DR FIONA ENKELMANN
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7 ways to care for your thyroid gland

9/26/2015

22 Comments

 
When I was sixteen I was an avid runner who loved competing in long distance events. One day I collapsed at the finishing line, pale as a ghost, with my heart beating too slowly and not pushing enough blood around my body. I felt terrible and it was all rather dramatic.

Leading up to this day, I had been having funny turns at school. At the time, with the wisdom of a sixteen year old, I thought it was funny to be having these “drop –attacks”. They occurred while I was walking along and then bam! I’d find myself on the ground. Along with this I felt irritable, had gained weight and was feeling extremely tired. My teachers and family put this down to “raging hormones” or “growing pains”, shrugging it off as normal adolescent behaviour.  

Eventually I was diagnosed with thyroid disease due to an autoimmune condition called Hashimoto’s Thyroiditis. I started taking Thyroxine, a synthetic form of thyroid hormone and began to feel better. I was traveling along reasonably well until I woke one morning and found that half of my face was paralysed. Yep, paralysed. I wasn’t even able to fully close my eyelids on that side. 

Can you imagine how horrific it was to see only the right side of my face moving as I screamed out to my mum? 

This time I was diagnosed with yet another autoimmune disease called Bell’s palsy. This is a condition in which the facial nerve, supplying the muscles of my face, was attacked by my own immune system. After a course of strong steroids, I was one of the fortunate ones who fully recovered after 6 weeks. For others it can take months or even years to recover. 

Prior to this double whammy of “bad luck” I had been a fit and healthy girl. Being a farm girl, I was more active than most. However I loved eating fruit and tomatoes, and this habit took its toll on my teeth. Six months prior to falling ill, I needed to have several dental fillings and in those days it was mercury amalgam. Was it just a coincidence that I fell ill with two auto-immune conditions after getting several mercury fillings? Had I known then what I know now, I would have avoided mercury fillings (aka silver fillings) at all costs . I explain my reasons for this below. 

As an Integrative GP who has lived with thyroid disease and clearly remembers living with Bell’s palsy, I’ve been intrigued as to why I had this “bad luck”.   There is so much more to autoimmune thyroid disease than just treating it with Thyroxine and this is a quick summary of what I’ve learnt.
Never look at the thyroid in isolation

In my case it’s clear that my immune system was going ballistic. It didn’t know what was friend or foe, and it is a good idea to ask why.

Start with gut health

Over 85% of our immune system lives in the gastrointestinal tract and there is very exciting emerging evidence that links gut health to a range of conditions including auto-immune diseases. Don’t worry I’ll be sharing this with you soon!

My general approach is to start with diet and nutrition, and whilst I believe no one diet fits all, I generally recommend removing any food allergens, especially gluten. I know. I get it. I too had a carb addiction, and it took me four months to quit the habit. Yet, there is evidence that patients with thyroid autoimmune disease have autoimmunity suggestive of coeliac disease (gluten allergy) and type 1 diabetes. It is definitely best to avoid gluten to prevent further problems, and for a number of my patients I have seen their thyroid function improve as a result. 

Next is healing the gut, which is one of the most exciting and interesting areas of medicine. Call me crazy, but I feel everything from depression and autism to arthritis and asthma, relates to gut health. For some, healing the gut means incorporating bone broths (or glutamine/glucosamine/turmeric supplements), and herbs like slippery elm, omega 3, and probiotics into your routine. Often there are accompanying mineral deficiencies such as magnesium and zinc, which when corrected contribute to the healing process. 

I recommend seeing a dietician/nutritionist who has training in GAPS or paleo diet to really help you fine-tune your diet and treat the cause of autoimmunity.

Manage the adrenal gland 

During medical school I learnt very little about the adrenal gland. I got the impression that they were somewhat insignificant glands that hung out above the kidneys, rarely causing trouble.  How wrong that was! 

When supporting the thyroid gland, we can’t ignore the adrenals. They are responsible for producing our stress hormones (cortisol, adrenaline, noradrenaline), DHEA, sex hormones and mineralocorticoids (aldosterone; responsible for salt/water balance). Cortisol excess impairs thyroid function. As the gross majority of us live in a chronic state of stress, the constant fight or flight response, increases demand on our adrenal glands and in turn our thyroid gland. 

