Episode - 5 Challenges of Reversing Hyperthyroidism…and How To Overcome Them


5 Challenges of Reversing Hyperthyroidism…and How To Overcome Them

From working with practitioners who don’t support your treatment choices to getting discouraged by roadblocks and stubborn symptoms, many people with hyperthyroidism face similar challenges.

While they can be discouraging, there are many things you can do to overcome these challenges and find success on your thyroid healing journey.

In this episode, I’m discussing the top five challenges I’ve encountered with my patients (plus a bonus one!) and strategies you can use to work through them. Enjoy the episode!


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Here is the transcript for this episode:

In this episode, I will be discussing five challenges of reversing hyperthyroidism as well as what you can do to overcome them. 

Challenge #1 is keeping the proper mindset. Mindset definitely will play a big role in your recovery. I have seen it time and time again. People who have a positive mindset will almost always recover quicker than those with a negative mindset. A lot of times, those with a negative mindset won’t recover at all. I’m not saying it’s just due to the negative mindset. Same thing goes with those who have a positive mindset. Just because you have a positive mindset doesn’t mean you are going to restore your health. Obviously, you need to do other things, like improve your diet and lifestyle factors. If all things are equal, those who have a positive mindset usually receive better results than those who have a negative mindset.

As far as you can change your mindset, I think you can. If you’re a negative person, if you have been negative for quite a long time, it might be difficult. Yeah, that doesn’t mean that you can’t make changes. It all comes down to our environment. This is another challenge. If you surround yourself with negative people or watch the news that’s negative all the time, then it’s easy to have that negative mindset, whereas if you’re surrounding yourself with things that are positive, that will help you to have that more positive mindset. 

Without question, if someone has been accustomed to having a negative mindset for many years, it will be difficult to change that mindset. But it’s not impossible. It really is up to you. It definitely can be done. 

For more on mindset, I would check out my Q&A episode related to mindset and thyroid health. 

The second challenge I want to discuss is struggling with managing the symptoms. This is definitely a big problem for many people with hyperthyroidism. Antithyroid medication such as methimazole usually does a good job of managing the symptoms, but there are a few problems with taking antithyroid medication, whether it’s methimazole or PTU. 

One problem is that side effects are common. Not everybody experiences side effects, but a good number of people do. Some people might be mild enough where they can continue to take antithyroid medication. Others might need to stop taking antithyroid medication. Maybe they tried methimazole, switched to PTU, and experienced symptoms that were severe enough with both where they could no longer take that. That’s an issue. 

Another problem is that many people don’t want to take the medication. I probably shouldn’t label this as a problem. When I was dealing with Graves’, I didn’t take the medication or think of it as a problem. I did things naturally, which I’ll discuss briefly in a minute or so. There are some people who need the medication, but they don’t want to take it. 

In my case, I was able to manage my symptoms naturally with herbs, like bugleweed and motherwort. There are some people where that’s not effective, and they might need to take the medication, or at least look into other options. 

Beta blockers are another option to consider, such as propranolol, metoprolol, atenolol, but they also come with side effects. I do have a podcast episode where I talk about beta blockers and natural alternatives. 

Low dose naltrexone (LDN) and cholestyramine are two other options from more of a medical standpoint. I can’t say they’re conventional because most endocrinologists don’t recommend them. If someone is unable to take antithyroid medication, let’s say if they can’t tolerate it, then they might want to look into something like cholestyramine, which is not specific for hyperthyroidism, but it can bind to thyroid hormone. 

I’ve had a few patients take cholestyramine because they were unable to take antithyroid medication, and the cholestyramine worked. It’s a little bit of an inconvenience. You have to take it away from food and supplements, and it’s in a powder form. It’s better than receiving radioactive iodine or thyroid surgery in my opinion. If you’re in a situation where you can’t take antithyroid medication, and I’ll talk about the natural approach, which obviously is my preference, but I want to give this as an option as well.

