As a new clinician, nearly twenty years ago now, managing endocrine concerns was a bit intimidating. It seemed that a rather significant number of women were presenting to my practice with concerns about their thyroid, and they were sharing that they didn't feel as if they were being heard anywhere else. True to my nature, when I am intimidated by anything, or when someone is in need of an advocate, I dive all in, so those first few years of clinical practice, as a nurse-midwife, I worked hard to understand this niche, and to understand why conventional treatments were leaving women feeling unsatisfied and misunderstood.
It became clear to me pretty early that similar to how I was managing my pregnant clients, those with thyroid disease also needed extensive education that I could not provide in our individual consultations, and it was important they could be their own advocate. Conventional medicine, much like modern obstetrics, had become about quick fixes. It was more patronizing than it was about offering individualized care. It's another way feminism shows up in healthcare (Chen et al., 2008), and not just because thyroid disease primarily impacts women, but because an exorbitant of women suffer for years before being diagnosed and treated; they're too often dismissed and gaslit by medical providers that either they are exaggerating their symptoms or if they would get their lifestyle under control, they wouldn't feel so bad (Khan et al., 2024).
My Healing the Thyroid program was born in efforts to offer a better option, where women are heard and empowered, and thanks to a great community, it was one of the more thriving aspects of my midwifery practice. A plethora of referrals were extended from my colleagues, who knew they weren't meeting the client's needs as they would have liked to but in their practices, there simply wasn't time or resources. Most importantly, time and time again, women were able to take an active role in their treatment plans and truly find healing.
Thyroid dysfunction is common. In fact, its incident is increasing (Zhang et al., 2023 & Wyne et al., 2022). It can lead to weight gain, sometimes rather substantially. Women have shared they can quickly gain 30 pounds or more in just a matter of months, regardless of what they eat or how much they exercise. They struggle with memory and focus, and then, rather randomly, anxiety and depression sneak up on them or they struggle to sleep.
Women are more often perceived as hysterical, emotional, and dramatic in medical settings when compared to care provided men (Markowitz, 2022). This perception, that women are more emotional than men, is not founded in science. It's reflective of gender bias and stereotyping in medicine that often leads to over-prescribing, under-prescribing, inequitable and inadequate treatment, and gaslighting as the result of physicians believing that a woman's condition is psychological and exaggerated, rather than biological or physical.
Women have also shared the health of their thyroid impacts their monthly flow, their fertility, their ability to produce enough breastmilk for their babies, and even how they transition into menopause. As they age, more and more health concerns arise, including high cholesterol, high blood sugar, and overwhelming fatigue that prevents them from showing up in their lives as they desire. They struggle to earn a living, to mother, or to maintain a healthy intimate relationship.
Are You Getting the Results You Want?
Women often share that they just feel awful, they're quite confident the issue is their thyroid, but their practitioner keeps telling them their thyroid labs are normal or even after several dose changes they can't identify much improvement. Other times, women will have labs that result high at times, and low at other times. They either feel unheard, misunderstood, or as if no one knows what is really going on and how to fix it. The reality is that just about any symptom one could experience, almost anything at all, could be related to a malfunctioning or inflamed thyroid (Wilson et al., 2021).
Certainly these experiences can occur in men as well, and I am here to help you too, but they are overwhelmingly experienced by women. Of all those diagnosed with thyroid disease, only about 10% suffer because of actual dysfunction originating in the thyroid. Most often this results from inflammation that can be resolved, or at least minimized. Thyroid medications though are the mainstay of treatment, no matter the underlying cause, which does nothing to address the inflammation. When we fail to identify the root cause, this inflammation can progress to autoimmune disease, a leading cause of death for women in the United States (Walsh & Rau, 2000).
Undiagnosed or improperly treated thyroid dysfunction may mean women are prescribed antidepressants for postpartum depression when what they actually have is postpartum thyroiditis. Ignoring this can mean long term disease that might have been thwarted if identified earlier in its presentation. It may also mean mistreated depression, significant impact on relationships, fertility problems, and tremendous suffering from being overweight. High cholesterol, high blood sugar, heart disease, and osteoporosis can also result from hypothyroidism (Zhang et al., 2023).