The adrenal gland is key to the mind/body connection and I will endeavour to explore the adrenal gland in future articles as a holistic approach for managing and supporting the adrenal gland is required. 

Remove the triggers!

There are a number of known factors that inhibit proper production of thyroid function. These are called “goitrogens” and include mercury, pesticides, lead, cadmium, halogens (fluoride etc.) and medications such as lithium. These are known “endocrine disruptors” and taking the steps to educate yourself about environmental pollutants so you can limit your exposure is so very important. If your thyroid is under strain, eating excessive amounts of certain foods such as isoflavone phytoestrogens from soy and thiocynates in cruciferous vegetables (broccoli, kale, cauliflower, cabbage) can tip the balance, impairing thyroid function. Best not to consume too many kale smoothies if your thyroid is strained! 

Support the thyroid – give it the fuel it needs.

The thyroid gland needs iodine for production of thyroid hormone. The majority of the Australian population are iodine deficient and will require supplementation or review of dietary intake. Unfortunately, an excess of iodine can also interfere with thyroid production, so getting your levels right is essential. It is best to do this under the care of trained integrative medical doctor or naturopath, who may choose to check levels (known as a corrected urinary iodine level). Iron and vitamin D are critical for proper production of thyroid hormones, and levels need to be optimised in management, alongside a number of other essential nutrients including vitamin E, B, and C. 

Gotta love zinc and selenium!

When it comes to thyroid health, zinc and selenium are the top two minerals that I prescribe. The production of thyroid hormone and the homeostatic feedback loop takes a bit of patience and perseverance to fully understand. A key point is that the thyroid releases T4, a mostly inactive hormone, which requires conversion to the active form T3. Zinc and selenium are essential in this conversion, with zinc also improving the responsiveness of cells to the thyroid hormone. If you are zinc and selenium deficient this pathway won’t be running at full steam, and I know I felt much better after optimising my own zinc and selenium levels. 

The thyroid contains the highest concentration of selenium, an essential trace element and powerful antioxidant, in the body. Studies have proven that selenium deficiency worsens autoimmune disease. Other research suggests that selenium is protective in prevention of disease also, especially against the harmful effect of mercury.

NB. I encourage you do to your own research on mercury (a good resource to start is http://thegooddoctors.com.au/health-podcast/dental-mercury-amalgam-an-environmental-and-health-issue/doctors) and if you elect to have it removed, do so with a dentist trained in safe removal. In a future article I will share my experience of getting mercury safely removed.

Never forget the mind body spirit connection
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Stress is a risk factor for autoimmune thyroid disease. There is clearly a link between our stress hormones and thyroid hormones. Thyroid hormone has the same precursor, tyrosine, as our stress hormones including noradrenaline and adrenaline. When under stress, Tyrosine is preferentially used for production of stress hormones, impacting normal thyroid function. High cortisol (seen in stress) and low cortisol levels (seen in adrenal fatigue resulting from prolonged stress) have a negative impact on thyroid production and how the tissues respond to the thyroid hormone. 

A holistic approach to autoimmune thyroid disease includes addressing the impact that stress has on our body, especially our gut health, as this is where the majority of our immune system lies. Meditation, exercise, living a soul driven life and having fun is all very important in stress prevention and ensuring  a healthy body, including a healthy thyroid gland. 

Dr. Fiona Enkelmann MBBS FRACGP MPH

22 Comments
Mel
8/14/2017 11:26:08 pm

Thankyou so much for this. It confirms lots of things I'm doing and nice to know I'm not alone on this journey

Reply
Fiona
8/15/2017 08:31:03 am

My pleasure Mel. Good luck!

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Suat ter
8/18/2017 06:04:58 pm

I have a hyperthyroid n on thyroid medication. I have been on BP tablets for a no of years now. My BP is going on a coaster roller, very high when sitting down, and my BP now is 165 n I can feel giddiness in my head and pins and needles on my legs. Have been to several GPs but to no avail. I am at my wits end, now I am considering taking radioisotopes to nick my thyroid.

