Thyroid dysfunction was recognized more than 100 years ago. A lack of thyroid hormone (hypothyroidism) is more common than an excess condition (hyperthyroidism).
Symptoms of Hypothyroidism include but are not limited to:
The standard laboratory tests for diagnosing thyroid dysfunction are:
The non-conventional methods for diagnosing hypothyroidism include:
Basal Body Temperature: There are two schools of thought as regards basal body temperature. The traditional school of thought developed by Dr. Broda Barnes advises taking the temperatures first thing in the morning. The newer school of thought advises taking the temperature at intervals during the day. I often ask patients to do it both ways.
Dr. Broda Barnes method:
Dr. Bruce Rind’s Method:
Body temperature as a means of diagnosing under activity of the thyroid is controversial. It should be used in the context of a patient history, physical exam and laboratory testing.
A second method for looking at thyroid function that is out side main stream medical practice is The 24 Hour Urine Collection for Free T3 and Free T4. This is the test favored by the Belgian endocrinologist Dr. Thierry Hertoghe. He argues that a 24-hour collection gives a more accurate picture of the persons’ thyroid hormone production than a spot serum measurement.
Remember, testing combined with history and physical exam is needed to make a diagnosis.
There are several issues regarding treatment of functional hypothyroidism.
Factors that may lead to Functional Hypothyroidism include:
This list is daunting but consideration of these issues may be important in dealing with a person with a refractory problem.
Thyroid Hormone Treatment Strategies:
The conventional medicine approach uses a synthetic T4. For many people this is perfectly adequate.
The advocates of the Dr. Broda Barnes method think that the animal glandular extract is a better form of replacement. They argue that the products in the extract provide a balanced supplementation that is more like our own natural glandular production. Many people feel better, (more energetic) with this form of supplementation. There is no objective evidence in the medical literature that one form is better than another.
There was an approach advocated by Dr. Denis Wilson. He argued that the problem is the over production of a product called reverse T3. Excess reverse T3 blocks the thyroid receptors and inhibits production of regular T3. He used escalating doses of slow-release T3 to shut down the persons own thyroid production and to reduce and halt the production of reverse T3. He then tapers the slow-release T3 and allows the persons own thyroid production to take over. His approach is intriguing. It has been beneficial for many patients. It has made other patients very ill. Its safety is not well established. It is unproven by any scientific observational process. It is difficult for patients to adhere to the regimen. It is not a technique I recommend.
There are a group of clinicians who have observed that patients with the problem of “low metabolism” have a dominant symptom of fatigue and general low energy. They have difficulty accomplishing the daily activities of their lives. There are many possible causes for this phenomenon including chronic infections, intoxications, chronic stress, endocrine disorders and other chronic diseases. The belief is that these underlying problems can create thyroid and or adrenal dysfunction or insufficiency. These clinicians have observed differences in patient history, physical exam and laboratory testing based on whether the individual has a problem that is predominately thyroid, adrenal or mixed. Most importantly, they have observed that patients with functional adrenal insufficiency do not respond to thyroid hormone either clinically or in terms of an improvement of their basal body temperature. This has led him to a therapeutic process that addresses this sub group of patients. I believe his approach may have merit.
Therapy must be individualized. Monitoring on a regular basis is essential. Many patients do very well with T4 (levothyroxine). Others need a combination of T4 plus T3 (cytomel or Nature Thyroid). Others do well with the glandular extract (thyroid extract by Armour).
Functional thyroid hormone therapy should be done with consideration of the interaction with other endocrine function such as adrenal function (Cortisone and DHEA) and pituitary function (growth hormone). Please review these issues in the other chapters of this section.