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Several have requested a discussion of thyroid problems. So,
within the confines of our brief newsletter, & requiring more medical
detail than I uaually lay on you here goes.
Thyroid dysfunction in one form or another is among the top ten
problems I see in my practice & it can be tricky to diagnose. The most
common form is hypothyroidism ( low thyroid function). That's what we'll
look at today.
WHAT ARE THE SYMPTOMS OF LOW
THYROID FUNCTION?
Because thyroid hormone regulates the biochemical activity of most
tissues, the deficiency symptoms can be myriad. Few people will have all
of these findings, but rather some constellation of the following:
| fatigue |
|
impaired memory |
| lethargy |
|
depression or low mood |
| sleepiness |
|
subtle personality changes |
| decreased initiative |
|
PMS |
| slowed speech & movement |
|
menstrual disturbances |
| dry or puffy skin, acne |
|
infertility |
| hair loss |
|
recurrent infections |
| coarse, brittle hair |
|
slowed wound healing |
| loss of hair curl |
|
increased allergies |
| thick slow growing nails |
|
headaches |
| weight gain |
|
muscle & joint pain/stiffness |
| difficulty losing weight |
|
bursitis |
| constipation |
|
hoarseness |
| watery eyes & puffy eyelids |
|
decreased sweating |
| swelling of face/extremities |
|
decreased sex drive |
| cold hands & feet |
|
decreased hearing |
| poor tolerance to cold |
|
anemia |
| increased cholesterol |
|
slowed heart rate |
| increased triglycerides |
|
heart dysfunction & irregularities |
| numbness & tingling |
|
shortness of breath |
| thick tongued |
|
difficulty maintaining normal physical & mental
activity |
HOW IS THYROID HORMONE
MADE?
Thyroxine (T4) is formed & stored in the thyroid. It is made
from a combination of Iodine (best derived from kelp) & the amino acid
L-tyrosine. Certain enzymes & other nutrient co-factors must be
present. Thyroid production is dependent on the average daily intake of
these precursors.
After release from the thyroid gland T4 is converted to T3
(triiodothyronine) in the tissues. T3 has four times the potency of T4
& is more physiologically active. Certain tissues such as brain,
spleen, & testes do not respond to T4 & must have T3. Some only
consider T4 to be a prohormone. The conversion of T4 to T3 does not always
occur as it should. Factors interfering with T3 production are Selenium
deficiency, stress, chronic or severe illness, & malnutrition.
Excessive Iodine (over 6000 mcg daily) will also inhibit thyroid hormone
release.
Deficiency of adequate amounts of the dietary substrates is often
the cause of a hypometabolic state in those under 50. Those over 50 are
more likely to have actual glandular mal- function.
Repeated dieting can be problematic because the lowered nutrients
produce lower metabolism which then induces lower absorption &
utilization & even lower metabolism perpetuating a vicious cycle.
WHAT ARE THE TESTS FOR THE
THYROID ?
Many have come to me feeling they have a thyroid problem, but
previous Dr's have told them their thyroid was normal based upon the
tests. Usually a test called TSH is ordered & if normal, the
possibility of thyroid dysfunction is dismissed.
TSH stands for Thyroid Stimulating Hormone which is a pituatary
hormone which can increase when thyroid levels decrease. Sufficient
thyroid decrease must occur to trigger this feedback loop. TSH increases
to try to stimulate the release of more thyroid. Accepting this result as
definitive testing presupposes the pituatary & hypothalamus (which
gives the signal to the pituatary) are doing their jobs. This may only
detect grossly overt hypothyroidism.
Since low thyroid is relatively common, it is important to do
additional testing to uncover borderline deficiencies which may still
cause significant symptoms.
My favorite thyroid tests are: Free T3, Free T4, T3 Uptake, TSH,
anti-thyroglobulin & anti-microsomal antibodies, & sometimes
thyroid peroxidase antibodies. Of course, when the thyroid feels abnormal
on a physical exam, we may need to have an Ultrasound or Scan.
The antibody tests are ordered to check for auto-immune thyroiditis
which is increasing in our population, no doubt from excessive chemical
exposure. There is also a strong heriditary pattern. For instance, in my
family, my mother, sister, brother, aunt, & niece have auto-immune
thyroiditis. I have thus far escaped, maybe from tremendously healthy
living. They all smoked & smoking also increases the risk.
Often there will be a thyroiditis long before the hormone levels
drop, although ultimately a thyroidits will alter thyroid production. The
thyroiditis may influnce thyroid hormone utilization & create symptoms
before the thyroid blood levels change. Early treatment with thyroid is
helpful for some who have symptoms suggestive of hypofunction.
Some Dr's use what is called basal temperature testing to further
ascertain hypometabolism & it can be useful. But one must keep in mind
that othere health conditions can also produce a low body temperature.
WHAT IS THE BEST
TREATMENT?
When the tests are normal, but the symptoms are present, we may
first try adequate nutritional presursor loading.
When the tests are abnormal my first choice Is Armour Thyroid, or
one of the other natural thyroids. I like this because it contains both T3
& T4. Because the tablet is tiny, I have the patient chew it for
maximum absorption, though it is not a chewable per se. When the T4 levels
are high normal, but the Free T3 is low or low normal, that suggests to me
that inadequate conversion of T4 to T3 is a problem, so I may only
prescribe sustained release T3 from a compounding pharmacy. I use this
form because the usual T3 (Cytomel) has a very short half life &
therefore does not provide consistent symptom improvement.
Probably 90% of those with diagnosed hypothyroidism are on
Synthroid, thyroxine, or some form of T4 only. When these people cannot
convert it to T3, they will have less than optimal results from their
thyroid treatment. Not much attention is given to this problem. The drug
detail people have done a good job on selling to the Dr's the so-called
superiority of the synthetic T4 preparation
We could go on & on, but enough is enough. If you want to know
more, see the books at: http://www.thewayup.com/thyroid.htm
ANOTHER SUBJECT
ENTIRELY!
Would you like to NEVER HAVE TO FILE YOUR INCOME TAXES AGAIN? I
would, & have long discussed a fair tax with friends. Well the
possibility is here & you can do something about it. Just check out
the Proposed Fair Tax which will be coming before Congress by going to
http://www.fairtax.org I love it because you are only taxed on what you
spend. So the wealthy pay according to spending & the poor get certain
rebates, but we all can save untaxed dollars! And better yet the 20% of
people who evade taxes, drug & criminal money etc. all end up
contributing like the rest of us. See what you think & if you like it
let your Congress Person know.
If you know someone who would like to receive this newsletter,
please feel free to forward it to them
THE SPECIALS ON INTERNET ORDERS UNTIL THE NEXT NEWSLETTER:
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Until next month. Stay happy & healthy.
Priscilla Slagle
M.D.
A Pendulum A Rhythm
The oscillation inherent within all
Learn
without assumption
Conserve and Plan
Act from decision
Reaction
is no longer as important
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