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Thyroid: The Master Gland - Are you Hypothyroid?

Posted By Frank O. McGehee, Jr, MD, CCN, Wednesday, May 27, 2015
Updated: Thursday, May 7, 2015
__ Is the outside third of your eyebrow thinning or non-existent?
__ Are your nails thin and brittle?
__ Do your feet and hands seem cold all the time? Conversely, are you severely intolerant to heat?
__ Is it almost impossible to lose weight, no matter how hard you exercise and watch your diet?
__ Do you "feel sluggish" throughout the day even after a good night's sleep?
__ Is your hair thinning or balding?
__ Do you have slow speech, movements, low blood pressure, hoarseness, or slow heart rate?
__ Do you have increased cholesterol levels?
__ If you take your under arm temperature before getting out of bed, is it below 97.6?
__ Are you pre or post menopausal?

If you answered yes to several of these questions asked in this article, you certainly should have your thyroid levels checked by a simple and inexpensive thyroid blood panel. The blood values included should be total T3 - the active form of thyroid, total T4 - the reserve thyroid, and TSH - thyroid stimulating hormone. In order to make a correct diagnosis, T3, T4, and TSH must be tested. Ideally, testing should be performed fasting after midnight; water only. If you are taking thyroid hormone, by all means take it one hour before the blood is drawn, so it can be determined how well your thyroid medication is or is not serving you.

Low levels of T3 and T4 indicate a need for thyroid replacement. Sometimes, the thyroid dose you are taking has not been given in sufficient dosage, or if on Synthroid, the body sometimes cannot convert T4 to active T3. The last thyroid value that needs to be tested is TSH. Thyroid stimulating hormone (TSH) values are different from T3 and T4 in that a high TSH means thyroid replacement is needed. Low T3 and T4 are the indications thyroid replacement is necessary. A recent study of 25,000 participants argues that the ideal TSH level is 1.4 or less, not the upper limit of 5.5 still cited by some laboratories.

Many patients are denied thyroid replacement by their physicians because the physicians only prescribe thyroid if thyroid values fall outside the "expected or lab range". For TSH, that level is 5.5. Some physicians feel fearful prescribing any thyroid even if values are outside of "the norm." The fear originates from past censure by their local medical boards. This was the routine practice twenty years ago. Today, most patients are offered synthoid and anti-depressants for their symptoms.

Lab ranges were originally designed to identify a disease in process for the physician. These values are decades old, and our bodies, needs, and lifestyles have changed since then. Unfortunately, by the time a patient falls outside the "expected range" full blown disease is already in process. As nutritionists, we designate an optimal number as desirable for all lab values. Variance either way from the optimal value allows us to treat deficiency before it becomes a disease.

Most physicians today prescribe a drug called Synthroid, which is T4 only. It is synthetic, or made in a laboratory, and the body cannot assimilate the chemical. Pharmaceutical Synthroid is 78% bio-identical. Imagine trying to open a locked door with a key that is 78% keyed to the lock! Most of the time T3 should be included in thyroid replacement, along with T4. In a few cases T4 alone is called for, and this is an extremely rare situation. Physicians are really not educated by the drug representatives or continuing medical education about a choice in prescription medication for hypothyroidism. The drug company markets Synthroid to physicians as if it is the only remedy to treat hypothyroid conditions. Insurance driven medicine and drug company incentives have made physician research thing of the past.

Our choice for thyroid replacement is a combination of T3 and T4, called Naturesthroid, which originates from a porcine tissue source. It is inexpensive and available at a compounding pharmacy, and remarkablty by order at CVS. Most probably, your greatest problem will be finding a physician to prescribe it. Science has proven the porcine endocrine system to be the most similar to our own. Dr. Broda Barnes stated more than fifty years ago that “patients talking thyroid replacement therapy have much better improvement of symptoms with natural desiccated thyroid made from a tissue source of a pig, rather than with synthetic hormones”1.

Besides the synthetic chemical make up of Synthroid, another problem has arisen to prevent absorption and conversion of T4 to activate T3 in our systems. Years ago, our soil was full of iodine and selenium. We used to receive iodine and minerals in our food. Iodine is T4. Depletion of the minerals in our soil over time has rendered most foods unable to meet our needs for iodine. Most every person could benefit from 50mg of a tablet called Iodoral daily. Many women today suffer from fibrocystic breasts, because of lack of iodine in the food sources. Application of iodine directly to cysts in breast tissue several times daily can reduce cysts over time.

Any time a patient feels they are over medicated or perhaps have taken by mistake or has taken too much thyroid medication, the patient should eat 1/2 cup of raw broccoli, and keep it available in the freezer at all times. Broccoli temporarily calms thyroid function. Thyroid medication be discontinued until your physician's advice can be obtained.

Seldom are these extreme symptoms a problem for our patients. We begin thyroid titration slowly, in 30 mg or 1/2 grain increments. We routinely retest T3, T4, and TSH about every three weeks, until optimal values have been achieved. This process sometimes takes about 6 weeks, or more but once the dose has been determined, patients are given a prescription which is good for a year.

