Do you struggle with any of the following symptoms?

What is hyperthyroidism?

Hyperthyroidism is a thyroid condition in which your thyroid is overactive. This indicates that your thyroid is overproducing too much thyroid hormone, known as thyroxine.

In hyperthyroidism, your metabolism is put on overdrive, which is why many patients often experience some common symptoms like diarrhea, unintentional weight loss, and an increase in appetite. 

What are other symptoms associated with hyperthyroidism?

Symptoms that may be associated with an overactive thyroid include unintentional weight loss, anxiety, diarrhea or loose bowel movements, increased appetite, nervousness, hair loss, irregular periods, irritability, sensitivity to heat, increased sweating, palpitations, rapid heartbeat, and insomnia.

While some individuals with hyperthyroidism may experience severe symptoms, others may experience little to no symptoms. 

How do I test for hyperthyroidism?

It is important to see a practitioner who will take a full medical history and assess your symptoms and complete a thorough physical examination.

Your practitioner will order lab tests to assess your thyroid function. These tests usually include a comprehensive thyroid panel including TSH and your free thyroid hormones T4 and T3.

Your Physician may also think it is warranted to assess for an autoimmune cause of your thyroid condition and will run other markers including anti-thyroid peroxidase, thyroglobulin stimulating immunoglobulin, and thyroglobulin antibody.

Along with a thyroid panel, your physician may assess other important markers including iodine, iodine/creatinine ratio, and order thyroid imaging to get a full picture of your thyroid function.

Your physician may also order a lipid panel to assess your cholesterol and triglyceride levels are hyperthyroidism may be linked to low cholesterol and triglyceride levels. 

Example of HIGH Thyroid levels on lab work before Thyroid treatment:

What causes hyperthyroidism?

There are several factors that could cause hyperthyroidism. The most common cause of hyperthyroidism is Graves Disease, an autoimmune attack on the thyroid. Other potential causes of hyperthyroidism may include:

Who is at increased risk for developing hyperthyroidism?

Hyperthyroidism is more common in females than males, affecting 2 out of every 100 females and 2 out of 1,000 males. Hyperthyroidism is also more common in:

How do you treat hyperthyroidism?

The treatments for hyperthyroidism vary depending on your symptoms and your lab and imaging results.

Oftentimes, anti-thyroid medications are prescribed which will prevent your thyroid from making an excessive amount of hormones. Some of the treatments for hyperthyroidism may include: 

What happens if I don't treat my hyperthyroidism?

Because your thyroid plays a major role in your metabolism, if it's not regulated or stable, it can wreak havoc on many of your other body systems. Some complications may include:

  1. Cardiac problems:
    1. Being in a hyperthyroid state can make your heart work faster and harder, causing palpitations and increased heart rate. This is why its so important to follow your physician's instructions in frequent lab testing and follow-up. While these complications can be seen in hyperthyroid patients, it can als  occur in hypothyroid patients who are on too much thyroid medication.
  2. Thyroid Storm:
    1. This is a potentially life-threatening condition when your body releases too much thyroid hormone putting you into a hypermetabolic state. Some symptoms may include sudden fever, deliria, rapid pulse and sweating. This is a medical emergency and you must seek immediate care.
  3. Weak brittle bones:
    1.  An excess amount of thyroid hormone can impair your body's ability to absorb calcium. Your bones become weak when they don't obtain enough calcium and can put you at great risk for fractures and osteoporosis. 
  4. Infertility:
    1. Excess thyroid hormone can interfere with a females menstrual cycle and can cause her to experience infertility. 
  5. Ophthalmic problems:
    1. Certain patients who have hyperthyroidism due to Graves Disease may experience eye problems. If untreated, these problems may lead to loss of vision.

Can hyperthyroidism cause hypothyroidism?

Yes. If you're on too much anti-thyroid medication or have had part of your thyroid removed, its likely that you will become hypothyroid.

