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How to combat mom's fake thyroid diets? [Or bullshit internet medicine in general]
Cantido
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I was diagnosed with hypothyroidism in 2015. A magical little pill called Synthroid caused me to rapidly lose 12 lbs, stop falling asleep in public and really turned my life and health around. I have been advocating for Americans to drop what their doing/reading and talk to their doctor first, and their personal trainer second, in all matters of their fitness goals and work performance.
Once upon a time my mother thought she could nature her way out of hypothyroidism. I repeatedly told her that those diets and home remedy were garbage directly aimed at her, but she did it anyway. I didn't find out until she saw the doctor and told me her cholesterol reached dangerous levels. She accused me of being "closed minded" but she got back on her Synthroid and got her health and Elizabeth Warren-levels of energy back.
I still have to point out advertisements disguised as medical news every now and then. But now she has sent me another one that I can't find evidence against.
Ridha Arem, M.D, runs the Texas Thyroid Institude in Houston, TX (its doctor-city there.) He peddles a variety of thyroid boosting products and a book called The Thyroid Solution. Normally this is the part where I go on google and I find an expose on the latest horseshit fads and diets and send it to her. But I can't find anything on this guy. His products and book seemed aimed specifically at those who have standard thyroid treatments and are not satisfied with their own performance. I think my mom is savvy enough to not gamble with her health on this stuff after last time, but I still wish to fine tune my radar (and hers) for the oceans of snake oil sold in this country.
Does anyone have a better eye for what is wrong with this specific incident, and knows how to better sniff through medical books online?
EDIT - An example of me failing in reverse was with Become a Supple Leopard. I was apprehensive about this book until I found out both my personal trainer and physical therapist found it to be a useful resource, and found out the author is in fact a physical therapist. Getting the most out of the book is knowing that the author is biased towards Crossfit and thinks the Crossfit variation of a squat is god, and everything else is very useful.
Once upon a time my mother thought she could nature her way out of hypothyroidism. I repeatedly told her that those diets and home remedy were garbage directly aimed at her, but she did it anyway. I didn't find out until she saw the doctor and told me her cholesterol reached dangerous levels. She accused me of being "closed minded" but she got back on her Synthroid and got her health and Elizabeth Warren-levels of energy back.
I still have to point out advertisements disguised as medical news every now and then. But now she has sent me another one that I can't find evidence against.
Ridha Arem, M.D, runs the Texas Thyroid Institude in Houston, TX (its doctor-city there.) He peddles a variety of thyroid boosting products and a book called The Thyroid Solution. Normally this is the part where I go on google and I find an expose on the latest horseshit fads and diets and send it to her. But I can't find anything on this guy. His products and book seemed aimed specifically at those who have standard thyroid treatments and are not satisfied with their own performance. I think my mom is savvy enough to not gamble with her health on this stuff after last time, but I still wish to fine tune my radar (and hers) for the oceans of snake oil sold in this country.
Does anyone have a better eye for what is wrong with this specific incident, and knows how to better sniff through medical books online?
EDIT - An example of me failing in reverse was with Become a Supple Leopard. I was apprehensive about this book until I found out both my personal trainer and physical therapist found it to be a useful resource, and found out the author is in fact a physical therapist. Getting the most out of the book is knowing that the author is biased towards Crossfit and thinks the Crossfit variation of a squat is god, and everything else is very useful.
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I've seen similar plans by doctors who make 20 to 100 step "personalized" therapy regimens with no controlled trials to determine whether all this stuff is actually necessary or effective, taking credit for what is basically the effect of the medication, the placebo effect of thinking you've outsmarted modern medicine, and a personal involvement in health. What this doctor is doing is basically charging money for what other doctors give for free: healthy behavior advice and encouragement that they are taking care of themselves properly.
Does this doctor have any publications in reputable peer reviewed journal articles? If so, have these articles been themselves reviewed with later citing publications? Or does the author get by on self published or non scientific published works? If that's the case, you're not going to find much fraud exposure. If the only harm is economic, people aren't going to go out of their way to pin this person.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
As an actual doctor at a teaching institute (Baylor), he would have been required him to 1) acquire a certain amount of CME credits to keep his license (48 very 2 years in Texas) and 2) was involved in publishing articles and findings and the like.... teaching hospitals do a ton of research (grants play a big role in their funding too). I could only find 33 published articles in PubMed, though the page lists he's done 40. But yeah, I would say that there's a high chance that he knows what he's talking about.
edit: mostly agree with the above - one thing to note is that specialists have significantly longer wait times than general practices, so a book like that is both cheaper and more accessible in many markets. The downside being that they aren't always credible.
edit2: the number of practicing physicians in the US has been declining over the years, for many reasons too.
