B.S., C.N.C.

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Our thyroid gland plays an enormous part in our everyday quality of life. Unfortunately, one of the most prevalent disorders of this gland, hypothyroidism, is also one of the most misdiagnosed or undiagnosed ailments we face. Needless to say, this creates an unhappy state for many people as they go from doctor to doctor trying to find - and treat - their many problems. These problems could all be traced back to either a sluggish thyroid or non-functioning thyroid, a thyroid being attacked by autoimmune antibodies, decreased conversion of T4 to T3, excess reverse T3, thyroid hormone resistance, or even a normal thyroid that is having the hormonal activity blocked by such things as estrogen and/or excess soy.

It takes a little legwork on the part of an astute physician to peel away layers and attempt to discover the core problem for the many symptoms their patients may experience. However, as we all know, that is not usually how present day physicians are trained. They are trained, primarily, by the pharmaceutical industry. Consequently, it's much easier to treat individual symptoms with drugs and let it go at that.

Perhaps, with a little information, we can all approach our MDs and make appropriate demands concerning our health. After all, it is our health and our body. We are paying - or at least someone is paying - for the care we receive.

At the risk of writing a small book, I'd like to give some basic facts about hypothyroidism, it's adverse effects, and the way it's appropriately or inappropriately treated - in most cases.

The best way to start out is to mention some basic signs and symptoms. As you read through them, you may note that some are disorders in and of themselves. That's my point.

  1. brittle nails
  2. hypotension
  3. cold hands and feet
  4. inability to concentrate
  5. cold intolerance
  6. infertility/decreased libido
  7. constipation
  8. irritability/restlessness
  9. depression
  10. menstrual irregularities
  11. difficulty swallowing
  12. muscle/joint pain
  13. dry/coarse skin
  14. muscle weakness
  15. elevated cholesterol
  16. nervousness
  17. essential hypertension
  18. poor memory/mental slowness
  19. eyelid swelling
  20. puffy eyes
  21. fatigue
  22. slower pulse
  23. hair loss
  24. TMJ
  25. low resistance/prone to infections
  26. headaches
  27. hoarseness
  28. weight gain w/ little food intake
  29. loss of outer 1/3 of eyebrows
  30. low body temp
  31. palpitations
  32. dry, coarse hair
  33. peripheral edema
  34. weakness
  35. immune system problems - lupus, RA, allergies,MS,uveitis, scleroderma, Sjogren's syndrome
  36. female problems - miscarriage, fibrocystic breast disease, ovarian fibroids, polycystic ovaries, endometriosis, PMS, menopausal symptoms

It's a very long list, but, think about it. How many of you can look at it and say, "hey, I'm being treated for depression, high cholesterol, joint pain, menstrual problems, headaches. I'm constipated." There is a drug for every one of those. What about the poor women with polycystic ovary syndrome who are taking lupron (another story),or fertility drugs in order to conceive? This is often a result of untreated hypothyroidism. How about people who have systemic yeast infections? (I know of physicians who blatantly deny the existence of systemic yeast infections.) A hypoactive thyroid results in decreased body temperature. This decreased body temperature promotes the increased growth of yeast (and bacteria) in the body. Candida and strep are known to survive in an environment a few degrees lower than our normal body temperature of 98.6 degrees.

Another very good example would be menstrual or menopausal problems. Most menopausal problems (mood swings, depression, sleep disorders, weight gain) could originate from an under active thyroid. How many women do you know that have been put on HRT (hormone replacement therapy) for menopausal symptoms? The toxic estrogen in HRT is known to mask the effects of thyroid hormone. Even if women refuse to take HRT, at peri-menopause or post menopause, when there is either sporadic ovulation or no ovulation (which results in no production of progesterone which counters estrogen dominance), women are, in most cases, estrogen dominant - and, therefore, hypothyroid. It is estimated that 90% of peri-menopausal or post menopausal women are hypothyroid. However, this very often goes undetected and untreated. The symptoms are treated; often with no relief. Instead, new symptoms appear. One last concern of women - either peri-menopausal or menopausal - is the rampant promotion of soy as a beneficial aid. Soy, in any form, is known to be toxic to the thyroid. It should not be ingested by anyone. Ironically, it's the isoflavones in the soy (which are highly promoted) that affect the thyroid most. It is very important that women avoid soy, in addition to red clover or any other high isoflavone substance.

