I believe, like many others, that evidence shows that our bodies develop imbalances during our lifetime. Our bodies intelligently compensate for these imbalances in a way that many times we don’t even know we have a problem. Symptoms can be minimal and can be hard to detect. Over years, an imbalance can turn into a chronic illness which has the potential to be fatal. Masking any known symptoms with a pill does not fix the root of the problem.

An imbalance with your thyroid gland can affect all ages but it is commonly misdiagnosed in the elderly since its symptoms can mimic other known problems associated with the elderly. Memory loss, sleepiness, constipation and dry skin are just several of the symptoms that an elderly person may experience. Many people assume it is a normal part of the aging process so they do not attempt to find the root of the problem.

Cliff Colgan, MS, located in Boulder, Colorado, is a Nutrition Therapy Practitioner trained in Functional Physiology and Dysfunction. He has an in-depth understanding of how the thyroid gland functions and how to successfully treat an imbalance in all age groups, specifically 55+ years old. Cliff has been successful in treating this imbalance with minimal to no prescription pharmaceutical drug usage. Drugs will alleviate only the symptoms and not treat the actual cause, thus lifetime consumption of the drug may be required. Cliff believes that each person requires a personalized program of support and whole foods diet analysis that meets their individual wellness concerns.

I asked Cliff to address the following questions.

What actually causes the thyroid gland to malfunction in the first place?

There are two basic ways the thyroid gland can malfunction. One is by producing too much thyroid hormone (hyperthyroidism) which boosts your metabolism and makes you nervous, and puts your body functions into overdrive. The second is too little thyroid hormone production (hypothyroidism) where there is too little metabolism energy and a general lack of energy and function. The large majority of thyroid cases in the U.S. (75-80%)are due to hypothyroidism, or too little thyroid hormone production.  90% of U.S. hypothyroid cases are due to autoimmune attack of the thyroid tissue by your own immune system. For a variety of reasons your immune system is tricked into believing your thyroid gland is a “foreign object” and white blood cells are sent by your bloodstream to the thyroid gland where the tissue is slowly attacked and made non-functional. This creates a lack of thyroid hormone production over several years in most cases. 

What tests do you perform to receive a proper, timely diagnosis of a thyroid gland disorder?

U.S. medical practice usually consists of a blood test for thyroid stimulating hormone (TSH). This is a hormone made by the pituitary gland in the brain in response to low blood levels of thyroid hormone. If blood levels of TSH are high, the physician assumes the thyroid is not making enough thyroid hormone and prescribes thyroid hormone substitute medication (either animal derived or lab produced) of which levothyroxine and Synthroid are examples.

The problem with this process of evaluation and treatment is no attempt to discover WHY the person’s thyroid is not producing enough thyroid hormone.  Often it is because of an autoimmune attack of the thyroid. Little is being done in the current U.S. medical system to determine why there is thyroid autoimmune activation and no systematic protocol to dampen or diminish thyroid tissue loss of function. However, there are an increasing number of functional medicine and alternative care practitioners who are being successful with dietary and supplemental support which dampens, slows and in some cases stops immune system lymphocyte attack of the thyroid.

To identify autoimmune thyroid activity, I suggest a thyroid peroxidase (TPO Ab ) serum antibody test and also a thyroglobulin serum antibody test (TGB Ab) along with a thyroid panel of tests that test for TSH as well as other thyroid hormone substances such as T4 and T3. Thyroid peroxidase and thyroglobulin are two important proteins responsible for helping to produce thyroid hormone in the thyroid gland. If the immune system of a person malfunctions and interprets either of these two proteins as “foreign”, these important substances are attacked by the immune system’s white blood cells and made inactive. So positive lab results to either TPO Ab or TGB Ab indicates there is autoimmune action by that person’s white blood cells to their thyroid gland. The problem is now identified to be an immune system problem and NOT the thyroid working poorly. But if the thyroid is being attacked by your white blood cells the thyroid will lose function over time, produce less thyroid hormone and eventually (if the immune system is not corrected) destroy the thyroid’s ability to make any thyroid hormone. Without naturally made thyroid hormone, a person must receive thyroid hormone from outside the body (from animal thyroid or synthetic thyroid hormone).  I feel that every attempt should be made to save the natural function of the thyroid before relying exclusively on thyroid hormone substitute medications for low thyroid hormone conditions.

A thyroid stimulating hormone antibodies test (TSI Ab) or TSI test can indicate hyperthyroidism (too much thyroid hormone production) which is also known as Graves’ disease.

