The primary reason why people choose to follow a natural treatment protocol is to avoid the risks associated with conventional medicine.  Although there is a time and place for drugs, surgery, and other conventional treatment methods, these methods of course don’t do anything to address the cause of the problem.  However, not everyone who follows a natural treatment protocol will receive optimal results.  Many times this is due to the patient not being compliant, although some will do an excellent job of following the doctor’s recommendations and still won’t show much improvement.

When this happens it becomes frustrating to both the doctor and patient.  Some doctors take pride in dealing with “tough cases”, and although I do work with a lot of tough cases, I think most doctors would prefer those cases when someone gradually improves without any setbacks.  Don’t get me wrong, as I like dealing with challenges, and many cases of thyroid autoimmunity can be complex.  However, I still get frustrated when someone is strictly following my recommendations but doesn’t receive optimal results.  There can be numerous reasons why someone doesn’t receive optimal results despite following the recommendations of their doctor, but when this happens it usually comes down to one or more of the following five factors:

1. The patient is reacting to a food allergen or antinutrient. If someone’s health isn’t improving then one of the first things they need to do is reevaluate their diet, as there is a good chance one or more food allergens or antinutrients are responsible for the person not progressing.  This can occur even if the person is eating a healthy diet.  Many people reading this are aware that gluten and dairy are common allergens, and thus if someone has been consuming gluten and/or dairy while following a natural treatment protocol and aren’t receiving optimal results, then these allergens definitely need to be COMPLETELY avoided.  This is true even if you haven’t noticed any negative symptoms upon consuming gluten and dairy.  And yes, even if you have received testing which showed that you didn’t react to these foods you still want to cut them out.

There are times when I’m working with someone who isn’t progressing as expected, and they have been strict about avoiding gluten and dairy.  Many times they have  avoided these allergens for a few months or longer.  If this is the case then they need to look at the possibility of other foods causing a negative reaction, such as corn, soy, eggs, and even gluten-free grains.  For example, someone might have eliminated gluten, dairy, corn, and soy, but after doing an elimination diet find out they have a sensitivity to rice.  And if they were consuming rice, even a few times per week, then this can cause gut inflammation and affect their recovery.  Obviously this is just an example, but it of course is possible to have a negative reaction to rice, as well as other gluten free grains.

If someone has a leaky gut, then eating nuts, seeds, and legumes can slow down their progress.  This usually isn’t due to a food intolerance, as these all have antinutrients which interfere with the absorption of minerals.  In addition, antinutrients such as lectins can cause further damage to the gut.  And so if someone has avoided all of the common allergens, but is still eating nuts, seeds, and/or legumes, then this can affect one’s recovery.  Some people also react to the nightshade family of foods.  These include tomatoes, eggplant, white potatoes, and most peppers.  These also have substances which can cause a leaky gut.

How can someone tell if they have a food allergy or intolerance?  It can be challenging to tell if someone has a food allergy or intolerance.  As for a food allergy, this can be detected through IgE testing, and is usually conducted in an allergist’s office.  Besides the fact that IgE testing isn’t always accurate (1) (2), delayed food intolerances are far more common.  And while there are numerous food intolerance panels available, none of these are completely accurate either.  This doesn’t mean that they don’t have some value, but false negatives are common, and if someone has a leaky gut this can also affect the results.

2. There is an underlying infection. If someone has ruled out food allergies and intolerances as a potential cause of their problem, and have eliminated the antinutrients I mentioned, then they will want to try to see if they have some type of infection.  Some healthcare professionals will initially do testing for infections, as a lot of functional medicine doctors will run a comprehensive stool panel to see if there are any bacterial infections, yeast, or parasites.  Although I do run a comprehensive stool panel every now and then, I don’t initially do this testing on all of my patients because 1) they are very expensive, and 2) they almost always come out negative for the presence of pathogenic bacteria, yeast, and parasites.  Sure, the test might reveal gut inflammation, or a deficiency of short chain fatty acids, but I usually assume that most of my patients have gut inflammation, and while it’s also common to have an imbalance of the short chain fatty acids, in my opinion it’s not worth a few hundred dollars to test for this.

