:48
  That medication is not going to do anything for the immune system attack on your thyroid.
• 19:54
  That is up to you to resolve, to look at, to see what you can address.
• 20:01
  So what is the treatment for Hashimoto's if your TSH is quote normal?
• 20:05
  The conventional treatment is nothing. The conventional treatment is just wait.
• 20:10
  Wait until your immune system has attacked your thyroid so much that your thyroid
• 20:15
  is injured, can't keep up.
• 20:17
  And then they will give you medication to supplement the thyroid hormone that
• 20:21
  your thyroid can no longer produce.
• 20:23
  What is the actual treatment for Hashimoto's when your TSH is normal,
• 20:28
  the actual treatment as recommended by me
• 20:32
  is look at the whole picture and figure out why your immune system is going
• 20:36
  haywire and then figure out what you can do to address that.
• 20:40
  Because you are the CEO of your own health.
• 20:43
  You can figure out the next step today. And like I said, if you need help, I am here for you.
• 20:50
  All of the links are down in the show notes. I'll see you next week.
• 20:53
  That's it for today. If you are ready to sort your Hashimoto's into thyroid
• 20:57
  or immune, start with Hashimoto's Decoded, and then come talk about it in the free community.
• 21:03
  Both links are in the show notes. I'll see you next week.
• 21:06
  This podcast is for informational and educational purposes only.
• 21:09
  Please discuss any questions or concerns with your trusted healthcare professional.