Hashimoto’s Thyroiditis Specialist in New York City, NY

Feel like you're constantly running on empty? Gaining weight at a surreal pace, despite making no changes in your diet? Struggling with focus and memory, no matter how much you sleep?

It may be Hashimoto's.

Traditional doctors may be brushing it off, saying all you need is a nap. But what you really need is a doctor who's been treating Hashimoto's for decades.

You need Dr. Borenstein.

He has what it takes to reach beyond symptoms and unravel the complex root causes of this debilitating autoimmune disorder: patience, curiosity and compassion.

Unlike traditional doctors, Dr. Borenstein doesn't just manage your chronic symptoms - he optimizes your whole health. That's why leading thyroid experts like New York Times bestseller Dr. Isabella Wentz and Dana "Hypothyroid Mom" Trentini recommend him as Manhattan's top functional medicine doctor for Hashimoto's.

As rare as it may seem in some medical circles, Borenstein really does listen - for as long as it takes. He'll keep testing and targeting root causes until you feel energized, focused and motivated to live the life you deserve. To schedule a consultation call Manhattan Integrative Medicine at ☎ (212) 262-2412 or contact us here.

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What exactly is Hashimoto's thyroiditis?

When your immune system attacks your thyroid gland - that little butterfly-shaped gland below your Adam's apple - disrupting its ability to produce thyroid hormone you're diagnosed with Hashimoto's thyroiditis. If not controlled, this autoimmune disorder can lead to an underactive thyroid gland (hypothyroidism).

A healthy immune system recognizes foreign invaders like bacteria or viruses, sending antibodies to the rescue. But when this imbalance occurs, the immune system attacks the thyroid gland instead. Antibodies begin attacking proteins in the thyroid gland, gradually killing thyroid cells.

Early stages of Hashimoto's present few symptoms. With each autoimmune attack, however, more thyroid cells are damaged, causing them to release their stored thyroid hormones. These temporarily high thyroid hormone levels can cause symptoms like: panic attacks, anxiety, accelerated heartbeat, sweating, trembling hands, diarrhea, and sudden weight loss.

As more thyroid cells are killed in each attack, the thyroid struggles to produce enough thyroid hormone, causing hypothyroidism symptoms like fatigue, weight gain, hair loss, constipation, brain fog and memory loss. Once a significant enough number of thyroid cells are destroyed, a hypothyroid patient must be prescribed lifelong medication.

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Hashimoto's Thyroiditis Symptoms

Hashimoto's affects each patient's body at a different pace to various degrees depending on his or her age, genetics, life style and environmental factors. Dr. Borenstein will check and monitor you for all these common symptoms:

• weight gain despite no change in your diet
• unexplained fatigue
• hair loss
• brain fog and memory issues
• low libido
• brittle, chipping nails
• feeling cold when nobody else does
• constipation and bloating
• frequent urination and excessive thirst
• pale and dry skin
• puffy face, eyes and belly
• enlarged tongue
• muscle weakness and aching
• joint pain with stiffness and swelling
• heavy or irregular periods
• depression and anxiety
• frequent infections and colds due to weakened immune system
• water retention
• high blood cholesterol
• carpal tunnel syndrome

You may notice your thyroid gland swelling, causing tightness in your throat that makes it difficult to swallow. As Hashimoto's disease progresses, your enlarged thyroid gland may struggle even harder to produce enough thyroid hormone, causing a goiter.

In more advanced cases, this metabolic imbalance can cause infertility and pregnancy complications, heart disorders, depression, cancer or even myxedema – hypothyroidism so extreme it can lead to coma or death.

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Causes of Hashimoto's Thyroiditis

What causes the body's immune system to suddenly attack the thyroid as if it were a foreign invader? We don't exactly how the disease starts in every patient, however, we do know that Hashimoto's disease can be genetic. We also know that deficiencies of nutrients like iodine selenium, zinc, and iron have been shown to induce thyroid inflammation.