I’m not being critical of those doctors who do this type of testing on all of their patients.  Quite frankly, it probably is a good idea to do such testing on someone who has obvious gastrointestinal symptoms.  The problem is that the lack of gastrointestinal symptoms doesn’t mean that the person doesn’t have pathogens in the gut, which is why some healthcare professionals choose to have all of their patients obtain this test.  On the other hand, a negative test for pathogens doesn’t necessarily mean the person doesn’t have an infection.  For example, I’ve had patients with symptoms of a yeast infection test negative for such an infection on a stool panel, and then not too long after this have a  test for yeast show up positive on a blood or urine test.  Similarly, parasites aren’t always detected in the stool.  In fact, this is the main reason why many labs will offer a 3 or 4-sample stool test.  Collecting a stool sample on three or four different days will reduce the likelihood of a false negative, although false negatives still remain a possibility, even with testing multiple stool samples on different days.

Plus, most comprehensive stool panels won’t test for all of the pathogens which can be detected in the stool.  For example, many labs offer both H. Pylori and C. difficile as “add-ons”, and other bacteria might need to be added as well.  This of course means that it can cost a lot more money if you want to test for everything the lab offers. In addition, one also needs to keep in mind that not all chronic infections can be detected in the stool.  Some examples include Lyme disease, Epstein Barr, and Cytomegalovirus.  It would be great if there was a lab which offered a comprehensive panel for infections which included both blood and stool testing, and tested for most of the common pathogenic bacteria, viruses, fungi, and parasites.

So that brings up the question, “is there a surefire method for detecting a chronic infection?”.  Unfortunately the answer to this question is “no”.  And so there are a few options.  One option is to do as much testing as possible, including blood tests and stool testing.  The problem is that if you don’t have health insurance then doing all of this will be very expensive, and this still might not completely rule out an infection.  What approach do I take?  Well, I think it’s a good idea to start with the basics, such as a complete blood count with differential.  This of course won’t determine if someone has a specific infection, but it sometimes can give an idea if someone is having an acute or chronic bacterial or viral infection, and sometimes even a parasitic infection if the eosinophils are elevated.  If this test reveals a potential infection then I will consider further testing.  If someone has overt gastrointestinal symptoms then I might do a stool panel, although I’m well aware of the limitations I mentioned above.  If I think there’s a strong possibility someone has an infection I might just put them on a dysbiosis protocol and see how they respond.  Or I might run an organic acids test, which looks at certain markers of dysbiosis.

3. Chronic stress is an issue. I probably should have listed this first, as stress is a common reason why many people don’t progress as expected.  Although some healthcare professionals might frequently use chronic stress as an excuse for a person’s symptoms or lack of progress, the truth is that chronic stress does affect the biochemistry.  In other words, the emotional component of stress can have a dramatic effect on someone’s health.  And for someone who is dealing with a thyroid or autoimmune thyroid condition, the fact that they have a chronic health condition only increases their stress levels.  It’s not so much the stress itself that is a problem, as everyone deals with acute and chronic stressors.  What’s important is the person’s perception of the stressor, and it’s essential for people with thyroid and autoimmune thyroid conditions to truly become an expert in handling stress if they want to restore their health, and maintain their health thereafter.

In fact, I’ve had some patients get to the point where they were symptom free and all of the labs were negative, but then a very stressful situation came along, and they relapsed.  This might sound discouraging to some people reading this, as you might be thinking to yourself “why would I want to follow a natural treatment protocol if there’s a chance that being exposed to a stressor will result in a relapse?”  After all, everyone will eventually have to deal with an acute or chronic stressor such as financial problems, a divorce, a trauma, the loss of their job, a death of a family member or close friend, etc.  While it’s just about impossible to prepare for all of the different stressors you will eventually have to deal with, if you become an expert in managing the stress then you will do a much better job of handling these future stressors.

It really is no different than eating well, as while some people are able to change their eating habits in one day, for others it takes time to accomplish this.  Some people need to make gradual changes in their diet over a number of weeks or months before they are eating mostly whole foods, and minimizing their consumption of refined foods and sugars.  The same concept applies when it comes to improving your stress handling skills, as it takes time to become an expert in managing stress.  Truth to be told, I still don’t consider myself to be an “expert” when it comes to stress handling, although I’ve made some great strides over the years.  If stress is an issue, you need to make stress management a priority if you want to receive good results. And the only way to truly become a master at handling stress is to block out some time every day to work on stress management.  I discussed this in greater detail in my blog post entitled “Blocking Out Time To Manage Your Stress Is Essential“.

4. Genetic polymorphisms. Although lifestyle and environmental factors seem to play a greater role than genetics in the development of most chronic health conditions, one still can’t dismiss the genetic component.  And when someone isn’t responding as expected to a natural treatment protocol, there is a possibility that a genetic polymorphism is the reason behind this.  A genetic polymorphism is a genetic defect that commonly affects a certain percentage of the population.

