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  Hypothyroidism  
 
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Hypothyroidism (symptoms of low thyroid function, from a variety of causes and mechanisms) is more common than is typically diagnosed. It is possible to have some laboratory values be returned in the normal range when you have low thyroid symptoms. Oral temperatures during the day of less than 98.0 degrees F (36.7 C) are very suspicious. When hypothyroidism is diagnosed, most doctors will prescribe thyroid medication and many use Synthroid (T4). However, a recent blinded study demonstrated that T4 and T3 in combination produced greater benefits than T4 alone, especially in the area of mental functioning.

There is a variation of hypothyroidism called Wilson's Temperature Syndrome (WTS), named after E. Denis Wilson, MD. Wilson's Temperature Syndrome is also known as Multiple Enzyme Dysfunction or MED. Dr. Wilson reports that when a body is under stress, such as illness, fasting, cortisol from stress, T4 (thyroxin – a thyroid hormone) is converted to Reverse T3 instead of T3 (triiodothyronine – the primary hormone that regulates the metabolic rate). As the T3 hormone levels in the blood drop to low levels, the patient's body temperature can subsequently drop below normal. When the body temperature decreases so does the function of important enzymes, as their activity is determined by temperature.

Wilson’s Temperature Syndrome is a state of chronic low body temperature. It may be genetic, or triggered by stress or inactivity, as well as diet, selenium or zinc deficiency, heavy metals and starvation. It seems to be part of the body's way to conserve fuel. WTS occurs when someone drops into this ‘conservation’ mode and is not able to later recover back to the normal ‘productive’ mode of functioning. An interesting side note is that Dr. Fahrenheit considered normal body temperature to be 100F. Some say the present average temperature is 98.2, and may be as much as 1 1/2 degrees lower than it was 150 years ago. A common time of death is in the very early morning, when the body temperature is at its lowest. Further information about Wilson's Temperature Syndrome (WTS) is available at his website.

The difficulty arises when these low metabolism conditions continue for too long, various repair functions are deferred too long, and the body begins to show signs and symptoms. For every degree of body temperature lost, biochemists say the loss in efficiency of enzymatic processes can be up to 20%. Chronic low body temperature is related to many syndromes and symptoms, including: allergies, apathy, chronic fatigue, "brain fog", "personal failure", depression, dizziness, hypoglycemia, lethargy, passive/aggressive syndromes, skin and joint conditions, sleep disorders, sexual dysfunction, past sexual abuse, yeast problems, porphyria, and many other poorly defined chronic low health states. Obviously, not all chronic problems are related to chronic low body temperature; but it would be prudent to measure one's body temperature from time to time to see if this is a possibility.

Hypopituitarism (low functioning pituitary) and hypothyroidism (low functioning thyroid) can both result in deficient production of T4, which is the raw material the body uses to produce the active thyroid hormone T3. Your doctor should be able to help determine which medications are best for you. Dr. Wilson's treatment plan is now called the WT3 Protocol.

This page gives further detail on the conversion of T4 to T3 and reverse T3, but casts doubt on whether reverse T3 is really an issue.

One way to test yourself is to take your oral temperature at 10 random times throughout the day: if the average is less than 98.0, you are hypometabolic (this means your metabolic rate has dropped below normal, though thyroid blood tests do not reveal a problem). However, there are many possible causes of hypometabolism, including Wilson’s Syndrome; others include fasting, Alzheimer’s Disease and meditation.

