For those with hyperthyroidism and Graves’ disease who choose to see an endocrinologist, it can be very frustrating being told that the only three treatment options someone has are 1) antithyroid medication, 2) radioactive iodine, and 3) thyroid surgery. Without question there is a time and place for conventional medical treatment, and while antithyroid medication such as Methimazole and PTU commonly causes side effects, they usually do a wonderful job of lowering thyroid hormone levels. There are even situations when more extreme treatment methods such as thyroid surgery are necessary. But while conventional treatment methods are sometimes necessary, it’s ludicrous that most endocrinologists don’t do anything to address the cause of the condition.
Why do most endocrinologists only give three treatment options to their hyperthyroid patients, and not try to address the cause of the problem? One obvious reason is the training they receive in medical school. But this isn’t the only reason, as these days there are many medical doctors who practice functional medicine, and most of these medical doctors were also brainwashed while attending medical school. Perhaps two of the main characteristics that result in some medical doctors practicing functional medicine are 1) having an open mind, and 2) being willing to deviate from the norm. In other words, having a closed mind and/or being afraid of deviating from the norm are probably the main two reasons why most endocrinologists refuse to practice functional medicine, and thus fail to address the cause of the hyperthyroid condition.
One more thing I’ll say here is that I’m not suggesting that endocrinologists shouldn’t prescribe antithyroid medication, recommend surgery in some cases, etc. What I am suggesting is that more endocrinologists should practice functional medicine, while utilizing conventional medical treatment whenever necessary. In fact, even if an endocrinologist chooses to recommend antithyroid medication to EVERY patient with hyperthyroidism, but at the same time does things to address the cause of the condition, this would dramatically reduce the number of patients who ended up receiving radioactive iodine or thyroid surgery.
So what I’d like to do now is discuss 7 things most endocrinologists don’t know (or won’t admit) about hyperthyroidism and Graves’ disease.
1. The autoimmune component of Graves’ Disease can be reversed. Please keep in mind that this isn’t just my opinion, and of course it’s important to elaborate on the meaning of “reversed”. I’m not suggesting that Graves’ disease can be permanently cured. I’ve been in remission from Graves’ disease since 2009, and while I would love to say that I permanently cured my Graves’disease condition, the truth is that for those with Graves’ disease who restore their health, there is always a possibility of experiencing a relapse if you don’t do a good job of maintaining your health and are exposed to specific triggers.
When I say the autoimmune component can be reversed, this means that by removing the autoimmune trigger and healing the gut, and doing other things to reduce proinflammatory cytokines and increase regulatory T cells, the autoimmune response can be suppressed. This admittedly isn’t an easy process, as there are times when finding the trigger can be challenging, and many people struggle making the necessary dietary and lifestyle changes. But if someone is willing to take responsibility for their health AND their autoimmune triggers are detected and removed, then it is very possible to achieve a state of remission and maintain your health thereafter. In other words, the goal should be to achieve a state of PERMANENT remission.
2. Eating healthy can play an important role in your recovery. Over the years I’ve had numerous patients bring up diet to their endocrinologists. In most cases an endocrinologist will tell the patient that diet isn’t a factor in the development of their condition, and because of this, eating well won’t do anything to improve their thyroid and immune system health. The truth is that certain foods can be a trigger, but this doesn’t mean that food is a trigger in everyone with hyperthyroidism and Graves’ disease.
That being said, certain foods are inflammatory, and since Graves’ disease is an inflammatory condition, it makes sense to avoid anything that will promote inflammation. Once again, this doesn’t mean that everyone will achieve remission by eating whole healthy foods, but it will be very difficult to restore your health if your diet consists mostly of refined foods, fast food, etc. In the past I’ve mentioned the triad of autoimmunity, and one component of this triad is a leaky gut. I’ve also mentioned in the past how the research demonstrates that gluten causes a leaky gut in everyone. As a result, it makes sense for anyone with Graves’ disease (or any other autoimmune condition) to avoid gluten while trying to restore their health.
3. There are natural agents that can lower thyroid hormone levels. Every now and then a patient will tell me that their endocrinologist is familiar with bugleweed, which is an herb that has antithyroid properties. But many endocrinologists aren’t familiar with bugleweed. L-carnitine can also lower thyroid hormone levels when taken in higher doses, but most endocrinologists also aren’t aware of this. Earlier I mentioned how some people do need to take antithyroid medication, as while many of my patients do fine taking natural agents such as bugleweed, this approach isn’t effective in everyone.
You may wonder whether or not you should take antithyroid medication, or give an herb such as bugleweed a try. When I was dealing with Graves’ disease I chose not to take antithyroid medication, but this doesn’t mean that this is the best decision for everyone. If you’re currently taking antithyroid medication, aren’t having any negative side effects, and are concerned that bugleweed won’t effectively manage your symptoms then by all means continue taking it. On the other hand, if you’re taking antithyroid medication and are experiencing side effects then you might want to give bugleweed a try.
If you were recently diagnosed with hyperthyroidism and haven’t taken any antithyroid medication then you might choose to start with bugleweed and see if it helps, and if not you can always switch to the medication. Those who are familiar with my “Graves disease story” know that I started with bugleweed and a few weeks later added motherwort to further help with my heart palpitations. Some people with hyperthyroidism take lemon balm and/or L-carnitine. Lithium is another option, although I can’t say it’s something I commonly recommend to my patients.
4. Genetics isn’t the main reason why people develop Graves’ disease. Although some endocrinologists will flat out tell their Graves’ disease patients that they don’t know why they developed this condition, other doctors will blame their patient’s Graves’ disease condition on genetics. While it’s true that genetics is a factor, it isn’t the most important factor. Earlier I mentioned the triad of autoimmunity, and the three components of this triad are 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut. So while you do need to have a genetic predisposition to develop Graves’ disease or any other autoimmune condition, you also need to be exposed to at least one trigger, and according to the triad of autoimmunity you also need to have a leaky gut. Similarly, in order to achieve a state of remission you need to remove any triggers and heal the gut.
