Slow Butterfly: How Healing Your Thyroid Transforms Everything

By Dr. Amy Gajjar

Do you have an underactive thyroid?

"I'm tired. I'm losing my hair. I can't lose weight. I have bad moods and feel like crap. They said the blood work is all fine. It's probably just stress."

Hashimoto's thyroiditis is the most common cause of hypothyroidism—underactive thyroid—and the most common autoimmune disease in the world. Unfortunately, it's often not diagnosed properly, and when it is, monitoring or medication are the only options offered.

As a result, many people suffer for months or even years without a diagnosis, and those on medication may still feel unwell, unable to live their best life.

But this doesn't have to be the case. If you have an underactive thyroid, there is much you can do yourself to improve your symptoms and live more optimally.

Your life should be more than just a matter of surviving day-to-day. Empower yourself so you can start to improve—today—wherever you are on your healing journey.

• Language: English
• Publisher: BookBaby
• Release date: Aug 16, 2022
• ISBN: 9781544533353

Book preview

AmyGajjar_SlowButterfly_EBook_FINAL.jpg

This book is for general informational purposes only. It does not constitute the practice of medicine or other professional health care services and is not intended to replace medical advice, diagnosis, or treatment. It is recommended that you seek advice from your physician or other healthcare professionals before embarking upon any suggested treatments. All efforts have been made to assure the accuracy of information in this book as of the date of publication. The author disclaims liability for any medical outcomes that may occur as a result of applying the methods suggested in this book.

Lioncrest Publishing

Copyright © 2022 Dr. Ameeta Gajjar

All rights reserved.

Slow Butterfly

How Healing Your Thyroid Transforms Everything

Dedicated to you, the reader.

Hoping that this book guides you in your healing journey. May you fly high like a brilliant, beautiful butterfly!

-

Contents

Introduction

Chapter 1

Key Essentials

Chapter 2

Sleep Is Medicine

Chapter 3

Stress—The Twenty-First-Century Epidemic

Chapter 4

Your Breath Is Your Anchor

Chapter 5

Let Food Be Your Medicine

Chapter 6

Keep on Moving

Chapter 7

The Environment Pulls the Trigger

Chapter 8

Many Paths in Your Healing Journey

Chapter 9

Living with Grace

Conclusion

Appendix A

From Chapter 3: Restorative Yoga Postures

Appendix B

From Chapter 4: More Breathing Techniques and Meditations

References

Further Reading and Resources

Acknowledgments

_

Introduction

"Do the best you can until you know better.

Then when you know better, do better".

—Maya Angelou

Can you relate to any of the following comments? If so, you should read this book.

I’m tired; I’m losing hair; I can’t lose weight; I have bad moods and feel like crap. They said the blood work is all fine. It’s probably just stress.

I was told it’s Hashimoto’s and there’s nothing else they can do about it; they’ll monitor, and if it gets worse, medication can be given.

They said I’ve got an underactive thyroid and told me to take this medication for life!

I’m on thyroxine but still not feeling better.

I wanted to know if there was anything I could do apart from taking the thyroxine. I asked about diet. They said diet has got nothing to do with it.

Why This Book Exists

Hashimoto’s thyroiditis is the most common autoimmune disease in the world, accounting for most cases of hypothyroidism (underactive thyroid). Unfortunately, it’s often not diagnosed properly, and when it is, monitoring or medication are the only options offered. This book focuses on Hashimoto’s thyroiditis, as this is the most common form of hypothyroidism. It is also relevant for those who have a diagnosis of hypothyroidism or who have hypothyroid symptoms but have not yet been diagnosed.

What this means is that many people can suffer for months and years without a diagnosis, affecting their life significantly. If they’re put on medication, they may still feel unwell. Because of this, many people suffer needlessly and are kept from living their best life.

But this doesn’t have to be the case. If you have Hashimoto’s or an underactive thyroid, it’s important to realise there is much you can do yourself to improve your symptoms and live more optimally. Your life should be more than just a matter of surviving day to day.

There is substantial evidence that lifestyle medicine improves thyroid health and leads to a pathway of healing. Success stories from patients are testaments to the fact that key areas of lifestyle, like nutrition, stress management, and the use of different healing modalities, have helped them feel better—sometimes so much better that they have been able to stop or reduce their medication.

As we shall see, the thyroid gland controls many functions in the body and there are hundreds of symptoms. Standard healthcare can be fragmented. This can be beneficial because it allows for specialist review for a particular symptom or issue, but it can also mean that the dots don’t get connected, as each doctor is dealing only with their particular speciality.

