This article is part of a special report on Thyroid Disorders. To see a comprehensive eBook on thyroid health,click here。
估计有2000万美国人具有某种形式的甲状腺疾病。取决于60 percentof these people are unaware of their condition.One in eight womenwill develop a thyroid disorder during her lifetime. The number of people suffering from thyroid disorders continues to rise each year. (1)
Hypothyroidism is one of the most common thyroid disorders. It’s estimated that nearly 5 percent of Americans age 12 and up have hypothyroidism. (2) It is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other not-so-fun symptoms.
Every cell in the body has receptors for thyroid hormone。These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body.
You can think of the thyroid as thecentral gear in a sophisticated engine。如果那个档位，整个发动机会随着它而下降。
That’s why people with hypothyroidism experience everything from weight gain and depression to infertility, bone fractures and hair loss.
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One of the biggest challenges facing those with hypothyroidism is that the standard of care for thyroid disorders in both conventional and alternative medicine ishopelessly inadequate。
The dream of patients with thyroid disorders and the practitioners who treat them is to find thatsingle substancethat will magically reverse the course of the disease. For doctors, this is either synthetic or bio-identical thyroid hormone. For the alternative types, this is iodine.
Unfortunately, in the vast majority of casesneither approach is effective。Patients may get relief for a short period of time, but inevitably symptoms return or the disease progresses.
So what’s the problem? Why have replacement hormones and supplemental iodine been such dismal failures?
This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the United States. (4) While not all people with Hashimoto’s have hypothyroid symptoms,已发现甲状腺抗体是标记物for future thyroid disease.
Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors don’t tell their patients is simple: it doesn’t affect their treatment plan.
但在Hashimoto的情况下，后果 - 即。据信副作用和并发症使用免疫抑制药物占潜在的益处。（感谢常规医学在这里有理智的相对时刻。）
So the standard of care for a Hashimoto’s patient is to simply wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid, and then give them thyroid hormone replacement. If they start to exhibit other symptoms commonly associated with their condition, like depression or insulin resistance, they’ll get additional drugs for those problems.
The obvious shortcoming of this approach is that it不解决the underlying cause of the problem, which is the immune system attacking the thyroid gland。如果潜在的原因没有解决，则治疗不会很好地工作 - 或者很长。
如果你在漏水的小船,拯救水将only get you so far. If you want to stop the boat from sinking, you’ve got to plug the leaks.
Extending this metaphor to Hashimoto’s disease, thyroid hormones are like bailing water. They may be a necessary part of the treatment. But unless the immune dysregulation is addressed (plugging the leaks), whoever is in that boat will be fighting a losing battle to keep it from sinking.
Hashimoto’s often manifests as a “polyendocrine autoimmune pattern。” This means that in addition to having antibodies to thyroid tissue, it’s not uncommon for Hashimoto’s patients to have antibodies to other tissues or enzymes as well. The most common are transglutaminase (Celiac disease), the cerebellum (neurological disorders), intrinsic factor (pernicious anemia), glutamic acid decarboxylase (anxiety/panic attacks and late onset type 1 diabetes).
For more on how to balance the immune system and treat Hashimoto’s,check out this article。
Research Spotlight: Health Coaching and Thyroid Health
Hashimoto的甲状腺炎是美国甲状腺功能减退症最常见的原因，与健康控制相比，患者对生活质量降低。额外的症状可包括慢性疲劳，干燥的皮肤，脱发和烦躁，使工作和社会生活变得困难。一项研究发表在Cureus, a medical journal known for raising funds via crowdsourcing, indicates that through collaborative healthcare, including health coach support, patients with Hashimoto’s can successfully change lifestyle behaviors to result in improved quality of life and lower symptom burden.
The main objectives and findings of the article were the following:
- In this pilot study, researchers sought to determine whether the support of health coaches and other professionals could help women with Hashimoto’s successfully change diet and other lifestyle behaviors, leading to improved thyroid function, metabolic profile, and quality of life.
- Seventeen normal and overweight women, aged 20 to 45, with Hashimoto’s participated in a 10-week online health coaching program that focused on implementing the Autoimmune Protocol (AIP) diet along with other lifestyle modifications, including sleep hygiene, stress management, and increased movement. Participants were also part of an online support community with each other and met with nutritional nurse practitioners and physicians periodically.
- During the duration of the 10-week program, patients were strictly adherent to the AIP diet about 95 to 100 percent of the time.Although no significant changes in thyroid function were measured after the program, six of the 13 women who were initially on thyroid medication were able to lower their doses. Symptom burden, BMI, weight, and inflammation all significantly decreased. Furthermore, patients reported improvement in all eight subscales of the quality of life survey, including physical, mental, social, and emotional health.
Key Findings and Significance
These findings stress the role of health coaches as change agents.The AIP, Paleo diet, and other similar diets are often discounted for being too “restrictive” and impossible to practically follow. However, participants in this study were 95 percent compliant with the dietary template and lost weight without tracking calories or macronutrients. And the diet resulted in significant health improvements! There is no doubt that the health coaches and online support group played key roles in the participants’ success. The program used in this study is called the “SAD to AIP in SIX”: Standard American Diet to Autoimmune Protocol in SIX weeks.
Although no measures of thyroid function significantly improved after the 10-week program, patients reported significant improvements in symptoms and quality of life, and many were able to lower their medication doses. When patients have support outside the 15-minute doctor’s appointment every six months, they are more able to change behaviors and lifestyles to benefit their health.
Health coaches support people who are trying to make big changes—like adopting a new diet or incorporating yoga into their exercise routine. How do they do it? By developing and honing skills like facilitating change and learning to listen. Find out more about becoming a health coach with theADAPT Health Coach Training Program。