Untreated thyroid disease affects thousands of women. For some it destroys their life. Feeling cold and exhausted diminishes the quality of your life. Women feel sick. Despite these symptoms, doctors often say “your labs are normal”. The untreated thyroid disease and the rejection is for many women a slap in the face. Why this is happening and how to get help is the subject of this blog. You will see why traditional medicine is unable to help women with thyroid disease. You will find out that help is within reach.
I am cold and Exhausted.
She sat there on a summer day in a wool coat, her face haggard and drawn from exhaustion, telling me how she had no energy, was steadily getting fatter, and felt cold no matter how many layers of clothes she wore. She retired early because she had difficulty functioning on the job. Gina couldn’t remember things and her brain worked so slowly that she felt like she was under water slogging her way through each day. She had seen 8 doctors over 5 years without relief. I knew what the problem was before any lab results were back. When I told her, she looked stunned. I knew right away that she had untreated thyroid disease.
This is a story I have heard over and over since starting my restorative medicine practice. Why does this happen? There are an estimated 20 million Americans with untreated thyroid problems. They occur far more often in women than in men. Yet, untreated thyroid disease is one of the most commonly misdiagnosed and mistreated health problems in America.
What is the trouble with a conventional approach to thyroid problems?
Gina’s doctor ordered the usual thyroid tests which didn’t effectively show whether her thyroid was working well. After ordering the test, they interpreted the results in a knee-jerk fashion by seeing that her results were in “the normal range.” The “normal range” is a spread from low to high of where 95% of the population’s thyroid levels are. Most of the patients I see are somewhere in the normal range but not at the best level to feel good.
Here’s how it works. When your lab results are ready, the doctor has his/her staff send you a message that “everything is normal.” The low thyroid levels go untreated. You’re crushed by this information because you feel awful and know in your heart that something is wrong, but it never shows up on testing, like Gina and her story above.
Why is the thyroid gland so important?
Your thyroid gland governs your metabolism, which is your body’s equivalent to your car engine. If your engine is sluggish, you move slowly. The speed of your engine runs affects how your body functions. Every cell in your body is under the influence of the thyroid gland. The speed of the chemical processes in your body depends on instructions from your thyroid gland.
The less active your thyroid gland, the more sluggish your body. Protein production slows down. Finger and toenails become brittle. Your hair is dry, your skin flakes. This sluggishness can affect your intestine and cause chronic constipation. Untreated thyroid affects the brain. It is harder to think. Everything slows down. Your energy decreases. You may feel like you are moving slowing and through a very thick liquid because everything is so difficult. Weight gain is out of control. No matter what you do—diet restriction or exercising—you continue to gain weight. The thyroid is the master regulator of your metabolic engine. When you metabolism slows down from an untreated thyroid, your body and mind suffer.
What about thyroid testing?
This is the subject of a lot of confusion and so a lot of thyroid problems are going untreated. While doctors seem stuck in an old paradigm, patients are suffering. So, let’s take an expanded view of thyroid testing.
T3 is your accelerator.
T3 (triiodothyronine) is your active thyroid hormone. It is like putting your foot on the accelerator. The more T3, the faster you go. T3 has cellular receptors (a place to act) in every cell in your body. This means it can put the foot on the accelerator in every single cell. Your regular doctor rarely orders this test. But when it is, I’ve seen, nothing is done about it when it is low. Thyroid disease goes untreated.
Low T3 has been linked to chronic fatigue.1 At the Sklar Center, we want to see levels in the optimal range, where you feel and function your best, not just somewhere in the “normal” range. It is the key to understanding your metabolism. When it is low, everything slows down. It is the most accurate and direct gauge of the speed of your engine.
T4 is your reservoir.
T4 (thyroxine) is an inactive thyroid hormone. Its only role is turn into T3. It is an available reservoir of hormone for when your body needs more T3. This is the hormone that your conventional doctor tests. If you have problems making T3 from T4, your T4 level can look fine even when you feel like you are exhausted. Using the T4 as the gauge of your thyroid health is misleading and, unfortunately, this results in an untreated thyroid problem. Doctors routinely do this.
Is TSH a good measure of thyroid function?
TSH (thyroid stimulating hormone) is the most commonly ordered thyroid test by your conventional medical doctor. The brain produces TSH. TSH regulates the thyroid gland. Again, like T4, it is an indirect test and does not show a low functioning thyroid gland much of the time. TSH levels go down with age so they are an even worse predictor of thyroid health in older people. Using this as the main test for thyroid activity is woefully misleading, but that’s usually what’s done. 2 This almost always results in you thyroid problem be ignored and untreated.
Reverse T3 puts on the breaks.
