It’s not uncommon for people experiencing symptoms indicative of a thyroid condition to have negative serum blood tests.  This includes the TSH, thyroid hormone levels (i.e. Free T3 and Free T4), thyroid antibodies, reverse T3, etc.  When someone mentions this to me then I’ll recommend for them to do other types of testing, such as testing the adrenals through the saliva, looking at secretory IgA to help evaluate the health of the immune system and gut, they can look at the hormones estrogen and progesterone, etc.  But what should one do when all of these tests are also negative?

The truth is that rarely is someone who has a thyroid or autoimmune thyroid condition negative with ALL of the different tests.  One problem is that these other tests can be costly, and most people can’t test for everything.  And quite frankly, there are dozens of different tests to choose from.  Here are some of the “alternative” tests available:

Adrenal testing through the saliva

Hormone testing (progesterone, estrogen, testosterone, etc.)

Hair mineral analysis

Parasitology profile

Pathogens profile

IgG Food Intolerance testing

Tests for toxins (BPA, PCBs, VOCs, heavy metals, chlorinated pesticides, etc.)

Iodine testing

Organic Acids

Amino Acids

Fatty Acids

Micronutrient testing

Neurotransmitters

Oxidative stress profile

Genetic Polymorphisms

Bacterial Overgrowth of Small Intestines

Intestinal Permeability

There are other tests besides the ones I listed, but the two points I want to make is that 1) most people won’t be able to afford to test for everything I listed here, and 2) it isn’t necessary to test for everything I listed.  If someone did obtain all of the testing I listed above, there is an excellent chance that we would find some values which were out of range.  This isn’t only true of people with thyroid and autoimmune thyroid conditions, but other people as well.  Fortunately, a lot of good information can be obtained by doing a thorough case history and asking the appropriate questions during the initial consultation, which will greatly help in determining which tests are a priority.

How Do You Know Which Tests To Order?

When recommending tests to patients, I typically choose those that are most likely to give me the information I need to find the underlying cause of the condition.  So while all of the tests I listed above can be valuable, some are more important than others.  For example, it’s common for people to have compromised adrenal glands, and this can definitely be a factor in one’s thyroid or autoimmune thyroid condition.  This is one of the reasons I test the adrenals in most people.  The gut also is compromised in a lot of people, and the saliva panel I recommend also tests for secretory IgA, which can give an indication if someone has gut problems, although this doesn’t just relate to the gut.  If the results are inconclusive then I very well might recommend doing a specific test for intestinal permeability.  But if I suspect someone has a leaky gut then another option is for the patient to save the money on additional testing, and just put them on a leaky gut protocol while continuing to monitor their symptoms and the results of the blood and saliva tests.

There are certain tests I would like to do on everyone if they were accurate, but unfortunately this isn’t the case with all of the tests I listed above.  An example of this is food intolerance testing.  Some natural healthcare professionals require all of their patients to obtain a food intolerance panel.  Some examples include the ELISA IgG4 panel and the ALCATZ.  Both of these can provide some valuable information, but they also are notorious for false negatives.  Believe me when I tell you that if food intolerance testing was completely accurate I would recommend this type of testing to everyone so that they would know which foods they should avoid.  The problem is these tests are very expensive, and there is a good chance that there will be some false results, which means the person who gets this test will avoid some of those foods they react to, but not all of them.

Plus, if someone has a leaky gut then these tests can become even more unreliable.  According to Dr. Natasha Campbell-McBride, who is the creator of the GAPS diet, “Testing for food allergies is notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are ‘allergic’ to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies.”

What Should Be Done When Some Of The More Important Tests Come Out Negative?

Let’s get back to the main question.  If someone has gone through all of the necessary testing, and everything comes back negative, then what should they do?  Here are a few things I recommend:

1. Make sure all of the necessary testing has been done. When someone tells me they have done all of the necessary tests, sometimes this is true, but other times it isn’t.  So you do want to make sure to at least do some of the more important testing.  Of course one of the challenges is knowing which tests are truly necessary.  To be honest, sometimes even the healthcare professional doesn’t know for certain, as they will initially recommend those tests they feel are necessary, but they might end up recommending other tests at a later date.

2. Make sure the tests have been interpreted correctly. Most of the time this doesn’t seem to be a problem, but every now and then I’ll consult with a patient who worked with a different healthcare professional who didn’t do a good job of interpreting the tests they recommended.  For example, I’ve had some patients who obtained the Adrenal Stress Index test from a different doctor, and their cortisol levels and DHEA were within normal limits, while their secretory IgA was well out of range.  But some doctors aren’t concerned about this as long as the other values for the adrenals look fine.  Similarly, some will do hormone testing and will only look at the LEVELS of estrogen and progesterone, but won’t pay attention to the RATIO of estrogen and progesterone, which is important.  Not too long ago I had a patient whose medical doctor ordered an iron panel, and both the serum iron and % saturation were out of range, and the ferritin was 11 ng/mL, which is extremely low, but was within normal limits according to the lab reference range.  But the medical doctor didn’t tell her anything was wrong, and so the patient assumed that she was fine in this area.

3. Keep in mind of the functional reference ranges for different tests. I just gave an example of the iron panel where ferritin was within the reference range (10 to 150 ng/mL according to that specific lab), but was on the low side at 11 ng/mL.  Ferritin has to do with iron storage, and a low ferritin is the first sign of an iron deficiency.  And so once it dips below 40 to 45 ng/mL there is a cause for concern, even if it is within the lab reference range.  The same thing can be said for 25-OH Vitamin D, as most labs have a reference range of 30 to 100 ng/mL.  But for optimal immune system health you want the levels to be at least 50 ng/mL, and 60 or 70 would be even better.  I’ve given a couple of examples regarding serum tests, but the same concept applies for other tests as well.  For example, if someone does a saliva test to look at the cortisol levels, the cortisol could be within normal limits, but on the low side, which might indicate problems with the adrenals.

4. Re-evaluate and do other tests if necessary. Sometimes it is necessary to do additional testing.  For example, I don’t initially conduct a comprehensive pathogens profile on my patients.  But if someone has gotten to the point where their adrenals and gut appear to be healthy and strong, and if they are still experiencing certain symptoms (i.e. fatigue, bloating/gas, etc.), then I might recommend doing a comprehensive test for pathogens.  Can’t I just include this test initially?  Sure I can, but in addition to this test being expensive, I don’t find this test to be necessary to do initially in most of my patients.  Of course if I do suspect problems with pathogens after going through the initial consultation then I very well might recommend such testing.  Many times if I suspect a pathogen problem I will just put the person on some natural antimicrobials (i.e. garlic, berberine, oregano oil, turmeric, etc.), and then if this doesn’t work a pathogens profile might be necessary to obtain

5. Focus on eliminating toxins. There are numerous tests for toxins available.  For example, one can do testing for heavy metals through the hair or urine.  The company Metametrix has a Toxic Effects Core Profile, which includes about one dozen of the common toxins.  Although I think it’s great that such comprehensive testing for toxins is available, the test is very expensive, and of course doesn’t test for every type of toxin we’re exposed to, but only the most common ones.  I think it’s safe to assume that just about everyone is toxic, and as a result I usually recommend for my patients to do things to help detoxify the liver.  And there are times when people might need to utilize other methods of detoxification such as infrared sauna therapy and/or colon hydrotherapy.  If someone has reached the point where all of the serum and alternative tests look good but they are still symptomatic, I will usually have them focus on eliminating toxins for a few months.  In some cases it can take awhile to greatly reduce one’s toxic load, but hopefully they will at least begin noticing an improvement in their symptoms after a few months.

So if you are experiencing numerous symptoms, yet all of the different tests you obtained were negative, then hopefully the information in this post will be of value.  There obviously is a reason behind someone’s symptoms, and so if everything comes out negative then in most cases it does come down to doing more detective work.  I realize this can be frustrating, and when this happens most medical doctors will simply tell the patient they need to live with the symptoms.  But if this describes your situation then please don’t give up hope, as you need to remember that there always is an underlying cause that is responsible for one’s symptoms.  In some people it can be challenging to find out the cause, but I can assure you that something in the body is out of balance which is responsible for the symptoms.

