Finding a good online thyroid doctor is not easy. Finding a good thyroid doctor in person isn’t really that easy either. The demand for thyroid doctors, or endocrinologists, has skyrocketed over the last decade and especially now. One reason for the increase is because we have a population suffering from an obesity epidemic. Two, we are going through a Covid-19 pandemic, which has only exascerbated thyroid symptoms for many people. Lack of sunlight and activity, limited access to healthy food in some areas and excessive alcohol consumption have tipped many, who were previously only teetering, over the edge.
It is important to choose an online thyroid doctor who will take an integrative or functional medicine approach to treatment. Conventionally trained endocrinologists usually have one treatment option if and only if one lab test comes back out of range. This is a narrow approach in my opinion. The thyroid is a complex gland which works in harmony with other hormones and organs in your body. Looking at the body and these systems from a holistic view is much more relevant. If finding an integrative or functional medicine doctor is out of reach for insurance reasons, here are the questions to ask an endocrinologist.
How to Choose an Online Thyroid Doctor
Question 1 Which lab tests will you order to assess my thyroid function?
A doctor should be looking at so much more than just your TSH. A reply to this question should have several thyroid markers listed as well as antibody tests and other hormone and nutrient levels. A thyroid ultrasound is also very important to look at. For a full list, read Absolute Minimum Thyroid Lab Tests
Question 2 What treatment options do you offer your patients?
I would run if the response to the question above is only this answer: Levothyroxine. An endocrinologist should have several treatment options available. You’ll want to hear things like Natural Desiccated Thyroid, Tirosint, Cytomel, other T3 options or compounded T3 and T4. Everyone’s body is different and patients do great on one treatment but horrible on another and vice versa for the next person. Sometimes it can take a few months of experimentation and investigation to see which treatment works better.
The problem with Levothyroxine, a synthetic version of Thyroxine (aka known as T4, a thyroid hormone you produce), is that your body must convert T4 into T3, the active form of thyroid hormone… the one actually used by the body. People have T4 > T3 conversion issues for a number of reasons and this is why Levothyroxine is problematic for many. They might not find any relief. Also, the Levothyroxine pills contain fillers which include gluten, lactose, cornstarch, sucrose, and dyes. These fillers should be avoided for those with autoimmune thyroid disease.
However, in some cases, medication may not even be necessary. I put my Hashimoto’s disease into remission with only dietary changes and high quality supplements. If you would like a session with me, an Integrative Health Specialist focused on thyroid disease, please click here.
Question 3 Do you have experience with Hashimoto’s disease? or elevated thyroid antibodies and what treatment/course of action do you recommend?
These are the two responses you don’t want to hear. 1) No or 2) if your thyroid antibodies are elevated, I take a “wait and see” approach.
Hashimoto’s disease, an autoimmune disease where your body attacks its own thyroid tissue, is the number one cause of hypothyroidism in the developed world. It goes undiagnosed for many because thyroid antibodies are not tested. Also, many docs don’t know what treatment options to recommend for elevated antibody levels but normal TSH. In many cases, when no treatment is offered, the antibodies eventually cause enough destruction to your thyroid tissue that the end result is eventual full blown hypothyroidism. A thyroidectomy (removal of the thyroid gland) may also be necessary.
Let me clarify if I haven’t made myself clear: elevated thyroid antibodies are not normal. They are however very common. But if you catch the problem early enough and do the right treatment protocols, you can save your thyroid and live symptom free! You do not want an endocrinologist who doesn’t have experience with successfully treating their patients with elevated thyroid antibodies. The endocrinologist should most definitely be talking about lifestyle, dietary/nutritional and (if necessary) pharmaceutical interventions here.
Question 4 How do you address adrenal fatigue?
The adrenal glands, which sit right on top of your kidneys, are often compromised when you have thyroid disease. The term has been coined as adrenal fatigue. However, it’s not yet officially listed in the medical text books so many doctors won’t acknowledge it. Some even say it’s not real. It is very real and a good endocrinologist should address adrenal health. After all, the adrenal glands are part of the endocrine system. The same system that the thyroid gland is part of. And an endocrinologist should know the linkages between the glands in the endocrine system. No?
The adrenal glands are responsible for many hormone related functions in your body. When they become stressed, people tend to have symptoms like extreme fatigue, vertigo when standing or getting up, afternoon crashes, insomnia and restless thoughts, etc. Sound familiar?
The Most Important Thing When Choosing a Thyroid Doctor or Endocrinologist
This is an important one. You’ll want to look out for this when you start your search. Does that doctor listen to you? Are they really listening to your symptoms and what you’re saying. A good doctor will adjust treatment protocol based on how you’re feeling and not just lab results. Find a doctor who is willing to spend time with you. And not someone who rushes you out the door after eight minutes with a prescription for Levothyroxine and a feeling of helplessness.