The truth is that most people who have the genetics for Graves’ disease won’t develop this autoimmune thyroid condition. In fact, when conducting the case history during an initial consultation, it’s not uncommon for the patient to tell me that they are unaware of any family members who have been diagnosed with Graves’ disease. If Graves’ disease was solely a genetic condition then I would imagine that when conducting my initial consultations a lot more family members would be mentioned as having Graves’ disease. If you’re wondering if there is any family history of Graves’ disease in my case, as far as I know there isn’t anyone in my family who has been diagnosed with Graves’ disease. Once again, I’m not denying that genetics isn’t a factor, but only that it’s not the main factor.
5. Chronic stress and adrenal imbalances can be the primary factor in the development of Graves’ disease. While genetics isn’t the main factor in the development of Graves’ disease, chronic stress and compromised adrenals seem to be major culprits in many people. It admittedly can be challenging to confirm this, as correlation doesn’t always mean causation. In other words, just because someone dealt with a lot of stress prior to developing Graves’ disease doesn’t mean that stress was the trigger.
That being said, I’m pretty sure stress was the main reason why I developed Graves’ disease. And while I can’t say that stress is the main factor in everyone I work with, it’s common for people I consult with to tell me that in their opinion, stress was their primary trigger. Keep in mind I’m not just referring to emotional stressors. Physical stressors can also be a culprit. For example, while emotional stress was a factor in my situation, prior to being diagnosed with Graves’ disease I was overtraining, which also will negatively affect the adrenals over time. So in my case I’m pretty confident that it was a combination of emotional and physical stressors that wrecked havoc on my adrenals, and set the stage for my Graves’ disease condition.
6. Some people with hyperthyroidism benefit from iodine supplementation. This is going to be a bit controversial, as I’m sure that many people reading this blog post agreed with the first five things listed here, but can’t believe that I listed iodine as potentially being beneficial for hyperthyroidism. First of all, I’d like to say right off of the bat that not everyone does well when supplementing with iodine, and I don’t have all of my patients take iodine. In fact, even if you’re open to taking iodine, it is wise to first test to determine if you have an iodine deficiency, and even if you’re deficient in iodine you need to increase your antioxidant status and start with small doses.
Most endocrinologists will advise their patients with hyperthyroidism and Graves’ disease to avoid iodine, not only in supplement form, but food sources as well. The reason is because iodine is a precursor to thyroid hormone, and so they’re concerned that taking iodine will exacerbate one’s hyperthyroid condition. But many decades ago, before radioactive iodine treatment was commonly recommended, Lugol’s solution was used to manage the symptoms of hyperthyroidism. And if someone is unable to take antithyroid medication and bugleweed isn’t helping to lower their thyroid hormone levels, there are times when iodine supplementation should be considered…especially if your endocrinologist is pressuring you to receive radioactive iodine.
7. Radioactive iodine doesn’t “cure” Graves’ disease. I think it’s safe to say that many people with Graves’ disease reading this understand that radioactive iodine isn’t a cure. But that won’t stop many endocrinologists from labeling it as a cure. While they can make an argument that in many cases radioactive iodine will be a permanent solution for hyperthyroidism, remember that Graves’ disease is primarily an immune condition, not a thyroid condition. So just to clarify, radioactive iodine treatment many times will permanently eliminate hyperthyroidism, but it will do absolutely nothing for the autoimmune component of Graves’ disease. And it’s obviously the same concept with thyroid surgery.
Why is this significant? The reason why this is important to understand is because having one autoimmune condition increases the likelihood of developing other autoimmune conditions in the future. Thus, if someone receives radioactive iodine, but nothing has been done to remove the autoimmune trigger and heal the gut, then you can’t conclude that Graves’ disease has been cured. In fact, earlier I mentioned how I don’t consider Graves’ disease to be completely curable due to the genetic component, and thus I mentioned how I try to help my patients achieve a state of “permanent remission”. On the other hand, someone who receives radioactive iodine shouldn’t be considered to be in remission, because while their hyperthyroidism very well may never return, the autoimmune component hasn’t been addressed.
As for those who have toxic multinodular goiter, I still wouldn’t consider radioactive iodine to be a “cure”, mainly because it doesn’t do anything to address the underlying cause of the condition. So while there might not be the same concern as with Graves’ disease (a risk of developing other autoimmune conditions in the future), there still is an underlying cause of toxic multinodular goiter. And not addressing this can lead to other health issues in the future. It’s also worth mentioning that I’ve worked with patients who had toxic multinodular goiter AND thyroid autoantibodies.
If you have a hyperthyroid condition and have seen an endocrinologist, please share your experience in the comments section below. If you had a negative experience please let me know! If you happened to have a positive experience with your endocrinologist please let me know! And if there is anything else you’d like to add regarding what most endocrinologists don’t know about hyperthyroidism please feel free to share this as well.
I have ended my relationship with my endocrinologist as I did not see any improvement in my hyper thyroidism. I have tried natural remedies however I still struggle. I will try Bugleweed.
Emily, although taking bugleweed is something to consider, just remember that you also need to do other things to address the cause of the problem.
do I have thyroiditis or Graves Disease.. a lab in Greece conducted 2 blood tests the result came as Thyroiditis I am hyper.. here in the UK the lab results came out as Graves Disease. The only symptoms I have is a very slight tremor of my hands hardly noticeable, and my thick hair has somehow gone slightly thinner. My dilemma is this.. I am hyper then I am given medication to make me Hypo, to me this is not the solution.. I want to know the trigger, the root problem before I take any form of medicine. I am having a scan to check my thyroid tomorrow.. I am not sure what to do as I feel the medications will only cover the symptoms ! and not cure the root problem that caused a hyper thyroid.. I have lost weight and I am eating well, however my metabolism is working over drive .. I will keep an open mind. Thank you for your article it has helped.