If she wants to get fussy with supplements and such thanks to rando thyroid diet #34, it is imperative that she first see an endocrinologist and get worked up for Hashimoto's thyroiditis. Hashitmoto's isn't just low production, it's an autoimmune disease that causes the immune system to attack the thyroid gland, and it can drastically change which supplements you should take. Larger doses of iodine are sometimes painted as helpful for hypothyroidism, but with hypothyroidism caused by Hashimoto's it's more complicated. It's just another thing to be aware of when looking at diets and supplements. Aside from the fact that you shouldn't eat a stick of butter every day, some things can have knock-on effects thanks solely to a difference in underlying cause. If she doesn't already hopefully knowing that can convince her to quit it and listen to specialists with her chart in front of them.
1. Avoid starch (and along with it high-processed foods), soy, cruciferous vegetables, stonefruits (such as peaches&almonds) and keep your millet intake low.
2. Eat more proteins (primarily meat/fish/eggs. Chicken overall is recommended since it's high on zinc and selenium which are important for a good thyroid function) and legumes.
No idea why butter would be a thing.
-Antje Jackelén, Archbishop of the Church of Sweden
I don't remember about the butter and don't care enough to look it up, I am unfamiliar with #1, and #2 I definitely know but if positive for Hashimoto's it might be better to cut out table salt if you plan to eat a bunch of fish.
My endocrinologist has never said anything about diet more than "keep iodine to a relative minimum" and "eat healthy and exercise because those things will make you feel better, and keep weight down so we don't need to adjust dosages as often." But that's why it's important to identify Hashimoto's before seeking dietary advice, because iodine is generally considered good to have but not necessarily for Hashimoto's, and it's better to make some of those changes under supervision if you have it.
TL;DR: My advice boils down to "get tested for Hashimoto's before going near a thyroid diet of any description because it can change what supplements are good/bad, and then after you know if you have it seek dietary advice from someone familiar with you and your needs." And by you I mean your mom.
These are things you don't really need 10 years of medical training to investigate and will likely help a lot in addressing her - and your - root problems with her healthcare.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
The only reason she is dissatisfied is the fact that synthroid is a pill and pills are "bad". Pills imply addiction.
The stigma against medication is bizarre, but I was resistant to it as well, until my doctor prescribed me a nose spray for my allergies, and I felt a million times better. And it reduced my snoring which made things better for my wife. And for most of my life I was so against medication...and I have no idea why. I feel like my dad is to blame.
Well, the book specifically recommends thyroid hormone supplementation, which is a pill, so I guess if she reads it, make sure she doesn't skip those parts? I've skimmed over excerpts from the book from the author's website and found that Chapter 22 straight up says medication is obviously necessary. Heck, if she wants to try Dr. Arem's special combination therapy, that's just a regimen of T3 and T4 (Synthroid is T4 only) so she'd have to be taking more pills.
Looking more at the website, the "scam" becomes more clear: the plan recommends you take 10 pills in addition to your prescribed thyroid medication (with convenient sale packages for all those supplements).
It looks kind of shady to me, but if your mom buys into this whole thing, at least it says in black and white that she should take her medication. If she's determined to go with this and spend a bunch of money, then I guess just make sure she doesn't skip that part.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
It's mostly (in my experience) because every medication you ever hear about comes with a massive list of possible side effects. I don't want a quickening irregular heart beat, oily discharge, sucicidal thoughts, more of the exact symptoms that the medicine is touted to cure, headaches, reduced appetite, increased appetite, addiction, or death. I just want to feel better!
It's not been easy but I think she's starting to come around. I still regularly have to spend a while finding and digesting medical journals with her, though.
The T3 is liothyronine, I don't know if mts can back this up now that I know he knows this stuff but not desiccated thyroid. People who love Natural Things love desiccated thyroid, people in a community I joined and then very quickly left even made their own and weighed it out themselves and they felt better for a while so THE END. It's Natural. There are a lot of reasons it's inferior to titrating the two separately, including the fact that cows are not the same as people in one or two important ways.
I mean I left the community more because they were all fucking antivaxxers than thinking they can weigh out their own cow thyroid gland powder, but you get the idea. If she's looking for natural alternatives to levothyroxine of all things and she hasn't run into that yet, it's probably on the horizon.