More importantly for some of us, when we receive care from an authoritarian clinician, within a hierarchical system that over-powers, rather than listens, we become oppressed. In fear of being labeled "difficult" or "needy," studies recognize that women downplay their symptoms out of concern they will not be taken seriously; we fawn. This is an abusive relationship, and healing is very difficult to acquire under these circumstances. I would love to work with you, to connect and encourage you, but also, empower you through education.
The Thyroid is the Smoke Alarm of the Body
Similar to the canary in the coal mine, the thyroid is the smoke alarm within the body, warning us of toxins and inflammation creating burden on the body. The thyroid, therefore, reflects the health of the entire body. If you have thyroid disease then, consider this the alarm that you have an underlying health issue that needs addressed, a fire that needs put out. It's a warning sign that shouldn't be ignored.
Conventional medicine is incredible for treating acute care issues, trauma for example. That's what our healthcare system is built for, sickcare. It isn't so excellent at treating chronic disease. In fact, we are facing crisis because of the rising prevalence of chronic disease (Holman, 2020). We don't really have a system focused on optimizing health. The primary medication prescribed for thyroid dysfunction doesn't offer a cure; the thyroid isn't healed because of it.
However, we have come to expect a prescription for most ailments, with many exceedingly frustrated if they leave a clinician's office without. Clinicians are trained to diagnose and prescribe, not educate and empower. We fail to see that most of these scripts, upwards of 80 to 90% are just bandaids covering up a problem beneath, and not only will this prescription simply bide us time without offering any real healing, it will allow for inflammation to progress so that additional dis-ease presents. Most commonly for those with thyroid disease, we eventually see diabetes, anxiety, depression, insomnia, acid reflux, nutritional deficiencies, and anemia.
Functional Medicine is a System Approach
Thyroid dysfunction is a chronic state of immune system overload and we don't always know why when first meeting with a client. We can see from the literature what the most common triggers are, but this also differs from person to person. Part of my role is to follow the smoke, so to speak, and find the fire that needs eliminated. Our bodies are a complicated system though. The thyroid does not live by itself in a vacuum. We have to address gut health, impaired digestion, an overtaxed nervous system, and imbalances in hormones throughout the endocrine system.
Piece by piece we need to dismantle the vicious cycle. Autoimmune conditions may relate to environmental triggers, gut dysbiosis, bacteria or viruses, parasites or toxins, but not often was the original issue a failing thyroid. All of this is addressed in my Thyroid Program. Part of healing any part of this dis-ease, is making some basic modifications, identifying the trigger, and then repairing the systems within the body to restore equilibrium, allowing the body to heal itself.
Time with clinicians in clinic visits is very scarce. Studies have found that physicians allocate a median of only 5 minutes on discussing major topics in private consultations, and the more complex, the more the client talks, so the less the physician does because no additional time for these complex visits are carved out of the schedule (Tai-Seale, et al., 2007). This doesn't even address that on average, three or four topics are discussed per visit, so talk time may be only a minute or two per concern. There simply isn't time to educate or dig into modifications that would actually offer more long term healing.
Endocrinologists focus on the glands, but like most clinicians, they typically have their own specialties and for most, this isn't the thyroid. Neurologists focus on the brain. Chiropractors focus on the spine and nervous system, not the endocrine system. Obstetricians focus on pregnancy. Naturopathic doctors have a limited scope of practice that does not include medical management, or prescriptions. Primary care providers are the more common practitioner for diagnosing and managing thyroid dysfunction, but is your provider comfortable digging into the root cause of your dis-ease. Is your doctor educating you?
Empower Yourself Through Education
You are more than capable of becoming an expert in your condition, whether you are dealing with hyperthyroidism, hypothyroidism, thyroid nodules, autoimmune thyroid disease, or thyroid cancer. There is a plethora of information available with only a few keystrokes on your computer keyboard, but again, thyroid dis-ease is complex. I have broken down the more complex components, in my Thyroid Healing program, into easy to understand concepts, but spared no knowledge so you can dive in as deep as you desire to understand your own path towards healing.
We discuss the various ways the thyroid may dysfunction and what diagnoses one might acquire. We talk about autoimmune responses that impact the thyroid, and how you can identify this within your laboratory results. Quite frankly, these labs can be complex, confusing even clinicians. We will work to understand these labs, so you can advocate for proper diagnosis, and ongoing management. We will also explore the many reasons labs may appear normal, but you may not feel well.
