Glenn S. Rothfeld - Thyroid Balance: Traditional and Alternative Methods for Treating Thyroid Disorders

THYROID
BALANCE

Traditional and Alternative
Methods for Treating
Thyroid Disorders

GLENN S. ROTHFELD, M.D., M.AC.
AND
DEBORAH S. ROMAINE

PRODUCED BY AMARANTH

Copyright 2003 by Amaranth. All rights reserved.
This book, or parts thereof, may not be reproduced in any form without permission from the publisher; exceptions are made for brief excerpts used in published reviews.

Published by
Adams Media, a division of F+W Media, Inc.
57 Littlefield Street, Avon MA 02322. U.S.A.
www.adamsmedia.com

ISBN 10: 1-58062-777-3
ISBN 13: 978-1-58062-777-1
eISBN 978-1-44051-936-9
Printed in Canada.

J I

Library of Congress Cataloging-in-Publication Data
Rothfeld, Glenn S.
Thyroid balance / by Glenn S. Rothfeld and Deborah S. Romaine.
p. cm.
Includes bibliographical references.
ISBN 1-58062-777-3
1. Thyroid glandDiseasesPopular works.
[DNLM: 1. Thyroid HormonesmetabolismPopular Works. 2. Thyroid DiseasestherapyPopular Works. 3. Thyroid GlandphysiologyPopular Works. WK 202 R846t 2002] I. Romaine, Deborah S. II. Title.
RC655 .R684 2002
616.4'4dc21
2002011332

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Contents

PART 1
The Thyroid Butterfly: Delicate and Elusive

PART 2
Thyroid Conditions: Living out of Balance

PART 3
Thyroid Therapies

PART 4
Restoring Thyroid Health: Living in Balance

Appendices

Introduction

You could be coming to this book for a variety of reasons. You might have a long-standing thyroid condition, and you want to make sure that youre still receiving the most appropriate treatment. You might be recently diagnosed with thyroid imbalance, either hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid). You might suspect that you have a thyroid imbalance but havent gone to the doctor yet. Or you might be searching, with your doctor, to identify the reasons for your symptomsfrom chronic tiredness to inability to become pregnantand thyroid imbalance has come up as a possibility. This book is for each one of you.

READERS WITH LONG-STANDING
THYROID IMBALANCE

If youve lived with underactive thyroid for years or even decades, youve no doubt adjusted to the routine of taking a pill every morning to supply your system with the thyroid hormone it needs. (The course of medication to treat overactive thyroid is limited to two years or less, so were just addressing hypothyroidism for now.) You probably feel fine, although sometimes its hard for you to tell because youve felt this way for so long. And despite changes in treatment approaches and the thyroid hormone replacement drugs that are now available, youre probably still following the same treatment plan your doctor implemented when you were first diagnosed.

This is partly because you seem to be doing fine, which fits into the category of If its not broken, dont fix it. And its partly because many doctors remain uninformed about new directions in thyroid treatment and are still firmly rooted in the world of Once you start on this brand, never change. Although there is some clinical value in both of these mindsets (which we discuss throughout the book), they are just as outdated as the premise that too much sugar causes diabetes (it does not; more on diabetes and its possible relationship to thyroid imbalance in Chapters 2, 9, and 17).

When was your last checkup? What blood tests did your doctor run? How much time did your doctor spend examining your neck and thyroid gland, and talking with you about how you feel? All too often, your routine follow-up for thyroid gets minimal attention. You might even get scheduled for a brief appointment rather than a full appointment, on the premise that if you were having any problems you wouldve scheduled a visit specifically to address your concerns. Some doctors dont even feel the need to see long-standing thyroid patients every year! They order blood tests. If the results are within normal ranges they authorize continuing prescription refills. If the results are borderline, theyll adjust your dose and have you repeat the tests. This is not an approach thats in your best interest, even if it is expedient.

If you have a long-standing thyroid imbalance, you might not know that youre having symptoms of inappropriate thyroid hormone replacement, taking either too much or too little. And because youve been receiving treatment for so long, you probably dont think that any symptoms you do have could be connected to your thyroid. After all, thats under control... it must be something else! But your bodys functions change over time, which you notice in other ways. Your thyroid function changes, tooeven when youre taking medication to regulate it.

NEWLY DIAGNOSED READERS

If youre newly diagnosed with thyroid imbalance, youre probably wondering what lies ahead. If you have overactive thyroid (hyperthyroidism), your course of treatment will come to an end within a defined time, depending on which treatment option you choose (more about hyperthyroidism and its treatments in Chapters 7, 11, 17, and 18). For half of you, this will be the end of thyroid imbalance and your body will return to normal function. For the other half of you, the chapters in this book about underactive thyroid (hypothyroidism) will also become important. About half of the time, treatment for hyperthyroidism causes hypothyroidism.

When you are newly diagnosed, you have many questions that seem not to have answers. Its not really that there are no answers, but that the answers vary depending on numerous factors. This is frustrating both for doctors and for patients. Doctors like to give patients definitive information just as much as patients want to have it. But, as youll learn as you read this book, its nearly impossible to give a definitive answer when it comes to thyroid balance. Indeed, thats a key factor in managing thyroid balance.

As frustrating as it might be for you, treatment for under-active thyroid when youre first starting out is a matter of trial and error. Your doctor will start with a prescription for thyroid hormone replacement that he or she believes is most likely to restore optimal thyroid function. If this sounds qualified, it is. It is, at best, an educated guess! As youll read in this book, thyroid function is a unique and moving target. What is normal for one person is not necessarily normal for younot in lab results, and not in thyroid hormone supplement doses.

Doctors, like most people, have their favorite tried-and-true approaches to common problems. Thyroid disease, which currently is diagnosed in more than thirteen million Americans, is one of the most common health problems in the world. Treatment stayed the same for nearly four decadesthrough two and possibly three generations of doctors. With few options, doctors quickly settle into patterns of treatmentand so do you.