It’s a question that’s often on the mind of patients who have been diagnosed with thyroid dysfunction: Can you actually reverse thyroid disease? It’s a fair question to ask after being told medication is your only option and your thyroid will continue declining indefinitely, no matter what lifestyle and dietary changes you make.
The conventional approach to treating thyroid disease, particularly hypothyroidism, is straightforward. You’re prescribed levothyroxine and told you’ll have to take it for the rest of your life before being sent on your way.
The American Thyroid Association's guidelines reaffirm that levothyroxine remains the standard of care for hypothyroidism. The problem is that many patients report no change after taking the medication, increased sensitivity to iodine-rich foods, problems with medication-induced hyperthyroidism, even from the smallest dose.
Some simply can't tolerate levothyroxine. So what if there was another way? What if the goal wasn't just to manage the numbers and stay on the meds, but to actually get to the root of the problem and reverse thyroid disease?
What Does "Reverse Thyroid Disease" Actually Mean?
Functional medicine practitioners aren’t talking about taking a magic pill that would make your thyroid completely healthy when they discuss reversing thyroid disease.
For Hashimoto’s disease, which is purported to be the most common cause of hypothyroidism, “reversal” means stopping the autoimmune attack and putting the disease into remission. Reversal depends on the extent of damage impacting the thyroid gland, but remission is possible in many cases.
In one mechanism, chronic iodine excess is known to induce or exacerbate autoimmune thyroiditis (like Hashimoto’s disease) with or without the presence of hypothyroidism, as the body intentionally uses inflammation to prevent the body from going into hyperthyroidism.
A functional medicine approach targets gut health, stress, nutrition, and the immune system itself to calm the attack on your thyroid gland. Conventional doctors manage thyroid hormone levels, while a functional medicine endocrinologist asks why your immune system is attacking your thyroid gland in the first place. They look for triggers like nutritional deficiencies or excesses, chronic infections, and food sensitivities. That is how you begin to reverse thyroid disease.
Finding a Functional Medicine Endocrinologist: It's About the Education, Not the Label
This brings us to the next crucial step. You can't just walk into any endocrinologist's office and expect to find a provider who uses this approach. So, how do you go about finding a functional medicine endocrinologist who actually practices this way?
In the U.S., "functional medicine doctor" can mean almost anything. Some are MDs, some are DOs, and others are naturopaths. The Institute for Functional Medicine (IFM) certification is excellent proof of additional training, but it's a certificate, not a medical license. It sits on top of whatever professional training the practitioner already has. A naturopath with an IFM certificate does not have the same clinical foundation as a conventionally trained physician who then specialized in endocrinology.
And this leads us to a question most patients never think to ask: What kind of medical education produced this clinician’s way of knowing? Your search changes completely when you start evaluating practitioners this way.
Why Your Next Functional Medicine Endocrinologist Might Be in South America
Here's where we challenge the standard search. You are missing a massive piece of the puzzle if you're only looking in the U.S. Doctors trained in other countries, like Colombia, are taught to use a different approach than their U.S.-trained counterparts.
A Colombian physician starts their medical education with a rigorous, broad generalist medical education that ends with a one-year rural health service to give back to their country. This is often described by Colombian clinicians as the ultimate test that helps them build further confidence in their own skills as they have to make do with all of their training in areas with very few resources. They train across multiple areas of medicine before optionally choosing a specialty.
All graduates become practicing doctors as generalists; from there, they might go on to a highly competitive residency at any time later in their career if they wish to specialize. They don't get shoved into a narrow silo from day one. They are instead allowed to grow and expand, evaluating patients as whole human beings, instead of looking at single body parts through the lens of narrow specializations.
Now, take that Colombian physician. They graduate as a generalist. They complete a year of grueling rural health practice where they have to think through how to provide care with few resources. They practice back in a hospital in a metropolitan area for years, then complete a demanding specialty residency in endocrinology.
Then, on top of that, they add IFM training to their skill set. What do you get? A functional medicine endocrinologist with a layered, rigorous clinical foundation that most U.S. practitioners simply cannot match.
These Colombian specialists combine the diagnostic rigor of a specialist with the "root cause" philosophy of functional medicine. Some of these physicians are fluent in English and offer virtual consultations. Suddenly, the world opens up.
Finding a Functional Medicine Endocrinologist Abroad Changes the Game
In the US, there often is the expectation that all doctors will know enough to help patients. I often see US physicians post in frustration on LinkedIn that none of their booked new patients are showing up and that all patients should automatically trust that the doctor knows best based on the abbreviated degrees after their name.
In talking with Colombian clinicians and patients, within the private sector, there is often more of an expectation of personal agency for the patient. Phrases like “si nos encajamos” (“if we’re a good fit”) are common as practitioners often explain their approach upfront before appointments and patients decide if this approach works for them or not, in regards to clinical knowledge and capability, as well as a relational fit.
In comparison, in the US, the liability-fearful culture means that clinical knowledge and approach and physician behavior are often kept hidden behind a closed door. Practices may attempt to prevent patients from reaching out beforehand with claims of potential HIPAA violations or “giving clinical advice” if the physician states their experience regarding a certain type of care.
In one case, a US physician became enraged when I asked him via email questions about his related case experience and said I was "not allowed to interview” him and then listed every accreditation after his name that he’d earned since his days with the Boy Scouts.
In another instance, a US dietitian likewise felt threatened by my communications after first attempting to play power games and turned a previous “this message was written on my iPhone” into a copy-paste again of every certification she’d ever collected. As a North American, this hasn’t been my experience with South American clinicians, where I don’t get accused of asking for clinical advice when I seek information to help determine fit. Instead, I’m met with quick responses, warmth, and openness regarding their respective approaches without the barrier of ego.
Forget the marketing labels. See what care is like internationally. Don’t hesitate to reach out to clinicians around the globe and note how they respond to simple requests such as “I have iodine-induced hypothyroidism; can you tell me if you have experience managing cases like this, and if not, how you would go about building upon your current knowledge to manage such a case?”
Learn to evaluate how a practitioner knows what they know. What training systems shaped them? Do they understand evidence-based medicine, or do they just repeat wellness slogans from Instagram? If you want a physician who combines medical rigor with the root-cause philosophy of functional medicine, it might be time to start looking beyond your own zip code.
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