Thyroid problems are not exclusive to women. Men often face a vicious circle of problems- especially as they age. Their body normally produces a small amount of estrogen. This is necessary. However, they, also, are exposed to toxic, environmental estrogens. This contributes to a state of estrogen dominance. In men, it has been found that estrogen dominance results in the conversion of testosterone to dihydrotestosterone - the inactive form of the hormone. Not only is this state of estrogen dominance masking the thyroid hormone activity, the low free testosterone levels may also be a contributing factor to some of the symptoms and signs of hypothyroidism in men. Somewhat of a double-whammy situation. How many men do you know that carry a good-sized spare tire around the middle, have had their muscle turn to fat, are losing or have lost their hair, have decreased or no libido, and are being treated for hypertension and hypercholesterolemia? What about men in that age bracket with prostate problems? How about younger men with impotence and infertility? Studies have found that an under active thyroid may result in all of the above and that the addition of thyroid hormone can be very useful in reversing many, if not all, of them.

Thyroid problems are known to affect all ages. I have discussed adults so far. What about children? Let's take this scenario... I'll give you my personal experience. Looking back eons ago, when I was a child growing up - not knowing then what I know now. I remember my mother having many "symptoms" of hypothyroid... classic Reynaud's syndrome, afternoon fatigue, weight gain, hair loss, dry skin. She had several miscarriages before conceiving me (was given DES in order to conceive me!), had endometriosis resulting in a total hysterectomy, resulting in many years of HRT. She also smoked; eventually passing away from a massive stroke. My hypothesis is, at this point - with the knowledge I now have - that my mother was hypothyroid at my conception and birth. I remember as a child being cold all the time, often losing feeling in my hands and feet. Eventually, I had the same symptoms as my mother of Reynaud's syndrome. I fought chubbiness through childhood and adolescence; was on birth control pills for years and had fibrocystic breasts until becoming post-menopausal. When I was pregnant with my children, I remember being so cold all the time and having nurses make unconcerned remarks about my 80/40 blood pressure and low pulse. I gained a lot of weight with my pregnancies and had very large babies. I attributed it to eating very healthy and taking good vitamins. I still didn't know anything about the thyroid at that point. I also had a miscarriage between my two daughters. Now, after many years of study and research, (and some resulting diagnostic tests) I know that my daughters and I are hypothyroid. After so many years where we all endured so many different symptoms and weren't able to "add 2+2 and get 4". Do you see the point I'm trying to make? Children are often born hypothyroid. It's not something that's routinely checked in newborns or children. Are you aware that hyperactive children are often hypothyroid? Think of all the children on Ritalin (?!) who could benefit from simply treating the hypothyroidism with a small amount of a natural thyroid hormone replacement. Mental problems are often traced to hypothyroidism. In a study of hypothyroidism at Georgetown University, results showed an inability to concentrate was prominent in 31% of the patients, forgetfulness in 26%, deafness in 17%, noises in the ears in 8%, and poor muscular coordination in 8%. Undiagnosed hypothyroidism in children often exhibits as - being dull, apathetic in appearance, being less active than normal, having emotional problems, undue fatigue, sleeping longer than others of his/her age, being a slow starter in the morning, having a short attention span, being prone to infections, having lack of self confidence, having difficulty associating with other children, being unable to sit quietly and study. I know children like that. If prospective fathers and/or mothers can have undiagnosed hypothyroidism, babies can be conceived and born with undiagnosed hypothyroidism. It may be sub clinical - not exhibiting as cretinism - but, still hypothyroid. These children may never have their thyroid checked during childhood or adolescence. At some point, the cycle will repeat itself; these children will become full-blown hypothyroid, either as children or later as adults. Actually, the very sad part is that they may NEVER be diagnosed as hypothyroid. They may have various symptoms treated throughout childhood and adulthood and simply pass the disorder on to their next generation. Fortunately, the American Thyroid Association (ATA) and the endocrinology community has now come around to the position that there is a potential for an adverse outcome when a mother has sub clinical hypothyroidism and when a mother has thyroid auto antibodies. Experts are actually saying that even mild hypothyroidism can cause serious problems with the pregnancy, including premature birth or lower IQ in the baby.

Before discussing detection and treatment, I'd like to point out a few more disorders that often have overt or sub clinical hypothyroidism as a basis. Are you aware that -

Smokers have increased risk of hypothyroidism. Thiocyanate adversely affects the thyroid and nicotine hinders the conversion of T4 to T3.

