Although I wish I can say that everyone with a thyroid or autoimmune thyroid condition who follows a natural treatment protocol will receive great results, the truth is that some people don’t respond as expected. Most of the time this is due to the person not completely following the recommended natural treatment protocol. But sometimes the person will follow the recommendations and still not receive optimal results. When you’re not receiving optimal results then you need to consider the following options:
1. Make sure you’re following the recommended protocol. If you’re not responding as expected, then you want to make sure you’re following the complete recommendations. For example, if you are told to eat mostly whole foods, and avoid common allergens such as gluten and dairy, then you need to ask yourself if you are following these recommendations. Sometimes a person will think they are following the recommendations, but aren’t aware that they are inadvertently cheating. For example, many people are allergic to corn. But most people aren’t aware that ascorbic acid, which is sold in most health food stores as Vitamin C, is made from corn syrup. As a result, a person may think they’re avoiding corn because they’re not eating any foods which contain corn, but they might not be aware that some of their supplements contain corn syrup, even if this isn’t mentioned on the label.
Another example relates with managing your stress levels. I’ve had patients who did a wonderful job of eating well and avoiding common allergens, and also took the nutritional supplements I recommended, but didn’t do a good job of managing their stress. Remember that the adrenals respond to stress by secreting cortisol, and if cortisol is constantly being secreted then this is going to lead to all sorts of problems. And so besides eating well and taking nutritional supplements you need to manage your stress levels. Similarly, you also need to make sure you get sufficient sleep each night.
2. Look at the gut, adrenals, and toxins. There are many different factors which can lead to the development of thyroid and autoimmune thyroid conditions. But I have found that three of the most important factors to look at are 1) the health of your adrenals, 2) the health of your gut, 3) your toxic load. In my opinion it is best to evaluate the health of the adrenals through saliva testing. You want to look at the cortisol levels throughout the day, and also look at the DHEA and 17-OH Progesterone. Some people assume that their adrenals are fine because they aren’t fatigued and don’t have problems sleeping. While many people with adrenal problems experience fatigue and/or sleeping difficulties, keep in mind that when I was diagnosed with Graves’ Disease I felt fine from an energy standpoint and also had no problem falling or staying asleep. However, my cortisol levels and DHEA were extremely depressed. So you can’t go by symptoms alone when evaluating the health of your adrenals.
The same concept applies to the gut, as while many people with gut problems experience symptoms such as bloating, gas, and/or constipation, some people with gut problems don’t have any digestive symptoms. In fact, I’ve had numerous patients test positive for a leaky gut, even though they felt fine from a symptomatic standpoint. And when we addressed the leaky gut problem, in most cases their health improved dramatically. There’s a reason why most natural healthcare professionals focus a great deal on the health of the gut, and the reason for this is because if someone has an unhealthy gut, then it is not possible to achieve optimal health.
As for toxins, I’ve always been an advocate of 21-day detoxification programs. I have been recommending these to my patients for many years, and I personally go through two detoxification programs per year. However, for many people even this isn’t sufficient. Obviously nothing is going to completely eliminate the toxins from one’s body. However, in addition to eating well and taking certain detox supplements, some people need to go through procedures such as colon hydrotherapy and colonic irrigation, as well as infrared sauna therapy. So if you’re not responding to a natural treatment protocol, toxins could very well be the reason, as sometimes just eating well and taking nutritional supplements isn’t sufficient.
3. Consult with a different natural healthcare professional. If you have followed a natural treatment protocol and haven’t received optimal results, consider working with a different natural healthcare professional. If the person you saw isn’t someone who focuses on thyroid and autoimmune thyroid conditions, then you might want to consider consulting with such a doctor. It really doesn’t matter which type of natural healthcare professional you work with, as long as they have experience dealing with thyroid and autoimmune thyroid conditions. This might mean driving a few hours to see this person, or speaking with someone remotely over the phone. While some people are fortunate to have someone practicing in their town who has experiencing helping people with thyroid and autoimmune thyroid conditions, some people aren’t as fortunate. Either way, if you’ve seen a natural healthcare professional and didn’t received ideal results, consider getting a second, and perhaps even third opinion.
4. Consider low dose naltrexone. Naltrexone is a prescription medication, and low doses are used to help people with different types of endocrine conditions. This includes autoimmune conditions such as lupus, multiple sclerosis, as well as Graves’ Disease and Hashimoto’s Thyroiditis. Some people receive great results when receiving LDN, while others don’t find the treatment to be beneficial. With regards to research studies, there are a few studies which show the benefits of LDN (1) (2). Although there aren’t any specific studies I know of which show whether LDN can help people with autoimmune thyroid conditions, there are a few studies which have shown the benefits of LDN and multiple sclerosis (3) (4), which is a different type of autoimmune condition. For more information on LDN you can read my blog post entitled Can Low Dose Naltrexone Cure Graves Disease and Hashimoto’s Thyroiditis?
5. Consider long-term treatment with Methimazole or Bugleweed. This of course only applies to those people with hyperthyroid conditions. In countries outside of the United States, many endocrinologists will do everything they can to help their patients avoid RAI. It’s not uncommon for them to recommend long-term treatment with low doses of antithyroid medication, such as methimazole. In fact, there have been a couple of studies which compared long-term continuous use of methimazole with RAI. One study concluded that long-term continuous treatment of hyperthyroidism with methimazole is safe. It also concluded that the complications and the expense of giving methimazole long-term do not exceed those of radioactive iodine therapy (5). A second study was conducted and came to the conclusion that long-term methimazole treatment was superior to RAI therapy in patients when mood, cognition, cardiac function and occurrence of thyroid dysfunction were compared (6).
Although I’m not thrilled about people taking prescription drugs on a long term basis, remember that we’re comparing risks vs. benefits. Plus, most people who receive RAI or thyroid surgery will be taking thyroid hormone for the rest of their life. In my opinion everything should be done to preserve the health of the thyroid gland. And while some people will be sensitive to even low doses of methimazole, for most people it won’t be a problem taking a low dose (i.e. 5 mg/day).
What should you do if you bring this up to your endocrinologist and he or she isn’t supportive of long-term treatment with methimazole? Well, this is where you need to take a stand. And so I would be firm, but at the same time polite, and if you’re unable to convince your endocrinologist to let you take low doses of methimazole on a long term basis, then I would speak with a different endocrinologist.
Another option is to take low doses of Bugleweed on a long-term basis to manage your symptoms. Once again, this isn’t the ideal situation, as I was able to wean off of Bugleweed for good after about six months, and just about all of my patients who are on Bugleweed are also eventually able to stop taking this herb. Of course I would recommend for people to consult with a natural healthcare professional if they’re considering taking Bugleweed for a prolonged period of time.
For some people, taking low doses of methimazole or Bugleweed won’t be sufficient to manage the symptoms.
6. Choosing between radioactive iodine treatment and thyroid surgery. When I consult with a patient, I will do everything I can to prevent them from receiving RAI or a thyroidectomy. However, I don’t have a 100% success rate and so every now and then someone will need to choose between these two treatment methods. For more information on this check out my article entitled “Radioactive Iodine vs. Thyroid Surgery: Comparing The Benefits and Risks“.
In summary, while my goal is to try to restore people’s health naturally, there of course are times when natural treatment methods aren’t too effective, and as a result, conventional medical treatment methods are necessary. So while I hope most people reading this are able to restore their health naturally, for those who don’t receive optimal results when following a natural treatment protocol, hopefully the information presented in this post will be valuable.