Bottom Line/Health: For millions of women with Hashimoto’s disease, the doctors give them hormone replacement and consider the job done. But the truth of the matter is, that’s just not enough.

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversations With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m talking to Dr. Brooke Kalanick, a leading naturopathic physician in private practice in New York City specializing in women’s hormonal and weight issues. Welcome, Brooke.

Dr. Brooke Kalanick, ND: Thank you.

Bottom Line: All right, Hashimoto’s. You’re not making enough hormones, so Western theory: replace the hormone, now you’ll have hormones. Doesn’t that work?

Dr. Kalanick: That’s the first step. We’re very glad that we have that because if your thyroid can’t make it, it’s great that we can take it. But that is just the beginning of the story. Many women don’t even know that they have Hashimoto’s. They know they had low thyroid; they’ll come to my office, they’ve been taking Synthroid for 10 years, and I’ll ask them if they know if it’s Hashimoto’s or not. No one’s even checked them.

Bottom Line: How could they not have checked it? Sorry, I’m cutting you off because that’s shocking to me that they’ve been under doctor’s treatment, and the doctor never checked for Hashimoto’s.

Dr. Kalanick: Or they checked and didn’t tell them. To be honest, it doesn’t change what they do. They’re still going to watch a couple of hormones on your blood work, make sure they’re in a safe range, and adjust your dose accordingly.

Bottom Line: What is the test that somebody would get to double check that it’s Hashimoto’s?

Dr. Kalanick: To double check that it’s Hashimoto’s, you’d get a TPO or an antithyroglobulin antibody test.

Bottom Line: Okay. Because I think that’s important if somebody – from what we’ve spoken about and will continue to talk about is that it’s important that somebody know the difference, because it’s treated potentially differently.

Dr. Kalanick: Yeah, and you do need both of those tests. Sometimes you’ll get one and not the other. But it doesn’t change what your conventional doctor typically does. They’re truly only monitoring you for – and I say this generally; I’m sure this doesn’t speak to every doctor, but for the most part, the rest of the immune problem with your hypothyroidism isn’t being addressed.

Bottom Line: So in Hashimoto’s, the immune system isn’t working; are there things that you can do to support that immune function so that the thyroid is not suffering quite as much?

Dr. Kalanick: Yeah. With Hashimoto’s, there’s an attack on your thyroid gland. Over time, it destroys enough gland that you stop being able to produce as much hormone. You can take the medication, but wouldn’t it be great if you also were doing things that quieted that immune attack, calmed this thing down so that you’re getting less frequent increases in your dosages, feeling better, and preventing other autoimmune diseases?

Because, in this case, we know the thyroid is under attack, but there could also be many other tissues under attack. And they say autoimmune diseases run in packs, but truly, it’s more that once it’s off the rails, it’s going to keep tagging things inappropriately.

Bottom Line: So we need to support the body and support the autoimmune. All right, how would you do that?

Dr. Kalanick: A really important thing is vitamin D. There are things that we know with autoimmune disease. If you think of your immune system a bit like a seesaw, and it’s always trying to interact with its environment and come back to level. With autoimmunity, it’s skewed one way or the other, and you’re having a hard time getting back to level.

While we can’t necessarily shut this thing off – once an autoimmune process is turned on, it’s turned on – but we can do things to make it easier for you to level out your seesaw – vitamin D being one that has great research towards doing that. So vitamin D really helps.

Supporting a system in your body called glutathione – it’s a main cellular antioxidant – so making sure that system is working really well, which is often very compromised with autoimmune patients.

Bottom Line: So you would supplement vitamin D. Would you supplement glutathione?

Dr. Kalanick: Glutathione isn’t something that’s absorbed very well from our digestive tract, so there are some newer forms of glutathione that seem to do better. But one thing you can do, if you’re working with someone super savvy, they can give you an IV of glutathione. That can work, but that’s not the case for most people. You can take the precursor to glutathione; an amino acid called N-acetylcysteine.

Bottom Line: NAC.

Dr. Kalanick: NAC. Or you can get some of these newer acetaldehyde forms of glutathione that seem to work a little bit better. So glutathione support. Also have to be able to regenerate that glutathione, so herbs like cordyceps help you keep your glutathione around longer. And vitamin D. And then turmeric has a lovely effect via a variety of mechanisms to try to keep your immune system a little bit more regulated.

Those are things you can take, but everything else that goes on in your body affects your immune system. Keep your blood sugar balanced, keep your stress under control, get enough exercise, but not too much – all of those lifestyle factors that don’t seem related to your thyroid, they really do help.

Bottom Line: The usual. The less stress we can put under our bodies, the less hard that it has to work. How’s that for fine English? Question about turmeric: is just cooking with turmeric enough, or do you really need supplemental levels?

Dr. Kalanick: If you’re trying to control an immune process, I think you need supplemental doses – a couple hundred milligrams several times a day of a high-quality form. But cook with it, too. I love doing that, doing more in our food, so get as much as you can from your food. But in order to really get on top of this thing, you need a little bit higher doses than you could get from food.

Bottom Line: We rattle off the names of these supplements, but the truth be told – and I always remind people of this – natural medicine isn’t do-it-yourself medicine, especially when you’re messing with your hormones. So take this list and go and talk to your doctor about it or go to a doctor or naturopathic physician that’s properly trained in this kind of supplement care.

Dr. Kalanick: Absolutely, and the important thing to remember about Hashimoto’s and autoimmune diseases is there are supplements that will make it worse. This teeter-totter I talked about, there are things that will push one side or the other. If you take things like green tea and açai berry, they’re going to push one side; if you take things like Echinacea and elderberry, they’ll push the other side.

And you don’t know which one is out of balance for you; not only could you be taking supplements and just wasting your money, you could also be making this immune process even worse.

Bottom Line: Great stuff. Thank you, Brooke. The bottom line: if you have Hashimoto’s and you’re simply treating it with Synthroid or one of the other thyroid hormones, that’s just not enough. Talk to your doctor about natural support for it. Could be vitamin D, could be glutathione, or could be turmeric. There are a number of things that can help support your body and help you strengthen your autoimmune system so that you don’t have to A) take as much hormones and B) your body isn’t struggling and fighting so much. This is Sarah Hiner with Bottom Line.