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Addisons
1/5/2018 10:05:47 am

Exercise IS stress to the body. I can't exercise like going to the gym or going for a simple light run without collapsing for the next four days.

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Fiona Enkelmann
1/8/2018 09:39:26 am

Hi Addisons, Thanks for posting. Yes, Exercise is stress to the body. Like all stress, in some cases it is a positive thing but like you are experiencing it can be negative also. It does highlight why you need to consider all factors prior to prescribing an 'exercise regime'. Perhaps in your case, more restorative exercise like yoga is better, to avoid a large cortisol spike. Also, you may be interested in looking into mitochondrial dysfunction and it's causes (such as CIRS (chronic inflammatory response syndrome)) as your picture of exhaustion suggests this.

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Mara
1/14/2018 06:03:34 am

Hi Fiona, it's so wonderful to come across your blog and story. I Can relate to the burnout resulting from the drive to succeed. For me it resulted in a nervous breakdown (I never ever thought that would happen to me!) I was then diagnosed with hasimotos 14 months ago, suffer from weight gain, fatigue, exhaustion after excercise and feel like I can't eat anything other than sushimi without feeling tired, bloated and forever vague.

This plus the year I am going to take back control of my health and life. I would love your help and would love to arrange an appointment to meet with you. I have sent an email to your wellness centre.

Thanks so much for sharing your story x

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Fiona Enkelmann link
1/15/2018 10:31:04 am

Hi Mara, Thanks so much for your message and I'm sorry to hear about your journey.... there is always a silver lining though and no doubt some great changes to come from it. I look forward to hearing from you and hope to help you feel empowered with your health. Warmest
FI

Reply
Elizabeth Mallett
2/27/2018 11:27:36 pm

Hi Fiona,
I too have hasimoto disease. I started having the same blackouts in my teens too. My doc said it was just due to my low bd and hr. I was misdiagnosed with depression and spent 12years on the wrong medication which never helped and my other symptoms were over looked or put down to anxiety. This resulted in the complete loss of facial hair, severe edema and no menstrual cycle! I changed docs and finally got the right diagnosis. However, I still get very bad swelling and am given diuretics to help manage which I find I am using more and more. I changed to a autoimmune protocol diet last year and have felt little to no improvement. Could there is something my doc is missing or not testing for? I am at a loss
Kind regards
Elizabeth

Reply
Fiona Enkelmann
2/28/2018 06:01:03 am

Hi Elizabeth,
Thanks for sharing your story. I can't comment directly on your situation however you may wish to look at a recent facebook post I did about thyroid health and optimisation of the thyroid. https://www.facebook.com/drfionaenkelmann/ and https://www.facebook.com/narayaniwellness/. It may be that you need further optimisation (including a change of medication, nutrients). Or there may be another cause for the swelling such as CIRS, inflammation, biotoxins. I suggest this only because you find the swelling really bad and sound motivated to feel better. I've done some posts recently on CIRS but this depends on the whole picture. I hope this helps! Good luck ,
Warmest
Fi

Reply
Fiona Enkelmann
2/28/2018 06:03:14 am

Hi Elizabeth,
Thanks for sharing your story. I can't comment directly on your situation however you may wish to look at a recent facebook post I did about thyroid health and optimisation of the thyroid. https://www.facebook.com/drfionaenkelmann/ and https://www.facebook.com/narayaniwellness/. It may be that you need further optimisation (including a change of medication, nutrients). Or there may be another cause for the swelling such as CIRS, inflammation, biotoxins. I suggest this only because you find the swelling really bad and sound motivated to feel better. I've done some posts recently on CIRS but this depends on the whole picture. I hope this helps! Good luck ,
Warmest
Fi

Reply
Mary Knights-Rutten
4/26/2018 11:06:46 am

To Dr Fiona, I have had hypothyroidism for about 40 years ! been on meds for that time .Over the last 5 - 6 years have had palpitations if my meds are too high or too low .My system seems to be very sensitive to the slightest change , and the AF seems to be getting worse . Can you help ?
regards
Mary