Another potential cause can be a chronic infection – like Epstein Barr virus, HHV6, Lyme disease and mycoplasma.

Studies have shown that Hashimoto's may also be related to Celiac disease, an autoimmune overreaction to the gluten protein in wheat, rye, barley, oats and other grains. Gluten can also directly trigger the autoimmune reaction that causes Hashimoto's disease.

Each patient's unique case may be caused by a combination of:

• chronic viral infections
• genetic predisposition
• leaky gut syndrome
• inflammatory allergens (like dairy and gluten)
• nutrient deficiencies
• extreme stress

Dr. Borenstein has seen various combinations of these causes and is adept at targeting each one until he discovers exactly what's causing your symptoms and how to resolve them.

While there are different root causes to Hashimoto's, he has discovered the treatments addressing and nourishing three organ systems that are impaired in Hashimoto's; the liver, the adrenals and the gut to make most of his patients feel better.

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Risk factors of Hashimoto's

About one out of every thousand Americans has Hashimoto's disease. Many more test negative for antibodies, but still struggle with inflammation and debilitating symptoms.

You may be at higher risk of getting Hashimoto's if you are:

• a woman
• pregnant
• between the ages of 45 and 65
• diagnosed with another autoimmune disorder

Dr. Borenstein will do a thorough analysis of your symptoms, general health, genetics and medical history before beginning diagnostics.

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Hashimoto's Diagnosis

Diagnosing Hashimoto's takes more than just one thyroid symptoms test – it takes time and patience. As soon as Dr. Borenstein suspects a thyroid issue he will order bloodwork to screen for every possible root cause.

First, he'll test your blood for these increased antibodies, which are very common in Hashimoto's patients:

• anti TPO: detects anti-thyroid peroxidase antibodies mistakenly attacking your thyroid enzymes and thyroid tissue
• anti TGAb: this antibody targets thyroglobulin, the storage form of your thyroid hormones

Then, he'll optimize the thyroid levels in your blood by testing for:

• TSH: your thyroid-stimulating hormone tells your thyroid gland to produce and release thyroid hormones into your bloodstream
• free T3: measures T3, the active form of thyroid in your bloodstream
• free T4: measures T4, the inactive form of thyroid in your bloodstream
• reverse T3: measures the inactive form of T3 which can be elevated in patients with poor T4 to T3 conversion

Dr. Borenstein will determine whether you have leaky gut syndrome, and detect any gluten or dairy sensitivities. He will also screen your blood for viruses like Epstein-Barr virus and human herpes virus (HHV6).

To optimize your nutritional status, he will test you for deficiencies of:

• vitamin D3
• B vitamins like B12
• folic acid
• ferritin
• magnesium
• zinc
• iodine
• iron

Especially in patients who have trouble losing weight, the following hormones may also require balancing:

• cortisol: your adrenal gland produces this crucial stress hormone
• leptin: helps regulate appetite by signaling hunger satisfaction
• insulin: this sugar level marker may explain why you have difficulty losing weight, or detect a pre-diabetic tendency

If the cause still has not been determined, Dr. Borenstein may test you for MTHFR - genetic defects in methylation enzymes. Some evidence of Hashimoto's can also be detected during a thyroid ultrasound.

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Hashimoto's Treatments

Depending on the root cause(s) he discovers, Dr. Borenstein will prescribe and meticulously monitor one or more of the following treatments to defeat damaging antibodies and resolve your thyroid dysfunction:

Hashimoto's Thyroiditis Diet

Patients with Hashimoto's must adopt a customized diet plan to address their vitamin and nutrient deficiencies. The vast majority of them are struggling with leaky gut syndrome and vitamin D deficiency. Many need to need to be eliminate inflammatory foods like gluten and dairy.

