FDA Alters Data
By Dr. Paul Varnas | November 15, 2008
The Union of Concerned Scientists surveyed 5,918 scientists at the FDA to examine the state of science there. The survey featured one essay question that allowed the scientists to provide a written narrative. Of the 997 FDA scientists that responded to the essay question, 20% stated that they had been asked, “…for nonscientific reasons, to inappropriately exclude or alter technical information or their conclusions in an FDA scientific document.” More than 40% feared retaliation if they expressed safety concerns in public.
There was a great deal of concern about political appointees influencing FDA actions; 61% of the scientists knew of instances when an FDA or HHS political appointee had inappropriately entered into FDA determinations or actions. Commercial interests also influence the FDA’s actions, 60% of the respondents knew of cases where “commercial interests have inappropriately induced or attempted to induce the reversal, withdrawal, or modification of FDA determinations or actions.”
The abuses of science at the FDA have very real consequences. A few instances of this abuse are posted on the website for the Union of Concerned Scientists. In February 2004, the FDA prevented Dr. Andrew Mosholder, one of its top experts from testifying at a public hearing addressing the potential risk of increased suicide rates in children taking antidepressants. The FDA forced Dr. Mosholder to remove information about the risks of antidepressants from records he was submitting to Congress—and to conceal the deletions, according to the House Energy and Commerce Subcommittee on Oversight and Investigations.
In April 2001 an FDA panel recommended to approve the antibiotic Ketek. The study of the drug was later found to be fraudulent. Doctors were receiving $400 for each patient that they enrolled into the study. Signatures and patient information were forged; 90% of the subjects at one location did not receive the drug. Even after the Annals of Internal Medicine wrote about serious liver problems caused by the drug, the FDA continued to cite the study. The FDA stated that “based on the pre-marketing clinical data it appeared that the risk of liver injury with Ketek was similar to that of other marketed antibiotics.”
The Office of Drug Safety (ODS) found 110 cases of liver problems between the release of the drug in 2004 and 2006—including liver failure and four deaths. ODS found that Ketek caused liver failure four times more frequently than other antibiotics and recommended that the FDA withdraw the drug from the market. In spite of these problems, the FDA allowed pediatric trials of Ketek to take place. The drug was given to children as young as six months old. The FDA ignored congressional requests for files, a briefing, and interviews with agents investigating this matter.
Dr. David Graham, associate science director of the Office of Drug Safety at the FDA alleges that FDA officials tried to suppress and delay the results of his work that came to the conclusion that Vioxx increased the risk of heart attack and stroke. According to Dr. Graham, the FDA was “virtually incapable of protecting America”. He also states that, “…the review and clearance process had been turned into a battleground, full of contention and intimidation because our managers, the people who fill out our performance evaluations, had created a system where it was taking a great risk to stand firm in our scientific beliefs.” His study indicates that between 88,000 and 139,000 people have had heart attacks or strokes and about 55,000 people have died because of Vioxx.
The FDA has a history of distorting scientific information, intimidation of employees and covering up its activities. How are we able to rely on any information that comes from an agency this corrupt?
Information obtained from www.ucsusa.org
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The Amish and Vaccines
By Dr. Paul Varnas | October 27, 2008
We all seem to pay attention to information sources that reinforce our beliefs. Conservatives watch Fox News and Liberals read the New York Times. It is pretty much the same way with the autism and vaccine controversy. I have heard from a couple of people “They did the study—the Amish don’t get autism.” We seem to take this kind of intellectual laziness for granted. It is in our politics, it is in our educational system and our news media are full of it. People who tend to believe in the medical establishment commonly say that there is no proven link to autism and vaccines. They feel as strongly—and with as little proof as the first group.
I looked for the fabled Amish study and could not find it. What I did find was a series of articles by a reporter, Dan Olmsted. Mr. Olmsted reasoned that if vaccines were causing autism, we should be able to look at an unvaccinated population and find little or no autism. He wrote a series of articles on autism and the Amish and came to the conclusion that the Amish did indeed vaccinate, but they did less vaccination than the general population and have less autism. He also felt that when autism was present, there was either a vaccine involved or some exposure to mercury.
