Dr. Kharrazian is a chiropractic practitioner with expertise in nutrition and neurology, and his book has proven popular with some holistic practitioners — including chiropractors and nutritionists — as well as some thyroid patients who are looking for other ways — in addition to or instead of thyroid drugs — to address Hashimoto’s disease and hypothyroidism. (You can read Mary Shomon’s in-depth Q&A with Dr. Kharrazian regarding the role of chiropractors in thyroid management here.)At its core, Why Do I Still Have Thyroid Symptoms makes it clear that hypothyroidism is not a one-size-fits-all diagnosis, and while thyroid replacement treatment helps some people, it doesn’t necessarily resolve symptoms in everyone. Why thyroid treatment doesn’t resolve symptoms for everyone is the overriding question Dr. Kharrazian seeks to answer. To tackle this question, Dr. Kharrazian has outlined his theories regarding the causes of Hashimoto’s disease, as well as his explanation of the various causes of what he refers to as «functional hypothyroidism» — which he defines as hypothyroidism despite normal — or «euthyroid» levels on thyroid blood tests.
He provides nutritional and supplement protocols, as well as dietary changes, that he feels will address and resolve Hashimoto’s and functional hypothyroidism. He also addresses the need to evaluate and manage blood sugar, digestive and adrenal imbalances, and outlines the tests and supplements needed to evaluate and treat each type of dysfunction.
There is a great deal of thoughtful research in Dr. Kharrazian’s approach, and his recommendations are explained in depth, and with many citations and journal references.Dr. Kharrazian points to the two key directions to look for in the causes of hypothyroidism — Hashimoto’s disease, and six types of metabolic pathway dysfunctions. Looking at Hashimoto’s, the book delves into the immune system issues that may cause the disease, Dr. Kharrazian focuses on two different types of Hashimoto’s, what he refers to as TH-1 (TH stands for T-helper cell) dominant., where natural killer and T-cells that kill other cells are overproduced, and TH-2 dominant, where too many B-cells — the cells that identify immune-unfriendly intruders — are overproduced. He provides detailed recommendations regarding tests to assess these issues, and nutritional protocols he says will help modulate these immune responses. One of the areas where Dr. Kharrazian has been breaking new ground is in his information about the role of diet as a trigger for Hashimoto’s disease.
In particular, he says, «anecdotal evidence strongly suggests a diet that is not only gluten-free, but also dairy-free promises the best results in managing Hashimoto’s.»We know that gluten sensitivity and celiac disease are more common in Hashimoto’s and other autoimmune disease patients, but in his book, Dr. Kharrazian argues that the linkage is much stronger than typically recognized, and proposes that most people with Hashimoto’s or hypothyroidism should consider a gluten-free diet. According to Dr. Kharrazian, «Because the molecular structure of gluten so closely resembles that of the thyroid gland, the problem may be one of mistaken identity. Every time undigested gluten mistakenly slips into the bloodstream, the immune system responds by destroying it for removal.» Dr. Kharrazian also takes a strong stand on the controversial issue of iodine supplementation. Not a fan of iodine supplementation for Hashimoto’s patients, Dr. Kharrazian recommends that patients «rule out an autoimmune thyroid condition,» before starting iodine, if taking it at all. Beyond Hashimoto’s, Dr. Kharrazian considers functional hypothyroidism to be the result of one of six metabolic dsyfunctions he has identified, including:
- Primary hypothyroidism, in which the pituitary gland is not functioning at all
- Hypothyroidism resulting from pituitary hypofunction
- Inability to convert T4 into T3 due to excess cortisol
- Excessive production of T3 which causes resistance to thyroid hormone, usually as a result of excessive testosterone from insulin resistance and/or polycystic ovary syndrome
- Hypothyroidism due to elevated thyroid binding globulin, which is the result of oral contraceptive or estrogen treatment
- Inability of hormones to get into cells, due to excessive cortisol
At the same time, some members of the chiropractic community need to make more realistic and supportable claims about treatment and cures, and recognize that more than a few thyroid patients need to continue thyroid treatment. For those patients, chiropractic approaches may complement and improve upon, but not replace, medical treatment.In my opinion, the best results for patients are likely to come when nutritionally-oriented holistic practitioners — including knowledgeable and ethical chiropractors — treat patients along side — but not necessarily instead of — medical doctors. That way, patients who require thyroid hormone can receive the medical treatment they need, while seeking to address and resolve underlying health issues. Overall, I think that Why Do I Still Have Thyroid Symptoms? is an excellent book for anyone with Hashimoto’s, and one that is best integrated into a patient’s broader thyroid bookshelf, much like many of the approaches outlined by Dr. Kharrazian can realistically be integrated into a broader approach to Hashimoto’s and hypothyroidism diagnosis and treatment. Final note: The book specifies that it focuses on hypothyroidism that results from Hashimoto’s disease and functional causes, and does not address solutions for patients with Graves’ disease, hyperthyroidism, or thyroid cancer.