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| Hair Trace Elements and Hypothyroidism |
David L. Watts, Ph.D., Director of Research
Trace Elements, Inc.
As a Clinical Psychologist and Licensed
Nutritional Consultant, Dr. Malter has a unique and keen insight into the
psychophysiology of stress and its reflection in TMA patterns. His
experience of using TMA for evaluating the mind/body interaction spans over
20 years. An excellent point is raised by his commentary, in that a majority
of people experiencing physical and emotional problems falls outside the
"medical/disease" model. They can be classified as having sub-clinical
conditions, i.e. falling within the normal medical ranges, but experiencing
real physical and emotional symptoms. This is particularly true in relation
to thyroid dysfunction.
As Dr. Malter mentioned we often see patients with many of the classic
symptoms of hypothyroidism, particularly depression, yet their thyroid
function may show no clinical abnormality according to the "medical/disease"
model. The TMA can often provide insight into their subclinical conditions.
|
Occurrence of Hypothyroidism |
It has been estimated by Barnes, et al,
that 40 percent of the American population suffers from hypothyroidism and
is the most common complaint seen by doctors in this country.(1) This
estimation was made over 25 years ago and if we include subclinical
hypothyroidism we can conservatively raise this estimation to over 50
percent. Severe clinical hypothyroidism is readily evident from blood tests,
however subclinical thyroid insufficiency is not easily detected through
normal tests. I have described subclinical hypothyroidism as a syndrome
rather than a disease and is characterized by fatigue, depression, cold
sensitivity weight gain and changes in the texture of the hair and skin.
Thyroid insufficiency affects females at a greater frequency than males.
From our database of over 2000 patients submitted with hypothyroid
predominate symptoms, 90 percent were females. The reason for this gender
difference has been discussed elsewhere and will not be reviewed here.(2)
|
Nutrition and the Thyroid |
Iodine
There are a number of nutrients that affect the thyroid. The most recognized being iodine. Iodine deficiency is associated with endemic colloid goiter a condition that occurred in areas of low iodine soils prior to its prevention with the introduction of iodized salt. Idiopathic nontoxic goiter is identical to endemic goiter but is not associated with iodine. In fact, iodides can actually reduce all thyroid gland activities by inhibiting thyrotropin possibly by inhibiting the hypothalamus. Reduced thyroid activity is often seen even in the presence of normal iodine levels.(3),(4) A great deal of emphasis is placed upon iodine in assessing thyroid status, but there are many other factors that are important.
Iron and Vitamin A
Iron and vitamin A deficiencies are prevalent in areas of endemic goiter, although, iodine intake is adequate. It is now recognized that the response to iodine therapy is ineffective in the presence of iron deficiency. Iron is required for the conversion L-phenylalanine to L-tyrosine and may be reduced by over 50 percent with iron deficiency. Many patients with hypothyroidism respond to vitamin A therapy.(5)
Selenium, Zinc and Chromium
Selenium deficiency can contribute to
hypothyroidism due to its involvement in the conversion of T4 to active T3.
Selenium is a constituent of the enzyme 1 iodothyronine deiodinase (IDI) an
enzyme responsible for the peripheral conversion of T4 to T3 in the liver
and kidneys. This enzyme is markedly reduced in selenium deficiency.(6)
Zinc influences the secretion of thyroid stimulating hormone (TSH).
Therefore, zinc deficiency or a low zinc to copper (Zn/Cu) ratio can be
involved in lowered thyroid expression.
A number of research studies have found an interaction between chromium and
thyroid activity. The mechanism is not yet understood, however this
association may be explained through TMA patterns.(7)
|
Thyroid Antagonists |
Nutritional
Goitrogens are naturally occuring
anti-thyroid substances found in foods that adversely affect the thyroid.
These are commonly known foods and therefore will not be discussed here.
Other nutritional factors known to inhibit thyroid function include:
(Calcium, Vitamin D, Cobalt (B12), PABA, Molybdenum, Bromine, Copper,
Lithium, Lead and Mercury)
Endocrine
Hormones antagonistic to the thyroid, include: (Estrogen, Insulin, Parathyroid)
Drugs
Medications That Reduce Systemic Thyroid Expression.(8)
| DRUG | USAGE | TRADE NAME |
| Sodium nitroprusside | Anti-Hypertensive | Nipride |
| Phenytoin | Anti-Seizure | Dilantin |
| Carbamazepin | Anti-Convulsive | Tegretol |
| Fluoxetine | Anti-Depressant | Prozac |
| Phenobarbitol | Anti-Seizure, Sedative | |
| Valproic Acid | Anti-Seizure |
TMA Patterns Associated with Decreased Thyroid Expression
The most common metabolic type indicating diminished
thyroid activity in TMA patterns is the Slow Metabolic Type 1. This
neuroendocrine pattern indicates parasympathetic dominance. The primary TMA
ratios found with reduced thyroid activity include:
Elevated Ca/P (> 2.63)
Elevated Ca/K (> 4.2)
Elevated Ca/Mg (>7)
Reduced Zn/Cu (<8)
Reduced Fe/Cu (< 0.9)
Reduced Na/Mg (< 4)
Reduced K/Co (<2000)
Reduced K/Li (< 2500)
Reduced Ca/Pb (<84)
Reduced Fe/Pb (< 4.4)
Reduced Fe/Hg (<22)
Reduced Se/Hg (<0.8)
Reduced Zn/Cd (<500)
Reduced Zn/Hg (< 200)
Elevation of the Ca/Mg ratio indicates a relative increase in parathyroid
hormone as well as insulin production. A reduced Zn/Cu ratio indicates a
reduction in progesterone relative to estrogen in the female. The
relationship of chromium and thyroid activity could be explained by
chromium's effect upon insulin sensitivity. Reducing insulin levels would
result in improved thyroid hormone activity. The increased cellular immune
response common in the Slow Metabolic type could contribute to thyroid
disorders due to an autoimmune response.