In one article he wrote about children being cared for by Homefirst Health Services in Chicago. Many of the families using the clinic home school and tend not to vaccinate. To quote Dr. Mayer Eisenstein, “We have a fairly large practice. We have about 30,000 or 35,000 children that we’ve taken care of over the years, and I don’t think we have a single case of autism in children delivered by us who never received vaccines.” Dr. Eisenstein makes the point that these observations do not rise to the level of an actual study, even speculating the families with autistic children may have moved or stopped going to the clinic. It is unlikely, but possible. An interesting side note, Dr. Eisenstein says that the clinic does not get many cases of severe asthma either.
Of course pro-vaccine people sharply criticize Dan Olmstead for his work. Some even say that his work is “dangerous” because it has people questioning vaccines. Articles have been written stating the he did not look very hard when looking for autism among the Amish in Lancaster County, Pennsylvania. “The idea that the Amish do not vaccinate their children is untrue,” says Dr. Kevin Strauss, MD, a pediatrician at a large clinic in Lancaster, Pennsylvania. “We run a weekly vaccination clinic and it’s very busy.” Dr. Strauss also notes that the Amish don’t vaccinate as much as the general population. He also says, “Autism isn’t a diagnosis - it’s a description of behavior. We see autistic behaviors along with seizure disorders or mental retardation or a genetic disorder, where the autism is part of a more complicated clinical spectrum.”
Olmstead’s critics say that Olmstead has not proven there is a connection between vaccinations and autism. The gorilla in the room is the fact that these critics haven’t proven that there isn’t. The research denouncing the idea that mercury in vaccines could be causing a problem says things like, “Gee, we gave the kids vaccines and tested the blood, stool and urine for mercury and didn’t find any.” or, “Gee, the Danes use a lower level of mercury in their vaccines and they have as much autism as we do.” or, “Gee, we checked kids with autism and those without and the mercury levels were about the same.” All of the medical journals sell ads to drug companies. Is there a better way to corrupt your findings than money? The studies that supposedly prove that the vaccines are not the problem are not exactly a “slam dunk”. Autism basically didn’t exist until the 1940s—it started after we started vaccinating children. That doesn’t necessarily mean that the vaccines are to blame; our environment has also gotten worse since the 1940s. But if there were real scientists in the medical community, they would compare the health of a population that does not get vaccinated to one that does. In the mean time, maybe it isn’t unreasonable to put the burden of proof on those who think that vaccines are a good thing, because they really haven’t proven that there is no connection between vaccines and autism. Let’s face it, a case of autism is a lot more inconvenient than a case of chicken pox.
We have provided you with a wonderful resource, www.thebetterhealthnews.com. There you will find free newsletters, patient education material, marketing information, health articles and more—all for free.
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PRACTICE GROWTH ON A BUDGET
By Dr. Paul Varnas | September 12, 2008
Part 1: Press Releases are Free Advertising
Because of tough economic times, many chiropractors are finding it necessary to cut expenses. You can cut your advertising and marketing expenses and still be able to effectively grow your practice. Don’t cut back on marketing, just cut back on how much you spend on it.
One of the real bargains in marketing your practice is a press release. You can’t beat the price because they are free. The more newsworthy the event, the more likely it is to get published, but you can write a press release for anything new in your practice. Hiring a new staff member, giving a lecture, or opening a new office is newsworthy.
Reporters will use press releases from people like you because it makes their job easier. If you can be creative and come up with something provocative, your chances of getting it published improve.
The format of a press release is simple, and you should always use the correct format (we will go over this in detail at the seminar). Here is a brief description of the format:
1. A press release should always begin with the following statement: “FOR IMMEDIATE RELEASE.”
2. The opening statement is followed by a compelling headline.
3. The subheadline should reinforce your headline statement and project the specific message.
4. You always want to specify the originating (author’s) location is all capital letters.
5. Write the body copy or story. It is important to use a conversational format—write like you would speak.
6. It is important to add media contact information, including name, e-mail address and phone number.
7. Always make reference to your website and phone number and use them in a way that incites action from the reader; that is, “go to my website and get this.”
8. Add summary information about the company or your practice.
9. Close with ###; that tells the machines that the news outlets use that the article has ended.
With a little bit of practice, you can become very skilled at writing press releases. In time you will become very good at thinking of newsworthy events like collaborating with a charity, seminars and events. You can check out www.practicewebinar.com and www.practiceseminars.com for information about upcoming marketing seminars and how to write an effective press release.