Read more at Suite101: Reverse-T3 Syndrome – Is It Real?: Doctors Doubt the Existence of Reverse-T3 Dominance | Suite101.com http://suite101.com/article/is-wilsons-syndrome-real-a121932#ixzz1xRhuR2zX

The treatment of choice preferred by conventional doctors is T4 (Synthroid) because of its long half-life in the body (which helps provide steady T3 levels), once-a-day administration, and usefulness in the treatment of such cases. Patients with hypopituitarism and hypothyroidism may, however, suffer with Wilson's Syndrome at the same time. In such cases, T4 therapy may not be adequate because impaired conversion of the T4 to the active compound T3 may prevent sufficient normalization of body temperature patterns, and, in some cases, can even feed the vicious cycle of Wilson's Syndrome. The simultaneous use of T4 with T3 may be the best approach for hypothyroidism, especially if Wilson’s Syndrome is suspected. Many doctors prefer using the standard T4/T3 combination found in desiccated thyroid products such as Armour thyroid and other generic brands. Additional adjustments in the T4/T3 ratio can be made to meet the needs of individual patients. Apart from their T3 content, glandular preparations like Armour also contain T1 and T2 which may have some function, as yet undiscovered, contributing to benefits seen when using these preparations compared to T4 use alone.

Thyroid hormone resistance is a controversial issue. Many researchers claim it is a rare genetic disorder, while others say it significant problem affecting a large percentage of patients. Thyroid hormone resistance refers to the body producing adequate amounts of thyroid hormone, but being unable to use the thyroid hormone, similar to insulin resistance. This occurs because the receptors where thyroid hormone is supposed to bind in the body are not working correctly. Receptors can malfunction from having vitamin and mineral deficits and heavy metal toxicities. Excess trans fatty acids can also cause a malfunction of these receptors. The production of autoimmune antibodies may block thyroid receptors from properly responding to thyroid hormone also. If thyroid hormone resistance is present, blood tests will indicate normal thyroid functioning, but the patient will have many signs and symptoms of hypothyroidism. The treatment for thyroid hormone resistance involves treating the underlying cause and sometimes using thyroid hormone.

Recognition and proper daily treatment of low thyroid function using thyroid hormone replacement therapy will result in resolution of deficiency symptoms usually beginning within the first month of therapy and reaching a maximum at 6-12 months of treatment.
 

 
 

Signs, symptoms & indicators of Hypothyroidism:
 
 
Lab Values - Hormones  Low T3 free level
  (Mildly) elevated TSH
  (Very) low free T4

Counter-indicators:
  Elevated/normal free T4
  Normal TSH or low TSH
  Normal/high T3 free level

Symptoms - Bowel Movements

  (Tendency to/very) infrequent stools
  Having hard stools

Counter-indicators:
  (Very) frequent stools or normal stool frequency

Symptoms - Environment

  Poor tolerance of cold

Symptoms - Food - General

  Frequent dieting

Symptoms - General

  Constant fatigue
  Fatigue that worsens during the day
  Minor/major fatigue for over 3 months or major fatigue for over 12 months
  Poor recovery from exertion

Counter-indicators:
  Not having constant fatigue
  (No) history of fatigability

Symptoms - Hair

  Dry hair
  Brittle hair

Symptoms - Head - Eyes/Ocular

  Bags under eyes
 People suffering from a thyroid problem (usually underactive, sometimes overactive) may have very baggy eyes.

  Missing outer third of eyebrows

Symptoms - Metabolic

  Low body temperature
  Low stamina
  Difficulty losing weight
  Frequent colds/flus

Counter-indicators:
  Definitely normal body temperature

Symptoms - Mind - Emotional

  Unexplained teariness/sadness
  Depression with anxiety

Symptoms - Mind - General

  Being unmotivated

Symptoms - Nails

  Brittle fingernails
 Thyroid diseases may produce brittle nails or splitting of the nail bed from the nail plate.

Symptoms - Nervous

  Numb/tingling/burning extremities

Symptoms - Reproductive - Female Cycle

  Irregular menstrual cycles
  Premenstrual bloating/weight/premenstrual weight gain or premenstrual abdominal bloating
  Poor concentration during cycle

Symptoms - Reproductive - General

  Probable/late/early miscarriage

Symptoms - Skeletal

  Joint pain/swelling/stiffness
  Stress-induced arthritis
 
 

Conditions that suggest Hypothyroidism:
 
 
Circulation  Anemia, Megaloblastic
 Pernicious anemia is associated with other autoimmune conditions such as Hashimoto's disease, a form of hypothyroidism.