Hypothyroid symptoms may include weight gain, hair loss, constipation, fatigue, joint pain, cold intolerance. Frequent follow-ups and lab testing with your Physician can help you keep your thyroid better managed. 

Case Study:

A 57 yo male presented to a clinic with a diagnosis of Graves’ Disease. His prior Physician recommended radioactive iodine, however, the patient wanted a second opinion. He was having significant symptoms including heart palpitations, significant weight loss, extreme hunger, increased heart rate and visual changes. He was undergoing a lot of stress from work and had previous infections. Through shared decision making, we decided to start the patient on methimazole (anti-thyroid medication), a beta blocker, immune support (specifically for autoimmune thyroiditis) and followed up three weeks later. The patient was also referred for a cardiac and ophthalmologic work-up.

I called the patient the next day to see how he was feeling on the medicine, and he said he already felt better and his heart rate was lowering. At his follow-up appointment three weeks later, the patient stated he was feeling significantly better and was no longer getting the adrenaline rush with obeshe was feeling a few weeks prior. The patient was responding well to the medicine and he was instructed to continue at the same dose. The Patient's nutrient status was also checked and he was put on several vitamins and liver support.

The patient came in several weeks later and said overall he was feeling 7.5/10 (10 being the best) and previously was feeling a 3/10. The patient's labs were run and he was responding very well to the medicine and we were able to reduce his thyroid medicine.

The patient is scheduled for a follow-up this month and will repeat thyroid labs and imaging so we can visualize the thyroid gland.

Are you experiencing these symptoms?

Have you been diagnosed with Hashimotos Thyroiditis but are unsure of the following steps you should take? Have you been put on thyroid medication but still not feeling better?

Are you still suffering from brain fog, weight gain, hair loss, constipation, fatigue? Hashimotos Thyroiditis is an autoimmune condition in which your immune system attacks your thyroid, often causing hypothyroidism.

10 of the Most Common Symptoms of Hashimoto's Thyroiditis:

  1. Dry Skin
  2. Hair Loss
  3. Constipation
  4. Weight Gain
  5. Muscle Weakness
  6. Swelling in Your Extremities
  7. Joint Stiffness
  8. Brain Fog
  9. Voice Changes
  10. Fatigue
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We take an Integrative Approach

At NES, we take an integrative approach to your thyroid health. We will inquire about your complete medical history to further investigate how your autoimmune condition manifested so we can remove any obstacles to cure.

Many factors can contribute to an autoimmune attack on your thyroid. Through extensive bloodwork, imaging, and physical exam, we will be better able to provide the appropriate treatment for you.

How We Treat Your Hashimoto's

Screening questions, labs, and imaging may be required before initiating therapy at your doctor's visit. Some patients diagnosed with Hashimoto's Thyroiditis may present with normal thyroid labs and imaging and may not require thyroid medication.

Depending on your thyroid lab values and antibody levels, your doctor will work with you by initiating dietary, lifestyle, supplement, and medication therapies.

Your doctor will follow up every few weeks with lab tests to make sure you are responding well to the initiated therapies.

Example of Hashimoto's Levels on Lab Work Before Treatment:

Case Study

A 41 year old female presented to clinic with symptoms of:

  • Lethargy
  • Depression
  • Inability to gain weight.

She was diagnosed with Hashimotos Thyroiditis and said she felt horrible and progressively worse.

We had her lower her thyroid medicine and re-test again in 4 weeks. We also discovered that her iron and ferritin were both extremely low, and initiated her on iron IVs.

After a few months, we decided to change her thyroid medicine to a cleaner form of medicine and repeated her labs again 6 weeks later.

After only 6 weeks, she said she wished she had been on this thyroid medicine 10 years ago. She said she was feeling amazing. She was also put on immune and inflammation support for her thyroid and oral progesterone therapy to help during her menstrual cycle.

Overall, in just under a year, the patient reports feeling significantly better and has been able to successfully put on some intentional weight gain. 

What is hypothyroidism?

