The parathyroid glands are located on the back side of the thyroid glands, and are responsible for producing parathyroid hormone. This hormone plays an important role in the regulation of calcium, phosphorus, and vitamin D. When calcium levels are low, the body responds by increasing the secretion of parathyroid hormone, which in turn increases the calcium levels in the blood. Hyperparathyroidism involves the excess production of parathyroid hormone, which in turn is due to overactivity of one or more of the parathyroid glands. From time to time I’ll have someone ask me “Is there is a natural treatment solution for hyperparathyroidism?”

In order to answer this, it’s important to look at the reasons why someone might develop hyperparathyroidism. There are two types of hyperparathyroidism.

Primary Hyperparathyroidism. This is the most common cause of hypercalcemia (1). The diagnosis of primary hyperparathyroidism is confirmed in the presence of hypercalcemia and either normal or elevated parathyroid hormone levels (1). The most common cause of this is due to an adenoma, which is a benign tumor. On rare occasions a malignant tumor is responsible for this condition. Hyperplasia (enlargement) of the parathyroid glands can be another cause of primary hyperparathyroidism.

Secondary Hyperparathyroidism. This is usually the result of another condition which lowers the calcium or vitamin D levels. Frequently it is associated with chronic kidney disease. The kidneys help with the conversion of vitamin D to its biologically active form, which is known as calcitriol (1,25-dihydroxycholecalciferol). If someone has kidney disease, then both the vitamin D and calcium levels can drop, and because of this the parathyroid glands will try to compensate for the decrease in the levels. In addition, when the glomerular filtration rate (GFR) falls, the phosphorus clearance decreases significantly, leading to hyperphosphatemia, and this is thought to be the principal cause of secondary hyperparathyroidism (2).

How Is Hyperparathyroidism Diagnosed?

Symptoms can be caused by damage to the organs from high calcium levels in the blood, or by loss of calcium from the bones, and can include bone pain, depression, feeling tired or weak, increased urine production, kidney stones, nausea and loss of appetite (3). However, in many cases hyperparathyroidism is diagnosed before any symptoms develop, and one of the main findings is a high serum calcium level on the blood test. This doesn’t mean that everyone who has a high serum calcium level has hyperparathyroidism, but when someone does have elevated calcium levels then it usually is a good idea to do a retest of the serum calcium, and in addition, to test the levels of parathyroid hormone, which are frequently increased as well in hyperparathyroidism.

What Is The Conventional Medical Treatment For Hyperparathyroidism?

Surgery is commonly recommended for those with primary hyperparathyroidism, and is advised in the presence of significant hypercalcemia, impaired renal function, osteoporosis, and in individuals younger than 50 years of age (1). However, if the calcium levels aren’t too high, renal function isn’t impaired, the bone density is normal, and the person isn’t experiencing any symptoms, then the medical doctor might take a more conservative approach. Medical management of mild disease includes using bisphosphonates, hormone replacement therapy, and calcimimetics (4). In some cases they won’t intervene and might just regularly monitor the serum calcium levels and bone density, and of course have you monitor your symptoms.

When surgery is indicated, the success rate is high, although rare complications include recurrent laryngeal nerve paralysis and hypoparathyroidism (5). At times it can be challenging to find the adenoma, and when this is the case then cervical exploratory surgery might be required (6). While in the past subtotal and total parathyroidectomies were common, these days more and more people with hyperparathyroidism undergo minimally invasive parathyroidectomy (MIP), which increases the chance of the person avoiding permanent hypoparathyroidism (7).

With secondary hyperparathyroidism, if the cause is due to a vitamin D deficiency then having the person supplement with vitamin D usually will be the recommended treatment. If the person has chronic kidney disease then this of course needs to be addressed. Just as is the case with primary hyperparathyroidism, phosphate binders and calcimimetics might be used in some cases. A parathyroidectomy is also a possibility in severe cases of secondary hyperparathyroidism (8).

Can Natural Treatment Methods Help with Hyperparathyroidism?

