When I was diagnosed with Graves’ Disease I chose not to take antithyroid medication to manage my hyperthyroid symptoms.  Many of my patients and email subscribers attempt to manage their symptoms without taking medication as well.  On the other hand, many others will choose to take antithyroid medication and/or beta blockers while trying to restore their health.  If you have hyperthyroidism and are deciding whether you should take the medication or manage your symptoms naturally I would make sure to read this entire post.

Keep in mind that my goal isn’t to scare anyone with this information, but just to make you realize that unmanaged hyperthyroidism comes with a great risk.  While getting a heart arrhythmia or suffering from a thyroid storm is rare, this can and does happen at times.  But if you do a good job of managing your symptoms the risk of developing these or other health conditions is less likely to happen.  So let’s go ahead and look at some of the things you need to do in order to safely manage your hyperthyroid symptoms.

1. Take action quickly.  When I was diagnosed with hyperthyroidism I knew that I was going to do something natural about it.  However, it took a few months before I took anything to manage my symptoms, which is a long time when you have an elevated heart rate.  This was foolish of me, and I’m lucky that nothing serious happened to me.  But some people aren’t as lucky when going a prolonged period of time without managing their hyperthyroid symptoms.  And so whether you choose to take prescription medication to manage the symptoms, or try taking herbs such as bugleweed and motherwort, it’s a good idea to take action quickly.

But what should you do if you can’t see a doctor quickly?  Sometimes it can be a few months before you can get in to see an endocrinologist, and if you plan on working with a natural healthcare professional it also can take some time.  Some people do choose to take herbs and supplements on their own to manage their symptoms, although it can be challenging to know what dosage to take.  If you prefer to take the medication, while it might take some time before you see an endocrinologist, you probably were referred to this endocrinologist by a primary care physician, and chances are he or she will give you something to manage the cardiac symptoms.  While they might not write a prescription for antithyroid medication, most will at least recommend a beta blocker to lower the heart rate.

2. Keep in mind that the herbs don’t work for everyone.  I was fortunate not to have to take any medication, as I used the herbs bugleweed and motherwort to manage my symptoms.  And over the years I have had many patients who also effectively managed their symptoms when taking the herbs.  However, the herbs don’t always do a good job of managing the symptoms in everyone, and there are some people who need to take the medication.  If the herbs do work then in most cases they should kick in within two to four weeks, and sometimes sooner than this.

3. You need to weigh the risks vs. benefits.  Everything comes down to risks vs. benefits.  I’ve worked with numerous patients who refused to take the medication, even if the herbs weren’t doing a good job of managing their symptoms.  And while there are certain circumstances when this is understandable, such as if the antithyroid medication causes elevated liver enzymes, or if someone has a negative reaction to the medication, if someone tolerates the medication well then it can be a good option.

Don’t get me wrong, as I’m not trying to convince anyone to take antithyroid medication or beta blockers.  However, I am suggesting that doing so is better than landing in the emergency room due to a thyroid storm.  For example, if someone has a resting heart rate of 150 beats per minute or higher, this isn’t something to play games with.  In fact, in this situation it might be best to take the medication immediately and not try the herbs, as you would want to lower the heart rate quickly.  Fortunately most of my patients don’t have a heart rate this high, but even a heart rate of 120 BPM isn’t something to take lightly.  My point is that sometimes it is necessary to take the medication, and don’t feel like you are giving in by doing so.  While overall drugs are overused and abused, and although there are potential side effects of taking antithyroid medication and beta blockers, sometimes taking prescription drugs is necessary, and there is no shame in taking medication for a very high heart rate.

4. Be aware of the signs and symptoms of a thyroid storm.  Although a thyroid storm is rare, it can happen, and when it does it’s an emergency situation.  It may be triggered by an acute event such as thyroid or nonthyroidal surgery, trauma, infection, or an acute iodine load (1). Some of the symptoms include change in alertness, confusion, increased temperature, very high pulse rate, diarrhea, shaking, and sweating (2).  If you suspect thyroid storm you should immediately go to the nearest emergency room.