There are numerous “controversies” when it comes to thyroid health.  And so the goal of this post is to discuss some of the more common controversies.  Although I have my personal biases, and will give you my opinion with regards to each of these “controversies”, my goal isn’t to persuade you to choose one side or the other, but instead is to provide you with some information so you can make an informed decision, or perhaps do some further research on your own.

Controversy #1: Iodine.  This might be the biggest controversy in the world of thyroid health.  Many healthcare professionals will recommend for people with hypothyroid and hyperthyroid conditions to supplement with iodine.  On the other hand, some will advise people with thyroid conditions to stay away from iodine…especially those who have autoimmune thyroid conditions.  I’ve written about iodine numerous times in the past, and I definitely would check out some of my previous articles and posts.

The Case For Iodine Supplementation: Iodine is necessary for the formation of thyroid hormone.  And so if someone has a hypothyroid condition and is deficient in iodine, then it would make sense to correct this deficiency so that the thyroid gland will be able to produce a sufficient amount of thyroid hormone.  But how about those people with hyperthyroidism and Graves’ Disease?  Well, even though this condition involves an excessive production of thyroid hormone, the cause of this is usually an overactive immune system attacking the TSH receptors.  And so in most cases it’s not caused by having too much iodine.  Plus, many years ago iodine in the form of Lugol’s solution was used by medical doctors to treat many cases of hyperthyroidism and Graves’ Disease.

In addition, many people with hyperthyroid conditions have benefited from iodine supplementation.  Besides some of the positive experiences my patients have received when supplementing with iodine, many other people have reported an improvement in their health upon taking iodine supplements.  And while one can make the argument that some of these people were taking numerous other supplements at the same time, many people don’t notice a positive change in their health until they introduce iodine.  In other words, I’ve worked with numerous patients who were taking certain supplements, but once they started taking iodine they began experiencing a big improvement in their health.

For those who question the safety of iodine supplementation, there is no question that a small percentage of people don’t do well when taking iodine.  However, the same can be said with other supplements and herbs as well.  But in most cases, those who have an iodine deficiency and take iodine with the proper precautions experience great benefits.

The Case Against Iodine Supplementation: Although iodine has helped many people with thyroid and autoimmune thyroid conditions, there have been cases when taking iodine has worsened a person’s condition.  There have even been reports of people who didn’t have a thyroid condition until they began taking iodine supplements.  In addition, there is a possibility that iodine can trigger an autoimmune response, thus causing an autoimmune thyroid condition.  While it’s great that many people have taken iodine and have benefited tremendously, what about those people who took iodine and had a negative reaction?

My Opinion About Iodine Supplementation: Those who have been reading my articles and blog posts for awhile know that I’m pro-iodine.  But I also realize that there can be risks with taking iodine, and that iodine isn’t for everyone.  With that being said, most people who react to iodine do so because 1) they take large doses of iodine without getting tested for a deficiency, 2) they don’t take the proper precautions, such as also supplementing with antioxidants such as selenium and vitamin C, as well as magnesium to help with the absorption.   I would encourage you to do some research on your own, and at the same time check out the following two articles I’ve written about iodine:

Can Taking Iodine Cause An Autoimmune Thyroid Condition?

Is Iodine Safe To Take In People With Hyperthyroidism?

Controversy #2: Gluten.  Many people with thyroid and autoimmune thyroid conditions can benefit from avoiding gluten.  Truth to be told, many people without thyroid problems can also benefit from avoiding gluten.  But when should someone avoid gluten?

The Case For Avoiding Gluten: If someone has a gluten sensitivity this can cause numerous problems if the person continues to eat foods which have gluten.  One of the main problems is that gluten can affect the permeability of the small intestine, thus leading to the condition known as leaky gut syndrome.  And while testing for a gluten sensitivity might sound like a good idea, most of the available testing isn’t completely reliable.  And the more accurate testing, such as Cyrex Labs Wheat/Gluten Proteome Reactivity & Autoimmunity test, is quite expensive.  For those who don’t mind spending $300+ on such testing that’s fine.  But it’s definitely less expensive to go on a gluten-free trial.  And quite frankly, most people should be eating whole, healthy foods, which are naturally gluten free.  Many people who are gluten free eat too much processed food, such as gluten free cereal, gluten free cookies, gluten free bread and pasta, gluten free pizza, etc.  I’m not suggesting that having these foods every now and then will cause problems, but many people eat these foods on a daily basis.

The Case Against Avoiding Gluten: When I first began working with people who have thyroid and autoimmune thyroid conditions, I wasn’t as strict when it came to having people avoid gluten.  And many people still received good results.  And so while some people do need to avoid gluten in order to restore their health back to normal, others might not need to completely avoid gluten in order to receive great results.

My Opinion About Avoiding Gluten: Although it’s true that some people who follow a natural treatment protocol who continue to consume foods with gluten will still be able to restore their health back to normal, the question that you need to ask yourself is whether or not consuming gluten on a regular basis is necessary.  Just because you don’t react to something doesn’t mean it should be part of one’s regular diet.  Keep in mind that this is coming from someone who is not completely gluten free, as while I eat mostly whole foods and minimize my consumption of gluten, every now and then I will eat foods which aren’t gluten free.  So I’m not suggesting that everyone needs to permanently avoid gluten, as I think for many people it’s fine to indulge every now and then.  But I do think those following a natural treatment protocol should make a serious attempt to avoid gluten, and even after restoring one’s health back to normal it’s a good idea to minimize your consumption of gluten-based foods.  And of course some people will need to avoid gluten on a permanent basis.

Controversy #3: Goitrogens.  I work with a lot of people who have hypothyroid conditions, and most of these people have Hashimoto’s Thyroiditis.  And many of these people do everything they can to avoid goitrogenic foods, such as broccoli, kale, cauliflower, spinach, strawberries, etc.  In the past I encouraged people with hypothyroidism to avoid goitrogenic foods, as a few years ago I wrote an article entitled “Goitrogens: Thyroid Inhibiting Foods You Should Avoid“.  So should people with hypothyroid conditions avoiding eating these foods?

The Case For Goitrogenic Foods: Many of the goitrogenic foods are very healthy.  Foods such as broccoli, kale, cauliflower, Brussels sprouts, spinach, strawberries, peaches, and other foods have plenty of nutrients which can benefit our health.  And when it comes to the research which talks about the thyroid-inhibiting effects of certain foods, these were performed on rats and mice, but perhaps more important than this is they involved large quantities of these foods.  I’ve never consulted with anyone with hypothyroidism who had their condition develop by eating too much broccoli or kale.  Remember that most people with hypothyroidism have Hashimoto’s Thyroiditis, which is an autoimmune condition that involves destruction of the thyroid gland.  One can argue that eating goitrogenic foods will only worsen one’s hypothyroid condition, but I haven’t found this to be true.  An exception to this might be if someone has an iodine deficiency, but even when this is the case it is controversial as to whether consuming small amounts of goitrogenic foods will inhibit thyroid activity.  For those who remain concerned, keep in mind that cooking these foods will reduce their goitrogenic activity.

The Case Against Eating Goitrogenic Foods: Even if there is only a small chance of goitrogenic foods inhibiting thyroid function, why take the chance and eat these foods?  After all, there are other foods people with hypothyroid conditions can eat, so why not play it safe and avoid those foods which can potentially cause problems with thyroid function…especially if someone already has a hypothyroid condition?

My Opinion About Eating Goitrogenic Foods: Although I don’t encourage people with hypothyroid conditions to eat large amounts of goitrogenic foods, I do think that in most cases, eating a small amount of goitrogenic foods is fine.  I discussed this in further detail in an article I recently wrote entitled “An Update on Goitrogenic Foods and Their Impact On Thyroid Health“.

Controversy #4: Soy.  I realize that soy is also a goitrogenic food, but there is so much controversy over soy and thyroid health that I figured it deserves special attention.