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Nutrition and ADHD
By Dr. Paul Varnas | September 11, 2008
Various nutritional approaches may help ADHD. Nutrition remains controversial because scientific studies, by their very nature, look at a single constituent. The paradigm in medicine is to try to find a “cure”, one thing that fixes the symptom. There is an inherent flaw in this way of thinking because it assumes that any health problem has one cause. If the problem, as some research suggests, is due to a lack of serotonin, then many factors can come into play. You need protein and the amino acid tryptophan to make serotonin. You also need folic acid, vitamin B6, vitamin C and other nutrients to make serotonin. Exercise helps us to produce serotonin. Essential fatty acids are necessary for the integrity of the nerve cell membranes. Many factors are involved. If someone with ADHD is not producing enough serotonin due to a lack of tryptophan, giving them folic acid in a study may not produce results. If the person is folic acid deficient, then giving B6 may not help and so on.
Serotonin is only one neurotransmitter—what if GABA is involved? Obviously, other nutrients will come into play. Sugar and the chemical reactions of the Krebs Cycle begin to matter. What if a heavy metal or a chemical toxin is interfering with those reactions?
When you think of ADHD that way, the inherent idiocy of debating whether or not B6 (or any other nutrient) should be used to treat ADHD becomes obvious. B6 fixes a B6 deficiency, not ADHD. If a patient with ADHD has a deficiency, then the nutrient will help.
There is a free MP3 file for patient education on natural health care and ADD/ADHD available at
Also, do you desire to grow your practice? You can get excellent free marketing advice in a webinar available to you at www.practicewebinar.com
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Low Testosterone
By Dr. Paul Varnas | September 3, 2008
In men, testosterone levels decline around the age of 30 and by age 80 may be down to 20% of someone in their 20s. Men with low testosterone tend to have less stamina, reduced muscle mass and reduced libido. They can also have cognitive problems as well as depression and anxiety. The thing you really notice in men with low testosterone levels is a lack of initiative—they fit the stay-at-home, couch potato stereotype. They may say things like, “I used to like to work on the car (go on a hike, go dancing, work around the yard, etc.), but I really don’t feel like doing that anymore.”
Low testosterone can lead to more serious health problems. It is linked to obesity (and increased abdominal fat), diabetes and heart disease. In the journal, Circulation (2007;116:2694-2701), a study examined the prospective relationship between endogenous testosterone concentrations and mortality due to all causes, cardiovascular disease, and cancer in a nested case-control study based on 11,606 men aged 40 to 79 years. The researchers concluded that endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes. Low testosterone may be a predictive marker for those at high risk of cardiovascular disease. Other research (Circulation 1999;100:1690-1696) showed that short-term intracoronary administration of testosterone, at physiological concentrations, induces coronary artery dilatation and increases coronary blood flow in men with established coronary artery disease.
Women can have low testosterone as well. Levels decline between the ages of 20 and 40. An article appearing in the journal, Clinical Geriatric Medicine (2003;19:605-616) reviews the changes a woman goes through when testosterone levels decrease. When a woman receives estrogen for hormone replacement therapy after menopause, there is an increase in sex hormone-binding globulin. The sex hormone-binding globulin binds to testosterone, further decreasing levels. Low testosterone is linked to a decrease in libido, as well as a decrease in muscle mass, fatigue, irritability, sleep disturbances, poor memory and cognition, headaches, and even depression. Testosterone may play a role in preventing Alzheimer’s disease, according to a recent animal study, according to Proceedings of the National Academy of Sciences (February 1, 2000;97:1202-1205). Nerve cells collected from rats and mice tend to produce a harmless form of beta-amyloid protein in the presence of testosterone. Under the influence of testosterone, much less beta-amyloid peptide is produced, and more of this secretory beta-amyloid precursor protein, which is considered by most people to be beneficial for the health of the nerve cells. Testosterone may actually reduce production of the protein that makes up plaques in the brains of Alzheimer’s disease patients.
You can inexpensively have testosterone levels tested, go to www.professionalco-op.com; there are hundreds of drawing stations nationwide.
Need help marketing and growing your practice? A free webinar will show your how. Go to
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Thrive During a Recession
By Dr. Paul Varnas | August 15, 2008
It seems like one of the hot topics for seminars and magazine articles these days is the recession and how to make your practice “recession-proof”. A lot of the articles center around cutting costs, but what is really needed is a strategy that will grow your practice. Chiropractors have an advantage over other professions during tough times because the care they offer is inexpensive and effective.
