Thyroid Disorders

Including Hashimoto’s

“I’ve been hypothyroid for many years. My doctor put me on thyroid hormones (Levothyroxine or Synthroid) and monitors my TSH every year. (S)he says that my thyroid is normal now, but I still have a lot of symptoms and feel like crap. I have constipation, brain fog, low energy, depression, and crappy skin. I don’t know why I feel so bad because my thyroid labs are normal.”

Unfortunately, this story is very, very common. Here’s a few reasons why:

Most hypothyroidism is caused by an autoimmune condition called Hashimoto’s

That means that most hypothyroidism isn’t a thyroid problem, but an immune problem.

In order to fully heal, you need to treat the immune system and inflammation.

Food sensitivities (including to gluten) are common in Hashimoto’s patients.

Hashimoto’s is a lifelong condition- but it can be put in remission and symptoms dramatically improved. 

The Lab Puzzle

TSH isn’t the only test for the thyroid, so your doctor most likely has an incomplete picture of your thyroid health

A complete panel should include:
Free T4
T4 (Total)
Free T3
T3 (Total)
Reverse T3
T3 Uptake
Free Thyroxine Index
TPO Antibodies
Thyroglobulin Antibodies

I run the above (a complete thyroid panel) on every patient in my office.

Inflammation is common in hypothyroidism.

CRP is a test that is run to look for inflammation, but like TSH, it isn’t the end-all-be-all test for inflammation. Even if you have normal/low CRP you almost certainly have inflammation if you’re hypothyroid!

Common Hypothyroid Symptoms
  • Constipation
  • Fatigue
  • Brain-fog
  • Inability to lose weight
  • Cold hands and feet
  • Slow metabolism
  • Dry skin
  • Hair loss

You may have all of these symptoms or only a few.

Common causes of Hypothyroidism

Autoimmunity (90% of cases)

Things that affect the immune system in a negative way can cause autoimmunity or exacerbate it-

  • Infections (viruses, parasites)
  • Gut dysbiosis (including SIBO and candida)
  • Toxic burden (ex. endocrine disruptors)
  • Tissue damage (from an injury or surgery)
  • Stress
  • Poor sleep
  • Diet
  • ​​​Inflammatory potential of foods​​
  • Nutrient (vitamin, mineral) deficiencies

It is not uncommon to see people with multiple things going on that are contributing to their thyroid problems.

Diet and Hypothyroid

Diet has a powerful role to play in treating or managing a thyroid, but it is often not enough to treat the big triggers (like infections). That is why I usually recommend a combination of diet, herbs, and vitamins to manage Hashimoto’s and hypothyroidism.

Diets that can help thyroid conditions (and that I have worked with) include:

  • Paleo
  • Autoimmune Protocol diet (AIP)
  • Gluten-free diet
Curing and Helping Hypothyroid

Hashimoto’s can be put into remission and it’s progression can be slowed or stopped. However, If you are on thyroid hormone replacement you will most likely need to stay on that for the rest of your life.

I have seen great changes in my thyroid patients over the years. Hashimoto’s in particular responds very well to dietary changes, herbal medicine, supplements, vitamins, and life coaching. I feel very lucky to be able to help people with this condition every day at my office in Chapel Hill.

I literally searched the world over (internet, LOL) and found Dr. DiNezza’s website. She is a well-rounded health care professional who is experienced in treating Hashimoto’s Thyroiditis so I drove 2.5 hours to see her for my first visit. She has been able to pinpoint the trigger that had stalled my healing process, and I am now on the right healing path. I am very thankful for her thoughtful and considerate care, and I really appreciate all that she has done to help me. 😊

Teresa S

I highly recommend Dr. DiNezza to anyone seeking better health. I am a Registered Nurse who appreciates the importance of a holistic, integrated approach to health and wellness. While I understand the importance of conventional medicine, I’ve also experienced its frustrations: the rushed 15 minute office visit where “your lab work is fine therefore you’re fine” despite not feeling well, the “just wait until it gets worse and then start take these pills” regardless of the root cause, etc.. So, from the very beginning, several things I’ve greatly appreciated about Dr. DiNezza is that she will sit down and really listen to you. Every detail. And talk with you. For a full hour! She’ll run tests to get to the root cause, and develop a multifaceted treatment plan that views each patient as an integrated person rather than a single disease. Personally, Dr. DiNezza has helped me on my journey to balance my wacky hormones. With Hashimoto’s hypothyroidism and a TSH of 4.49, I struggled with fatigue and other symptoms of low thyroid. However, since anything below 4.50 is considered “normal” by conventional standards, I had a hard time finding someone who would treat me despite my symptoms. In addition, I had signs of PCOS (My testosterone, FSH, LH, estrogen, and progesterone hormones were also out of wack. No fun!). Over the course of working with Dr. DiNezza (running tests, being encouraged and supported in my dietary changes, and being introduced to effective supplements I hadn’t known about), I’m thrilled to say my TSH is now down to 1.69, my symptoms have improved, and my other PCOS-related female hormone levels are improving as well. I am so grateful for the role Dr. DiNezza has played in getting me back on track and I am excited to see what further improvement the future holds. Dr. DiNezza feels more like my partner in “health-hacking” (as I like to call my health-improvement tinkering) than my “doctor”, and I love that. She respects my input but knows vastly more than I do and is an excellent resource. She is intelligent and personable and I definitely recommend her to anyone looking to work toward better health!

Sarah S

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