In this interview I discuss Hashimoto's Thyroiditis and Graves' Disease with Linda Lizotte.

Linda: This Linda Lizotte, I'm the co-founder of Designs for Health, nutritionist and I'm happy to interview Dr. Nikolas Hedberg tonight. Let me tell you a little bit more about his background. Dr. Nikolas Hedberg, he's a D.C., D.A.B.C.I. He's a board certified chiropractic internist by the American Board of Chiropractic Internist. His practice is in Asheville, North Carolina where he focuses on autoimmune thyroiditis.

 

Dr. Hedberg is the author of the book 'The Complete Thyroid Health and Diet Guide' which is a comprehensive guide to diagnosing and treating thyroid disorders that's sitting right here next to me, it's fantastic. Dr. Hedberg lectures at integrative medicine conferences. Has been published in medical journals and teaches advanced functional medicine courses through Functional Medicine Town and as an adjunct faculty member at Hawthorn University. Health care practitioners of all disciplines consult with Dr. Hedberg on the most difficult cases, his practice philosophy can be summed by this quote by Sir William Osler, "It is much more important to know what sort of a patient has a disease than what sort of a disease that patient have." Wow, very good. Okay. Let's work to getting started. So thank you Dr. Hedberg.

Dr. Hedberg: Thanks for having me again Linda. I really appreciate it.

Linda: Again the book 'The Thyroid Alternative: Renew your Thyroid naturally' he's got some nice write ups in here by some doctors that we know. We have Dr. David Brady foreword. He's got a really nice write up by Dr. Daniel Taylor, chiropractor, he's been in clinical rounds. Dr. Ernest Colin and... who's a clinical director of Holistic Medical Clinic of Carolina. And Dr. Geoffrey Moss from Massachusetts that a lot of you know so well. So fantastic book.

It's definitely... we're going to go through a lot of it, what's in there tonight. Obviously, we'll... the book is more patient friendly and I know that was difficult for Dr. Hedberg to do as it is for any of your practitioners to try to bring this to patients. That's where this book might be really useful to you because you're trying to explain the same stuff. So get the book and if it's something that you're trying to explain to your patients on a regular basis you can just hand it to them. You don't have to explain it all saying it a 100 times.

Dr. Hedberg: Thank you.

Linda: So, all right. So I know that that's why probably why you wrote the book Dr. Hedberg no?

Dr. Hedberg: Yeah. There's some good thyroid books out there but I wanted to give a broad overall picture of functional medicine and all the on causes of thyroid disease because a lot of people seem... the feedback have gotten already is, they [inaudible 00:03:03], 'Wow, I never even knew that the adrenal is going to affect the thyroid and the Lyme disease can cause thyroid problems. So it's... I think to me a good job educating people about thyroid disorders.

Linda: Yes. We're going to learn some new things and learn some things like you just mentioned that I wasn't really up on before so... I would love for you to start with some of the statics that you state in the book and just some great information about autoimmune thyroid disease. That probably would make a good start to all of this.

Dr. Hedberg: Right. Now is the best time to be a functional medicine practitioner because autoimmune disease is on the rise. We're really the only ones who can identify why it's there and really get these patients under control and improve their quality of life. Autoimmune thyroid disease, it's the number one autoimmune disease in the United States. Actually about 10% of the US population has autoimmune thyroid disease. So if a huge number of people, almost one of every 10 people you brought into is going to have it. Twenty-seven million Americans, mostly women, about 50% of them will go undiagnosed. And 90% of the hypothyroidism you're going to see in practice is actually due to Hashimoto's.

So when we see someone and you think that they have a thyroid problem there's a good chance there's going to be autoimmunity involved. Conventional treatment it's the same whether you have autoimmune thyroid disease or not. We have the hypothyroidism it's not autoimmune. You get medication Synthroid. If you have Hashimoto's it's the exact same treatment. That's why a lot of conventional physicians they don't run thyroid antibodies because it's not going to change how they treat it. We know that when someone does have Hashimoto's, it's not necessarily an issue with the thyroid gland, it's really an issue with the immune system.

Linda: Good point. So I do want you to go into that a little bit more, but before you do, you might want to just talk about the diagnosis and how that might... maybe differs from diagnosis of just plain old type of hypothyroidism or any other thyroid condition.