People do not stop getting sick just because the economy is bad. Budgets are tight, but let’s face it, chiropractic (when practiced properly) is a tremendous health care value. If your practice is down and funds are tight, you need to find a way to cheaply and effectively market. There are people out there who need care, they just need to be able to find you.
Aggressively market to get new patients
One mistake many pratices make when times are hard is to cut back on marketing. Marketing is an investment in the future growth of your practice. You can, however, improve the effectiveness of your marketing and reduce the costs by being creative. Here are some ideas:
• Partner with other related businesses to share marketing expenses and to help each other grow. For example, get the local health club to display your newsletter; in return, you place their literature in your office. Or you can share a mailing with other non-competing businesses—a dentist, a health food store, a beauty shop, etc.
• Join a business referral organization, make a plan on how to market your practice within the group and make a sincere effort to attend the meetings.
• Create powerful, direct marketing messages on post cards, classified ads and utilize local bulletin boards. Always use direct marketing, stop using identity marketing. When you try to put every possible bit of information about you and your practice into an ad, that is identity marketing. It is expensive and not very effective. Direct marketing grabs the reader’s attention and lets them know what is in it for them. For great direct marketing templates and examples, visit: http://www.wholehealthamerica.com; you can also download a free e-book on marketing at http://www.thebetterhealthnews.com.
• Make sure you have a good website that has a lot of information for visitors.
• Publish your own newsletter which highlights the benefits of your services. People throw away advertising, but keep newsletters. You can leave a copy of your newsletter in your waiting area and at local businesses.
• Hold group classes, like a stress-reduction workshop, or an injury-prevention workshop.
Marketing does not have to be expensive, just effective. Many of the best ways to market are cheap or even free. It is important for you to let potential patients know what benefits they can expect from your services. Also, it is hard for people to take that first step to see a new doctor. Good marketing creates interest and awareness. That’s it. Your marketing really only needs to incite action. For example, get them to go to your website (which should have a lot of interesting and relevant information) for a free report or a CD. Make sure you capture their contact information right on the site. This way you can build a list of potential new patients and keep in contact with them regularly.
Want more help and advice?
There are some FREE resources available to help you with these strategies. You can download a free guide entitled, Recession-Proof Your Practice at www.wholehealthamerica.com. Ben Clark, president of Big Ben Media and I have put together an intensive weekend workshop to show chiropractors exactly how to make their offices more profitable. You can go to www.practiceseminars.com for more information and to register for the event.
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Money is not a four-letter word
By Dr. Paul Varnas | August 13, 2008
Money, to many natural health practitioners, is a four-letter word. This is not because they are learning disabled or that they cannot spell, but because they feel that it cheapens a noble calling. It is an unfortunate attitude and one that is not only harmful to the practitioner, but to the public in general.
If you cannot make a good living, how will your message get to the people who need it most? The Bible says that the worker is worthy of his hire. It is important that people who practice natural health have practices that thrive. The more of us that are out there educating and healing people, the better it will be for the public.
Health care costs in the United States now exceed $2 trillion annually—a figure that represents 15% of the American GDP. If it were its own economy, it would be the fourth largest in the world. In other words, Americans spend more on health care than the entire economies of all but three of the nations in the world. And, as you well know, with all of this expenditure, Americans are not particularly healthy.
We go to seminars that focus on how to fix problem cases. Many of us are excited by finding the esoteric treatment that helps the problem case. There is satisfaction in that, but sometimes it doesn’t pay as well as it should.
The smart practitioner knows that most of the problems suffered by most patients are very easy to fix. Chemical exposure and poor lifestyle choices are the cause of most of the health problems that walk through your door. You can easily make a very good living with a system that addresses these very common health problems. A good system will save you time in the office, so you can focus on those interesting, difficult cases.
Many chiropractors (and other health practitioners) want to see more patients in order to grow their practices and make a good living. There is an inherent flaw with this idea—there is a ceiling on how much you can earn. Running from room to room, and working very hard, will not create financial rewards that match the amount of effort and stress involved. Many find themselves at the mercy of insurance companies—dealing with shrinking coverage and shrinking incomes.