5. You can restore your health regardless of how you manage your symptoms.  Bugleweed, motherwort, lemon balm, and L-carnitine are some of the herbs and supplements used to manage the hyperthyroid symptoms.  Just keep in mind that they aren’t doing anything to address the cause of the problem.  And so whether you take medication to manage the symptoms, or take a natural approach, you still need to do things to address the underlying cause of your condition.  And so for those people who take antithyroid medication such as Methimazole, PTU, or Carbimazole, or a beta blocker such as Propranolol, you can still can take a natural treatment approach.

Why Did I Decide To Write This Post?

If you’re wondering why I decided to write this post, there are a few reasons.  Of course the main reason is because I work with a lot of patients with hyperthyroidism, and from time to time I consult with someone who prefers not to take any medication, even if they are putting their health at risk.  In fact, as of writing this post I’m working with a teenager with Graves’ Disease whose symptoms aren’t being effectively managed by the herbs, and her mother doesn’t want for her to take Methimazole.  She was concerned about the Methimazole causing liver failure, which is unlikely, although I can certainly understand the concern of the mother.  But once again, everything comes down to risks vs. benefits, and the risk of this teenager having problems from not taking the medication is in my opinion much greater than her experiencing liver failure.

I had another situation recently when a patient of mine with Graves’ Disease sent an email to inform me that his heart rate was over 190 BPM while working.  Of course I advised him not to overexert himself and to take it easy, and it’s important to point out that while he was trying to manage his symptoms with the bugleweed, he also had a prescription for a beta blocker that he wasn’t taking.  He was concerned about the side effects of the beta blocker, but when someone has a pulse rate of 190+ BPM the main concern should be to get the heart rate down as quick as possible, and to not worry about having a negative reaction to the medication.

Should You Just Receive Radioactive Iodine?

I’m sure there will be a few people reading this and wonder if the “benefits” of receiving radioactive iodine are greater than the potential “risks” of treating your condition naturally.  Of course only you can make this decision, but I do want to say that if people with hyperthyroidism and Graves’ Disease do what is necessary to manage their symptoms and receive the proper guidance when taking a natural treatment approach, then the risks of something bad happening is low.  On the other hand, with regards to receiving radioactive iodine, there are risks of being exposed to  radiation, and there are also risks of not having a functioning thyroid gland, which is usually a consequence of receiving this treatment.

Truth to be told, there are people who receive radioactive iodine and are pleased with their decision.  On the other hand, there are many people who receive this treatment and never feel the same again, and they end up regretting their decision.  The problem is that you don’t know which category you will fall under.  And if someone receives radioactive iodine and doesn’t respond well, there is less of a chance that they will benefit from a natural treatment approach.

In summary, when following a natural treatment protocol it is important for anyone with hyperthyroidism or Graves’ Disease to manage their symptoms.  Some will choose to do this with medication, while others will attempt to manage their symptoms with herbs such as bugleweed and motherwort.  Either way, you want to make sure to take action quickly, and keep in mind that herbs such as bugleweed and motherwort don’t work for everyone, as some people do need to be on the medication.  Plus, if you choose to take the medication to manage your symptoms you still can restore your health, as you just want to make sure you’re safe while addressing the cause of your condition.

Many people with thyroid and autoimmune thyroid conditions work with an endocrinologist.  And it’s not uncommon for me to consult with someone who is intimidated by their endocrinologist.  In other words, they are afraid to say what’s on their mind and don’t want to upset their doctor.  This is especially true with those people who have Graves’ Disease, although I also see it at times with some people who have hypothyroidism and Hashimoto’s Thyroiditis.  You’ll probably be disappointed to learn that I’m not really going to teach you how to hypnotize your endocrinologist (although that would be cool), but I am going to give you a few tips that hopefully will help you feel more at ease when speaking with your doctor.