Counter-indicators:
  Anemia (Iron deficiency)

Digestion

  Heartburn / GERD
 Gastrointestinal manifestations of hypothyroidism include GERD as a result of delayed emptying of the stomach.

Hormones

  Low Sex Drive
 Hypothyroidism can trigger loss of libido in both men and women.

  Hyperprolactinemia
 Primary hypothyroidism with reduced circulating thyroid hormone results in an increased production of TSH by the hypothalamus, which acts in turn as a prolactin releasing factor to raise the circulating prolactin level. Restoration to a euthyroid state by the administration of thyroid hormone corrects the problem. Galactorrhea secondary to hypothyroidism is usually associated with amenorrhea. Any menstrual function abnormality is usually restored merely by correcting the underlying condition.

Infections

  Lyme Disease
 Hypothalamus/pituitary/adrenal axis dysfunction is frequently associated with Lyme disease, and many Lyme patients have (at least temporarily) both thyroid and adrenal insufficiency.

Inflammation

  Tendonitis
 Chronic tendonitis is occasionally associated with hypothyroidism.

Lab Values

  Elevated Total Cholesterol
  Elevated Triglycerides

Mental

  Bipolar Disorder, Manic-Depressive
 Depression, whether unipolar or bipolar, can be a symptom of hypothyroidism. Here is the testimony of one woman who found out the hard way:

[About 10 years ago, for a period of 5 years, I was hospitalized 5 times for psychiatric emergencies, with diagnoses of schizophrenia, bipolar, psychotic depression, and so on. Now, after years of treatment with slow-release Armour thyroid (a compounded medication prescribed by a doctor who practices functional medicine) I no longer take any antidepressants or any other kind of psychiatric medications. I learned about Hashimoto's and I insisted on antibody tests which showed that Hashimotos disease was my problem. Even then, the endocrinologists I saw would not treat me, telling me to stay with my psychiatrist, which is why I went to a doctor who practices functional medicine.

I am not saying that all people with mental health diagnoses such as bipolar disease have a thyroid problem! But, one problem is that thyroid testing may exclude many people who can benefit from thyroid treatment by calling them "normal". Also, TSH alone may not be sufficient to diagnose a thyroid problem. E.L.M.

A good friend of mine has been treated by a psychiatrist for years with bipolar disorder. The depression part of it kept getting worse, particularly in the winter and spring. Finally, because of my own experience, I suggested she talk with her doctor about thyroid problems. She was tested by her doctor. She did not have antibodies. However, her doctor told her that her free T3 (a measure of the active form of thyroid in the bloodstream) was too low, and put her on thyroid medication. She prescribed a combination of T4 and T3. It will take many months, perhaps a few years, for my friend to know how much this helps with her seasonal problems. But she is feeling better already. And if this could happen to me, it could happen to other people too.
] E.L.M.

Metabolic

  Problem Caused By Being Overweight
  Edema (Water Retention)
  Hypoglycemia
 Patients suffering with Wilson's Syndrome, a form of hypothyroidism, occasionally experience intense and previously unfamiliar cravings for sweets. The low body temperature patterns may affect the function of enzymes involved in glucose metabolism that could result in lower blood sugar levels which might contribute to sweet cravings.

  Problem Caused By Being Underweight

Musculo-Skeletal

  Rheumatoid Arthritis
 A study of rheumatoid arthritis patients found evidence of thyroid dysfunction 3 times more often than in controls. The excess thyroid dysfunction was due to either hypothyroidism or Hashimoto's thyroiditis. [Annals of Rheumatic Diseases, 1993;52 pp.454-456]

Organ Health

  Retinitis Pigmentosa
 There is an increased occurrence of thyroid disease (Hashimoto's thyroiditis) in patients with retinitis pigmentosa. [ Am J Ophthalmol, 1996 Dec, 122:6, pp.903-5 Abstract]

Pain

  Low Back Pain / Problems

Respiratory

  Sleep Apnea
 Hypothyroidism can present itself as obstructive sleep apnea and snoring.