I also teach endocrinology and use it in my research (admittedly with insects). However, I DID just finish revamping my Thyroid lecture and there are a few things specifically about Dr. Arem's website that make me leery. Paladin had the right of it- it's mostly advocating taking your existing, prescribed, thyroid medication. However, he also suggests taking "Bioidentical hormone replacement for menopause" in his fourth section, and this is where I get very uncomfortable.
In 2016 the Endocrine Society put out a review paper titled "Compounded Bioidentical Hormones in Endocrinology Practice: An Endocrine Society Scientific Statement". The paper is easily found through Google Scholar, and if you can't get a hold of it I can send you a copy. In it, the Endocrine Society specifically warns about the phraseology used by Dr. Arem.
The rest of the paper describes the endocrinology of sex hormones and Thyroid hormones, and what to look out for in terms of "bioidentical" hormones.
My summation of this is that Dr. Arem does have the medical chops and background, but there is definitely a reason he's in very private practice. Many of this therapies exist only to sell you what are sugar pills at best, and actively damaging supplements at worst. I'd avoid his stuff if possible.
I don't have any other help for fighting the stigma of pills or fighting against desiccated thyroid, sorry.
T3 is triiodothyroine and is the more bioactive form of thyroid hormone. Thyroxine is T4. Not sure where the dessicated thyroid stuff is coming from, I didn't see that anywhere but admittedly didn't scoop too hard. My guess is the powdered thyroid is being convinced that having more of the stuff that makes your thyroid your thyroid helps your thyroid stronger. Like the highlander of endocrine glands.
Basically you have Thyroid stimulating hormone which increases production and output of T4 and to a lesser extent T3. That gets released into the blood. T4 can be converted peripherally to T3 at the target tissue. This is more efficient that just making T3.
It looked to me that the doc was just peddling nutritional supplements to be healthier which then boosts thyroid function maybe. I dunno.
The thyroid is really important for energy flux. Boosts mitochondrial transcription to improve ATP synthesis and regulates body temp etc. in fat/BAT.
other things it does:
BMR
fuel breakdown/storage
nerve development.
tied to activity and weight also.
so in theory healthy eating with healthy body weight could improve thyroid function but that is grossly simplistic and doesn't take into consideration the cause of the condition.
Hey, @mts I was re-reading the paper I mentioned in my post and they had this to say about desiccated thyroid, which I found interesting and I'm sure you will as well.
Also important for @ceres as well!
In short, desiccated thyroid has "more" T3 per molecule of T4 than your body normally produces. This is probably not the best idea, in addition to the effects on TSH (thyroid stimulating hormone) because T3 has a shorter half-life, and in desiccated thyroid you're getting "less" T4 per dose, so you'd have to take the produce more frequently.
thinking about it more with the addition of @Arch stuff,. I can see the rationale for it. You basically store all your thyroid hormone in the colloid of your follicular cells (basically thyroid cells). Its a sort of fatty gel like vacuole. I assume the idea is when you dry it out and take it you are basically are dosing yourself with iodothyroines. you make thyroine with one or 2 iodines attached then join those together to get T3 or T4.
this sounds like a terrible idea especially if you are supplementing a "normal" thyroxine dose. I mean if you are anti-meds and only taking DThy, you would likely not overshoot too badly (hopefully) but better than not taking it. you get the hey this helps people and then others follow suit since it helped someone else.
seems way less controlled and more variable.
Whatever. The text I read gave off the impression that synthetic and animal thyroid hormone were just options with different properties. Sure.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
I read the chapter 20 excerpt as him pushing T3 supplementation which is not all that common.
If this is a pattern of bouncing from diets to supplements and "natural" remedies, there will be no end of fighting individual battles against each fad or fraudulent claim.
You need to get her to articulate her mistrust of doctors and pills to a professional used to dealing with them. Otherwise it'll be a constant cycle that you aren't responsible for fixing. You may have to accept that.
My mom believes a bunch of crazy shit and I'm much happier not attempting to convince her otherwise.
If she's looking at diets and books, it's not too hard to pick up what she's telling you about and help her see at least enough reason to stick with her medication. It's not harmless, but it's doable. If she finds herself in a facebook community where people think like that you might have a much harder time convincing her that DIY thyroid is a bad idea. It might be better in the long run to help her learn to spot snake oil than to try to deflect each new thing.
Pointing out the guy admits the need for medication is inescapable in Chapter 22 has helped out tremendously.