As for whether natural treatment methods can help with hyperparathyroidism, it depends on the cause. In cases of primary hyperparathyroidism, following a natural treatment protocol probably isn’t going to help much. However, keep in mind that this isn’t my area of expertise, as my practice focuses on thyroid and autoimmune thyroid conditions, and not parathyroid issues. If someone has hyperparathyroidism which is caused by an adenoma, and they want to give natural treatment methods a try, then they might want to look into methods such as the Gerson Therapy, which can help with many different health conditions, and can be especially successful when dealing with adenomas and carcinomas.

If someone has secondary hyperparathyroidism then this stands a greater chance of being helped by following a natural treatment protocol. However, if someone has hyperparathyroidism due to chronic kidney failure then certain precautious need to be taken, such as eating a low protein diet. Whether or not you have primary or secondary hyperparathyroidism, if you’re interested in trying to treat it naturally then in my opinion it’s best to work with a natural healthcare professional.

In summary, hyperparathyroidism involves the excess production of parathyroid hormone, and there are two different types. Primary hyperparathyroidism is frequently caused by an adenoma, although in some cases it can be caused by a malignant tumor or hyperplasia. Secondary hyperparathyroidism can be caused by a vitamin D deficiency, and is frequently caused by chronic kidney disease. There is a greater chance of people with secondary hyperparathyroidism being helped by following a natural treatment protocol, although it still might be worth looking into natural treatment methods for those who have primary hyperparathyroidism. This is especially true for those who are asymptomatic and/or only have slightly elevated serum calcium levels.

One of the most frequent questions I get asked is “how can I find a natural endocrinologist?”  Some people who ask this question are actually trying to find out how to find a natural healthcare professional who focuses on endocrine conditions.  However, others are hopeful that they can find an endocrinologist who will treat their patients naturally.

The truth is that it is rare to find an actual endocrinologist who focuses on natural treatment methods.  This doesn’t mean it’s impossible, but I wouldn’t count on finding a local endocrinologist who has a great deal of knowledge about eating well, nutritional supplements and herbs, eliminating toxins, etc.  Unless if you get lucky and happen to have a natural-minded endocrinologist in your area, usually the best case scenario is finding an endocrinologist who is open to you working with a DIFFERENT healthcare professional who focuses on endocrine conditions.

I’ve consulted with numerous patients whose endocrinologist wasn’t supportive of natural treatment methods.  I’ve even had a few patients who told me their endocrinologist threatened to dismiss them from care if they continued to follow a natural treatment protocol.  So while it is rare to find an endocrinologist who recommends natural treatment methods, it also is a challenge to find such a doctor who is even open to the idea of one of their patients trying to get to the root cause of the condition.  Of course this comes down to their training in medical school, as they don’t receive any training with regards to nutrition, supplements and herbs, detoxification, etc.

Here’s An Alternative Option To Consider

Although you’re unlikely to find a local endocrinologist who recommends natural treatment methods to their patients, if you prefer to work with a medical doctor then you might be able to find a holistic medical doctor who has a good amount of experience dealing with endocrine conditions.  Most holistic medical doctors work with different types of conditions, but many see a good amount of people with thyroid and autoimmune thyroid conditions.  An example of this is Dr. David Brownstein.  I’ve mentioned him numerous times on my website, and actually interviewed him in the past in a blog post entitled ” An Interview With Dr. David Brownstein On Iodine and Thyroid Health“.

To my knowledge Dr. Brownstein doesn’t exclusively work with endocrine conditions.  But he sees a good amount of people with thyroid and autoimmune thyroid conditions, and has even written a book on the topic.  I’m not suggesting that you consult with Dr. Brownstein, although if you live in Michigan then perhaps this is an option.  There of course are other medical doctors in practice who take a more natural approach with their patients, and perhaps even one practices nearby where you live or work.

Holistic Medical Doctor vs. Other Types of Natural HealthCare Professionals

The main advantage of seeing a holistic medical doctor is their ability to prescribe medication.  So for the person who has hyperthyroidism and needs to take antithyroid medication, then the holistic medical doctor will be able to write a prescription for this.  Similarly, someone with hypothyroidism or Hashimoto’s Thyroiditis who needs to take thyroid hormone can also receive a prescription if working with a holistic medical doctor.  While just about all endocrinologists will recommend synthetic thyroid hormone (i.e. levothyroxine) to their patients with hypothyroid conditions, many holistic medical doctors are open to writing a prescription for natural thyroid hormone (i.e. Armour or Nature-Throid).

