Hypothyroidism: Is It Possible or Probable? Part 2

Let's pick up where we left off last time. We were looking at how a doctor decides to make a diagnosis of hypothyroidism by gathering information from research articles. This happens despite the fact that doctors are not very qualified to analyze the quality of the study from which they are gathering the information. Just as many people take a blind leap of faith in their doctor, your doctor is a taking a blind leap of faith in the research team that performed and published the study.

So how can you feel comfortable that a doctor can make a diagnosis with a high confidence of probability? By following some very fundamental rules of making a diagnosis:

1. The human body is a closed, contiguous system. Everything has some effect on everything else. Though an easier route to take, you should not look at individual parts of the whole (concentrating on a "problem thyroid gland" instead of looking at how the thyroid gland is affected by other parts, as well it affects other parts).
2. A single physical exam finding, lab test, symptom, etc. means nothing on its own. Gathering all the pertinent information will develop a better picture of what is truly going on in the person (making a diagnosis on a low TSH without correlating it with other findings is diagnosing from possibility, not probability).
3. Most people don't follow the textbook. Doctor's study disease processes (pathology) and are looking for a certain presentation that a person with a certain disease "should" have. This is rarely the case. Most people have only portions of what they "should" have according to their diagnosis, along with some extra findings that don't exactly fit the mold.

If your doctor always keeps these things in mind, s/he will turn over more rocks to uncover significant findings, relate it back to the entire person and piece them together to come up with the answer to the most important question of them all..."So what's your story?"

Once your doctor knows "your story," they can make their diagnosis from a standpoint of probabilities.

One final note: I said last post that I was going to making things more clear, while I kind of rambled on without giving an example. I promise to be behave and make it all a little more simple in Part 3.

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Hypothyroidism: Is It Possible or Probable? Part 1

So, you think you have hypothyroidism? You feel sluggish, you can't drop that body fat, your joints ache, your hair is thinning and you're depressed and anxious. You almost hope that you have a thyroid problem so you can get a quick fix.

You cruise by your trusted doctor to see what s/he thinks...could it "possibly" be hypothyroidism? A better question would be is it "probable" that you have hypothyroidism.

Before hearing the verdict, it is best to know how your doctor thinks so you know how to interpret their interpretation of their physical, history and lab testing.

Doctors think in terms of possibilities and probabilities and they get their numbers to make certain calls from research articles (and their own experience). If an article claims that 80% of the subjects demonstrated X if Y happened, that gives doctors a pretty good sign to tell someone that it is probable that X is there because Y happened (as long it was a well performed study, with a significant amount of participants, variables controlled, replicated several times in other research studies and the authors had no financial gain to have an outcome one way or the other...so see if a drug company is paying for the study or not).

If the study had less than 50% of the participants demonstrating X if Y happened, then the doctor will say that there is a possibility that you have X because Y happened.

So how good are doctors at statistics? The studies done on how good a doctor is at understanding the statistics of a research paper shows that they score very, very poor. But aren't research papers the very place where doctors learn when to make a correct diagnosis?

Oops.

While the general public might not know this, drug companies certainly do. They have been known to stop research that does not have favorable outcomes for them, as well as play games with the numbers to make it look better than it really is. Do you think the doctor would read the 20 pages of statistical data or the 2 paragraph conclusion at the end that has whatever the author wants to pull out of the numbers as s/he wants? This is called trolling, since the author goes trolling through the numbers to pick out what they want.

So how can you and your doctor do better than just guessing? By collecting and comparing all the pertinent information and making a good clinical judgment. This means not just running labs and relying on them as the end all be all. Doctors should get a full history, perform a full exam, and then order test to help fill in the blanks. You should be documenting changes that you noticed before, during and after treatment to relay back to the doctor.

This way any judgments that are going to be made on possibilities and/or probabilities will be compared to other pertinent findings, making them more accurate.

In Part 2 of Hypothyroidism: Is It Possible or Probable, I will clear this up a little better.

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If You Want to Lose Weight, Don't Be a One Trick Pony

So many lunges, crunches and the better half of your day on that treadmill. You ask your doctor, you ask your trainer, you ask anyone that will listen..."Why can't I lose the weight?" Everyone seems to have an opinion, but most of them revolve around the same premises. Workout harder/longer and eat less?

Maybe you've tried that and it didn't work. Maybe running marathons daily on an empty stomach doesn't fit with your goal of losing weight in a healthy way.

When it comes to your body, there is no one solution for any problem. So to say the best way to lose weight is to _________, you are really underestimating the complexity of human physiology.

The people that I have helped reach their health goal (in this case losing body fat), understand that there are many different ways to achieve their goal. When it comes to the human body, doing more variables is better than doing more of one single thing.

Your thyroid gland (your metabolic regulator) is a perfect example of this. Your thyroid gland responds differently to different stimuli, and can influence the way other parts of your work.

Here's an example. You are trying to stay healthy and get your goal of 100 ounces of water per day (I am happy so far). To meet this goal, you fill up a large plastic bottle and make sure it is done by the end of the day. You have to leave it in your car during the day because of work, so it gets a little heated up. You don't care about drinking some hot water if it will help you lose weight.

While you are doing this one thing right (drinking plenty of water), you are not doing everything right.

First problem: If you are filling up straight out of the tap, you are getting more than just water. 2 sides that come with your watery meal is chloride and fluoride (both halogens). In your body, these similar structures compete with other similar structures (like iodide) to bind with other structures. Iodine/iodide are important part of the formations and utilization of thyroid hormone, or the hormone responsible for your metabolism. You would be better served if you either drank spring water, or had some sort of filtration device.

Second problem: The plastic bottle that you are using can leech off chemicals that are very similar in chemical makeup of estrogen. Estrogens and their stunt doubles are fat soluble, and can build up in large amounts if you are storing excess fat. The more there is in the body by either taking in too much, storing too much, or not eliminating enough, the more likely that they will bind to thyroid hormones (because estrogens increases thyroid binding globulins, or TBGs) at a level that slowly catches up to you and causes problems. Definitely get your bottle out of the car, since heat really leeches off those estrogen mimickers. Better yet, use a glass bottle. Problem solved.

In order to get the best results, you should have a complete strategy that really emphasizes a lot of the little things. You will see your efforts go much further than killing yourself by doing one or 2 things (which may even hurt you in the long run).

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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.

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Hypothyroidism: I Blame It On My Glandular Disorder

Remember what your 4th grade teacher told you about assuming things? You make an.... well, you remember.

Many people with hypothyroidism are treated by assuming that their thyroid gland is not working good enough, that is why the are overweight, losing hair, losing their memory, in pain and/or depressed. The solution is to give a little exrta hormone to help out that lazy gland.

Many people with hypothyroidism have that exact problem. Many more do not. Almost all are treated the same.

There are those that have a perfectly good thyroid gland, it's just not being stimulated to release enough hormone.

There are those that are releasing enough thyroid hormone, but the hormone isn't getting used very efficiently.

There are those that don't have enough nutritional substrate to make enough thyroid hormone.

There are those that have some sort of thyroid autoimmune disorder that can be triggered from something in the environment causing problems to the gland.

And then there are those that have a mixture of the above.

The people that are getting the best results aren't assuming, they are getting to the bottom of their problem and taking action.

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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.

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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:

1. It's not a thyroid problem.
2. 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
3. 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.

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