Most of what I discuss below is common sense, but the reason why I put this blog post together is because every week there are at least one or two patients who tell me they are intimated by speaking with their endocrinologist.  They are concerned because most endocrinologists aren’t open to a natural treatment approach, and so their doctor doesn’t want to hear anything about how diet and lifestyle can improve one’s health.  Don’t get me wrong, as every now and then I’ll work with a patient who has an open-minded endocrinologist, but this definitely isn’t the norm.  With that being said, let’s discuss some of the reasons why you shouldn’t be intimidated by your endocrinologist, or any other medical doctor for that matter.

1. Remember that your endocrinologist is a person just like you.  Even though some doctors have a superiority complex, I’m pretty sure they are made of flesh and blood just like you.  When you think about it, it’s silly to be afraid of your endocrinologist, or any other doctor.  Although I realize it might not be easy to find another endocrinologist to work with, there is no good reason to put up with an endocrinologist who isn’t willing to listen to you, and who just wants to tell you what to do without having you question them.

2. Keep in mind that we all have our biases.  Although I’m not opposed to conventional treatment methods, there is no question that I’m biased towards taking a natural treatment approach.  And the reason for this is not only due to my personal experience with natural treatment methods, but my training in chiropractic school as well.  It definitely didn’t have anything to do with how I was raised by my parents, as I wasn’t brought up with a natural mindset, and if in the past I chose to go to medical school instead of chiropractic school I can almost guarantee that I wouldn’t be writing this post, as I probably would be prescribing drugs or getting ready for a surgical procedure.

And it’s a similar situation with most endocrinologists, as they have gone through years of training to help people through conventional treatment methods.  While it would be great if there were more open-minded endocrinologists, and perhaps there will be in the future with the help of organizations such as the Institute for Functional Medicine, unfortunately most medical doctors have a closed mind and don’t want to hear about natural treatment methods.  Sure, there are a few exceptions, but it’s still rare to find an endocrinologist who has any type of experience or interest in taking a natural treatment approach for thyroid and autoimmune thyroid conditions.

3. You are in charge of your own health.  The reason why you probably work with any healthcare professional is to seek their advice and receive recommendations.  However, this doesn’t mean that you are required to follow their recommendations.  So for example, if someone with hypothyroidism needs to take thyroid hormone medication and prefers to take Armour or Nature-Throid, there is a good chance the endocrinologist they are working with will refuse to write a prescription for this.  If this is the case with you then of course you can choose to take synthetic thyroid hormone medication, or you can call around and try to find a different doctor who is willing to prescribe natural thyroid hormone medication.  Similarly, if someone with Graves’ Disease sees an endocrinologist for an initial consultation, and if the endocrinologist gives radioactive iodine treatment as the only option, then this person can choose to receive the treatment, but of course they also have the option of seeking a second opinion.  It’s the same concept when someone consults with me, as I will give them my recommendations, and then it’s up to the person to decide whether or not they want to follow my advice.

4. Do some research before you choose your doctor.  In most cases, before someone schedules a consultation with a natural healthcare professional they will do some research on the Internet to learn more about the doctor.  I know this is frequently the case with my patients, and I require people to first attend a free webinar so they can get a better idea of my approach, and make it easier for them to decide if they would like to work with me.  But this usually isn’t the case when someone schedules an appointment to see an endocrinologist.  Many people will choose an endocrinologist based on 1) whether they are a provider on their health insurance plan, and/or 2) the location of the practice.

While it’s fairly easy to learn about my approach by visiting my website and/or attending one of my webinars, I realize that this isn’t always the case with other doctors.  For example, if an endocrinologist is part of a group practice then they might only have a single page on the website dedicated to them, and it might not tell you much about the doctor.  If you have specific questions feel free to email the practice, or better yet, call the office and see what you can find out.  And if you can’t find the answers you’re looking for then try to contact a few other offices.

5. Be careful about how you approach your endocrinologist.  Although it’s true that you are in charge of your health, and while you want to be able to have a two-way conversation with your endocrinologist and not just listen to his or her recommendations, you do want to be a little cautious when trying to communicate with your doctor.  For example,  if you are also working with a natural healthcare professional, it probably wouldn’t be a good idea to tell the endocrinologist “Hey doc, I’m also working with a natural doctor and he recommends for me to do some blood and saliva tests, and so I’m hoping you will be able to order these.  Oh yeah, he also says that diet is a big factor with these conditions.  Plus, any drugs you prescribe need to be gluten and dairy free.”  Okay, perhaps you wouldn’t word it exactly like this, but my point is that most endocrinologists want to be the authority figure, and most don’t want to take orders from a natural healthcare professional.

