Understanding and Diagnosing Hypothyroidism
Apr 30, 2016 09:13PM
By Gert Walter
With up to 40 percent of the adult population hypothyroid, and only 10 percent diagnosed, it is important to understand why so many patients seeking medical attention for weight gain, joint pain, feeling cold all the time, chronically being tired, brain fog, dry skin, hair thinning and loss, constipation and much more, are told that their thyroid is functioning normally.
The thyroid gland’s hormone production and control is quite complex, yet often physicians use only the most basic thyroid stimulating hormone (TSH) test which doesn’t really tell the whole story. TSH is actually a pituitary (in the brain) hormone that controls the thyroid gland. In the late 1960s, TSH was the first lab test to be developed that could detect some forms of hypothyroidism. Today, it is still considered by many doctors to be the gold standard, but it does not detect type II or III hypothyroidism.
The thyroid gland itself is near the adam’s apple and makes T4 (thyroxine) which in turn is then converted by enzymes to T3 (triiodothyronine). T3 is the actual active hormone that is responsible for keeping the body’s cells energized and functioning efficiently. Interestingly, people are usually treated with synthetic T4 (synthroid, levothyroxine and others), but T4 is not the active hormone; T3 is. The body doesn’t have any T4 receptors. If the body doesn’t convert T4 to T3 well, or if other steps in the feedback loop are not functioning well, then hypothyroidism will persist. However, the correct answer is not to prescribe T3 alone, as only T4 can cross into the brain, crossing the blood brain barrier. Nature- Throid and Armour Thyroid are two oral pharmaceuticals that contain both T4 and T3 and often do a better job optimizing T3 and making people feel better than just Synthroid.
Normally, T4 and T3 affect the number and activity of mitochondria, the intracellular “batteries” that produce chemical energy. More active mitochondria results in more energy. But even in the normal range, there are wide variations in how much energy is produced and in how people feel. Adjusting thyroid hormone levels from the low end of normal to the upper end can make a huge impact on how someone feels about life.
Iodine is crucial for the functioning of the thyroid. T3 contains three iodines and T4 contains four. In fact, iodine is important for the production of all hormones and helps protect the breasts, prostate and immune system.
Hashimoto’s thyroiditis is an autoimmune disease, where the immune system attacks the thyroid cells. This inflammation often results in an under functioning thyroid gland. Interestingly, 90 percent of people with Hashimoto’s have gluten intolerance. The treatment is the same, with additional adjustment of their diet to minimize gluten. Also iodine and selenium are important.
Hypothyroidism worsens heart disease, weakens the immune system, worsens asthma, increases the chance of getting pneumonia and increases obesity. So even when told your thyroid levels are normal, it is important to ask the doctor what was checked. If it was only the TSH, then find a physician who will investigate more thoroughly, and who is willing to listen to your symptoms. You and your body will thank you by feeling better, and being healthier.
Learn more at an informational workshop from 6-8:30 p.m., May 12, at El Basha, 256 Park Ave., Worcester. For more details, call 978-263-1406 or visit MedicalAestheticsNE.com.
Dr. Gert Walter, M.D., FACEP, is the medical director and co-owner of Medical Aesthetics of New England, PC. 274- 2A Great Rd., Acton. For more details, call 978-496-3121 or visit MedicalAestheticsNE.com.