what kind of doctor do i need to see for my thyroid

Wouldn't it be astonishing if we could observe the one doctor who could give us a magic pill to make all of our problems become away? We would lose weight, abound our hair back, accept energy once more…

While there may not be one magic pill out in that location, finding the doctor who is right for you lot, can change the grade of your wellness journey and put you on the path toward healing.

I recommend that everyone with Hashimoto's consult with a healthcare professional person. Fifty-fifty if you lot are extremely knowledgeable nigh Hashimoto'south, information technology helps to have an objective individual to bounciness ideas off of, aid you identify potential triggers of your condition, and resolve them.

That said, ane of the questions I hear the nigh from my readers is: "What type of doctor should I see for Hashimoto's?"

The sad reality is that many patients are often disappointed after coming together with conventional doctors, who tell them that there is nothing that can be done about the autoimmune attack on the thyroid. Such doctors simply prescribe one type of thyroid hormone, don't dose the thyroid hormones correctly, and leave their patients feeling miserable!

In this article, I'd similar to offer some information virtually the conventional approach to thyroid care, versus a Root Cause approach, and how to detect a doctor who can assist you lot meet your wellness goals.

Read on to learn:

• The conventional approach to thyroid handling
• The Root Crusade approach to treating Hashimoto's
• Different approaches to medication management
• Questions to ask your practitioner
• Insurance concerns

The Conventional Approach

The conventional arroyo to treating Hashimoto's focuses on looking at ane particular organ or part (the thyroid), versus looking at the body as an integrated whole.

Here are the typical recommendations made for those with Hashimoto's:

ane. The standard of care approach to Hashimoto's, practiced by virtually conventional doctors and endocrinologists, is focused on testing for depression levels of TSH (thyroid-stimulating hormone) if a patient presents with a series of known thyroid symptoms.

The issue with this for someone with Hashimoto'south is that it is not a "preventative" exam, and a person with Hashimoto's may appear to have normal TSH levels and exist told they are fine… for years.

TSH oftentimes tests as abnormal only afterward a lot of damage to the thyroid has already been washed. There are v stages of illness progression in developing Hashimoto's, and TSH doesn't normally test as abnormal until phase 4!

If your thyroid labs appear "normal," you lot're likely going to exist told that there is nothing you can practise, other than look until the thyroid is destroyed to the bespeak that you volition demand thyroid medications.

two. If thyroid levels are deemed "aberrant," levothyroxine (T4) is the thyroid hormone of selection prescribed to nearly people with Hashimoto's.

However, patients are often not dosed on medication appropriately because outdated and cookie-cutter lab reference ranges are used. These measure the levels of thyroid hormone in the pituitary gland, but non in the residual of the torso. (Furthermore, I've found that many clients respond better to non-T4-axial hormone medications. This is considering some people'south bodies don't fairly convert T4 to T3, so they may need a combination T4/T3 medication for optimal support. (As a pharmacist, I accept appropriate medication utilise seriously. Please check out my article on thyroid medication options to larn more than.)

3. Thyroid medications are expected to address a patient'south symptoms, and patients are oftentimes told that they should begin feeling better in a few weeks. Once on this prescription-just path, a patient will probable have limited follow-ups that are focused primarily on the medication's effectiveness at improving their TSH levels. TSH levels may improve, but the patient'due south status can worsen, equally Hashimoto'southward is progressive and their immune organisation will likely proceed to assault the thyroid (if the underlying root crusade of the condition is left unaddressed).

Many have gone to conventional doctors to seek help for specific symptoms like brain fog and weight gain, only to exist given express recommendations such as "Possibly you're just getting older", or the often hurtful "Exercise more and eat less" (which of course can make things worse if you have dumb thyroid and adrenal function).

Patients who go along to exist symptomatic are frequently referred to other specialists for additional medications to target symptoms, such as dermatologists for hair loss, or psychiatrists for depression. These symptoms are not recognized as being related to the autoimmune thyroid condition or its root causes.