Other than the ability to write prescriptions there really isn’t any advantage of seeing a holistic medical doctor when compared to a different type of natural healthcare professional (keep in mind that in some states naturopathic doctors can write prescriptions for certain medications as well).  I’m sure many people feel more comfortable seeing a medical doctor due to their extensive training.  Just remember that this extensive training doesn’t involve anything that has to do with actually healing the body.  And most holistic medical doctors will admit to this, as they have received their training outside of medical school.  I commend those medical doctors who have taken the initiative to do more than just manage the symptoms of their patients.

If you do decide to see a holistic medical doctor, just make sure you look at his or her credentials AFTER they graduated from medical school.  In other words, what additional training did they receive once they became a medical doctor?  Did they just attend a couple of nutritional seminars, or did they dedicate hundreds of hours to better improve their knowledge?  Perhaps they have some additional credentials to prove this.  For example, the Institute of Functional Medicine has a certification program that many medical doctors have gone through.  I’m not sure if I would choose a medical doctor based on them having this certification alone, but if they have achieved this certification and in addition to this they have gone through additional training, then perhaps this is someone to consider working with.

In the future I plan on writing another post where I will discuss the different types of natural healthcare professionals.  This will include naturopaths, chiropractors, holistic medical doctors, acupuncturists, and other natural-oriented professionals.  The truth is that many of these natural healthcare professionals can help people with endocrine conditions.

In summary, while it is possible to find an endocrinologist who focuses on natural treatment methods, in most cases it will be very difficult to find one in your area.  But if you have your mind set on working with a medical doctor then you might have success finding a holistic medical doctor who isn’t an endocrinologist, yet has experience dealing with thyroid and autoimmune thyroid conditions.  If you’re looking to choose a medical doctor mainly because they can prescribe medication (i.e. synthetic or natural thyroid hormone), remember that some states allow naturopathic doctors to prescribe medication as well.  While there are some excellent holistic medical doctors out there, just keep in mind that many other natural healthcare professionals have a good amount of experience with endocrine conditions.

I would like to wish everyone a Happy Thanksgiving!  I hope you have enjoyed my articles and blog posts this past year, and there will be more to come in 2014!

The mitochondria have a number of important functions in a cell, and the most well known function involves the production of Adenosine triphosphate, which is also known as ATP.  In fact, most of the ATP is generated inside of the mitochondria.  ATP is created from the breakdown of carbohydrates and fats, and involves a process known as oxidative phosphorylation.  The goal of this post isn’t to discuss in detail the function of the mitochondria, but instead is to demonstrate how important they are to one’s thyroid health, and overall health as well.

But why is ATP important?  In addition to its well established role in cellular metabolism, extracellular ATP and its breakdown product adenosine exert pronounced effects in a variety of biological processes including neurotransmission, muscle contraction, cardiac function, platelet function, vasodilatation and liver glycogen metabolism (1).  ATP also plays an important role in DNA and RNA synthesis (2).

Certain coenzymes are important for the formation of ATP.  In order for these coenzymes to work efficiently, they require an adequate supply of certain nutrients.  This is one of the many reasons why eating well is extremely important to one’s overall health.

Although the mitochondria are essential for life, they constitute the greatest source of reactive oxidants.  They also contain heavy metal ions such as iron and copper, and all of this favors the formation of free radicals.  Free radicals are molecules with unpaired electrons, and in this state they are very reactive and can cause damage to our cells.  Fortunately the body produces antioxidants to help prevent free radical damage, and of course many people get antioxidants in the food they eat and/or the supplements they take.

The primary cause of cell death is a depletion of cellular ATP.  Mitochondrial function does deteriorate as one gets older.  It was proposed that the maximal life-span is mainly an expression of the genetic control over the rate of oxygen utilization, and that the rate of mitochondrial damage produced by free radical reactions increases with increasing oxygen consumption, which ultimately causes cell death (3).  So while oxygen is of course necessary to survive, aerobic metabolism is what leads to the formation of these free radicals.