Does this mean you shouldn’t tell them that you are working with a natural healthcare professional, assuming this is the case?  Is it wise not to say anything else about taking a natural treatment approach?  Before you tell your endocrinologist you are taking a natural treatment approach, I would simply ask him or her the following question: “What are your feelings about taking a natural treatment approach for my condition?”  Or you can ask “”What are your thoughts about me working with a natural healthcare professional to help improve my health while I work with you simultaneously?”  By doing this you aren’t openly admitting that you are currently following a natural treatment approach, but the question should elicit a response from the endocrinologist.  If the endocrinologist gives a negative response then it might be best not to further talk about natural treatment methods, unless if you’re looking for a good argument.  On the other hand, if the endocrinologist seems to be open to natural treatment methods, or even if they aren’t open but they don’t have a negative reaction, then you might want to tell the endocrinologist that you are thinking about taking a natural treatment approach, and you can also ask if he or she would be willing to work with you while you do this.

Keep in mind that you don’t have to tell the endocrinologist that you are considering working with another healthcare professional to try to address the cause of your condition.  After all, most of them don’t think that there is an underlying cause for thyroid and autoimmune thyroid conditions.  As a result, it might be best to tell them that you are working with a natural healthcare professional who is trying to improve your overall health by offering nutritional support and lifestyle advice, and not tell them that you are specifically looking to restore your health naturally.

While every now and then I’ll work with a patient who is seeing an open-minded endocrinologist, most endocrinologists are opposed to natural treatment methods.  In some cases they will refuse to work with you if you tell them you’re taking a natural treatment approach, and usually the best case scenario is that they won’t be thrilled about what you’re doing, but they will be still willing to write an order for labs and prescribe medication.  I do see this changing in the future, as more and more medical doctors are being exposed to functional medicine.  But unfortunately it still is challenging to find an endocrinologist who is open minded.

In summary, many people with thyroid and autoimmune thyroid conditions are easily intimidated by their endocrinologist.  And the reason for this is because most endocrinologists are close-minded when it comes to natural treatment methods.  Just remember that your endocrinologist is a human being just like you, and also remember that you are the one who hires your endocrinologist, as it’s not the other way around.  You are in charge of your own health, and while I realize it isn’t always easy to find another endocrinologist to work with, this doesn’t mean that any doctor has the right to talk down to you and insist that you need to follow their recommendations, even if you are uncomfortable with them.

Of course it is ultimately your decision how you want to approach your endocrinologist, and if you have something you want to add to this, or if you just want to share the experience you had with your endocrinologist please feel free to post a comment below.

Turmeric is one of the most well known herbs, and there are thousands of research studies showing its benefits.  Over the years I have had many of my patients with thyroid and autoimmune thyroid conditions supplement with turmeric.  But because turmeric is poorly absorbed, if you take a turmeric supplement you need to make sure you take one that has increased bioavailability.

But before talking about turmeric supplements, I’d first like to briefly talk about why turmeric has become even more commonly used over the years.  Turmeric is derived from the plant Curcuma longa, and it has been commonly used in the Indian subcontinent not only for healthcare purposes, but also for the preservation of food and as a yellow dye for textiles (1).  Curcumin is what gives turmeric its yellow color, and it has been shown to exhibit antioxidant, anti-inflammatory, antiviral, antibacterial, antifungal, and anticancer activities and thus can potentially benefit people with various malignant diseases, diabetes, allergies, arthritis, Alzheimer’s disease, and other chronic illnesses (1).  I have written a separate article entitled “Turmeric and Thyroid Health“, where I spoke about many of these health benefits.