The Case For Eating Soy: There is some evidence that soy can help to prevent certain types of cancer. And eating some organic fermented soy might have other health benefits as well.  For example, there is evidence in animal studies that soy can prevent osteoporosis, although this is inconclusive.

The Case Against Eating Soy: First of all, most soy in the United States is genetically modified.  And so if you are going to eat soy, please make sure it’s GMO-free.  While there might be some health benefits of consuming some organic, fermented soy, this is controversial.  Soy is a goitrogen, and so it can potentially can inhibit thyroid activity, although someone probably will need to eat a large amount of soy for this to happen.  Soy also has antinutrients, such as lectin and protease inhibitors.  And so eating soy can make digestion difficult, and potentially interfere with the absorption of certain nutrients, such as iron.  While there is some evidence that the phytoestrogens of soy has certain health benefits, there is also evidence that it can cause problems, such as infertility.

My Opinion About Eating Soy: Without question, I am opposed to people eating non-organic soy, since most of the soy is genetically modified.  However, I’m also not in favor of people eating large amounts of soy, even if it is organic and fermented.  As for eating small amounts of fermented, organic soy, I think doing this on an occasional basis is fine for most people.  I personally try to avoid soy-based foods, although I do occasionally eat some foods which have organic, fermented soy, and I don’t think having very small amounts of soy will lead to major health problems in most people.  For example, if someone takes a nutritional supplement with organic, fermented soy I think that in most cases this will be fine.  On the other hand, I would be cautious about eating soy-based foods on a regular basis, even if the soy is organic and fermented.

Controversy #5: Fluoride. Although many people (including myself) avoid fluoride, from time to time I’ll have a patient ask whether they should use toothpaste with fluoride, or if it’s okay to drink water that has fluoride.

The Case For Using Fluoride: This honestly will be tough to defend, as I really do feel strongly about intentionally using products which have fluoride.  But I’ll give it a shot.  First of all, millions of people use toothpaste with fluoride and drink fluoridated water, yet many of these people don’t have a thyroid problem.  Plus, even though fluoride can affect thyroid health, it’s probably safe to conclude that most people with hypothyroid conditions didn’t develop this condition due to fluoride exposure.  In addition, thousands of dentists recommend fluoride in order to prevent the formation of cavities.

The Case Against Using Fluoride: There is strong evidence that fluoride can have a negative effect on thyroid health.  In fact, in the past, fluoride was used as a treatment for hyperthyroid conditions by numerous medical doctors.  Even if it really does help to prevent the formation of cavities, one always needs to consider the risks and benefits.  In my opinion we don’t need to use fluoride-based toothpaste and have fluoride in the water to have healthy teeth, and many other healthcare professionals would agree with me.

My Opinion About Using Fluoride: My wife and I have used a fluoride-free toothpaste for many years, and so have our two daughters.  And so I do recommend not using fluoride-based toothpastes, and recommend drinking water without fluoride.  This might mean drinking reverse osmosis or distilled water, or perhaps buying a separate fluoride filter.

In summary, there are numerous controversies in thyroid health, but these are five of the biggest ones.  Although I revealed my personal opinions for each of these, other natural healthcare professionals will argue with my viewpoints.  Many will tell all of their patients with thyroid and autoimmune thyroid conditions to avoid iodine, while others will tell all of their patients to never eat gluten, not to consume any goitrogenic foods, etc.  Some also won’t agree with my perspective involving fluoride, and of course many dentists and numerous other healthcare professionals feel that some fluoride use is beneficial.  The frustrating part is that if you do research on PubMed, or another source, there will be no clear cut answers.  Clinical studies are definitely lacking in these areas, and so ultimately it is up to you to do your own research and decide what is best for your health.

There is a lot of controversy when it comes to iodine supplementation in thyroid and autoimmune thyroid conditions.  When it comes to hyperthyroidism and Graves’ Disease, most endocrinologists will advise their patients to avoid iodine.  On the other hand, while some natural healthcare professionals also recommend for their patients to avoid iodine, others advise their patients with hyperthyroidism to take iodine.  What I’d like to do is use this post to answer some of the most common questions people have about iodine supplementation in those with hyperthyroidism.

Question: Since Iodine Is Involved In the Production Of Thyroid Hormone, And Hyperthyroidism Involves An Excess Of Thyroid Hormone, Isn’t It Wise For People With Hyperthyroidism To Avoid Iodine?

Answer: Although it’s true that iodine is necessary for the formation of thyroid hormone, this doesn’t mean that everyone with hyperthyroidism should avoid iodine.  First of all, remember that most people with hyperthyroidism have Graves’ Disease.  And although this condition involves an excessive production of thyroid hormone, the reason for this is due to the autoimmune component.  It’s the TSH receptor antibodies which stimulate or attack the TSH receptors, which in turn results in the overproduction of thyroid hormone.  Giving someone iodine doesn’t mean the thyroid gland will produce even more thyroid hormone.  In fact, in the past, medical doctors actually recommended Lugol’s solution as a treatment for hyperthyroidism and Graves’ Disease.

Question: Can Taking Iodine Worsen One’s Hyperthyroid Condition?

Answer: It is possible, although in most cases iodine supplementation doesn’t cause problems in people with hyperthyroidism.  However, if someone doesn’t take the proper precautions then there is a chance that iodine can exacerbate the autoimmune response in people with Graves’ Disease.  I discussed this more in the article I wrote entitled “Can Taking Iodine Cause An Autoimmune Thyroid Condition?”  During the formation of thyroid hormone an oxidation reaction takes place, and this is why antioxidants such as selenium and vitamin C are necessary to take.  Plus, there does seem to be some people who just don’t do well when taking iodine.  But just as is the case with everything else, it comes down to the risks and benefits.  And if the proper precautions are taken then the benefits of iodine supplementation usually outweigh the risks.

Question: Can Taking Iodine Cause A Hyperthyroid Condition?

Answer: As I mentioned before, iodine can potentially exacerbate the autoimmune response if the proper precautions aren’t taken, and this in turn can worsen one’s condition.  And it can also trigger an autoimmune response for those people who don’t have an autoimmune thyroid condition, thus potentially leading to the development of Graves’ Disease.  In fact, I’ve spoken with a few people who think their condition might have been triggered by iodine supplementation, although I think it’s safe to say that most cases of Graves’ Disease aren’t caused by supplementing with iodine.  And with regards to iodine directly causing hyperthyroidism, in most cases someone would have to take very large doses of iodine for this to happen.

With that being said, some euthyroid people do experience hyperthyroid symptoms upon supplementing with iodine, and sometimes this happens when low doses are taken.  Plus, there have been a couple of publications which showed that kelp might have caused iodine-induced hyperthyroidism (1) (2).  One of these reports involved a 39-year-old woman who already had multinodular goiter and drank kelp-containing tea, and developed hyperthyroid symptoms.  The other situation involved a 72-year-old female who developed hyperthyroidism while consuming kelp supplements.  However, in most cases when you read about iodine-induced hyperthyroidism in the literature, this is usually the result of taking organic forms of iodine-containing drugs (3).

Question: Should Everyone With Hyperthyroidism Take Iodine?

Answer: Those who have read past articles and posts that I’ve written on iodine know that I’m pro-iodine.  However, this doesn’t mean that I recommend for everyone with hyperthyroidism and Graves’ Disease to take iodine.  In fact, before I recommend iodine to my patients I think it’s a good idea to test for an iodine deficiency.  And then if someone is deficient in iodine I recommend for them to start taking small doses of iodine, and to make sure they take antioxidants such as selenium and/or vitamin C, along with magnesium, and the B vitamins.

Question: What Form Of Iodine Do You Recommend?

Answer: Many healthcare professionals recommend Iodoral.  I like Iodoral, but the smallest dose you can take is 12.5mg.  I commonly recommend Prolamine Iodine to my patients, which comes in doses of 3mg.  This is still well above the RDI, but approximately 1/4 of the dosage of iodoral.  Lugol’s solution is another option.  Lugol’s solution is a mixture of 5% iodine and 10% potassium iodide in water, and two drops of a 5% solution is equivalent to 12.5mg to iodine, and so this is why Iodoral was formulated to include 12.5mg per tablet.  It was actually designed to help prevent gastric irritation and to eliminate the unpleasant taste associated with iodine.  However, some people claim to get better results when taking Lugol’s solution.    There are other variations of iodine as well.

