In this episode, we’ll explore why that happens, the truth about remission, and the most common reasons relapses occur. I’ll share practical ways to calm symptoms naturally, when combining meds with herbs makes sense, and why addressing your immune system and not just your thyroid is essential for long-term stability. If you would prefer to listen to the interview you can access it by Clicking Here.
This episode is inspired by a message I received on Instagram. I’ll go ahead and read it and then respond.
It starts off by saying, “I have Graves’, and I just listened to you on The Root Cause Podcast,” someone else’s podcast. “It was so informative and helpful. There is so much out there about hypothyroidism and Hashimoto’s, but hardly I ever find any podcast or information on Graves’ and hyperthyroidism. It was awesome to gain some information.
“I am diving deep now with a functional doctor on trying to stay off of methimazole and avoiding getting my thyroid taken out. I have managed before to be off of meds for over a year, and then it came back with a vengeance after I had my baby. Back on low-dose methimazole. Started taking Thyroid Calm, and it seems to help. I take it daily and skip some days with my meds. Eventually would like to be off for good.
“Also now working with a functional doctor on trying to see if there is any correlation with hyperthyroidism and high cholesterol. It’s always a deep dive.”
Let’s start off by talking about Graves’ versus Hashimoto’s visibility. If you have been searching for answers about Graves’ or other types of hyperthyroid conditions, you probably have noticed there is no shortage on books, podcasts, articles on Hashimoto’s. When it comes to Graves’, there is not a lot of information out there, which is one of the big reasons why this podcast has a little bit more of a focus on hyperthyroidism and Graves’. A lot of the content also will benefit those with Hashimoto’s, but I don’t have a whole lot of episodes dedicated to Hashimoto’s.
I do have a good amount of episodes dedicated to hyperthyroidism and Graves’ because out of all the thyroid-related podcasts out there, none of them that I have found have any episodes that focus on hyperthyroidism. The exception is those who have interviewed me, when I am on another podcast, talking about hyperthyroidism and Graves’. Other than that, typically, they are focusing mainly on hypothyroidism/Hashimoto’s.
Why is that the case? There are a few reasons. One obvious reason is Hashimoto’s is a lot more common than Graves’. A lot more people have Hashimoto’s. In fact, I’m pretty sure that Hashimoto’s is the most common autoimmune condition, not just autoimmune thyroid condition. When it comes to Hashimoto’s versus Graves’, approximately eight times as many people are diagnosed with Hashimoto’s as with Graves’.
I’m sure there are a lot more people who are undiagnosed with Hashimoto’s. You can be undiagnosed with Graves’ for a while, but it’s more common with Hashimoto’s. That’s one reason.
The second is because most functional medicine practitioners have more experience with Hashimoto’s. That brings us back to the first point: There are a lot more people with Hashimoto’s. Even when I interview practitioners, it’s not uncommon for me to interview a practitioner who has their own Hashimoto’s journey. I have had a few with their own Graves’ journey. Even when the focus isn’t on thyroid health, when I’m talking about perimenopause or some other health condition, it is quite common for them to say, “I had Hashimoto’s.” It’s not as common with Graves’.
Those are the two main reasons I would say that you see a lot more information related to hypothyroidism and Hashimoto’s, why Hashimoto’s content dominates.
My goal not just with the podcast but with everything I do is to focus more on hyperthyroidism/Graves’. Even with the books. I have written two books that focus on hyperthyroidism. I have a book on Hashimoto’s as well. That probably will be the only book that I write that is dedicated to Hashimoto’s. I might come out with books that focus on both. I am pretty sure I will come out with others that just focus on hyperthyroidism. I have other pieces of content, like articles and a Facebook group. I have a Facebook group dedicated to both, but I also have a much larger Facebook group that just focuses on hyperthyroidism.
Let’s go ahead and get back to the message. That was one point that the person brought up on Instagram. Also, the person said that they managed to be off of medication, and it came back with a vengeance. They started taking Thyroid Calm and skipped some medication. We’ll talk more about this.