Skin-Hair-Nails

  Cold Hands and Feet
  Female Hair Loss
 In rare cases, diffuse hair loss may be the only symptom of hypothyroidism, but in many people with hypothyroidism the hair is not affected. Once thyroid hormone is administered, regrowth of hair occurs in approximately 2 months.

  Dry skin

Symptoms - Glandular

Counter-indicators:
  Absence of hypothyroidism

Uro-Genital

  Menorrhagia (Heavy Periods)
  Amenorrhea
 In many cases, an underactive or overactive thyroid gland is responsible for the absent menstrual cycles.

  Endometriosis
 Endometriosis often have their symptoms aggravated by low progesterone levels, estrogen levels that are too high, or have ongoing xenoestrogen exposure. This can result in symptoms of hypothyroidism and they may need thyroid supplements even though measured TSH, T3 and T4 are normal. After taking progesterone for several months, thyroid function may become normal and thyroid supplements can be reduced and possibly eventually discontinued.
 
 

Risk factors for Hypothyroidism:
 
 
Autoimmune  Autoimmune Tendency
 A positive test result for the thyroid autoantibodies antithyroglobulin and antiperoxidase will confirm the diagnosis of Hashimoto's thyroiditis.

Autoimmune hypothyroidism is the most common organ-specific autoimmune disorder. Two specific forms of autoimmune hypothyroidism exist:

1) chronic autoimmune thyroiditis, which is also known as Hashimoto's thyroiditis or Hashimoto's disease, and its variants, postpartum and sporadic thyroiditis

2) autoimmune atrophic thyroiditis, which is also known as primary myxedema. Myxedema is an older term referring to the skin changes characterized by pitting and swelling (water-logged appearance) associated with hypothyroidism.

Environment / Toxicity

  Gulf War Illness

Family History

  Hypothyroidism in family members
 Hypothyroidism tends to "run in families". If you have a history of either hypothyroidism, or paradoxically, hyperthyroidism in your family, it increases the chance that you may someday develop the condition. However, except for a few rare disorders, hypothyroidism is not transmitted in a typical dominant or recessive manner. If you have a strong family history of underactive or overactive thyroid disease, you should mention this to your physician.

  Hyperthyroidism in family members
 A family history of hyperthyroidism leads to a higher chance of developing hypothyroidism (not just hyperthyroidism).

Hormones

  Hypopituitarism / Empty Sella Syndrome
  Low Adrenal Function / Adrenal Insufficiency
 A suggestive but unresolved issue is the connection between the thyroid and the adrenal glands. An altered sensitivity of tissues to thyroid hormone may take place when there is a reduction in adrenal hormones.

  Low Progesterone or Estrogen Dominance
 Progesterone increases sensitivity of estrogen receptors, and can therefore redirect estrogen activity and inhibit many of unopposed estrogen's undesirable side-effects, which includes interference with thyroid hormone activity.

Lab Values - Chemistries

  (Moderately/history of) elevated CK
 In hypothyroidism, slight elevations of serum creatine phosphokinase (CPK) levels are common. In contrast, we describe six hypothyroid patients with extreme elevations (17- to 160-fold) of CPK levels. Enzyme analysis showed only MM isoenzyme in four cases and MM plus trace MB isoenzyme in two patients. Hypothyroidism should, therefore, be considered when elevated CPK levels, even extreme, are found. Isoenzyme analysis in such a case will show primarily an MM pattern, although trace MB fraction can also be seen. This isoenzyme pattern suggests that the sources of the CPK elevations is skeletal muscle. [JAMA. 1977 Jul 25;238(4):pp. 325-6]

  (Very) low HDL level

Counter-indicators:
  Excellent HDL level

Lab Values - Hormones

  Having low/having low-normal TT4 level

Counter-indicators:
  Having normal/having elevated TT4 level

Nutrients

  Iodine Requirement
  Copper Deficiency
 There are a limited number of studies that suggest low copper levels may reduce thyroid function. In cases where hypothyroidism is not responding properly to medication, make sure that copper levels are normal.

