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Thyroid Disorders

Thyroid Disorders

Would you do thyroid testing on children if their parents have hypothyroidism because of the genetic link? What age would you start testing them? And would it be based on if they have symptoms?

Dr. Amy Nett: Because yes, we’ve said that Hashimoto’s is approximately 70 percent based on genetics, so a very strong...

I seem to see this presentation quite often in my practice. How do I know if it’s due to Hashimoto’s or pituitary gland dysfunction? Based on TPO or thyroglobulin antibodies, I know with Hashimoto’s you don’t always have to see them. Do you have to do a TSH stimulation test?

Dr. Amy Nett: Yes. I don’t know if you have to do the TSH stimulation test because is that actually...

On week 37, part 5, Chris talks about patients who have low TSH and low T3 and T4 that this can be caused by Hashimoto’s or pituitary gland or hypothalamic dysfunction. Can this occur with HPA axis dysfunction as well?

Dr. Amy Nett: So HPA axis dysfunction can certainly cause low thyroid function potentially, also low T3 and T4, it...

If a child has diet low in iodine, would it be okay to give them something like 400 micrograms of iodine in kelp capsules to help support their iodine levels? Would their levels need to be tested beforehand? If someone has known Hashimoto’s, would you do iodine testing on them? In the week 37 material we specifically talk about doing testing on people with hypothyroidism without Hashimoto’s, so I wondered if it should be done on someone with Hashimoto’s?

Dr. Amy Nett: Okay, so let me answer these one at a time. So if a child has a diet...

Looking for advice on an odd pattern we’ve been seeing for a while. We frequently find patients with a functionally normal thyroid panel on the initial case review testing. Then they do a 30- to 60-day reset, then repeat the blood about two to three months after the first test. Even with most markers on the case review panel improving, we invariably find total T3 has dropped to 80 or less with little to no change in other thyroid markers. Is there some other kind of physiologic reason for this other than standard factors that impair T4 to T3 conversion? Most of them are on a standard American diet, so they usually add lots of veggies.

Dr. Amy Nett: Total T3 is dropping and all of the other thyroid markers are staying normal. I’m just thinking,...

Homocysteine of 11, TPO, or thyroid peroxidase, antibodies at 245. She has been diagnosed with Hashimoto’s and is on 100 mg of Synthroid. Her thyroid markers are all in the functional ranges. Her vitamin D is low at 29.5, She also has low-normal iron stores, trying to focus on organ meats. Her chief complaints are are fatigue, body aches, weight. She had an ablation. She believes she’s still premenopausal which make sense since the estrogen markers are normal, sort of high normal. Progesterone is low normal. Testosterone is below normal. DHEA is low normal, with DHEA-S in range at the lowest. She has High 5-alpha-reductase activity.

Dr. Amy Nett: Interesting. Because DHEA actually upregulates 5-alpha-reductase activity. So I would’ve expected with low DHEA that she would...

So today you have a patient on Nature-Throid from her naturopath feeling much better in terms of hyperthyroid system. Free T4 and free T3 are good and TSH is suppressed at 0.01. Do you think this TSH suppression is okay?

Dr. Amy Nett: This is really tricky. Chris and I have a patient that we both work with and she...

What are possible reasons for making antibodies to TTG6?

Chris Kresser: The whole modern lifestyle essentially can trigger or provoke autoimmunity. There’s many, many, many potential causes of autoimmunity....

Are DIM products goitrogenic? Can DIM products be used with hypothyroid patients?

Chris Kresser: It’s a good question I think you’re asking me because DIM is often isolated from cruciferous vegetables and...

Hypothyroidism seems to be associated with many conditions. Is that untreated hypothyroidism if the patient is on a synthetic thyroid hormone? Are the associations still a factor?

Chris Kresser: That’s a good question. My assumption would be that it’s untreated hypothyroidism. And once the patient is treated...

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