Why Many People With Thyroid And Autoimmune Thyroid Conditions Should Consider Supplementing With Turmeric

With most chronic health conditions, inflammation is a big factor.  And it’s no exception with most of the patients I work with.  This is especially true with those patients who have autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  And while the overall goal should be to address the underlying cause of the condition, taking things to help with the inflammation can be beneficial.  And turmeric is one of the best options available for helping to reduce inflammation.

In fact, autoimmune conditions are characterized by an increase in proinflammatory cytokines, and numerous research studies show that turmeric can help to reduce these cytokines (2) (3).  In addition, having an abundance of regulatory T cells is necessary for a healthy immune system, and for keeping autoimmunity in check.  And there is evidence that turmeric can help to increase regulatory T cells (4).

How To Increase The Absorption Of Turmeric

So if you take a turmeric/curcumin supplement, then how can you be certain that it will be well absorbed?  Although curcumin can help many people with numerous health conditions, the potential health benefits of curcumin are limited by its poor solubility, low absorption from the gut, rapid metabolism, and rapid systemic elimination (5) (6). What I’d like to do below is list some of the different mechanisms used to increase the absorption of turmeric.

Piperine.  Piperine is an alkaloid that is responsible for the pungency of black pepper.  Numerous studies show that piperine can greatly increase the bioavailability of curcumin in humans (5) (7).  It accomplishes this by inhibiting hepatic and intestinal glucuronidation.  One study showed that in humans, curcumin bioavailability was increased by 2,000% after combining curcumin with piperine (7).

Liposomes, micelles, and phospholipid complexes.  This involves combining turmeric with a source of fat, which in turn will increase its absorption.  An example of a curcumin supplement which falls under this category is Meriva, which has been involved in a few research studies.  Meriva is a patented phytosome complex of curcumin with soy phosphatidylcholine (8). The absorption of a curcuminoid mixture and Meriva was examined in a randomized, double-blind, crossover human study, which revealed that the absorption of curcumin was about 29-fold higher for the Meriva mixture (9).

Nanoparticles. Nanoparticles are very tiny particles, and studies show that nanoparticles of curcumin increases its bioavailability (10) (11) (12).

How Much Turmeric Should You Take?        

Curcumin does seem to be safe at doses as high as 12 grams per day over 12 months (13), although most people don’t need to take this high of a dosage.  This is especially true if someone is taking a curcumin supplement that has been enhanced by one of the methods I listed in this post.  When this is the case, many people will receive benefits from taking 500 to 1,000 mg of curcumin per day.  On the other hand, some people find that taking 2,000 to 4,000 mg of curcumin/day is more beneficial.  In some people, taking higher doses of curcumin has caused symptoms such as nausea or abdominal discomfort.  And so while curcumin seems to be safe, not everyone can tolerate higher doses.

Eating Turmeric vs. Taking A Turmeric Supplement

I’m sure some reading this are wondering if you can get the same benefits from eating turmeric.  First of all, while many people with thyroid and autoimmune thyroid conditions can benefit from supplementing with curcumin, I do want to say that not everyone needs to take this as a supplement.  In fact, while I do recommend supplements to my patients, I’m also an advocate of getting as many nutrients as you can from the food you eat.  However, supplementation is frequently necessary in order to get a therapeutic effect.  If you do choose to eat turmeric rather than taking it as a supplement, you still want to make sure to prepare it in a way to help increase its absorption. So for example, mixing turmeric with black pepper will help to increase its absorption.

In summary, turmeric can help greatly in reducing inflammation, which in turn can benefit many people with thyroid and autoimmune thyroid conditions.  However, turmeric is poorly absorbed, and so if you choose to take a turmeric supplement, you want to make sure that the absorption has been enhanced using one of the methods I described in this post.  And the same is true if you choose to eat turmeric.  Many people notice a difference when taking 500 to 1,000 mg of turmeric per day, although some people can benefit from higher doses.

