For most thyroid patients, having thyroid disease is a lifetime, chronic health condition that can often be challenging. As patients, we do our best to be informed, and take actions that help improve our health, but with so much to learn -- and sometimes limited information from health professionals -- it's easy to get off track in various ways.
Stay on track. Learn about these nine thyroid mistakes that you may be making.
1. Stop Blowing Off Your Medication
One of the most common questions I hear from readers, and Learn more about why some thyroid patients refuse to take their prescribed medications.
And if you have good intentions, but have a hard time remembering to take your thyroid medication, here are 10 ways to remember to take your thyroid pills.
2. Stop Waiting for the Last Minute to Get Medication RefillsOne of the most common complaints I hear from patients is that they've called in to get a refill, and the doctor won't order the refill without the patient coming in for an appointment, and sometimes also with blood work. And one of the most common complains I hear from doctors is that patients cancel appointments, or don't have a follow-up on the books, and then wait until their last thyroid pill -- with no refills -- is in the bottle -- and then call the office, frantically requesting a refill, and get angry when they are told that they need to have an appointment or come in to get the refill.
Patients, clarify with your doctor how frequently he or she wants to see you in a year, in order to get thyroid medication refills. It's reasonable for the doctor to request blood work and a check-in every six months. Don't wait until the last minute to request a refill, or you could be left in a lurch. And doctors, make sure that your refill policy is clear, sensible, and well-explained to patients in advance. And don't abuse the process -- patients can quickly figure out if a doctor is requiring excessive marked-up blood work and office visits too frequently as a way to pad income.
3. Stop Drinking Coffee At the Same Time as You Take Your Thyroid MedicationsMany of us love our morning coffee, but one of the biggest mistakes that people on thyroid hormone replacement drugs make is to take our pills in the morning, and then grab that first cup.
Do yourself a favor, and wait at least an hour after you've taken your thyroid hormone replacement medication before you have that first cup of joe. Otherwise, the coffee can affect your medication absorption, making it less effective -- and making you more hypothyroid.
Learn more about the interaction between coffee and thyroid drugs.
4. Stop Overdoing It With Raw Goitrogenic FoodsYes, kale is a super food, and broccoli is healthy, but did you know that these foods can also affect your thyroid?
Cruciferous vegetables, and some of the leafy greens, are known as "goitrogens," foods that can slow the thyroid, inhibit absorption, and even cause a goiter -- an enlarged thyroid gland.
5. Stop Overlooking the Effects of Calcium, Soy, and Fiber on Your Thyroid TreatmentBefore you grab that calcium supplement and down it with your morning thyroid pills, or take your medication with calcium-fortified juice, or go on a soy-heavy diet, or start eating a high-fiber diet, it's important that you know how these things can impact your thyroid health and medication absorption, and what you can do to ensure you are getting the most from your thyroid treatment. Read 10 Things to Know About Thyroid Disease, Foods and Drinks.
6. Stop Getting Rushed into Radioactive Iodine (RAI) PrematurelySometimes, when patients are hyperthyroid, doctors say that the only treatment is ablation -- or destruction -- of the gland, using Radioactive Iodine - a treatment known as RAI. Unfortunately, some patients don't realize that in some cases, antithyroid drugs may be a better option, even offering a possibility of remission. Or they may not be informed that breastfeeding must be suspended during and after RAI, or that experts recommend delaying pregnancy for six months to a year after RAI treatment. I have even heard from patients who had needless RAI within weeks of blood tests showing hyperthyroidism -- but they were in a hyperthyroid phase of Hashimoto's - which usually ends up with the thyroid self-destructing and leaving a patient hypothyroid.
7. Stop Taking Thyroid Advice From Uninformed People and SourcesWhether it's the teenage clerk at the health food store handing you iodine supplements, slick Internet ads promising thyroid cures, overpriced ebooks claiming to offer drug-free solutions to thyroid disease and weight loss, or cranky MDs with axes to grind, there are a lot of people out there trying to sell thyroid patients all sorts of costly supplements, programs, ebooks, webinars.
Two words: Buyer Beware!
8. Stop Accepting Less than "Optimal" Treatment for HypothyroidismMost thyroid patients end up hypothyroid...whether due to the self-destruction of the gland in Hashimoto's disease, surgery for cancer, goiter, hyperthyroidism, or nodules, or RAI ablation. But when you end up hypothyroid, some thyroid patients are not aware that there's more to treatment than being handed a prescription for a levothyroxine (synthetic T4) drug, and coming in for annual Thyroid Stimulating Hormone (TSH) tests.
Savvy patients are learning that cutting-edge doctors embrace the concept of "optimal" hypothyroidism treatment, which means that along with symptoms, TSH, Free T4, Free T3, antibodies, and Reverse T3 are evaluated, and addressed with innovative treatment approaches that go beyond levothyroxine. Learn how some of the nation's top doctors are optimizing treatment for an underactive thyroid.
9. Stop Losing Your Thyroid Gland on the Basis of an "Indeterminate" or "Inconclusive" Biopsy of a Thyroid NoduleThyroid nodules are common, and with CT scans, ultrasounds, x-rays, and dental imaging, more of them are being discovered than ever before. When thyroid nodules have suspicious characteristics, doctors typically order a fine needle aspiration (FNA) biopsy of the thyroid, to evaluate whether the nodule is cancerous. A substantial percentage of these biopsies turn out to be "indeterminate" or "inconclusive" - and doctors can't determine whether there is thyroid cancer present.
Their solution? A partial or full thyroidectomy, followed by pathological assessment of the nodules.
The problem? The majority of these indeterminate nodules actually turn out to be benign, but the patients, often undergoing a surgery, and left with no functional thyroid gland, face a lifetime of unnecessary hypothyroidism.
Many patients and physicians are not aware of a relatively new test, the Afirma Thyroid Analysis, by Veracyte. This test can almost entirely eliminate indeterminate or inconclusive thyroid biopsy results, and provide conclusive results of nodules, allowing patients to avoid the hundreds of thousands of needless thyroidectomies that are performed each year in the United States.