disclosure

Better Health Update #34 - Monte Kline, Ph.D.

Thyroid Problems

The thyroid gland is frequently associated with various health complaints. Thy thyroid is a bilobed endocrine gland in the pharynx region at the base of the neck. It primarily produces the hormones thyroxine (referred to on blood tests at T4) and triiodothyronine (referred to on blood tests as T3). The thyroid gland particularly relates to metabolism, and thus may be involved with fatigue, obesity and other problems.

THYROID DISEASES

1. Hypothyroidism - This refers to deficient activity of the thyroid, under-producing thyroid hormones. It is a very common condition manifesting symptoms such as fatigue, loss of appetite, obesity, painful menses, muscle weakness, dry and scaly skin, yellow-orange coloration to the skin (particularly the palms), hair loss (including eyebrows), frequent infections, constipation, slow speech, intolerance to cold, and drooping, swollen eyelids (myxedema).

2. Hyperthyroidism - As the name would suggest, this is the opposite of hypothyroidism. In hyperthyroidism the thyroid is over-producing thyroid hormones, creating overactive metabolism. Symptoms include nervousness, irritability, increased perspiration, fatigue, weakness, frequent bowel movements or diarrhea, insomnia, hair and weight loss, nail problems, hand tremors, moist skin, heat intolerance, rapid heart beat, high blood pressure, and malabsorption (due to overactive metabolism). It is generally believed that hyperthyroidism is autoimmune in nature.

One form of hyperthyroidism is Grave's Disease (named after British physician Robert Graves 1796-1853). Grave's Disease is generally indicated by goiter (enlargement of the thyroid gland) and protruding eyeballs.

3. Thyroiditis - This refers to inflammation of the thyroid gland. Subacute thyroiditis is believed to be caused by viral infection. Symptoms include sudden onset of a neck pain that may be described as "sore throat," increasing tenderness in the neck, and low grade fever (100 to 101 degrees). The neck pain often shifts from side to side, ultimately settling in one area, frequently radiating to the jaws and ears. It's aggravated by swallowing or turning the head and may be confused with dental problems, a regular sore throat, or ear infection. In the early stages hyperthyroidism is common, due to the enlargement of the thyroid.
Subacute thyroiditis produces lassitude and prostration beyond other thyroid disorders. It generally takes several months to subside.

One form of thyroiditis is Hashimoto's Disease. This is an autoimmune condition in which the body becomes allergic to thyroid hormone, characterized by lymphocytic infiltration of the thyroid. Many believe this to be the primary cause of primary hypothyroidism. It occurs in women eight to one over men, most often between the ages of 30 and 50. Often there is a family history of thyroid problems, plus people with chromosomal disorders (such as Down Syndrome) are more likely to have Hashimoto's.

Someone with Hashimoto's Disease will typically complain of painless enlargement of the thyroid or a feeling of fullness in the throat. About 20% of the patients are hypothyroid when first seen. Other forms of autoimmune disease may be involved as well, such as rheumatoid arthritis, systemic lupus erythmatosus, Addison's disease, hypoparathyroidism, diabetes, and Sjogren's syndrome.

Silent Thyroiditis occurs most often in women, often in the postpartum period, is characterized by mild thyroid enlargement, a hyperthyroid phase for several weeks to several months, sometimes followed by a temporary hypothyroidism. This may be an autoimmune disorder.

4. Wilson's Syndrome - Named after E. Denis Wilson, M.D., this is also known as Multiple Enzyme Dysfunction or MED. When the body is under stress from illness, fasting, corticosteroid drugs, etc., T4 may be deiodinized to Reverse T3 (RT3) instead of to T3. Then, as the T3 levels drop, body temperature may drop below normal, decreasing the function of important enzymes. This can be the cause of thyroid system dysfunction when the more common tests are normal.

THYROID BLOOD TESTS

Conventional medicine determines thyroid problems with various blood tests:

1. Total Serum Thyroxine (T4) - This is the most common thyroid blood test. Often if your medical doctor says they tested your thyroid, this was the extent of it, even though there are many other possible thyroid tests. This is low if you're hypothyroid and high if you're hyperthyroid. Unfortunately, this often tests in the "normal" range when a person has a subclinical thyroid problem.

2. Total Serum Triiodothyronine (T3) - This is also low if you're hypothyroid and high if you're hyperthyroid.

3. Reverse Triiodothyronine (RT3) - A high level of RT3 suggests Wilson's Syndrome.

4. Serum Thyroid-Stimulating Hormone (TSH) - TSH is a pituitary hormone that stimulates the thyroid to produce thyroxine. This is the best test for demonstrating primary hypothyroidism, as distinguished by an underactive thyroid being caused by pituitary gland function. This is high in primary hypothyroidism (thyroid is the cause) and low or normal in secondary hypothyroidism (pituitary is the cause of the low thyroid).

5. Free Thyroxine - The Merck Manual states that while this is theoretically the ideal thyroid test, it is difficult to measure, having many technical pitfalls.

6. Thyroid Hormone Binding Ratio (THBR; T3 Resin Uptake) - This test is designed to get around problems of variation in Thyroxine-binding globulin (TBG) and measure the unsaturated thyroid hormone-binding sites, rather than the circulating T3 hormone. This is low in untreated hypothyroidism and high in untreated hyperthyroidism.

