Vancouver Thyroid Centre
Have you been told that you don’t have a thyroid disorder? Has general testing from your MD or other physician been evaluated as normal, yet you continue to feel like there has been a mis-diagnosis?
Vitalia Healthcare Naturopath is proud to host the Vancouver Thyroid Centre with Dr. Jennifer Luis. Using evidence-based medicine including both natural and pharmaceutical treatment options, our Naturopathic Physicians test, diagnose and treat thyroid disorders. Dr. Luis has helped many people resume healthy lives with thyroid disease. Please click HERE for Dr. Luis’ Biography and personal experience with Hashimoto’s Thyroiditis and HERE for testimonials.
A ground-breaking 2012 publication in the Journal of Restorative Medicine brought light to the differences between tissue-level (cellular) hypothyroidism and brain hypothyroidism. Standard blood testing of TSH (thyroid stimulating hormone) is based on brain levels of thyroid hormone. These levels generally stay stable except in extreme cases of hypo- or hyperthyroidism and are not a reflection of the metabolic rate of the rest of the body. In order to look at cellular levels of thyroid hormone, further testing with calculations of hormone ratios and a detailed history of medical symptoms are evaluated. Hypothyroidism is a complex condition and usually involves auto-immunity and inflammation with up-regulation of the immune system.
Our comprehensive thyroid testing starts with a simple blood draw to analyze 7 different markers including free hormone levels, reverse T3, and antibodies. Depending on if the individual has already been diagnosed with Hashimoto’s (auto-immune thyroiditis) and their current symptoms, further tests may be recommended such as:
- Iron and ferritin levels
- Vitamin D *
- Digestive health - food sensitivities, SIBO, microbiology stool testing
- Red Blood Cell mineral levels **
- Inflammatory markers such as CRP and homocysteine
- Methylation and other genetic testing
- Omega 6:3 ratio and lipid profile
- hypothalamus function - prolactin, FSH/LH
- Adrenal and cortisol function, potentially adrenal antibody levels
- Sex hormones such as estrogen, progesterone, testosterone, DHEA
- Heavy metal toxicity
- Multiple other tests are available upon request or as required for a more comprehensive assessment
* Vitamin D is a steroid hormone and influences over 2000 genes in the body. Most people are not reaching optimal levels even with supplementation and should be tested to determine the correct level of dosing. Low Vitamin D levels correlate to many disorders including auto-immune disease.
** RBC Mineral Profile - Nutrient deficiency is common as a result of dietary factors and digestive disorders that inhibit the absorption of minerals from food into the body. Magnesium is estimated to be deficient in more than half the population with normal thyroid function and a much greater proportion in those with abnormal function. In some cases, although selenium is required to convert thyroid hormone, elevated levels of selenium can mimic the symptoms of hypothyroidism. Testing the levels of minerals can be done by a blood draw and examining mineral levels contained within red blood cells which act to transport nutrients through the body.
Complete Thyroid Evaluation
In addition to testing the blood markers specific to thyroid function, other nutritional values and hormones can be assessed to dig deeper. Typical thyroid testing from a medical doctor is only serum TSH (Thyroid Stimulating Hormone) and an additional T4 level ONLY if the TSH is out of range. At Vitalia, our Advanced Profile includes up to 7 blood markers (TSH, free T4, free T3, reverse T3, both antibodies and SHBG) to pick up on the details of thyroid function.
In some cases, symptoms of hypothyroidism are present yet even the Advanced Profile appears relatively “normal”. The tricky part about labs is that the values assessed are only a measure of the levels found in the blood. Hormone levels can be made at optimal amounts and travel to the cells by blood, yet not be transported into the cells efficiently. This results in cellular hypothyroidism and can be caused due to limited thyroid receptors on the cell, insensitivity of these receptors, decreased transportation of thyroid hormone and poor utilization of hormone.
Vitamin D, iron, iodine and selenium are some of the most important nutrients to enable proper production, transport and utilization of active thyroid hormone. Deficiencies will lead to “hypometabolism” (aka low or slow metabolism) despite good thyroid function. A Complete Thyroid Evaluation measures these nutrients and thyroid markers to determine and understand the whole thyroid system. In some cases, other hormones such as the stress hormone cortisol play a role in the biochemistry of thyroid hormones and is also easily evaluated by saliva.
