How I Conquered Rheumatoid Arthritis – Part 2
As I took the drug methotrexate given for rheumatoid arthritis and realized that it was making me feel worse than my flares, I got the conviction that this was not the right solution for me. Unfortunately, this was the only type of treatment that my rheumatologist could offer: this, or other biologics with other side effects and additional risks.
I want to say that I totally understand people who go this route, because when we are in pain and see our health deteriorating, we almost have no choice. We want to try what is available with conventional medicine, as it is for most of us, our primary route for care.
It is hard to explain, but I felt deep inside me that there was another way. Why?
We have to go back to my first autoimmune diagnosis, 7 years before my diagnosis of Rheumatoid Arthritis. I was 34, had 2 young kids, and was navigating a stressful period at work. I was not sleeping much, losing a lot of weight, constantly hungry, and shaking often, but I did not know at that time how to listen to my body. It seems crazy now, with all those signs, but I was just trying to manage everything as a busy working mum. I was trying to progress my career while feeling, at the same time, very guilty for not being with my kids, so I was overcompensating by not sleeping much on weekends to be with them and show them that I loved them, and I had a tendency to refuse any help.
In reflection, of course, I could have done things differently, but I was not aware at that time of the dangerous road I was going down.
After a friend saw that I was not well and pushed me to go to the doctor for tests, especially since I had been having my period continuously for almost a month, the diagnosis came: Graves’ disease. Basically, my thyroid was overreacting, producing too many hormones and accelerating my metabolism. That is why I was so thin despite always being hungry and eating a lot. That is why I was not sleeping at night.
I followed the usual route and went to see an endocrinologist. He was very shocked. My thyroid hormone levels were 3 times higher than the upper limit, and he immediately put me on beta blockers and methimazole to reduce my thyroid hormone production. I was lucky not to have ended up in the ER, he said. I was at serious risk of heart failure or stroke, and he was very surprised that I had not been hospitalised yet.
So I followed his advice and started the treatment immediately. It seemed to help reduce my thyroid hormones. However, I had several questions for which my endocrinologist could not give me a satisfying answer. I asked why I had developed this condition. He said it was probably genetic and that it happens to women like me after having children…
Really? That is it?
So there was nothing else I could do apart from taking the treatment. After seeing that my first endocrinologist did not welcome too many questions, I changed to another one. She was more open and happy to take the time to answer me.
With her, I continued my treatment, which helped to reduce my thyroid hormones. But I had real difficulty with the idea of taking pills every day, so I would often skip them, partly to see if my body was returning to balance. During check-ups, I felt so sad when she would tell me that my levels were too high again and that we needed to increase the dosage of the medicine. Once I was back on the medication, my levels would come back within range.
I once asked whether I would have to take those pills for life. She took the time to explain that this was not advisable with Graves’ disease, as the medication would eventually start to affect my liver, and my body would stop responding to the medication eventually. The best solution, she said, would be to have my thyroid removed or to take radioactive iodine.
When I asked whether that would solve the problem for good, her answer gave me pause.
In the first case, a thyroidectomy, I would have to take hormones for the rest of my life since I would no longer have a thyroid. She also mentioned surgical risks given how vascular the area is, so I immediately ruled that option out.
I then considered radioactive iodine. But when I asked how it worked and whether I would be free of medication afterwards, the answer was even more troubling. She explained that it is imprecise, as it is impossible to know the exact right dose for my thyroid. It might destroy too little or too much of it, and in either case, I might still need to take medication for the rest of my life.
And then she added: “If you have the radioactive iodine treatment, you will need to make sure not to share a toilet with your children or family for several days afterwards, to protect them from exposure.”
Really?
That ruled it out entirely. If something could still be harmful to the people around me for days after I received it, how could putting it in my body be the right answer? It simply did not make sense to me.
So, with no satisfying solution from conventional medicine for my thyroid, that was the first time I began looking for an alternative approach. I went to see a naturopath in Hong Kong, where I was living at the time.
I will be honest: in that first consultation, I was a little annoyed. I had carved out 30 minutes between work meetings, planning to slip out and slip back quickly. But the naturopath was asking a lot of questions!
I had never seen a naturopath before. I knew they had a more natural approach to health, but I had not realized they were going so deep into understanding a person’s history, environment, and emotions, in addition to their health concerns. He asked about my childhood, my digestion, my sleep and many other things. At the time, I could not see the connection to my thyroid, and part of me just wanted to get back to the office before my next meeting.
And then he asked about my children. How I cared for them. My working hours, etc. He stopped, looked at me, and said, “That is a lot on you…”
And I just started crying.
It was the first time that a health professional had truly acknowledged everything I was carrying, put all the pieces together, and told me I needed to take care of myself, to breathe.
As he explained how certain foods and lifestyle factors could affect my thyroid, and why, I felt confident that I could follow his guidance and turn my health around.
I started following his recommendations, and yes, my thyroid improved. My levels came back within range, and together with my endocrinologist, we were able to reduce my medication.
I was so looking forward to telling her about the role of diet in my thyroid health improvement, and in particular, removing gluten. She smiled and said, “Yes, removing gluten is good for weight loss, but it has no impact on the thyroid.”
I was a bit disappointed by her response, but I knew what I had felt as changes in my body and my overall well-being. And it turns out, the science supports it. A great deal of research shows that gluten, and more specifically a protein called gliadin, has a molecular structure that closely resembles that of thyroid tissue. When gluten breaches the intestinal barrier and enters the bloodstream, the immune system can mistake the thyroid for the same threat and attack both. This phenomenon is called molecular mimicry. Studies also show that gluten promotes increased intestinal permeability, commonly known as leaky gut, which raises thyroid antibody levels and can accelerate autoimmune activity. The connection is considered significant enough that some researchers now recommend that anyone diagnosed with an autoimmune thyroid condition be screened for gluten sensitivity, and vice versa. (See references at the end of this article.)
My endocrinologist was following the training she had received. She was practising conventional medicine as it is taught. She most likely had very little knowledge of nutrition, so I do not blame her.
However, that moment made something clear to me. There are two worlds when it comes to chronic diseases, specifically. The world of conventional medicine, where you are given medication and should feel fortunate if your doctor welcomes questions (which was the case with my second endocrinologist, not the first one), but where there is rarely a long-term solution to fully heal. And the world of naturopathy, functional medicine, where there is a holistic approach that considers the whole person, the root causes, and how to stimulate the body’s self-healing mechanism to regain health and vitality as we should.
It should have been the happy ending to my health struggles. The change in diet and lifestyle had helped bring my thyroid back into balance. But unfortunately, it was not the end of my health issues.
What happened over the next 7 years, slowly leading to my diagnosis of Rheumatoid Arthritis, is what you will discover in the next article.
References: Esfahani KS et al. The Role of Gluten in the Development of Autoimmune Thyroid Diseases: A Narrative Review. International Journal of Endocrinology and Metabolism, 2024. PubMed: https://pubmed.ncbi.nlm.nih.gov/40065831/