7. Free Thyroxine Index - This is the product of the THBR and the T4 and provides an estimate of the concentration of free T4.

8. Thyrotropin-Releasing Hormone (TRH) - This is used in conjunction with measuring TSH. An injection of TRH should cause a rapid rise in TSH. The rise is exaggerated in primary hypothyroidism. The test is used to distinguish pituitary from hypothalmic hypothyroidism. Someone with a pituitary deficiency causing their hypothyroidism does not release TSH in response to TRH. If a hypothalmic disorder is present, where there is a deficiency of TRH, TSH should release should be normal, though it may be delayed or prolonged.

9. Radioactive Iodine Uptake (RAI) - This test is not frequently done due to cost and radiation exposure. It is used for diagnosing hyperthyroidism, in which RAI is elevated.

THYROID SELF-TEST

A simple test using axillary basal temperature for determining possible thyroid problems was popularized by the late Broda Barnes, M.D., in his book Hypothyroidism: The Unsuspected Illness. The procedure is simple:

1. Place a thermometer by your bed at night.
2. Upon wakening place the thermometer under your armpit (try to move around as little as possible in doing this).
3. Keep it there for 15 minutes, while keeping still and quiet.
4. A temperature of 97.6 or lower may indicate a hypothyroid condition.
5. Readings on several different mornings are necessary to determine a definite pattern.

In my experience I've found that many people with this low basal temperature do not have an underactive thyroid, but underactive adrenal glands (or other endocrine glands).

CAUSES OF THYROID PROBLEMS

Conventional medicine generally doesn't approach thyroid problems (or much of anything else) from the perspective of what causes the problem. It's generally just a matter of diagnosing it and drugging it with synthetic hormones.
It's admittedly tough to figure out what the root causes of thyroid problems are, but here are some possibilities:

1. Autoimmune reactions - Most often conventional medicine views autoimmune reactions as causing various thyroid problems. The question they generally don't ask is, "What causes these autoimmune reactions?"

2. Iodine deficiency - The mineral iodine is a primary component of thyroxine hormone. Thus, hypothyroid problems can come from iodine deficiency.

3. L-Tyrosine deficiency - This amino acid is often deficient in hypothyroid people.

4. Overall nutrient deficiencies - Potentially any nutrient deficiency may contribute to developing any health problem - including thyroid problems
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5. Food or environmental sensitivities - Reactions to food or environmental substances may lead to the more serious problem of autoimmune reactions. Thus, desensitizing the body to food and environmental substances may reduce autoimmune reactions.

6. Toxicity - Why does the body all of sudden start attacking itself resulting in autoimmune disorders? The theory that makes the most sense to me is that toxicity sets the body up for autoimmunity. External toxins and internal, self-produced toxins accumulate in our bodies until the proverbial "straw breaks the camel's back." When the body finally reacts to its accumulated toxic load, many different health problems may manifest themselves. Autoimmune disorders are one possibility.

NATURAL MEDICINE APPROACHES

What does natural medicine offer for your thyroid problem? Maybe something, and frankly, maybe nothing. In many cases synthetic hormone replacement therapy is the only alternative. With some people natural medicine approaches can either eliminate the need for synthetic hormone replacement therapy or perhaps reduce it.

In many cases it's helpful to take a natural supplement along with one's synthetic drug therapy. Understand that whenever you're taking a synthetic hormone replacement drug, it stops any natural production of that hormone. Taking a natural glandular along with the drug may maintain some stimulation for the gland that's supposed to be doing the job. Bottom line, don't beat up on yourself too much if you can't get free from your drug replacement therapy - just do some natural medicine approaches to compensate for the potential damage done by the synthetic hormones.

Relative to thyroid problems, the following general possibilities exist for supplementation (as always individual testing at the clinic would be necessary to determine which specific supplements are right for you).

1. Multi-Vitamin Mineral - For any health problem, as well as for overall health, this is the basic supplement for covering the bases. I'm talking about a hypoallergenic, good quality multi, not the kind you get at the drug or discount store.

2. Thyroid Glandular - A bovine thyroid glandular supplement makes no claims for thyroxine content (though there may be some). Rather it is designed to be more of a nutritional stimulant to the thyroid gland, helping restore it to normal function. I definitely do not recommend taking this kind of supplement without first testing one of the four different products we have at the clinic.

3. Iodine - An organic iodine supplement such as from kelp or dulse is often beneficial. Most of our thyroid glandulars already include this.

4. L-Tyrosine - Since low levels of this amino acid are found in many low thyroid people, supplementation may be helpful - at least if this nutrient is deficient. Again, individual testing is important.

5. Herbs - In addition to kelp herbs that are recommended for thyroid problems include bayberry, black cohosh, and goldenseal.

DISCLAIMER: The information contained in this publication is for educational purposes only. It is not intended to diagnose illness nor prescribe treatment. Rather, this material is designed to be used in cooperation with your nutritionally-oriented health professional to deal with your personal health problems. Should you use this information on your own, you are prescribing for yourself, which is your constitutional right, but neither the author nor publisher assume responsibility.