Thyroid

Thyroid

Why you still have hypothyroid symptoms

Approximately 27 million Americans suffer with hypothyroidism today—the majority being woman, another 10-15 percent of Americans have subclinical or mild hypothyroidism. This number would actually be higher if the medical profession shared the views of the endocrine society who believe that many million more patients are going undiagnosed because the lab range currently being used by most labs is too broad, and therefore misses many patients who actually have hypothyroid conditions. The current lab values that we see here in California typically range from .5 -5.5, while the endocrine society believes that the range should optimally be 1.8-3.0.

So if you are one the many of patients who contact us daily, and tell us that you were either diagnosed as being hypothyroid years ago, but continue to suffer the same debilitating symptoms of fatigue, weight gain, constipation, brain fog, memory loss, cold hands and feet or just being cold, thinning hair, brittle nails, and your doctor insists that your thyroid is normal , and may even suggest that you are depressed as a cause of your symptoms. I’m here to tell you that you aren’t crazy! Many woman I consult with are made to feel crazy simply because they know that they don’t feel right and yet their doctors tell them that everything is normal! Well I would feel crazy too, and I feel for you, it’s not easy to figure out all the medical mumbo jumbo when your healthy let alone when you don’t feel well or don’t have a clear head.

Why TSH?

Here’s what your doctor may not know and why you may be going undiagnosed. First of all many if not all of our patients are diagnosed with one simple marker in their blood, and that marker is TSH or thyroid stimulating hormone, and the reason that this marker is used so widely is that the only thing that your doctor is typically concerned with is whether to give you thyroid replacement hormones, and whether after giving you those hormones is your tsh level within the laboratory ranges specified above. If it is, then as far as he is concerned, your thyroid must be working properly. However the problems with this analysis are multiple. First of all we need to understand a little bit about thyroid physiology, which I will discuss with you here in a moment, but you also need to know that the primary reason for hypothyroidism in the united states has nothing to do with the thyroid itself, I will get to that in a little bit, but its important that you read this and understand what I am about to tell you, because its critical to getting your healthy once and for all.

Patterns of Hypothyroidism

How many different patterns of hypothyroidism do you think there are? Dr Datis Kharrazian author of "Why Do I Still Have Thyroid Symptoms when my lab tests are Normal” has identified 22 patterns of hypothyroidism! That’s right 22 patterns and for the most part most doctors are only looking at the one blood marker I discussed above, so how many of those patterns are they looking at? Just one! How is that possible you might ask, I have already answered that, most doctors simply look at your TSH level to determine whether you need thyroid replacement hormone or not. End of story.

How your thyroid works

So lets take a quick tour of thyroid physiology. Thyroid hormones T4 and T3 are dependent on adequate levels of TSH to stimulate the thyroid to produce these hormones, TSH is dependent on adequate levels of TRH being released by the hypothalamus, and that gland in your brain is reliant on adequate levels of dopamine and serotonin to be in supply in order for it to work properly. So if you look upstream from the thyroid you can see that there are several things to look at right away, first of all are there adequate levels of dopamine and serotonin available, and if not what does the body need for those neurotransmitters to be produced? Or said another way what is interfering with the production of those hormones?

Feedback Loops to the Pituitary

Now when the pituitary secretes TSH it is dependent upon Protein bound T4 to feedback to it to keep the levels within normal range, in other words the pituitary signals the thyroid to make hormones, when the hormones are released into your blood, the pituitary picks that up and this is how the TSH level is kept within range. If your thyroid is not working for whatever reason and it is not producing adequate amounts of T4 then the pituitary secretes larger and greater amounts of TSH to stimulate the thyroid, therefore if your TSH level is high, then you are for sure hypothyroid.

Is Synthroid the Answer?

So the doctor will then put you on synthroid or levothyroid, which is simply a synthetic T4 hormone, and with adequate amounts of T4 circulating in your bloodstream your TSH levels will undoubtedly come down, and so you go to see your doctor and he tests your TSH levels and they are normal, but you feel lousy, what’s a doctor to do?

The Mystery of T4 unlocked!

