Title: Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back Authors: Izabella Wentz Edition: 1 Finished Date: Rating: 5 Language: English Genres: Thyroid Level: Entry Publishers: HarperOne Publication Date: 2017-03-28 ISBN: 978-0062571298 Format: ePub Pages: 384 Download: ePub

## Thyroid

The thyroid gland

• produces thyroid hormones
• determines the speed of every function in the body
• enhances the activity of every function in the boy

### Hypothyroidism = too little thyroid hormone

a clinical state of low levels of thyroid hormone in the body

the low levels of thyroid hormone can occur as a result of a variety of different reasons, such as

• iodine deficience
• surgical removal of the thyroid gland
• excess use of thyroid-suppressing medications
• pituitary suppression
• damage to the thyroid (physical or disease induced)

Hashimoto’s causes most cases of hypothyroidism in the United States, Canada, Europe, and in other countries that add iodine to their salt supply.

sluggish metabolism leading to

• weight gain
• fatigue
• forgetfulness
• cold intolerance or sensitivity to cold
• depression
• dry skin
• constipation
• loss of ambition
• loss of hair
• muscle cramps
• stiffness
• joint pain
• loss of the outer third of the eyebrows
• menstrual irregularities
• infertility
• weakness

### Hyperthyroidism = too much thyroid hormone

Classic symptoms include

• weight loss
• palpitations
• anxiety
• eye protrusion
• tremors
• irritability
• menstrual disturbances
• fatigue
• heat intolerance
• increased appetite

## Autoimmunity

With one autoimmune condition, the chances of developing another one will increase.

### 3 factors necessary for autoimmunity to develop

1. The genetic predisposition
2. Triggers that turn on the genes
3. Intestinal permeability (known commonly as leaky gut) that interrupts the immune system’s ability to regulate itself

we cannot change our genes but we can turn off gene expression by eliminating triggers and intestinal permeability.

environmental toxins -> genes, inflammation, oxidative stress, mitochondrial injury -> thyroid dysfunction

• A person who has the genes for Hashimoto’s but has not been exposed to the triggers will not develop the condition.
• A person who has the genes and was exposed to the triggers but does not have intestinal permeability will not develop Hashimoto’s.
• New research in autoimmune disease suggests that intestinal permeability always precedes autoimmunity.
• Another person who has both the intestinal permeability and the triggers but not the genes will not have Hashimoto’s.
• In this case, they may not have any symptoms at all, or they may develop a different autoimmune condition depending on their genetic background.

Bottom line is, all three must be present in order to develop an autoimmune condition.

Autoimmunity is reversible. If one of the three factors is removed, a person will no longer present with autoimmune disease.

Scientists initially demonstrated this with celiac disease, where gluten acts as both the trigger and the initiator of intestinal permeability. Once gluten is removed, the damaged tissue in the small intestine, which is the hallmark of celiac disease, regenerates. Then, as long as the person no longer has any additional triggers for intestinal permeability, all of the symptoms and autoimmune markers of celiac disease go away.

### Why Autoimmune Conditions Often Co-Occur

A person who has been diagnosed with Hashimoto’s is at greater risk for other autoimmune diseases, including

• type 1 diabetes mellitus
• celiac disease
• multiple sclerosis
• rheumatoid arthritis
• Crohn’s disease
• lupus
• vitiligo
• pernicious anemia,

This is because the underlying disease mechanism is the same in each autoimmune condition, and autoimmunity can be progressive—once the immune system has begun to attack one organ, other organs may be targeted as well. Some scientists will go as far as to say that all autoimmune conditions are the same condition but with a different target.

## Chronic disease

lifestyle interventions should be used before medication in mild cases and alongside medication in advanced cases.

## Health journal

• subjective symptoms
• objective thyroid markers
• thyroid antibodies
• heart rate
• blood pressure
• thyroid-stimulating hormone (TSH)

start by questions

• What are your health goals?
• Do you want to have more energy?
• Do you want to lose that extra twenty pounds?
• Do you want your hair to grow back?

## the Symptoms, Diagnosis, and Origins of Hashimoto’s thyroditis

Hashimoto’s thyroiditis is the most common autoimmune condition in the United States and worldwide.

the immune system recognizes the thyroid gland as a foreign invader and launches an immune response against it as if it were an invading virus, bacteria, or other pathogen.

This autoimmune destruction of the thyroid gland eventually results in the thyroid no longer being able to produce sufficient thyroid hormone. This in turn leads to a hypothyroid condition.