Some practitioners don’t utilize nutrition in their offices because it is not covered by insurance. This is exactly the wrong idea. More than 40% of Americans already take supplements—and they pay cash for them. They are taking them without guidance, and in many instances are taking inferior products. You can help these people—and increase your income more than you can imagine. You may not suddenly be able to have an all-cash, all-referral practice, but nutrition will help you to develop cash patients who refer. It is almost like having a business within a business. You can actually go to www.thebetterhealthnews.com and get free MP3 files that will help you to develop a nutritional practice. You can also get a free marketing e-book. While you are at it, go to www.practiceseminars.com to learn how to completely transform your practice into a profitable, stress-free entity that is fun to work in.
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Thyroid Part 3
By Dr. Paul Varnas | August 12, 2008
The last installment contained suggestions from Dr. Harry Eidenier on how to interpret lab values to find hidden hypothyroidism. Using the Barnes basal body temperature alone is not a satisfactory way to diagnose hypothyroidism. These lab values and treatments only apply if symptoms are present (see last post).
Treatment (as recommended by Dr. Harry Eidenier):
1. TSH greater than 2.0, but less than 10.0: Give the patient (adult, 180 lbs) 2-3 capsules of GTA at breakfast and lunch (make sure that you are regularly monitoring the thyroid with blood tests if you use GTA). GTA is porcine thyroid glandular with the T4 removed (but not the T3). It will change serum values, so watch them. Also give 2-3 capsules of Optimal EFAs with each meal. Give 1-2 capsules. Nucleozyme 3 times each day. Give 20 drops of Liquid Iodine Forte in water (pure water—without chlorine or fluorine) 2 times each day. This is primary thyroid hypofunction.
2. T4 is above the midline and/or T3 is below the midline: This is a problem with conversion. Give the patient (adult) 2-4 capsules of Meda-Stim with breakfast and lunch (along with the above regimen).
3. T4 is below the midline of the range: Give 1-2 capsules of L-Tyrosine twice each day (in addition to the supplementation given in #1).
4. TSH less than 2.0 (with symptoms and low temperature): This is thyroid hypofunction secondary to anterior pituitary hypofunction. Give 1-2 tablets of Thyrostim 3 times each day. Give 2-3 capsules of Optimal EFAs 3 times each day. If T4 is below the midline on this panel, add 20 drops of Liquid Iodine Forte in water (pure water—without chlorine or fluorine) 2 times each day and 1-2 capsules of L-Tyrosine twice each day.
5. TSH less than 2.0 (with symptoms and low temperature) and T3 is below the midline of the lab range, or low in relation to T4: Give 1-2 tablets of Thyrostim 3 times each day. Give 2-3 capsules of Optimal EFAs 3 times each day and 2-4 capsules of Meda-Stim at breakfast and lunch.
One interesting side note is for patients who have been on Synthroid and are still having symptoms; they are usually having trouble converting T4 to T3. The doctor monitoring the levels will usually say that everything is fine. If you give this patient Meda-Stim, they will feel infinitely better because Meda-Stim (another Biotics product) helps with the conversion from T4 to T3 (the more active form of the hormone).
When you find and treat someone’s hypothyroidism, you really improve the quality of that patient’s life. These people often become grateful and enthusiastic patients.
Of course there is much more to treating thyroid than what is here. There are autoimmune problems and hyperthyroidism. Hypothyroidism is much more common and you can get great results with a number of complaints including:
• Obesity and trouble losing weight
• Fatigue
• Depression
• High Cholesterol
• PMS
• Ovarian cysts
• Uterine fibroids
• Dry skin
• Some headaches (usually one that starts in the morning and fades as the day goes on)
• You can prevent heart disease, miscarriages and improve the IQ of the newborn.
Nutrient recommendations in future blogs will not be so brand-specific. An exception was made because much of this material was written by Dr. Harry Eidenier. It did not seem proper to change his recommendations to generic nutrients.
We have provided you with a wonderful resource, www.thebetterhealthnews.com . There you will find free newsletters, patient education material, marketing information, health articles and more—all for free.
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Thyroid Part 2
By Dr. Paul Varnas | August 6, 2008
This is one area where there is some controversy in how traditional medicine does its job. It is also an area where you can get life-changing results with some simple nutrition.