Hypothyroidism increases the risk of high cholesterol, heart disease, and diabetes (Syndrome X), plus the risk of osteoporosis. A hypothyroid accelerates the rate of bone loss, in addition to decreasing HDL(good) cholesterol and increasing LDL (bad) cholesterol. It slows down metabolism, slows the body's ability to process carbohydrates and the cells ability to absorb blood sugar. It creates physical stress, which raises cortisol levels, which raise insulin levels, which increase weight gain. Hence, the above mentioned Syndrome X.

Hypothyroidism is directly correlated with the formation and increase of mucin (mucopolysaccharides), which is a jelly-like material that attracts and holds water - thereby causing swelling. Studies have shown a high level of these compounds in the skin of hypothyroid patients and a reduction almost immediately after the start of thyroid therapy. Lupus, rheumatoid arthritis, progressive systemic sclerosis, polymyositis, amyloiditis, necrotizing arteritis, and rheumatic fever are all associated with the deposition of mucopolysaccharides in connective tissue and other tissue. Thyroid therapy has been shown to be helpful in treating many of these disorders.

Thyroid deficiency is prevalent in anemia. Studies show that a subnormal temperature, which is characteristic of low thyroid function, can contribute to anemia by its effect on blood cell production in the bone marrow. People with hypothyroidism often become anemic because of hypothermia. Most red blood cells are made in the bone marrow located in the proximal portion of the long bones of the body, because that is where temperature is highest. However, when the body temperature drops, even these areas have difficulty producing red blood cells, even in the presence of sufficient iron and vitamins. On examination, the red blood cells are found to be normal in size, shape and hemoglobin concentration. There simply are not enough of them. Anemia contributes to fatigue.

In addition to causing dry skin, a hypo thyroid can lead to acne - in part because circulation is reduced and the skin does not get the blood supply it needs. Skin cells are deprived of oxygen, and the waste products are not removed. Untreated hypothyroidism is often found to be a cause of psoriasis and eczema. Boils and carbuncles are also known to be related to hypothyroid conditions.

People on beta-blockers for cardiac problems or hypertension are often found to be hypothyroid.

Patients on chemotherapy are often hypothyroid. These chemicals (interferon, interleukin, tamoxifen, mitotane) inhibit the production of the thyroid hormone. Combine chemo with radiation and the risks are much higher. Actually, upon postulating, virally originated cancers could have undiagnosed hypothyroidism as the basis. Remember, viruses and bacteria flourish in subnormal body temperatures. Hypothyroidism has been found to contribute to the cancer process.

In cases of hypothyroidism, estrogen dominance is often present. Estrogen is a known growth hormone and is implicated in all hormonal cancers.

In addition to being a major contributor to atherosclerosis, thyroid deficiency also tends to reduce the strength of the heartbeat. The amount of blood pumped out to the body is reduced with each beat, often by as much as 40%.

Bone healing is delayed in hypothyroid conditions.

"Winter itch" - itching over the extremities, especially the lower parts of the arms and legs, has been associated with hypothyroidism. Blood circulation through the skin is less than normal when hypothyroid, but is reduced even further in cold weather since at that time, more blood is shifted away from the skin to the interior of the body to preserve body heat. More thyroid hormone is needed in cold weather to step up the body's burning of fuel required to combat cold.

Studies have found a strong link between hypothyroidism and depression. Depression associated with hypothyroidism is partially or fully relieved with sufficient thyroid hormone treatment, resulting in getting the TSH down to the range of .5 to 1.75. Hypothyroidism has been found to slow the thought process, producing depression and sometimes hallucinations, delusions and even paranoia. In adulthood, a change in personality or depression, fatigue, uncharacteristic irritability or a change in sleep pattern should raise a suspicion of thyroid dysfunction.

Clinical studies have shown that men and women suffering from multiple sclerosis have low serum T3 concentrations coexisting with normal T4 levels which may indicate changed peripheral conversion pathway of thyroid hormones. Thyroid dysfunction is common in people with MS - both hyper - and hypo-thyroidism. Antithyroid antibodies have also been found in people with MS. Many autoimmune disorders are related to underlying thyroid disease.