4. The conventional approach is near managing the "disease" rather than offering the support and tools needed to aid patients fully recover. In that location are commonly no lifestyle recommendations or attempts to find triggers for the autoimmune response against the thyroid, and ane's thyroid antibodies are rarely fifty-fifty tracked. (However, the progression, or regression, of Hashimoto's can often exist tracked by monitoring fluctuations in i's thyroid antibody levels, as college antibody counts are usually correlated to a greater autoimmune attack on the thyroid. Read more than about that here.)

5. The conventional arroyo limits its focus to the particular follow upwardly engagement and labs, monitoring the medication's effects at each visit, instead of having a practitioner truly partnering with the patient to effigy out why their bucket is leaking in the start identify (and what they can do about it).

There is never a focus on making the autoimmune issue better! Instead, the condition is seen every bit "irreversible", but patients are told that medication volition at to the lowest degree supply the trunk with the hormone (which the thyroid is no longer able to produce on its own) that it needs.

And so, Should I Meet an Endocrinologist?

I of the common questions I receive from readers is whether they should see an endocrinologist in one case they have been diagnosed with Hashimoto's.

Often, patients think that endocrinologists will have admission to the latest and greatest advances in medicine, just this is not necessarily the case with Hashimoto's.

While I have the utmost respect for the profession of endocrinology and believe that every person who has been diagnosed with Hashimoto'south should see an endocrinologist at least once for a full evaluation and a thyroid ultrasound, many patients with Hashimoto'due south stop up disappointed with the care they receive from their endocrinologists and conventional doctors.

This is because the conventional medical approach to treating thyroid affliction focuses on replenishing thyroid hormone levels with the apply of synthetic thyroid medications in one case the "thyroid has burned itself out" and tin can no longer produce its own thyroid hormones.

While at that place is a time and identify to see an endocrinologist, I recommend that most people with Hashimoto's find a functional medicine-minded practitioner who tin can help dig for root causes and accept an individualized approach to treating the condition.

The Root Cause Approach

Nearly conventional doctors have non been trained in the root cause approach. When asked what to do about the immune imbalance that triggered the autoimmune affliction in the first identify, they, unfortunately, don't have whatever answers.

Frequently, conventional doctors volition kindly offer to test you for other autoimmune conditions, as the underlying immune imbalance can interpret into the development of new autoimmune conditions if non addressed, but they will Non test you lot for underlying root causes of the autoimmune condition.

Why?

Just, considering this is non something they have been trained in — much of their preparation is focused on identifying a condition, and using medications and/or surgery to treat the status.

My training in chemist's schoolhouse was very much the same. "If someone has 'X' disease, y'all recommend 'Y' drug!" I learned about helpful lifestyle changes for a few of the weather condition besides, only to be perfectly honest, the lifestyle recommendations were severely lacking in my training.

Furthermore, most conventionally trained doctors, pharmacists, and nurses are not trained in root crusade resolution. I was never told that adrenals, food sensitivities, toxins, nutrient deficiencies, digestive issues, and infections could create chronic autoimmune illness within the body, and that addressing these issues can help a person feel better and fifty-fifty issue in remission.

In dissimilarity, the Root Cause arroyo focuses on why your immune system may be out of balance in the offset identify.

The Root Cause approach focuses on figuring out what triggered your condition, what can exacerbate your condition, too as the interventions that can make you feel better, reduce the assail on the thyroid gland, preclude you lot from getting another autoimmune condition, and go your condition into remission.

This approach to Hashimoto'south is patient-centered and looks at the underlying bug and the person's individuality.

The Root Cause Arroyo to Hashimoto'southward involves:

• Utilizing comprehensive thyroid tests to determine diagnosis and the need for thyroid hormone therapy.
• Using optimal and functional ranges of thyroid hormones instead of outdated reference ranges.
• Optimizing thyroid hormones, utilizing the T1,T2, T3, and T4 hormones when necessary (all are produced past the thyroid gland, merely only T4 is present in levothyroxine, the well-nigh unremarkably prescribed thyroid drug).
• Optimizing diet through eliminating reactive foods also as addressing deficiencies and digestion.
• Addressing the stress response.
• Addressing the health of the detoxification system.
• Addressing the state of the gut.
• Identifying the person'southward unique triggers such as chronic infections, toxins, or traumas.
• Tracking thyroid antibodies every three months to see if the interventions are making the condition less ambitious.
• Appreciation of the person'southward experience and always utilizing the person's symptoms as a guide for adjusting treatment.