Our Complete Thyroid Evaluation uses samples of blood, saliva and urine. It includes:
- TSH, free T4, free T3, reverse T3, Anti-TPO, Anti-thyroglobulin
- Vitamin D
- Urine Iodine, Selenium, Bromide and Cadmium
- Adrenal Salivary Stress Index (4 point cortisol, insulin x2, DHEA, progesterone, salivary IgA, anti-gliadian antibodies)
Often further exploration of digestive function is important to ensure that nutrients are absorbed from food and supplementation and any causes of inflammation are eliminated. A high portion of people with auto-immune thyroiditis (Hashimoto’s) have an imbalance in the microbiology of their digestive system. Conditions such as SIBO and candida can be tested for and treated both with diet, supplementation and in some cases prescription medications.
Also known as auto-immune thyroiditis, Hashimoto’s is the cause of an estimated 50% of hypothyroid cases. But what is it and does it matter when it comes to treatment options? The answer is YES.
Auto-immune thyroiditis is a condition in which the body’s immune system is attacking the thyroid. This results in destruction of thyroid tissue and function over time. If left untreated, the thyroid will become inactive and lifelong thyroid medication may be required. Upon diagnosis, Hashimoto’s patients should have a thyroid ultra sound to determine the extent of scar tissue and potential nodules present due to the antibody attack to the tissue.
Hashimoto’s should be looked at as both a thyroid disorder and an auto-immune disease. Often in conventional medicine, patients are given thyroid replacement therapy only. This is where Naturopathic medicine and functional medicine differs. In order to treat effectively, all causes of inflammation in the body must be identified and addressed. This often starts with digestive health since the foods that we eat and the health of the intestines are the first place where inflammation can enter the rest of the body. The digestive disorder SIBO (small intestine bacterial overgrowth) is extremely common to people with hypothyroid and Hashimoto’s.
When determining if the cause of ones hypothyroidism has an auto-immune component, a blood test is performed. Levels of antibodies against the thyroid are detected in elevated amounts. Testing can be used in part to monitor the impact of inflammation on the auto-immune aspect of Hashimoto’s.
Treatment Strategies in Patients with Thyroid Disorders
Depending on the state of thyroid dysfunction along with patient and doctor preferences, there are a wide variety of treatment options. If a patient requires extra thyroid hormone support, medications such as desiccated thyroid, combinations of levothyroxine (T4) and liothyroxine (T3) and/or herbal and mineral combinations are used. Medications can often be compounded to use forms without dyes and other additives and to provide individual doses not conventionally dispensed in regular pharmacies. Blood thyroid levels are monitored carefully when changes of medication or dose are made until a stable state is achieved.
Research-based Treatment Strategies to improve Hashimoto’s Thyroiditis:
Thyroid-Gut Axis: How Does the Microbiota Influence Thyroid Function?Nutrients June 2020
Relationships between the thyroid and gluten (celiac and non-celiac reactivity), Vitamin D, Iron, Iodine, Zinc, Selenium, Vitamin D and probiotics have been clinically and research-based correlated. This literature research provides rational behind supplementation and dietary restrictions for auto-immune thyroid patientsNutrients June 2020
How this applies: Normal, healthy digestion is the first place to start when beginning to address thyroid disease. If important nutrients are low and beneficial bacteria are low, how can we expect the body to have optimal levels of thyroid hormone and low levels of auto-immune markers?
The February 2020 edition of Therapeutic Advances in Endocrinology and Metabolism showed when the common bacterial infection by Blastocystis hominis was treated, significant reduction in Hashimoto’s antibodies were achieved. The study looked at healthy patients and Hashimoto’s patients ‘blood thyroid hormone and antibody markers and the presence of B. hominis in the stool. The immune marker Interleukin 17 was also measured. After treatment, TSH, Anti-TPO and IL-17 also decreased and free T3 improved.
What does this mean to the Hashimoto’s patient? Testing the microbiology of the digestive system using GI 360 and eradicating invasive microorganisms will lower inflammation throughout the body. Less inflammation can result in less symptoms, a general overall improvement with health and preservation of thyroid function. Using a variety of herbs and sometimes the right antibiotic or anti-fungal, unbalanced flora can be corrected.