There are many articulate researchers who have discovered a definite link between hypothyroidism and fibromyalgia/chronic fatigue. They have found that taking synthetic T4 does not result in the alleviation of symptoms. The only therapy that works effectively has been suppressive doses of natural thyroid hormone. If you are a thyroid patient who has signs and symptoms of fibromyalgia, you should consider being evaluated by a practitioner with expertise in the condition, whether it's a holistic or complementary MD, an internist or rheumatologist. And, if you are a fibromyalgia patient, it's also worth digging somewhat deeper to determine if you have an underlying thyroid problem that may be contributing to - or even causing - your fibromyalgia symptoms.

Researchers have found that it is highly beneficial to have the thyroid routinely checked as part of a physical exam. The third generation TSH test now being used is known to be very sensitive. However, MDs need to be aware of the new normal values that have been set down (.3 - 2.5). Also, the TSH does not indicate what is going on with the thyroid at a more cellular level. Underlying hypothyroidism can occur when there is peripheral cellular resistance to thyroid hormone or impaired T4 to T3 conversion. People with cellular resistance may have perfectly normal circulating thyroid levels yet have signs and symptoms of hypothyroidism. Thyroid hormone resistance is usually the problem when serum T4 and T3 levels vary from just above to several fold above the upper limit of normal while the TSH is normal. (This condition is often found in people with fibromyalgia and chronic fatigue). Therefore, it is of great importance that Free T3, Free T4, Reverse T3, and anti-thyroid antibody tests be performed. If the TSH is good (.3 - 1.9) and free T4 is high, but free T3 is low, that may signify a conversion problem (the liver, kidneys, and other tissues do not properly convert inactive T4 to active T3). Also, if rT3 is high, this signifies that T4 is being converted to rT3 (which is not active) instead of the active T3. Events found to be associated with alterations in the peripheral conversion of thyroid hormones (decreased T3 and increased rT3) are: aging, burns/thermal injury, caloric restriction and fasting, chemical exposure, cold exposure, chronic alcohol intake, insulin-dependent diabetes, liver disease, kidney disease, severe illness, severe injury, stress of any kind, surgery, toxic metal exposure, and/or estrogen administration(oral HRT results in an increase in thyroxine binding globulin which binds to thyroid hormone and causes it to be inactive). A TSH above 1.0 is not good for many people, women, especially, due to hormone imbalances. They may still feel bad and have many hypothyroid symptoms. Actually, it has been found that, in many instances, a TSH above 2.0 is representative of a failing thyroid. Some MDs continue to order total T3 and T4; these are not found to be beneficial- nor are the thyroid uptake tests.

Many researchers have determined that the best way to uncover a hypothyroid condition is by checking the basal temperature. It is recommended that you take your temperature under the arm first thing in the morning Ė without much movement - for 10 minutes. Record this for 5-7 days in a row. Menopausal women and men can take their temperature any day. Women of child-bearing age need to take it beginning on day two or three of their menstrual cycle, due to hormonal fluctuations. Some holistic clinicians feel that a more optimal method might be by taking an oral temperature every 3 hours, 3 times a day, 3 hours after you wake up - then adding them all together and dividing by 3 to get the average basal temperature. This should also be done 5-7 days in a row, as above. If the temperature is below 97.5, then, hypothyroidism should be suspected. Either method should give you an indication. THEN, it may be a good idea to have the thyroid tests done.

Once a diagnosis of hypothyroidism has been made, it is important for your health and well-being to be given the correct replacement and in sufficient doses. Most, if not all, conventional MDs routinely prescribe Synthroid. This may be fine for some hypothyroids, but, in many it has been found to very unproductive in terms of quality of life. T3, triiodothyronine, is the active thyroid hormone, and it is produced (mainly in the liver) from thyroxine. The female liver is less efficient than the male liver in producing T3, as is the female thyroid gland. The thyroid gland, which normally produces some T3, will decrease its production in the presence of increased thyroxine. Therefore, thyroxine often acts as a "thyroid anti-hormone", especially in women. In people who are seriously hypothyroid, it can suppress their oxidative metabolism even more. It's a very common, but serious, mistake to call thyroxine "the thyroid hormone".