I would read the following article I wrote, where I spoke about how to differentiate between thyroiditis and Graves’ disease:
https://www.naturalendocrinesolutions.com/articles/natural-treatment-methods-subacute-thyroiditis/
I agree that just taking the medication won’t address the cause of the problem, which is why it’s wise to work with a natural healthcare practitioner.
Hi,
my name is Tanja Dias, and I wrote you maybe one or two years ago. I was diagnosed with a very severe Graves Disease, my values were super high. First I took medication, that my body reacted allergic to, then the doctors wanted to operate me imeadiatly but I secretly took an Antihistamin to oppress the allergic symptoms. After 1.5 years, my values were down to normal and I got of all medications. Recently, I went to my first check-up after more than one year and my endocrinologist could not believe what he saw, the the ultrasound of my thyroid was completly normal, as if there never has been anything, and all my values were super. He asked surprised: What have you done? And when I replied, I’ve changed my nutrition, He looked sceptical.
But I want you to know, that it worked for me, and I thought it might be interesting for you.
Here is, what I did:
No more gluten, animal products, increased intake of all kind of vegetables, fruits, legumes, fresh smoothies, also soy milk (i know that is controverse) low salt intake, no fish.
I still had a lot of stress in my life, and still have. This did not work out for me so well, also I often don’t sleep enough. But I tried to get rid of at least some stress factors or take things a bit more easy, accepting things I cannot change.
So as you see, it was not all perfect, but it worked for me, even though the stress remained. What helped me were people like you out there, that gave the possitive message that one can get back to normal without operation. I never wanted to have my thyroid removed and I promised myself to keep it because it is valuable. This sounds a bit weird but it helped my.
I wish you and your work the very best! Thank you for being out there and spreading hope.
(Sorry for my English, I am from Germany.)
Tanja Dias
Thank you so much Tanja for sharing this with everyone. I’m glad that changing your diet and reducing stress helped!
I can’t get my heart rate under control, but all other symptoms have gone. Thank you for all your help.
You are very welcome Meggin, and since all of the other symptoms are gone, hopefully the resting heart rate will decrease soon as well!
Thanks for all your wonderful articles. I have Grave’s disease. I recently became aware that there is a connection between Epstein Barr Virus (EBV) and Grave’s. I saw your article on the subject (thanks for writing it) and also read a book about the connection. Even after the active form of the virus (Mono) goes away, the virus can lodge in the thyroid and antibodies against the virus attack the thyroid. I had a blood test for EBV and was surprised that my antibody levels are through the roof. I don’t even remember having Mono. I have been taking anti-viral supplements such as L-lysine and BHT to go after the virus. I have not had my thyroid hormone levels tested since starting this about a month ago but it will be curious to see if it works. Also, acupuncture has lowered my free T3 levels although my TSH is still very low and my T4 levels are still a little out of range.
Thank you for reading my articles Kimberly, including the one I wrote on Epstein-Barr. Yes, a lot of people have very high EBV titers, and many like you don’t recall having mono. While taking anti-viral supplements is fine, you also want to continue doing things to improve your immune system health. I’m glad acupuncture has helped…coincidentally I got acupuncture done today!
Dear Doctor Osansky, My name is Luis González-Tamarit. I am writing from Spain. I think you have my name in your records. I have your Guide and I have bought your book. Besides that I read your texts regularly.
Well, the fact is that a year ago I was diagnosed with Mal de Graves, Multinodular Goiter (not extreme). The first reaction of my endocrinologist was to take me to the operating room to remove my thyroid. I objected frontally. Faced with my vehement and well-founded refusal (many dangers of such an operation), I prescribed Metimazol or Tiamazol (in Spain the trade name is Tyrodril 5mg) First an attack dose and after the constants returned to normal, the new dose is 2 , 5mg every two days)
Apparently all good, but … I think I have side effects: as memory loss (not associated with Alzheimer’s) sadness, tiredness and sometimes mental confusion. This is terrible especially for me, that I am a writer and that is why I need the best possible balance at the time of writing (there are many opinions on this)
I continue taking the recommended dose and the thyroid values are at normal levels.
I also took Thyroid Calming, an herbal supplement from the Herb Pharm Laboratory. The supplement is over. I asked myself a question:
Can I substitute the herbal supplement for Methimazole or is it possible to combine both? This question I think I could not do it to my Endocrine, with a slightly officalist position in matters of thyroid diseases. Thank a lot dear Doctor, especially for keeping open points of view in relation to the Graves Desease. Iwish for you and your family a happy yera 2019.
My best wishes
Thank you Luis for getting my free guide and purchasing my book, as well as for reading my articles and blog posts. I’ve had patients take bugleweed and Methimazole at the same time, and this usually isn’t a problem. Thanks for the New Year wishes, as I hope you and your family have a happy new year as well!
Thanks great article ! I’ve had Graves since 2008 and 2 relapses . I changed to Integrative endo as previous one just wanted me to have thyroidectomy as I also have TED . The new one is great and willing to ‘ work with me ‘ I am on carbimazole and I recover very quickly when on it now only very small dose and I feel fine ! Also gluten free and mostly plant based diet . I also taken low dose naltrexone which endo is happy about and feels this contributed to quick recovery !
Lyn, I’m glad you found an integrative endocrinologist, as they are difficult to find! I’m glad the LDN seems to be helping, as it usually is hit or miss with my Graves’ disease patients who take it.
You may have Graves disease and Hashimoto’s thyroiditis. Most patients with Graves disease that I have seen do not bounce from High to low. But patients who have both, do. In fact, Graves only patients have a difficult time getting their TSH levels to rise if they only take thyroid lowering medications. To confirm if you have both, this can be checked by checking the antibodies for both Graves disease (TBII or TRAb) and Hashimoto’s (TGAb) for a proper diagnosis. People I have seen with Hashimoto’s only do better on Regular L-Carnitine rather than antithryoid meds. It’s a little trickier when you have both but if you take both meds and Regular L-Carnitine, you can probably lower your meds dose and stay more stable.
