Time to finish up this segment, but first a quick recap.
It all starts with your doctor's ability to pull out useful information from research and textbooks to know what to look for to make a confident diagnosis of hypothyroidism. They can add to their level of confidence by performing a good history, a full exam and necessary testing. This will give you and your doctors clues to what might be causing it, what to do about it and how to see if things are getting better.
OK, example time.
While there are many different presentations that a person with hypothyroidism can show, we are going to keep it simple here. 3 women all come in with fatigue, stubborn weight loss, painful joints, signs of thinning hair, normal TSH levels and were told that their thyroid was not the problem (as indicated by their lab work). They were given pain meds and told to eat less and exercise more.
All 3 women go for a second opinion, which they get after a good history and full exam were performed.
Woman #1. Her problems started after she gave birth to her first child. She is a long time soy milk drinker, eats microwaved dinners for lunch at work, long time birth control user, irregular menstrual cycles, and states that her breast are tender to the touch.
She might need some hormonal testing. It is "probable" that her issues are stemming from an estrogen imbalance, so steps in reducing any excess exogenous estrogen intake and making sure that her elimination system is working as needed would be a great place to start.
Woman #2. She says that her problems have been a gradual progression. She is a type A personality, gets stressed at work and home and only has time for a coffee for breakfast. She took her last doctor's advice and eats 1200 calorie diet and jogs for 1 hour 5 times per week. She did loose weight according to the scale, but she feels that her belly fat has actually increased.
She might need some testing for stress hormones. These can really limit the ability of the thyroid to produce hormone, as well as for that hormone to be utilized. She would need to make some major life changes (including the diet and exercise program) to better manage levels of stress.
Woman #3. She claims to drink tap water, use fluoride toothpaste, only really eats salads and salmon to try to loose the weight and has dental fillings.
She might need to get testing for heavy metals. These also can disrupt the thyroid and thyroid hormone. Getting rid of the fillings, eliminating outside sources of toxins and ramping her body's detoxification system would be a good start here.
All 3 woman have very different stories, but the same symptoms. While non of them are textbook hypothyroidism, all are suffering from direct and indirect influences causing what should fall under the blanket diagnosis of hypothyroidism (but you can call it whatever you want). Wouldn't it make sense to address those problem areas that are affecting the thyroid? Most treatment programs are geared towards just the thyroid. If you ask me if I think that would work, I would say it is possible, not probable.
To treat every person with the diagnosis of hypothyroidism the same would be a mistake. To rule out thyroid problems because of normal TSH lab test would be a mistake as well. By truly understanding what is going on with the individual, you are truly working from probability instead of possibility.
Saturday, July 19, 2008
Hypothyroidism: Is It Possible or Probable? Part 3
Saturday, March 15, 2008
Hypothyroid Problems: Is There Something in the Air
Do you know anyone that works in the OR? If you do, they can tell you about how useful X-ray is to the surgeon to be able to locate structures of the body. They may also tell you about the lead shielding that they have to wear. It consist of a body apron that goes from your shoulders to your knees and a thyroid shield to protect your thyroid. Too much exposure can cause harm to the organs under the shields.
Imagine trying to figure out that X-ray exposure was bad for you. It's not visible light. If you can't see it, it must not be there, right? That's like dropping your food on the floor, examining it for any visible gunk and eating it if it passes your visual inspection.
So what if there was something else in the air that is bad for you? Do you think it would take a little time to figure out? And when we did figure it out, do you think it would take some time before people accept it and start taking it serious? I do.
We are now pumping so many waves into the air these days that there is actually some problems creeping up. Everyone has a cell phone. More and more places have wireless Internet. These invisible waves are now flooding our friendly skies.
So what does this have to do with your thyroid problems? There is evidence that these waves are causing problems with cells within the human body. There is poor cell signaling, poor detoxification and overall mayhem. The thyroid gland is so dependant on feedback from other parts of your body that it may actually be mimicking a problem with the gland itself.
Treating the thyroid may give some short term relief, but not long term solutions. Adjusting yourself in your environment is going to be your only hope for real success.
Sunday, February 17, 2008
Hypothyroidism: Cause or Effect?
The way health care is set up today, a doctor is of the mindset to find what disease is causing the person to be sick and treat the illness. You target in on the area that explains the problems and treat that. You are no longer Mr. and Mrs. Smith, you are a diabetic, a cancer patient, or a patient with a thyroid disorder.
Alternative practitioners have a slightly different viewpoint. They address the whole person as opposed to parts of the whole. This doctor feels that you can't have a problem in a single area without affecting other areas. They try to treat the person to bring them up to the optimal level of health so that their body can adjust to take care of the problem.
In a person with hypothyroidism, the most popular way to treat the problem is by giving more thyroid hormone. Many people feel better, while some may even get worse.
The flaw in this way of treatment is that it assumes that the problem lies in the thyroid's ability to produce its own thyroid hormone. It ignores the tons of literature that has demonstrated many other causes that has made a person have hypothyroidism. Missing the cause can lead to less than desirable results.
One other point to consider is the hypothryoidism a cause or effect. Most people know that people that have hypothyroidism often times struggle with weight loss. This is usually a sign that helps make the diagnosis. It should also be known that a person that is not active and gains a larger portion of body fat will often times decrease their thyroid production through multiple causes.
What about the cause and effect of taking thyroid hormone medication when your thyroid is functioning as it should? Might this have a negative effect on your thyroid? Might this have a negative effect on other body parts?
There are many that find great relief with medications, and I am not saying to get off them. My point would be to make changes in your life that will help your body help itself. Who knows, you might get to the point that you no longer need medication.
Monday, February 11, 2008
My Armour Thyroid Medication Isn't Working...Try, Try Again?
A question was posted to me if I had ever heard of symptoms of depression getting worse when a trial of Armour Thyroid medication was began. The answer is a resounding YES.
When treating hypothyroid problems, it is very important to make sure to cross all your t's and dot your i's. Before any treatment program is begun, you need to make sure you have measured the appropriate labs and test (meaning thyroid panels and others that indirectly affect the thyroid and thyroid hormone that seem to be playing a role in the case), history and a symptom survey.
If changes in labs and symptoms are favorable, then you are probably on the right trail. If things make no change or get worse, this also tells you valuable information as well.
How about an example:
You come in with normal thyroid labs, low core body temperature, depression, fatigue, unexplained weight gain and chronic pain all over. You begin taking a mix of Armour Thyroid and Synthroid and things get worse.
There are a couple ways of interpreting this pattern:
- It's not a thyroid problem.
- You made need to tweak the amount of thyroid hormone, the % of T3 and the % of T4 in the prescription, and/or change the medication to a different type
- It may not be a problem with lack of thyroid production by your body. It could either be a problem with converting enough thyroid hormone to its useful form, excess thyroid binding structures in your body (binding to already made thyroid hormone, making it useless in the body) or poor binding of thyroid hormone to its receptors.
Going back to a detailed labs, exam, history and presentation, you can piece things together better.
In this example, the normal thyroid panel may lead you to believe that maybe thyroid production is normal. Maybe giving exogenous thyroid hormone isn't the place to start.
A lowered body temperature with depression, fatigue, weight gain and pain still points to a hypothyroid problem, so don't jump ship yet.
This leaves you looking at the third interpretation as your most likely cause. This is where most people are losing their battles. If you fail to look at this as a problem of physiology (how well or poorly your body works) and not just pathology (the body isn't working because of disease), your rate of success will usually be less than optimal.
