Healing Hashimoto's Hypothyroidism in Portland is my passion. I'm Dr. Jolene Brighten and this is is a true story you may find close to home…
Maddie’s doctor looked at her labs and told her, “I don’t think your thyroid is your problem. Instead, I’d like to refer you to a psychiatrist because I think your problems are largely due to stress.”
It’s true, Maddie was stressed.
And if you looked at her chart without hearing her story, you might also think it's“all in her head.”
By the time Maddie made her way into my Portland clinic I was her 11th doctor.
Eleventh! Not, 3rd or even 8th, but instead Maddie’s last attempt (she promised herself) to get better.
Truth is…many of my patients feel they have “seen everyone” before they come to me.
Maddie's Symptoms Were Real
Maddie’s fatigue, constipation, anxiety, and daily joint pain were a constant reminder that something was wrong. She listened to her body, she sought help, but every naturopath, functional medicine doctor, and other healthcare provider would eventually give up on her case too.
There’s a fundamental difference between me and these other docs. Sure, we may have started out on the same journey to attain our medical education, but for me—Hashimoto’s is personal.
You see, I have Hashimoto’s Hypothyroidism too.
Mine developed after having a baby, so my doctors were quick to chalk my symptoms up to being a mom.
This is when my life took a turn and I found myself digging so deep into the research and educating the world on everything that I was learning that when I resurfaced out of the depths of the scientific abyss I found that others were now looking to me as one of the leading authorities in thyroid disease.
Through what I learned I was able to reverse my autoimmune diseases (yes, I was lucky enough to develop more than one), put them into remission and reclaim my life. And I’ve helped several thousand other women do this too.
So, I know a thing or two about thyroid disease and today I want to share with you what 10 of Maddie’s other doctors missed.
Maddie Did Need Help with Her Stress
Her doctors weren’t wrong about that and some of them even prescribed meditation and deep breathing—you know those common things all of us know we should be doing, but don’t actually follow through with.
The problem was, these were just words and honestly, Maddie admitted if one more person told her to meditate she was going to lose it—big time.
I asked Maddie one simple question that changed everything—”What do you do when you feel the stress bubbling up?”
You see, it’s one thing to set aside the time to de-stress and relax, but it is entirely another to make a conscious effort to disrupt the pattern in the moment.
Make no mistake, this does take work and effort. But recognizing and disrupting the stress patterns is a literal re-wiring of your brain. Of course, that’s going to take some effort. But it is so worth it!
You know what Maddie did when she was stressed?
She ate ALL THE THINGS. But mostly salty things.
Sound familiar? So many of us do this that it is not even worth the conversation of saying we shouldn’t judge. But seriously, let’s not judge.
Because the judgment Maddie was feeling from her doctors for not doing [fill in the blank] enough kept her from sharing this crucial information.
Maddie was in need of support and some killer lifestyle strategies if she was going to achieve her goal of putting her autoimmune disease and her symptoms into remission. So, I prescribed a session with my Functional Nutrition and Lifestyle Consultant who helped instill the confidence Maddie needed to master her diet and lifestyle changes.
In my practice, I offer patients two complimentary sessions with my personally trained consultants to help ensure a patient's success. Before I was ever a doctor I was a nutritional biochemist, so me and food go waaaay back. It was way back then that I came to understand the profound power of “Food as Medicine.”
What you put at the end of your fork truly has the power to keep you out of the doctor's office and in good health!
I truly believe this. So I gift these two sessions at no charge because I am that committed to helping you heal yourself! And you know what…this is part of the secret sauce that gets my patients better faster and for good!
But as to the question I asked Maddie, ”What do you do when you feel the stress bubbling up?” Here's two big clues her answer provided:
Clue Number One:
Maddie was eating when stressed. A stressful state shunts blood away from your gut and to your large muscles. Or in other words, your gut can’t work, you can’t digest and now the bacteria are having a field day with the smorgasbord you so graciously ate for them.
She couldn’t rest, let alone digest.
So, all those gut healing therapies her other doctors had given her made little difference because Maddie was in sympathetic overdrive, which had her in a mode to fight, flee or just plain freeze.
No wonder her gut wouldn’t move! And she was relying on over 600 mg of magnesium (prescribed by a previous doctor) every day just to have a bowel movement.
