Trust What your Doctor Says About the Thyroid? Not So Fast...
One of the biggest mistakes that you can make as a thyroid patient is to trust the advice that your doctor gives you.
I know you are probably getting ready to write a comment below (which you should!) about why this is terrible advice and why your doctor knows best.
But hold on to that thought for just a minute.
I'm not saying that your doctor is clueless but I am saying that there are nuances to thyroid management that are largely ignored by thyroid doctors.
This leads to thyroid patients who continue to suffer from thyroid related symptoms despite listening to their doctor and taking their advice.
If you've been in the thyroid game for more than 5 years you know exactly what I am talking about.
If you are someone who was recently diagnosed with thyroid disease then this might sound crazy and off the wall.
Just allow me some time to set the record straight.
Today I am going to discuss lies that your doctor has probably told you about the thyroid which are completely false.
Again, it's not that your doctor is trying to intentionally lead you astray or to be malicious but it is the case that doctors tend to act like they know more than they do, especially when it comes to thyroid management.
I've had the opportunity to listen to thousands of thyroid patients over the years so I have heard and listened to the "advice" that doctors have given.
Some advice is okay while other advice is completely false and should be ignored.
Why should you care about whether or not your doctor is right?
Well, you should care a lot because it impacts how you feel.
If you take the wrong advice or listen to a doctor that doesn't know what they are talking about then you may spend the next 5 years suffering needlessly from symptoms such as weight gain or fatigue that could otherwise have been eliminated.
What is more concerning is just how prevalent this bad advice is.
I'm not talking about a couple of bad eggs here. I'm talking about MOST doctors, especially endocrinologists and family practice doctors.
If you want to hear the most common lies and why they are completely false then keep reading...
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Commons Lies Perpetuated by "Expert" Doctors
Before we jump in please know that this isn't an exhaustive list of lies that I've heard perpetuated by doctors.
This just happens to be a list of some of the more common lies that I've heard.
Chances are high that you've heard others that aren't included on this list and if you have then I want to hear them!
Please take a second when you are done reading through this list to share lies that you've been told.
And if you aren't sure if something your doctor has said is true or not, feel free to leave that comment below as well.
I will take those questions and make another blog post because we are going to need multiple parts and blog posts for this topic.
Without further ado, let's jump in:
#1. Biotin is harmful to your thyroid and should be avoided.
The first lie that I want to talk about has to do with biotin and thyroid function.
This has been popping up a lot lately probably because there have been some recent studies (1) on the topic.
This lie goes something like this:
"Biotin is harmful to your thyroid and should, therefore, be avoided. If you are taking a supplement with biotin then you need to stop immediately because it can cause problems."
There's only one problem with this statement...
It's completely false.
But it is rooted in some partial truth which is why I think it's somewhat believable.
So let's talk about biotin and your thyroid.
Is it true that biotin is harmful to your thyroid? Not at all.
Is it true that biotin can cause issues with thyroid lab tests? Yes, that is true (2) but it's not nearly as impactful as you might think.
Biotin interferes with the thyroid lab testing assay but has absolutely zero to do in impacting thyroid function.
So while it may make your thyroid lab tests inaccurate, the changes that it causes on your lab tests are not real changes in thyroid function but a fabrication due to lab interference.
There's a big difference.
And guess what? There's a simple solution.
Just stop taking biotin 2 days before you get your thyroid labs tested!
That will solve the problem 100%.
Unfortunately, some doctors use this lie as a way to try and recommend that thyroid patients avoid supplements with biotin because they seriously dislike supplements.
If you understand this lie then you will know that biotin is not only helpful for hair regrowth (and other issues) but that it also doesn't impact thyroid function.
#2. The dose of natural desiccated thyroid fluctuates and is not consistent.
This is another lie used by doctors as a way to recommend against the use of thyroid medications in the Natural Desiccated Thyroid family.
These medications contain a combination of both T4 and T3 thyroid hormones and are often sought after by thyroid patients who have done some research on their own.
And doctors absolutely hate these medications for what appear to be illogical reasons.
I know because when I was in training I was told to never prescribe them.
And when I asked why not I was told "because they come from pigs".
That was the only reason given to me.
It's illogical to assume that something that comes from animals is somehow inferior to medications that are man made but here we are.
Don't bother trying to understand their logic because it won't get you far.
Instead, let's talk about debunking why this statement is NOT true.