Practically this can mean that someone with Hashimoto’s may have high cholesterol and be advised to go on a cholesterol-lowering medication (statin). They may have gut symptoms and be referred to a gastroenterologist; have hair loss and be referred to a dermatologist; have anxiety or depression and be given medication and referred to psychiatrists; have heavy, painful periods and see a gynaecologist; have palpitations and be referred to a cardiologist; and of course, be referred to an endocrinologist for hormone therapy. This is not to say that people may not need to be referred, but if Hashimoto’s is diagnosed early and treated, the symptoms may resolve or reduce.

Figure 1 is a useful way to look at this. The branches of the tree represent different symptoms under their respective medical specialties, as is taught and practised in mainstream medicine. However, if we look deeper towards the roots, there are various underlying factors and processes (e.g., inflammation, lifestyle factors) contributing to these. If a leaf has become discoloured through disease, painting it will not be sufficient; if the roots aren’t addressed, it’ll continue to become diseased. When using a functional medicine approach, we are interested in looking at the roots, and if these issues are addressed, the rest will fall into place, resulting in overall health improvement.

Figure 1: Functional Medicine Tree

The importance of lifestyle medicine or complementary therapies was not taught at medical school all those years ago. Although I had an interest in nutrition during my medical school days and during my time as a general practitioner (GP), I didn’t take it further until later after I had left London and came to Sydney. I completed my fellowship training with ACNEM, the Australasian College of Nutritional and Environmental Medicine, and also with ASLM, the Australasian Society of Lifestyle Medicine. This was a turning point for me and how I practised medicine. After years of being busy, burned out, and stressed, I regained a passion and interest in my work, and found a way of life with more meaning and purpose. I love learning and have completed various courses including life coaching, Ayurvedic lifestyle, meditation, energetic healing, and more recently yoga teacher training. I have learned that although mainstream medicine has its strengths, there are also many other paths to healing, and they can complement each other. It doesn’t have to be all or nothing, nor do they have to contradict each other. I invite you to take a step forward and be open to all aspects of medicine and healing.

I have aimed to write this book from a practical perspective, with enough information for the reader to understand the central concepts, but not so much as to be overwhelming. I incorporate this framework when seeing patients in the clinic to ensure a comprehensive overview.

"The secret of change is to focus all your energy,

not on fighting the old but on building the new".

—Socrates

How This Book Can Help You

This book is primarily dedicated to you—someone who has been told they have Hashimoto’s or hypothyroidism, has bloods monitored regularly (in case it gets worse and thyroxine is needed later), or has already been started on thyroid medication and told that nothing more can be done. This book is also for the person who may be experiencing hypothyroidism symptoms and has not yet received a diagnosis.

Empower yourself so you can start today to improve yourself—wherever you are on your healing journey.

In this book, we start off learning some basics about the thyroid gland and look at the adrenal glands, gut, and liver—all of which are important in treating thyroid conditions. The thyroid gland is like a thermostat; it responds to everything around it. Healing the thyroid is not just about the thyroid!

"The good physician treats the disease; the great physician

treats the patient who has the disease".

—Sir William Osler, physician

Then we identify some important lifestyle factors, highlight why they are important, and recommend practical steps towards improvement. We start with taking a deeper look at the importance of a good night’s sleep for detoxification, inflammation reduction, and physical and emotional healing. By the end, hopefully, you will appreciate the importance of this activity that we spend one-third of our lives engaged in, and have access to concrete steps for improving your sleep without needing sleeping pills.

We then go on to discuss stress, which affects every part of our body and mind. Most visits to the doctor’s office these days are stress-related. This fact no longer surprises us, not because it’s okay but because our modern society has normalised stress. Having practical strategies to manage our stress is a key requirement of healthier and more mindful living. For example, we’ll teach you the correct way to breathe. Most people get it wrong, believe it or not, but correct breathing can help our bodies regulate stress and improve our health. Control your breath, control your life!

In the next chapter, we discuss nutrition and recommend different diets, based on extensive research that drastically improves thyroid health.

We then talk about why some physical movement is important. Some of you may be suffering from fatigue and feel that exercise is the last thing on your mind. It’s about movement and taking it slowly, day by day. Start where you are with practical tips discussed on how to incorporate more movement into your daily life.

We then discuss environmental factors, which are now a significant aspect of what affects our health—what we eat, what we drink, what we breathe in, and many other ways we are exposed to chemicals. Although we can’t get away from it all, we can at least take steps to reduce our exposure and toxic load. That is increasingly important in the world we are living in today. As the quote goes, the genes load the gun; the environment pulls the trigger.

This moves us nicely onto discussing the array of evidence-based nutrients, herbs, and other therapies that can help in the healing journey.

We end with our final chapter, Living with Grace, where I share personal experiences towards healing and moving forward in life with purpose, and how you can do the same.