The British Medical Journal [BMJ 2000;320:1332-1334 (13 May)] published research examining the flaws in diagnosing hypothyroidism. The authors concluded that there are indeed flaws with the way that we diagnose hypothyroidism. First of all, the research is lacking that shows us the relative importance of lab tests and symptomatology in diagnosing the thyroid. TSH production is affected by the level of thyroid hormone, but it is also affected by other things. We don’t fully understand how various illnesses affect TSH and the thyroid hormones. There is also a need to consider the possibilities of false positive and false negative results when looking at lab tests related to the thyroid.
Dr. Broda Barnes was a proponent of using basal body temperature to diagnose hypothyroidism. . In his book, Hypothyroidism, the Unsuspected Illness (Harper Collins Publishers Inc, 1976), he states that hidden hypothyroidism is responsible for many chronic health problems including heart disease, immune system problems and chronic fatigue. He also felt that laboratory tests miss many cases of hypothyroidism.
Barnes developed a way to screen for hypothyroidism using a basal body temperature. Basal body temperature is taken the very first thing in the morning, before there is any movement or activity. The thyroid is the body’s thermostat, controlling metabolism. Body temperature is a reflection of that metabolic activity and people with underfunctioning thyroids tend to have low basal body temperatures.
Combining the basal body temperature and information in a health history can give valuable information about how well the thyroid is functioning. The following symptoms are evidence of poor thyroid function. The more symptoms present, the more likely that there is a thyroid problem.
Possible Signs and Symptoms:
Below are some of the symptoms of hypothyroidism. All of the symptoms need not be present for the patient to have hypothyroidism. Also, an underfunctioning thyroid can lead to high cholesterol, heart disease and immune system problems.
• Low body temperature. Patient feels cold even when others do not.
• Fatigue.
• Lack of motivation
• Poor memory
• Loss of interest in sex
• Dry, itchy or scaly skin
• High cholesterol
• Muscle cramps at rest
• Constipation
• Cysts and fibroids
• Sadness or crying for no reason (This can include women who have this symptom or experience mood swings at certain times during their menstrual cycle)
• Inability to lose weight
• Puffiness under the eyes
• Ankle swelling
• Depression
• Frequent colds
Barnes used the basal body temperature test to determine a possible problem with the thyroid. Patients takes their axillary temperature the very first thing in the morning before they get out of bed or even move around. They should even shake down the thermometer the night before (make sure that they use a mercury thermometer, not a digital one).
If the thyroid is functioning properly, the axillary temperature should be between 97.8°F and 98.2°F. Basal body temperature is a useful tool. Patients taking thyroid medication can be screened to see if their temperature is too high from taking too much hormone. You can have a woman take her basal body temperature throughout her cycle and get an idea of estrogen and progesterone levels. If she has excess estrogen, her temperature will be normal at midcycle, but begin to drop as she approaches her period and stays low until a few days after her period stops. If she has low progesterone, the temperature will be higher as she approaches her period and will decrease during her period, approaching normal as the period ends.
The problem with using body temperature as a diagnostic tool is the fact that other things besides the thyroid can be responsible for a low temperature. The good news is that nutrition is a low risk, high gain therapy. You have a very good chance of doing the patient some good—even if your diagnosis is not a slam dunk. When you improve someone’s thyroid function, you change their life. Even if you are wrong, it is unlikely that you will do any harm.
Using the patients’ symptoms, basal body temperature and looking at their blood tests with new eyes can enable you to effectively treat patients with hidden thyroid problems.
Lab:
If the patient has a low basal body temperature and many of the symptoms listed above, the lab can help you to get an idea of the source of the problem and to plan a nutritional strategy. If you go to www.professionalco-op.com, you can get very good prices on blood chemistries with nationwide drawing stations available.
Although I would like to claim it, I did not come up with this way of looking at lab tests and symptoms. It is a very good, common sense approach. This information, and the supplement suggestions have been obtained from the writing of Dr. Harry Eidenier, who works closely with Biotics Research Corporation. Dr. Eidenier has very specific recommendations and since I am using his diagnostic criteria, it is only fair that I use his treatment recommendations as well. His approach utilizes some Biotics Research products.
• TSH: If the TSH (thyroid stimulating hormone) levels are lower than 2.0 (in the presence of symptoms and low basal body temperature), it may indicate that the thyroid problem is secondary to hypofunction of the anterior pituitary. This is secondary hypothyroidism. In the absence of symptoms, this is not the case.
