The Thyroid Gland
     

 


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Thyroid Conditions

Any condition that causes malfunction of the thyroid gland results in thyroid disease. The thyroid gland is an important gland that lies at the front of the neck, just below the Adam’s apple. The gland stores 90 per cent of the body’s iodine, which it uses to produce the hormones thyroxine (T4) and tri-iodothyronine (T3). These hormones act on almost all the tissues and organs of the body to:

  • stimulate the growth of the developing child, and especially growth of the brain,

  • increase the metabolic rate of the body (the rate at which energy is consumed).



Hypodthyrodisim

The classic medical model states hypothyroidism in adults is almost always caused by an autoimmune disease (called Hashimoto’s disease), in which the body’s immune system reacts against the thyroid gland. The damaged gland is unable to produce normal amounts of T3 and T4. This type of thyroid disease is much more common in women than in men. But as you read below you'll see the model is out dated.

A recent study showed that nearly 13 million Americans may be unaware of and undiagnosed for their thyroid conditions. Are you one of them? Another study showed that if you are a pregnant woman and you have a low thyroid your child's IQ will be affected. Yet another recent study showed that if you an elderly woman with thyroid problems you will have an increased risk of heart disease

The big myth that persists regarding thyroid diagnosis is that an elevated TSH (thyroid stimulating hormone) level is always required before a diagnosis of hypothyroidism can be made. Normally, the pituitary gland will secrete TSH in response to a low thyroid hormone level. Thus an elevated TSH level would typically suggest an underactive thyroid.

Click here to read an interview with Mary Shomon, the Thyroid guide from About.com.

Hyperthyrodisim

When the human body is exposed to excessive amounts of thyroid hormone the result is a disease known as hyperthyroidism (or thyrotoxicosis). The most common cause of hyperthyroidism is Graves' disease, named after the Irish physician Robert J. Graves, who was among the first to describe it. It is noteworthy that hyperthyroidism is at least seven times more common in women than in men, although the reasons for this are poorly understood. Because there is a complex, hereditary tendency for the production of thyroid autoantibodies, it is not rare for Graves' disease to occur in many family members.

Some people with Grave’s disease develop enlarged thyroid glands called goiters, and although the thyroid gland may continue to produce T3 and T4 normally, excess production in these goiters can lead to hyperthyroidism. Cancer of the thyroid, of which there are various types, does not usually cause hyperthyroidism.

Hyperthyroidism typically begins with a gradual onset of a constellation of symptoms, including increased nervousness and emotional instability associated with a fine tremor of the hands. The patient feels warm, perspires freely, and is intolerant of heat since a greater proportion of the body's energy is dissipated as heat. The pulse races, the heart thumps, and the systolic element of the blood pressure is elevated. In severe cases of hyperthyroidism, heart failure may occur. The drive to physical overactivity is dampened by increasing weakness and easy fatigue. Bowel movements may be normal, but they are often punctuated by bouts of diarrhea. Menstrual periods may become scant or may disappear entirely. Perhaps most striking is the apparent paradox of an increase in appetite associated with a loss of weight, the result of the fact that the excess of thyroid hormones leads to an increased metabolism. There is often, but not always, a swelling in the neck, and the physician's fingers may often detect the outline of an enlarged thyroid gland.

Enlargement of the thyroid gland

Goiters are benign (not cancerous) enlargements of the gland. They may occur as a result of iodine deficiency, autoimmune disease or quite normally during pregnancy. Other swellings of the gland may be caused by benign cysts or cancer in the gland. The majority of thyroid enlargements are not malignant.
 

Thyroid disease can result in either an underactive gland, with a reduced output of T3 and T4 (hypothyroidism) or an overactive gland (hyperthyroidism). Rarely, hypothyroidism can occur from birth if the gland has failed to develop. Because a fully functioning thyroid gland is required for normal development of the brain, any reduction in function (for example as a result of iodine deficiency) can cause mental retardation. Adults may develop hypothyroidism from dietary iodine deficiency, although this is rare because iodine is added to salt, breads and cereals to prevent deficiency.

The most common causes of thyroid malfunction are as follows:

1) Increased exposure to the cold especially without properly clothing the extremities will via the hypothalamus and pituitary cause an increase in thyroid hormone output which over time can overwork the thyroid thus leading to dysfunction.

2) Various strong emotional states can also affect TSH and thus cause thyroid hormone output to change. If this emotional state isn’t properly dealt with, thyroid dysfunction will eventually result. Other causes of pituitary dysfunction (see the pituitary) can cause thyroid disturbances secondary to pituitary malfunction. In these cases the pituitary must be restored to normal function for the thyroid to be also restored.

3) Nerve pressure at the mid cervical spine can cause thyroid dysfunction. I have seen time after time in patients of mine involved in car accidents with resultant whiplash and cervical nerve dysfunction, that they will go into a state of hypothyroidism and put on 10-30 pounds over the next 3-4 months.