There is a whole, growing field of medicine defended to this approach, known as functional medicine.

Functional medicine practitioners can have a variety of backgrounds. Some may be medical doctors, doctors of osteopathy, physician administration, nurse practitioners, chiropractors, (compounding) pharmacists, naturopathic doctors, doctors of integrative medicine, acupuncturists, and nutritionists. This list may besides extend to other professions too.

While all of the to a higher place-listed practitioners can help you with addressing the root crusade of the condition, in almost states, only medical doctors, osteopathic doctors, physician assistants and nurse practitioners volition be able to prescribe thyroid hormones (await for ones that are trained in functional or integrative medicine). Some may also be limited in the ability to prescribe other helpful medications similar LDN, which has been found to be helpful for improving thyroid symptoms and antibodies.

The biggest challenge with seeing these types of practitioners is that they are often not going to exist covered by insurance. This is because the recommendations, interventions, and tests recommended past these types of practitioners are often considered "experimental," and insurance companies are going to be very resistant in reimbursing them for their services.

However, these are the professionals working with the latest enquiry and coming back with unmatched outcomes and numerous success stories! (Sometimes, astonishing success stories event after a few uncomplicated lifestyle changes that they recommend!)

Approaches to Medication

When the TSH is elevated to the point of needing medications, nigh conventional doctors will prescribe Synthroid (generic name: levothyroxine), a synthetic T4-containing thyroid medication, which was the number 1 prescribed medication in the U.S. in 2019, accounting for 114 million prescriptions!

While levothyroxine may work well for some people with Hashimoto's and hypothyroidism, in that location are many people who continue to take symptoms of hypothyroidism on this medication. One reason is because levothyroxine (chemical name tetraiodothyronine or T4) is a prohormone that needs to be converted to the more physiologically agile liothyronine (chemic name triiodothyronine or T3) in the torso, to fully activate thyroid receptors.

"On paper", this simple conversion should happen only fine, merely it doesn't ever happen that way in the body. This is because the conversion requires a lot of different pieces to be in place, including having plenty nutrients (that act equally co-factors in the chemical procedure), having proper gut and liver function, and existence on a low-stress setting (every bit chemical messengers related to stress may block or alter the conversion, resulting in the person not having enough T3 on board).

Some people who do not have enough T3 on lath may benefit from T3-containing thyroid medications or natural desiccated thyroid medications (NDT), which are derived from the thyroid glands of animals and don't crave a person to convert T4 to T3 (a process that is impaired in many people with Hashimoto's).

However, most conventional practitioners are not going to be comfy with medications other than constructed T4 medications… In fact, most clinical guidelines and pharmacology textbooks recommend only using synthetic T4 medications.

This is considering, in prior years, the NDT medications were not manufactured precisely, and this resulted in inconsistent dosing between batches.

Additionally, T3 medications were misused and given to people without thyroid disease in loftier doses, to induce hyperthyroidism and try to achieve weight loss — a very dangerous scenario!

Today, the manufacturing process of NDT medications has been revamped, and now the medications are safe and effective when used correctly for people who are supposed to receive them (i.e. people with hypothyroidism) — unless, of course, there'due south a recall! More on that in a minute.

If you're seeing a conventional md and taking a synthetic thyroid medication, you can cry, plead and beg for NDT or a T3-containing medication, but most of them are not going to requite yous a medication they are not experienced in prescribing. And this is really a expert thing — yous don't want to be someone's very first patient on a medication they don't know how to utilize. Instead, you want to work with a practitioner that is well versed in using the various thyroid medications.

Another reason why a person may not experience well while taking levothyroxine could be due to issues related to absorption. For those needing to take multiple medications or those that take issues with malabsorption such as low stomach acrid, H. pylori, acid reflux or SIBO, taking a medication like Tirosint may aid with proper absorption.