Thanks for your comments Linda!
I was diagnosed with Graves’ disease two years ago and have been taking Carbimazole. Started on a low dose of 5mg and for the last 6 months only take 2.5mg or half a tablet. My TSH levels are normal now my only symptoms are sometimes a rapid heartbeat otherwise feeling good.
I would like to wean myself off the Carbimazole but am scared of getting the horrible symptoms back.
Any suggestions would be appreciated.
Thank you
Mary, I’m glad that you’re on a very small dosage of Carbimazole, although I understand wanting to wean yourself off of it since you have been on it for so long. If you have done things to address the cause of the condition and improve your overall health then this will greatly decrease the chances of you having a relapse.
I went to see an endocrinologist after being treated under an NMD to get a
Second opinion on what I could take if I got pregnant since some herbs have contraindications during pregnancy and the endocrinologist looked at my previous blood work which showed I had high T4 and hashimotos antibodies yet refused to see that I had hyperthyroidism and said the only way she could help me was if I went off the herbs for 6 weeks and have me retested. First off if I were to go off of the herbs for 3 days I would feel an immediate difference. She also did an ultrasound and my thyroid looked completely normal. I’m hoping my hyperthyroidism will reverse. I’ve had a super clean diet for 2 years (aip) and have been taking bugleweed, Motherwort and a couple of other herbs plus suplements. Anyway, I am thankful to be on the natural route although it would be nice to be able to talk to an endocrinologist who was more open minded…or is it even needed? Not sure.
Diana, it sounds like you’ve done some great things for your health, and so keep up the good work! As for speaking with an open minded endocrinologist, I wish there were more of them, but they’re difficult to find! As I mentioned in the blog post, most will either recommend antithyroid meds, RAI, or thyroid surgery.
When reading your post, everything sounded familiar. I take synthroid and tapazole to treat my thyroid, but what I really struggle with is the associated thyroid eye disease. My eyes are always swollen and red. I take prednisone for that. A lot of side effects come with taking prednisone.
Is there something you can suggest specifically targeting my eyes? My endocrinologist seems to think it is a totally separate issue and does not treat.
Any suggestions would be greatly appreciated.
Lavonna, I’m sorry about your eyes. I’ll include links to a couple of blog posts I’ve written on thyroid eye disease:
https://www.naturalendocrinesolutions.com/archives/5-things-to-know-about-thyroid-eye-disease/
https://www.naturalendocrinesolutions.com/archives/what-supplements-can-help-with-thyroid-eye-disease/
I fired both my doctors starting with the endocrinologist. firstly she NEVER booked a follow up and never got back to me about my complaints with the tapazole and the metoprolol she had me on, I had some serious side effects. backed right into my neighbours truck and I honestly don’t know if I looked, was so out of it I couldn’t drive so could not work. was calling her office from week one, NO response. even my GP wouldn’t help as she said she wasn’t my specialist, if it wasn’t for sites like these I would have run out of the heart meds without weaning and likely suffered a heart attack from that. fortunately I found all of you and started the slow down without any help from the professionals. I saw a naturopathic doctor and I felt is was really just more of the same, since not a single one could tell me anything I didn’t learn on my own, I am now taking bugleweed, lemon balm, L-carnitine, and am thinking about the motherwort also doing mostly fine. that endo had me on such a high dose of both meds that I went extremely into HYPOthyroid and since then have both antibodies grave’s/hashimotos so I’ve decided to essentially be my own doctor and look to treat the cause NOT the symptoms. there is more to this experience but ill leave out the really ugly bits and say it was terribly unpleasant and that endo was not only ignorant but unprofessional, unknowledgeable and ultimately useless.( she had asked me where I was in terms of having children, when I said nowhere cause… really I had no current plans, she said “good!” with no other commentary and walked away, …. I’m 38 thought that was incredibly insensitive.) I did get a nice permanent blood work sheet from my GP, lovely lady that she is. so I can do my own blood work through a separate company that allows me to access it online and thusly adjust my doses, which I have to say can still vary, I may still have some triggers undiscovered. ( the naturopath had me on these herbs and supplements I am not just running blind)
Jennifer, I’m sorry that you had a bad experience with your doctors, including the endocrinologist. I agree that the endocrinologist sounded like she was very unprofessional. That’s great about getting the permanent blood work order from your GP, and I’m glad that you are doing things to try detecting your triggers.
I’m not sure where to start with how awful it was to see multiple endocrinologists several years ago when I was suffering from active Grave’s disease. One told me to pray for cancer when I told him that was the only way I would ever consider a thryroidectomy (despite a negative biopsy). Many others (even from very prestigious hospitals (in the DC/Baltimore area) told me it was all in my head. The best response I got was that the one endo didn’t think she could help me.
I did finally convince my PCP to start treatment. I started with a low dose of methimazole and then added in a low dose of Synthroid to balance out my hormone levels (those were always normal, but my TSI antibody levels were elevated). After reading about your recovery (despite not knowing about functional medicine), I substituted Bugleweed for the methimazole. Because it was working, my PCP did not object and continued to prescribe the Synthroid as needed. I also took lemon balm and L-carnitine during that time (based on my own research into natural treatments for thyroid disease). After about 5.5 years of treatment I was able to stop the bugleweed, synthroid and lemon balm. That was 3.5 years ago. So far no relapses and my latest test for TSI antibodies was the lowest it has ever been.
I was gluten free prior to developing overt symptoms of Grave’s disease, but still eating many conventional (non-organic) foods. I am now mostly all organic, have switched to natural cleaning products and personal care products, cut out all dairy and other foods that bother me, still gluten free, and am still taking the l-carnitine. With the help of a functional medicine doctor I have rebalanced my gut flora and insulin levels (which were through the roof due to SIBO (which I no longer have)).
