One of the challenges that patients with Hashimoto’s thyroiditis and hypothyroidism face is the persistence of fatigue, depressive symptoms, anxiety, and some time many other annoying symptoms, despite achievement of normal thyroid tests with thyroid hormone therapy. These persistent symptoms can significantly alter the quality of life, work performance, and can disturb relationships. When Hashimoto’s patients express their lingering symptoms in the face of normal thyroid tests, doctors oftentimes dismiss these symptoms, and may not believe that the root of the symptoms is the thyroid condition, leaving patients feeling at a loss and frustrated. But these symptoms are real and are indeed related to the Hashimoto’s disease.
The reason for the persistent symptoms are, for some patients, a slight deficit in T3, the most potent form of thyroid hormone. For this reason, optimizing thyroid hormone therapy and individualizing the treatment with a combination of T4 and T3 may help improve or even resolve the persistent symptoms. But for many patients, the persistent symptoms are related to the inflammation chemicals that are produced by the immune system and poured in the bloodstream, as a result of autoimmunity and immune system reactivity.
In Hashimoto’s thyroiditis, the immune system attacks the thyroid and inflames it, and this is what causes hypothyroidism. But while attacking the thyroid gland, the immune system produces a wide range of inflammation chemicals called cytokines. These inflammation chemicals promote inflammation in the body, bloating and achiness, but also have the ability to impair mental and physical energy, and can affect brain functions. This explains many of the persistent symptoms of Hashimoto’s thyroiditis including brain fog, anxiety, low energy, low mood, irritability, anger, and mood swings.
Over the years, many patients have asked if I would recommend a thyroidectomy (surgical removal of their thyroid) with the hope that their symptoms will go away and that they will regain a normal quality of life. I personally have rarely opted for this drastic form of treatment because of the potential surgical risks and surgical complications that may occur during the thyroidectomy procedure. Thyroidectomy, even performed by the best thyroid surgeon, can be complicated by hypoparathyroidism and recurrent nerve damage. For these reasons, I seldom recommend thyroidectomy for patients suffering from Hashimoto’s thyroiditis.
The rationale for removing the thyroid gland in Hashimoto’s patients struggling with persistent symptoms is the removal of the organ in the body (i.e. the thyroid gland) that annoys and irritates the immune system. Removing this organ, would lead to a calming effect on the immune system, which will then reduce the production of the inflammation chemicals and antibodies that promote the persistent symptoms.
A recent, well conducted study published in The Annals of Internal Medicine by researchers in Norway evaluated the benefits of thyroidectomy in patients with Hashimoto’s thyroiditis and persistent symptoms and has shown tremendous benefits as far as resolution or improvement of symptoms, including fatigue, and regain of quality of life. The study also demonstrated a significant drop in Anti-TPO antibody after surgery compared to patients who were treated with thyroid medication. Anti-TPO antibody is a marker of thyroid autoimmunity, and reactivity of the immune system on the thyroid gland. This research is clearly showing that surgical removal of the thyroid may be an option for patients and doctors to consider if significant, debilitating, and quality of life-impairing symptoms have persisted despite adequate thyroid hormone therapy.
I still believe, as I have advocated for years and detailed in my book, The Thyroid Solution, that a more holistic approach of management of Hashimoto’s thyroiditis, taking into account both perfecting thyroid hormone balance and providing optimal care of the immune system, should be the first choice. From my own experience, my Thyroid Wellness Mind-Body Program has worked in thousands of patients with Hashimoto’s thyroiditis and hypothyroidism who have struggled with persisting symptoms.
The use of selenium, which has been shown to improve thyroid autoimmunity, as well as the use of many other antioxidants and ingredients to support the immune system, including zinc, glutathione, and others, all found in ThyroLife Optima, improve and lower immune system reactivity. These combined with probiotics, omega-3 fatty acids, adequate Vitamin D supplementation, avoidance of foods that are irritating to the immune system such as gluten containing foods and dairy, have helped many thyroid patients with persistent symptoms. In my program, I also emphasize the importance of good quality of sleep, the practice of relaxation techniques, and the use of detoxing methods to add more benefits and to make the immune system produce less inflammation chemicals, which are the root of the persistent symptoms. So before you consider the drastic measure of having your thyroid gland removed to regain your quality of life, energy, and sanity, I recommend that you embrace my Thyroid Wellness Program. Doing so may prevent you from taking unnecessary surgical risks.