Question: Can I Supplement With Kelp?

Answer: Even though I mentioned a few negative studies involving kelp, many people do fine when taking a kelp supplement.  However, the downside of kelp is that 1) it can be more challenging to dose, and 2) heavy metals such as mercury and arsenic can be a factor.  You can minimize your exposure to toxins by purchasing a higher quality, organic kelp supplement, although this doesn’t guarantee that the supplement will be free from toxins.  The advantage of kelp is that it’s a natural food, and includes other trace minerals.

Question: If It’s Determined That Iodine Supplementation Is Beneficial, How Much Should I Take?

Answer: This does depend on the person.  If someone has a mild deficiency, then they will require less iodine when compared to someone who has a moderate to severe iodine deficiency.  I usually will start someone with 3mg of iodine, and then slowly increase the dosage.  But for some people even 3mg is too much.  And how much iodine someone will build up to depends on how deficient the person is.  When I was diagnosed with Graves’ Disease I began with 3mg of iodine and took as much as 24mg of iodine per day.

Hopefully this provides you with some valuable information about iodine supplementation.  But I still didn’t answer the main question in the headline, “Is iodine safe to take for people with hyperthyroidism?”  If someone has a deficiency in iodine and takes the proper precautions (which includes working with a competent natural healthcare professional) then in most cases taking iodine is safe.  There are still some people who will react to iodine even if they are deficient and take the proper precautions.  But in my experience it is rare for people to have a negative reaction to iodine supplementation, although due to the controversy involving iodine you will be sure to hear any “negative cases” with regards to iodine, and the truth is that while some people don’t do well when taking an iodine supplement, some people have negative reactions to other supplements as well.

Millions of people get the flu shot every year, and most of these people don’t look at both the benefits and the risks before receiving it.  Many people receive the flu shot due to the advice of their medical doctor, while others might be encouraged to receive it due a friend, family member, or another source.  But is getting the flu shot a wise decision for people with thyroid and autoimmune thyroid conditions?

I have personally never received the flu shot, even before I was diagnosed with Graves’ Disease.  But does this mean that I recommend for everyone not to receive the flu shot?  Well, I realize that in certain age groups people are more at risk of getting the flu.  One problem I have is that the flu vaccine won’t always prevent someone from getting the flu, and it might not even reduce the person’s chances of contracting the influenza virus.  There is a lot of controversy over the flu shot, and in most cases I just don’t see the benefits outweighing the risks.

I’m sure there are some people reading this who have received the flu shot for many years, and haven’t gotten the flu virus.  However, I’ve known a number of people who received the flu shot but still got the flu.  In fact, some people have gotten sick with the flu shortly after getting the flu vaccine, and so there is the possibility that getting the flu shot can sometimes increase the risk of someone getting sick with the flu.

Some Basic Information About The Flu Vaccine

Most people know that the flu is a contagious condition which affects the respiratory system.  It is caused by the influenza virus.  While many cases of the flu are mild, severe cases can result in hospitalization, and in some cases even death.  According to the Center for Disease Control and Prevention, young children, elderly people, and people with certain health conditions should receive the flu vaccine (1).

There are two types of flu vaccines.  Most people get the flu shot, which contains inactive viruses.  There is also a nasal spray, which contains weakened flu viruses.  The spray is approved for healthy people aged 2 through 49 who are not pregnant (2). It should not be used in those who have asthma or children under age 5 who have repeated wheezing episodes (2).

There are numerous chemicals present in the flu vaccine.  The ingredients include thimerosal, aluminum salts, formaldehyde, and residual antibiotics (3).  There are flu vaccines available which do not contain thimerosal, but I’d still be concerned about the aluminum salts, formaldehyde, and antibiotics.

Those People With Graves’ Disease and Hashimoto’s Thyroiditis Need To Be Cautious

There are no studies I’m aware of which show that the chemicals used in the flu vaccine can directly affect thyroid health.  While it might be a good thing that there aren’t any studies which show that getting the flu vaccine has a negative effect on thyroid health, there also aren’t studies which confirm that the flu shot is safe when it comes to thyroid health.  But what is known is the impact that the flu shot has on the immune system.

The goal of receiving the flu vaccine is to get the body to produce antibodies against certain strains of the influenza virus.  The problem is that there can also be other strains you’re not protected against.  But the more important point is that the effect the flu shot has on the immune system isn’t natural, and it can have a potentially detrimental effect on the immune system in people with autoimmune thyroid conditions.  Plus the chemicals included in the vaccine can also be harmful.  I’m not suggesting that getting the flu shot can trigger an autoimmune response.  But I wouldn’t be surprised if it had the potential to do this in some people.

However, one can also take the opposite perspective.  In other words, one can make the argument that people with Hashimoto’s Thyroiditis and Graves’ Disease have compromised immune systems, making them more susceptible to contracting the flu virus, and as a result they might benefit from getting the flu shot when compared to the general public.  I don’t know of any evidence which shows that having an autoimmune condition of any kind makes someone more likely to get the flu, and I’d still be cautious about getting the flu shot for those with autoimmune thyroid conditions.

So What Should You Do?

Obviously the decision as to whether or not to get the flu shot is ultimately yours to make.  Even though I choose not to receive the flu shot, some people might decide that getting the shot is the right choice for them.  I personally prefer for people to improve the health of their immune system naturally, as eating well, managing one’s stress, and making sure one gets sufficient sleep each night can have a huge impact on the immune system.  In addition, having vitamin and/or mineral deficiencies (i.e. vitamin D, selenium, zinc) can weaken the immune system, and thus it’s important to get these and other nutrient deficiencies corrected.

In summary, although there is no evidence that getting the flu vaccine can have a negative effect on thyroid health, it without question does affect the immune system.  Plus, the chemicals included in the vaccine can also be harmful.  As a result, those people with Graves’ Disease and Hashimoto’s Thyroiditis needs to be cautious about receiving the flu shot.

I’ve briefly spoken about the benefits of resveratrol in other articles and blog posts.  However, I figured it was time to create a blog post which focuses on this natural polyphenolic compound found in the skin of red grapes (1).  There have been many clinical trials involving resveratrol, and what I’m going to do in this post is discuss some of the benefits associated with resveratrol, and include some of these studies.

Conditions Resveratrol Can Help With:

Cardiovascular Disease. It has been known for awhile that resveratrol can potentially play a protective role against cardiovascular disease (CVD).  The cardiovascular protective capacities of resveratrol are associated with multiple molecular targets and may lead to the development of novel therapeutic strategies for atherosclerosis, ischemia/reperfusion, metabolic syndrome, and heart failure (2). Obviously eating a healthy diet and exercising on a regular basis are both very important in preventing CVD, but taking resveratrol might also help in this area as well.

Obesity. Resveratrol can help some people with obesity.  In 2003, resveratrol was discovered to be a small molecule activator of sirtuin 1 (SIRT1), an important molecular target regulating cellular energy metabolism and mitochondrial homeostasis (3).  Resveratrol can decrease adipogenesis and viability in maturing preadipocytes (4).  Additionally, resveratrol increased lipolysis and reduced lipogenesis in mature adipocytes (4).

I recently wrote an article entitled “The Role of Leptin In Thyroid Health“, which discussed how leptin is connected with obesity.  In this article I discussed how the inflammatory component of an autoimmune condition such as Graves’ Disease or Hashimoto’s Thyroiditis can cause leptin resistance, which in turn leads to obesity.  And as I discussed in the article, taking certain supplements, including resveratrol, can help with the inflammation, and this in turn can play an important role in helping people with obesity.