Other Factors Which Lead To Mitochondrial Damage

As I mentioned earlier, free radicals are produced by the mitochondria.  So essentially the free radicals produced by the mitochondria are responsible for their own damage.  How does this happen?  Well, during oxidative phosphorylation, normally all of the oxygen consumed is converted in mitochondria to something called the superoxide radical.  Superoxide is then transformed to hydrogen peroxide by certain enzymes.  When these enzymes are unable to convert the superoxide radical to hydrogen peroxide, this causes oxidative damage.  Mitochondrial damage in turn can lead to the development of inflammatory mediators, such as tumor necrosis factor alpha.

One also needs to keep in mind that certain nutrients are important for the mitochondria to function normally.  As a result, if someone eats a lot of refined foods and sugars, thus resulting in a deficiency of those nutrients important for mitochondrial function, then this can result in mitochondrial decay (4).

Certain toxins can also cause mitochondrial damage.  For example, one study showed that thimerosal-derived ethylmercury (which is used as a preservative in certain vaccines, skin test antigens, and tattoo inks), inhibits mitochondrial respiration and leads to an increase in the formation of superoxide (5).  The study found a five-fold increase in the levels of oxidant damaged mitochondrial DNA after Thimerosal treatment.

There is also evidence that certain pathogens can cause damage to the mitochondria.  For example, one study showed that Clostridium difficile can cause damage to the mitochondria (6).  However, this was conducted on hamsters, and it is unknown if the same effect takes place with humans.  There is also evidence that an H. Pylori infection can cause mitochondrial damage (7)

The Importance of Thyroid Hormone For The Health of The Mitochondria

It has been known for a long time that thyroid hormones act directly on mitochondria, and thereby control the transformation of the energy derived from oxidations into a form utilizable by the cell (8).  Those with hypothyroid conditions consume oxygen more slowly because the mitochondria respire slowly.  On the other hand, those with hyperthyroid conditions consume oxygen faster because the mitochondria consume oxygen faster.

One study I came across discussed how hyperthyroidism is associated with tissue oxidative injury (9).  In other words, hyperthyroidism can lead to an increase in mitochondrial damage.  However, the same study discussed how thyroid hormone can activate mitochondrial mechanisms which provide protection against tissue dysfunction.  So while having an excess amount of thyroid hormone isn’t a good thing for the health of the mitochondria, having healthy levels of thyroid hormone can help to protect the mitochondria from damage.

Another study I came across looked at the effect of thyroid hormone on the mitochondria (10).  The article discussed how thyroid hormone status has a profound impact on mitochondria, and that thyroid hormones stimulate mitochondriogenesis and increase cellular oxidative capacity.  So what this is saying is that thyroid hormone is important for the formation of mitochondria, and also increases the cells capacity to utilize oxygen.

How To Improve The Health Of The Mitochondria

I recently attended the International Conference on Human Nutrition and Functional Medicine, and they dedicated an entire day discussing how to improve the health of the mitochondria.  One of the presenters was Dr. Matthew Hirschey, and he spoke about how caloric restriction can help to improve the health of the mitochondria, which in turn can increase lifespan.  This has not yet been proven in humans, although it has been proven with many different species of animals.  So while one wants to eat well, it also is important not to overeat, which of course many people have a tendency to do.

During the presentation Dr. Hirschey spoke about how Okinawa, Japan has the world’s longest life expectancy, and a low rate of chronic health conditions which are related to the aging process.  Although genetics can play a role in this, Dr. Hirschey also mentioned how they tend to eat until they are 80% full, whereas it’s common for people who live in other countries (including the United States) to eat until they are close to 100% full.  This of course is common when going out to eat, as many people will start off with a high carbohydrate appetizer, have a big meal, and even though they are stuffed will “make room” for dessert.