It is possible for a person’s immune response to be so exhausted that a TPO Ab or TGB Ab test may be negative. If client symptoms suggest hypothyroid lack of activity, serum antibody tests should be repeated if initially negative. If the client doesn’t want to repeat the antibody tests, he/she can can elect to go on a gluten free diet and see if low thyroid symptoms improve. Gluten in wheat and other grains is a protein that often triggers antibody reactions to the thyroid gland. Removing all gluten sources from the diet is often my first recommendation to autoimmune hypothyroid clients. Removing gluten from the diet can be alarming and fear provoking to the client at the start of treatment, but the improvement of symptoms and a general elevation of  how one looks and feels is worth changing some eating styles to improve their quality of life. I tell my clients if they want to continue their current way of eating they will continue to feel worse and worse. All the supplements and vitamins you could take cannot overcome an eating style that contributes to the problem by disrupting the immune system embedded in your small intestine. Consistently removing the foods which cause the inflammation of your gut, cause the immune attack of your thyroid to lessen and stop in some cases. 

There are other blood and saliva tests that can be done to indicate other malfunctions of the thyroid and brain for the other ten percent of U.S. hypothyroid cases not due to autoimmune attack, but they are outside of the space and scope restrictions of this blog.

What treatment do you recommend to resolve a thyroid imbalance?

Thyroid underfunction often results from the body’s activation of the immune system white blood cells. This immune system activation can be caused by different mechanisms in different people.

I find that identifying and eliminating food that tends to activate allergic inflammation of the intestinal tract is very helpful. For most autoimmune thyroid sufferers, eliminating the consumption of foods which contain gluten (wheat, rye, barley, oats, and the breads, pastas, pastries and products made from these grains). Also delayed allergic reactions to dairy can activate the immune systems of the digestive tract of susceptible people. Having a holistic nutritionist help you identify inflammatory foods which give you allergic challenge can help you to heal an inflamed small intestine which can be a large cause of your immune sytem being so destructive to your thyroid.

Balancing your food intake to prevent eating large amounts of high carbohydrate foods (rice and other grains, potatoes, bread, pastries etc) is very helpful. This includes processed sugar (also products made with sugar). These foods cause large releases of insulin by your pancreas and resultant disruption of your body’s other hormones. Eating lower carbohydrate vegetables (both raw and cooked) and some protein containing foods such as fish, organic raised poultry, and organic red meat as well as beans puts much less insulin in your bloodstream which allows your whole metabolism to work more effectively. Natural supplements such as vitamins, minerals and other phytonutrients can help support your intestinal health short term, but reducing intake of large amounts of quick releasing carbohydrate foods is essential to allowing your immune system and organs like the small intestine and liver to relax and quit working so hard.

Anything you can do to help support your intestinal health will help quiet your immune response to your thyroid. Besides limiting high carbohydrate food consumption you may have infections and inflammation of the stomach, small and large intestines. Especially curbing the inflammation of the small intestine, the site where your food is absorbed into your bloodstream is essential to dampening the immune attack of the thyroid gland.  A holistic practioner who can suggest prebiotics, probiotics, digestive enzymes and weak acid (betaine HCL) which can help your intestinal health. This practitioner can also suggest herbal supplements that can dampen bacterial, viral and parasitic infections that are sapping your intestinal health.

Is your treatment plan different if the person is elderly?

The treatment plan is largely the same but depending on the condition of the elderly client’s intestinal tract, more time may need to be spent on healing their gut before more advanced steps like liver detoxification and blood sugar balancing can occur without incurring problems.  Many elderly clients don’t produce enough stomach acid to help digest the protein in meats and fish. This can cause stomach distress when the stomach doesn’t empty its contents in a timely manner. Food can be released back into the esophagus causing burning and irritation. In addition, lack of bile production by by the liver or its delivery of bile from the gall bladder can cause a problem in digesting fats from the meal. 

Detoxifying the liver is the next step after stabilizing the intestinal health and again support of the liver with nutrients  is as important as detoxifying it of toxins. A less aggressive approach may need to be taken to allow toxins to release more slowly. Dietary fiber is important to allow the released liver toxins to bind to the fiber so it can be eliminated through the large intestine and not reabsorbed into the bloodstream.  

Medication levels may need to be adjusted as the body heals and allows naturally made levels of thyroid hormone to be more effective. The client may need to talk to the health care provider about reducing thyroid medication levels to prevent hyperthyroid symptoms. Other medications may need to be adjusted or perhaps eliminated as the client regains body function.

The treatment plan may take more time with the elderly client.  However the relief of symptoms and the resultant increase of energy levels in the elderly client can be dramatic and very satisfying to the client and the practitioner.

Cliff Colgan can be reached directly by phone at 303-898-6109.