Note: It is not normal or acceptable to indefinitely require a daily supplement to have a bowel movement.
Clue Number Two:
She was craving salty foods. Hello adrenals!
Your adrenals do more than just pump out stress hormones. They also regulate your blood pressure… and salt has a thing or two to do with that system. This is why we crave salt when we're stressed.
Yes, we needed to work on the lifestyle piece, but her adrenals were in need of some serious love.
Maddie had adrenal testing done and based on the results she was given adrenal glandulars on multiple occasions. It was too much and too fast because every time Maddie took them she was feeling more anxious, irritable and as she described it “not in control of my own body.”
Some of her doctors said take more. Some of them told her she must be taking them wrong. (I don’t like either of these answers.)
What Maddie actually needed was adaptogenic herbs, along with nervines to nourish the parasympathetic nervous system. Say what?
She needed not just herbs that would push the gas on the adrenals, but also herbs that would put the hush on the way stress was driving Maddie’s nervous system crazy. I got her going with a combination of Holy Basil, Ashwagandha, Passionflower, Gotu kola, and Licorice.
And we fed her adrenals—B vitamins, vitamin C, healthy fats, quality proteins and no blood sugar swings!
Maddie’s other doctors were more concerned with “pushing those adrenals to work,” than asking, “why is the body responding in this way?”
As it turned out, Maddie had several underlying infections.
When there are chronic infections the immune system gets to work trying to clear them out of the body and making lots of inflammation in the process. Your adrenal glands should be keeping inflammation in check so things don’t get out of control. They do this by making cortisol.
But when conditions are right, as is the case with chronic infections, HPA dysregulation (commonly known as adrenal fatigue) can occur. When this happens inflammation goes up, cortisol goes down and every single cell in your body feels it.
Maddie’s doctors told her that her inflammation was only moderate and they rushed in with all the natural anti-inflammatory herbs and supplements that they knew of. There’s a fundamental issue with this—when you replace medications with herbs without regard for the root cause you are still practicing allopathic (or conventional) medicine. It’s actually a phenomenon that is referred to as green allopathy.
Now let me be clear—I’m not judging another doctor for using natural therapies instead of drugs in an attempt to help a patient. Nor am I judging the allopathic approach to medicine, which we can agree is profound in acute situations, but not necessarily the best lens to view chronic disease through.
But with that said, I want to share with you a very important distinction that is often overlooked.
If your doctor uses the same logic, but different tools, you will not achieve root cause resolution. The idea of doing the same thing and expecting different results is what many brilliant people have defined as insanity…including Albert Einstein, who I think we can agree was a legit genius.
You can replace your “pill for every ill” with “a supplement for every ill,” but won’t necessarily get the results you need because there is a fundamental flaw in your logic.
Thinking chasing symptoms with supplements will somehow produce more favorable results than chasing symptoms with drugs only ensures a forever customer for the supplement company.
It is agreed that supplements are needed, especially in the healing phase and that symptoms should be addressed. But it is important that we make a distinction between when we're treating symptoms and when we are treating the root cause.
And we should be careful, because this symptom chasing logic is the same logic that assumes every thyroid patient presents the same way, that everyone feels best somewhere within a broad lab reference range, and that every patient will be just fine on Synthroid.
None of this is true, in case you’re wondering.
This was Maddie’s issue. Her doctors recommended excellent supplements to keep inflammation at bay, but they didn’t dig deep enough to figure out why she was inflamed in the first place.
Turns out, Maddie had methane dominant SIBO, reactivated EBV, antibodies for CMV, Bloastocystis hominis and periodontitis (a dental infection). Every provider had ran the first 4 tests, but no one thought to check her mouth.
In Functional Medicine our thinking goes like this—if you have an issue in the large intestine then we need to find out what is happening in the small intestine. And if you have an issue in the small intestine then you need to ask, what is happening in the stomach? And so on.
Your gut is a tube, a twisty turny tube, but nonetheless, a tube.
If you’ve got an issue at the terminal end then it only makes sense to ask what is going on up stream.
She’d received 4 rounds of antibiotics for the SIBO. None of them helped. Not the first one, not the second one and so they just kept prescribing…until Maddie said no more.