Cancer. Resveratrol exhibits anticancer properties, as suggested by its ability to suppress the proliferation of a wide variety of tumor cells, including lymphoid and myeloid cancers; multiple myeloma; cancers of the breast, prostate, stomach, colon, pancreas, and thyroid; melanoma; head and neck squamous cell carcinoma; ovarian carcinoma; and cervical carcinoma (5).  Focusing on thyroid cancer, resveratrol may arrest cell growth in both papillary and follicular thyroid cancer by activation of the mitogen-activated protein kinase (MAPK) signal transduction pathway as well as increase of p53 and its phosphorylation (6). Resveratrol also influences thyroid function by enhancing iodide trapping and, by increasing TSH secretion via activation of sirtuins and the phosphatidylinositol- 4-phosphate 5 kinase γ (PIP5Kγ) pathway, positively affects metabolism (6).  This isn’t to suggest that I’d feel comfortable using resveratrol to treat cancer, but it might help to prevent certain types of cancers, including thyroid cancer.  Obviously more studies need to be conducted in this area, but the evidence seems promising.

Alzheimer’s Disease. Resveratrol also modulates the pathomechanisms of debilitating neurological disorders, such as strokes, ischemia, and Huntington’s disease (7).  Alzheimer’s disease is another neurodegenerative disorder, and there is evidence that resveratrol can help with this condition.  Deposition of amyloid-β and tau hyperphosphorylation are cardinal pathologic features of Alzheimer’s disease that lead to the formation of neuronal plaques and neurofibrillary tangles, respectively (8).  In animal models of Alzheimer’s disease, resveratrol promotes the non-amyloidogenic cleavage of the amyloid precursor protein, enhances clearance of amyloid beta-peptides, and reduces neuronal damage (9).

Resveratrol can also be beneficial for the health of the liver, as it can help with nonalcoholic fatty liver disease (10) (11), and might be protective against hepatocellular carcinoma (12).  Resveratrol can also act as a natural aromatase inhibitor (13).  There is also evidence that resveratrol has antiviral and antimicrobial activity (14) (15).  It also might benefit people with fungal infections (16), although it doesn’t seem to be beneficial against Candida albicans (17) (18).  There are numerous other benefits as well with resveratrol.

How Can Resveratrol Help People With Autoimmune Thyroid Conditions?

Chronic activation of something called nuclear factor-kappaB (NF-kappaB) plays a role in the pathogenesis of different types of autoimmune conditions.  This includes Graves’ Disease and Hashimoto’s Thyroiditis.  I frequently talk about how the goal should be to suppress the autoimmune response of the condition, and one of the keys of doing this is by inhibiting NF-kappaB.  In order to accomplish this it is important to find out what’s triggering the autoimmune response, and then remove this trigger.  Restoring the health of compromised areas of the body can also play an important role in suppressing the autoimmune response.

However, certain supplements can also help with the inhibition of NF-kappaB.  And resveratrol is one of those supplements which can help with this (19) (20) (21).  Although taking resveratrol alone can be beneficial, combining it with turmeric can be an even more powerful combination.  In the article I wrote entitled “Turmeric and Thyroid Health” I discussed how this herb can help with autoimmune conditions.

Although this blog post discussed the benefits of resveratrol, I’m not suggesting that everyone who has Graves’ Disease or Hashimoto’s Thyroiditis should take it.  When it comes to the inhibition of NF-kappaB, one could always begin by taking some good quality omega-3 fatty acids, along with gamma-linolenic acid (i.e. borage oil, black currant seed oil).  If someone has a vitamin D deficiency then this definitely needs to be addressed.  Then if necessary, other nutrients and herbs can be taken to help with the inflammatory process, including resveratrol and/or turmeric.

In summary, resveratrol can help with many different conditions, including cardiovascular disease, obesity, cancer, Alzheimer’s Disease, and numerous other conditions.  Resveratrol can also help with the inflammatory process associated with conditions such as Graves’ Disease and Hashimoto’s Thyroiditis by inhibiting NF-kappaB.  Although not everyone with an autoimmune thyroid condition needs to supplement with resveratrol, in some cases it can greatly benefit people with these conditions.

Graves’ ophthalmopathy, also known as thyroid eye disease, is common in people with Graves’ Disease, and involves the thyroid antibodies attacking the tissues of the eyes.  Graves’ ophthalmopathy is clinically relevant in approximately 50% of patients with Graves’ disease, with severe forms affecting 3%-5% of patients (1).  In fact, many people consult with me not due to the high pulse rate, palpitations, or the other symptoms associated with Graves’ Disease, but instead are primarily concerned with their eye symptoms.  And most people want to know if there are any supplements or herbs they can take to help with this condition.

Before I discuss some natural approaches to help with thyroid eye disease, I’d first like to talk about the conventional medical treatment approach to this condition.  Although radioactive iodine is commonly recommended to people with Graves’ Disease, RAI can worsen ophthalmopathy, especially if it is administered to those patients who smoke, have a severe case of hyperthyroidism, or those with high levels of TSH-receptor-binding inhibitory immunoglobulins (2). If the condition is severe then steroids might be given, such as prednisone, but sometimes a wait-and-see policy is recommended in mild Graves’ ophthalmopathy, and the reason for this is because the condition can resolve spontaneously (2).

So if someone with Graves’ ophthalmopathy is looking to take the conventional medical approach, they are essentially looking at 1) taking steroids, or 2) playing the waiting game.  Although I’m not opposed to people taking steroids, there are natural options which might help with the inflammation.  And while they might not be as potent as the prescription drugs, they of course don’t come with the side effects.

Address The Inflammation and the Autoimmune Component

If someone has Graves’ ophthalmopathy and is looking to follow a natural treatment protocol, the treatment approach won’t be much different when compared to the one given to someone who has Graves’ Disease without thyroid eye disease.  In other words, there aren’t any or herbs which are specific for Graves’ ophthalmopathy.  Supplements and herbs which are specific for the eyes such as eyebright and lutein usually won’t help with this condition.

On the other hand, taking supplements and herbs which can decrease inflammation may help.  The effectiveness depends on the severity of the condition.  Pro-inflammatory cytokines are associated with autoimmune conditions such as Graves’ Disease, and studies show that the cytokines of the IL-1 family and Tumor Necrosis Factor (TNF) play a big role when it comes to Graves’ ophthalmopathy (3).  So the goal should be to give supplements which have shown to inhibit these proinflammatory cytokines.  Here are some supplements which may help to at least ease some of the symptoms associated with Graves’ ophthalmopathy while the cause of the condition is being addressed:

EPA and DHA.  Numerous studies show that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can inhibit TNF-alpha and IL-1 (4) (5) (6).  These are found in fish oil and krill oil.  For those who are a vegetarian, some studies have shown that flaxseed oil can also inhibit these pro-inflammatory cytokines (7) (8).  The problem is that many people have problems converting alpha-linolenic acid into DHA and EPA, which are responsible for forming the prostaglandins which help with inflammation.

Gamma-Linolenic Acid (GLA).  GLA is a type of omega-6 fatty acid.  Although you want to be cautious about consuming too many omega-6 fatty acids, studies also show that consumption of GLA rich oils such as Borage oil, Black Currant Seed oil, or Evening Primrose oil can have beneficial effects on inflammatory disorders and can reduce the production of pro-inflammatory cytokines (9) (10) (11).

Turmeric.  Turmeric is rich in curcuminoids, and numerous studies have shown that curcumin has anti-inflammatory properties and can inhibit proinflammatory cytokines(12) (13) (14) (15).  Turmeric is a wonderful herb, and I’ve written a separate article entitled Turmeric and Thyroid Health.

Resveratrol.  Resveratrol is a polyphenolic phytoalexin found in grapes, fruits, and root extracts of the weed Polygonum cuspidatum,  and it exhibits anti-inflammatory, cell growth-modulatory, and anticarcinogenic effects (16).  Numerous studies have shown that resveratrol has an inhibitory effect on pro-inflammatory cytokines (17) (18).  So resveratrol is yet another powerful supplement with anti-inflammatory properties.

Vitamin D.  Vitamin D3 also has anti-inflammatory properties (19) (20).  And many people are deficient in vitamin D.  I recommend for all of my patients to test their vitamin D levels, and if they are deficient I recommend for them to supplement with vitamin D3, along with increasing their sun exposure.  So if someone has thyroid eye disease then they without question want to make sure they are not deficient in vitamin D.

