ADVERTORIAL Thyroid medication: why less really is more by Dr. Raquel Espinol


Introduction The thyroid gland regulates metabolism by releasing hormones called thyroxine (T4) and triiodothyronine (T3). When the thyroid underperforms, it causes everything in your body to work less efficiently. This is known as hypothyroidism. Hypothyroidism affects more than 30 million American adults and is five to eight times more common in females.1


By conservative estimates, one in eight women will develop hypothyroidism.1


The most common cause of hypothyroidism is an autoimmune disease called Hashimoto’s thyroiditis. This makes up 75-85% of hypothyroid cases. Oftentimes, people with Hashimoto’s struggle to find a medication or treatment plan that works for them and continue to suffer through symptoms like:


• Fatigue


• Feeling cold • Losing hair


• Gaining weight • Depression


While there are many treatment options for hypothyroidism, not all are created equal. Selecting the most appropriate one is vital to managing this disease.


Thyroid hormones: T3 and T4


The two hormones to remember are T4 (thyroxine) and T3 (triiodothyronine). T4 circulates throughout your bloodstream and is stored in your tissues until needed. Once your body finds a need, it converts T4 into T3. Establishing the exact levels of T4 and T3, and determining if the conversion process is working normally, are critical to designing the best treatment approach.


While most healthcare providers understand the critical nature of T4 to T3 conversion, many fail to recognize the factors that affect this process. These include:


• Nutritional deficiencies/excesses • Autoimmune diseases • Gastrointestinal diseases such as celiac disease, acid reflux, or irritable bowel syndrome


• Use of interfering medications like proton pump inhibitors (Nexium®


and Prevacid® • The body’s own obstacles to converting T4 to T3


Some people continue to suffer from hypothyroid symptoms despite being on medication for years. But with some effort, patients can work with their doctor to find an approach that works for them.


What can interfere with hypothyroid therapy?


Some commonly used prescription drugs that can interfere with thyroid medication absorption and efficacy:


• Antacids • Lithium • Amiodarone • Antibiotics • Antidepressants • Dopamine agonists • Colestipol • Cholestyramine • Estrogen, testosterone


Some commonly used nutraceuticals that can interfere with the absorption of thyroid medicines:


• Iron • Calcium • Magnesium


• Chromium picolinate


Some foods that can interfere with absorption of medication:


• Soy products • High-fiber/high-bran foods


• Calcium-enriched foods/beverages , for example) or H2 blockers (Tagamet®


for example), which inhibit the dissolution and absorption of thyroid hormone tablets


,


Digestive complications or diseases such as celiac disease, autoimmune gastritis, and irritable bowel syndrome can also complicate thyroid hormone therapy.


Make sure to discuss with your doctor all of your medical conditions, medications (both prescription and nonprescription), and nutritional supplements before starting or switching thyroid hormone therapy.


Dr. Raquel Espinol graduated with honors and received her doctorate in naturopathic medicine from Sonoran University of Health Sciences (formerly Southwest College of Naturopathic Medicine). She struggled with her own thyroid condition, which was not successfully managed until she discovered naturopathic medicine and worked with a naturopathic doctor to control her condition. This firsthand success inspired her to pursue a career in naturopathic medicine specializing in thyroid diseases.


Dr. Espinol works with men and women addressing thyroid conditions, hormone imbalances, and weight loss. She is licensed to practice in Arizona, California, Oregon, Washington, Utah, and Montana.


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