The last thing I’ll say with cholestyramine, and I do have at least one if not multiple episodes where I at least bring it up, not necessarily focusing on it. I think one episode might focus on it. In one about conventional symptom management, I talk about it. It’s not typically prescribed by medical doctors. 

The point I want to make here is that in order to get a prescription for cholestyramine, you probably would not want to ask the endocrinologist to listen to this podcast or refer him to my website. They probably won’t want anything to do with me. But if you check out the podcast episode where I spoke about cholestyramine or on my website, where I have at least one article on cholestyramine, I did present some research. You could show your endocrinologist the research, and I have had other people do that. If they see the research, they are more likely to prescribe it. Some might already be familiar with cholestyramine. It’s not their first option, and it’s not my first option either. But it’s a better option than surgery or radioactive iodine. 

LDN modulates the immune system. If someone has Graves’, that could be an option. If someone has a nonautoimmune thyroid condition, LDN isn’t an option, whereas cholestyramine would be an option for someone who has toxic multinodular goiter, for example. LDN doesn’t work with everybody. 

It is fairly easy to get a prescription though, even if you can’t get it locally from a local practitioner. There are websites that you can get them from. LDNDirect.com is one that is pretty cost-effective, and you can schedule a remote appointment with a practitioner and get a prescription. If you live overseas, there is also LDNScience.org. They have a resource where you can search for a practitioner, either in the United States or overseas.

There are also natural agents, like bugleweed or motherwort, which is more of a natural beta blocker is how I describe it. Lemon balm has a calming effect. L-carnitine, which in higher doses, the research shows 2,000-4,000-mg a day can help with hyperthyroidism. Once again, when I dealt with Graves’, I took bugleweed and motherwort, and they worked fantastic. That’s not the case with everyone. 

If you can’t tolerate the medication, and if you haven’t tried the natural agents I just mentioned, definitely look into those. Probably a good idea to work with someone to help you with those. If the natural agents don’t work, then you would want to look into LDN and cholestyramine. 

If the natural agents don’t work, you want to first ask, why aren’t they working? Is it because they’re just not working, or is it because you’re not taking a good quality supplement? Not all herbs are the same. Not all of them are the same potency. Are you taking enough of a dosage? If someone is just taking 500mg of L-carnitine twice a day, that might not be enough, at least according to the research. Same thing with bugleweed. You might be taking a less potent herb and not a high enough dosage. Those are things to consider as well. 

As far as going over the pros and cons when it comes to the natural agents, they can in many cases, not all cases, help with the symptoms and side effects that are more likely when taking antithyroid medication. 

As far as the cons, they aren’t as potent as the medication. As a result, they aren’t effective in every single person. 

As far as what you should do specifically to manage your symptoms, I can’t tell you what to do. Hopefully, most people listening to this already manage the symptoms safely. If not, if you aren’t doing anything and haven’t tried the natural agents, then you definitely could look into those and see if they help out. They do work in about 70-75% of people. 25-30% of people where they don’t work. 

If you haven’t tried anything, try the natural agents. If they work, that’s wonderful. If they don’t, then you might need to look into something like antithyroid medication or those alternatives like cholestyramine and LDN. 

Challenge #3 is not giving into peer pressure. What I mean by that is when it comes to restoring your health, it will greatly increase if you’re not surrounded by people who are pressuring you to receive radioactive iodine or thyroid surgery. Instead, you are surrounded by people who support your decision to save your thyroid. I assume that’s why you are listening to this. 

It’s unfortunate that many people are surrounded by negative people. I mentioned this earlier with mindset. If you have a negative mindset, it just might be something you’re used to. There’s a chance you also are around others who are negative. Maybe it’s intentional. Maybe those are the people you have been associating with, and you enjoy their company, and you haven’t really thought about them as being negative. You like to exchange in negativity. 