Natural, desiccated porcine (pig) thyroid had been used since the 1800's. Synthetic hormones have been used for about 50 years. We are constantly being told by MDs or product literature that synthetics are better due to controlled dosage and therefore effectiveness. We are also told that natural thyroid hormone is substandard because it is impossible to control the dosage. Due to several lawsuits brought against Synthroid for misleading marketing, alongside such statements from the FDA as "no currently marketed orally administered levothyroxine sodium product has been shown to demonstrate consistent potency and stability and, thus, no currently marketed orally administered levothyroxine sodium product is generally recognized as safe and effective", conditions have finally allowed for the resurfacing of natural thyroid hormone as a safe, effective and consistent treatment for thyroid disease. Natural desiccated porcine thyroid contains T1, T2, T3 and T4, which is very comprehensive support for an ailing thyroid gland. It is not going to be turned away by the immune system of the body, and is ready to be used and will adequately survive any barriers of digestion. T3, being the active and therefore most important hormone, can immediately go to work, leaving an ample supply of T4 to attempt conversion into T3. Synthetic hormones only contain T4 (as Levothyroxine Sodium) - the inactive thyroid hormone, which needs to be converted to T3 to be of any use. Unlike itís synthetic counterparts, natural thyroid has never been recalled for dosage inconsistencies or any other reason. The three most prominent natural thyroid replacements are Armour, Westhroid, and Naturethroid, which are all made from freshly excised and promptly frozen porcine glands. They are chemically assayed in many ways (not just US?). Levels of T3 and T4 must always be within a very narrow margin - if they are not then the batch will be discarded. FDA regulations require consistent content of thyroid hormone. There are minor differences between each of the three, and that basically is in their binding ingredients. Westhroid and Naturethroid are identical, however, Naturethroid is bound with microcrystalline cellulose making it hypoallergenic and suitable for patients with food allergies. Westhroid is bound more traditionally with cornstarch. The company which now owns the Armour name and manufactures "Armour thyroid USP" has recently added a polymer to the formula. This may account for the claims about its apparent inactivity. Some people have found that the tablets passed through their intestine undigested, so, it may be advisable to crush or chew the tablets before swallowing. Synthroid is bound with cornstarch and also contains - as a filler - talc.

2009 UPDATE:
As anyone who has taken Naturethroid or any other desiccated thyroid hormone replacement knows, in 2009, most of those products were either taken off the market or were simply unavailable. My family and my doctor dealt with the problem as best we could, but, eventually, we had to switch from Naturethroid to "the synthetics". This was not an easy process, and once again, I was blessed to have a physician willing to work with us on the conversion and dosage.

The conversion tables for Naturethroid to levothyroxine and triiodothyronine were confusing. One source stated that 1 grain of Naturethroid equaled 100mcg of T4 and 25mcg of T3. However, another source stated that 1 grain of Naturethroid equaled 38mcg of T4 and 9mcg of T3. We opted to convert based on the lower amounts. At first, due to the extremely high price of brand name Synthroid and Cytomel, my doctor decided to prescribe generic levothyroxine and liothyronine. After several months, recurrence of many symptoms, and extensive research on generic versus brand-name, we were changed from generic liothyronine to brand name Cytomel. In my additional research, I found that the generic T3 is not only inferior, but, the dosage is known to fluctuate between 20% more and 20% less than the prescribed dosage. I'm sure that this is the reason my family and I reacted badly to the generic. After being put on brand-specific Cytomel ( which is much more expensive) and generic levothyroxine, we are all back to normal and even - and I hate to admit to this - better than we were on Naturethroid.

That was about 2 years ago, and we are all faring quite well on the doses of the lower conversion tables.

According to the New England Journal of Medicine 1999, patients with hypothyroidism show greater improvements in mood and brain function if they receive treatment with Armour thyroid rather than Synthroid (thyroxine). The researchers found that substituting Armour thyroid for Synthroid in treating hypothyroidism led to improvements in mood and in neuropsychological functioning. Not all tissues that need thyroid hormone are equally able to convert thyroxine to triiodothyronine, the active form of the hormone. But most patients with hypothyroidism (reduced thyroid function) are treated only with thyroxine. On 6 of 17 measures of mood and cognition -- a catchall term that refers to language, learning and memory -- the patients scored better after receiving Armour thyroid than after receiving Synthroid. No score was better after Synthroid than after combination treatment. The authors also detected biochemical evidence that thyroid hormone action was greater after treatment with Armour thyroid. The patients who were on Armour thyroid had significantly higher serum concentrations of sex hormone-binding globulin.