Having certain genetic polymorphisms can affect phase 1 and phase 2 detoxification, the immune system response, the metabolism of folate, vitamin and hormone receptors, and even DNA repair enzymes.  So for example, a toxin such as mercury might have triggered an autoimmune response in a person with a polymorphism affecting the detoxification pathways.  This person might have received months of chelation therapy, but still hasn’t noticed an improvement in their symptoms because their body isn’t doing a good job of eliminating the mercury due to the genetic polymorphism, which in turn is affecting the detoxification pathways.

I also mentioned how certain genetic polymorphisms can affect the immune system response.  Proinflammatory cytokines are a factor in autoimmunity, and someone can have genetic polymorphisms of these cytokines.  I’ve spoken about the Th1 and Th2 pathways in past articles and blog posts, and you can have polymorphisms of Th1 cytokines such as IL-2 and TGF-B1, and Th2 cytokines such as IL-6 and IL-10 (3).  So if someone isn’t responding then it’s possible that they have one or more polymorphisms which are affecting their progress.

But how can someone tell if they have certain genetic polymorphisms?  Testing is available for the more common polymorphisms.  For example, many people reading this are familiar with the MTHFR polymorphism, and many labs offer testing for this.  The company Genova/Metametrix offers testing for certain polymorphisms.  For example, they have an “ImmunoGenomic Profile”, which will measure some of the Th1 and Th2 cytokines such as TNF-alpha, IL-4, IL-6, IL-10, etc.  They also have a “DetoxiGenomic Profile”, which tests for a few dozen of the most common polymorphisms relating to detoxification.  I can’t say I routinely do this type of testing on my patients, but it’s something to consider if someone isn’t responding as expected.

5. Toxic overload. Many of my patients initially will do things for detoxification.  However, while this of course is beneficial, many times the person needs to be more aggressive in eliminating toxins from their body.  First of all, we need to keep in mind that different people are exposed to a different amount of toxins.  And while there are some tests available to measure the levels of certain toxins, it’s impossible to measure ALL of the different toxins.  So for example, if someone obtains a hair analysis or a urine test to look at heavy metals, and if such testing reveals low levels of mercury, arsenic, and other toxic metals, this doesn’t necessary mean that they have low levels of other types of toxins.

A second factor to consider is that some people eliminate toxins better than others.  As a result, if two people are exposed to the same level of toxins, one person might do a very good job of eliminating  toxins, while the other person might not do a good job of eliminating toxins.  There can be a few reasons for this.  One reason could be that one person has higher levels of glutathione, which plays an important role in the detoxification pathways.  Genetics can also be a factor.  As I mentioned earlier, if someone has a certain genetic polymorphism then they might not be able to eliminate toxins as efficiently as another person, and this also can be related to glutathione production.

A third factor to consider is that people react differently to toxins. So for example, one person might have a severe reaction to a small amount of a specific toxin, while another person might not react to a large amount of the same toxin.  In the past I’ve mentioned the Chemical Immune Reactivity Screen from Cyrex Labs.  Although I admit this isn’t a test I commonly order, it’s a very interesting test, as it measures the immune system response to some of the more common toxins, such as mercury, arsenic, lead, formaldehyde, bisphenol A, parabens, and isocyanate.

In any case, if someone follows a natural treatment protocol recommended by their doctor and still isn’t receiving optimal results, toxins need to be considered.  And it’s also important to keep in mind that some people have more than one health issue going on simultaneously.  For example, it’s common for people with Graves’ Disease and Hashimoto’s Thyroiditis to have a leaky gut, along with intestinal dysbiosis.  However, their bodily tissues might also be overloaded with toxins.  And so when someone has a leaky gut I will focus on repairing the gut and correcting any dysbiosis.  Once the gut has been healed and the dysbiosis has been corrected, if the person is still symptomatic and/or still has elevated thyroid antibodies, then toxins need to be considered.  Although I might give some recommendations to help the person boost glutathione levels while repairing the gut, this might not be sufficient.

In some of my past articles and blog posts I’ve mentioned Dr. Walter Crinnion, as he is a naturopath who focuses on detoxification.  He has been in practice for around 30 years, and while I was working towards my masters of science in nutrition degree he was the instructor for my biotransformation and detoxification course.  He is a big proponent of both sauna therapy and colon hydrotherapy.  In fact, he said if he had to choose one method of detoxification it would be colon hydrotherapy.  Although colon hydrotherapy can be very effective in removing toxins, the problem is that you don’t want to receive colon hydrotherapy if you have a leaky gut.  And so you first need to correct the leaky gut, and then if necessary receive colon hydrotherapy.  While I personally don’t recommend colon hydrotherapy to most of my patients, it can be an excellent method of eliminating toxins.

