iThei mdcdaelcinfd o c elllllrlllll ftecdf hslcinfd olidfmdhtlbtktbe“Every great journey begins with a single step.”
—Chinese proverb3: Restoring Thyroid Hormone Levels
Conventional medicine focuses on restoring normal thyroid function
through the use of supplemental hormones. If we are to use the analogy
of a cup with a hole in it leaking liquid to symbolize the depletion of
thyroid hormones, conventional medicine does not consider the source
of the leak (autoimmune destruction); it simply keeps adding more water
to the cup.
While medication does not address the root cause, it is a crucial first step
toward feeling better and reversing the negative effects of hypothyroidism
on the body. Whether one should start replacement thyroid hormone is
primarily determined by lab tests and secondarily the patient’s symptoms.
Traditionally, physicians did not prescribe thyroid hormones when some-
one was considered to have subclinical hypothyroidism (elevated TSH
but normal to borderline low T4 levels), but more progressive endocri-
nologists and physicians now recognize the value of beginning thyroid
hormone supplementation in subclinical hypothyroidism, especially in
those experiencing symptoms of hypothyroidism.
Additionally, new guidelines also recommend starting supplemental thyroid
hormone earlier in the game—even if T4 levels are still normal to borderline
low. Recommendations are to start supplemental hormones in subclinical
hypothyroidism when the TSH is above 10 μIU/ml (without symptoms)
and when the TSH is between 3 and 10 μIU/ml if symptoms are present.10, 11
Hormone supplementation in conventional medicine is considered life-
long, making Hashimoto’s a chronic condition dependent on the tra-
ditional medical system with a continued need for physician visits, lab
monitoring, and daily medication with the potential of dose escalation as
more thyroid tissue destruction occurs.
Lab tests to repeat thyroid function studies need to be performed four
to eight weeks after starting the medication and after any dose chang-
es. Once the dosage is stabilized, tests should be performed every six to
twelve months or more frequently if the patient has thyroid symptoms.^4