What is your trigger? We have to consider chronic stress, exposures from your diet and your environment, even pathogens and allergies. There are a number of tests, at reasonable prices, to help us identify your trigger. I have offered resources to help you work towards recovery, so you don't have to trial a plethora of high dollar supplements or bounce from clinic to clinic, and expert to expert.
Prescriptions are the mainstay of treatment in conventional medicine, with surgery the only other option, because that's all clinicians have time to offer. It's all they are taught. More than half of those with Hashimoto's have other organs suffering inflammation. An inflamed pancreas can lead to diabetes, inflamed myelin to Multiple Sclerosis, an inflamed brain to Parkinson's, Alzheimers, or dementia. Inflammation may occur in the intestines, leading to a diagnosis of irritable bowel or Crohn's disease, and inflammation in the joints may mean Rheumatoid Arthritis if this is not addressed. Endometriosis, pernicious anemia, and osteoporosis are additional inflammatory responses. Again, let's work to correct the dysfunction, not just identify the proper prescription.
The modules in my program will allow you to lead your own healing with the ultimate goal of attaining remission. Sometimes that isn't possible, but optimizing health is certainly attainable, which can minimize the progression of inflammation and ward off subsequent dis-ease. You are the expert of your own body and its experiences. It is our job, as clinicians, to honor that, to listen to you, to support and trust you. I have years of experience doing just this and its been an honor to witness healing.
As a clinician, I can support this education with evidence that your primary care provider will respond to, that is evidence-based, but can also offer you guidance through my own clinical experience, which sometimes can be more of an art. Add to that the depth of natural treatments which can truly enhance treatment modalities for offering the thyroid healing, my training and experience in botanical medicine offers a truly unique opportunity for those with thyroid dis-ease.
Take a peek at my comprehensive Thyroid Healing program, available to anyone and everyone. You are offered lifetime access, so as science evolves, so will this program at no additional charge to you. If you'd like to combine this with private consultations, so I can help you work through your unique journey, feel free to schedule a new client, virtual consultation.
References
Burgos, N., Toloza, F. J. K., Ospina, N. M. S., Brito, J. P., Salloum, R. G., Hassett, L. C., & Maraka, S. (2020). Clinical outcomes after discontinuation of thyroid hormone replacement. A systematic review and meta-analysis. Thyroid, 31(5), 740-751.
Chen, E. H., Shofer, F. S., Dean, A. J., Hollander, J. E., Baxt, W. G., Robey, J. L., Sease, K. L., & Mills, A. M. (2008). Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain. American Emergency Medicine, 15(15), 414-418.
Holman, H. R. (2020). The relation of the chronic disease epidemic to the health care crisis. ACR Open Rheumatology, 2(3), 167-173.
Khan, K., Tariq, N S., & Majeed, S. (2024). Psychological impact of medical gaslighting on women: a systematic review. Journal of Professional & Applied Psychology, 5(1), 110-115.
Markowitz, D. M., (2022). Gender and ethnicity bias in medicine: a text analysis of 1.8 million critical care records. PNAS Nexus, 1(4).
Tai-Seale, M., McGuire, T. G., & Zhang, W. (2007). Time allocation in primary care office visits. Health Services Research, 42(5), 1871-1894.
Walsh, S. J. & Rau, L. M. (2000). Autoimmune diseases: a leading cause of death among young and middle-aged women in the United States. American Journal of Public Health, 90(9), 1463-1466.
Wilson, S. A., Stem, L. A., & Bruehlman, R. D. (2021). Hypothyroidism: diagnosis and treatment. American Family Physicians, 103(10), 605-613.
Wyne, K. L., Nair, L., Schneiderman, C. P., Pinsky, B., Flores, O. A., Guo, D., Barger, B., & Tessnow, A. H. (2022). Hypothyroidism prevalence in the United States: a retrospective study combining national health and nutrition examinations survey and claims data, 2009-2019. Journal of Endocrine Society, 7(1).
Zhang, X., Wang, X., Hu, H., Qu, H., Xu, Y., & Li, Q. (2023). Prevalence and trends of thyroid disease among adults, 1999-2018. Endocrine Practice, 29(11), 875-880.
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