Even if you get aggressive and utilize a combination of supplements (i.e. milk thistle, NAC, etc.), sauna therapy, and colon hydrotherapy to eliminate toxins, it can still take many months to notice results.  In his book Clean, Green, and Lean Dr. Crinnion talks about how he commonly sees the autoantibodies of patients normalize after putting them on a comprehensive program to eliminate toxins.  The downside is that this does take time, and even he admits that for some people it can take a couple of years before they receive optimal benefits from a detoxification program.

In summary, it can be frustrating when someone is strictly following the recommendations of their doctor, yet for some reason isn’t progressing as expected.  There are numerous reasons why someone’s health doesn’t improve, but five common factors include 1) the person is reacting to a food allergen or antinutrient, 2) there is an underlying infection, 3) chronic stress is an issue, 4) they have one or more genetic polymorphisms, and 5) toxic overload.  It can be challenging to find out which of these factors is responsible for the patient’s lack of progress, but doing so is of course necessary to help them restore their health.

More and more people are working with natural healthcare professionals.  And it’s becoming more common for people to see more than one natural healthcare professional.  For example, someone might see a chiropractor to receive spinal adjustments, get deep tissue massages from a licensed massage therapist on a regular basis, see a biological dentist for their oral health, etc.  And of course there is acupuncture.  Over the years I have had many people with thyroid and autoimmune thyroid conditions ask me if acupuncture can benefit their health, which is why I decided to write this blog post.

Before talking about whether or not acupuncture can help with thyroid and autoimmune thyroid conditions, let’s first discuss some of the basics of acupuncture.   As most people reading this know, acupuncture involves using fine needles which are inserted at specific locations of the body, which are known as acupuncture points (1).  These points are linked together in a network of “meridians”, which run longitudinally along the surface of the body (1).  There are 20 meridians, and 12 of these are referred to as “primary meridians”, and these relate to specific organs (2).  There is also something called “Qi”, which is probably best described as an energy that flows through the meridians, and as described by Dr. Yin Lo in an article he wrote in Acupuncture Today, “Qi is what carries the effect of acupuncture from one acupoint to other parts of the body” (3).

Acupuncture affects all of the systems of the body, including the immune system, gastrointestinal tract, and the endocrine system.  It helps to promote blood flow (4), stimulates the release of neurotransmitters and endorphins which help to decrease pain (5), helps to reduce stress (6), and as I’ll mention later in this post, it can modulate the immune system.

What Are The Benefits of Receiving Acupuncture?

There are many different benefits of acupuncture.  And if you search through the literature you’ll see many studies which show that acupuncture can help people with a wide range of different health conditions.  Here are just a few conditions acupuncture might be able to help with:

Acute and chronic pain. There are many different studies which show that acupuncture can benefit people with chronic pain.  One systematic review compared the effectiveness of acupuncture with other treatment methods for alleviating pain due to osteoarthritis of the knee (7).  This review involved 114 trials and 9,709 patients, and they concluded that acupuncture can be considered to be one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short term.  However, the authors did admit that a lot of the evidence is still of poor quality, and therefore more research is probably needed in this area.  There is also is evidence that acupuncture can be more effective than medication for pain relief for both acute and chronic low back pain (8) (9).  Randomized controlled trials have shown that acupuncture has short-term effectiveness in the treatment of neck pain (10).

Infertility and polycystic ovarian syndrome (PCOS). Acupuncture can help with some cases of female infertility (11) (12). With regards to PCOS, a literature review in 2010 showed that acupuncture may help people with PCOS by increasing blood flow to the ovaries, reducing ovarian volume and the number of ovarian cysts, increasing insulin sensitivity and reducing cortisol levels (13).  A recent randomized controlled trial involving 32 women with PCOS showed that repeated acupuncture treatments resulted in higher ovulation frequency, and that ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion (14).

Asthma. One randomized controlled study showed that acupuncture performed in accordance with the principles of traditional Chinese Medicine showed significant immune-modulating effects and that asthma patients can benefit from acupuncture treatment (15).  However, there are other studies which don’t show benefits of acupuncture in the management of certain cases of asthma (16).