Supplements and Hashimotos Thyroiditis:
Selenium supplementation. In the International Journal of Endocrinology June 2020, a dose of 200mcg of selenium was given to 40 patients with normal thyroid function for 3 months. Blood markers were tested before and after. The anti-thyroperoxidase antibody had a significant decrease in levels after treatment.
In other words: We all make some level of antibodies against aspects of our thyroid. This is normal and can be thought of as the body dealing with dysfunctional or old proteins that need to be recycled. When antibody levels are above a threshold and a person exhibits thyroid-related symptoms, Hashimoto’s is diagnosed. This study showed that the most common antibody found in Hashimoto’s can be lowered using the mineral selenium.
Of note: Overdosing or taking too much selenium can cause a person to have hypothyroid symptoms, which is interesting because deficiency does this too. Ideally, testing selenium levels using a Red Blood Cell Elements test can be used prior to supplementing.
A newer approach to auto-immune and inflammatory disorders is showing to be beneficial with Hashimoto’s thyroiditis. Low dose naltrexone, or LDN therapy helps to stabilize and improve the immune system by up-regulating endorphins and promoting anti-inflammatory pathways. LDN for inflammatory conditions is an off-label use of the drug naltrexone and is currently being used to improve conditions such as Hashimoto’s, IBS, fibromyalgia, multiple sclerosis, cancer, psoriasis, rheumatoid arthritis and more. For more information, the LDN Research Trust has details on their website.
As there are often many components to hypothyroidism, a patient can expect to look at the body as a whole and not just the thyroid. This includes examining digestion, other hormonal dysfunction such as high or low cortisol, estrogen or progesterone deficiencies or imbalance, blood sugar levels and insulin resistance and concomitant auto-immune disorders.
Low Dose Naltrexone (LDN) Therapy
In the last 10-15 years, the use of the pharmaceutical drug naltrexone in low doses (LDN) has gained attention and popularity. When administered at about 10% of the dose, it has an immune-modulating effect in part by releasing endorphins and reducing pro-inflammatory pathways. This means when used to treat Hashimoto’s and other auto-immune or inflammatory conditions, LDN can reverse and work to remove the cause of symptoms and disease. By balancing the immune response to a more homeostatic state, patients feel better.
A documented study of Hashimoto’s patients showed that after 13 months of LDN treatment, 65% of the individuals had a statistically significant decrease in auto-immune antibodies against the thyroid. It is important to note that LDN is a medically supervised treatment that requires regular monitoring in order to insure safety. At Vitalia Healthcare, we are pleased to provide LDN therapy for those that meet the criteria. For more information on LDN, please visit the LDN Research Trust Organization
Dr. Jennifer Luis completed her undergraduate degrees in Cell Biology/Genetics and in Secondary Education at the University of British Columbia. After teaching at an alternative secondary school in Vancouver for a number of years, she returned to school as a student herself and graduated as a Naturopathic Physician from the Boucher Institute of Naturopathic Medicine in British Columbia. She has continued learning with additional advanced training in thyroid and hormonal therapy, SIBO and digestive health, LDN therapy, paediatrics, acupuncture and more.
Hashimoto’s thyroiditis, hypothyroidism and the complications associated with these conditions such as adrenal dysfunction, digestive disturbances, hormone imbalances and weight gain make up the majority of Dr. Luis’ practice. As a patient with thyroid dysfunction herself, Dr. Luis recognizes the challenges of navigating treatment through conventional medicine and is passionate about helping others feel better with both alternative and traditional therapies.
Dr. Luis uses a variety of methods to improve health such as supplementation, acupuncture, Bowen therapy, IV therapy and chelation. A strong emphasis on the use of laboratory testing helps her focus treatment specific to the individual health needs of her patients. Diet and nutrition guidelines are a part of each treatment plan and any deficiencies are addressed. Having 3 children herself, Dr. Luis has a good understanding of the challenges of incorporating healthy life choices into a busy lifestyle.
Dr. Luis is licensed by and in good standing with the College of Naturopathic Physicians of BC and is a member of both the BC Naturopathic Association and the Canadian Association of Naturopathic Doctors. Dr. Luis also holds a license to prescribe pharmaceutical agents in BC.
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