I’m not suggesting that those with Graves’ ophthalmopathy need to take all of these supplements I mentioned.  At the very least you want to take some type of omega-3 fatty acid, and it’s a good idea to take a form of GLA.  If you’re vitamin D deficient then it probably is a good idea to take vitamin D3 to increase the levels.  Taking fish oils, a good form of GLA, and making sure you have healthy vitamin D levels will help a great deal with the inflammatory process.  Also, keep in mind that there are other supplements and herbs which have anti-inflammatory effects other than the ones I mentioned, but these are some of the more effective ones.

So if you have Graves’ ophthalmopathy, hopefully you understand that the key to overcoming this condition is to address the autoimmune component of Graves’ Disease.  Supplements and herbs which might help include fish oils, GLA, vitamin D3, turmeric, and resveratrol.  However, keep in mind that the overall goal should be to find out what’s triggering the autoimmune response, and then to remove this trigger while restoring the health of compromised areas of the body.

Most people reading this know that iodine is important for the formation of thyroid hormone.  There is a good amount of evidence that an iodine deficiency during pregnancy can lead to health issues with the developing fetus.  And so to reduce the chances of health issues developing in the fetus, it probably would make sense for all pregnant women to take a prenatal vitamin with iodine during pregnancy, or perhaps a separate iodine supplement in some cases.  But many women with Hashimoto’s Thyroiditis are told to completely avoid iodine.  And so what approach should pregnant women with Hashimoto’s Thyroiditis take?

While some healthcare professionals will recommend for everyone with an autoimmune thyroid condition to avoid iodine, I don’t necessarily share this viewpoint.  However, even though I feel that s0me people with thyroid and autoimmune thyroid conditions can benefit from iodine supplementation, I am very cautious when it comes to recommending iodine to people with Hashimoto’s Thyroiditis.  In some cases iodine can trigger an autoimmune response, and may worsen the condition of someone with Hashimoto’s Thyroiditis.  On the other hand, some people with Hashimoto’s Thyroiditis have benefited from supplementing with iodine.

Understanding The Importance Of Iodine To The Developing Fetus

Beginning in early gestation, maternal thyroid hormone production normally increases by 50%, and this requires an adequate iodine supply that is obtained primarily from the diet and/or as supplemental iodine (1).  In addition, fetal thyroid hormone production increases during the second half of pregnancy, which further contributes to the increased requirements of maternal iodine due to the fact that iodide readily crosses the placenta (2).  Because of increased thyroid hormone production, increased renal iodine losses, and fetal iodine requirements in pregnancy, dietary iodine requirements are higher in pregnant adults than in nonpregnant adults (2).

Iodine deficiency isn’t something to take lightly, and numerous studies demonstrate the importance of iodine sufficiency during pregnancy.  One study provides evidence that even mild iodine deficiency during pregnancy can have long-term adverse impacts on fetal neurocognition that are not ameliorated by iodine sufficiency during childhood (3).  In other words, any damage in fetal brain function due to an iodine deficiency supposedly isn’t reversible by correcting this deficiency during childhood.  Another study looked to assess whether a mild iodine deficiency during early pregnancy was associated with an adverse effect on child cognitive development (4).  The results of the study showed the importance of adequate iodine status during early gestation and emphasize the risk that low iodine levels can pose to the developing infant, even if the iodine deficiency is mild.

Why Do Many People With Hashimoto’s Thyroiditis Avoid Iodine?

The big concern with iodine consumption in autoimmune thyroid conditions is that it might exacerbate the autoimmune response.  I actually wrote about this in a post entitled “Can Taking Iodine Cause An Autoimmune Thyroid Condition?”  In the article I discussed how there is evidence that consuming iodine can increase the TPO antibodies.  However, I also mentioned how adequate selenium is important for the oxidation of iodide to iodine, and if someone has a selenium deficiency then this can cause oxidative damage.  As a result, taking selenium is important when supplementing with iodine.  Does this mean that people who take iodine and selenium won’t have any problems?  Not necessarily.  First of all, other vitamins and minerals are also important to supplement with, such as magnesium.  It’s also a good idea to supplement with vitamin C and the B vitamins.  But some people who do this still don’t do well when consuming iodine.

Plus, another factor to consider with Hashimoto’s Thyroiditis is that the increase in thyroid antibodies itself can pose a risk to the fetus…especially in the first trimester of pregnancy.  So if taking iodine happens to worsen the autoimmune response, then this might cause further harm to the baby.  On the other hand, sometimes the pregnancy itself will suppress the autoimmune component.  And if this is the case then this will greatly reduce the chances of iodine causing any problems. This once again is assuming the proper precautions are taken.

Should Pregnant Women With Hashimoto’s Thyroiditis Avoid Iodine?

This is an obvious dilemma for pregnant women who have Hashimoto’s Thyroiditis.  Should they avoid supplementation with any iodine and avoid all foods with iodine, and hope that the baby will be fine?  Or should they “take the chance” and take a prenatal vitamin with iodine, and hope that this doesn’t trigger an autoimmune response?  Of course another option is to have pregnant women test to see if they have sufficient levels of iodine.  This can be a catch-22, as myself and many other natural healthcare professionals recommend a 24-hour iodine loading test through the urine, which involves taking a 50 mg tablet of Iodoral before performing the test.

I’m in favor of a prenatal vitamin with iodine for women with Hashimoto’s Thyroiditis.  After all, in most cases we’re talking about 150 to 200 mcg of iodine, which is a fairly small dose.  Plus, taking iodine in the presence of these other nutrients will usually minimize any negative effects of the iodine.  While there are people who seem to have problems tolerating even small doses of iodine, remember that we’re talking about risks vs. benefits here, and in those women with Hashimoto’s Thyroiditis, it is my opinion that the risk of completing avoiding iodine during pregnancy is in most cases greater than the risks of having a small amount of iodine in the form of a prenatal vitamin.

Are there cases when a pregnant woman with Hashimoto’s Thyroiditis should consider taking a separate iodine supplement?  This of course is even more controversial.  The problem is that there aren’t any clinical trials which involves pregnant women taking higher doses of iodine.  And by higher doses I don’t necessarily mean 25 to 50 mg per day, but even 6 to 12 mg/day of iodine, which is well above the RDI.  However, I did come across a case study where three newborns developed congenital hypothyroidism, and it seems that excess maternal iodine ingestion was the cause (5).  All three newborns had to go on levothyroxine, although 2 of the newborns were able to discontinue levothyroxine a few weeks after the excess maternal iodine ingestion was discovered.  And so in two of these newborns the hypothyroidism was transient, although one of the babies remained on levothyroxine at 30 months of age.

With that being said, I have worked with some pregnant women with autoimmune thyroid conditions who were taking higher doses of iodine on their own, and in none of these cases was there harm done to the baby.  To be fair, I’ve only had a few pregnant women take higher doses of iodine (all took it on their own), and so I’m not suggesting that taking higher doses of iodine during pregnancy is safe.  I personally don’t recommend for pregnant women to take very high doses of iodine, regardless of whether or not they have Hashimoto’s Thyroiditis.

In summary, there is a lot of evidence which demonstrates the importance of iodine sufficiency during pregnancy.  However, since many people with Hashimoto’s Thyroiditis try everything to avoid iodine then this brings up a dilemma.  Although I’m not suggesting that women with Hashimoto’s Thyroiditis should supplement with high doses of iodine, in most cases, taking a prenatal vitamin with iodine won’t exacerbate the autoimmune response, and at the same time will provide the developing fetus with a small amount of iodine that is necessary for proper cognitive development.

Many people with thyroid and autoimmune thyroid conditions attempt to go on a gluten-free diet.  And while completing avoiding gluten can be a challenge for someone who is accustomed to eating foods which contain gluten, these days it is much easier to get foods which are gluten free.  Just about every health food store has gluten-free items, as does many conventional supermarkets.  And some restaurants serve gluten-free food.  However, many people who think they are completely avoiding gluten are in fact getting some exposure to it in one way or another.  And in some people, even a small amount of gluten can cause problems.  So the goal of this blog post is to reveal some of the “hidden” sources of gluten.

