Dr. Kharrazian is a chiropractic practitioner with expertise in nutrition and neurology. He is author of the book, "Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?" which details the nutrition-based approach that Dr. Kharrazian has developed to address Hashimoto’s and hypothyroidism, and which he disseminates to chiropractors and other healthcare providers via workshops and educational seminars.
Mary Shomon: Since chiropractic care is known for the focus on spinal issues and back pain, how has the thyroid -- an endocrine gland that is usually not primarily involved in spinal or back conditions -– become a focus for chiropractic care?
Dr. Kharrazian: Many patients with hypothyroidism suffer from a long list of musculoskeletal complaints, such as carpal tunnel syndrome, autoimmune joint diseases (arthritis or joint degeneration), poor recovery from muscle injury, inflammation, headaches, back pain caused by obesity, and other issues that lead them to seek the care of a chiropractor.
Since many patients don’t realize these symptoms are caused by hypothyroidism, it is not uncommon for a chiropractor to run lab work and identify the underlying problem. Many of these patients have been to one or more primary care physicians who failed to diagnose their hypothyroidism.
The licensed doctor of chiropractic is not trained in just spinal manipulation, but also in proper differential diagnosis. Differential diagnosis is the process in which the presenting problem is examined in terms of underlying causes and related health issues. Chiropractic education is primarily focused on basic anatomy, physiology, histology, pathology, physical examination, radiology, and laboratory diagnosis.
Mary Shomon: Can you explain a bit more about the education chiropractors receive, and how, from your perspective, it differs from the education received by medical doctors (MD)?
Dr. Kharrazian: The doctor of chiropractic (DC) degree is equal in hours to the doctor of medicine (MD) degree, with almost identical programs the first two years. The programs diverge, however, in the second half. During this time, the DC program focuses on diet, nutrition, and spinal manipulation, while the MD program emphasizes the study of pharmacology.
Chiropractors are licensed in every major state in the United States as a primary healthcare provider, and their education as doctors is approved and recognized by the United States Department of Education, as well as every major state regulatory body. Chiropractors have both professional and legal responsibilities to properly diagnose their patients.
Doctors of chiropractic are trained to diagnose conditions such as hypothyroidism through the use of patient history, a physical examination, laboratory tests, imaging studies, electrodiagnostic studies, and more.
Mary Shomon: Some people have the idea that chiropractors are using spinal manipulation to treat hypothyroidism. Is that true?
Dr. Kharrazian: All chiropractors understand that the proper management and treatment for hypothyroidism is thyroid hormone replacement, and if a chiropractor identifies hypothyroidism, he or she refers the patient to a medical doctor for proper treatment.
The notion that a chiropractor will attempt to treat hypothyroidism by performing spinal manipulation or by taking a patient off of replacement therapy is misguided and naive. The chiropractic community would not tolerate such actions, and the chiropractor would face severe legal consequences and potential disciplinary action, such as revocation of his or her license by state chiropractic board. As a chiropractor who is involved in chiropractic education, consultation for state board complaints, and medical-legal issues, I have never heard of a chiropractor attempting to use spinal manipulation to correct a thyroid problem. It is just not happening.
Mary Shomon: In your opinion, how can chiropractic care support those with hypothyroidism? What potential role is there for a chiropractor when it comes to diagnosing and treating patients with thyroid conditions?
Dr. Kharrazian: The answer is simple -- to provide guidance in a healthy lifestyle, sound nutrition, and a good diet. The goal is not to cure or treat the condition. In fact, in my book, I state several times that Hashimoto’s hypothyroiditis, an autoimmune thyroid condition that accounts for about 90 percent of cases of hypothyroidism in the United States, cannot be cured but instead, tamed or put into remission with dietary and lifestyle adjustments. These changes can greatly improve function and quality of life. More importantly, they can prevent future autoimmune diseases from developing.
Lifestyle, nutrition, and diet are areas of extreme importance for patients suffering from thyroid conditions, and they are areas that go unaddressed by the average medical doctor. That most people develop hypothyroidism as result of autoimmune Hashimoto’s thyroiditis is easily confirmed by thyroid antibody blood tests. However, in the standard health care model, these antibodies typically are not tested because the results do not affect treatment. Whether test results are positive or negative, treatment will always be thyroid hormone replacement. Management of hypothyroidism consists solely of making up for the loss of thyroid hormones due to autoimmune destruction of the thyroid gland. It is a very narrow and linear model that does not account for the mechanisms of autoimmunity itself.