Functional MedicineGet to the root cause of medical problems
Treating Autoimmune Conditions like Hashimoto’s
Hashimoto’s, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder that affects the thyroid. It is probably the most common thyroid disease and most common autoimmune condition. It occurs when your immune system attacks the thyroid, causing inflammation. Initially it often presents with excess thyroid production, but eventually, as it continues to attack the thyroid, it presents as hypothyroidism.
Hashimoto’s often goes undiagnosed for years, especially in the excess thyroid production stage, unless it sends you into a really high heart rate or high blood pressure. Most of the time people are not concerned if they are thin and have high energy. They may just think that they are anxious and on the nervous side.
But it’s a big concern, especially for women, when they become hypothyroid and don’t have energy and are gaining weight and can’t lose it, says Dr. Jamie Walraven of Ageless Wellness Center in Peachtree City. This is when most people get diagnosed.
“The story I hear all the time is, ‘I used to be thin and eat whatever I want and have lots of energy and now I don’t’,” Walraven says.
The typical medical approach for someone who thinks they have a thyroid condition is to do a TSH (thyroid-stimulating hormone) test. But you have to do some additional special testing to diagnose Hashimoto’s, looking at the antibodies, Walraven says.
The general standard of care for treating Hashimoto’s is to either block down the thyroid if it’s producing too much hormone, or to supplement the thyroid hormone with thyroid medication. While this works for most people, there are others that this does not work for because they’re missing part of the picture.
“Roughly 85 percent of your immune system lies in the gut, so we definitely need to take a closer look at your gut,” Walraven says. “While it may not be 100 percent of the time, I will tell you that 100 percent of the time when I have looked in depth at anybody with any kind of autoimmune disorder, they had some gut issues. When you have a ‘leaky gut’ you’re not absorbing vitamins, you’re not digesting your foods properly, you may have an overgrowth of yeast, or vitamin deficiencies.”
Off-label uses of medications like low-dose naltrexone have proven useful in treating Hashimoto’s and other autoimmune disorders. Naltrexone is an FDA-approved drug for reversal of opiates, so it can’t be used with someone who is currently taking opiates. But what it does, when used in small doses, is trick the autoimmune system into working better.
According to Walraven, the typical patient with Hashimoto’s is a middle-aged woman who’s noticed that over the past few years she has been unable to lose weight in spite of limiting her diet and calorie intake. Exercise has been difficult because she’s tired all the time.
“Things seem to change during pregnancy so often we’ll notice those symptoms start after the birth of a child,” Walraven says. “We’ll commonly check the thyroid and if the antibodies come back positive, it’s not uncommon for me to be the first person telling them they have Hashimoto’s. At this point, she’s really on board with fixing this because the synthroid that she’s been taking is not working well. And of course she does not want to develop any other autoimmune disorders. If someone has one autoimmune disorder, they are more likely to develop a second autoimmune disorder.”
Commonly there are other family members that have Hashimoto’s or thyroid issues as well that have gone undiagnosed, Walraven says.
“Looking at the gut, a person may or may not have gut symptoms, but in this case she had bloating and heartburn. I would recommend the AIP or autoimmune Paleo diet for anyone with an autoimmune disorder,” Walraven explains. “We can also perform testing to look for vitamin deficiencies. For her case, there were not only deficiencies, but also markers for inflammation in the gut, so when we looked at those markers there were indices of bad absorption, an overgrowth of bad bacteria and an overgrowth of yeast. With all of that, we also did food sensitivity testing so she will know what foods to avoid.”
When you have vitamin deficiencies, it’s important to replace those vitamins, Walraven says. “But if you’re taking vitamin supplements but not absorbing them, all you’re getting is expensive poo. We can correct that through IV nutrition and picking out supplements that not only replace the vitamins but help balance the gut and decrease the overgrowth of yeast.”
Probiotics are really important. Walraven also typically starts a patient on low-dose naltrexone. In the example of her middle-aged patient’s case study, “that really turned her around. Her low body temperature went up, so she wasn’t always complaining of being cold. Her metabolism changed so she was able to lose weight, and her energy improved. And she was actually able to think better.”
Whether someone’s already been diagnosed with Hashimoto’s or not, an appointment with Dr. Walraven and Ageless Wellness can determine the best route to take to maintain optimum health.
Ageless Wellness Center is located at 1000 Commerce Drive, Suite 300, Peachtree City. For more information or to make an appointment, call 678-364-8414.