5 Things I Wish More Doctors Knew About THYROID

Hey, everyone,

Dr Gibbs checking in. I am so excited to announce that my new practice, Consultants in Metabolism, is coming along and should be open in June. The practice waitlist is open for applications now.

Today I would like to start discussing discuss several things that I really wish more doctors knew about THYROID. If they did I wouldn’t have spent 20+ years undiagnosed, exhausted, cold, and just feeling worn out. 

The first thing I wish more doctors knew is that TSH, which is Thyroid Stimulating Hormone, can be normal or even low, and you can still have not enough or not the right balance of thyroid hormones in your body to feel well. TSH stands for Thyroid Stimulating Hormone. This is a brain chemical that tells your thyroid to make more thyroid hormone. Without enough TSH, your thyroid does not, ( unless you've got a disease,)  make enough thyroid hormone. 

So there are several conditions that can cause you to have not enough TSH, or not enough signal to your thyroid to make more hormone. If your TSH is low, this doesn’t automatically mean you have too much thyroid hormone. Some of these conditions include high body insulin levels, the wrong balance of thyroid replacement medications, and extreme stress, which induces another brain chemical ACTH which pushes down TSH.

The second thing -  A palpable thyroid is always abnormal. The opposite is not always true: a non-palpable thyroid isn’t always functioning normally either. What is palpable? Palpable means that you can feel it when you put your fingers on it. And that's right at the bottom of your neck, on either side of your windpipe, behind your collarbones. Palpable means that instead of just feeling the ridges of your windpipe, you can actually feel a thickness or a lumpiness between your fingers and your windpipe. 

A palpable thyroid can mean several things, especially if it's uncomfortable when you touch it. The most common reason for this to happen is a very common autoimmune disease, which is called Hashimoto's or autoimmune thyroiditis. If you have this condition, it is possible that your thyroid blood tests that your physician routinely gets will be completely and utterly normal, even though your thyroid function is no longer normal and you may not feel well. Meanwhile, your immune system is busy destroying your thyroid, and sooner or later you're going to start having even more symptoms and frankly abnormal lab tests. This deterioration is actually treatable, and it's better treated before you lose all your thyroid function, than waiting until you've been having symptoms for a while. A Hashimoto’s thyroid can have nodules which are quite large, or just be firm and rubbery feeling. 

There are also other benign or not benign conditions that can cause palpable nodules, so these should always be checked out by a doctor who is knowledgeable in treating thyroid conditions.  Then there are goiters:  this is when the whole thyroid is enlarged, either with nodules or without. There are several reasons that goiters form, the most common being iodine deficiency. A sonogram is generally recommended to evaluate an enlarged thyroid, so ask your doctor.

The formation of goiters is one of the reasons for the introduction of IODIZED salt in the USA in 1924. Lack of iodine can cause intellectual and developmental disabilities, and it is proposed that nationwide IQ increased by over 3 points after its introduction, and 15 points in iodine-deficient areas. Iodine is also necessary for glandular secretions like tears, sweat, breast milk, and even saliva. 

Iodine deficiency is now more common than it was 10 years ago because so many people are either not adding salt to their food, or using salt that does not contain iodine, like most sea salt. And keep in mind, too much iodine is not good for thyroid either. There are many iodine supplements that have WAY too much iodine and can make an abnormal thyroid even worse. So if you are taking iodine supplements, make sure you are not taking more than one milligram per day, and the USRDA is only 0.15 milligram! 

Thing number three is that there’s a constellation of symptoms that indicate thyroid disease, not just being overweight. I had almost all of them. When I had low thyroid I was skinny!, way skinnier than I am now. I had constipation, cold extremities, I was cold all the time and my body temperature was always low, except at night when I would wake up drenched in sweat. I had thinning hair, especially on top, I needed more than 8 hours of sleep. My eyebrows on the outside corners stopped growing. I had extreme tiredness (for years I just thought I was lazy, having been told there was nothing wrong with me) puffy wrists and ankles, puffy sinuses, pale complexion, brittle fingernails, low blood pressure, and a slow pulse. I got sick frequently with sinus or upper respiratory infections because my immune system was suppressed by the thyroid problem. When I wandered into my first lecture about integrative thyroid treatment, my jaw nearly hit the floor! (and I am a thyroid surgeon) They were talking about me, and I had no idea about all this stuff. Getting properly treated was miraculous for me because I didn’t even know what normal felt like before then.

So if you’re like me, and having trouble getting your symptoms under control by other means, come check out my new practice website at www.DanaGibbsMD.com.

If you’re a physician reading this and want to know even more, check out the course I sponsor on Integrative Endocrinology techniques that can help some of your most difficult patients with thyroid, adrenal, and other endocrine abnormalities. https://www.allergyaccessmd.com, and look for the courses tab. There are also some links there to other free resources that I recommend.

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