But before I mention these sources, I want to briefly talk about why even a small amount of gluten can cause problems.  If you’ve been following me for awhile, then you know that I’m not an extremist when it comes to gluten.  In other words, I don’t believe that everyone with a thyroid or autoimmune thyroid condition needs to avoid gluten on a permanent basis.  However, I do think it’s a good idea for people with these conditions to go on a gluten-free trial.  One can always test to see if they have a gluten sensitivity problem, although most testing out there is inaccurate, and the more accurate testing is very expensive.

What Happens If Someone Consumes Gluten When They’re Sensitive To It?

So what happens if someone who is has a gluten sensitivity problem consumes gluten?  Well, they might experience symptoms such as bloating, gas, fatigue, brain fog, etc.  On the other hand, some people who are sensitive to gluten don’t experience any overt symptoms.  This is true even with some people who have Celiac Disease.  But even if they aren’t experiencing symptoms, if someone who has a gluten sensitivity consumes gluten, this can cause damage to the intestinal lining, and potentially result in problems with intestinal permeability (1), also known as a leaky gut.  But eating gluten when one has a sensitivity can cause other problems, such as peripheral neuropathy (2).  Consuming gluten may also cause something called “gluten ataxia” (3).

I’m not trying to scare anyone into giving up gluten.  I’d be a hypocrite if I tried to do this, as I wasn’t 100% gluten free when I followed a natural treatment protocol after initially being diagnosed with Graves’ Disease, although since I ate mostly whole foods for the most part I did avoid gluten.  At the time I wasn’t fully aware of the potential risks of consuming gluten, and when working with someone who is trying to restore their back to health, I want to try to do everything to help them achieve optimal health.  And since I don’t know who might be sensitive to gluten and who might not be, I currently recommend for those following a natural treatment protocol to at least go on a gluten free trial.  So I’m not telling everyone to avoid gluten on a permanent basis, although some people will of course need to do this.

I commonly have patients tell me they’re “almost” gluten free.  So they might be “80%” gluten free, or perhaps “95%” gluten free.  I commend those who try to avoid gluten, as I realize it’s not an easy process.  The problem is that if someone is sensitive to gluten, even a small amount of gluten might cause problems, and potentially can prevent them from receiving optimal results.  And while some people are intentionally consuming a small amount of gluten, others are trying everything they can do to avoid it, but are being exposed to it on a daily basis.  Many of these people will be fine, but some people might not receive optimal results when consuming even a small amount of gluten, which is why I want to discuss three “hidden” sources of gluten.

1. Packaged gluten-free foods.  There are hundreds of different gluten-free foods.  There are gluten-free cookies, gluten-free cereals, and many other gluten-free items.  Of course just because something is gluten-free doesn’t mean that it’s healthy.  For example, I came across some information which revealed that Fruity and Cocoa Pebbles are now gluten free (4).  But even though they are gluten-free, they still have artificial ingredients.  There are “healthier” gluten-free cereals which don’t have any artificial ingredients, and the same can be said for many other processed gluten-free foods.

But even if you purchase a processed food which is gluten-free, it still might have traces of gluten in it.  According to the U.S. Food and Drug Administration, one of the criteria proposed is that foods bearing the claim “gluten free” cannot contain 20 parts per million (ppm) or more gluten (5).  I once attended a seminar where the presenter spoke about people with a gluten sensitivity problem reacting if the food contained less than 5 ppm.  I wasn’t able to find any studies showing this, but if someone is trying to avoid gluten it’s important to realize that many packaged foods which are labeled as being “gluten free” might still have trace amounts of gluten, and in some cases this can cause problems.  The obvious solution to this is to ditch the processed foods, even the “healthier” ones, and stick with whole foods.

2. A gluten-free meal in a restaurant. If you eat out on a regular basis, chances are you’re not completely avoiding gluten.  Even if you visit a restaurant which has a gluten-free menu, cross contamination is a strong possibility.  Does this mean that someone who is trying to avoid gluten can’t eat out at all?  Just like many other people, I enjoy eating out.  But if someone is trying to restore their health and is sensitive to gluten, then it is a good idea to not eat out at all.  This of course not only includes going out to a restaurant, but also to the house of a friend or family member for dinner, unless if you know for sure there won’t be any cross contamination, which most of the time isn’t the case.  But what should you do if you go on a vacation?  Well, with some proper planning you can stay at a hotel which has a small kitchen, and this way you can prepare your own meals.

Keep in mind that I’m not suggesting that those who follow a natural treatment protocol should avoid eating out on a permanent basis.  All I’m saying is that if someone eats out then there is a strong possibility they are consuming some gluten.  And if they happen to have a gluten sensitivity problem, this can affect their recovery.  So when someone is trying to restore their health back to normal it really is a good idea to avoid eating out.

3.  Cosmetics which include gluten. This admittedly isn’t something I have paid much attention to in the past.  Although I encourage my patients to use natural products and cosmetics, I haven’t focused much on telling them to use gluten-free products.  There’s some controversy as to whether gluten can be absorbed through the skin, and while I couldn’t find any studies on this, some reputable sources claim this isn’t the case.  However, if you use any product that might be swallowed then it’s a good idea to make sure it’s gluten-free.  Two examples include lipstick and toothpaste.  If someone is trying to avoid gluten then one will probably want to make sure these products are gluten-free.  I did find a website which has a list of a number of gluten-free toothpastes, which you can access by clicking here.  Keep in mind that there are other toothpaste brands which might also be gluten-free but aren’t on this list.  Another option is to make your own toothpaste.  You can always just use baking soda, or if you perform a Google search for “homemade toothpaste” you’ll come across some recipes.

I know all of this might seem to be going overboard, especially for someone who claims not to be a “gluten extremist”.  Truth to be told, most people probably don’t need to use a gluten-free lipstick or toothpaste.  However, for some people it will make a difference.  While many people might be fine with very small amounts of gluten, others might need to completely avoid it.  And if this is the case, you want to stay away from all processed food, avoid eating out, and perhaps be cautious about lipstick, toothpaste, and other products which might be swallowed.

When I was diagnosed with Graves’ Disease, I was given a prescription for Methimazole and Propranolol.  I was experiencing a high pulse rate, palpitations, and initially I wasn’t doing anything to manage the symptoms.  A few months had passed before I decided to take Bugleweed, and then I eventually added Motherwort.  Looking back this probably wasn’t a smart decision, as I should have either taken the medication, or I should have taken the herbs sooner.  But either way it is important to do something to manage the hyperthyroid symptoms.

I work with a lot of people who have hyperthyroidism and Graves’ Disease.  Many of them are taking antithyroid medication initially, some are also taking a beta blocker, while others have already been taking herbs such as Bugleweed, Motherwort, and/or Lemon Balm.  Sometimes there will be people who are taking the medication AND taking the herbs at the same time.  And there are some people I speak with who aren’t taking anything for symptom management.

The Pros And Cons Of Taking Prescription Medication For Symptom Management

Even though I’m a natural healthcare professional, I do realize that there is a time and place for taking medication.  And when someone has a very high pulse rate and heart palpitations, this would be one of those times when taking medication may be a wise choice.  Although I personally chose not to take the prescription medication and did fine with an herbal approach, some people don’t do well when trying to manage their symptoms with Bugleweed and/or Motherwort.

Keep in mind that the medication is much more potent than any herbs you can take.  This can be both a good and a bad thing.  It’s beneficial when someone has moderate to severe cardiac symptoms which can’t be controlled by the herbs.  When this is the case, taking the medication  can prevent someone from needing to receive radioactive iodine treatment or thyroid surgery.  So even though I frequently talk about the medication not addressing the cause of the condition, I’m fine with someone taking it on a temporary basis while I try to detect and correct the cause of the problem.

