Q & A with Dr. Amy Myers about The Thyroid Connection

Thyroid Connection
A whopping 27 million Americans suffer from thyroid dysfunction — and many don’t even know it — says functional-medicine doc Amy Myers, MD.

In her new book, The Thyroid Connection: Why You Feel Tired, Brain-Fogged, and Overweight — and How to Get Your Life Back, Myers outlines a 28-day plan to reverse thyroid dysfunction, including Hashimoto’s disease, hypothyroidism, and hyperthyroidism.

Even though millions of people suffer from thyroid disorders, says Myers, conventional medicine continues to miss the boat. We wanted to talk to her about why that is — and how to actually get a correct diagnosis and reverse thyroid dysfunction. Here’s what she had to say:

What are the various symptoms of thyroid dysfunction, and why do millions of people suffer from symptoms of thyroid dysfunction without even knowing it?

There are actually a huge range of thyroid dysfunction symptoms because your thyroid affects all of your metabolic processes.

If your thyroid is underactive and you are hypothyroid, then everything slows down, leading to fatigue, weight gain, hair loss, infertility, anxiety, and hormonal imbalances.

If your thyroid is overactive and you are hyperthyroid, then everything speeds up, which can cause symptoms such as weight loss, tremors, anxiety, panic attacks, loose stool, and insomnia.

Because these symptoms are so vague and your doctor typically only talks to you for 15 minutes or less, they’re often written off as symptoms of aging or stress.

There’s also a big problem with doctors not checking your thyroid if you’re not a woman in the age range where most thyroid dysfunction is diagnosed or if you’re a man. Then, if your doctor does check your thyroid levels, they’re using reference ranges that are far too broad and looking for “normal” instead of optimal levels.

Why do more women experience it than men?

The truth is that we don’t know 100 percent yet. We suspect that because women usually develop thyroid or autoimmune issues (or often both) during pregnancy or menopause, that it’s related to hormones.

Why do you think thyroid dysfunction is especially hard for conventional medicine to diagnose versus functional medicine?

To put it plainly, they’re often not looking for it. As I mentioned, they’re typically only spending a few minutes with you and if you have another health condition such as autoimmunity, fibromyalgia, or chronic fatigue they can overlook it.

They’re also using reference ranges that are too broad and only ordering one or two thyroid markers, namely a TSH or thyroid stimulating hormone and a T4. TSH tells you what your pituitary gland is doing because it signals to your thyroid to ramp up or slow down thyroid hormone production, so it’s not telling you what your thyroid is actually doing. T4 is the storage form of thyroid hormone, and even if your T4 levels are normal, you might not have enough of the active form of the hormone, which is T3, or you might be high in RT3 (Reverse T3) which actually puts the brakes on your thyroid hormone receptors.

What is the best way to diagnose it? What are the best tests?

I run a complete thyroid panel on all of my thyroid patients to see what their pituitary is doing, their T4 levels, their T3 levels, and their reverse T3 levels, plus the two types of thyroid antibodies, which tells us if your thyroid dysfunction is actually caused by autoimmunity, which means your immune system is attacking your thyroid.

Here’s the full panel that I run on my patients, and you can read more about what the levels mean in my book, The Thyroid Connection.

  • TSH
  • Free T4 (the storage form)
  • Free T3 (powers metabolic processes)
  • Reverse T3 (slows down metabolic processes)
  • TPO, TG -AB

I also check for the essential nutrients that your body needs to produce thyroid hormones, convert them into their active form, and allows them to enter your cells and bind to thyroid hormone receptors. The nutrients that you can test for include selenium, iron, zinc, vitamin D, magnesium, and vitamin A.

Once thyroid dysfunction is diagnosed, what is the typical conventional medicine approach — and what’s wrong with it?

If you have hypothyroidism, or an underactive thyroid, the conventional medicine approach is simply to prescribe supplemental thyroid hormone and calls it a day. The trouble with this is that most commonly prescribed form of supplemental thyroid hormone is only T4, the storage form of thyroid hormone, so if you’re having trouble converting it to its active form you’ll still experience hypothyroidism symptoms.

If you have hyperthyroidism, or an overactive thyroid, the treatments are much more severe. You’ll be prescribed propylthiouracil (PTU) or methimazole, which stops your thyroid from producing hormones, but carries the unpleasant side effects of dry skin, hair loss, and hair loss. (I was prescribed PTU and was one of the rare people who developed toxic hepatitis as a result, in addition to extreme dry mouth and nostrils.) If this isn’t successful, their next step is ablation with radioactive iodine, I-131 or surgically removing part of your thyroid. Iodine ablation essentially destroys your thyroid, leaving you with no thyroid function to restore, and it can lead to infertility. If you opt for surgery, you are at least usually left with some part of your thyroid, which you can then restore through proper diet and lifestyle changes.

What about the typical functional medicine approach? What are some key lifestyle-based approaches to treating thyroid dysfunction?

In functional medicine, we look at the root cause of thyroid dysfunction and work to restore proper thyroid function by addressing them. This involves optimizing your diet for the nutrients essential for thyroid function, healing your gut, reducing your toxic burden, healing underlying infections, and relieving your stress.

All five of these environmental factors play a big role in thyroid health, and by addressing these, patients can often restore their health and vitality naturally, and come off of their supplemental thyroid hormone.

There are thyroid-calming herbs, including bugleweed, motherwort, and lemon balm, that can be used for hyperthyroid patients to manage their symptoms without harsh medications, ablation, and surgery, while we work to address these root causes.

Do you ever need drugs for thyroid dysfunction?

If your thyroid has become too damaged, or it was ablated or surgically removed, then you will likely need to be on supplemental thyroid hormone for life.

This is the case for me, as I no longer have a thyroid, and part of the reason I wrote this book is to clear up the myth that if you’re eating right, eliminating toxins, and managing your stress that you shouldn’t need supplemental thyroid hormone. These hormones are no different than someone with type I diabetes taking their insulin. Your body needs them to function properly, and there should be no shame or stigma around taking them to support your health.

Of course, we always want to make sure we’re addressing the root cause of your thyroid issues, so that you can achieve optimal health and prevent future chronic illnesses, but these lifestyle changes can go right alongside your supplemental thyroid hormone.