If you are struggling with thyroid symptoms despite being on thyroid medications, it may be helpful to run across a doctor that is trained and familiar with the use of a variety of thyroid medication options, including T4-simply medications (Synthroid, Levoxyl, Tirosint, levothyroxine, Euthyrox), T3 medications (Cytomel, liothyronine), Natural Desiccated Thyroid (NDT) medications (Armour*, Nature-Throid, WP Thyroid), and compounded thyroid medications (hypoallergenic blends of T4 and T3 in compounded, physiological ratios). This type of a practitioner volition be able to help you observe the type of thyroid medication that will work most effectively for you.

As such, I urge you to seek an adept that is knowledgeable in thyroid pharmacology. 🙂 (You'll observe resource to assistance you find such a practitioner in your surface area, further on in this commodity!)

Note: I wanted to give you a heads upwardly that in that location has been a contempo call up on all electric current lots of Nature-Throid and WP Thyroid (manufactured past RLC Labs, Inc), due to sure lots being plant to be sub-potent. This ways that the affected medications may accept too little thyroid hormone in them. A person who is stable on their electric current dose of thyroid hormone, who and then receives these afflicted lots, may become hypothyroid!

As such, at that place may be a current backorder of Nature-Throid and WP Thyroid medications in your surface area. Please contact RLC Labs and your local pharmacist direct if you have any questions or concerns.

*Notation: While Armour Thyroid does non take any gluten-containing ingredients, it is not tested for gluten content, and cannot be certified equally gluten-complimentary. Armour does contain sodium starch glycolate, which tin can exist derived from wheat or corn.

Questions to Ask Your Practitioner

So, how exercise you find the right physician?

If you lot're looking for a practitioner who can assistance you accost Hashimoto's, it'due south important to know what you are looking for in a healthcare partner.

For example, if you are getting started on your thyroid journey and want to become some baseline labs and a thyroid ultrasound, you might want to start with an endocrinologist. If you're looking for a more comprehensive approach that involves addressing your root causes, a functional or integrative practitioner is going to be your best bet. If you are looking for someone to help personalize your thyroid medications, compounding pharmacists are an excellent resource.

Here are some questions to enquire your practitioner to see if they are a good fit for you:

1. Do they prescribe hypoallergenic thyroid hormones similar Tirosint, compounded thyroid medications, or natural desiccated thyroid medications (NDTs like Armour Thyroid, Nature-Throid, WP Thyroid, NP Thyroid and others)?
2. Do they have experience with prescribing low-dose naltrexone (LDN)?
3. Do they order a full thyroid panel that includes TSH, Costless T4, Costless T3, TPO/Tg antibodies, or just the TSH test?
4. Do they accept accounts with functional medicine lab companies like Ulta Labs, Direct Labs (GI-MAP test for gut infections), My Med Labs (nutrient sensitivity testing), or ZRT Laboratory (Adrenal Stress Profile) so they can help you dig for hidden root causes?
5. Can they society food sensitivity tests?
6. Optional: Practice they offering telemedicine (virtual date via video conferencing) options?

I encourage you lot to write out a list of these and other questions yous have for your healthcare provider, and wait for a like-minded practitioner who tin can offering yous the level of care that y'all need on your individual journeying.

Finding Dr. Right in Your Area

To help you locate a practitioner in your expanse, I have compiled a database of recommended clinicians and practitioners. The list of names in this database correspond practitioners who have shown an interest in my Root Cause approach to Hashimoto'due south. Yet, yous will still need to be your own advocate in asking the right questions to discover someone who will be a good fit for you. Unfortunately, I'm unable to evaluate each of them individually at this point, merely I hope this listing provides a starting place for yous.

You can also check my listing of compounding pharmacies to discover a chemist who will chemical compound your thyroid medications for y'all.

I as well recommend searching the Plant of Functional Medicine'southward practitioner database, where yous tin can search world-wide for healthcare advocates who are experienced in functional medicine. ZRT Laboratory offers a practitioner database also.

Booking Virtual Appointments

While 2020 has been a crazy year, these days, there is something that may assist even if you live in a place with very few experienced practitioners. Something to consider is telemedicine, which allows you lot to work with a functional physician remotely, via Skype, Zoom, Google Meet, or other video conferencing applications. With telemedicine, y'all can work with a practitioner who is a proficient fit for you, but may not be located in your area.