Regular exercise is also important for optimal heath of the mitochondria.  It seems that an age-associated decline in mitochondrial function contributes to insulin resistance in the elderly (11), and studies have shown that there is a robust improvement in skeletal muscle mitochondrial content and function in response to an achievable program of moderate intensity physical activity (12). Another journal article discussed how the cardioprotective effects of exercise might be mediated, at least partially, by redox changes and include the up-regulation of mitochondrial chaperones, improved antioxidant capacity, and/or elevation of other protective molecules against cellular death (13).  More research needs to be done in this area, but the evidence is strong that engaging in moderate exercise on a regular basis improves the health of the mitochondria.

Certain nutritional supplements can also help to improve the health of the mitochondria.  Some of these include Acetyl-L-carnitine, CoQ10, resveratrol, lipoic acid, and omega 3 fatty acids.  This doesn’t mean that everyone should take all of these.  While I recommend for just about everyone to take an omega 3 fatty acid supplement, not everyone needs to take these other supplements I listed.  However, I do think it’s worth reading a blog post I wrote entitled “CoQ10 and Thyroid Health“, as many people with thyroid and autoimmune thyroid conditions have depleted CoQ10 levels.   There is also evidence that improving the vitamin D status of those with a vitamin D deficiency can help to improve mitochondrial oxidative function (14).

To summarize these findings, thyroid hormone is important for the health of the mitochondria.  As a result, someone with a hypothyroid condition will have problems with the production of ATP.  Remember that ATP is important for energy production, and so a decreased production of ATP can lead to a decrease in energy, which is quite common with hypothyroid conditions.  But as I mentioned earlier in this post, ATP is also important for proper neurotransmission, muscle contraction, cardiac function, platelet function, vasodilatation and liver glycogen metabolism.  And so having a hypothyroid condition can affect all of these functions. On the other hand, a hyperthyroid condition can lead to an increase in mitochondrial damage.  Some of the factors which can help to improve the health of the mitochondria include caloric restriction, regular exercise, and taking certain nutrients such as magnesium, fish oils, the B vitamins, vitamin C, lipoic acid, and CoQ10.  Obviously taking supplements isn’t a substitute for eating well, as eating a diet consisting of mostly whole foods while avoiding the refined foods and sugars is essential for optimal mitochondrial health.

Most people who consult with me for the first time are aware of the importance of eating a healthy diet.  Many of these people have already made some wonderful changes, as it’s not uncommon for me to consult with someone who is gluten free, dairy free, avoids refined foods and sugars, etc.  Of course there are also people who know they need to eat well, but haven’t yet made the necessary changes.

While people should strive to eat healthy most of the time, if someone begins a natural treatment protocol it is extremely important to be strict.  Every now and then in my articles and blog posts I discuss how I’ll indulge every now and then, as I’ll have a slice of pizza or dessert, or eat something else that I normally wouldn’t eat.  However, when I was diagnosed with Graves’ Disease and followed a natural treatment protocol I was very strict.  I began following a natural treatment protocol during the fall, which means that I eventually had to deal with the holiday season.  I also had a birthday during this time, and it admittedly was tough not having any birthday cake!

For those people following a natural treatment protocol in an attempt to restore their health back to normal, it is important to avoid the temptations that the holiday season might bring.  While many of the patients I work with do a great job of eating well, some people fall off the wagon as soon as Thanksgiving arrives, and many don’t get back on track until after the New Year.  I’ve had patients who were doing a wonderful job of following their diet for numerous months until the holiday season arrived.

Why Is It So Difficult For Many People To Eat Healthy During The Holiday Season?

One of the big problems with holidays such as Thanksgiving and Christmas is that many families and friends get together for meals.  This makes it extremely difficult to avoid the temptations, unless if perhaps you’re the host of these gatherings.  But even in this case this can be a challenge, as chances are most of your guests won’t be expecting a gluten free , low-carbohydrate meal, along with healthier dessert choices (i.e. fresh fruit).  Some people will prepare unhealthy foods for their friends and family members but will avoid eating them.  But for some people, it is very difficult to resist these foods.  If I had the temptation of pecan pie when I followed a natural treatment protocol I’m not sure if I would have been able to resist having a small piece!

