Monday, December 24, 2018

Thyroid Autoimmune Disease

Diagnosing and treating thyroid conditions in women is extremely important, concluded a group of practitioners in a recent round-table discussion, Thyroid Immune Testing – “Guidelines, Testing Platforms, and Clinical Impact on Women’s Health” and published in the Journal of Women’s Health.

The goal of the Expert Panel Discussion was to collect information from experts in the field so that clinicians could better identify the early signs and symptoms of autoimmune thyroid disease and to understand the role that thyroid-stimulating hormone (TSH) receptor antibodies, such as thyroid-stimulating immunoglobulins (TSI) and thyroid-blocking immunoglobulins (TBI), play in the disease states of Graves’ disease and autoimmune thyroid disease (AITD or Hashimoto’s thyroiditis), respectively.

Helena Rodbard, MD, a practicing endocrinologist, Past-President of the American College of Endocrinology, and Past President of the American Association of Clinical Endocrinologists served as moderator of the Roundtable.

The American Thyroid Association (ATA) has recently recommended thyroid antibody
testing. Dr. Rodbard emphasized that understanding the early signs and symptoms of hypo- and hyperthyroidism are so important for practitioners treating women, because the prevalence of these diseases is so much higher in women. Often, the early symptoms may be overlapping. She also opens the discussion with topics such as treating women who are pregnant and have Graves’ disease, the role of thyroid dysfunction and fertility, when to encourage physicians to look for clustering of other autoimmune diseases such as type 1 diabetes or rheumatoid arthritis, and how thyroid function test measurement is affected by women who use biotin.

My Take:
It is estimated that one-third of all women diagnosed with underactive thyroid actually have Hashimoto’s thyroiditis – an autoimmune disease. However, blood tests for this condition are seldom performed as conventional medicine has no treatment.

Finally, the ATA has recommended thyroid antibody testing. I frequently request thyroid antibody testing on patients (mostly women) who exhibit signs and symptoms of hypothyroidism. I suspect the condition represents more like half of all underactive thyroid cases rather than a third.

Clinically, I use an herbal combination containing Bacopa, Bladderwrack, and Ashwaganda to reduce and eliminate the antibodies. However, that often does not dramatically improve the symptoms of extreme fatigue, weight gain, dry skin and hair loss.

Adding fairly large doses of both vitamin D and vitamin B12 dramatically improves the symptoms. If the vitamin D exceeds 4,000 IU per day, then the levels must be monitored with laboratory testing. I use methylcobalamin or occasionally adenocobalamin, the active forms of vitamin B12, rather than the food quality form, cyanocobalamin.

Bottom Line:
Hashimoto’s thyroiditis is much more common than previously thought. If you have been diagnosed with hypothyroidism, please have thyroid antibody testing performed. You may have to repeat the test over time as the antibodies can be transient.

Source: November 27, 2018 Today’s Practitioner

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