This is a little bit different than the mindset talk here. If your goal is to avoid radioactive iodine or thyroid surgery, and you’re surrounded by people who are telling you that you need to receive one of those things, then again, you are more likely to give in. 

There are some people who are more stubborn than others, like myself. When I dealt with Graves’, there was some negativity, but I wasn’t about to give into the peer pressure of others. My endocrinologist was not really pressuring me, but I can’t say all my family members were supportive of my decision to take a natural treatment approach. Not that I announced it to everybody, but I come from a conventional medical mindset.

Getting back to the endocrinologist. Most endocrinologists are closed-minded toward a natural treatment approach. Even if you were to ask them if diet plays a role in helping with hyperthyroidism, almost all of them will say no. Even if that’s what they believe, there’s nothing wrong with taking a different approach, a more positive approach. “I haven’t seen diet work, but it’s not going to hurt to eat a healthy diet. If anything, it will benefit your overall health, so why not eat whole, healthy foods?” Most of them will say briefly, “No, diet won’t change anything.”

Keep in mind that many endocrinologists will discourage natural treatment methods. Some people will pressure you to receive radioactive iodine or thyroid surgery. Some will justify putting you on antithyroid meds and then say, “If you’re not in remission,” or what they refer to as being in remission, “within 18-24 months, because it’s dangerous to be on medication longer than that, you’ll need to pick between radioactive iodine or thyroid surgery.” 

I have another episode on long-term treatment with methimazole. Even though it’s not my first choice, if it’s choosing between long-term treatment with methimazole or radioactive iodine/thyroid surgery, there are plenty of studies that show long-term treatment with methimazole is safe. If you’re taking massive doses, like 20-40mg, maybe not. If you’re taking 5-10mg long-term, that does seem to be safe. Not the ideal situation, but everything is risk versus benefits. 

If I was trying to avoid radioactive iodine and thyroid surgery, and if I was taking a conventional approach, not doing anything naturally, and two years went by, and I wasn’t in remission, or I went into so-called remission and relapse, I would be looking to buy time. Methimazole for example would be a way of buying time while you’re still trying to find your triggers and correct the underlying imbalances. 

When it comes to family and friends, it’s common for people with hyperthyroidism to have friends or family members who have more of a medical mindset and therefore might not be thrilled if you tell them you’re trying to take a natural treatment approach. If you tell them that your endocrinologist was recommending radioactive iodine or thyroid surgery, and you’re talking about trying to save your thyroid, hopefully you’re in a situation where you do have supportive friends and family members. If you’re in a situation where you have unsupportive friends and family members, especially those who are close to you, then you have some decisions to make. If it’s a spouse, I’m not saying to break up with your spouse. In some cases, you have to stand your ground. You will need to be firm. 

In addition to standing your ground, I would try to surround yourself with positive people. Even if you have real close family members that there’s nothing you can do about them but deal with the negativity, you still can try to surround yourself with more positive people. You can join one of my Facebook groups. Not everybody there is positive though. A lot of people are. There are negative posts on any social media. Maybe going somewhere locally, like some place that is more focused on natural health. There probably won’t be a center locally that focuses on helping people with hyperthyroidism naturally. It is important. It doesn’t even have to be necessarily health-related. 

Getting back to the mindset, trying to surround yourself with positive people in general. Since we’re talking about peer pressure, trying to avoid those people who are telling you, “You need to follow your doctor’s recommendations. If you don’t, something bad will happen.” Risk versus benefit. Obviously, you want to take this seriously. At the same time, it’s easy for people to tell you what to do when they’re not in your situation. That includes your endocrinologist as well. 

There might be people who were in your situation. Someone who received radioactive iodine, and maybe they had a good experience. “I think everybody should get radioactive iodine” because they had a good experience. Same thing with thyroid surgery. Everybody is different. Not everybody has a good experience. Even if they did, you don’t have hyperthyroidism due to a lack of radioactive iodine. It’s one of those things, where if one can save their thyroid, obviously I think it’s important to do so. 