Cancer patients receiving chemotherapy. I came across one study involving 45 patients with cancer who had acupuncture administered one day prior to them receiving chemotherapy (17).  The study showed that acupuncture can have positive effects in cancer treatment patients who experience nausea, vomiting, pain, insomnia, and anxiety as a side effect of chemotherapy.  And so while I’m not a big fan of chemotherapy, those who do receive this might want to consider getting one or more acupuncture treatments beforehand.

Migraines. There have been numerous studies showing that acupuncture can benefit some people with migraines, although there also have been studies which have shown that acupuncture doesn’t have a greater effect than sham acupuncture.  A randomized controlled trial involving 175 patients with migraines showed that verum acupuncture is more effective than sham acupuncture in reducing the discomfort of an acute migraine, as well as in preventing migraine relapse or aggravation (18). Another randomized controlled trial involving 480 patients with migraines showed that acupuncture had a clinically minor effect on migraine relief compared with sham acupuncture (19).  A few other studies showed that acupuncture was no more effective than sham acupuncture in reducing migraine headaches (20) (21).

Acupuncture and Thyroid Health

There aren’t a lot of clinical trials involving acupuncture and thyroid health, although I did come across a few of them:

Acupuncture and Subclinical Hypothyroidism. One study looked at the influence of acupuncture on the quality of life in patients with subclinical hypothyroidism (22).  The study involved 27 female patients who were found to have elevated TSH levels, along with normal levels of thyroid hormones.  Twenty of the 27 patients who underwent the treatment showed a significant decrease in the severity of clinical symptoms, and the TSH levels fell down to the physiological values.  The study concluded that acupuncture may be regarded as an alternative to substitution therapy of subclinical hypothyroidism.  Of course this is just a single study involving only 27 people, and without question more research needs to be done on this.  With that being said, the results still were encouraging, and it might be worth for some people with subclinical hypothyroidism to see an acupuncturist.  Plus, remember that most people with subclinical hypothyroidism have Hashimoto’s Thyroiditis, and the improvement in these patients might suggest that receiving the acupuncture treatments modulated the immune system, which I’ll discuss shortly.

Acupuncture and Thyroid Eye Disease. One study compared the therapeutic effect and side effects on hyperthyroid exophthalmos with the combination of acupuncture and medication, and with medication only (23).  It involved fifty two cases, and it showed that the improvement of thyroid eye disease was better in the acupuncture and medication group than in the medication group alone. Hyperthyroid exophthalmos is typically due to the TSH receptor antibodies attacking the tissues of the eye, and so this also suggests that acupuncture might modulate the immune system, in this case benefiting people with Graves’ Disease.

Acupuncture and benign thyroid nodules. This study involved 46 patients with thyroid adenoma who were treated by electrochemical treatment during acupuncture anesthesia (24).  After three months to four years follow up the cure rate was 97.8%.  In addition to this being another small study, it was conducted in 1994, and so it would be nice to see larger, more current studies.

Acupuncture and autoimmunity. I did not come across any specific studies which showed that acupuncture can help with Graves’ disease or Hashimoto’s Thyroiditis.  However, acupuncture can modulate the immune system (25) (26), and thus it potentially can benefit people with immunological conditions such as those with allergies, infections, immunodeficiency syndromes, and autoimmune conditions.

Of course the lack of clinical trials related to thyroid health doesn’t mean that acupuncture can’t be beneficial for those with thyroid and autoimmune thyroid conditions.  I’ve had numerous patients see an acupuncturist and report back a positive improvement in their condition.  One thing to keep in mind is that while acupuncture might benefit people with autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis by modulating the immune system, in most cases it won’t do anything to address the trigger.  For example, if someone has a leaky gut due to a gluten intolerance or an H. Pylori infection, receiving acupuncture probably isn’t going to heal the leaky gut, and most likely wouldn’t eradicate the H. Pylori infection (although by modulating the immune system it might improve the chances of eradicating H. Pylori when combined with other methods).  With that being said, acupuncture when used in combination with other natural treatment methods can potentially benefit those people with thyroid and autoimmune thyroid conditions.

In summary, acupuncture involves acupoints and meridians, which relate to specific organs.  Qi is an energy that flows through the meridians, and carries the effect of acupuncture from one acupoint to other parts of the body.  Acupuncture can help people with many different conditions, including those with acute and chronic pain, infertility, PCOS, asthma, patients receiving chemotherapy, migraines, and other conditions.  There are a few small studies which show that acupuncture can benefit thyroid health, probably by modulating the immune system in those people with Graves’ Disease and Hashimoto’s Thyroiditis.  And while acupuncture alone usually won’t restore someone’s health back to normal, many people with thyroid and autoimmune thyroid conditions can benefit from receiving acupuncture when combined with other natural treatment methods.