• TSH: If the TSH is greater than 2.0 (in the presence of symptoms), the problem is with the thyroid itself. The higher the value, the more likely that this is the case. When TSH values are 3.0 or more, it is very common for the patient to have symptoms and come into the office saying, “The doctor said my thyroid is fine.” Most doctors won’t diagnose the patient as being “borderline” hypothyroid until the TSH gets to be above 7.0.
• T4: If the T4 is less than the middle of the lab range (in the presence of symptoms and low temperature), there is a good chance that the patient needs iodine and tyrosine.
• T3: If the T3 (free, total or uptake) is below the middle of the reference range and the T4 is above the middle of the reference range, it is a conversion problem. T4 is converted by the body to the more active form, T3. In the presence of symptoms, this needs to be address. The cause can be from too much stress (cortisol), too much estrogen, or a lack of nutrients needed for the conversion. Another test, RT3, can show the presence of reverse-T3, which is an isomer of the active form of thyroid hormone. Reverse T3 is not active, and can make the thyroid panel look normal in a patient that has the symptoms of hypothyroidism.
Part 3: Supplementation
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Depression? High Cholesterol? Stubborn Weight Gain?–Maybe it is Thyroid
By Dr. Paul Varnas | August 1, 2008
You’ve seen this patient; she (usually a she) is tubby, tired and depressed. Her hair is brittle, skin is dry and she can’t seem to lose weight no matter what she does. You look up hypothyroidism in the medical dictionary and her picture appears next to the two paragraph description of the condition. She cries for no reason, catches a lot of colds, her ankles swell and she is puffy under the eyes. You notice that the lateral third of her eyebrows is missing. She may or may not be taking antidepressants or statins. You suggest that her thyroid may the source of her problems and she says, “But the doctor said my thyroid was fine”.
More than likely the doctor checked TSH and found it within normal limits. You may take this opportunity to tell her that TSH isn’t even a thyroid hormone—it’s a pituitary hormone. More importantly, using it as your only criterium isn’t a very good way to diagnose thyroid problems.
There are flaws in how we diagnose hypothyroidism. The British Medical Journal [BMJ 2000;320:1332-1334 (13 May)] published an article examining this. The authors concluded that there are some problems with how hypothyroidism is diagnosed. The article points out that when diagnosing the thyroid, there is not adequate research showing us the relative importance of lab tests and symptoms. TSH production is affected by the level of thyroid hormone, but it is also affected by other things. Also, there is a need to consider the possibilities of false positive and false negative results when looking at lab tests related to the thyroid. Furthermore, we don’t fully understand how various illnesses affect TSH and the thyroid hormones.
Dr. Broda Barnes was critical of the lab work available to diagnose hypothyroidism. Dr. Barnes felt that the basal body temperature should be between 97.8 and 98.2 degrees, and used temperature to diagnose hypothyroidsm. If a patient has a low basal body temperature and hypothyroid symptoms, that is justification to treat the thyroid. The problem is that many things can cause a low temperature. Using basal body temperature and symptoms to make this diagnosis is also unsatisfactory.
It is important to understand how to diagnose hypothyroidism—so many health problems are linked to it. Many people on antidepressants should be getting thyroid support. Research appearing in the American Journal of Psychiatry (March 1993;150:3:508-510) suggests that the thyroid may be involved with some cases of depression. It was a small study that looked at 16 patients with subclinical hypothyroidism and 15 with normal thyroid function. The frequency of depression over the course of a lifetime was higher in the group with subclinical hypothyroidism.
Hypothyroidism can cause high cholesterol and heart disease. Now, research appearing in the Annals of Internal Medicine (2000; 132(4):270-8) shows that subclinical hypothyroidism and thyroid autoimmunity can also increase the risk of heart disease. Could it be that your patient who is on cholesterol lowering medication should actually be getting thyroid support? Hypothyroidism can be responsible for miscarriages. If an expectant mother has hypothyroidism and doesn’t miscarry, her baby will have a lower IQ than if her thyroid was normal [According to a study published in the New England Journal of Medicine (1999;341:549-555, 601-602),]. Problems losing weight, dry skin and immune system problems may have the thyroid at their root.
Fortunately, a number of doctors have been wrestling with this problem and there are now ways to combine lab information with symptoms and come up with a diagnosis—and a safe and reasonable treatment. When you treat with nutrition, you are using a therapy that has great potential to get good results without causing the same kind of risk to the patient that drug therapy poses. In the next installment I will place some guidelines and recommend some resources.
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