Reply
Fiona Enkelmann
4/26/2018 08:09:56 pm

Hi Mary, it sounds like you’re having a tricky time! Are you already following the advice I’ve listed above - these steps could help stabilise the inflammation and give you some relief. On top of this, other key nutrients like coQ10 and magnesium may be helpful but really depends on your full history. I personally have a long waiting list but can recommend one of my naturopaths as a good support for you as your explore this approach. I hope that helps - there is quite a lot that may be of benefit and give you some relief!

Reply
Kristy
5/2/2018 10:32:18 am

Hi Fiona, I've come across this article through googling for a GP with further interest into thyroid function. 2 years ago I had a full thyroidectomy due to a large goitre and a few other growths that were all benign. Although growing up I was always convinced I didn't have proper thyroid function due to fatigue nothing was ever diagnosed. When I was told my thyroid was going to be removed and I would be placed on synthetic meds for the rest of my life I actually was over the moon and relieved at the thought I may be able to live a somewhat normal life! How wrong was I! Since the removal of my thyroid in April 2015 my life has been a living hell, 20kg weight gain, fatigue at an all time high and that's just the beginning. I actually work in Carlton and would love to combat my issues, I guess what I would like to understand is, do you believe you would be able to help me given I've had a full thyroidectomy or is there someone else who specializes in this area.

Reply
Fiona Enkelmann
5/4/2018 06:16:03 pm

Hi Kristy,
We are currently doing a video series on the thyroid now and hope to have this up on our facebook page next week. The thyroid medication you are taking is T4 (inactive) and requires the body to convert it to T3. This requires the key nutrients iron, vitamin D and zinc. The thyroid is also impacted by gut health and the adrenals - a more holistic approach may be needed.
Feel free to get in touch with our team - and hopefully our videos will provide you with some extra information. Good luck!

Reply
Tracey
5/2/2018 02:06:14 pm

I accidentally unsubscribe the blog. Dr Fiona could you please recommend a holistic dentist to me. I would like to remove my Mercury fillings from my mouth. I have grave desease
but now is under control. Thanks

Reply
Fiona Enkelmann
5/4/2018 06:20:25 pm

We have a few to chose from in Melbourne. I used Dr Terry Rose in Moonee Ponds (quite affordable) - he uses safe removal techniques. I would recommend that you see him in conjunction with your naturopath or doctor, to support you with mercury detoxification eg selenium, vitamin C, GSH. Hope that helps!

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Kristy
5/2/2018 02:44:42 pm

Also accidentally unsubscribed 😬

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Traezi
6/5/2018 03:05:14 pm

Hi dr Fiona,
I am 55, live in SE Melbourne, post Tortola thyroidectomy 1999.
Came across you whilst searching for Intergrative doc specialising in thyroid optimisation. Im just wondering if you take Rt3 numbers as a factor of optimising via correct meds.
My RT3 today is 583 , extremely high and I understand I need to decrease that number by adding T3 meds to my protocol. I have seen a few gps who dismiss my extreme hypo symptoms and I’m at my wits end. I can’t continue to feel so unwell.
Are you open to helping with this?
Many thanks in advance.

Reply
Georgina
7/25/2018 10:08:01 am

Hi Dr Fiona,
I'm just wondering if it's possible to shrink a large thyroid goitre and aid an enlarged thyroid. My doctor wants me to have a full thyroidectomy but I'm wondering if anything else can be done?
Thanks, Georgina

Reply
Nolan link
4/16/2019 03:08:19 pm

Great advice Fiona!

Reply
Lidia
6/13/2021 07:06:01 am

I have been battling Hashimoto’s for 22 years now. Since then I have been diagnosed with NAFLD/NASH, Coeliac , RLS, Fibromyalgia . They change my prescription every six months because it’s either too high or too low. I have been to many GP but no one would send me to a specialist and none of the GP I have been too have heard tha LDN can be used for Hashimoto’s. I am so tired,,,,

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