In past articles and blog posts I’ve discussed the difference between a “standard” paleo diet and an “autoimmune” paleo diet.  A standard paleo diet allows someone to eat vegetables, fruits, nuts, seeds, meat, fish, and eggs.  An autoimmune paleo diet is even more restrictive, as nuts, seeds, eggs, and the nightshade vegetables are also excluded from this diet.  Of course with either diet you want to avoid refined foods and sugars, and you’ll also notice that grains aren’t included in either diet.  But the focus of this post is going to be on legumes, which are also excluded from both a “standard” paleo diet and an autoimmune paleo diet.

Which Foods Are Considered To Be Legumes?

Legumes include beans, peas, lentils, peanuts, and other podded plants.  The following are some of the more well known legumes:

Black beans

Garbanzo beans (chickpeas)

Green beans

Jelly Beans (just kidding)

Kidney beans

Lima beans

Navy beans

Pinto peans

Soybeans

Lentils

Miso

Dried peas

Peanuts

Why Are Legumes Excluded From Both A Standard And An Autoimmune Paleo Diet?

So why are legumes excluded from both a standard and an autoimmune paleo diet?  After all, there are numerous health benefits of legumes, which I’ll list below.  But even though this is the case, the primary reason why legumes are excluded from these diets is because they have compounds that can interfere with nutrient absorption and increase the permeability of the gut .  And some researchers theorize that a leaky gut is a characteristic of all autoimmune conditions.

What Are Some Of The Health Benefits Of Legumes?

Even though legumes are excluded from both a standard paleo and an autoimmune paleo diet, they do have numerous health benefits:

1. They are a good vegetarian source of protein. For example, one cup of lentils has approximately 18 grams of protein. Most beans are also a good vegetarian source of protein.
2. They are a good source of fiber. One serving of beans provides two to four grams of fiber.
3. They are a good source of certain vitamins and minerals. Beans are an excellent source of folate, and zinc bioavailability from legumes is relatively good (1). Although beans are high in iron, the bioavailability from legumes is poor (1).  Many beans are good sources of calcium, and while the bioavailability is lower than from milk and green leafy vegetables, it is still pretty good (1).

What Are Some of The Risks of Eating Legumes?

Although there are health benefits of eating legumes, there are certain health risks as well.  Most legumes have bioactive compounds such as lectins, saponins, and enzyme inhibitors (2).  These can interfere with the absorption of nutrients, and can also lead to an increase in intestinal permeability.  However, this doesn’t mean that everyone who eats legumes will develop nutrient deficiencies or a leaky gut.  Most healthy people who eat small amounts of thoroughly cooked legumes probably shouldn’t be too concerned.  Sprouting legumes might also help to reduce some of these compounds.  However, according to Loren Cordain’s research, cooking doesn’t completely eliminate lectins, and soaking, sprouting, or cooking doesn’t reduce saponins.

In the previous paragraph I mentioned how most healthy people probably can eat small amounts of thoroughly cooked legumes, but how about someone who has an existing thyroid or autoimmune thyroid condition?  Should these people avoid legumes?  Well, it does seem to depend on the person.  Many will argue that people with autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis should avoid legumes, along with other foods that can have a negative effect on the health of the gut.  And while I do initially recommend for my patients with autoimmune thyroid conditions to avoid these foods, some people are able to reintroduce legumes and other foods without a problem.

What’s The Deal With Peanuts?

I personally love most nuts and seeds.  Although peanuts are actually a legume, I still tend to categorize them with nuts.  And if peanuts were considered to be healthy I would be eating them on a regular basis.  But while I think that both peanuts and peanut butter are delicious, you really do want to minimize your consumption of these.  This isn’t to suggest that peanuts have no health benefits, as they do have some good nutrients, and they might have cardioprotective effects (3) (4).  One study even showed that peanut butter consumption can lower the risk of developing type 2 diabetes (5).

However, while peanuts have some health benefits, they are highly allergenic.  In addition, peanuts are also high in aflatoxins (6) (7).  Aflatoxins are fungal metabolites which can have a negative effect on our health.  And so even if someone doesn’t have a peanut allergy or sensitivity, the aflatoxins can have a negative effect on their health.  Cyrex Labs has a test called the Chemical Immune Reactivity Screen, which measures the immune system response to certain chemicals.  And it does test for aflatoxins.

