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Welcome to the website for Jim Chialtas, L.Ac., and Laurel Acupuncture Clinic of Functional Medicine, located in San Diego.

Click on the tabs above to learn more about what Functional Medicine is, and about many of the health concerns I specialize in. Or scroll down for my blog. You might find it helpful to use the labels in the lower right column to find topics that interest you.

In addition to seeing clients privately in my clinic, I also offer many of the same services remotely to US residents. Please feel free to contact me to set up a consultation or appointment. Thank you!

4/17/09

The Unheard Thyroid

More and more I am developing an interest in helping those people who suffer from Thyroid conditions. In particular my interest lies with Hypo-Thyroid or low thyroid conditions. Believe me, these people are everywhere. It is my sincere opinion that these people are not getting their needs met by the mainstream approach. My goal in working with these people is to offer a well rounded approach to understanding the problem at hand as well as offering a scientifically backed treatment regimen. The bulk of this article will detail how mainstream medicine often times misses the intricacies of Hypo-Thyroidism how the condition could be approached to better address the underlying cause.

The Symptoms


Low energy
Difficulty losing weight
Weight gain even with high levels of exercise
Constipation
Hair loss (particularly of the outer third of eyebrow)
Get sick easily and/or often
Low libido (in both men and women)
Infertility
Cold hands and feet (or just plain feeling cold!)
Currently taking Thyroid medications but still feel crummy

Do any of these sound familiar? All of these symptoms can be related to low Thyroid function. Many of these are extremely common complaints in my practice and affect a large portion of the population.

The Problem with the Mainstream Approach

The general ways that a person is diagnosed with a Thyroid condition is through a routine blood screen. There are several particular markers which can indicate either high or low Thyroid function. The most common marker is thyroid Stimulating Hormone (TSH). Typically this has a laboratory reference range of 0.35 - 5.50. If you are out of this reference range you are indeed clinically diagnosable as either Hyper- or Hypo-Thyroid. And chances are that you feel awful! The unfortunate part of working in these reference ranges is that they are extremely broad and do not pick up sub-clinical dis harmonies which might otherwise be causing any or all of the symptoms described above. The message here is that in order to be helped by the mainstream approach you need to have blood work that is way out of normal. As I will describe later I use both the Laboratory ranges and what are called Functional ranges. The Functional range for TSH is 1.8 - 3.0. As you can see, the Functional range is a much smaller range and its use allows the practitioner to detect dis harmonies that may otherwise be hiding or can be addressed before they become serious. But believe me, there are plenty of subjective complaints from people who are just outside of these Functional ranges who slip through the cracks of mainstream medicine. These people need help but are generally not getting it. This is simply due to how the mainstream medical approach looks at illness. The other really important thing that gets missed in a great number of known Hypo-Thyroid patients is the Auto-immune connection. That means that the immune system is actually attacking the Thyroid tissue. The way this gets diagnosed is to look for antibodies against Thyroid tissue. (Antibodies normally help the immune cells target and destroy foreign invaders in the body. In this case the Thyroid is seen as foreign and worthy of destruction.) If there are antibodies against Thyroid it is important to realize that you have an immune disorder first and a Thyroid disorder second. Recently I had two different women come into my clinic with known Hypo-Thyroid conditions. Both have been medicated for many years for these low Thyroid conditions. Neither felt particularly good with their Thyroid medication. I ordered a test for Thyroid antibodies and of a normal reference range of 0 - 40 one woman came up with over 800, and the other came up with over 11,000! Unfortunately, their doctors never thought it necessary to look. Treating an Auto-immune thyroid like a normal Hypo-Thyroid not only doesn't work, it is just not good medical practice. I find this to be really troublesome and scary stuff! I hope that you find this a point of concern as well.

The Good News

The good news is that there is help out there. When I work up a Thyroid patient I make sure to utilize both Functional and Laboratory ranges not only for the Thyroid but for all other markers in the body to look for other contributing factors. Also, knowing that between 50 - 80% of all Hypo-Thyroid patients are actually Auto-Immune Thyroid (Hashimoto's) in nature, I most definitely order an antibody test to rule out this leading cause of low thyroid. If you have Hyper-Thyroid or high Thyroid you definitely have an Auto-Immune problem. The real take home message about Auto-Immune Thyroid is that even though it is the Thyroid symptoms that are making you feel crummy, your primary problem does not reside with the Thyroid itself. The problem is the immune system. Supporting the thyroid itself with pharmaceutical drugs or natural herbal/nutritional formulas simply will not work. And taking some basic thyroid supplements like Iodine will actually make your Auto-Immune Thyroid condition worse! Not until you focus your attempts squarely on balancing out the immune response can you see any significant results with the vast majority of Hypo-thyroid conditions. I will work with you to understand your particular condition and help you successfully treat the core of the problem.

The Unfortunate Reality

Yep, there is an unfortunate reality here... I am an acupuncturist telling you this. Not only do I have to challenge what your doctor might have said, but I have to negotiate the image or expectations of what an acupuncturist knows, or put another way, is allowed to know. I encounter this conundrum all of the time. People generally don't understand my training or ability to manage serious conditions like Auto-Immune Thyroid. And in many instances to do a better job at it than the mainstream approach! Just the other day I was talking with a Pharmacist who after sharing with him about the antibody tests I ran on those two women asked me very sternly, "So once you find that you must immediately refer them to their medical doctor! Right?" It noticeably shook him that I was managing these types of patients. The unfortunate part of this interaction is really two fold. One, my medical degree has been once again misunderstood, disrespected and disregarded. And two, a highly educated person thought it essential to refer back to the very institution which more times than not will miss the true diagnosis, allow for extreme reference ranges to be out of range before treatment, and who's treatment protocol involves replacement hormones (which don't work in Auto-Immune conditions). Or in the case of a known Auto-Immune condition involves either surgically removing or chemically killing Thyroid tissue or chemically suppressing the Immune system which can leave the patient open to much worse illnesses than low thyroid function.

Either way you look at it the mainstream approach is quite severe and in my opinion lacks the sensitivity to manage the core of the condition. But putting my ego aside for a moment, we as medical practitioners must at all times keep the best interest of our patients in mind. I feel very confident in my diagnostic approach and treatment protocols to effectively, and probably for the first time in that person's life, finally address the core of the problem. If people like me don't do it, then who will? It is time that we take a closer look at our options. Just because the mainstream approach is going strong doesn't mean that it is practicing the most up to date medicine. These things that I am handing down here come right out of the very same highly prestigious medical journals that doctors read. Contrary to what my medical degree might imply to the mainstream world, I am only providing information based upon the most cutting edge and up to date research available. And it is my privilege and joy to do so.