Thyroid’s Twin, Reverse T3. Reverse T3 is another thyroid hormone that we have not mentioned. It is the mirror image of T3. In the world of biological reactions this means that it can take up the place of T3, but it isn’t going to cause the metabolic changes we want to see. It is isn’t going to put the foot on the accelerator. It does exactly the opposite. It puts the breaks on. Reverse T3 can be the root cause of thyroid disease which goes untreated.
Reverse T3 is useful during times of famine when we need to slow down body processes to conserve energy. Most of the time, we are not in a famine situation and Reverse T3 levels rise for other reasons. Reverse T3 levels rise when we become stressed and produce high cortisol levels. Levels also rise when we lack certain nutrients like selenium and iodine. The result of a high Reverse T3 is that we can have any or all the symptoms of low thyroid and still have normal T3 thyroid blood testing.
What does this mean for patients?
So, in Gina’s case, Doctors did not order the proper test for truly evaluating thyroid function. Her doctors only ever ordered free T4 levels and they were normal despite her extreme symptoms. They should have tested for the free T3 to accurately assess whether the accelerator was working in her engine. Sometimes doctors do order Free T3, but then interpret it as being in the normal range. Often, they don’t understand where the level needs to be for a person to feel well and function properly. So even when patients have pressured their unwilling doctors to order the free T3, usually the results come back “in the normal range”. And patients are disappointed that they don’t qualify for treatment in the opinion of their doctor. Even with the right testing their thyroid disease is still untreated.
What is the functional medicine approach to thyroid treatment?
In the few times that your tests are outside the reference ranges, conventional doctors do diagnose low thyroid function. However, the medications that are prescribed restore only one of your thyroid hormones, T4. These are the pharmaceutical products know as levothyroxine, Levoxyl ™, or Synthroid. ™ . Once you are treated with one of these medications, your conventional doctor will use the TSH test to guide your treatment. Unfortunately, TSH is known to be a poor guide to restoring your thyroid hormone adequately. So, millions of people are suffering with low thyroid symptoms and are being told everything is normal and there is no more treatment to be done.
What’s the history behind doing this?
For many years, porcine thyroid, derived from pig’s thyroid glands was processed and formed into tablets for humans to use. It worked very well and was used for many years starting in the 1930’s. It contains T3 as well as T4 and some other minor thyroid hormones. It was the main thyroid replacement used until the development of Synthroid™ which is synthetic T4. By some sleight of hand and aggressive marketing, Synthroid became the biggest selling thyroid medication.3
The makers of Synthroid marketed their product as a superior one to doctors even though it, like Armour thyroid, had been grandfathered in by the Food and Drug Administration since it had never met regulatory standards. A study of effectiveness of Synthroid was finally published in the Journal of the American Medical Association after being suppressed for many years by the makers of Synthroid TM. It showed that Synthroid was no more effective or consistent than other T4 preparations.4 By then most doctors had converted from Armour thyroid to Synthroid thinking it was a more modern treatment. The use of Armour thyroid was thought to be “old fashioned” and fell out of favor to the detriment of the public. 5
Relief is here at last!
As expected, Gina’s Free T3 was one of the lowest levels I had ever seen. When I showed her the results on her lab test, she began to cry—tears of anger that no one over the course of five years had figured out her problem—and tears of relief that finally she could feel better.
We started Gina on a low dose of Armour thyroid while further evaluating probable causes of low thyroid function. Within the first month of treating her thyroid, her energy improved, and she no longer needed to wear a wool coat to keep warm. Eventually, her brain worked better, and she was even able to go back to school for retraining. Gina knew that she would enjoy her retirement.
https://www.sklarcenter.com/wp-content/uploads/2019/09/adrenal.jpg14142121Dr. Susan Sklarhttps://drsklar.wpengine.com/wp-content/uploads/2018/09/Banner.jpgDr. Susan Sklar2019-09-10 16:37:312019-09-10 16:45:19Adrenal Fatigue Symptoms and Treatment: Tired All the Time
https://www.sklarcenter.com/wp-content/uploads/2019/09/Cold-woman-in-coat-thyroid-blog.jpg10241024Dr. Susan Sklarhttps://drsklar.wpengine.com/wp-content/uploads/2018/09/Banner.jpgDr. Susan Sklar2019-09-04 16:04:362019-09-14 06:02:07DO YOU FEEL COLD, FAT, AND EXHAUSTED?
https://drsklar.wpengine.com/wp-content/uploads/2018/09/Banner.jpg00Dr. Susan Sklarhttps://drsklar.wpengine.com/wp-content/uploads/2018/09/Banner.jpgDr. Susan Sklar2019-08-27 19:31:212019-09-13 18:13:42Tired All the Time?