The greater the numbers of the above mineral ratios present in a TMA
profile, the stronger the tendency toward reduced thyroid expression. It
should also be noted that these ratios would be reversed in hyperthyroid
conditions.
Psychophysiology of Thyroid Disorders - Brain Hypothyroidism
The relationship between thyroid dysfunction and
psychiatric disorders has been recognized for over a century and described
in cases of myxedema and cretinism. Depression is one of the major symptoms
accompanying hypothyroidism. However, other conditions associated with
hypothyroidism accompanying mood disorders include:(8)
Fatigue
Constipation
Loss of Appetite
Excessive Sleep Pattern
Poor Memory
Weight Gain
Cognitive Defects
Decreased Sex Drive
Reduced Interest
Poor Concentration
Reduced Sense of Pleasure
Fatigue is the most common physical symptom associated with depression and
results from a diminished thyroid function. The basal metabolic rate of a
person with hypothyroidism can be reduced as much as 40-50 percent below
normal. It is therefore not difficult to understand the relationship between
thyroid status and the health energy continuum.
The thyroid has a significant role in regulating central nervous system
(CNS) development and function, and is known to affect cerebral metabolism
in adults.9 Thyroid hormones regulate brain functions via its interaction
with the catecholaminergic system and affects synaptic levels of
norepinephrine uptake and its receptors. In most patients suffering from
depression, the serum levels of TSH, T4 and T3 are within the normal range.
However, even with a normal systemic thyroid status, a patient may actually
be suffering from "Brain Hypothyroidism".(10),(11) Reduced cerebral thyroid
expression could therefore, contribute to a host of psychological symptoms.
This would explain why many patients with psychiatric conditions respond
well to thyroid support, since there are extensive T3 receptors in the
brain. The effectiveness of serotonin reuptake inhibitors (SSRI) such as
ProzacÆ may be effective in some patients due to the drug's effect of
increasing the availability of T3 in the brain. Conversely, thyroid hormone
increases the brain content of serotonin.(8)
Conclusion
Meng stated that "In the majority of cases, the
symptoms of hypothyroidism develop slowly and as a result, they often are
not recognized or are misjudged for a long time. In the case of subclinical
hypothyroidism, an indication for treatment does not exist in all patients.
In cases of doubt, therapy can be initiated and discontinued after 6-12
months when there is no therapeutic effect."(12)
Early treatment of patients with physical and psychological symptoms of
hypothyroidism may help in preventing progression to an overt hypothyroid
condition. TMA can provide insight to individual thyroid status and aid in
modifying diet and nutritional intake to prevent the long-term and chronic
conditions associated with hypothyroidism. Therapy can aid not only in
depression but in other thyroid related conditions as well, including,
musculoskeletal disorders, fibromyalgia, chronic fatigue, cardiovascular
disorders,(13),(14) diabetes (15),(16) and conditions associated with auto
immune responses.
References:
1. Barnes, B. et al.
Hypothyroidism: The Unsuspected Illness. Harper and Roe Pub. N.Y., 1976
2. Watts, DL. The Nutritional Relationships of the Thyroid. J. Orthomol.
Med. 4,3, 1989.
3. Mu, L. et al. Endemic Goitre in Central China Caused by Excessive Iodine
Intake. Lancet, Vol. II, 1987.
4. Zimmermann, M., et al. Persistence of Goiter Despite Oral Iodine
Supplementation in Goitrous Children with iron deficiency anemia in Cote
d'lvoire. Am.J.Clin. Nutr. 71, 2000.
5. Beard, JL. et.al. Impaired Thermoregulation and Thyroid Function in
Iron-Deficiency Anemia. Am.J.Clin.Nutr. 52, 1990.
6. Essential Trace Elements and Thyroid Hormones. Lancet, Vol. 339, 1972.
7. Interaction of Chromium with Insulin: A Progress Report. Nutr. Rev. 56,6,
1998.
8. Hennessey, JV., et al. The Interface Between Thyroid Hormones and
Psychiatry. The Endocrinol. 6,3, 1996.
9. Smith, CD, Ain, KB. Brain Metabolism in Hypothyroidism Studied with 31P
Magnetic-Resonance Spectroscopy. Lancet 345, 1995.
10. Jackson, IMD, Whybrow, PC. The Relationship Between Psychiatric
Disorders and thyroid dysfunction. Thyroid Update 9, 1995.
11. Bauer, MS, Whybrow, PC. Thyroid Hormones and the Central Nervous System
in Affective Illness: Interactions That May Have Clinical Significance.
Interg. Psychiatry 6, 1988.
12. Meng, W. Diagnosis and Therapy of Hypothyroidism in Adulthood. Z Arztl.
Fortbild. 90,1, 1996.
13. Perk, M, O'Neill, BJ. The Effect of Thyroid Hormone Therapy on
Angiographic Coronary Disease Progression. Canadian J. Cardiol. 13, 1997.
14. Kinlaw, WB. Thyroid Disorders and Cholesterol: Identifying the Realm of
Clinical Relevance. The Endocrinol. 5,2, 1995.
15. Gray, RS, et al. Hypercholesterolemia in Diabetes with Clinically
Unrecognized Primary Thyroid Failure. Horm. Metab. Res. 13, 1981.
16. Danforth, E. The Role of Thyroid Hormones and Insulin in the Regulation
of Energy Metabolism. Am.J. of Clin. Nutr. 38, 1983.
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