I never did discover the trigger for my Grave’s disease. I had had a fine tremor from the time I was in elementary school and never could tolerate heat very well. The final nail in the coffin to fully throw the switch was going thru surgically induced sudden early menopause (due to endometriosis) and stopping the synthetic hormones (birth control pills) that I had been taking to try to mitigate the symptoms of the endometriosis. The functional medicine doctor also helped me to rebalance my hormone levels.
Now if I could only find out why I cannot tolerate Vit D supplements (my levels are extremely low and I have been having deficiency symptoms), I think I might be able to more fully recover from all of the autoimmune issues.
Thanks for sharing your experience Christine, as I’m glad that you finally were able to stop taking the synthroid, along with the bugleweed and motherwort. And that’s great news about the TSI antibodies. I’m happy to hear that the functional medicine doctor helped you to overcome SIBO, balance your hormone levels, etc.
Thanks Dr. Eric and everyone for sharing your experience with hyperthyroid. It has helped me a lot. I was diagnosed with Graves Disease and Hyperthyroid about 10 years ago. The endocrinologist prescribed Methimazole. After a week of taking it, I did not feel good so I went to see my primary doctor. Blood work showed that my liver enzymes were very high so I had to stopped it. I did not go back to that endocrinologist, instead, I went to an acupuncturist and she prescribed the herbs you all mentioned and told me to keep a diet free of salt, preservatives, eat a lot of fruit, veggies, and no processes foods. I followed her instructions and took the herbs for many years. Blood work came back normal after 3 months of taking the herbs. I continued having blood work done every 3 months for a while, then became every 6 months. After few years of doing well, I decided to stopped the herbs and went back to eating all kind the things.
Big mistake, my blood work done a month ago shows that my thyroid is overactive again. The endocrinologist wanted to have my thyroid destroyed with radioactive iodine. But, after reading your articles I had the courage to said “NO”. I will go back to the herbs and to a healthier diet.
How far is your practice from Asheville, NC? I live in NY, but I might go to visit my daughter who lives in Asheville, and if possible, I would like to see you.
Thanks Dr. Eric
Irma, I’m glad that you have benefited from my experience with Graves’ disease. I’m glad you were helped by an acupuncturist, although I’m sorry that you’re thyroid is overactive again. It’s great to hear that you are looking to get back on track with the diet and supplements and holding off on RAI. My practice is in Matthews NC, which is approximately 2 1/2 hours from Asheville. I work with most patients remotely, but if you prefer an in-office appointment you can call our office at 1-888-570-8873. I do require everyone to watch one of my free webinars before becoming a patient, and if you haven’t done this already you can access it by visiting the following link:
https://www.naturalendocrinesolutions.com/free-webinars/free-webinar-for-hyperthyroidism-and-graves-disease/
Hi doc, could you tell me why is it when reducing calorie intake, specifically carbs, hypothyroidsm kicks in, after at least 3 days of dieting on white bread, fruit, veggies for my carb portions (and meat portions usually are tuna, beef and pork, avoid chicken), palpitations, soreness of eyes, throat area feels swollen, anxiety sets in? I don’t want to eat rice anymore and want to lose weight, rice kills above symptoms… I take all natural remedies such as Acetyl-L-Carnitine 1000mg in the morning and 500mg in the late afternoon, when experiencing palpitations a couple of drops of motherwort, and I take Kings Herbal which is a locally made herbal conconction in my country, plus 1 capsule Laminine at bedtime, 1 tsp turmeric after dinner. So far, I have never taken any conventional meds and my thyroid blood panels are normal., i just want to get back to my thin self without experiencing palpitations and all the symptoms I mentioned above… please help, I eat all day when I diet, lots of eggs, tuna sandwiches, fruit etc, I’m not hungry at all, and just after 2 or 3 days without rice, I shed a couple of lbs, but experience ill effects mentioned…why?
Eating a low carbohydrate diet for a few days usually won’t result in hypothyroidism, and I have a lot of my patients follow an AIP diet for at least 30 days without a problem. That being said, there is evidence that following a very low carbohydrate/ketogenic diet can lead to hypothyroidism in some cases. I’m glad your thyroid panel is normal, although it sounds like you have some other imbalances that need to be addressed.
I have seen several endos for over ten years, with hypo symptoms starting sixteen years ago. I have found most endos are focused on diabetes, however the latest is beginning to acknowledge that my out of reference Ths levels, T4, T3 and Revese T3, together with high TPO levels need to be addressed. However they only follow the protocol of conventional medicine.
I now manage my own health and trialled Iodine , 2mg every other day. It caused even more severe hot flushes, often lasting up to one hour at a time. I no longer supplement with iodine, but am now trying selenium to regulate the thyroid.
Audrey, you are correct that many endocrinologists focus on diabetes, and those who do work with thyroid autoimmunity don’t do anything to address the cause of the condition, which of course I discussed in my blog post. I’m sorry you didn’t do well with iodine. Many people with Graves’ disease and Hashimoto’s benefit from selenium supplementation, although doing this alone usually isn’t sufficient to restore one’s health.
Hi Doc. Thank you for your efforts to educate us. Here’s my story!
Around a 2 years ago, I quite rapidly lost 15 pounds that I did not need to lose! Also, I noticed I was losing a lot of hair and had a rapid pulse (90s-100), so I googled the symptoms, and came up with hyperthyroidism! I called my GP, who said I was probably wrong but, she humored me by re-checking my labs that had been normal 6 months earlier! Labs indicated I had Graves, and I was sent to an Endocrinologist, who of coarse presented me the 3 usual options of, anti-thyroid drug, radio active iodine or as a last resort, surgical removal of my thyroid!
