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Diagnosis of overactive thyroid (Grave's disease) quickly leads to treatment with radioactive iodine to destroy the gland. Diagnosis of underactive thyroid (hypothyroidism) quickly leads to thyroid hormone replacement. But do these treatments really help?

Diagnosis of thyroid disease often leads to drastic treatments that have life-long effects. People who are diagnosed with overactive thyroid, with conditions such as Grave's disease, are usually treated with radioactive iodine. This destroys overactive thyroid tissue, but it increases lifetime risk of developing thyroid cancer (especially when the radioactive isotopes are given to children), and it can aggravate a complication of hyperthyroidism called exophthalmia (bulging eyes).

People who are diagnosed with underactive thyroid, with conditions such as Hashimoto thyroiditis, are almost always put on thyroid hormone replacement therapy. Typically someone who is diagnosis with hypothyroidism will be put on a medication like Synthroid for life.

But the hormone in thyroid hormone replacement therapy is not the form of the hormone that the body actually uses, and many people continue to have symptoms, or re-develop symptoms, even when the doctor has done everything possible.

Everything, that is, except watchful waiting.

A Doctor Who Didn't Prescribe Radioactive Iodine

A physician herself, Nina (not her real name) was diagnosed with Grave's disease. She expected her endocrinologist to recommend that she take the radioactive iodine cocktail to burn out her thyroid and then a few months later go on thyroid replacement hormone for life. Nina's doctor, however, had another idea.

Since Grave's disease is an autoimmune condition, and the symptoms autoimmune diseases tend to wax and wane over time, Nina's endocrinologist suggested that they simply wait a few months to see if the thyroid would not correct itself. Six months later, without any treatment at all, Nina's overactive thyroid symptoms had disappeared. Although Nina continues to have annual checkups 20 years later, Nina's Graves disease healed itself and has never come back.

A Doctor Who Told Her Patient "Eat Something, Already"

Dylan was a fitness fanatic, and almost compulsive about integrating the practice of intermittent fasting (eating no food at all for two 24-hour periods each week, although he did drink water during his fasts). Dylan started feeling run down, so he went to his doctor. The labs came back and showed clearly deficient thyroid hormone.

Dylan's doctor prescribed thyroid replacement therapy, but for only three months. After Dylan completed this initial prescription, the doctor suggested that Dylan try cutting back on his fasts just to see if that was what his thyroid really needed. "Eat something, already," the doctor said.

Sure enough, when Dylan stopped intermittent fasting, his thyroid hormone levels returned to normal, and to Dylan's surprise, he started building muscle again without packing on fat. Now three years later, Dylan's thyroid hormone levels continue to be normal.

Continue reading after recommendations

  • Boelaert K, Newby PR, Simmonds MJ, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med. Feb 2010. 123(2):183.e1-9.
  • Jacobson EM, Tomer Y. The CD40, CTLA-4, thyroglobulin, TSH receptor, and PTPN22 gene quintet and its contribution to thyroid autoimmunity: back to the future. J Autoimmun. Mar-May 2007. 28(2-3):85-98.
  • Photo courtesy of cbgrfx123 by Flickr :
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