Supplements and Medications

  Using typical/using high/using low dose T4
  Desiccated thyroid use
  Using synthetic T3

Symptoms - Food - General

  History of/history of frequent dieting
 
 

Hypothyroidism suggests the following may be present:
 
 
Autoimmune  Autoimmune Tendency
 A positive test result for the thyroid autoantibodies antithyroglobulin and antiperoxidase will confirm the diagnosis of Hashimoto's thyroiditis.

Autoimmune hypothyroidism is the most common organ-specific autoimmune disorder. Two specific forms of autoimmune hypothyroidism exist:

1) chronic autoimmune thyroiditis, which is also known as Hashimoto's thyroiditis or Hashimoto's disease, and its variants, postpartum and sporadic thyroiditis

2) autoimmune atrophic thyroiditis, which is also known as primary myxedema. Myxedema is an older term referring to the skin changes characterized by pitting and swelling (water-logged appearance) associated with hypothyroidism.

Hormones

  Low SHBG
 Modest reductions in SHBG levels may be encountered in individuals with hypothyroidism.

  Hypopituitarism / Empty Sella Syndrome
 
 

Hypothyroidism can lead to:
 
 
Hormones  Hyperprolactinemia
 Primary hypothyroidism with reduced circulating thyroid hormone results in an increased production of TSH by the hypothalamus, which acts in turn as a prolactin releasing factor to raise the circulating prolactin level. Restoration to a euthyroid state by the administration of thyroid hormone corrects the problem. Galactorrhea secondary to hypothyroidism is usually associated with amenorrhea. Any menstrual function abnormality is usually restored merely by correcting the underlying condition.
 
 

Recommendations for Hypothyroidism:
 
 
Animal-based  Glandular / Live Cell Therapy

Botanical

  Kelp / Seaweed
 Kelp is a large, leafy brown edible seaweed rich in vitamins and minerals that grows along colder coastlines. Kelp is an excellent source of iodine, a major component of thyroxine and triiodothyronine, hormones that affect weight gain and cellular metabolic rates. One to two milligrams of iodine per week are required to prevent goiter. Based on epidemiological studies, thyroid disease is practically unknown in people who regularly eat kelp.

  Cayenne Pepper (Capsicum frutescens)
 See link between Hypothyroidism and Ginger.

  Ginger Root (Zingiber officinalis)
 The liberal use of ginger, cayenne and other spicy herbs has helped restore a normal body temperature for some people with hypothyroidism.

Diet

  Raw Food Diet
 A short-term (2-4 week) diet of only raw foods, with heavy emphasis on raw greens, seaweed, nuts, seeds, sprouted beans and seeds, and freshly extracted vegetable juices, can improve thyroid function. However, a long-term raw food diet may help you feel warmer, but many raw foodists find they tend to be cold.

  Coconut
 Lauric acid (as from coconut oil) has been shown to boost thyroid hormone activity along with the body's metabolic rate (BMR). This is a great advantage to those needing weight loss or who suffer from an underactive thyroid.

  Therapeutic Fasting
 Low levels of thyroid hormones may return to normal after a lengthy fast.

  Spicy Foods
 See link between Hypothyroidism and Ginger.