The lie here is that Natural Desiccated Thyroid medications (NDT for short) are inconsistent in their dosing.
Your doctor will say that the amount of thyroid hormone found in each lot of NDT varies between lots and will cause fluctuations in thyroid hormone and make management of your thyroid too difficult.
They will also sometimes claim that this will cause problems for you and that the medication isn't safe.
There's one big problem:
This isn't true.
Having said that, this lie does have some validity which we will talk about now.
It is true that the therapeutic dose of forms of Natural Desiccated Thyroid can differ MORE than therapeutic doses of levothyroxine and Synthroid but that difference is only 5%.
It works like this:
All prescription medications have what is called a therapeutic index (3).
This therapeutic index is a range that the medication can fall within and still be considered "therapeutic".
You may think that if your medication says that it contains 100mcg then it contains 100mcg, right?
Well, you'd be wrong.
When you are manufacturing millions and millions of tablets and capsules using machines and ingredients from all around the world, there are bound to be variations in dosing from lot to lot.
The FDA accounts for this and allows minor variations in dosing of various lots of medications to still consider them "therapeutic" and viable.
The range for levothyroxine and Synthroid is 5% on the high end and 5% on the low end.
So if your dose of levothyroxine can fall within 95% and 105% of the stated dose and still be considered "therapeutic".
Using our example of 100mcg, some doses of 100mcg of levothyroxine may actually contain 96mcg and others may contain 104mcg.
You have no idea what your dose actually is as a thyroid patient but you can feel comfortable knowing that it falls within that range.
How does this compare to natural desiccated thyroid medications?
Well, the range that these medications can fall within to still be considered "therapeutic" is slightly larger.
That range is 10% on the high end and 10% on the low end.
In other words, your dose of NDT can be 91% of the stated dose or 109% of the stated dose and still be considered "therapeutic".
So while it is true that there is variation between synthetic thyroid medications and natural desiccated thyroid medications, the variation is not small and usually doesn't make a huge difference.
#3. Taking your thyroid out is an easy solution for fixing thyroid problems.
If there is one lie that should stand out to you it should be this one.
This one should come with a huge flashing warning sign and some sirens.
Because this is a blog post, that's impossible, but at least I can write about it!
Why is this so important?
Because removing your thyroid will have profound consequences that will last for the remainder of your life.
And thyroid removal is often sold as something that is a quick and simple solution for an otherwise overwhelming and terrible problem.
Before we go on, you should know that sometimes thyroid removal is unavoidable.
For instance, in the case of thyroid cancer or other life threatening conditions, removing your thyroid may be necessary and life saving.
I'm not talking about people who fit into this category.
Instead, I'm talking about people who are struggling with relatively minor or moderate issues that don't necessarily require thyroid removal but in which it may be recommended.
And if you are someone in this situation then my recommendation is to do whatever you can to avoid getting your thyroid taken out!
Your doctor will tell you that removing your thyroid is easy because you can just take thyroid medication for the rest of your life.
What they don't tell you is that this medication will never do as good a job as your own thyroid gland and that many thyroidectomy patients suffer from symptoms such as weight gain (4), fatigue (5), hair loss, and other symptoms afterward.
Removing your thyroid gland does make managing thyroid function easier from the doctor's perspective but it's definitely not easier from the patient's perspective.
If you are someone who has had their thyroid removed and experienced these issues please leave a comment below!
This will help those people who are on the fence about getting their thyroid removed.
#4. Supplements do not help your thyroid and can even hurt you.
This is another lie that I hear all of the time.
I mentioned previously that doctors hate certain things and supplements are one of those!
Because I produce and manufacture thyroid supplements and have for the last 5 years, I have heard from thyroid patients what their doctors say when they mention they are using my supplements.
It's not uncommon for us to receive emails from people telling me that their doctor told them that they couldn't use thyroid supplements because, in the opinion of their doctor, they aren't safe or may cause issues.
While I'm sure the doctors are well-meaning, and probably believe that, it's simply not true.
In fact, it's often the case that the use of thyroid supplements helps so much that thyroid patients are able to reduce the amount of thyroid hormone that they are taking.
This by itself should be considered a huge win for thyroid patients but doctors often use this as a reason to avoid them!
The logic is that taking a supplement that causes you to change your dose of thyroid medication is somehow a problem.
