Thyroid Q&A

Q – How does Dr. Pucci treat the thyroid?

A – When a patient presents with a health problem, we look for underlying mechanisms referred to as “root causes.” For thyroid problems—and women’s wellness in general—common root causes include any of the following: 

  • Estrogen surges during pregnancy that can cause the thyroid to go haywire
  • Autoimmune disease that attacks the thyroid (and other) glands or tissues
  • Infections, anemia, blood sugar dysregulation, inflammatory food toxins, and more that can trigger thyroid flare-ups
  • Thyroid problems themselves can be a symptom of some other underlying pathology such as poor heart function, neurotransmitter imbalances, and so on, including pituitary disorders
  • Oxidative stress and the exposure to chemicals, pesticides, metals, and radiation will affect thyroid

In a standard medical model, your physician or endocrinologist will not look for these.

Instead, he or she will run your blood work to measure the TSH and provide a prescription for either a synthetic or bio-identical hormone replacement (Synthroid, etc). The medical system and your insurance provider are only concerned about pathology, which is to say that if the thyroid TSH measure on the lab test is okay, and if your thyroid does not need to be removed surgically (or is not cancerous, etc.), then everything is “normal” and considered to be fine. This lack of treatment options is also why the debilitating symptoms of thyroid persist.

In a functional model, we look at the big picture.

  • First, we run a comprehensive blood panel because we need to see the thyroid in context.
  • Next, we run a complete hormone panel and look for the common underlying inflammatory triggers such as infections, toxins, and so on.
  • In most instances, we also take a look at the complete gut microbiome because thyroid function tends to slow down or complicate your body’s digestive tract.
  • We also develop a nutritional profile using your DNA.

This information gives us a complete picture—rather than standard medicine’s small, isolated snapshot—so that the root causes of your particular thyroid or overall health issues can be addressed. Once we have a metabolic baseline, we can implement an individualized set of treatments and clinical sessions to improve your metabolic function.

Q – If I have Hashimoto’s, how is that handled differently?

A – This is an important question because 9 out of 10 thyroid sufferers have Hashimoto’s thyroiditis, not primary hypothyroidism. Primary hypothyroidism can often be adequately managed using thyroid hormone replacement, at least for a while, and is what the medical system is designed to identify and treat. But this is not the case for most people.

Hashimoto’s is an autoimmune condition, which means that the immune system has malfunctioned and started to attack the thyroid rather than protect it. The thyroid, like other organs in the body, is vulnerable to immune system disruptions. This can happen either because these organs have become a storage site for toxins that should be shuttled out of the bloodstream or because they are so metabolically complex that they break down easily.

Once a person has an autoimmune condition, the functional priority is to manage the autoimmune condition rather than only the thyroid itself. This is because autoimmunity does not just contain itself to one site (the thyroid), it is systemic and will potentially identify and attack numerous target tissues, including the brain, the joints, the pancreas, the myelin sheath protecting the nerves, and so on. So a Hashimoto’s patient has a higher potential to develop further complications as the problem progresses.

With all patients, we start by examining the whole person for their basic underlying metabolic and health status, including the inflammatory triggers that will overstimulate the immune system. We then work on appropriate dietary changes that generally include removal of specific proteins, antinutrients (foods that interfere with the body’s absorption of important nutrients) and neurotoxins. We treat common symptoms such as constipation, blood sugar dysregulation, adrenal fatigue and estrogen overload using nutrition. And we dive further into determining which toxins and microbial infections or chronic yeast problems are causing the body distress. In a standard medical model, these facets are entirely ignored.

Q – What do all thyroid patients have in common?

A – All thyroid patients generally have neurotransmitter or brain chemistry imbalance, maladaptation to stress in the form of excessive steroid hormones (cortisol), and a malfunctioning hypothalamus (midbrain) pituitary mechanism. The interactions among the brain, the thyroid and the adrenals constitute the HPT axis, a major part of the neuroendocrine system that controls reactions to stress and regulates many body processes including digestion, the immune system, mood, emotions, sexuality, and energy storage and expenditure.

Because of this strong interrelationship and the cascade of symptoms that occurs because of poor thyroid management, all of our recommendations include a baseline metabolic workup to fully understand the neuroendocrine system, the health of the immune system (and inflammation), and brain chemistry. We call this the gut-brain-hormone approach to your symptoms. Constipation, for example, can be caused by low thyroid hormone or lack of dietary fiber, but more often it is also a result of neurologic dysfunction that starts in the brain stem (the vagus nerve, which operates “primary parasympathetic” functions responsible for all aspects of digestion) and ends in the transverse colon, where you feel constipated.

In many thyroid cases, patients also suffer with brain fog, insomnia, mood swings, irritability and anxiety. Again, there is a metabolic component at the heart of these symptoms; yet, since nervous system and brain health are inextricably linked, we work on brain function specifically to improve thoughts, feelings, and focus while helping to reduce symptoms.

Q – What if I just take a “wait and see” approach? Will I get better on my own?

A – If I were to line up all the thyroid patients I’ve consulted together with their pages and pages of laboratory tests and their bottles and bottles of nutritional products, the line might stretch from here to Montauk. The line would stretch even farther if I add in all the patients’ tears and sleepless nights and times that I heard them say, “My doctor said those symptoms weren’t related” or “My husband said I should do something about this but I didn’t think there was hope” or worse, “My doctor said it’s all in my head,” after which their doctor handed them a prescription for Lyrica or some other prescription and sent them on their way.

Instead, what my patients tell me is they wish they’d found me sooner. What I have learned about thyroid (and countless other health problems) is that the “wait and see” approach IS the standard medical model. But when you go it alone, trying out nutritional products and searching the internet as your salvation, you’ll get lost, and eventually you’ll get worse because you’re following the same Replacement Model that the medical system is using instead of examining the root cause and taking a full throttle, hands-on approach.

Having a doctor you can trust and who can guide you through the process, one who’s willing to listen and also provide you insight about you and how your entire being works, one who does not minimize you or your health condition, is priceless.