Legumes Are High In FODMAPs

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, and I’ve written a separate blog post entitled “Should People With Thyroid Conditions Follow a low-FODMAP Diet?“.  Most legumes are considered to be high FODMAP foods due to the non-digestible galacto-oligosaccharides (8) (9).  Those people with small intestinal bacterial overgrowth (SIBO) don’t do well with high FODMAP foods, and so if someone has SIBO then they probably won’t be able to tolerate legumes, although some people with SIBO are able to consume small amounts.

In summary, legumes include beans, peas, lentils, and peanuts, and they are excluded from both a “standard” paleo and an autoimmune paleo diet.  The main risk of eating legumes is that they have compounds which can interfere with nutrient absorption and increase the permeability of the gut.  However, this doesn’t happen in everyone, and legumes also have some good health benefits.  So while some people are better off avoiding them, others do fine consuming thoroughly cooked legumes in small amounts, and this includes some people with Graves’ Disease and Hashimoto’s Thyroiditis.  The problem is that it’s impossible to predict who will do well when consuming legumes and who won’t do well, and this is why I do have most of my patients with autoimmune thyroid conditions avoid eating legumes while trying to restore their health.

Hair loss is one of the most frustrating symptoms many of my patients with thyroid and autoimmune thyroid conditions experience.  This is a problem with both hypothyroid and hyperthyroid conditions, and sometimes the hair loss can be very severe.  In fact, it’s not uncommon for the patient to be most concerned about the hair loss, even if they are experiencing numerous other symptoms.  As a result, many people who experience hair loss want to know what they can do to quickly stop this, and of course get their hair to grow back.

The good news is that most cases of thyroid hair loss are reversible.  In other words, the hair loss will usually stop and eventually grow back.  The bad news is that it can take a good amount of time for this to happen.  When hair loss is a result of a thyroid hormone imbalance you would figure that the hair would stop falling out once the thyroid hormone levels have normalized.  But unfortunately this usually isn’t the case, as while everyone is different, it commonly takes a number of months after the thyroid hormones have normalized for the hair loss to stop.

This understandably can be very stressful and frustrating, as someone might have normal thyroid function tests for a few months and still be experiencing hair loss.  I receive emails all of the time from my patients asking when the hair loss will stop, and if there is anything they can take to slow it down and/or help it to grow back.  Although there are supplements which can help with some cases of hair loss, in most cases these won’t help much if the cause of the hair loss is the thyroid hormone imbalance.  In other words, if the main cause of your hair loss is the thyroid hormone fluctuations, then not surprisingly, addressing this problem is the best approach.

Other Factors Which Can Cause Hair Loss In Thyroid Patients                  

Although in most people with thyroid and autoimmune thyroid conditions the hair loss is a result of the thyroid hormone imbalance, there can be other factors which cause hair loss.  So let’s go ahead and look at some of these other causes.

Nutrient Deficiencies.  30% of women before the age of 50 have hair loss due to some type of nutritional deficiency, with depleted iron stores being the most common cause (1).  A suboptimal intake of the amino acid lysine can also be a factor (1).  Getting back to iron, in women with hair loss, a ferritin level of 70 mcg/L is recommended (2).  However, keep in mind that ferritin can elevate due to inflammation, and so one can’t rely on the ferritin alone to determine the iron status.  In addition to iron and lysine, a few studies have shown that a zinc deficiency can play a key role in hair loss (3) (4).  A biotin deficiency can also result in hair loss (5).  Many women take evening primrose oil to help with hair loss, as this has gamma linolenic acid (as does borage oil and black currant seed oil), and supposedly a deficiency of GLA can be a factor in some cases of hair loss, although I wasn’t able to find any research studies confirming this.

Other Hormone Imbalances.  In addition to having hyperthyroidism or hypothyroidism, other hormone imbalances can result in hair loss.  One study showed that a low estrogen to androgen ratio (ratio of estradiol to free testosterone) might be responsible for triggering hair loss in women (6).  Problems with the estrogen and progesterone receptors can also be a factor in some people (7).  High levels of androgens in postmenopause can result in hair loss (8) (9).  High levels of prolactin can also cause hair loss (10).