### Population

• families <= genes
• 5-8 times more common in women
• tend to peak around puberty, pregnancy, and perimenopause

### the stopping points of the remission

• Feeling better
• Eliminating all of your symptoms
• Reducing your thyroid antibodies
• First under 100 IU/mL
• Then under 35 IU/mL
• Regenerating thyroid tissue
• Experiencing a functional cure

### continue to be at risk after Hashimoto’s thyroditis is cured

You will be at risk for developing the condition again, especially if you come across specific environmental triggers, which current research shows can turn on our gene expression. Repeat exposure to the triggers may switch on your Hashimoto’s-producing genes and reignite the autoimmune attack on the thyroid.

### How Hashimoto’s is unique

Hashimoto’s has a unique set of symptoms compared to non-autoimmune hypothyroidism.

In Hashimoto’s, individuals can fluctuate between hypothyroid and hyperthyroid symptoms, and even experience symptoms of both conditions simultaneously.

the immune system has identified thyroid cells as foreign or harmful substances and has developed antibodies to attack these cells.

This attack leads to inflammation and damage of the cells that produce thyroid hormones.

*As the thyroid cells are damaged and destroyed by the immune system, thyroid hormones that are usually stored inside of the cells are released into circulation, leading to an excess level of thyroid hormones. This causes a transient hyperthyroidism and may even cause a toxic level of thyroid hormone in the body (known as thyrotoxicosis or Hashitoxicosis).

Eventually, the extra hormone is cleared out of the body, and the person becomes hypothyroid as the damaged thyroid gland has a difficult time making enough thyroid hormone.

In this case, you might initially experience symptoms such as irritability, anxiety, and restlessness (hyperthyroidism), and then once the extra hormone gets cleared out, feelings of apathy and depression (hypothyroidism) can result. And this can happen again and again, making a person feel like they are on a roller coaster!

In addition to experiencing symptoms of hypo- and hyperthyroidism, most people with Hashimoto’s also experience a variety of other inflammatory symptoms, such as irritable bowel syndrome (IBS), acid reflux, diarrhea, constipation, bloating, rashes, allergies, pain, and other nonspecific symptoms. Nutrient deficiencies, anemia, intestinal permeability, food sensitivities, gum disorders, poor stress tolerance, and hypoglycemia can occur as well. It’s important to note that many of these additional symptoms or conditions are present in many other autoimmune conditions.

### A synthetic thyroid medication alone cannot result in full recovery

gut + detoxify

Often patients with Hashimoto’s will present multiple systemic symptoms in addition to typical hypothyroid symptoms. The body becomes stuck in a chronic state of immune system overload, adrenal hormone abnormalities, gut dysbiosis, impaired digestion, impaired detoxification, inflammation, and thyroid hormone release abnormalities. This cycle is self-sustaining and will continue to cause more symptoms until an external factor intervenes and breaks the cycle apart.

### How Hashimoto’s make patients in their own words

• Having Hashimoto’s is like living a lie; putting on your public face for a few hours here and there after you’ve spent the entire day feeling like you’re wearing a weighted blanket, hoping no one catches you sleeping till 10:00 A.M. and napping at 2:00 P.M. and unable to remember anything on your to-do list. You’re embarrassed of yourself, and it’s spirit crushing.”
• “I feel trapped inside. Alone in a dark cave with my dreams, but no gas/energy to carry my dreams to the world.”
• “An out-of-body experience where I don’t know who I am anymore, nor how I got this way. When I’m tired, I feel like there’s a weight on my body preventing me from moving.”
• “I feel like I’m sitting on the sidelines of life, watching everyone else enjoy their journey, wondering if I’ll “ever have my zest for life back.”
• “Like being a clean freak but a bum is running the show.”
• “To be at the mercy of an invisible illness, no control over my mood, no understandable explanation to my family on why I’m crying in the laundry room for no reason.”
• “The worst part of this disease is trying to convince doctors that I am so unwell and having them tell me to eat less, exercise more, and take an antidepressant because my TSH and napping at 2:00 P.M. level is ‘in the normal range.’ Basically being told, ‘It’s all in your head. Your blood test results show you are fine. What is really going on with you is that you are unhappy in your life, nothing to do with thyroid disease.’”
• “Confusing, exasperating, numbing, exhausting. It’s so incredibly hard on those who have it, as it is hard on those who love us. It’s hard to explain the feelings, the desperation, the weight gain, and the lack of intimacy to those who have not experienced it firsthand. It’s just hard.”