For those people with a thyroid or autoimmune thyroid condition, following a natural treatment protocol can be a big challenge.  Probably the greatest challenge during this time is sticking to the diet.  Although many people are disciplined and don’t cheat while trying to restore their health, others can’t resist certain temptations.  Obviously there are other temptations besides birthday cake, but every month it seems as if I get at least one or two emails from patients telling me that they “gave in” to birthday cake.  And since my birthday is in October I figured it was a good time to write a post on this topic.

On the surface it might seem silly to write a post which is focusing on birthday cake.  However, this post isn’t just about avoiding birthday cake, but it’s about trying to avoid all other temptations which can affect your recovery.  There are numerous situations which make it very difficult to stick with the diet while following a natural treatment protocol.  In addition to birthday parties, another big challenge is dealing with the holiday season, as during this time I also receive a lot of emails about sticking to the diet.  And of course it’s common to struggle with one’s diet while going on vacation.  So there are numerous scenarios which can make eating well even more challenging.

The Emotional and Physiological Aspects of Eating Well

Many people have strong cravings which makes it challenging to eat well.  And in these cases it’s not always just a matter of having the “willpower” to resist eating certain foods.  For example, if someone has blood sugar imbalances then they most likely will have a great challenge avoiding eating certain foods such as refined carbohydrates.  Similarly, if someone is addicted to caffeine then it can be a challenge to go “cold turkey”.  Sure, without question there is also an emotional component behind this, as I’ve known numerous patients who have successfully given up eating sweets and/or coffee immediately, and not slowly wean off of these.  But one can’t deny that there is also a physiological aspect when it comes to overcoming cravings.

The first thing someone needs to do is to make up their mind that they want to change their eating habits.  Once they have made this commitment the next step is to correct the physiological aspect of any cravings they have.  With regards to sugar cravings, in addition to avoiding the refined sugars, and minimizing the consumption of healthy sugars as those present in fruit, additional support might be required.  Some nutrients and herbs which can help to balance blood sugar levels and increase insulin sensitivity include chromium, alpha lipoic acid, and gymnema.  As for how to overcome caffeine cravings, for some people this can be more challenging, but one strategy is to switch from drinking coffee to another beverage which has some caffeine, but not as much, such as green tea.  Not only does green tea have a lower amount of caffeine than coffee, but it also has an ingredient called theanine, which counteracts the effects of caffeine.

The Key Is Setting Yourself Up For Success

Once you have decided to make the commitment to eat well, in addition to correcting any physiological aspects of cravings, you also want to do whatever you can to set yourself up for success.  Here are some tips to help accomplish this:

1. Try not to bring junk food into your home. It obviously is more challenging to resist certain temptations if you have easy access to them.  As a result, whenever you go grocery shopping you ideally want to avoid buying junk food, and only buy healthy, whole foods.

2. Get your friends and family on your side. It will be easier to eat well if your friends and family members are encouraging you to do so.  Many people might not understand why you are choosing to follow a natural treatment protocol, but even if this is the case, there shouldn’t be any arguments about wanting to live a healthy lifestyle.  One of the biggest challenges is trying to follow a strict diet when the spouse or significant other is freely eating whatever he or she wants.  This is especially true when the refrigerator and cabinets are filled with foods you are trying to avoid.  Although it might be difficult to convince your spouse and children to follow the same diet you’re following, at the very least I would try to incorporate healthier options.

3. Don’t put yourself in a position to cheat. This is especially important when first beginning a natural treatment protocol, but it can also be true months after starting one.  For example, if there is a birthday party you are invited to, then pass on going to it.  And if it’s a party of a close friend or family member and you feel you need to go, mention your strict diet to the person running the party ahead of time, and consider leaving right after they blow out the candles and before they have a chance to shove a piece of cake into your face.  In addition, don’t go to the party hungry, as if the party is around lunchtime, eat lunch before you go to the party.  And the same thing applies with a party that is being held around dinnertime.  Even though I’m focusing on birthday parties, this obviously applies to other types of parties as well.

4. Consider confronting your temptations. I realize that this contraindicates the previous tip about not putting yourself in a position to cheat, but sometimes implementing this strategy initially can help a great deal.  When I was close to graduating from chiropractic school I went on my very first detoxification.  While following the detox there was a seminar I wanted to attend in a different state (Orlando Florida), so a friend and I drove to Orlando, and his parents lived in Daytona Florida, which is about one hour away from Orlando.   We stayed at his parent’s house for one night, and the first night we were there everyone wanted to go out for pizza, including my friend, who wasn’t on a detox.