Challenge #4 is finding the right practitioner. Obviously, I’m going to be a little bit biased because I’m a natural healthcare practitioner. That is really where the focus is. An endocrinologist is fine to work with, but keep in mind their focus will be to diagnose someone with hyperthyroidism or Graves’ specifically maybe, to prescribe antithyroid medication if you choose to take medication, as well as do follow-up blood tests. I’m not discouraging people from working with an endocrinologist, but as you know, endocrinologists mostly have that negative mindset. They won’t do anything naturally. 

When it comes to trying to save your thyroid, to reversing your hyperthyroid condition, you want to ideally work with a natural healthcare practitioner. There are plenty of practitioners who focus on hypothyroidism, including Hashimoto’s. Unfortunately, there aren’t a lot of natural health care practitioners who focus on hyperthyroidism. That could be a challenge. 

You might just want to self-treat your condition by following the recommendations I am giving, not necessarily just in this episode, but on this podcast in general. If you’ve been following me for a while, you know that I won’t be a big supporter of that. Not to say that you can’t do some things on your own, especially from a diet and lifestyle perspective, but I do recommend for something as serious as hyperthyroidism to work with someone, and not to self-treat your condition. I’ve said in other episodes trying to self-treat your condition usually ends up costing more time and money. Like I said, cleaning up your diet, managing stress, and other lifestyle factors, that’s perfectly fine. I would really be careful about trying to do everything on your own. 

The question you might have is: How can you find a natural healthcare practitioner who has experience with hyperthyroidism? It’s not an easy question to answer. There aren’t a lot of practitioners who focus on hyperthyroidism. 

I work with people who have Hashimoto’s as well, but if you have been following me for a while, you know my background. I dealt with Graves’ and have been in remission since 2009. As a result, at least 80% of my practice, if not more, consists of people with hyperthyroidism. I did write a book on Hashimoto’s called Hashimoto’s Triggers, released in 2018. That is probably my one and only book on Hashimoto’s. 

As of recording this, I have one book on hyperthyroidism, which I’m getting ready to release a third edition this year. I am actually working on my next book on hyperthyroidism as well, a different type of book. 

I’m definitely more of a hyperthyroid expert than a hypothyroid expert. Part of that is my experience. Also, realizing that there is not enough practitioners who focus on hyperthyroidism. You could try to do a search online to find a natural healthcare practitioner who focuses on hyperthyroidism. Do a random search, like “naturopath who focuses on hyperthyroidism” or “functional medicine doctor who focuses on hyperthyroidism.” I don’t have a great solution when it comes to that. 

You can go on Amazon and look for those who have written books on hyperthyroidism besides myself. Those who have written books on hyperthyroidism, you would hope would be somewhat of an expert on hyperthyroidism. You can’t always go by that. There are non-practitioners who write books on thyroid health. Not to say they don’t have knowledge and experience, but you want to be careful. 

Some listening to this might wonder: Do I accept new patients? My goal is not to toot my own horn and say, “Yeah, you have to see me.” Because my practice focuses on hyperthyroidism, and because there are not a lot of practitioners who focus on hyperthyroidism, I don’t even have the capacity for everyone. Not that everyone who listens to this will want to work with me. In an ideal situation, we’d have more practitioners working with- The point is there is plenty of people to go around, which is not a good thing. We don’t want a lot of people with hyperthyroidism. There are more people with hyperthyroidism than practitioners.

The answer is yes. At least as of recording this, if you want more information on working with me, you can go to the website WorkWithDrEric.com. Once you visit that, it will tell you the next steps you need to take to work with me. I do require people to go through a few steps: watching a recorded webinar to understand what it’s like to work with me, filling out a brief online application. Not everybody is a good fit to work with me. If someone doesn’t want to go through the steps, they’re probably not a good fit. I’d hate for someone not to go through those steps and realize they would be a good fit for me. It’s not as bad as it sounds. A little bit time-consuming, but not hours and hours. The recorded webinar is an hour. The application will take five minutes or less. 