Not recommended:
  Soy Isoflavones (genistein, daidzein)
 Soy isoflavones have been found to inhibit the activity of thyroid peroxidase, an enzyme required for thyroid hormone synthesis in cell culture and animal studies [Anti-thyroid isoflavones from soybean: isolation, characterization, and mechanisms of action. Biochem Pharmacol. 1997;54(10):pp. 1087-1096. Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect. 2002;110 Suppl 3: pp.349-353.]. However, high intakes of soy isoflavones do not appear to increase the risk of hypothyroidism as long as dietary iodine consumption is adequate. Since the addition of iodine to soy-based formulas in the 1960s, there have been no further reports of hypothyroidism developing in soy formula-fed infants [Pediatrics. 1995;96(1 Pt 1): pp.148-150]. Several clinical trials in premenopausal and postmenopausal women with sufficient iodine intakes have not found high intakes of soy isoflavones to result in clinically significant changes in circulating thyroid hormone levels [J Med Food. 2003;6(4): pp.309-316. Am J Clin Nutr. 2002;75(1):145-153. J Clin Endocrinol Metab. 1999;84(1): pp.192-197. J Clin Endocrinol Metab. 1999;84(10):3479-3484].

Drug

  Conventional Drugs / Information
 Please see the link between Hypothyroidism and Thyroid Medications.

Extract

  Plant Sterols / Sterolins (Phytosterols)
 With both Hashimoto’s disease (hypothyroidism), the body has become confused and sets up an autoimmune attack on the thyroid gland. When this autoimmune reaction is reduced, there is an opportunity for unhampered thyroid production and metabolism. Sterols and sterolins balance the immune system by decreasing the specific immune factor (Interleukin-6) responsible for the autoimmune reaction. As a result, thyroid function may be allowed to return to a more normal state.

Habits

  Fluoride Reduction/Avoidance
 From an article Fluoride: A Statement of Concern by Paul Connett, PhD, 2000

Another line of evidence which indicates that fluoride is an endocrine disrupter is the number of studies that indicate the fluoride may inhibit the functioning of the thyroid gland. Andreas Schuld, president of a group called Parents of Fluoride Poisoned Children, has prepared an excellent summary of the evidence that points in this direction (53, 54). To put the matter as simply as I can, his group has been able to show that areas of endemic fluorosis are also areas designated as being endemic with iodine deficiency disorders (IDD). The group rediscovered studies and documentation from the European medical literature spanning over 30 years of research testifying to fluoride's pharmacological effectiveness in the treatment of hyperthyroidism (the term used to describe an over-functioning thyroid gland). Thyroid hormones are absolutely essential for normal growth and development. Hyperthyroidism means that the thyroid gland is producing too much of the thyroid hormones, T3 and T4. These two hormones have 3 and 4 iodine atoms respectively. Schuld's group has also shown that there is a remarkable similarity between the symptoms listed for hypothyroidism (under active thyroid gland) and those reported for fluoride poisoning (55). Putting these two conditions together, it appears that fluoride decreases the production of thyroid hormones. If you are suffering from hyperthyroidism, fluoride might be of some benefit. But for a normal person if you are exposed to too much fluoride it could result in reducing thyroid hormone production below normal and necessary levels (i.e., hypothyroidism).

It is not clear just how fluoride reduces thyroid hormone production. It may be that fluoride competes with iodine uptake into this gland. Alternatively, fluoride might inhibit the enzymes inside the gland which assemble the hormones from its chemical precursor, the amino acid tyrosine.

Schuld also points to research that fluoride can also stimulate the thyroid glands, which seems contradictory to the discussion above. However, stimulation may not lead to production of the hormones if iodide is in short supply. Such a situation (over stimulation coupled with iodide shortage) might explain the condition known as goiter. Here the gland grows and grows producing a swelling in the neck. The gland grows because it is being stimulated, but because there are no thyroid hormones produced, there is nothing to switch off the stimulating signal. In other words, the normal feedback mechanism is not working. This signal is the hormone (thyrotropin or thyroid stimulating hormone) which is produced by the pituitary gland - the master gland as far as hormonal control is concerned.

53. Schuld, A. (1999). How Do Fluorides Interfere With Thyroid Function. Fluoride Watershed, Journal of the National Pure Water Association, 5, (November), pp. 3-6.

54. Parents of Fluoride Poisoned Children [PFPC] (1999). Comparison of over 150 symptoms and associations: Hypothyroidism/Fluoride Poisoning. PFPC, Vancouver, Canada.