To make a long story short I went to the pizza place with my friend and his family, and I ordered a plain salad.  I’m pretty sure I was also avoiding meat at the time, so if I recall correctly I just ordered a plain salad…no chicken, no croutons, no salad dressing.  When they brought out the pizza I really thought about breaking the detox, or at least just indulging for the night and then getting back on track.  But I resisted the temptation, and when I was diagnosed with Graves’ Disease and followed the natural treatment protocol, I used the “pizza story” as my personal motivation to eat well without cheating.

This probably won’t work for everyone, but many people who follow a natural treatment protocol will indulge right before becoming strict with their diet.  In other words, they will eat a lot of junk food for a few days or weeks before starting the protocol.  You might want to consider putting yourself in a situation similar to my “pizza incident”, as within the first few days of beginning the natural treatment protocol you might want to consider “confronting your primary weakness” with regards to junk food, yet do everything you can to not give into the temptation.

Having Birthday Cake In The Future

As I’ve mentioned in previous articles and blog posts, once someone has restored their health back to normal they can usually indulge every now and then without having a serious setback.  Of course there are exceptions to this, as for example, if someone has Celiac disease then they really should avoid gluten permanently.  The good news is that there are plenty of gluten free options for dessert.  Which brings up another point, as when someone is following a natural treatment protocol which overlaps with their birthday, some will wonder why they can’t just have healthier type of cake, such as a gluten free cake without any artificial ingredients.  I get this question asked during the holidays as well, as every year a few people will ask me around Thanksgiving if they can have gluten free pecan or pumpkin pie.

Obviously I’d rather my patients have a gluten free piece of cake which doesn’t have any artificial ingredients when compared to a cake which has gluten and/or artificial ingredients.  But even if it’s gluten and dairy free, cake is still not considered to be healthy, and eating the “healthier” cake will still spike up your blood sugar levels.  I’m not suggesting that having a single piece of gluten free cake while following a natural treatment protocol will cause someone to relapse.  To be honest, some people following a natural treatment protocol would do fine eating a single piece of gluten free cake during Thanksgiving.  One problem is that many people won’t stop at one piece of gluten free cake.  In addition, everyone is different, and so for some people, having single piece of cake might be an issue, even if it is a “healthier” version.

When I followed a natural treatment protocol for my Graves’ Disease condition, I had to deal with eating well on my birthday, as well as during the holiday season.  It wasn’t easy, but I of course realized that indulging for a few minutes on my birthday or on Thanksgiving wasn’t worth the potential setback.  When I was following a natural treatment protocol, perhaps I could have had a gluten free piece of birthday cake without a problem, but I didn’t want to take the chance.

In summary,  many people find it very challenging to eat well when following a natural treatment protocol.  And even though most people feel better when making dietary changes, some people still have problems resisting certain temptations while trying to restore their health back to normal.  The first thing someone needs to do is to make the commitment to eating well.  They also need to do some things to set themselves up for success, such as not bringing junk food into their home, getting their family members and friends to understand the importance of them being strict with the diet, not putting themselves in a position to cheat, and to consider confronting their temptations.  Also keep in mind that while you want to be strict while following a natural treatment protocol, you probably will be able to eat birthday cake again in the future, after you have restored your health back to normal.

Over the years I’ve had numerous patients ask me about the potential benefits of maca, also known as Lepidium meyenii.  Of course there are many beneficial herbs that people can take, such as ashwagandha, eleuthero, rhodiola, etc.  However, this doesn’t mean that everyone with a thyroid or autoimmune thyroid condition should take all of these herbs.  And to be honest, while I’ll be discussing some of the benefits of maca root in this blog post, I can’t say that I commonly use this herb in my practice, although over this past year I have been recommending it more frequently to my patients.

Maca is an Andean plant that belongs to the brassica family. Some of the more common uses is to help improve sexual function and fertility (1) (2).  It seems that maca can be beneficial for both men and women.  For example, one small study showed that maca improved sperm production and sperm motility (3).  Another study showed that maca lowers measures of sexual dysfunction in postmenopausal women independent of estrogenic and androgenic activity (4).  These were both very small studies, and there are other small studies which show that maca can be effective in men and perimenopausal women.

