Chris Kresser: Yeah, so I think in the thyroid unit we covered this, but a large percentage, well, let’s see how I would say this. Not everyone who produces thyroid antibodies will have abnormal thyroid markers currently, nor will they ever have abnormal thyroid markers. In fact, the majority of people who produce thyroid antibodies do not go on to clinical hypothyroidism.
Now having said that, people who do produce thyroid antibodies are way more likely to go on to clinical hypothyroidism than people who don’t. I think it’s seven- or maybe even twenty-fold higher risk. I can’t remember the exact number. I mention it in the thyroid presentation. So what we can say about this patient is they’re currently not hypothyroid, but they are producing a lot of thyroid antibodies, and their risk of becoming hypothyroid in the future is much, much higher than someone who wasn’t. So what I would focus on in this patient is immune regulation. And it sounds like from a lifestyle perspective she’s doing really well, and I’m not sure how much more improvement you can do there. I mean, certainly the daily meditation practice would be helpful. Social support and some of the other things that are important that we talked about, of course, but you need to also look for GI issues, HPA axis dysregulation, and nutrient imbalances that could contribute to immune dysregulation.
Again, this kind of seems to be a theme for today’s webinar, but in cases where you have just general nonspecific symptoms or presentation like immune dysregulation and there are no kind of key signs or symptoms that point you to a specific underlying pathology, that’s where you have to cast a wider net and do the testing to figure out what it is that’s triggering that antibody production. Now we know that people with Hashimoto’s, in many cases, it’s a strong genetic predisposition because of the prevalence of Hashimoto’s autoimmune thyroid disease in first-degree relatives of people who have it. But that doesn’t mean there aren’t environmental factors at play.
So I would go looking for those factors and address them if the patient’s willing to do that. I would just explain what I explained to them, you’re not hypothyroid now but given your high antibody production, you’re at a magnitude higher risk than someone who is not producing these. And if you want to head this off at the pass and prevent it from happening in the first place, then you know I would suggest doing this testing and addressing any issues that we find. So that’s basically how I would phrase it.