The Autoimmune Protocol Diet has resolved inflammation and leaky gut for hundreds of our patients. It requires eliminating or restricting these foods: all grains; legumes (beans, soy, peanuts, hummus); dairy products, processed foods, vegetable and canola oils, eggs, nuts and seeds, chocolate and certain spices like coriander and cumin; nightshade vegetables like tomatoes, peppers, eggplants and potatoes; alcoholic beverages; gum, refined sugars and alternative sweeteners; emulsifiers and food thickeners; and NSAID painkillers like ibuprofen (Advil), aspirin (Bufferin), and naproxen sodium (Aleve).

Instead of the above inflammatory foods, you can improve your thyroid health by eating more:

• antioxidant-rich fruits and vegetables
• wild caught fish
• coconut oil
• probiotic-rich yogurt and kefir
• kimchi and sauerkraut
• sprouted seeds and beans
• bone broth

Supplements

Along with diet changes, addressing leaky gut syndrome may also require taking custom doses and forms of nutritional supplements like:

• L-glutamine: this anti-inflammatory amino acid fuels the enterocytes in your gut
• zinc: this anti-oxidant moderates thyroid and insulin functions and keeps your intestinal wall strong and non-porous
• aloe: this prebiotic reduces acid reflux and tames inflammation
• probiotics: help recolonize the gut with good bacteria, and create enzymes that destroy bad bacteria
• digestive enzymes: lactase, amylase, protease, and lipase enzymes break down proteins, starches, fats, and dairy in your gut
• betaine HCL: increases stomach acid production, aids digestion, and improves nutrient absorption

Anti-Virals

If he has detected a viral infection, Dr. Borenstein will prescribe an anti-viral protocol – usually Valtrex or Valcyte to treat a wide range of viruses.

If a botanical medicine option is appropriate, he may suggest anti-viral supplements such as Byron White Formulas – hand-crafted targeted plants that support the immune system, detoxification and the body's homeostatic mechanisms.

Low Dose Naltrexone

If you don't respond to other treatments, Dr. Borenstein may decide to lower your thyroid anti bodies with Low Dose Naltrexone. Low doses of this medication have been found to normalize immune system function, and lowering thyroid antibodies. Once your immune system is in balance again, you may be able to get off the LDN. Dr. Borenstein works with a prime compounding pharmacy that will help titrate your precise dose.

Thyroid Optimization Therapy

While getting those damaging antibodies under control, Dr. Borenstein will also be replacing your supply and optimizing your levels of thyroid hormone with the following:

• natural desiccated thyroid: levothyroxine is the main hormone produced by your thyroid gland and the synthetic form is the most common hormone replacement therapy: you may be prescribed Armour® and Nature-Throid®, Westhroid® or all natural WP Thyroid®
• Cytomel® T3: this direct, active, strongest and most powerful of all the thyroid medication must be used exactly as prescribed
• slow release T3: this time-release formula can help prevent the hormone rollercoaster that some patients experience
• compounded sustained-release T3: can treat or prevent goiter (enlarged thyroid gland)
• Tirosint®: a liquid levothyroxine capsule that's hypoallergenic

Dr. Borenstein will customize a protocol to address your unique combination of symptoms and contributing root causes. He's also highly experienced at preventing any negative interactions between the treatments listed above, as well as potential contraindications with any other medication you may be taking.

Dr. Borenstein will monitor your progress, and continually check in for feedback before adjusting your protocol. As rare as it may seem in some medical circles, he really does listen – for as long as it takes.

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Reserve your appointment

You don't have to keep dragging yourself through the work day wondering how to stop feeling tired. You don't have to put up with sudden weight gain in stomach regions that force you into the next largest jeans size.

If you've had enough stale advice from traditional doctors and are sick of asking them: "Why am I always tired and have no energy?" stop guessing, and call Dr. Borenstein for a conclusive diagnosis. Resolve your Hashimoto's. Learn how to cure hypothyroidism permanently. Call Manhattan Integrative Medicine to schedule a consultation at ☎ (212) 262-2412 or contact us here.