For a little history, I am from a very large family with 15 single births, all to same set of parents! Auto-immune conditions do run in our family. Only the females so far, though I have 7 brothers! Funny enough, several of my sisters have Hashimoto’s (auto-immune low-thyroid), and take thyroid supp. One of my older sisters was diagnosed with Graves after having an incredible amount of stress on the job, and as a single mom! She was very anxious with her pulse running around 150, and she was told she needed immediate treatment to prevent a thyroid crisis! So, She had the radio active iodine, and is of coarse thyroid hormone dependent for life!
I was determined not to lose my thyroid, if I did not have to! So, even though I am very sensitive to drugs, I took the Methemizole 10mg 3x/day, + Propanolol 10mg 2x/day, with order to re-check labs in one month! But, after about 3 weeks, I became so ill, I was dizzy, nauseated, felt weak and could not walk a straight line! My labs showed I was having a toxic reaction to too much of the anti-thyroid drug, and my T3 & T4 were off the chart low! Had to to quit drugs cold turkey!
After 3 months, my hyper symptoms were returning, even though I was doing everything I could to reduce stress and eat healthy, etc. So, back on the Tapazol, but 10mg/day this time, and no Propanolol (heart med). After 3 more months, labs were normal and I was cut back to 5mg/every other day. BTW, I was already gluten free for years before suddenly developing Graves, and I ate reasonably healthy, was thin and active my whole life. I had Mono (Epstein Bar) as a teen, many years earlier! I had a ton of stress, (who doesn’t?) and, I had recently started dancing a couple times/week, sometimes dancing hard! And, I also had recently moved into a beautiful brand new mobile home, complete with all the toxins they throw in for free, and lots of EMFs through thin walls to boot!!! Who knew that could be a problem? I never considered it until Graves hit me!
Still not sure what the actual culprit was, but 2 years later, I have been drug free for 6 months, and (knock on wood), labs are normal! I have regained all lost weight plus some! Hair and nails are better. TSH is still very low, but apparently that takes a lot of time to change. Endo agreed to check my Iodine level twice during that first year and it was off the chart low! They would not address that, so I have added a natural supplement called ‘Thyromin” a few times/week. I also take a small dose of cbd oil with no thc daily!
I feel great! I eat mostly organic with lots of fruits and veggies. Of coarse, I moved out of the mobile home, and I still dance, but not ‘the hustle’, just in case that was too much stimulation! That’s my auto-immune journey in a nut shell so far!
Thanks again Doc, for all you do to educate others along your journey!
Thanks for sharing your story Cindy! It must be cool to have 7 sisters and 7 brothers! I’m so happy to hear that you have been drug free for 6 months, have normal thyroid hormone levels, regained weight, etc. Yes, it usually does take a good amount of time for the TSH to normalize. It sounds like you’re doing a lot of awesome things for your health, and I’m glad you feel great!
Thank you Eric for another great article and information regarding Grave’s condition.
I was diagnosed about 2 years ago – was feeling very weak and lost weight. Endocrinologist was pushing to take 4 tablets of PTU every day. I was against it as I didnt want my body to be exposed that many tablets so I started to take only 1X tablet a day in the morning.50mg tablets. Plus I added Bugleweed. In few months all blood test went to normal readings and I also feeling well. I am considering to maybe reduce PTU to 1/2 tablet a day but scared that my symptoms will come back. I would really would like to get rid off PTU and thinking about seeing natural endocrinologist here in Sydney, Australia if I will be able to find a good one.
Dr. Eric I had usual blood test checking TSH, T3, T4. Would you be able to suggest any other test I should ask my doctor ?
Thanks.
Jan
Jan, I can understand wanting to get off of the PTU, and I wish you the best of luck in finding a natural endocrinologist, as hopefully they are more common in Australia than in the US. In addition to the TSH, Free T3, and Free T4 I would also try to get the thyroid antibodies tested (at least the thyroid stimulating immunoglobulins, and try to measure the thyroid peroxidase and thyroglobulin antibodies as well). Vitamin D is very important for optimal immune system health, and since you’re taking PTU I assume they’ve been monitoring the liver enzymes, but if not I’d get this done as well!
Thanks a lot Eric for additional information regarding further tests. I will my doctor to do tests when I will have my next appointment.
Yes, doctors checked my liver and it is functioning well thankfully.
Eric, what about Cortisol and Iodine?
Would these tests be helpful as well?
Jan, I commonly recommend cortisol testing for my patients, either through saliva or dried urine testing. Iodine is controversial, as while I’m pro-iodine, some people don’t do well when supplementing with iodine, even if they have an iodine deficiency. But I will say that when I recommend iodine testing I use a company called Hakala Labs, which offers urinary iodine testing.
Hi Jan, I am in Sydney too and not known of a natural endocrinologist available. May I ask whom you saw who can direct you to dosage of bugleweed? I am looking for a holistic practitioner. Most GPs and specialist aren’t too helpful when you tell them about natural therapies.
Thanks Dr. Eric! I read almost all of your articles related to Grave Disease and Hyperthyroid. It was very informational and helped me understand my disease more.
I found out I have hyperthyroid due to grave disease in Sept 2017 (T4 was 3.67 and TSH was >0.03). My doctor prescribed me 20mg Methimazole at that time. Over the year, the doctor does reduce the medication to 10mg because my T4 does improve to 1.64, however, TSH never goes up. I started to have symptoms of grave disease in March 2018. My eyes are getting puffy and enlargement of my thyroid gland. My doctor said it is normal for me since I have graves disease. She just asked me to continue to my medication. Besides my medication, I am also taking Selenium and L-Carnitine. Unfortunately, my eyelids are still retracted and puffy. Are my eyes still in the active phase? Any chance my eyes can be reversed?
Last week, I found out that I have a pretty big nodule when I did the annual ultrasound check up. I am very scared that it will be a toxic one because I was told that it is a solid nodule. Now I am waiting to do the biopsy to find out. If this is a toxic nodule, is surgery the only treatment for me? After reading your article, I understand that surgery and radioactive iodine would not help or treat graves disease. These treatments might worsen my eye conditions. Is that true? Would you please able to suggest any treatment for my case? How come I got thyroid nodules even I am taking medication?