She was then given a recommendation for high dose magnesium and was sent upon her way.
No one treated the Blastocystis parasite, in fact, they all dismissed it as an issue.
Here’s what I did differently:
I sent Maddie to a biological dentist to have an exam. When the diagnosis of gum disease was in, her dentist and I went to work to clear that infection and Maddie had a new morning and evening routine.
While we worked on the mouth infection I started Maddie on a very low dose of Natural Desiccated Thyroid hormone for 5 reasons:
ONE: She didn't have enough thyroid hormone.
Her T4 and T3 were low, indicating she was having issues with making and converting thyroid hormone. Without enough thyroid hormone for her cells, Maddie was tired, anxious, constipated, and it explained why she was shedding more hair than she was growing.
TWO: Maddie was inflamed.
She was inflamed, which means that less thyroid hormone was getting converted and the cells were unable to use it effectively. Yes, she wasn't making enough and what she was making wasn't being well utilized.
THREE: Maddie had poor motility and low stomach acid.
Thyroid hormone stimulates the production of hydrochloric acid. Hydrochloric acid, in turn, helps you absorb the nutrients your thyroid needs to function, stimulates other digestive juices to start flowing, and defends against any more unwanted critters from getting in.
No thyroid hormone means gut and thyroid get worse. Plus, you can not heal without it.
FOUR: No one had tried it.
With all of her symptoms, she was never given a prescription for thyroid medication. All because her labs were “normal.” She recalls her primary care doctor briefly mentioning it, but then dismissed the idea that it could help.
Other providers felt they could help her thyroid to function again naturally. I'm a big fan of this too. But sometimes you need more than a handful of herbs and supplements. If Maddie hadn't shared her entire health story with me I may have thought we could give a trial of natural therapies too.
But understand this—a trial of natural therapies, not an indefinite prescription.
If your hypothesis is that natural therapies will restore thyroid function and the expected outcome is improved symptoms and lab markers then you should certainly be monitoring for the expected outcome. If the expected outcome is not achieved (ie feeling better & better labs) then you must formulate a new hypothesis to test.
In Maddie's case, it was time to test Natural Desiccated Thyroid hormone.
FIVE: She had hypothyroid symptoms.
Sure, her labs were semi-normal from a conventional perspective, but were less than optimal from a functional medicine perspective. But basing my recommendations (like her other doctors did) on her labs alone would have been a great disservice to her. Her story had provided me with the data I needed to make the call to prescribe. And my clinical experience has taught me that patients in this scenario need at least a little thyroid medication to help them feel better.
This was another fundamental issue lacking in her previous care—if Maddie didn’t have the energy to do the work she was never going to heal. Healing takes effort and energy, which is why I make sure my patients get symptom relief sooner than later so that they can do the necessary work to heal.
After 2 weeks on the thyroid medication and the other holistic therapies we were employing, Maddie’s digestion began to improve, her energy was beginning to climb and she felt less anxious. She continued to improve at this low dose while also working to resolve the root cause of her symptoms.
We also focused heavily on getting the parasympathetic system going before and during meals. This was so that Maddie’s gut could do what it was designed to do.
Instead of eating every time Maddie felt stressed she now stopped and asked, “Is this food really what is best for me?” Yeah, I know it’s nothing glamorous or even a hint of revolutionary, but this one little act is pure magic for changing habits.
Did we treat the SIBO?
Eventually, we did treat the SIBO directly, but after two years on a Low FODMAP diet my priority was getting Maddie away from a restrictive diet and figuring out which foods were actually problematic.
Two years is about 21 months too long to be on that diet, which was why we were also working on replenishing the nutrient depletions that were brought on by restricting too many foods for too long.
Treat the Terrain
Maddie’s SIBO, constipation, mouth and parasitic infection told me something that was huge in turning her health around. Maddie’s terrain had been compromised.
Her gut was no longer the glorious microbe nourishing environment it once was. Think of going from a lush jungle to the desert…no one has an easy time surviving in the desert.
Blastocystis hominis is a common infection in Hashimoto’s patients. Historically, it has always been thought to be a harmless parasite and the recommendations were only to treat if there were symptoms.
Note: We only test for this when there are symptoms.