Speaking of which, last year around Thanksgiving I had a couple of patients ask if it was okay to have a slice of gluten-free pecan pie.  If someone has just started a natural treatment protocol then it’s probably best for them to avoid these types of desserts, even if they are gluten free.  On the other hand, if someone can’t resist the pecan pie, then of course I’d prefer them to eat a gluten-free version.  But overall it’s best to stick with eating whole foods when someone is restoring one’s health back to normal.

But what about those people who have already restored their health back to normal?  Well, if someone has already restored their health back to normal and then eats a few bad meals or desserts during the holiday season this usually won’t cause a problem.  So for example, if someone eats some unhealthy food on Thanksgiving day, and then again at a holiday party, and one more time for a Christmas or Chanukah dinner, in most cases this won’t cause any long-lasting problems.  On the other hand, the person who eats junk food just about every day from Thanksgiving to New Years Day is more likely to encounter problems, and might even suffer a relapse.

What Can You Do To Avoid The Temptations?

When it comes to avoiding the temptations which come along with the holiday season, it really comes down to one’s mindset.  For example, I grew up eating mostly junk food, and even though I was eating much healthier before being diagnosed with Graves’ Disease, I was far from perfect.  But as I mentioned before, once I was diagnosed with Graves’ Disease I was pretty strict.  And the main reason for this was a change in my mindset, as I just told myself that I was going to do everything I could to restore my health back to normal, and this included avoiding junk food until I had restored my health.

For other people it might be a greater challenge to make these changes.  For example, if someone works at a corporate job where they constantly have junk food available for the holidays and/or have holiday parties, then this can admittedly be challenging.  Similarly, if you do dinner at the house of a family member or friend who prepares a dinner consisting of plenty of carbohydrates (i.e. mashed potatoes, pasta, pastries and other foods you should avoid), this also can be a challenge when you’re constantly around these foods.  Of course you can simply plan to stay home for the holidays, which I realize might mean breaking a tradition, but when it comes to your health it is worth it.

With the corporate job example it could be a greater challenge, as I don’t know of anyone who quit their job due to the constant exposure of unhealthy food during work.  However, in this case you just need to make the decision that you will avoid all of the temptations and do whatever is necessary to restore your health back to normal.  And if you need a little bit of motivation I’ll tell you a personal story that some people reading this have already heard.

When I was a student in chiropractic college I went on my first liver detoxification program under the guidance of another healthcare professional (my nutrition instructor from chiropractic school).  I forgot exactly how long the detoxification was for, but it was at least one month in duration, and I had to avoid all processed foods, and initially had to avoid eating meet.  So I was able to eat fruits, vegetables, nuts, and seeds, and I think a small amount of grains, although I can’t remember for sure.  This was pure torture for someone who was used to eating plenty of processed foods on a daily basis.  In any case, I attended chiropractic college right outside of Atlanta Georgia, and during the detoxification I wanted to attend a seminar which took place in Orlando Florida.  I went with a friend, whose parents lived in Daytona Florida.  And so on our way to Orlando we stopped by his parent’s house and spent the night there.

We arrived right around dinner time, and I remember his father saying  “Let’s go out for pizza”.  Just like many other people, I loved pizza (and still do).  And if there was one big weakness of mine, it was pizza!  To make a long story short, I went to the pizza place with my friend and his family, and I ate a plain salad (no dressing, no croutons, no parmesan cheese, no chicken) while everyone else was eating pizza.  I realize for many people this isn’t a big deal, but at that time it was extremely difficult for me to avoid this temptation.  The reason I brought up this story was to provide some motivation, as if I was able to avoid pizza that night, there is no question that anyone reading this can avoid the temptations of the holiday season (yes, even pecan pie!).

In summary, without question it can be a challenge to avoid eating junk food during the holiday season.  For those people following a natural treatment protocol, it is very important to try to eat well during this time.  But it also is important for those people trying to maintain their health.  In order to avoid these temptations, the best thing you can do is to change your mindset and make the decision that you are going to eat healthy, and under no circumstances will cheat.  And you also want to try your best to avoid those situations where you will be surrounded by these unhealthy foods.