### diagnosis

blood tests
thyroid ultrasounds
biopsies of the thyroid gland

#### 1. thyroid-stimulating hormone (TSH) test: a screen test for thyroid function

• TSH is a pituitary hormone that sends out signals to the body to make more thyroid hormones when low levels of circulating thyroid hormone are sensed.
• hypothyroidism: elevated TSH
• hyperthyroidism: low TSH

In the earlier stages of Hashimoto’s, a person’s TSH may fluctuate between the two extremes and at times even generate normal readings. You could have a normal TSH for years while experiencing unpleasant thyroid symptoms.

problem of the test

• the normal ranges of TSH for healthy individulals included elderly patients and others with compromised thyroid function

=> underactive thyroid hormones were considered as normal

solution: ask for a copy of any lab results

Recent advancement of ranges for nomal people

• the Natuional Academy of Clinical Biochemistry: < 2.5 $\mu$IU/mL
• the American College of Clinical Endocrinologists: 0.3-3.0 $\mu$IU/mL
• Functional medicine practioners: 1.0-2.0$\mu$IU/mL

#### 2. TPO antibodies and TG antibodies: The best blood tests for Hashimoto’s

Thyroid antibodies indicate an autoimmune response to the thyroid gland.

The two antibody tests with elevated results in cases of Hashimoto’s are:

• Thyroid peroxidase antibodies (TPO antibodies)
• Thyroglobulin antibodies (TG antibodies)

Many people with Hashimoto’s will have an elevation of one or both of these antibodies.

And the higher the thyroid antibodies, the greater the likelihood of developing overt hypothyroidism and possibly additional autoimmune conditions.

People with Graves’ disease and thyroid cancer may also have an elevation in thyroid antibodies including TPO and TG, as well as TSH receptor antibodies.

While a small number of antibodies may be present in normal individuals without thyroid disease, elevated thyroid antibodies indicate that the immune system has targeted the thyroid gland for destruction. Essentially, they are indicative of a disease process. The greater the number of antibodies, the more aggressive the attack on the thyroid gland.

Traditional doctors may not always test for Hashimoto’s antibodies unless there is an elevation in TSH, which is a problem, as these antibodies can be elevated for decades before a change in TSH is seen.

Current medical reports state that 80 to 90 percent of people with Hashimoto’s will have TPO antibodies.

#### 3. thyroid ultrasounds

you could have Hashimoto’s even if your thyroid antibody test is negative.

#### 4. Cytology

In a cytology test, a very thin needle is inserted through the skin on the neck into the thyroid gland to remove thyroid cells. The cells are then studied under a microscope, and this examination can reveal if the cells show signs of Hashimoto’s. As this diagnostic method is much more invasive than a standard blood test, it is usually reserved to determine whether thyroid nodules are benign or cancerous, not to diagnose Hashimoto’s. Additionally, even this advanced test can miss Hashimoto’s because only a limited number of cells are removed during cytology, and not every thyroid cell may show signs of Hashimoto’s.

#### 5. Free T3 and Free T4

The thyroid gland produces various hormones, including T1, T2, T3, T4, and calcitonin.

The most active form of thyroid hormone is triiodothyronine (T3), and the next is thyroxine (T4).

When they’, they’re called

free T3 and free T4: T3 and T4 are active and circulating in the body, which can be measured by a blood test.

T3 and T4 are low but your TSH tests in the normal range: may lead your physician to suspect a rare type of hypothyroidism known as central hypothyroidism.

### 5 stages of Hashimoto’s

• Stage 1

• have genetic predisposition
• not exposed to the necessary autoimmune triggers => no eveidence of an immune attack o n the gland
• Stage 2: the beginning stage of the autoimmune attack on the thyroid

While thyroid antibody tests may be positive at this stage, all of the other thyroid blood tests will be considered within normal limits.

That said, a person in stage 2 may be highly symptomatic. Doctors who don’t do advanced testing often misdiagnose people in this stage with anxiety or depression, or label them as hypochondriacs.

• Stage 3: the beginning of thyroid gland failure, i.e., subclinical hypothyroidism.

The thyroid can no longer compensate for the autoimmune attack, so we can actually quantify changes in the traditional thyroid tests—most notably the TSH will begin to show as slightly elevated.

• Stage 4: Hashimoto’s involves overt thyroid gland failure.