Challenge #5 is preparing for roadblocks in your recovery. It would be great if everyone with hyperthyroidism progressed without any setbacks. Unfortunately, it’s common to hit roadblocks in your recovery. When this happens, like if a patient I’m working with is hitting a roadblock, then usually what I do is look into one’s diet and lifestyle and make sure they’re eating well and being somewhat strict with their diet, blocking out time for stress management. It’s not always diet and lifestyle, but those are the first places I look. 

If they seem to be doing everything, then I might ask, “Have we found all the triggers? Do we need to do additional testing?” Maybe we have done all the testing already, but that is something to consider.

This is yet another reason for working with a practitioner, because even when working with a practitioner, it’s common for people to hit roadblocks. It’s not always easy. It’s not like I always have an instant answer for why they’re not progressing. But it’s arguably even more difficult on your own to figure out why you’re not progressing. It’s always good in my opinion to work with someone.

Finally, I’ll say don’t be discouraged if you hit a roadblock. I know it’s easy to say. Since I’m saying it’s common to hit roadblocks, hopefully you’ll at least be a little bit more prepared, and you won’t get as discouraged. You will just have the mindset, “Hey, it’s a bummer that I’m not progressing as expected, but I listened to this episode, and I know that roadblocks are common. There are times where I might take a step back.” But as long as you’re taking a couple of steps forward for every step back, that’s fine. 

Try not to get discouraged. It is common. Another reason to work with someone to try to overcome those roadblocks. 

I want to give a bonus challenge. I mentioned five challenges people face with hyperthyroidism when trying to reverse their condition. A bonus challenge for some people is dealing with thyroid eye disease. Many people with Graves’ have thyroid eye disease. Like Graves’, thyroid eye disease is also an immune system condition. With Graves’, you have those TSH receptor antibodies. Thyroid stimulating immunoglobulin is a type of TSH receptor antibody that binds to the TSH receptors. With thyroid eye disease, you get those same antibodies that are attacking the tissues of the eyes. 

Similar to Graves’, the goal with thyroid eye disease is to find and remove triggers, heal the gut, and address underlying imbalances. There are some nutrients that can help. With thyroid eye disease, you have a lot of oxidative stress. Selenium could be helpful. Alpha lipoic acid could be helpful. Berberine could be helpful. Some of these are in my thyroid eye disease bundle, which you could check out by visiting TEDBundle.com. Having healthy Vitamin D levels is important for a healthy immune system. Omega-3 fatty acids. There are a number of things that are important. 

Even if you do things to address these deficiencies, which you should if you are deficient, you still usually need to address other factors, like remove other triggers and correct other underlying imbalances. 

I would definitely check out some of my other podcast episodes on thyroid eye disease. There are a few of them. One of the interviews is with neuroophthalmologist Dr. Rani Banik. There is at least one or two others where I’m talking about it. Check those out on my podcast. 

I want to summarize what I discussed here. Try your best to keep the proper mindset. You want to do your best to manage the hyperthyroid symptoms. Consider both natural and conventional options. Be open-minded. Try to surround yourself with positive people, so it’s not just the mindset, but try not to give into peer pressure. Consider working with a natural healthcare practitioner as you know. I mentioned roadblocks, so you want to mentally prepare for those in your recovery. Try not to get discouraged if you hit roadblocks. If you have thyroid eye disease, you need to remember it’s an immune system condition, so you need to find and remove triggers, heal the gut, and address other underlying imbalances. 

That is all I want to discuss when it comes to the challenges of reversing hyperthyroidism. Of course, there could be other ones besides the ones I mentioned, but these are some of the more common ones. As usual, I hope you found this episode to be valuable. I look forward to catching you in the next episode.