Here’s why you can feel lousy sick, depressed, have brain fog, poor memory, constipation, gain weight, are you ready for this? T4 is mostly inactive in the body! That’s right the hormone that regulates the TSH level, isn’t metabolically active in your system! It needs to be converted to T3, which is the metabolically active form of thyroid hormone. Your TSH levels have nothing to do with evaluating T3, your TSH levels are an indication that there are adequate levels of the inactive form of T4 circulating your blood! 93% of the hormones that your thyroid produce are T4, the inactive form, and only 7% are the active form!

Conversion of T4

The 93% of T4 must get into the peripheral circulation where it is converted by an enzyme known as 5’ diodinase. This enzyme is what takes your into T4 and converts it into active T3.

Every cell in your body has thyroid receptors. I mean every cell, which is why a properly functioning thyroid is so critical to your health. With out a normally functioning thyroid all the cells in your body stop functioning at their optimal metabolic rate!

60% of the protein bound T4 get converted into T3, another 20% get converted into reverse T3, which is unusable by the body, and another 20% becomes T3 sulfate and T3 acetyl acetate, these are inactive forms of T3 and must get into your gut, and IF your gut is healthy it goes through another enzymatic process that converts another 20% into Free T3. How do you know if your gut is functioning properly? You[probably don’t know, and this is yet another area that we need to look at. We test you to make sure that you don’t have parasites, fungus, bacteria infections, leaky gut, food sensitivities. etc. It’s easy to see how you’re TSH level could be normal, but if your gut is not function normally you could still be hypothyroid!

Other common patterns rarely looked at

Here’s another pattern for you, if you have estrogen surges or dominance that leads to an increase in thyroid binding globulin, which decreases the amount of free T3 in circulation. This is called an under conversion problem.

*Remember, we haven even spoken about the most common cause of hypothyroidism in the United States yet!

Testosterone & Hypothyroidism?

There is also a condition that mimics hypothyroidism in many women, and that is called PCOS. Polycystic ovarian syndrome. When your body is producing too much testosterone, because of an up regulation of an enzyme called 17, 20 lyase you can have symptoms of hyperthyroidism, but also an increase in testosterone will cause you to have decreased amounts of thyroid binding globulin in your blood leading to an over conversion of T4 into T3, and while you might think this is good, any time there is an excess of hormone in the body, we will get something called receptor down regulation which simply means that your thyroid receptors will shut down!

I know this may be getting a bit thick for you, but its important for you to get the big picture as to why you might be feeling the way that you do when your doctors says everything is alright! The thyroid is a very sensitive gland and as such responds to many conditions and upsets in the body.

The Number one Cause of hypothyoidism in the United States

The number one cause of hypothyroidism in the United States is not an iodine deficiency! It is however the number one cause worldwide. In the United States the number one cause of hypothyroidism is…

Hashimotos Autoimmune thyroid.

Hypothyroidism is a condition, but Hashimotos is a disease. It is an autoimmune disease, which means that your immune system is attacking your very own thyroid and destroying it over time. It is not a problem with the thyroid; it is a problem with your immune system causing a thyroid problem! Unfortunately with autoimmune diseases one can often lead to another. So that your immune system may start attacking your joints and you end up with rheumatoid arthritis, or it can attack your brain or nerves and you end up with multiple sclerosis, or if it attacks your intestines, you could end up with celiac disease, fibromyalgia, you get the idea. Autoimmune diseases need to be taken seriously!

So if you have Hashimotos autoimmune thyroid and you are on synthroid, or some other natural or synthetic hormone, you might need it, but its like going to your mechanic because your car is sputtering and he puts new tires on your car, you may have needed new tires, but your car is still sputtering because the problem wasn’t your tires! It was something in the engine or transmission!

Why isn’t this checked more often? Because there is no drug cure for an autoimmune condition! So very few doctors check for it , and when it is, it doesn’t change the course of treatment!

In our office we routinely screen for and find Hashimoto’s and then we begin to look at full immune panels, and test things with crazy names like cytokines, and Th1 Th2 , and interleukin 6, and tnf alpha, and inf gamma to help determine immune system dominance, and begin to quiet down the immune system naturally, giving pateintss back their lives sometimes in a just a few short weeks.