* The thyroid can no longer make enough hormone and is not able to compensate due to advanced thyroid damage.
* This is the stage when most people are diagnosed by their overt symptoms and obvious out-of-range labs. Their labs are going to **show an elevated TSH and low levels of T3 and T4**. Most patients are likely to receive a prescription for synthetic thyroxine, such as levothyroxine (brand names include Synthroid, Levoxyl, and others).

• Stage 5: This stage brings progression to additional autoimmune diseases like lupus, rheumatoid arthritis, Sjogren’s, psoriasis, and others.

## Thyroid Symptom Assessment

The Fundamental Protocols will help most of these symptoms. Fatigue, mood, and stomach issues may be the first symptoms to resolve, while hair regrowth and weight loss may be a more gradual process.

Which of the following thyroid symptoms do you have?

Rate your symptoms on a scale of 1 to 10, where 1 means you do not experience the symptom at all, 10 means it drastically affects your lifestyle, and n/a means it doesn’t apply to you. I recommend that you come back to this assessment after completing each protocol to track improvements.

# the Fundamental Protocols

## 1. the Liver Support Protocol: 2 weeks: detoxify

1. remove toxins/remove potentially triggering foods
• at home
• food
2. add supportive foods
3. reduce toxic exposure
4. support detoxification pathways

## 3. the Adrenal Recovery Protocol: 4 weeks: stress response

chronic stress

stress resilience
resting
reduce stress
reduce inflammation
balance blood sugar
replenish key nutrients

1. rest
2. de-stress
3. reduce inflammation
4. balance the blood sugar
5. replenish nutrients and adaptogens

## 3. the Gut Balance Protocol: 6 weeks

1. remove reactive foods
2. supplment with enzymes
3. balance the gut flora
4. nourish the gut

heal instestinal permeability

bowel syndrome
leaky gut

bloating
stomach pain
diarrhea
constipation

remove reactive foods
balance gut flora
supplement with enzymes and nutrients to nourish the gut

gluten
dairy

## DIG-AT-IT approach

• Depletions, Digestion
• Idine, Inflammation, Infection, Immune Imbalance
• Gut, Gluten
• Adrenals, Alkaline Phosphatase
• Triggers
• Intolerances
• Toxins

## the failure story

• Attaching to a dogma that prevents them from getting better (I am not going to change my diet, use medications, take supplements, or do any testing!)
• Being unwilling to invest in themselves or necessary healing alternatives (I will not see a doctor who doesn’t take my insurance or pay for this expensive test or supplement.)
• Doctor shopping (They get multiple opinions from multiple practitioners but don’t follow through on the recommendations, or they attempt to implement multiple contradicting recommendations.)
• Perfectionism and unrealistic expectations (I want to completely get off medications and have zero thyroid antibodies within one month of making changes after having had Hashimoto’s for twenty years.)
• Adopting “sick” as part of their identity as a way to get attention from others or to fulfill other unmet needs
• Paralysis by analysis (Someone who spends a tremendous amount of time researching their condition but doesn’t take action. This person knows all about the Paleo diet, selenium, and gut infections but has yet to try the diet, buy the supplement, or get their gut tested.)
• Social isolation and lacking a support network

## the success story

• Having a positive, can-do attitude
• Accepting the support of a loving spouse, friend, family member, or support network (We’re in this together, honey!)
• Being grateful for small gains and improvements and celebrating little successes (Yes! My hair stopped falling out!)
• Dreaming big (I have to get better; I’ve got books to write, mountains to climb, children to
• Doing stress-relief hobbies (yoga, writing, working out, knitting)
• Being willing to invest in themselves because they are worth it!
• Refusing to stop living just because they have Hashimoto’s
• Asking for help from others
• Surrendering their need to control the situation
• Resting when they need to rest

## functiona medicine practioner

If you’re looking for a practitioner who can help you address Hashimoto’s, here are some questions to ask:

1. Does the practitioner prescribe compounded thyroid medications or natural desiccated thyroid medications (NDTs like Armour Thyroid, Nature-Throid, WP Thyroid, and others)?
2. Does the practitioner prescribe low-dose naltrexone? (See page 251 for more information.)
3. Does the practitioner order adrenal saliva testing?
4. Does the practitioner have an account with functional medicine lab companies like Genova Diagnostics, Doctor’s Data, ZRT Laboratory, or BioHealth Laboratory?
5. Does the practitioner order food sensitivity tests?

you can also order the same tests on your own at a discounted price through direct-to-consumer lab companies. For a listing of direct-to-consumer lab companies, please go to www.thyroidpharmacist.com/action.