The Doctor Is In

QUESTION: I feel tired all the time. I get eight hours of sleep, but I don’t feel refreshed when I wake up and I drag through the day. My friend said she thinks I might have a thyroid issue, but I’ve heard that once you start taking thyroid medicine you have to take it for the rest of your life. I don’t want to do that. Are there natural ways to improve thyroid function?

DR. RASKIN: I would like to answer this question slowly, one part at a time. You say you are tired despite getting an adequate amount of sleep, and your friend diagnosed you with an underactive thyroid? You don’t say if your friend has a medical degree, and I’m sure your friend was just trying to be helpful, but there is a lot of medical misinformation out there that I would like to dispel.

If I had a problem with my computer and I couldn’t get connected to the Internet, I wouldn’t seek out advice from my dry cleaner. It’s not for me to say that he wouldn’t know the answer, but I might be skeptical.

First of all, fatigue despite getting lots of sleep could be a symptom of many conditions, including obstructive sleep apnea, anemia, depression and many other serious medical disorders. The only way to know for sure is to see your doctor who should do a work-up, including blood tests that may in fact lead to a diagnosis of an underactive thyroid.

Doctors can sometimes miss an underactive thyroid if they don’t run all of the relevant tests including TSH, Free T3 and T4 and thyroid antibodies. So, be sure to discuss these tests with your doctor to see if they could help define your condition.

The thyroid is a small butterfly-shaped gland located at the base of the neck above the Adam’s apple. It is vital for the body’s metabolism and temperature regulation. An underactive thyroid can have a variety of causes and is quite common affecting about 1 in 10 women and a smaller percentage of men.

Sometimes this happens when your thyroid comes under attack by your own body’s immune system, or other times it can be a result of aging, dietary factors or other hormonal imbalance.

Symptoms of an underactive thyroid include sluggishness, weight gain, feeling cold, constipation and dry skin.

If your thyroid is indeed not making enough hormone—regardless of the cause—the only proven treatment is to replace the amount of thyroid hormone that will correct the deficit.

The replacement of the hormone may be necessary for the rest of your life or it may not. Just like diabetics who don’t make enough insulin may need to have insulin replacement for the rest of their lives, the same rule may apply for those with underactive thyroids. That is why bloodwork should be done routinely to monitor the levels.

Although there are many people out there who believe that dietary supplements may improve thyroid function, there are no scientific studies showing that natural or dietary supplements actually improve thyroid function in any safe and significant manner.

As more research is done, some supplements may show promise, but until then, synthetic thyroid hormone is still the safe, proven way to treat an underactive thyroid.

Some supplements that are touted to help can actually do harm. For example, the thyroid needs iodine so some suggest taking kelp, which contains lots of iodine.

Unfortunately, a high level of iodine may do the exact opposite and reduce the amount of thyroid hormone secreted or released from the gland. Other supplements that some claim to help include B vitamins, selenium and pineapple. Again, although interesting, there is not enough scientific data to endorse these products for this use.

So, save the garlic and ginger for a spicy Thai curry, and speak to your doctor when it concerns your thyroid.

Palisadian Damon Raskin, M.D., is a board-certified internist who offers preventative medicine, concierge services and addiction medicine to patients in and around the Palisades. Contact: (310) 459-4333. To submit your medical questions, email info@palipost.com.