Stress.  There is evidence that neurohormones, neurotransmitters, and pro-inflammatory cytokines released during the stress response may also significantly influence the hair cycle (11) (12) (13).  In addition, acute emotional stress may cause alopecia areata by activating corticotropin-releasing hormone receptors around the hair follicles, leading to intense local inflammation (14).  This isn’t to suggest that most people with thyroid and autoimmune thyroid conditions have hair loss due to stress, although since many people with these conditions deal with a lot of stress this shouldn’t be overlooked.  Plus, there is also the possibility that the thyroid hormone imbalance is what initially causes the hair loss in some people, but the increased anxiety and stress due to the hair loss is a contributing factor.  In other words, even when the thyroid hormone imbalance or another factor causes the hair loss, the anxiety and stress associated with the hair loss might worsen the problem in some people.

Drugs and Other Toxic Agents.  Taking certain medications can also lead to hair loss (15) (16).  This usually isn’t the reason behind hair loss in most of my patients, although during those rare cases when drugs are causing hair loss, it is almost always reversible by stopping the medication.  Many patients with hyperthyroidism and Graves’ Disease take beta blockers such as Propranolol and Metoprolol, and these also have the potential to increase hair loss in some people (17).  I wasn’t able to find studies showing that environmental toxins such as heavy metals or xenoestrogens can cause hair loss, but it wouldn’t be shocking if these were factors.

How Can One Determine The Cause Of The Hair Loss?

If someone has been dealing with a thyroid or autoimmune thyroid condition then there is a pretty good chance that this is what’s responsible for the hair loss.  However, there is always a chance that one or more of the other factors I discussed can be responsible for the hair loss, or at least be a contributing factor.  For example, someone could have had a nutrient deficiency or a sex hormone imbalance which directly or indirectly caused the thyroid or autoimmune thyroid condition.  In this case it might be necessary to correct all of these imbalances in order to completely stop the hair loss.

Obviously one can also do some additional testing to see if someone has an imbalance of the sex hormones, test some of the nutrients (i.e. conduct an iron panel), and/or run an adrenal panel to see if someone has imbalances in cortisol and/or DHEA.  But even if someone has one or more of these other imbalances it doesn’t necessarily mean these are responsible for the hair loss.  However, if someone does have a nutrient deficiency or a hormone imbalance, even if these aren’t the causes of the hair loss it of course still would be a good idea to correct these imbalances.

Can You Just Take Some Supplements To See If It Will Help?                                   

It’s very common for people to take some supplements and see if this will help with their hair loss.  If the hair loss is due to a thyroid hormone imbalance then taking supplements probably won’t help that much.  However, taking certain nutrients such as biotin, evening primrose oil, and low doses of zinc for a month or two usually won’t cause any problems, even if someone doesn’t have a deficiency in these nutrients.  On the other hand, taking iron supplements can be problematic if someone doesn’t have an iron deficiency.

I’m fine with most patients taking some nutrients such as biotin, zinc, and a form of GLA.  But many times this won’t have much of an impact with regards to hair loss.  There is also evidence that peppermint oil can help with hair growth (18).  But in most cases, correcting the thyroid hormone imbalances and then waiting a few months for the hair to normalize is the best option, although I definitely would recommend getting an iron panel as well.  While incorporating stress management techniques might not help much, it definitely won’t hurt, and most people can benefit from improving their stress handling skills.

In summary, hair loss is very common with both hypothyroid and hyperthyroid conditions.  Although most cases of thyroid hair loss are reversible, it can take some time for the hair loss to stop and grow back.  In addition to having a thyroid hormone imbalance, some other factors which can cause hair loss include nutrient deficiencies (i.e. iron, zinc, biotin, GLA), other hormone imbalances, stress, as well as drugs and other toxic agents.  Please feel free to share your experience with hair loss in the comment section below.