Thanks so much and any suggestions appreciated.
Liza
Hi Liza,
In most cases the free T4 and free T4 need to be well below the reference range before the TSH starts increasing. A free T4 of 1.64 is still on the high side, which is why the TSH didn’t start increasing. Based on what you said in your comments my guess is that your eyes are still in the active phase, and most likely can be reversed if the autoimmune component is addressed. There is a chance that radioactive iodine can exacerbate your thyroid eye disease symptoms. Surgery doesn’t seem to do this, although I of course would recommend first working with a natural healthcare practitioner to try to address the cause of the problem. As for your question regarding thyroid nodules, keep in mind that antithyroid medication doesn’t do anything to address the underlying cause.
I was recently in a car accident and hospitalized. They discovered I had multiple Thyroid Nodules and I was very scared because it was something very foreign to me to hear about. However I went to see what I thought was a Endocrinologist they the discard Dr. at the hospital recommended. She did an ultrasound but was very vague in answering my questions. She sent me to get an Ultrasound at the hospital and it was recommended that I get a FNB. They had to do both the left and right for a 2.5 M nodual and they both turned out to be benign. However today I went to the Dr. Office to get my Pathology report of the biopsy and found out that the Dr. that was referred to me was not an Endocrinologist but a Surgeon who removes the Thyroid. I was so upset and also it help me to understand why she could not answer my questions which she never reviled to me that she was not an Endocrinologist and said for me to come see her in 6 months for a follow up. I’m sharing this for someone like me who may find themself in this situation with an “Incidental Finding” to do your homework to find someone who knows about your condition. I was still in Trauma from my car accident which I suffered a Occipital Fracture, concussion and nerve damage. I found an herbalist who has helped me to change my diet and put me on Bladderwrack/ Irish Moss Shakes and I’m already feeling and seeing improvements. I was breaking out into hives for the past couple of months and my Dr. had no answer for me and I believe it was associated with my Thyroid Disease now. Since starting my new diet and herbs I have not had any breakouts. I will continue to follow you as well during my road to recovery.
Please forgive for some of the misspellings. I was writing this pretty fast because a conference call. Wish there was an edit button. 😊 Correction: “was an Endocrinologist that the discharge”
No worries about the misspellings!
Thank you so much for sharing your experience with everyone Angel. I’m glad that the new diet and herbs seem to be helping.
Hi. I’m Yan. I’m diagnosed with hyperthyroidism (thyroid nodule at the right lobe). I have difficulty maintaining my weight, had palpitations before and experienced almost severe hair fall. I had numerous blood tests, undergo RAI uptake to test whether my nodule is hot or cold, took meds and even advised to have a biopsy, but I didn’t coz I’m afraid that it might just get worse. I’m now trying conventional/ natural methods to cure my symptoms but I admit that I cannot really strictly continue my change in diet. for now, there’s still some times that I have a pain on my neck and feel that it’s enlarging.
Yan, I realize that it’s very challenging to follow a strict diet. Although there is no specific supplement or herb you can take to shrink your thyroid nodule, some of the more common causes of thyroid nodules include problems with estrogen metabolism, an iodine deficiency, and environmental toxins.
I am experiencing problems with my thyroid and not able to get the doctors to understand what I am going through. Is there any way you can contact me.
Carol, if you are interested in scheduling a consultation please send an email to staff@naturalendocrinesolutions.com.
Hello, How do I find out if the reason I have a goiter on right lobe and i lean more towards hyperthyroidism is because of toxins, iodine deficiencies or estrogen metabolism?? Have you not seen anyone shrink a goiter?? I have heard testimonies of ppl curing them??
Thanks
Claire, you can do a urinary test for iodine, and the DUTCH test is quite comprehensive with regards to estrogen, although there is no perfect test for estrogen metabolism. Environmental toxins can be more challenging to detect, as there are so many of them, although you can start by testing for heavy metals. Here is an article I wrote that you might find interesting:
https://www.naturalendocrinesolutions.com/articles/can-supplements-and-herbs-shrink-your-goiter/
hello Doctor,
I have a very stressful job that has been particularly stressful for the last several months. I noticed some tremors about a month ago and have had a hard time breathing at high altitudes (I ski every weekend and we do a lot of high altitude hiking to out of bounds skiing during those ski weekends). My friends convinced me to see a doc after a bout of what seemed like a low level flu (body aches, fever) because I couldn’t keep up on the hikes (which is unusual).
My GP had blood drawn and my T3 and T4 were high and my TSH was very low. I have no TPO antibodies, but have TSH receptor antibodies. My new endo says that I have Graves (my mom has Graves and was diagnosed at age 67- two years ago; I just turned 50) and she called and wants to put me on methimazole. I’m not inclined to do this. She prescribed a beta blocker last week which I am also reluctant to take.
As soon as I got the first blood work done, I looked up your articles and started taking Bugleweed and Motherwort. I am also taking L-Carnitine, selenium, turmeric, a multivitamin, and a lot of Vitamin C. The herbs and supplements seem to help..
I don’t know if I’m taking enough bugleweed and motherwort. I really thought that because I had the flu-like symptoms and an upper respiratory infection right before this, that I likely had thyroiditis and not graves.
I have always been the healthiest person that I know (for real!) and so I am really not interested in taking pharmaceuticals for this issue. I would like your opinion about the thyroiditis (my CRP is very low and my ERP is also quite low) vs Graves. All my other numbers (except vitamin D) are really excellent.