4) If you suffer from hypoadrenia (see the adrenals), the thyroid will often slow down to decrease your metabolic rate and give the adrenals a chance to rest.

5) Because of the thyroid’s effect on insulin secretion, prolonged intake of refined carbohydrates and sweets can cause the overtaxing of your thyroid gland and lead to dysfunction. Our bodies were not designed to handle large amounts of refined products and physiologically we pay the consequences when overindulging.

6) Because of the resultant change in endocrine output taking birth control pills, epinephrine, cortisone, can lead to thyroid dysfunction.

7) Taking synthetic thyroid hormone for an inactive thyroid gland will tend to make your thyroid rely more on this outside source and will thus lead to further inactivity. Take a look at this article which substantiates this.

8) Overeating, especially fats and sugars over prolonged periods will make the body produce more thyroid hormones (to increase fat burning and glucose uptake) than it can comfortably produce. This can lead to hypothyroidism.

9) X-rays striking the thyroid (including dental x-rays) can damage the thyroid.

10) Prolonged intake of vitamin A supplements and also zinc can lead to hypothyroidism.

11) A lack of iodine in the diet can lead to dysfunction.

12) An imbalance in the amount of estrogen in the body (be it due to pituitary, liver, ovary, or adrenal malfunction) can alter thyroid function.

When you look at the various symptoms of a low functioning thyroid, you'll soon see that diagnosis by symptoms is indeed fruitless. However, this long list gives you a good idea that the thyroid can affect many body sytems.

Symptoms of Hypothyroidism

  • The most common is fatigue.

  • Skin can become dry, cold, rough and scaly.

  • Skin problems (such as eczema psoriasis acne and boils)

  • Hair becomes coarse, brittle and grows slowly or may fall out excessively.

  • Sensitivity to cold with feelings of being chilly in rooms of normal temperature.

  • Difficult for a person to sweat and their perspiration may be decreased or even absent even during heavy exercise and hot weather.

  • Constipation that is resistant to magnesium supplementation and other mild laxatives is also another common symptom.

  • Difficulty in losing weight despite rigid adherence to a low grain diet seems to be a common finding especially in women.

  • Depression and muscle weakness

  • mental and physical slowness lethargy

  • memory loss

  • heavy menstrual periods

  • a hoarse voice

  • increased weight

  • allergies

  • anxiety

  • arthritis

  • bleeding gums

  • brittle hair or nails

  • frequent infections

  • headaches or migraines

  • chest pain or heart palpitations

  • intolerance of cold or heat

  • coarse skin

  • colitis

  • collagen disease

  • confusion

  • nervous system changes leading to crawling sensations on the skin

  • high or low sex drive

  • history of heart attacks

  • insomnia

  • iron deficient anemia

  • leakage from the breast

  • listlessness

  • low blood pressure

  • memory loss

  • muscle cramps

  • muscle weakness

  • night blindness

  • obesity

  • poor circulation

  • raised cholesterol levels (not attributed to diet)

  • slow movements

  • slurred speech

  • some hearing disturbances

  • suicidal tendencies

  • swollen ankles

  • urinary symptoms.

Symptoms of Hyperthyroidism

  • racing of the pulse

  • tremor of the hands

  • weight loss despite an increased appetite

  • diarrhea

  • intolerance of heat

  • excessive sweating

  • decreased need for sleep

  • anxiety

  • becoming increasingly emotional

  • Protrusion of the eyes is a striking feature

  • the elevated pulse may be severe enough to progress into an arrhythmia (abnormal rhythm of the heart).

Goiters

Both hypothyroid and hyperthyroid people may have goiters. As some of the nerves of the larynx (voice box) travel through the thyroid, any thyroid swellings can also cause a hoarse voice. The image to the left is a typical goiter.
 

Hypothyrodisim Diagnosis

Your Doctor Does Not Likely Understand How To Interpret Your Tests Properly

Thyroid function tests have always presented doctors with difficulties in their interpretation. Laboratory testing is often misleading due to the complexity and inherent shortcomings of the tests themselves. Many doctors not having an adequate understanding of what the test results mean, will often make incorrect assumptions based on them or interpret them too strictly. A narrow interpretation of thyroid function testing leads to many people not being treated for subclinical hypothyroidism.

Old Laboratory Tests Unreliable

Most all older thyroid function panels include the following:

  • Total T4

  • T3 Uptake and

  • Free Thyroxine Index (FTI).

These tests should be abandoned because they are unreliable as gauges of thyroid function. The most common traditional way to diagnose hypothyroidism is with a TSH that is elevated beyond the normal reference range. For most labs, this is about 4.0 to 4.5. This is thought to reflect the pituitary's sensing of inadequate thyroid hormone levels in the blood which would be consistent with hypothyroidism. There is no question that this will diagnose hypothyroidism, but it is far too insensitive a measure, and the vast majority of patients who have hypothyroidism will be missed.

