Allison Futterman is a writer for People of Charlotte. In addition to her work for
POC, her writing has been published in local and national magazines, online publications,
and literary journals. Now, she’s a first time book (co)author. What You Must Know About Hashimoto’s Disease was written with endocrinologist and thyroid expert, Dr. Brittany Henderson. Together, they are working to bring credible information, support, and hope
to people with Hashimoto’s Disease. The book is available on Amazon.
Dr. Henderson, you are a renowned thyroid specialist/ researcher/speaker. Can you give us a brief introduction to you and your work?
BH: Absolutely. My interest in thyroid disorders began after working with an endocrinologist during my residency. I enjoyed the procedural aspects of thyroid care, but even more exciting was treating someone with thyroid medicine could dramatically impact their overall health and wellbeing. I completed my endocrinology fellowship at Duke University Hospital and served in Medical Directorship roles at both Duke and at Wake Forest Baptist Medical Center. Currently, I am owner and lead physician at the Charleston Thyroid Center in Charleston, SC.
What is Hashimoto’s Disease?
BH: Hashimoto’s Disease is currently the most common reason for hypothyroidism (or underactive thyroid) in the United States. It is an autoimmune disease, meaning a disease where the body’s immune system incorrectly identifies and attacks the thyroid gland, causing it to malfunction.
AF: From a patient perspective, you may have suffered from symptoms for a long time, without even knowing that you have this illness. But you do know that you don’t feel well, and that something is physically wrong with your body. Maybe your doctor has dismissed your concerns over your symptoms. Maybe all your basic blood tests are normal. But still you don’t feel right.
What are the symptoms?
AF: For me, it was a feeling of intense pain and pressure in my throat and neck. I also had chills, weakness, no energy, body aches, exhaustion, nausea, eczema flare-ups, increase in migraines, and hair loss. And I had a strong awareness that my body was out of balance—in essence, feeling generally not well.
BH: Symptoms can be different for everyone and in the book we refer to the set of individual symptoms as a person’s “Hashimoto’s signature.” The most common symptoms include extreme fatigue and exhaustion, as in Allison’s case. Other symptoms include: dry skin, swelling, cold intolerance, constipation, weight gain, hair loss, muscle aches, anxiety and depression.
How did you two meet?
AF: We met after I did an extensive search for someone in the Charlotte area who specialized in thyroid issues, and I couldn’t find anybody. Technically any endocrinologist can treat thyroid problems, but few are experts in the specialty. I found Dr. Henderson when she was at Wake Forest. I realized immediately that she was unusual, because she possessed extensive knowledge, but was also very caring and compassionate. A rare combination in a doctor. I started thinking about how overwhelming it was dealing with this illness, even with the help of a great doctor. I could always email her if I had a question. But what about everyone who didn’t have someone to turn to?
BH: Allison is right. The search to find a thyroid expert can be challenging. The lack of proper training in thyroid care and paucity of research in Hashimoto’s Disease has resulted in a severe and real lack of proper medical care for those with thyroid illness. As a result, patients are left with inaccurate and contradictory information on Hashimoto’s Disease found all over the Internet. Up until now there was no single source of reliable and scientifically based information.
Is that what led to doing a book together?
AF: Yes. I thought about the book I wish had been available when I was first diagnosed. The options out there tended to be dogmatic—with an either/or approach. All natural/alternative
or strictly conventional. There were books by chiropractors, hormone specialists, even a self described “medical medium!” But I couldn’t find any that were written by an endocrinologist, and certainly none written by a doctor and patient. I starting thinking about how well we got along, and how we were both strongly motivated to help people by providing useful information. It just seemed like we would be a natural fit for a collaboration.
BH: Because the treatment of thyroid disease involves a lifelong working relationship between thyroid doctor and patient, it seemed fitting that there be a book co-written by a doctor and patient. Since there was nothing like that, wee wanted to fill that void, using our collective backgrounds and experience. From a patient’s perspective, Allison knew what questions someone with newly diagnosed Hashimoto’s would have. Additionally, I wanted to provide a comprehensive yet easy-to-understand guidebook to assist the reader along every possible stop in their thyroid journey. Our teamwork brought a book to life for patients that may not have access to the best thyroid care but still want solid and reliable medical information. Our book truly bridges the gap between conventional and complementary thyroid medicine.
How was the experience of working on the book together?
AF: It was completely natural and organic, and we were in sync throughout the process. We were both dedicated to creating a book that was not only informative, but reader friendly. Our shared goal was always to be a source of help and encouragement for knowledge seeking patients, along every stage of their Hashimoto’s journey.
BH: I agree! It was an awesome experience. I’m so proud of what we accomplished together as a team.
What was the most challenging part of the book project?
BH: Most of my writing was done early in the morning before clinic or on the weekends. Because I knew the material so well, putting the words on paper came naturally. All of the extra hours of editing and perfecting the text while working as a full-time physician were the most challenging.
AF: For me, it was writing on my “bad” days. There were times when I was having flare-ups,
and I wasn’t able to do as much as I wanted. I took advantage of my “good” days to be as productive as possible.