Dr. Hedberg: Right. So usually you'll pick up on some of the symptoms but usually that's TH8 thyroid stimulating hormone's going to be elevated. Looking at total T4, total T3, 3T4, 3T3, many times those are going to be decreased. But the two antibodies you want to run to really make the diagnosis are thyroid peroxidase antibodies and antithyroglobulin antibodies. You've got to run both. I see a lot of blood work done from other practitioners and they just do thyroid peroxidase. But you're going to have antithyroglobulin antibodies positive.

Thyroid peroxidase antibodies could be negative so you really have to run both. If any of those are elevated then you know how to... know to diagnose [inaudible 00:06:19] which is kind of the opposite. You can run what's called a TSI, thyroid stimulating immunoglobulin and then also TS8 receptor antibodies. If any of those are positive then you also have the diagnosis of graves.

You can also see a mixed Hashimoto's and graves. You will have thyroid... say thyroid peroxidase as positive and they'll have the TS8 high positive. So they'll actually have both.

Hashimoto's can actually start of as like a grave's presentation because there's a lot of information. The thyroid gland is producing a lot of extra hormone so they actually have... they actually has symptoms of too much thyroid hormone. But it's actually the beginning stages of Hashimoto's and then they eventually fall into the hypothyroid category overtime as the thyroid gland gets destroyed from the immune system.

Linda: That's very interesting. I did not know that the thyroid peroxidase can be negative and say really all... absolutely [inaudible 00:07:25] antithyroid antibodies, that's fascinating.

Dr. Hedberg: Exactly.

Linda: And then I have seen patients where they seem to be over producing but then they go into like a complete hypothyroid. Of course they like to use that as a treatment to kind of bring thyroid out to and then treat them with the thyroid hormone, but I've never heard before that that's the beginning of the Hashimoto's. That's very interesting.

Dr. Hedberg: Yeah. We can certainly present that way.

Linda: All right. So you got this thyroid gland and you've got... you were mentioning this is a really an immune system disorder and you also mentioned that autoimmune is on the rise and we're all seeing that. So we absolutely cannot disagree with that. So the thyroid glands, right in the throat, right in the center [bone 00:08:17] between the head and the rest of the body, why is this gland so prone to autoimmune disease?

Dr. Hedberg: There's actually a paper I once quoted, it was just published this year in 2011, out of a journal hormonal research. And actually the title was a paper is "Why is the thyroid so prone to autoimmune disease?"

Linda: Really?

Dr. Hedberg: So it's out there and everyone even in conventional medicine and research they're trying to figure out why is it so prevalent now, why is it growing? Basically the authors say that these are basically preventable environmental factors like high iodine intake, selenium deficiency, pollutants such as tobacco smoke and industrial smug, as well as infectious diseases and certain drugs. They've all been implicated in the development of autoimmune thyroiditis.

So you really have to have three things for autoimmune disease. Number one is a genetic predisposition. There's not a lot we can do about that at least not yet. The second thing is usually gut permeability, leaky gut. And with our modern day high stress lifestyles, electromagnetic creation, computers, cell phones. We're all under more stress. We're working longer hours, there's more pollution. As you know and our food is hollow. You can pick up an orange off the shelf and it might not even have a single milligram of vitamin C in it. Medications, infections, toxic metals.

So they're recognizing this in conventional literature that it is the environment and our modern day lifestyles that are triggering this. Now thyroid is just is just... it's very sensitive to toxins and it's the largest endocrine gland in the body because of very, very high blood supply right directly from the heart. Over time there's enough environmental insults and the autoimmunity can be triggered.

Linda: Fascinating. So you remind me of the... Dr. Loyd did a lecture at out Glacierfest this summer, in August and he talked about the perfect storm. He was referring to autism. I think a lot of us came out of that lecture saying, "Wow, the perfect storm is... correlate to fibromyalgia, can relate to Hashimoto's, can relate to so many other... probably most of the disorders that functional medicine practitioners like yourself deal with. It's never just one cause not typically. I think that's far as of our medical doctors as to why they can't just put everything under a tiny little simple blanket.

Dr. Hedberg: Exactly. The thyroid...