Friday, January 1, 2010

What Causes Low Thyroid (Hypothyroidism)? What can we do about it?

Note that the November 14th Natural Wellness Choices newsletter discussed Hypothyroidism and the Limitations of Blood Tests. Today’s newsletter is a follow up which discusses why hypothyroidism is so common and what can be done. DE

A Quick Review:

Hypothyroidism is missed when blood tests alone are used to make the diagnosis

Hypothyroidism can cause or at least contribute to many common, serious medical problems such as:
  • Coronary artery disease
  • Congestive heart failure
  • Chronic fatigue
  • Depression
  • Memory problems
  • Fibromyalgia – painful muscles
  • Attention deficit
  • Chronic or recurrent infections
  • Fertility problems
  • Menstrual irregularities
Hypothyroidism is quite common. Using blood tests alone - approximately 20% of Americans are hypothyroid.

This raises the obvious question - Why is low thyroid so common?

We have an epidemic of low thyroid function because we live in a toxic environment. Some of the causes of hypothyroidism include:

We live with hypothyroidism long enough to have children. Hypothyroidism is commonly inherited.

Estrogen Dominance
Estrogen dominance causes our liver to make more thyroid binding globulin which will make less thyroid hormone available for use in the cells. It also appears to decrease intracellular utilization by impairing the conversion of T4 to T3.

Estrogen dominance may be caused by:
  • age related decline in progesterone production (women & men)
  • birth control pills
  • using real estrogen without balancing it with progesterone
  • estrogenic hormones used in raising livestock
  • exposure to estrogen petrochemicals, plastics, herbicides and pesticides via air, water, food – especially if food or drink is stored and heated in plastic containers
Yeast - Unhealthy GI tracts à abnormal thyroid regulation + autoimmune thyroiditis

We are exposed to a lot of substances which work against a healthy gastro-intestinal tract:
  • Antibiotics
  • Chlorine
  • Fluoride
  • Aspirin and NSAIDS (non-steroidal anti-inflammatory drugs)
Antibiotics primarily lead to the overgrowth of yeast (candida) in our GI tracts via their indiscriminate killing. Not only do antibiotics kill the “bad” bacteria but they wind up killing off the “good” bacteria we need to have in our colon (these good bacteria include Lactobacterium acidophilus). Chlorine and fluoride are also added to municipal tap water and kill the healthy bacteria more readily than fungi and further contribute to yeast overgrowth. Pain relievers like aspirin and NSAIDs are well known for their ability to cause GI tract damage - a “leaky gut” condition. An impaired intestinal barrier combined with the overgrowth of bacteria and fungi allow chemicals to enter the blood stream that appear to be able to damage the hypothalamus and alter thyroid production. Candida also increases autoimmune thyroiditis by disrupting the immune system and causing “friendly fire”

Mercury released from our dental amalgams and fluoride added to our water can lower thyroid function.

Selenium deficiency is related to lack of trace minerals in our soil. The proper conversion of precursors into thyroid hormone depends on a selenium containing enzyme.

Lack of iodine in our soil and diet can lead to decreased thyroid hormone production.

Medical x-rays can harm the thyroid gland (especially x-rays used in dental work and in the neck region).

Perchlorates widely found in drinking water inhibit the production of thyroid hormone by blocking the reuptake of iodine. These are found in California from where we grow much of our produce.

Too much protein in the diet. Dr. Barnes observed than when protein intake is high, the dose of natural thyroid needed to restore normal function increased dramatically. “The China Study” by Dr. T. Colin Campbell shows that the healthiest people eat much less animal products.

Treatment of Hypothyroidism

A comprehensive approach to hypothyroidism includes:
  • Deal positively with stress: exercise, deep breathing, get enough sleep
  • Take Natural Thyroid Supplementations
  • Bioidentical hormone supplementation when needed
  • Iodine (Iodoral) and Selenium supplementation
  • Avoiding tap water – avoid fluoride and chlorine
  • Avoiding “silver” amalgams which are 50% mercury
  • Eat organic
  • Avoid sugar
  • Avoid pesticides, herbicides
  • Never heat food or liquid in plastic; avoid plastic water bottles
  • Avoid antibiotics as much as possible
  • Do a yeast cleanse and take probiotics
  • Detoxify using supplements such as milk thistle, N-acetyl-cysteine, selenium. Far infrared sauna is also useful.
  • Reduce protein intake – eating a Plant Based Diet
Most wellness oriented physicians use desiccated pork thyroid or compounded products which contain the active thyroid hormone known as T3 or triiodothyronine.

Proper dosing of thyroid is critical

Physicians who are new to using natural medicine may try to use the right thyroid supplement (such as desiccated thyroid) but dose it according to the TSH level. This approach will usually result in under dosing. The TSH will fail to reflect cellular thyroid activity if either central regulatory mechanisms or tissue utilization of thyroid are off. Both of these issues appear common and this results in the TSH level becoming low when thyroid is dosed to compensate for less than perfect utilization in our cells. If we think about the thyroid issue from the perspective of the cell (the worksite for thyroid), we can see why the TSH approach is limited -the TSH producing regulation system does not “see” how well the thyroid is used once it is delivered to the cell. We need to look at other ways to "look inside" the cells.

How do we best assess thyroid status?

The best assessment of cellular thyroid activity is obtained by a good history, physical exam and free hormone levels. More information on this topic can be seen on the November posting on the limitation of blood tests

Selected References

JAMA. 2003;290:3195-3196 Effects of Reducing the Upper Limit of Normal TSH Values Vahab Fatourechi; George G. Klee; Stefan K. Grebe; Rebecca S. Bahn; Michael D. Brennan; Ian D. Hay; Bryan McIver; John C. Morris III

NEJM, February 1999, pp. 424-429 Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in Patients with Hypothyroidism Bunevicius, et al.