Slow Butterfly is about healing every part of you and becoming a better version of you—physically, emotionally, mentally, and spiritually. You owe it to yourself. It is time for you to start taking steps towards your brilliance.

I hope this book empowers you to heal yourself and to become the best version of you.

Empowering you to HEALth.

Warm regards,

Ameeta (Amy)

Primum non-nocere = first do no harm.

—Hippocrates

Chapter 1

Key Essentials

The part can never be well unless the whole is well.

—Plato

What Are Hypothyroidism and Hashimoto’s?

Hypothyroidism (underactive thyroid) is the most common thyroid disorder in Australia, affecting one in thirty-three people, and approximately ten times as many women as men. It is most commonly diagnosed in women between thirty and fifty years of age (So et al. 2012; Biondi et al. 2019).

Most cases of hypothyroidism in the western world are autoimmune, involving activation of the immune system—Hashimoto’s thyroiditis (HT). Iodine deficiency remains the most common cause of hypothyroidism globally (Vanderpump 2011).

The prevalence of hypothyroidism in Australia is not precisely known but is thought to be similar to the USA; approximately 4.6 percent of the population (Hollowell et al. 2002); 10 to 20 percent of Australians have thyroid autoimmunity based on blood tests (Walsh 2016). It is also likely many more people have a thyroid problem that has not yet been diagnosed.

How Does Hashimoto’s Develop?

Hashimoto’s is progressive and there are different stages, from the mere presence of antibodies without any hypothyroid symptoms which can worsen with further thyroid gland inflammation to more severe hypothyroid symptoms. When people first develop Hashimoto’s antibodies, they may have normal thyroid hormone levels, and their thyroid gland is still functioning normally. Hence, at this stage, they do not have an underactive thyroid. But over time, as the autoimmune process continues, and thyroid tissue is destroyed, less thyroid hormones are produced. Then symptoms appear or worsen, such as fatigue, weight gain, and brain fog. This process could take months or years. The diagnosis of hypothyroidism will be made if the hormone levels fall outside the range, or if the antibodies are requested, and they are positive. However, the levels could be within the normal range (which is quite wide), in which case, there will be no diagnosis despite there being symptoms. We call this subclinical hypothyroidism, and many people in this category can suffer for years without a proper diagnosis being made.

Further, antibody testing, which is a separate test to thyroid hormone levels, may not be done, in which case HT cannot be diagnosed—people can have HT even if their thyroid hormone levels are in the normal range. There is acknowledgment on either side of the ranges but not so much for anything in between. Yet, thyroid problems come in many shades of grey.

The longer the inflammation continues, the more thyroid tissue can be destroyed, which worsens symptoms, such as fatigue, brain fog, constipation, and weight gain. Hence the importance of early detection to preserve thyroid tissue and, more importantly, to prevent long-term complications, such as cardiovascular disease, dementia, and osteoporosis.

Hashimoto’s is a systemic illness affecting the thyroid gland, and hence, we need to take a holistic approach when healing Hashimoto’s. We will discuss the thyroid gland first: what it is, what it does, and why it’s essential. We also consider gut health (where most of the immune system is located), the adrenal glands (which directly affect thyroid function), and the liver (which has multiple functions, including detoxification). Discussing each of these parts in detail will help us understand the whole and how it relates to the development of HT.

What is inflammation, and how does it contribute to Hashimoto’s?

We are all familiar with acute inflammation—for example, when there is an injury or infection, the immune system is activated to help heal the trauma. The symptoms include redness, swelling, heat, and pain at the site. This is the body’s response to try and cope with the acute trauma and allow healing to take place, which occurs over a short period of time of days to weeks. Then the inflammation settles, and the body returns to homeostasis—balance.

However, various reasons (such as lifestyle factors and environmental toxins) can cause inflammation to occur systemically at a much lower level. This is known as chronic inflammation or met-inflammation that lasts months or years. It doesn’t switch off as it does in acute inflammation because of the ongoing presence of various triggers (e.g., poor diet, stress, toxins). This type of inflammation is one of the key drivers for most, if not all, of the chronic illnesses we are seeing today—including autoimmune conditions, obesity, and diabetes.

If acute inflammation is like a raging fire, chronic inflammation is like smouldering ashes (Egger et al. 2011).

The Thyroid Gland

The thyroid gland is a small butterfly-shaped gland in front of the neck that weighs around an ounce. It is like a thermostat—it regulates many aspects of our physiology, including metabolism, body temperature, and protein production. It’s also sensitive; the canary in the coal mine, meaning it detects and responds to any changes in our bodies—whether physical or emotional. It is therefore not surprising that the thyroid gland is amongst the first part of the body to be affected by disturbances and why Hashimoto’s is the most common autoimmune condition (Merrill and Mu 2015).