More About Maca

There are actually a lot of studies on maca, although without question, larger trials need to be conducted.  But most of the studies I came across showed that maca has some great benefits.  Differences have been shown between the effects of the black, yellow and red maca varieties, as black maca shows the best results on spermatogenesis, memory and fatigue, while red maca is the variety that reverses benign prostatic hyperplasia and experimentally induced osteoporosis (5). In addition, maca reduces the glucose levels, and its consumption is related to the lowering of blood pressure and an improved health score (5). For those who are concerned about whether taking maca is safe on a long term basis, studies have demonstrated that short and long term consumption don’t show in vivo and in vitro toxicity.

Experimental scientific evidence showed that maca has nutritional, energizer, and fertility-enhancer properties, and it acts on sexual dysfunctions, osteoporosis, benign prostatic hyperplasia, memory and learning, and protects skin against ultraviolet radiation (6). A few different trials have shown that maca can help to reduce the symptoms of depression (7) (8), and can also improve diastolic blood pressure (8).  One study showed that maca can even affect the cytokines, as consumption of maca was associated with low serum IL-6 levels (9).

How Does Maca Work?

Initially it was thought that Maca root worked via phytoestrogens, but it looks like the mechanism of action is through numerous alkaloids, and not its plant hormones (10).  However, other components also can play a role such as sterols (campesterol, stigmasterol and beta-sitosterol), as well as polyunsaturated acids and their amides, called “macaenes” and “macamides”, as well as aromatic glucosinolates (10).  Although the exact mechanism of how maca root works still isn’t known, maca apparently affects the hypothalamus and pituitary gland (11).  And of course the hypothalamus and pituitary gland affect the output of the adrenal hormones, thyroid hormones, as well as hormones secreted by the ovaries and testes.

Can Maca Benefit People With Thyroid and Autoimmune Thyroid Conditions?

As I already mentioned in this post, maca seems to affect the hypothalamus and pituitary gland.  These of course both play a role in thyroid health, as the hypothalamus releases thyrotropin-releasing hormone (TRH), which in turn stimulates the pituitary gland to release TSH, which stimulates the thyroid gland to release thyroid hormone.  In this matter it is possible that taking maca root can affect thyroid health, and perhaps even help to increase the output of thyroid hormone in some people with hypothyroid conditions.  However, maca doesn’t seem to directly affect the thyroid gland, and so if someone with hyperthyroidism or Graves’ Disease were to take maca it shouldn’t increase the output of thyroid hormone.  With that being said, every now then I’ll receive an email from someone with hyperthyroidism who took an adaptogenic herb such as maca or eleuthero and claimed it increased the hyperthyroid symptoms.  Although this isn’t something my patients commonly experience when taking adaptogenic herbs, if this does happen to you then obviously I would discontinue taking the herb.

Maca does have a very small amount of iodine, and so those who are trying to completely avoid iodine might want to avoid taking maca.  With that being said, taking a few grams of maca doesn’t seem to cause problems in most people with autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  But of course everyone is different, and so if you take maca and feel as if it’s worsening your condition then obviously I would advise you to stop taking it.  As I briefly mentioned earlier, maca is part of the brassica family, which also includes broccoli, kale, cauliflower, etc.  Many people with hypothyroid conditions avoid these foods due to their goitrogenic properties, although taking maca is unlikely to inhibit thyroid hormone production in most people.

Many people with thyroid and autoimmune thyroid conditions have problems with the adrenals and sex hormones (i.e. estrogen, progesterone, testosterone).  And since maca affects the hypothalamus and pituitary glands, it not only can affect thyroid health, but since the pituitary gland also secretes hormones such as FSH, LH, and ACTH, maca can also potentially affect the output of these hormones as well.

As for what dosage of maca to take, this will vary from person to person.  Most of the studies have used anywhere from 2 grams to 10 grams per day of maca.  If you decide to take maca it probably would be best to start with a smaller dose and then gradually increase it if necessary.  This is especially true if you’re taking maca to help with hot flashes, as if the dose is too high then it might actually increase the number of hot flashes in some women.  Plus, while some notice an improvement in their symptoms in as little as three or four days, in some people it can take a week or longer before noticing a positive change.

In summary, the use of maca root is growing in popularity, as some of its benefits include helping to improve sexual function and fertility, reducing glucose levels, lowering blood pressure, reducing hot flashes, and in decreasing depression.  Maca apparently affects the hypothalamus and pituitary gland, and thus can not only potentially affect thyroid health, but can also affect the output of adrenal hormones, as well as estrogen, progesterone, and testosterone.  Most people who take maca should begin with a small dosage and gradually increase it if necessary.