Healing Autoimmune Thyroid Disorders
by Elaine Moore
September 3, 2000Many patients are diagnosed with hypothyroidism or hyperthyroidism, but they're never told if theirs is an autoimmune disorder. But unfortunately, many doctors never even bother to confirm or disprove one's autoimmune thyroid status, and this is where medicine fails us...since there's always the possibility that one's particular form of thyroiditis is caused by an infection or a genetic aberration. Furthermore, guidelines for treating autoimmune disorders are ignored when autoimmunity isn't considered an issue.
For example, treatment for an infection would consist of antibiotics and anti-inflammatory agents. Properly treated, thyroiditis would resolve. Treated as a glandular disordr, the thyroiditis would persist while the patient kept gobbling replacement hormone. Genetic disorders, in a similar vein, could be treated with gene manipulation. However, strongly influenced by HMO and other insurance mandated guidelines, many doctors no longer go that extra mile to determine this. Does this really matter? After all, logically, the primary goal in hypothyroidism is replacing thyroid hormone and in hyperthyroidism of cutting down the amount of thyroid hormone available to the tissues.
This approach, while offering a temporary solution, doesn't address the underlying disorder. Rather, it implies that the thyroid is defective or at fault. This is hardly the case. In autoimmune thyroid disease, the thyroid is the victim, not the cause.
The very nature of autoimmune disorders needs to be taken into consideration if the disorder is indeed autoimmune. Patients on dozens of different thyroid boards complain that they never feel well, their symptoms range from hyper to hypo, they're fatigued, can't lose weight, etc. Well, no wonder. Autoimmune disorders aren't stable entities. Symptoms in autoimmune disease tend to wax and wane.
Patients with Hashimoto's thyroiditis, an autoimmune disorder responsible for most instances of hypothyroidism, don't have constant levels of destructive autoantibodies. Like most autoimmune antibodies, these IgG immunoglobulins only last about 120 days. New antibodies are formed at a rate proportional to the immune system's response. How can these patients be expected to thrive on one standard thyroid hormone replaement dose while their immune status is ignored?
Same with Graves' disease, an autoimmune thyroid disorder responsible for more than 90% of all hyperthyroidism. Patients with Graves' disease go into spontaneous remission at the rate of 10-25% annually. But in the meantime they suffer from cardiac, muscle and psychological symptoms. To deal with this, conventional medicine recommends destroying the thyroid, rendering the patient hypothyroid. This is akin to lobbing off a leg to treat a bunion. Wiser physicians, who are less influenced by insurance guidelines, treat the patient with antithyroid drugs, medications which halt thyroid hormone production or they treat mild symptoms with beta blockers.
Another consideration is the natural course of autoimmune thyroid disease. Symptoms wax and wane and patients often move from one disorder to another. It's not uncommon for a patient to have hypothyroidism, hyperthyroidism, and autoimmune thyroid failure or primary myxedema at different times in their lifetime. This must be accounted for.
Many long term hypothyroid patients have moved into hyperthyroidism and their doctors have ignored their symptoms and discounted their lab tests, causing them to develop severe hyperthyroidism before this was recognized. And many Graves' patients are rendered hypothyroid with treatment, and as their natural disease course progresses, they become more hypothyroid although their symptoms are discounted and they're encouraged to report back in a year.
With the wide availability of laboratory tests to confirm autoimmune thyroid disease, there's no reason, other than the insurance having to pay $100 for the test, for patients not to be tested. With current knowledge of the immune system, it's possible to treat many autoimmune thyroid symptoms by reducing factors, such as excess iodine or stress, which disrupt the immune sytem. Autoimmune disease patients should be encouraged to use immune system modulators such as the plant sterols effectively which promote immune system balance. Immune system balance rather than a cheap fix should be the therapeutic goal.
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