55. Utiger R. (1995). Thyrotropin-Receptor Mutations and Thyroid Dysfunction. The New England Journal of Medicine 332. Website: http://www.nejm.org/content/1995/0332/0003/0183.asp

Also, the damaging effects of bromine (same family as flourine and iodine) on thyroid tissue appears to contribute to the development of auto-immune diseases in the thyroid gland (Hashimoto's thyroiditis). Bromine is routinely added to flour and bread in the US.

Hormone

  Thyroid Medications
 Thyroid medication should be taken separately from iron and possibly calcium supplements to ensure availability for absorption. It is known that taking iron tablets, or vitamins with iron at the same time as your thyroid hormone can make the thyroid hormone less effective. Many doctors recommend at least 2 hours between taking iron and the thyroid hormone.

A doctor from Johns Hopkins published a letter in JAMA reporting that several patients taking levothyroxine experienced an increase in TSH levels after they started to take calcium supplements. When they changed their pattern and began to take the calcium and thyroid hormone at least four hours apart, TSH returned to the initial level.

One woman ingesting large amounts of calcium carbonate (1250 mg tid) with levothyroxine (T4), continued with symptoms of hypothyroidism until delaying calcium carbonate administration by 4 hours. This separation of supplement times resulted in a return to normal thyroid status. [ Ann Pharmacother 2001;35(12): pp.1578-83]

Once you start on thyroid hormone replacement (especially higher doses of even natural hormones) your thyroid gland can start to atrophy. If you remain on thyroid replacement for more than three years it becomes difficult to stop.

If Wilson's Syndrome (Wilson's Metabolic Syndrome) is suspected, one treatment regimen is as follows. Dr. Wilson recommends treatment through a programme of time-release T3 tablets (7.5–15mcg), which are taken every 12 hours until the body temperature reaches an average of 98.2 or until you develop symptoms of hyperthyroidism (such as rapid heart beat). Your Naturopath or MD can work with you to increase the dose until this is achieved. Once you reach a normal temperature, you maintain the dose for 30 days, then taper the dose down slowly before tailing it off completely. With little or no T4 left in the system, rT3 production eventually decreases, and the conversion of T4 can occur normally.

  Progesterone
 Within weeks of using adequate natural progesterone cream, symptoms of hypothyroidism, in some women, may disappear. This is because natural progesterone increases sensitivity of estrogen receptors, and can therefore redirect estrogen activity and inhibit many of unopposed estrogen's undesirable side-effects, which include interference with thyroid hormone activity.

Lab Tests/Rule-Outs

  Test Thyroid Function
  Test Adrenal Function
 Cortisol and DHEA are among the hormones produced by the adrenal glands. It is possible that these hormones can reduce the immune system dysfunction seen in Hashimoto's thyroiditis. More studies are needed, but taking these medications appropriately carries little (if any) risk and can markedly improve the patient's function and overall health.

  Test / Monitor Hormone levels

Mineral

  Iodine
 Sometimes a low functioning thyroid gland will improve with the addition of iodine in some form. Seaweeds and kelp have been found helpful. See link between Hypothyroidism and Selenium, and the link to Fluoride Avoidance. Before prescription thyroid medication is considered, supplemental iodine should be tried.

Miscellaneous

  Reading List
 A good resource be Dr. Kenneth Blanchard's book, What Your Doctor May Not Tell You About Hypothyroidism published in January, 2004. He specifically discusses SAD and it's relationship to thyroid reserves, as well as the use of T3 and Armour thyroid.

Wilson’s Syndrome, The Miracle of Feeling Well. is an older book and somewhat controversial although many doctors are using variations of his therapeutic approach. This book contains much useful information and many testimonials of people helped by using T3 therapy.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Strongly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences







GLOSSARY

Adrenal Insufficiency:  Also known as Adrenal Exhaustion or Low Adrenal Function, this is a condition where the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Antibody:  A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.