The American Thyroid Association once made a statement that there was no evidence that desiccated thyroid has any advantage over synthetic thyroxine. Their statement should have actually read that: there is no evidence in the form of published, peer-reviewed, double-blind studies that desiccated thyroid has any advantages over synthetic thryoxine. Because if you ask the hundreds of thousands of patients who have switched from synthetic thyroxine to desiccated thyroid and find it the optimal thyroid replacement for them -- along with the doctors who prescribed it for them -- they can provide volumes of anecdotal "evidence" of superiority in terms of quality of life and improved health. What was not mentioned is that the American Thyroid Association (ATA), as well as many of its members, have long enjoyed a close financial relationship with the manufacturers of Synthroid, the top-selling levothyroxine drug, and one of the top-selling drugs in the U.S. Abbott Labs, the current manufacturer of Synthroid, has, for example, been a major sponsor of the American Thyroid Associationís annual meeting, and according to their website, was a sponsor of the event in 2001, 2002, and 2003. Synthroid's manufacturer is also the key funding source for many endocrinologists who receive hefty financial support for everything from their patient literature to attendance at meetings in resort locations and funding for research projects.

Dosage and frequency are both very important when considering natural, desiccated thyroid. It is not taken in the same "once a day" dosage as Synthroid. Due to the short half-life of T3, it is necessary to take the replacement in divided dosages and always on an empty stomach, if possible. Protein, calcium and iron are all known to interfere with the absorption of the hormone. The most beneficial strategy is to take the first dose in the morning an hour before breakfast. Then, take the second dose 10-12 hours later, about two hours before your evening meal. Keep in mind, though, it's not set in stone. It is known to be a very forgiving hormone. As long as you're able to keep to a good time schedule, if it's not entirely on an empty stomach, at least it's being taken on time. Having said all of that, concerning desiccated thyroid hormone replacement, there are also some guidelines for taking a combination of levothyroxine and Cytomel. Any replacement levothyroxine, whether it is from desiccated thyroid or synthetic, needs to be taken on an empty stomach, and, in most cases, first thing in the morning. Therefore, at least one hour before breakfast or two hours after, take your entire prescribed dose of T4. At the same time, take one-half of your prescribed dose of T3 (Cytomel). Six to ten hours later, you should take the other half of your prescribed dose of T3. T3 (Cytomel) is the more potent, stronger of the two replacement hormones. It has been found, and I, personally can attest to it, that it is best to take the second dose of T3 before 3PM due to it's energizing effect in most people. My personal schedule, since I am an early riser, is to take my T4 and half Cytomel around 3AM. Then, I take my second dose of Cytomel around 9:30AM. With the 6 to 8 hour half life of Cytomel, this schedule allows me to be able to relax and be ready for sleep between 7PM and 8PM most nights. It's also very important to always start taking desiccated thyroid replacement at the very lowest dosage. This would be taking 1/4 grain two times a day. If, after taking that dose for two to three weeks, improvement in not noticed, then, the dosage would need to be increased for another two to three weeks. This slow titration of dosages will ensure the most adequate dose with no side effects or hyperthyroid reaction from overdosage. Of course, this all needs to be accomplished with the help of a patient, supportive physician. I have been blessed with such a physician. As long as I didn't endanger my health, he went along with whatever therapy I wanted to try. I knew, after all my studies and research, that natural thyroid was the way I wanted to go. He worked very carefully with me in titrating my dosage up to the point where I felt close to perfect and my cholesterol was in a very good range. However, Iím always one to experiment with myself. I asked my MD to switch me from natural thyroid with it's 4:1 ratio of T4 to T3 to levothyroxine and sustained release T3 in a 10:1 ratio. Within 3 months, my cholesterol soared dangerously high, my T3 dropped, and my TSH went up. My skin got very papery and my hair started coming out by the handfuls again. I immediately switched back to the natural thyroid and, in about six months, things finally got back to normal. I didn't need to be titrated to an effective dosage of levothyroxine and Cytomel since we simply used the conversion table. However, I DO recommend that anyone who is not already taking replacement thyroid hormones and is interested in having their physician start them on generic T4 and Cytomel, always start at the very lowest dose of both hormones in the 4:1 ratio mentioned and work up very slowly. In the beginning, we were having bloodwork every 3 months to monitor the levels. As the results got closer to what our physician wanted, we would go 6 months between tests.