Why don’t I talk about relapse? I want to cover a few of these points in this message. The problem is that most of the time, they’re not doing anything to address the cause of the problem. Pretty much 100% of the time, the endocrinologists aren’t doing anything to address the cause of the problem. If the person is seeing an integrative endocrinologist, which there aren’t many of. I did have a couple on the podcast, Dr. Angela Mazza, who is in central Florida; Dr. Brittany Henderson, who is in Charleston, SC. There are not a lot of them.
Most of these people weren’t in true remission. Most of these people were on antithyroid medication, usually methimazole, for a year and a half to two years. Then the thyroid hormones and TSH looked good, so they were taken off of the medication. The immune system was ignored. The endocrinologist didn’t recommend anything for the person’s immune system health, which is why most people eventually relapse. All they do is take the medication. Maybe they make some changes to their diet on their own.
Remission doesn’t always mean resolution. Usually, it doesn’t mean resolution because it’s not true remission. Stress is a big trigger.
This person also mentioned that it came back with a vengeance after having a baby. That also brings up post-partum thyroiditis, which is actually Hashimoto’s. It’s not Graves’. With post-partum thyroiditis, people have the antibodies for Hashimoto’s. During pregnancy, when a lot of people have Hashimoto’s, the pregnancy modulates the immune system, where it’s no longer attacking the thyroid. When the person gives birth, they get a flare-up of post-partum thyroiditis, which often presents as hyperthyroidism. In this case, even though this person has a history of Graves’, it’s also possible that this was post-partum thyroiditis as Hashimoto’s.
Sometimes, what happens is it doesn’t happen right after the birth process, but months after. In that case, not to say it can’t be post-partum thyroiditis. Perhaps, in this case, it was the Graves’ relapsing. We don’t have enough information since it was just a comment on Instagram.
Being a mom is very stressful. Sleepless nights or a few hours’ sleep. Everybody is different. Some get more sleep than others. Some might get 5-6 hours’ sleep. Others are not getting much sleep.
Other stressors of course in life could be a factor. Becoming an expert in handling stress is important because that’s one of the biggest reasons why people relapse.
The biggest reason is because they weren’t in remission in the first place. They never did anything to address the immune system component. But even people who do improve their diet and lifestyle and do testing to find their triggers, again, for those people who do relapse, stress is a big factor.
As a reminder, I was diagnosed with Graves’ in 2008. I have been in remission since 2009. Thankfully, I haven’t relapsed, and I’ve had my share of stressors. Everybody is different. Even though I have had a good amount of stressors, I have also greatly improved my stress handling over the years. We also need to consider other stressors, not just emotional stressors, but overtraining or dealing with certain infections. There are numerous reasons why someone might relapse.
I can understand that it can be incredibly frustrating when someone does relapse, especially if they feel like they’re doing everything right, and they’re in a good place. Then they feel like they’re back where they started. If all you did was take the medication and not do anything to improve your health, the good news is there is a lot you can do to improve your health.
For someone who has done a lot to improve their health, and then they relapse, that can get more frustrating. All you can do is get back on track.
I hope I continue to remain in remission, but if I were to relapse tomorrow, yes, I’m sure I would be bummed out. I would go back to what I did years ago. Maybe not exactly the same thing, but I would take a similar approach. I wouldn’t have any regrets that I followed a natural treatment approach years ago, and I didn’t receive radioactive iodine or thyroid surgery.
This person also mentioned Thyroid Calm. This person was back on low-dose methimazole now, and they take Thyroid Calm daily now, which seems to help. They skip their meds sometimes. That’s up to the person. I won’t say anything about skipping medication.
When I dealt with Graves’, I didn’t take medication at all. This person is doing what I call the functional overlap, where you are using meds but also layering in herbal support, things like bugleweed or Thyroid Calming Formula. There are a few different formulas that have bugleweed, motherwort, and lemon balm combined. This is what this person is doing.