More than and more, medicine is using these remote options, and many doctors are embracing technology to expand their services. In the current climate that nosotros are living in, this might be particularly beneficial! When looking for Dr. Right, be sure to enquire if they offer virtual appointments.

Remember, you are your best health advocate!

Will Insurance Embrace My Practitioner?

If you are working with a practitioner who accepts insurance, keep in listen that they may not be able to spend as much time with you every bit necessary due to reimbursement guidelines, and they may not be able to guild functional medicine labs.

While these labs tin can be extremely important in getting to the root cause, they are outside the standard of care and considered experimental, so almost endocrinologists, primary care doctors, and internal medicine doctors volition not run those tests.

Many insurance companies turn down to reimburse doctors who use "non-canonical labs" or order what they deem every bit as well many tests for a patient. Unfortunately, the insurance companies have besides much control over the practice of medicine.

Often, you will need to notice a practitioner outside of insurance to get the care, attending, and testing y'all deserve. In some cases, you lot may be able to submit the claims to your insurance visitor for reimbursement. However, some insurance companies may not reimburse for these labs, so be prepared to pay out of pocket if needed.

I retrieve of these tests as a wellness investment. Many of us will get out and spend money on a pocketbook or a pair of shoes that makes us feel better in the short term, just spending money out of pocket for a lab test could dramatically improve our health in the long term.

In the outcome that y'all cannot find a doctor who will exist able to prescribe medications and order the functional medicine labs, you may want to work with your medical dr. on monitoring your medications while you work with a functional medicine practitioner (who may non take prescriptive authority) to guild the tests for you lot.

If you lot cannot find a practitioner to order the tests for y'all or if you lot have a high deductible, you tin can also order the same tests on your own through direct-to-consumer lab companies. (I've prepare a few tests that you can club through them at a discounted price! Find them here, in the "Labs" section.)

The Takeaway

I believe that everyone needs to find a practitioner who will permit them be a part of their healthcare squad. You want someone who can guide you and besides heed to yous and your concerns. You lot want someone who is open to thinking outside the box and who understands that you lot may not fit in with the standard of care.

It's also important that you don't expect your doctor to change for yous. Instead, find a doctor that fits your situation and understands your needs. There is a time and a identify for an endocrinologist, a functional medicine practitioner, and a compounding pharmacist. It is up to you to ask the right questions and find the healthcare partner who will help you lot achieve your healthcare goals.

For more data on existence your own healthcare advocate and finding your root crusade, I encourage you lot to choice upward a copy of my books Hashimoto's: The Root Crusade and Hashimoto's Protocol . I wrote these books after struggling to notice the help I needed from my doctors, learning to dig for my own root causes, and discovering the earth of functional medicine. My goal is to empower you lot with the knowledge y'all need to get improve and give yous the tools and strategies you need to take dorsum your health, as well every bit reduce your dependency on the medical organization!

There are many strategies (that you'll notice in my books) that you can implement on your own, such as eliminating inflammatory foods (and inflammatory people, too, equally stress is a huge trigger!), addressing your food deficiencies, and taking helpful supplements.

Merely for other interventions, similar getting on the right medication, testing for infections, or doing an avant-garde detoxification protocol, it is helpful to have a specially trained practitioner on your side.

1 24-hour interval, I hope that every single practitioner will be well versed in diagnosing and reversing Hashimoto'south! In the meantime, over the past few years, I've been collecting names and contact data for practitioners that can help from other thyroid patients.

If you're looking for practitioners who believe in the root cause approach to treating thyroid issues, bank check out my listing of agreeing practitioners!

I hope that this information helps you take accuse of your own health!

P.S. You can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion affiliate for free by signing up for my newsletter. You will also receive occasional updates about new enquiry, resources, giveaways and helpful information.

For future updates, brand sure to follow us on Facebook and Instagram besides!

References

1. Lewis South. The Top l Drugs Prescribed in the United States. Healthgrades website. https://www.healthgrades.com/right-care/patient-abet/the-top-50-drugs-prescribed-in-the-united-states. Published September 5, 2019. Accessed August xiii, 2020.

Note: Originally published in September 2015, this article has been revised and updated for accuracy and thoroughness.

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