1. Suzanne Somers, "Breakthrough," Copyright 2008, p. 122

Tags:  Frank McGehee  hypothyroidism  thyroid 

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Thyroid and Fertility

Posted By Administration, Wednesday, January 20, 2010
Updated: Friday, April 18, 2014

Fiona 021e website size  Thyroid problems are extremely common, and because they can be asymptomatic, it can be difficult to know if a condition is present.  The thyroid is absolutely essential for healthy fertility.  Dysfunction can cause ovulatory disorders, menstrual irregularity, and recurrent miscarriage.  The thyroid gland is key to support ovarian function. If thyroid function is low, the eggs will not mature fully and, ovulation can be either delayed or prevented.  Surprisingly, 5-20 percent of women in their reproductive years have a thyroid condition.

Autoimmune thyroid disease is one major cause of many thyroid conditions. Women who test positive for thyroid antibodies will generally develop hypothyroidism at a rate of 20% per year.  Often times, when a fertility general health screening is done, the only test completed for the thyroid is TSH (Thyroid Stimulating Hormone).  TSH is a useful test to screen for hypo or hyperthyroidism, however it does not detect autoimmune conditions.  Autoimmune thyroid antibodies can be present with no symptoms of hypothyroidism at all.  In autoimmune thyroiditis, TSH levels are often normal so it is important to complete a full thyroid panel. This can determine if there is a risk of developing hypothyroidism which could threaten a pregnancy.  When a woman becomes pregnant, there are widespread hormonal changes in the body, including an increased demand for thyroid function. If autoimmune antibodies are present, this can trigger miscarriage due to inability of the thyroid to compensate normally for pregnancy. Many cases of recurrent miscarriage or premature birth are related to thyroid disease so this is a very important part of fertility screening in those who suffer from miscarriages. One of the protective functions of pregnancy is a decrease in immunity, so it is unlikely that a new flare up of Grave’s disease (an autoimmune disease which causes symptoms of hyperthyroidism and goitre) will occur during pregnancy, however often we see worsening of hypothyroidism.

Another condition which can be present in those with thyroid disease is primary ovarian failure.  This is caused by autoantibodies to the ovary and is associated with autoantibodies to the thyroid.  This condition, although not common, can be devastating for women.

In men, hypo- or hyper- thyroidism can cause poor development of sperm, so for all men with sperm quality concerns, the thyroid should be screened.   Although thyroid disease is more common in women, it can still happen for many men and go undetected.

Symptoms of Hypothyroidism:

fatigue, weakness, weight gain, dry skin or hair, feeling cold, constipation, irritability, depression, muscle cramps, menstrual irregularities.

Symptoms of Hyperthyroidism:

anxiety, feeling hot, insomnia, heart palpitations, weight loss, hunger, sweating, trembling

To optimize fertility the following lab testing for thyroid should be done.  Explanation of thyroid lab values and normal ranges are included.

TSH – Thyroid Stimulating Hormone.

This is a hormone released by the pituitary gland (in the brain) which stimulates the thyroid to release thyroid hormones.  It is controlled by feedback mechanisms, when thyroid hormone is low in the bloodstream, the pituitary gland will increase its output of TSH to stimulate more release of thyroid hormones.

Normal Levels :  0.4 – 4 mIU/L.   If levels are above 2, and especially if thyroid antibodies are present with signs and symptoms of hypothyroidism, this is suspect of “subclinical hypothyroidism” and may present risks for fertility.

Free T4 – Thyroxine.

A thyroid hormone produced by the thyroid gland.  This is the most abundant thyroid hormone in the body.  It is also the weaker of the thyroid hormones.  It represents 80% of the thyroid hormones in the body, and its major function is to be converted into the stronger T3 hormone.  This is a measure of the T4 which is not bound to carrier proteins.

Normal Levels:   8.5-15.2 pmol/L

Free T3 – Triiodothyronine.

A thyroid hormone produced from the conversion of T4 by enzymes.  This is a much stronger thyroid hormone and has powerful effects on the body’s metabolism.  It represents 20% of the total thyroid hormones in the body. The conversion of T4 into T3 can also be impaired, so this is important to investigate.  This is a measure of the T3 which is not bound to carrier proteins.

Normal Levels:  3.5 – 6.5 pmol/L

Reverse T3

When there is sufficient T3, the body will convert excess T4 into a compound known as reverse T3.  This compound is inactive, and serves to protect the body from excessive overstimulation by thyroid hormone. It can bind to receptors where T3 would normally bind, however it does not stimulate the receptor as T3 would. In some cases, the body may actually convert T4 excessively into reverse T3, which can result in metabolic abnormalities. This condition should be screened for whenever signs and symptoms (including low body temperature) are present in fertility patients.

Normal Levels:  200-300 pmol/L

Thyroid peroxidase antibodies

These are antibodies against an enzyme known as Thyroid Peroxidase.  Thyroid peroxidase is involved in the conversion of T4 to T3.  If antibodies exist, this can cause a conversion disorder which results in hypothyroidism.

Normal Levels: <35

Antithyroglobulin antibodies

These are antibodies directed against a protein known as Thyroglobulin.  Thyroglobulin is present in the thyroid gland and is essential for the production of thyroid hormones.  These antibodies can trigger destruction of the thyroid gland.

Normal Levels:  <20

Treatment for thyroid conditions can involve thyroid hormones, nutritional supplements, amino acids and herbal medicines, depending on which type of thyroid condition is present.  Naturopathic treatment for thyroid is often integrated with conventional thyroid medications when needed to optimize response for fertility concerns.

- Dr. Fiona McCulloch

Reference:  Mosby’s Manual of Diagnostic and Laboratory Tests

Tags:  Infertility  thyroid 

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