The one thing I will say is these combo formulas, some of them can be really good, but bugleweed is the main herb that helps with the symptoms of hyperthyroidism. When someone is trying to rely more on the herbs than medication, and I am not telling anybody to do this, if someone is taking medication, it’s up to them to continue taking it or stop taking it. But if someone is taking medication, and they want to try to rely more on herbs, you might want to consider taking bugleweed separately and not a Thyroid Calming Formula.
If a patient is working with me, and they are taking Thyroid Calming Formula, and it seems like it’s helping, I won’t tell them to stop. If they’re not taking anything, I am not going to tell them to start with the combo. When I dealt with Graves’, I took bugleweed and motherwort separately. I did not take lemon balm. If someone wants to take lemon balm, I recommend taking that separately. If someone is taking Thyroid Calming Formula or another variation, and it seems like it’s helping, or they already purchased it and want to give it a try, that’s fine.
The problem with these formulations is they don’t have a lot of bugleweed because they need room for the motherwort and the lemon balm, too. Lemon balm might have some mild antithyroid properties, but it’s definitely not as potent as bugleweed.
Getting back to the person skipping medication. Obviously, people can do what they want. I have no control over this. Even with my patients, they will skip sometimes. Keep in mind, you want to be safe while addressing the cause of the problem. I can’t say I’m a big fan of people skipping the meds. I could understand if someone decides not to take it altogether.
What I mean by that, not saying to stop it, but if someone is, like in my situation, where they didn’t start it to begin with, and they just want to take herbs. If someone is already taking medication, if it’s causing side effects, I could understand- You could go back to the prescribing doctor. You want to be careful. You want to be safe if you do choose to take medication.
I know I sound like a hypocrite if I said, “Don’t take the medication” because I didn’t take it, and I work with people who don’t take it on their own, and people who do take it. I’m pretty open-minded. Like antibiotics, you either take them, or you don’t. You don’t take them every other day or once a day instead of twice a day. It’s similar with this. You will either take the meds, or you won’t. Don’t skip around and miss doses.
If someone is going to take the meds and they will take something like bugleweed, which I can’t say all of my patients do this, but I do have patients who take both because they want to try to get off the medication sooner or later. I am not telling them to do this.
Let’s say you’re taking bugleweed and methimazole. You will do a follow-up thyroid panel eventually. As that becomes more hypo, you will ask the prescribing doctor to reduce the dose of the antithyroid medication.
I also recommend taking them apart. Don’t take them right next to each other. Maybe 30-45 minutes apart. You can take them further apart. This is just the approach I take. There is nothing in the research that talks about taking methimazole and bugleweed at the same time. I don’t know of any interactions. There is nothing in the literature. You can ask a pharmacist. There is nothing I have seen or heard, and I have had people do it for many years. I usually have them space it out and not take one right after the other.
In this case, this person is on a small dose, which is great. Regardless, even if someone relapsed and needed to be on medication, I wouldn’t look at it as failure. There is a time and place for medication. If someone is taking the herbs, and it’s not effective, and they need to be on medication, I would not look at this as failure. There is a time and place for medication. As long as you’re trying to do things to address the cause of the problem, while taking the medication, then that’s what’s important.
Even when I took bugleweed and motherwort, those weren’t addressing the cause of the problem. Those are naturally managing the symptoms. If that’s all I did, I wouldn’t have restored my health.
Those are some of the main points I wanted to mention here. It’s great this person is working with a functional medicine doctor.
Is there any correlation with hyperthyroidism and high cholesterol? It’s another great question. High cholesterol is actually more common with hypothyroidism. I have some articles. I’m pretty sure I have a podcast episode where I talk about cholesterol and the thyroid. When someone is hypo, it’s more likely to cause high cholesterol. If someone is taking antithyroid medication, which is blocking thyroid hormone production, that might cause high cholesterol.
It’s very sad because a lot of people who have high cholesterol are given a statin. The thyroid might not be looked at. I am not talking about people who are listening to this, but just in general. You might know someone who has high cholesterol, and they’re on a statin. You might want to ask, “Did you ever get your thyroid checked to make sure you don’t have a thyroid issue?”