In ending this discussion, it is a good idea to mention things to be aware of concerning your thyroid and things that may help to support it. Some alternative physicians place a lot of emphasis on the adverse affects of chlorine and fluoride in the water supply, toothpaste and other sources on the thyroid gland. The rationale is that both chlorine and fluoride are very near iodine on the periodic chart and can therefore chemically interfere with iodine metabolism. As a preventive measure it makes sense to filter water to remove these chemicals and to avoid exposure from other sources. Along these same lines, keep in mind that - despite it's promotion as a supreme antioxidant - green tea (and black tea) needs to be avoided. In the plant world, the green tea plant is known to pull the highest amount of fluoride from the soil. It doesnít make any difference whether it is natural fluoride, or not. Fluoride is toxic to the thyroid. That alone outweighs any benefits of green tea. In addition to chemical and environmental factors, thyroid function can be depressed by imbalances in other endocrine glands. Increased insulin levels from sugar-handling stress can depress thyroid function and increase cortisol levels. Increased cortisol levels caused by all forms of stress can depress thyroid function as well. Hypoadrenia or adrenal exhaustion often precedes or occurs with a hypothyroid state. To correct hypothyroidism by addressing the cause, one must engage in an effective stress reduction strategy, correct sugar-handling stress and provide adrenal support. Deep diaphragmatic breathing (abdominal) is known to be beneficial for stress and anxiety while supporting the thyroid. Doing a shoulder stand (yoga position) for 2 minutes a day can gently stimulate the thyroid gland. Exercise such as walking or resistance training is also found to be beneficial. There are many herbs that have been found to enhance, optimize or tone the thyroid gland. Some of them are: fo ti, saw palmetto, bladderwrack, ashwaganda, guggul, iris versicolor, and black cohosh. Supplements such as vitamin E, selenonethionine, B complex, zinc, omega 3, magnesium, and L-tyrosine aid in the conversion and production of thyroid hormone. In the case of selenomethionine - it is known to decrease thyroid peroxidase antibodies, which would be beneficial in Hashimoto's thyroiditis. Always keep in mind, however, that there is a fine line between hypothyroidism and hyperthyroidism. In this case, it's not good to experiment on yourself. Seek the advice of a holistic MD, or other knowledgeable health care practitioner.

Nutritionally, it has been found - as indicated in a publication of the National Academy of Sciences (National Academy Press, The Role of Protein and Amino Acids in Sustaining and Enhancing Performance, 1999) - that when too little protein, or the wrong kind of protein, is eaten, there is a stress reaction, with thyroid suppression. Many of the people who don't respond to a thyroid supplement are simply not eating enough good protein. The quality of most vegetable protein (especially beans and nuts) is so low that it hardly functions as protein. Soy is not to be regarded as a source of protein. As mentioned earlier, soy is toxic to the thyroid and should not be eaten in any form by anyone. (This includes components of soy such as genistein and daidzein often promoted as a beneficial supplement for menopause. IT IS NOT!) Eggs and some cheeses are beneficial, as long as they are organic. It is important that you donít fast for prolonged periods or drastically cut calories. Both of these situations will put you in a hypometabolic condition.

Additional situations that may affect thyroid hormones are:

It is known and has been found by researchers over the last 100 years in this country and Japan that there are inherant genetic risk factors,or tendencies, to health disorders and illness. The research has been based on biochemical individuality or metabolic differences. Thyroid disorders are included in those genetic risks. It is very important to not downplay these risks. The information could very well offer a means to preventative therapies.

No matter how it has been decided to adjust your thyroid, it is always important to be aware of any symptoms that may indicate HYPERthyroidism. These may include feeling warm, anxiety, diarrhea, rapid heartbeat, unexplained weight loss,and/or palpitations. These feelings may signal too high a dose, or the wrong type of hormone replacement. Keep in mind, also, that a therapy that works for one person, does not necessarily work for all persons. Some people may do fine on long-term T4 therapy alone, while others find that symptoms return after months or years. Others do very well on natural desiccated thyroid, twice a day - while still others find their symptoms returning after a period of time. Thyroid hormone replacement is very individualized. There is no magic bullet.

There may be some who disagree with the information I've given. Keep in mind, I've studied and researched always from a holistic perspective. This information comes from those sources in addition to personal and professional experience. Anecdotal evidence is very important, in my opinion. I would much rather know of repeated experiences by humans than choreographed, clinical "studies" where components of foods or nutrients or herbs are studied instead of the whole food or plant with all it's natural components. It's like comparing apples to oranges, if you think about it. This also includes natural thyroid, in my opinion. It contains many thyroid hormone components which may all have benefits in relieving symptoms and restoring health, well-being, and quality of life for many sufferers.

Sue Bondzeleske, BS, CNC, HHP

Please email me if you have any questions.

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