Do I really have Graves? I think that I need to schedule an appointment with you.
thank you.
best,
michelle
Hi Michelle,
It does look like you have Graves’ disease, as with subacute thyroiditis the TSH receptor antibodies wouldn’t be positive. Here is a blog post I wrote on this topic:
https://www.naturalendocrinesolutions.com/archives/graves-disease-vs-subacute-thyroiditis-whats-the-difference/
I definitely would work on getting your vitamin D levels up, as healthy vitamin D levels are important for a healthy immune system. As for scheduling an appointment, I’d be happy to work with you. If you decide you want to move forward I require everyone to first watch a free webinar, and towards the end I talk about my services. You can access a free recording by visiting the following link:
https://www.naturalendocrinesolutions.com/hyperthyroid_webinar_recording-2017
Hi! I have a question. Are Graves disease and overactive thyroid two separate issues within the body, or is Graves disease just a fancy term for overactive thyroid? I ask because I’m confused — I was diagnosed 8 months ago with Graves and overactive thyroid. My TSH, T3, T4, and TPO antibody levels were all very abnormal, so I went on a gluten-free and dairy-free diet and started taking methimazole (10mg once a day). Fast forward to now — all my levels are normal (T3, T4, TSH, and TPO antibody) and I feel great. Since my thyroid is no longer overactive (albeit with the help of the methimazole), does that mean I no longer have Graves? Or is it possible to still have Graves even with normal thyroid levels? I thought the indicator of Graves was an abnormal level of TPO antibody, but like I said, I’m confused as to what is the right answer here. Any clarity you could provide would be much appreciated.
Taylor, most people with Graves’ disease have an overactive thyroid (high thyroid hormone levels, depressed TSH), but not everyone with an overactive thyroid has Graves’ disease. In addition to having hyperthyroidism, most people with Graves’ disease will have elevated thyroid stimulating immunoglobulins. Here is an article I wrote on this topic:
https://www.naturalendocrinesolutions.com/articles/how-is-graves-disease-diagnosed/
Hi
I have your book and always read your posts, which I have always found really helpful
I have been on low dose Neo mercazole for about 8 years. Having regular blood check ups Got down to 5 gam every 2 days. Also herbs bugleweed ect. We lived in Nz and was well cared for by Dr
Moved to Tasmania and felt Dr was watching my back
But she really checked my bloods and had a complete change of mind on her protocols ( moved to the root cause protocol). I got smart and thought I was doing so well and cut back on herbs and drug
Then started to feel unwell and then wamoh it all came back. As I could not see an endocrinologist for 6 weeks put myself back on 20 mg a day. Saw endocrinologist who said radioactive iodine. I asked questions and argued and he got miffed
My question is how wise would it be to go back to staying on neo mercazole and try for low dose, herbs and other stuff you suggest ?
🐝
Claire, I appreciate you reading my book and blog posts. As for whether you should stay on low doses of the neo mercazole, while it’s not ideal to be on this permanently, everything comes down to risks vs. benefits, and you just want to make sure that you’re safe while trying to find and address the cause of your condition. If the antithyroid meds aren’t causing elevations in your liver enzymes or any other side effects then it should be okay to continue taking this for now. On the other hand, you said you cut back on both the meds and bugleweed, and so there is a chance you might be fine taking the full dosage of bugleweed.
Hi Dr Eric,
Good to read your post. I was diagnosed with Graves 3 years ago. I went on meds for about a year and got back to normal, then off medication. My bloods were normal for 2 years but recently I had a check up test and levels are low again, although Graves TPO antibodies were borderline. I have no symptoms whatsoever and am dreading going back to GP consult as all she just send me to the endocrinologist to have radioactive iodine which I don’t want to have. As mentioned I have no symptoms at all (normal heart rate, no sweating, no weight loss) but I know my GP and specialist will not think outside the box and just rely on numbers. I am very frustrated. Can you please advise your opinion on how to manage subclinical patients. There seems a lot of difference in opinion about whether or not to treat, or just monitor.
Asha, it’s great that you’re not experiencing symptoms. It sounds like your TSH is low, but are your thyroid hormone levels (T3 and T4) normal? If so then I’d be surprised if your endocrinologist recommended radioactive iodine, as most won’t do this for subclinical hyperthyroidism. If the TSH is low but the thyroid hormone levels are high, then they will recommend doing something even if you’re not experiencing cardiac symptoms, as high thyroid hormone levels can have a negative effect on bone density. Also, you mentioned the TPO antibodies, but the thyroid stimulating immunoglobulins (TSI) are more specific for Graves’ disease. Did you have these tested as well?
Hi Dr Eric,
Thanks so much for replying. My TSH is low and free T4 is high (no test was done for T3). The TSH receptor antibody was within normal range. (Is this the TSI you mention? I do not think I have seen any of my test reports with this indicator otherwise).
Would natural products such as bugleweed assist to bring my indicators back to normal range?
Hi Asha,
That’s great about the TSH receptor antibody being within normal range…and yes, the TSI is a type of TSH receptor antibody. I took bugleweed when I had hyperthyroidism, and it helped to normalize my TSH and thyroid hormones, and many of my patients have also had success with bugleweed. However, bugleweed doesn’t work for everyone, and of course the goal should still be to try to address the underyling cause of your condition while taking bugleweed.
Hi Dr Eric,
Can you provide your opinion on how patients who are subclinical (no symptoms but blood test show hyperthyroidism) should be managed? I am in this bucket and feeling fine, no symptoms but GP is already looking at radioactive iodine which I want to oppose.
I was diagnosed in 2016 with Graves’ disease and hyperthyroidism. I’ve been on Methimazole and metoprolol for my conditions. I have bulging eyes and goiter. I stopped taking Methimazole on August 16, 2019 and metoprolol in September 2019. I stopped taking both medications is because I did not see any change in my condition plus my endocrinologist informed me that my next step would be take a medication break to see how my thyroids would react to no medication. To be honest I have not had any of the side effects since stopping the medication. I want to try sea moss but not sure if it’s a good idea since my thyroids are over producing. Have you had any patients with hyperthyroidism and Graves’ disease that take sea moss and what are their results? My diet consists of a lot of vegetables up until about 3 weeks ago due to becoming sick with sinus infection, stomach virus, and flu.