Is the doctor/patient element the main thing that distinguishes What You Must Know About Hashimoto’s Disease from other books on the topic?
AF: No, that’s only one of several things. Most books on Hashimoto’s take either a traditional or alternative medical approach. It’s typically all or nothing. You must eliminate all gluten. You shouldn’t take Synthroid (the most common thyroid medicine). Or the opposite, where anything outside of Western medicine is deemed unworthy of consideration. There isn’t much middle ground that is explored in the books that are available. We explore ideas from one end of the spectrum to the other.
BH: My medical practice is thyroid-only and has always focused on using any and all effective tools, whether it be natural desiccated thyroid (NDT), Synthroid, radioactive ablation, or dietary and nutritional changes to positively impact and optimize thyroid health. I used the same approach when writing the book. We should be using both mainstream and alternative medical approaches in our treatment of Hashimoto’s. What You Must Know About Hashimoto’s Disease is different because for the first time we acknowledge and support the idea that there is no one-size-fits-all approach to thyroid care. The book truly bridges the gap between conventional and complementary medicine.
What are some of the misconceptions about Hashimoto’s?
BH: The major misconception, in my view, is that Hashimoto’s is a disease that already has a cure (thyroid replacement medicine) and that nothing more needs to be done to understand it. That is just not the case. Hashimoto’s is a complex and multi-faceted autoimmune disease that significantly impacts people’s lives. We need to do better with research, diagnosis, treatment, and root cause analysis to understand how to best treat, cure, and prevent it. I hope that our book initiates a spark of renewed interest for scientific researchers in this area.
AF: I agree. A major misconception is that all you need to do is a take a pill everyday for the rest of your life, and you’ll be fine. It’s not always that simple. It took me quite some time to get my dosage in the range where I was getting optimum thyroid levels. And it’s still something that needs adjusting at times. Another misconception is that you only need to have your thyroid blood tests once a year. That’s how often most doctors order them. I usually get them checked every three months, because I want to keep on top of it.
Speaking of blood tests, isn’t that an area of controversy?
BH: It is. Many doctors believe a TSH level will tell you everything you need to know about someone’s thyroid function. This just isn’t the case. The book explores all of the other important thyroid tests including T4, T3, and thyroid antibodies. Thyroid disease can be a puzzle to diagnose and treat. Therefore, performing comprehensive testing provides us with the missing pieces necessary for medical decision-making. Future research in this area is needed to allow for more widespread acceptance in the mainstream medical community.
Why do you think there is a lack of qualified doctors when it comes to Hashimoto’s disease?
BH: Training programs and research hasn’t progressed far enough to produce many qualified doctors. The most qualified providers are those who see thyroid patients as a majority of their clinical practice and utilize all available information including laboratory testing, ultrasound, and nuclear medicine studies for diagnosis and treatment. Research drives practice guidelines and until there is more high quality research driving clinical treatment, qualified doctors will remain scarce.
AF: From a patient’s perspective, I believe a lot of it is related to the fact that Hashi’s patients (and thyroid patients in general) require ongoing care. Treatment usually needs tweaking or changing over time, and I think this can be frustrating to doctors who want to check a box and be done.
What is the best advice you can give someone with Hashimoto's?
AF: Be your own best advocate. This applies along every step of the way. From finding a doctor, to testing that would lead to a diagnosis, to speaking up if your treatment isn’t working for you. Nobody knows how you feel better than you!
BH: Don’t be afraid to seek a second or third or fourth opinion if you aren’t getting better or finding the medical care you require. Your health should come first—all the time.
Anything else patients can do to be proactive?
AF: I find that keeping a log of my symptoms when I’m having a flare-up is very helpful. It’s good to have a tangible record of the variety and intensity of symptoms when you’re going through a rough patch with your Hashimoto’s. This can be something as simple as a hand written chart on a piece of paper. Or you can use an app such as Boost Thyroid—where you can have one central place for recording your symptoms, that is easy to use and free.
BH: Yes! Being aware of your symptoms is the first step. Identifying your triggers is also helpful. By avoiding triggering events that contribute to the onset of flares (stress, infections, food sensitivities), you can quiet the autoimmune response, reduce your antibodies, and optimize your thyroid health.
Where can people go to find a doctor who is qualified in dealing with thyroid issues?
AF: They can go to the website of the American Thyroid Association
or the website of the American Association of Clinical Endocrinologists. Both allow you to search by specialty.
BH: Both of those websites are good resources for finding a thyroid doctor. Remember to always be a critical consumer of your healthcare. Just because someone is listed as a thyroid expert doesn’t mean that he/she has the rigorous training or treatment style that you require. It’s important to “move on” if you feel you aren’t receiving the care you need. If you are searching for a thyroid doctor and are willing to make the drive, you might consider seeking an opinion at my own thyroid-specific practice in Charleston, South Carolina – the Charleston Thyroid Center. You can learn more about the practice and/or schedule an appointment online at charlestonthyroidcenter.com.