The approach to decimate every organism living in her gut (antibiotics and Low FODMAP diet) was noble. But it was the opposite of what Maddie needed.
She needed her gut motility supported, her microbiome restored and a good dose of healing herbs to get back on track. We started with healing her gut, reintroducing foods and getting her a sense of normalcy. Important after being “the freak who brought her food everywhere for 2 years,” as she put it.
I kept Maddie on a dose of Gut Rebuild at 3 caps twice daily for 6 weeks. But at the end of 6 weeks, she was feeling so good with this product that she asked to continue. I highly value my patient’s opinions about what is working and not working.
After all, they are the only ones living in their body. So they are literally the expert on what they need.
She continued the Gut Rebuild for an additional 6 weeks.
I don’t heal my patients, I teach them to heal themselves.
After 6 months of working with me, Maddie’s constipation was gone. Her thyroid antibodies were down, she had forgotten all about the pesky anxiety issue and she was more active than ever! Read Healing Anxiety with Functional Medicine.
With more energy and no joint pain, Maddie became more active. She picked up paddle boarding on the Willamette River and trail running in Forest Park with new friends.
When she first came to see me, Maddie explained she had been socially isolated because her pain and energy were keeping her from playing!
This new found community was breathing life back into Maddie and she was now spending time with more like-minded health warriors.
I never told Maddie to go out and make friends. I didn’t have to.
You see, as we bring the body back into alignment and commit to showing up more present in this world we effortlessly move towards those things which serve us, which build us up.
All I needed to do was show Maddie the picture and give her the personalized roadmap back to health.
This is also where I differ from other doctors—I don’t heal my patients, I teach them to heal themselves.
My perspective is this—you know what you need to heal, in fact, you have all the answers.
How do you think I figure it out? It’s you, silly!
You give me what I need. Everything to determine what labs to test, what tools to use, and what therapies might work best. All of it comes from you!
This is what I tell my patients:
Navigating your own health is like reading a book that is too close to your face. You know all the answers are right there, but it’s just way too close to make out the words.
Enter Me. I stand back at the right distance to clearly read those words back to you. I take your entire story, along with your labs and paint a clear picture. How you got to where you are, what to do to fix it, and what’s coming. If we don’t act now.
But make no mistake, while I am guiding you and giving you direction, it is YOU who takes the step. It is you who does the work.
So in my mind—I don’t heal people. They heal themselves.
And if I’ve done my job right, come the end of our journey together there is little need to continually meet with me except for a couple of times per year.
Why? Because Docere (the root for doctor) literally means teacher.
My job is to teach you how to care for your body so well that you know exactly what to do when things get off a little off balance. And for when things get really out of balance…I am here.
Wishing you love and an abundance of support on your healing journey!
Dr. Jolene Brighten
Oh and one more thing I'd like to say because I would feel remorse not to have said it. Maddie's doctors are not bad doctors. Instead, I'd like to think that they are just at a different place in their journey. They are discovering their own unique gifts and talents for enabling people to heal.
For them, Hashimoto's may not be the condition they love to treat—for me it is. And that's another fundamental difference in how I helped Maddie heal her Hashimoto's hypothyroidism.
*My patient's name was changed to Maddie in this Healing Hashimoto's Hypothyroidism in Portland story. I received full permission to share her journey with you.
Hey Portland! There is a New Thyroid Doctor in Town!
My office is located inside the Centrl Eastside coworking space at 329 NE Couch. I'm super proud to say we are the very first Functional Medicine practice in one of Portland's local coworking spaces.
I know—that's so Portland.
I am super excited to be sharing space with some of the most innovative, creative thinkers across an array of industries.
Plus, everyone in our space is really cool. Like you actually like going to work cool.
But more importantly, this space is really inviting and comfortable for patients. And it has plenty of room for larger educational sessions (coming soon!).
Here's a pic of me in the new space. I came in to find this on the window of my office.
I told you they were cool!
If you're in Portland or thinking about traveling here, be sure to keep a lookout for events we'll be offering.
You can also follow me on Facebook to stay up to date on what's happening in health, my clinic, Portland events… with a little mix of the foods I love eating!
Hope to see you in Portland!
Dr. Jolene Brighten
Your Natural Thyroid Doctor