The downside is that these medications can be toxic to the liver.  This is especially true with antithyroid medication such as Methimazole (Tapazole) and PTU.  And this is one reason why most endocrinologists will monitor the liver enzymes.  In addition to affecting the liver enzymes, some people will experience side effects when on the medication.

The Pros And Cons Of Taking Herbs For Symptom Management

The obvious benefit of taking herbs such as Bugleweed and Motherwort is that they represent natural methods of managing the symptoms.  And unlike the medication, people rarely experience side effects when taking the herbs, and these herbs typically won’t put stress on the liver.  As I mentioned earlier, I took Bugleweed and Motherwort to manage the symptoms, and did so for a number of months.  And many of my patients also take one or both of these herbs for symptom management.

The main disadvantage of taking the herbs is that for some people they aren’t potent enough to manage the hyperthyroid symptoms.  Although it usually takes some time before these herbs begin helping with the symptoms, I’ve had some patients who took higher doses of these herbs and gave them a sufficient amount of time to work, but still didn’t notice an improvement in their heart rate and/or the palpitations.  As a result some people do need to take the medication.

Which Hyperthyroid Treatment Method Should You Choose?

So which method should you choose to manage the hyperthyroid symptoms?  Should you take the medication?  Or should you try taking the herbs?  This of course is something for you to decide.  As I mentioned earlier, many of my patients are taking antithyroid medication and/or beta blockers when they first consult with me, and I never tell anyone to stop taking the medication.  And if someone is taking the herbs and they are doing a good job of managing the symptoms then I’m also fine with this.

However, if someone is taking a healthy dosage of Bugleweed and/or Motherwort, and if these herbs aren’t doing a good job of managing the symptoms, then it might be a good idea to switch to the medication.  On the other hand, some people who initially take the medication experience side effects, and as a result decide to switch to the herbs.

Ultimately it is up to the person as to which treatment method to choose to manage their hyperthyroid symptoms.  What it comes down to is that the medication can help, but taking the meds might lead to side effects and can put stress on the liver.  Bugleweed and Motherwort can also manage the hyperthyroid symptoms, but these herbs might not be potent enough to do this in some people.  And so you need to consider these factors when deciding whether taking the medication or the herbs is the best option for you.

Most people who follow a natural treatment protocol realize that it takes time to see results, let alone restore one’s health back to normal.  But many people still want to know how long it should take before they feel better, before they begin to see positive changes in the blood tests, and how long it will take to restore their health back to normal.  And so I thought it would be a good idea to write a post about the expectations one should have when following a natural treatment protocol.

Because everyone is different, it is impossible to predict exactly how long someone will begin to notice an improvement in their condition, or in their blood or saliva tests, etc.  With that being said, in most cases it shouldn’t take too long before someone notices positive changes from a symptomatic perspective.  For example, when I consult with a patient for the first time, I will go through their case history and ask them numerous questions, which is the case with most healthcare professionals.  Most of the time I will also recommend certain tests in order to determine what the underlying cause of the condition is.  Sometimes this can be a challenge, especially since many people have more than one problem which may be causing or contributing to their condition.

In any case, once I recommend a specific natural treatment protocol to a patient, I usually want them to notice an improvement in their symptoms within one or two months.  Some people notice positive changes sooner, as I’ve had patients who felt better after only a couple of weeks on the protocol.  But the goal of this article is to set you up for realistic expectations, and while there’s a chance you might feel better after a few weeks, in most cases it will take one or two months before noticing any positive changes.  And of course in some people it can take longer than this, although if someone isn’t showing any improvement in the symptoms after a few months then you really have to question whether changes need to be made in the natural treatment protocol you’re following.  Don’t get me wrong, as I don’t expect people to be symptom free after one or two months, but in most cases there should be at least SOME positive changes.

Having Realistic Expectations With The Blood Tests

Now that you have an idea as to how long it should take before you notice positive changes in the symptoms, the next question is “how long does it usually take to see an improvement with the blood tests?  Of course if someone is on medication then this sometimes can be a challenge, as they might already have good numbers with regards to the TSH and thyroid hormone levels.  So for example, if someone with Graves’ Disease is taking Methimazole, then they might already have a normal TSH and/or thyroid hormone levels.  So in this case, how would you know if the natural treatment methods are working?  Well, assuming the person remains on the same dosage of Methimazole, if the natural treatment methods are doing what they’re supposed to do then the TSH should continue to increase, and the thyroid hormone levels should continue to decrease.  When this happens the endocrinologist usually will lower the dosage of the medication.

But how long should it take to see these changes on a blood test?  With most people I like to see positive changes in the blood tests within 2 to 4 months of starting the natural treatment protocol.  This doesn’t mean I expect the levels to be normal (assuming the person isn’t on medication), although every now and then this will happen.  How long should it take before someone has normal blood tests without being on the medication?  Once again, this will vary from person to person.  When I was following a natural treatment protocol for my Graves’ Disease condition it took about 6 months before my TSH and thyroid hormone levels normalized.  With some patients it will take longer than this, although I’ve had a few patients who had normal levels within three months.  This doesn’t necessarily mean they were stable at this point, but it’s still a great feeling when the labs normalize without you being on medication.

However, keep in mind that it’s not just about normalizing the TSH and thyroid hormone levels.  In people with Graves’ Disease or Hashimoto’s Thyroiditis, they will typically have high thyroid antibodies on the blood tests.  And so you want the antibodies to eventually normalize as well.  One problem is that the antibodies can fluctuate, and so you can’t get overexcited just by seeing an improvement in the thyroid antibodies.  But one of the goals of following a natural treatment protocol is to normalize the thyroid antibodies, and then keep them at a normal level.

Having Realistic Expectations With Other Tests

I commonly recommend other tests to my patients.  The main tests I recommend are saliva testing for the adrenals, along with a hair mineral analysis test.  Sometimes I’ll also test the hormones, and at times I’ll recommend an intestinal permeability test to find out if someone has a leaky gut.  But how long does it take for these tests to normalize?  By now you should know that it depends on the person.  With the cortisol levels and DHEA, it’s not uncommon to see these normalize within two or three months, although for some people it will take longer than this.  If someone has a problem with intestinal permeability, then the average period of time to correct this condition is three to six months.  If someone has a hormone imbalance then this can also take a few months to correct.

The Patient Needs To Do Their Part

Of course it’s very important for the patient to follow the necessary recommendations.  For example, if someone gets the cortisol levels tested in the saliva and they’re out of range, it is important for the person to 1) eat a healthy diet consisting mostly of whole foods while minimizing their carbohydrate intake, and 2) do a good job of managing their stress.  While adrenal support supplements might be necessary, if someone takes the recommended supplements but does a poor job of managing his or her stress, then they won’t recover as quickly as someone who does an excellent job of managing their stress.

Similarly, if someone has a leaky gut that was caused by eating gluten, and if they continue to eat gluten, then it will take a longer time to heal the gut compared to someone who is compliant.  Expecting to heal the gut within three to six months is unrealistic for someone who continues to eat poorly and doesn’t avoid food allergens which might be responsible for the gut problem.  And the same concept applies to correcting other compromised areas of the body.

How Long Does It Take To Achieve Optimal Health?

The ultimate goal of any natural treatment protocol is to help the person to achieve optimal health.  But how long does this take?  6 months?  One year?  Two years?  You probably already know the answer to this, which is that this will vary from person to person.  If you want to have realistic expectations then 6 to 12 months is a good range for most people.  However, for some people it will take longer than this.  But as I discussed in this article, you should be seeing positive changes along the way.  Most people reading this understand that it takes time to restore one’s health.  But in most cases it shouldn’t take 6 to 12 months to notice positive changes.

In summary, many people can benefit from following a natural treatment protocol.  However, some people have unrealistic expectations, as they expect to receive almost miraculous results very quickly.  Usually it takes time for these conditions to develop, and as a result, it almost always takes a good amount of time to restore one’s health back to normal.  And of course numerous factors play a role in the speed of recovery, such as the severity of the condition, as well as the compliance of the patients.  To no surprise, those who comply with the recommended treatment protocol are more likely to recover faster than someone who isn’t compliant with the recommendations.