Key Thyroid Function Tests
Laboratory Values and Interpretation

(Note: These are general values/averages. Lab values can vary somewhat from lab to lab. Always check to find out what the specific normal range is for the test value at YOUR lab.)

Test / Name

Normal Range

Interpretation

"TSH" Test -- Thyroid Stimulating Hormone / Serum thyrotropin 0.4 to 6 Under .4 can indicate possible hyperthyroidism. Over 6 is considered indicative of hypothyroidism. Note: increasing numbers of doctors are finding that a TSH of around 1 - 2 is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. There is now research out that provides some scientific basis for this, saying that values above TSH of 2 may in fact represent abnormal levels. See the British Medical Journal article.
Total T4 / Serum thyroxine 4.5 to 12.5 Less than 4.5 can be indicative of an underfunctioning thyroid when TSH is also elevated. Over 12.5 can indicate hyperthyroidism. Low T4 with low TSH can sometimes indicate a pituitary problem.
Free T4 / Free Thyroxine - FT4 0.7 to 2.0 Less than 0.7 is considered indicative of possible hypothyroidism.
T3 / Serum triiodothyronine 80 to 220 Less than 80 can indicate hypothyroidism.

Basal Body Temperature

The basal body temperature was popularized by the late Broda Barnes, M.D. He found the clinical symptoms and the body temperature to be more reliable than standard laboratory tests. This is clearly better than using the standard tests. However the patient must:

  • Not sleep under electric blankets or water beds as they falsely raise temperature

  • Acquire a sensitive and accurate thermometer

  • Be compliant and do the procedure as instructed

To purchase Hypothyroidism: The Unsuspected Illness by Broda Barnes, click here.

Another Way To Check for Hypothyroidism

This revised method of diagnosing and treating hypothyroidism seems superior to the temperature regulation method promoted by Broda Barnes and many natural medicine physicians. Most patients continue to have classic hypothyroid symptoms because excessive reliance is placed on the TSH. This test is a highly-accurate measure of TSH but not of the height of thyroid hormone levels.

New Range for TSH to Diagnose Hypothyroidism

The basic problem that traditional medicine has with diagnosing hypothyroidism is the so-called "normal range" of TSH is far too high: Many patients with TSH's of greater than 2.0 (not 4.5) have classic symptoms and signs of hypothyroidism (see below).

  • So, if your TSH is above 2.0 there is a strong chance your thyroid gland is not working properly.

Free Thyroid Hormone Levels

One can also use the Free T3 and Free T4 and TSH levels to help one identify how well the thyroid gland is working. Free T3 and Free T4 levels are the only accurate measure of the actual active thyroid hormone levels in the blood.

When one uses free hormone levels one will find that it is relatively common to find the Free T4 and Free T3 hormone levels below normal when TSH is in its normal range, even in the low end of its normal range. When patients with these lab values are treated, one typically finds tremendous improvement in the patient, and a reduction of the classic hypothyroid symptoms.

Secondary or Tertiary Hypothyroidism

There are a significant number of individuals who have a TSH even below the new 1.5 reference range mentioned above, but their Free T3 (and possibly the Free T4 as well) will be below normal. These are cases of secondary or tertiary hypothyroidism, so, TSH alone is not an accurate test of all forms of hypothyroidism, only primary hypothyroidism.

Low Metabolic Energy

Many people suffer a wide variety of symptoms that have one common denominator: low metabolic energy. This most commonly involves two of the "primary players" in the endocrine system - the adrenal and thyroid glands. An excellent article explaining the relationship of these two important glands and how we can diagnose which organ is causing the problem can be found here.

Part 2



  Hypothyroidism - Main Index   NEJM Study Proves Armour Thyroid Better Than Synthroid
  The Thyroid Gland - Anatomy & Function   Thyroid disorder may cause high cholesterol
  Thyroid Disease Far More Widespread Than Originally Thought, 13 Million May Be At Risk   Thyroid Deficiency In Pregnancy Affects Child IQ
  Thyroid Problems Up Heart Attack Risk In Elderly Women   Hypothyroidism - A Comprehensive Look
  Temperature Regulation For Thyroid Testing - The Barnes Basal Temperature Method   Optimum Diagnosis and Treatment of Hypothyroidism With Free T3 and Free T4 Levels
  How To Monitor Your Treatment With Natural Hormone Therapy   An interview with Mary Shomon, the Thyroid guide from About.com
  Hypothyroidism and the Role of Armour Thyroid, Seaweed, Exercise, and More   National Organization of Women, Gray Panthers, and Stop Patient Abuse Now to Take Action Against Pharmaceutical Market Abuses
  Is Synthroid Going to be Pulled Off the Market?   Synthroid Has a Long History of Problems, Says FDA
  Hair Trace Elements and Hypothyroidism   Low Metabolic Energy - The Link Between the Adrenal & Thyroid Glands
  To the Article Index   What YOU can do to help
 


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