But it really shouldn't be viewed in this way.
Why is it a problem that your thyroid is working better than it did before using the supplement?
If the supplement helps your own thyroid do its job and allows you to naturally produce more thyroid hormone then that is a GOOD thing and should be considered a success.
But, like much of what we've discussed here, there is some partial truth to this lie.
It has been the case in the past that some unscrupulous manufactures of thyroid supplements use active thyroid hormone in their supplements.
This is quite rare but it does happen from time to time and this IS an issue.
Fortunately, reputable manufacturers of thyroid supplements do not have this issue so it can almost entirely be avoided as long as you purchase from quality brands.
When in question, avoid supplements that are produced or manufactured overseas where the rules from the FDA don't apply.
If you are someone who uses my supplements then you don't need to worry about this at all because each lot undergoes third party testing to verify ingredient quality and content.
If you don't want to use my supplements then just make sure you find someone who does the same.
#5. Free T3 and Free T4 lab tests are not important and don't need to be tested.
This lie has to do with thyroid lab tests.
The lie goes something like this:
"TSH is the best and only test necessary for asses thyroid function and other tests such as free T3 and free T4 aren't necessary".
But like everything else on this list, this is also a lie.
While it is true that the TSH does have some value in evaluating thyroid function, it's far from the single best test out there, and often times thyroid patients need additional tests to see the full picture.
To solidify this, let's look at a couple of other examples:
Consider the case of testosterone, estrogen, progesterone, and cortisol.
These are all other hormones produced by the body, they are all very important, and are very similar to thyroid hormone in how the body regulates them (through the brain/pituitary connection).
When your doctor wants to evaluate these hormones he/she will directly order the corresponding hormone level in your blood to see its level.
If your doctor wants to check your estrogen level you better believe that he/she is going to order a free estradiol level (the most powerful estrogen).
If your doctor wants to check your testosterone level you better believe that he/she is going to order a free and total testosterone level.
Why then is it the case that your doctor does NOT order free thyroid hormone levels?
Thyroid hormone is the only hormone system in the body that doctors completely neglect free thyroid hormone levels and the only reason given is that "it's not necessary".
I'm sorry, but "it's not necessary" is not a scientific or logical argument.
It is a logical argument to suggest that free t3 and free t4 levels should be ordered BECAUSE they represent the actual value of thyroid hormone in the serum.
These lab tests represent the amount of free thyroid hormone floating around in your bloodstream which is both free and active and available for use by the body.
Why you would ignore such critical information is illogical and potentially harmful to thyroid patients.
If your doctor is unable to give you a reason why you shouldn't order free t3/free t4 levels then it's probably time to seek out a second opinion because that doctor is not practicing critical thinking.
#6. Once you start taking thyroid medication you must take it for life.
The use of thyroid medication is another topic clouded in confusion by thyroid patients.
Many doctors will tell thyroid patients that once they start taking thyroid medication that they will be required to use it for the rest of their life.
This obviously scares a lot of thyroid patients and has been the source of much anxiety for certain people.
But is it true?
It is true in certain instances but not in all cases.
For instance, if you have had your thyroid removed or ablated or you are in end-stage Hashimoto's then, yes, it is true.
But if you have a potentially reversible cause of low thyroid function then there is a chance that you can get off of your thyroid medication at some point in the future.
Thyroid hormone use does not have to be a lifelong thing in every single case but the evaluation of potentially reversible causes of hypothyroidism is not something that most doctors look into.
Your doctor is more interested in putting you on a thyroid medication and monitoring it every 3-6 months than they are trying to reverse your condition.
But what's interesting is that some thyroid patients may be able to either reduce their dose of thyroid medication or get off of their medication entirely if they can treat the underlying cause.
Wrapping it up
I hope you've found this list of thyroid lies both helpful and enlightening!
I wish it was the case that information on the thyroid was more widespread and more accessible but that just isn't the case right now.
You would expect doctors to be up to date on thyroid function and management but that isn't always the case. In fact, that's rarely the case.
As a thyroid patient, you know better.
Do your best to learn more about thyroid function so you can take your health into your own hands.
Also, please take a minute to write about your experience below! If you've had an interaction with a doctor that didn't sit right with you, tell me about it below.
I know that there are so many things said to thyroid patients that aren't true but I need to know what they are in order to debunk them.
With that in mind, share your thoughts and experiences below!
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