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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