Apnea:  Cessation of breathing.

Autoimmune Disease:  One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Bipolar Disorder:  Also known as manic-depression, this disorder is characterized by alternating periods of extreme moods, usually swinging from being overly elated or irritable (mania) to sad and hopeless (depression) and then back again, with periods of normal mood in between. The frequency of the swings between these two states, and the duration of the mood, varies from person to person.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Chronic Fatigue Syndrome:  CFS (Chronic Fatigue Syndrome) is a disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.

Copper:  An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.

Endometriosis:  A condition whereby endometrial tissue builds up in parts of the uterus where it does not belong or areas outside of the uterus, forming 'ectopic implants'. Unlike the normal tissue lining the uterus, ectopic tissue has no place to shed in response to a decline in estrogen and progesterone. This results in debris and blood accumulating at the site of the implant leading to inflammation, scarring and adhesions that ultimately cause symptoms and complications. Symptoms typically occur in a cyclic fashion with menstrual periods, the most common being pelvic pain and cramping before and during periods; pain during intercourse; inability to conceive; fatigue; painful urination during periods; gastrointestinal symptoms such as diarrhea, constipation, and nausea.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Estrogen:  One of the female sex hormones produced by the ovaries.

Fatty Acids:  Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.

Galactorrhea:  Galactorrhea is inappropriate lactation in the woman who is not pregnant or has not recently given birth. It can be unilateral or bilateral.

Gastric Reflux Disease:  Gastro-Esophageal Reflux Disease (GERD). A common relapsing condition affecting approximately 10% of the U.S. population and caused by an abnormal exposure of the lower esophagus to refluxed gastric contents, causing irritation and injury to the esophageal tissues. GERD develops as a result of relaxations of the transient lower esophageal sphincter. Typical presenting symptoms are heartburn, an epigastric burning sensation and acid regurgitation. However, some patients may present with atypical symptoms such as chest pain, shortness of breath, wheezing, and coughing.

Gastrointestinal:  Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Glucose:  A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.

Hormones:  Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Hyperthyroidism:  An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.

Hypoglycemia:  A condition characterized by an abnormally low blood glucose level. Severe hypoglycemia is rare and dangerous. It can be caused by medications such as insulin (diabetics are prone to hypoglycemia), severe physical exhaustion, and some illnesses.

Hypothalamus:  An important supervisory center in the brain regulating many body functions. Despite its importance in maintaining homeostasis, the hypothalamus in humans accounts for only 1/300 of total brain weight, and is about the size of an almond.

Hypothyroidism:  Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.

Insulin:  A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Millimeter:  (mm): A metric unit of length equaling one thousandth of a meter, or one tenth of a centimeter. There are 25.4 millimeters in one inch.

Mineral:  Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.

Myxedema:  A condition arising from diminished thyroid function, characterized by hard swelling of subcutaneous tissue, hair loss, lower temperature, muscle debility, hoarseness and the slow return of a muscle to neutral position after a tendon jerk. Resulting thyroid cell destruction eventually progresses to thyroid failure.

Pernicious Anemia:  Anemia caused by a vitamin B12 deficiency.

Pituitary:  The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.

Porphyria:  Any of several usually hereditary abnormalities of porphyrin metabolism characterized by excretion of excess porphyrins in the urine. Porphyrias are relatively rare disorders and can be classified based on the principal site of expression of enzymatic defect in heme synthesis.

Postpartum:  After childbirth.

Prolactin:  An anterior pituitary peptide hormone that initiates and maintains lactation.

Rheumatoid Arthritis:  A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).

Schizophrenia:  Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia is associated with dopamine imbalances in the brain and defects of the frontal lobe and is caused by genetic, other biological, and psychosocial factors.

Selenium:  An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.

Serum:  The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Stomach:  A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

T4:  Thyroxin, thyroid hormone also prepared synthetically, for treatment of hypothyroidism and myxedema.

Thyroid:  Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.

Yeast:  A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.

Zinc:  An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.