The thyroid gland is a small endocrine gland that sits directly under the atom's apple. Structurally, it looks like a butterfly and plays a highly critical role in your body. It controls body temperature, metabolism, energy, and weight.

People can develop thyroid disease for several reasons, such as genetic predisposition, autoimmunity, toxin exposure, nutrient deficiencies, and infections. It is most commonly seen in women, and often it is diagnosed between the ages of 20-40.

Symptoms of thyroid disease include weight gain, fatigue, hair loss, depressed mood, loss of eyebrows, hoarseness of voice, and dry skin. Routine blood work can help identify a thyroid problem, and more comprehensive testing can help you learn if your thyroid gland is working optimally.

A thyroid ultrasound can help you learn about the size of the gland if it contains any nodules (growths on the thyroid gland; can have one or many) and if there are signs of autoimmunity (your immune system attacking the gland).

Generally, a normal thyroid gland should not be felt in your neck. If your neck is swollen or enlarged, it is a good idea to get it checked out!

Learn how to optimize your hormones by understanding what they do in your body. An optimal thyroid gland can help ensure that your body temperature is well regulated has a thriving metabolism where you can quickly lose weight and feel energetic and happy.

How NES can optimize your hormones to treat your hypothyroidism

At NES, we help you learn about these endocrine glands and educate you on how these hormones work in your body. We also help you understand how hormones work together and create a treatment plan that is completely individualized to your needs.

We test for markers that contribute to the underlying cause of thyroid diseases such as nutrient deficiencies (ex. Selenium, Zinc, Vitamin B12/Folate, Vitamin C, Vitamin D), detailed thyroid markers such as antibodies (ex. TPO antibody, TGB antibody, TSI) and thyroid hormones (ex. T4, T3, fT4, fT3, RT3). 

What our process typically looks like

At your doctor's appointment, your doctor will order a comprehensive thyroid panel. Examples of markers that may be run include TSH, FT3, FT4, Anti-TPO, thyroglobulin, ferritin, zinc, iodine. 

By assessing these markers, your doctor will be better able to determine whether you're a candidate for thyroid medication and evaluate for nutrient deficiencies or excesses that could exacerbate your condition.

This information is helpful in generating treatment recommendations for you.

The treatments will also usually consist of diet and lifestyle recommendations, supplement recommendations, stress management recommendations, medications, possible imaging, referrals to specialists, future lab recommendations, and next steps for follow-up.

Case Study

A 60 year old female presented to the clinic with a history of Hashimotos. She said her thyroid has been off for almost 10 years. She said she’s tried everything for her thyroid and nothing has been helping. She presented with a very high TSH of 68.900 (should be less than 4.5). She said her husband is a physician and no one has been able to regulate her thyroid.

After a detailed discussion with the patient, she admitted that she was also taking many supplements in the morning very close to her thyroid medicine. Amongst those supplements, she was taking iron and calcium and was never told she needed to take those nutrients at least 4 hours away from her thyroid medicine as they inhibit absorption of thyroid hormones. The patient was on a compounded thyroid medicine that included both T4 and T3 hormones.

Even though her TSH was so high, we changed her medicine to a lower dose and instructed her to take her medicine at least 4 hours away from her other supplements. We also ordered more lab tests assessing for other absorption issues that could be impeding her ability to absorb thyroid medicine.

The patient returned two months later, and her TSH went down from 68.900 to 9.8. At that visit, we also diagnosed the patient with Celiac Disease and changed her thyroid medicine to a liquid form, helping optimize her ability to absorb. At that visit, we told her to avoid all gluten, and increased her thyroid medicine slightly. The patient was also had low iron, which is necessary for optimal thyroid function, so we had the patient do some iron IVs. After several visits, we were able to reduce how much T3 thyroid hormone the patient was on, and got to her TSH to a normal value of 2.160. 

Want to know more about hypothyroidism? Read this article!

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

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Scottsdale, AZ 85255

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