Functions of the Thyroid Gland

Regulates cell metabolism

Governs the basal metabolic rate (BMR)

Increases energy (increases mitochondrial number and function)

Upregulates neurotransmitters

Regulates temperature

Makes proteins—increases the uptake of amino acids and glucose

Bone health—needed for good bone quality and collagen

Gut function—intestinal motility

Bile production and gall bladder function

Breakdown of lipids and excretion of cholesterol in bile

Growth and development (especially foetal and in infancy)

When the thyroid is underfunctioning, we call this hypothyroidism (hypo meaning under or low). There are hundreds of symptoms that can be associated with hypothyroidism.

Typical Symptoms of Hypothyroidism

Fatigue, low energy

Weight—gaining weight or difficulty losing weight

Bowel symptoms—commonly constipation, IBS, bloating, gas, and reflux

Brain fog, poor memory, forgetfulness

Mood disorders—anxiety, depression, bipolar affective disorder

Gynaecological—heavy, painful periods; fibroids; ovarian cysts; endometriosis; recurrent miscarriage; infertility

Breast cysts

Heart—palpitations, low heart rate

Dry hair and skin, hair loss

Cold hands and feet

Muscular aches and pains, long recovery after exercise

Poor immunity, recurrent infections

Common Signs Found on Examination

Goitre (thyroid enlargement)

Thinning of the outer third of the eyebrows

Puffy face and hands

Slow reflexes

Hoarse or husky voice

Slow, weak pulse

However, there can be times when people may develop symptoms of an overactive thyroid, such as increased heart rate, increased perspiration, anxiety, or weight loss. Triggers, such as infection or stress, can cause rapid thyroid tissue destruction, and the thyroid hormones are released into the bloodstream, causing a flux of hormones in the system. Not everyone experiences these flares, but it’s important to be aware of the fact that the thyroid gland can be affected this way temporarily. Hence, the importance of a thorough assessment. This excess of hormones would then be brought back into balance as the body tries to keep the levels under control. If there are concerns of an overactive thyroid, a blood test called TSH receptor antibody (TRAb) can be requested. This is specific for Graves’ disease (autoimmune hyperthyroidism) and would not be present in someone with HT having a temporary flare. Let’s now take a look at the hypothalamus–pituitary–thyroid axis.

The Hypothalamus–Pituitary–

Thyroid Axis (HPT Axis)

Figure 2 illustrates the connections between the hypothalamus, pituitary, and thyroid glands. There is also an HPA axis—the hypothalamus, pituitary, and adrenal axis. The thyroid–adrenal connection is significant, and we will discuss this in more detail in Chapter 3.

There are two parts of the brain that affect the thyroid gland’s production of hormones. The hypothalamus makes a hormone called thyrotropin-releasing hormone (TRH). This stimulates the pituitary gland to produce a hormone called thyroid-stimulating hormone (TSH). This would be familiar to many of you as this is the primary hormone tested to determine thyroid function. This then stimulates the thyroid gland to make thyroxine (T4). If there is sufficient thyroid hormone, it is sensed by the hypothalamus and pituitary gland so that less TRH and TSH are made, and hence less thyroid hormone is made. This is referred to as negative feedback, in which increased production in one part of the feedback loop triggers another part to produce less, and vice versa. In this case, if the body makes too little thyroid hormones, then more TRH and TSH are released to stimulate more thyroid hormone production. Conversely, if there’s too much thyroid hormone, then less TRH and TSH are released so that less thyroid hormone gets produced.

Figure 2: Relationship between the Thyroid, Pituitary, and Hypothalamus

Thyroid Hormones

The main thyroid hormones that are of clinical relevance are called T4 and T3. Thyroid hormones have a tyrosine backbone (amino acid) and iodine molecules attached to this. Thyroxine (T4) has four iodine molecules attached and has low physiological activity. Triiodothyronine (T3) has three iodine molecules attached and is the most metabolically active thyroid hormone (approximately five times more potent than T4). Reverse T3 (RT3) is the mirror image of T3; it’s inactive and competes with T3 for the thyroid receptor site.

Figure 3: Structure of Thyroid Hormones

Over 90 percent of the thyroid hormone made in the thyroid gland is T4, and the rest is T3. The body is always sensing how much thyroid hormone we need. The ideal ratio of T4 to T3 is around three to one.

One important thing to understand is that most of the T4 to T3 conversion happens outside the thyroid gland—mainly in other peripheral tissues, such as the liver, gut, and kidneys. This tells us that the whole body needs to be healthy for optimal thyroid function, not just the thyroid gland. Merely giving thyroid hormone replacement won’t work if other parts of the body are dysfunctional. With our view of the thyroid gland as a thermostat, we