My Top 3 Reasons
I am Izabella Wentz, a pharmacist, Hashimoto’s patient, and author. I believe that thyroid patients are not getting the treatment and attention they deserve from the medical community.
There are three major issues that I see: diagnosis, medication management, and counseling regarding lifestyle interventions.
- Thyroid patients are not diagnosed appropriately. The TSH is not a reliable marker of thyroid function as it can fluctuate, especially in those with Hashimoto’s. TPO antibodies may become elevated years and sometimes even decades before a change in TSH is seen and may be associated with fatigue, recurrent miscarriages, and many other issues before the TSH becomes affected.
- I believe that patients should be better optimized on their medications. Just because a TSH falls within the “normal” range does not mean the medication is dosed appropriately. We need to treat the patient, not the lab values! Patient symptoms are key! As a pharmacist, I can tell you that there are many medications that have prodrugs (an inactive precursor of a drug, converted into its active form in the body by normal metabolic processes) that do not get converted to the active drugs in the body. T4, by definition, is a prodrug and does not always convert to T3! Sometimes combination medications are needed.
- Lifestyle interventions such as eliminating infections, addressing nutrient depletions, reducing sensitizing foods and addressing adrenal function can help reduce or eliminate autoimmunity, yet they are ignored by mainstream medicine.
Here is my story
Before I was diagnosed with subclinical hypothyroidism, I had been suffering from fatigue and quite a few digestive and allergic symptoms.
I struggled with chronic fatigue for almost eight years before I was finally diagnosed with Hashimoto’s. I had always been an active and energetic individual, but then never seemed to have recovered from the debilitating fatigue after a mono infection during my first year in college.
This fatigue kept me from pursuing my dreams and passions in my early twenties, but eventually, I learned to compensate. I would sleep for 12 hours a night so that I could participate in my classes, study, work and enjoy a social life.
After my primary care doctor said all of my tests were “normal,” I consulted with an allergist-immunologist who ran a whole slew of tests for food allergies (not intolerances), environmental allergies and autoimmune markers.
One of the tests that came up positive was Thyroid Peroxidase Antibodies (TPO Antibodies). These antibodies are positive in 95% of those with Hashimoto’s. Mine were above 2000! The normal range for that particular test should have been less than 30.
My TSH was at 4.5, which fell in the “normal” range at the time but is now known to be too high and indicative of subclinical hypothyroidism. I have a note from my physician that says: “Your thyroid function is normal. No need to do anything.”
Additionally, my blood sugar was 53, showing that I had been experiencing hypoglycemia.
The allergist told me that at one point I might be at risk of developing hypothyroidism, but not to worry about it. Instead, I was prescribed three different allergy medications and referred to a gastroenterologist who diagnosed me with acid reflux and IBS and, you guessed it, gave me more medications.
After another year of stomach issues, anxiety, fatigue (sleeping 12 hours per night), a persistent chronic cough, taking my medications as prescribed, I followed up with my primary care doctor again.
At that point, my TSH jumped to 8, which was above the reference range. I was then told that I should start thinking about thyroid hormones.
I don’t blame the doctors. They meant well and were trying to help me, but people don’t always realize what they don’t know. I also didn’t know much … I was a new grad pharmacist at the time, and although my knowledge of pharmaceutical therapies was very much current, I knew very little about lifestyle interventions that would prevent, reduce or eliminate autoimmunity. I was surprised that there weren’t many established lifestyle interventions for my condition, so I decided to start doing some research on my own.
In a perfect world, where autoimmune thyroid conditions would be treated appropriately, this scenario would have happened instead:
- I would have been advised that based on my TPO antibodies, TSH and family history of thyroid disorders I was at high risk for developing hypothyroidism within the next year.
- I should have been started on a low dose of thyroid medication to make up for the extra demand placed on my thyroid that was leaving me exhausted.
- I should have been tested for food intolerances (IgA, IgG), not just food allergies (IgE) or told to follow an elimination diet for my IBS and acid reflux, which would have helped slow down or eliminate the progression of Hashimoto’s.
- I should have been informed about lifestyle interventions to address autoimmunity and inflammation.
- I should have been informed that inflammation from my thyroid, gut, and my hypoglycemia was taxing my adrenals, leading me to develop a multitude of environmental allergies.
- I should have been told to work on balancing my blood sugar …
My personal mission is to spread awareness about lifestyle interventions and promote further research.
The right diagnosis, the right medication, and the right lifestyle changes have made a tremendous difference in my life. I feel like I have the old me back, after almost 10 years of living in the shadow of my fullest potential.
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.
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