High cholesterol is not as common with Graves’. If someone has unmanaged hyperthyroidism, usually you will see lower cholesterol. Sometimes, it will get not crazy low, but I usually like to see cholesterol above 150. We don’t want to see cholesterol crazy high, but we also don’t want to see it crazy low. If someone has a cholesterol of 80, that’s too low. Cholesterol is important for forming the sex hormones and cortisol, and it has other important functions.
If someone has hyperthyroidism, and they are taking medication but are still hyper, yet their cholesterol is still high, there could be other factors. A lot of inflammation can cause cholesterol to increase. Sometimes, eating a lot of saturated fat. If someone is following a carnivore diet, so they are eating a lot of animal protein, everybody is different. There are some people who can get away with eating animal protein, and their cholesterol and LDL will look fine. There are people who are eating a lot of animal protein, and their total cholesterol and LDL are very high. That could also be a factor.
There are some genetics as well. I wouldn’t just rely on the lipid panel. You might want to look at some other markers, like LDL particle. I might have brought this up before, but I also have written some articles related to cholesterol and looking at some advanced lipid markers as well. Those are things that you might want to consider if your cholesterol is high.
Finally, this person also said something that stuck with me. It’s always a deep dive. Honestly, that’s true. For most people, it’s complex. Graves’, other autoimmune conditions, even non-autoimmune hyperthyroid conditions, they can be challenging and complex. Healing isn’t always linear.
People with Graves’, it will get discouraging because I want to see the antibodies, for both Graves’ and Hashimoto’s, decrease and eventually normalize. Sometimes, it’s like a rollercoaster ride, where you’ll take two steps forward and one step back. When you see that one step back, if the antibodies decrease, but then they increase, it gets discouraging, which I understand. If we see it consistently increasing, that’s not good.
If we see a rollercoaster pattern, over time, it’s getting lower, that’s great. Obviously, if someone is gradually improving, their antibodies are gradually decreasing, with no setbacks, that’s even better. A rollercoaster effect is quite common. Setbacks are common. That’s why I talk about setbacks and roadblocks. Progress is not always linear.
This person is working with a functional medicine practitioner, which is great. Work with someone who welcomes complexity. Don’t get me wrong. I definitely enjoy working with people who progress gradually without any setbacks or roadblocks. I have come to realize after working with people with hyperthyroidism for over 15 years, more times than not, there are going to be setbacks and roadblocks.
Another reason why you want to work with someone who is experienced. If someone is just a newbie in practice, they have to learn somehow, but they might not be used to the setbacks and roadblocks.
It’s great that this person is working with someone. Hopefully the person who wrote this message will do things to improve their immune system health beyond taking Thyroid Calm. This also shows this person has a natural mindset, not just relying on medication.
Whether you’re dealing with Graves’ or a non-autoimmune thyroid condition, whether you’re on methimazole or taking bugleweed or Thyroid Calming Formula, again, this is a process that asks for patience. You want to receive the right support.
Of course, the purpose behind this podcast- I have other resources as well beyond the podcast, like my books and my webinar. In my free webinar, I talk about the framework I use to help people with Graves’ or hyperthyroidism move toward long-time stability. It’s called “The Five Steps to Reverse Hyperthyroidism and Graves’.”
I talk about how to avoid radioactive iodine and support your thyroid and immune system naturally; the forming categories of Graves’ triggers, including some hidden ones that often get missed; how to break the hyperthyroid cycle, which is true especially if you have relapsed after a period of remission; how to work with more complex situations like thyroid eye disease or those with toxic multinodular goiter. It’s not just about Graves’. This isn’t about quick fixes, but it will help you feel more grounded in what’s possible, what to focus on first.
If you haven’t checked out that webinar, you might want to do so. You can sign up at SaveMyThyroid.com/HyperWebinar.
Thanks again for tuning in. Wherever you are on your healing journey, just keep looking beneath the surface. Sometimes, that’s where the clearest answers come from.
I’ll end it on this note. Thanks for tuning in. Hope you found this episode to be valuable. Of course, look forward to catching you in the next one.
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