As with all aspects of this
website this is not a complete discussion of all possible mechanisms,
testing or treatment. Rather it is meant to get the reader to begin to
think constructively about their symptoms and whether their diagnostic
evaluation is complete.
The standard medical assessment of
Hypothyroidismis
carried out regularly on annual checkups across the country.
The tests are called Thyroid stimulating hormone (TSH) and thyroxine
(T4). The thyroid produces the inactive hormone T4 and the
active hormone T3 is produced by cleaving an iodine molecule from the
T4 structure. The thyroid gland sits just below the “adams
apple” or larynx. The pituitary a small gland found at the base of your
brain produces TSH when T4 is low. The system works as a furnace T3
stimulates the production of energy that all cells need. The
pituitary acts as a thermostat, turning on the furnace for heat (T4 and
T3) when cold and the heat (T3 and T4) in return turns off the
thermostat when it gets to warm.
If the thyroid is lacking in its hormonal output the metabolism and in
return the body becomes sluggish. This simple explanation
explains many of the common hypothyroid symptoms of fatigue, sensation
of cold, weight gain, paleness, constipation, etc. The conventional
diagnosis of hypothyroidism is high TSH and low T4. This is
because TSH stimulates the production of T4. So if T4 is low
you would expect high TSH to stimulate the thyroid to produce more
T4. This is the classical picture of a laboratory confirmed
hypothyroid diagnosis: high TSH and low T4.
It is now widely believed by a large body of researches and doctors
that these blood indices alone are insufficient for uncovering all
cases of hypothyroidism or otherwise underactive metabolism.
In actuality one of the leading causes of hypothyroidism is
autoimmune thyroiditis (Hashimoto’s). This is where the
thyroid becomes inflamed from the body’s own immune system.
A positive test result for the
thyroid autoantibodies antithyroglobulin and antiperoxidase will
confirm the diagnosis of Hashimoto's thyroiditis.
T4 and T3 are bound to proteins in the blood called sex hormone binding
globulin. Conventional diagnostics records T4 bound and typically
doesn’t consider free unbound readings of T4 and
T3. Furthermore T4 and T3 are actively converted back and
forth between each other. The
enzyme
reverse T3 (rT3) changes the active T3 back into the inactive
T4. So some cases of undiagnosed hypothyroidism are reflective
of an active rT3. This would leave low levels of active T3, normal T4
and in return normal TSH. This laboratory finding would not be
caught be clinicians just looking at TSH and T4.
For most uncomplicated cases of hypothyroidism synthetic or desiccated
hormone is used in treatment. Though there are also other
alternative treatment strategies based on the findings of laboratory
tests and the constellation of symptoms. It should never be about
everyone with hypothyroid receives synthetic hormone. Rather
the cure should fit the case!
Stress and inactivity can play a significant role in some cases. For
this reason the adrenal hormones cortisol and DHEA should be assessed
as they have an intimate relationship with the thyroid. In other cases
it is helpful to normalize anemic conditions and assess assimilation of
nutrition. Many chronic conditions can express as fatigue so a
thorough work up is crucial. For instance the Annals of
Rheumatic Disease in 1993 showed that rheumatoid arthritis patients had
a three times incidence of hypothyroid state as compared to
controls. Estrogen dominance can alter thyroid function. In
this case it is important to resolve the primary problem first, that be
estrogen dominance. Managing, preventing and treating
hypothyroidism means understanding the complicated workings of the
hormonal system.
Once again this is not a complete discussion. Adapting a comprehensive
analysis and treatment plan is crucial. Hormonal disruptions
are often more than just a single hormone deciding it no longer wants
to carry its own weight anymore.
If you believe your symptom picture looks like hypothyroidism and you
can’t get extended and appropriate testing and care call the office and
we will get you back on the road to Wellness!
