Archive for Nov 2008

11.21.08

The Two Major Problems with Thyroid Hormone Treatment

The two major problems with conventional medical treatment present themselves to my office on a regular basis.
1. Patients are on the wrong type of thyroid hormone.
2. Patients are not taking an adequate amount that relieves them of the clinical signs and symptoms of their hypothyroidism.

Let’s address the first problem. The typical type of thyroid hormone that is prescribed is synthetic levothyroxin or T4, most commonly Synthroid®. In fact, Synthroid® is the third most commonly prescribed medication of all medications. This form of thyroid hormone has some problems for many patients. Levothyroxine or T4 is not the active form of thyroid hormone; it is merely a prohormone. The T4 must be converted into the active form of thyroid hormone called T3 or liothyronine or triiodothyronine. This conversion process is not always possible for many patients and they never achieve results from the medication they are taking. I have also seen patients with actual toxic responses to the synthetic T4 they are taking including rashes and severe headaches. Unconverted T4 is toxic to the system.

Natural desiccated thyroid hormone such as Armour® or Nature Throid® is a far more complete product that most people do much better taking. Desiccated thyroid hormone medication is derived from USP (United States Pharmacopoeia) porcine, or pig, sources. It has been successfully treating hypothyroid patients for about 100 years. This medication naturally contains all active and inactive forms of thyroid hormone including T4, T3, and the more inert forms T2, and T1. It also contains small amounts of calcitonin, which is a hormone naturally found in the thyroid gland that regulates calcium metabolism by keeping calcium in the bones and out of the blood. This form of thyroid hormone would inevitably contain things that we have yet discovered or understand. Nature has a way of providing a complement of things that are far beyond the basic understanding of science.

The argument by many physicians against the use of desiccated thyroid hormone medications stems from the incessant need to prescribe a synthetic hormone that is perceived as “more stable” and “more superior” than a natural product. Both of these arguments are patently false. Sources of desiccated thyroid such as Armour® and Nature Throid® are FDA regulated to achieve a particular potency in each batch. And the superiority of natural thyroid speaks loud and clear by the overwhelming majority of patients whose symptoms are largely relieved from a whole product. This is not unlike the marketing that used to take place regarding the “superiority” of infant formula versus breast milk. In fact, many women who still breast-fed were looked upon as being uninformed of the “science.” This, of course, has been proving incorrect. There was no manufactured formula that could possibly compete with the natural known and unknown beneficial components of breast milk.

The second problem regarding the treatment of hypothyroidism is the actual dose of thyroid hormone used. Too often, patients are woefully under treated by thyroid hormone doses that are too low to provide complete symptomatic relief of their hypothyroidism. It is not uncommon to see this with patients on synthetic T4, but I have even seen patients on natural desiccated thyroid hormone who still suffer from the symptoms of hypothyroidism. This is one reason why patients will think that the natural form of thyroid hormone medication “did not work” for them. They were prescribed the desiccated thyroid hormone but were kept on doses that too low for relief. The medication gets the blame when it was actually the doctor who was wielding the medication who should get the blame. So, why is this happening?

The main reason why patients are left on inadequate thyroid hormone doses is because of the laboratory analysis that is used to determine a particular dose. Enter, the TSH, or Thyroid Stimulating Hormone. Patients always tell me that they were left on a particular dose of thyroid hormone medication because their doctor said their “labs were great” or “my TSH was normal” even though their clinical signs and symptoms of hypothyroidism were not. The clinical approach to changing a dose of thyroid hormone should be based on the clinical response of the patient’s body tissues to that particular thyroid hormone dose. The TSH simply does not necessarily tell a doctor what is going on with a patient’s body’s response to their thyroid hormone medication. The clinician must learn to be just that…a clinician, and listen to the subtle nuances of the patient. This of course takes time and effort that most conventional doctors cannot afford nor have the specific training to do.

At Iluminar, the individual patient is considered and an in depth clinical process of determining a patient’s cellular response to a dose of thyroid hormone is considered. Some of these clinical assessment tools include the basal body temperature, a thorough tracking of the known clinical signs and symptoms a patient is experiencing, Achilles tendon reflex, and an advanced Basal Metabolic Rate (BMR) machine that determines the metabolic rate as it relates to the thyroid hormone dose used.

Contact us now to find out how you can achieve superior results for your Metabolic Health.

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11.19.08

Fibromyalgia: The Elusive Hypometabolic Disease

This controversial condition was first recognized by the American Medical Association as recently as 1987. It is defined by the presence of disperse body pain and tenderness with often debilitating fatigue and depression. It is currently a condition that is ineffectively treated and at times even ignored. Despite being present in approximately 2% of the general population, many patients still find proper diagnosis and treatment elusive.

The diffuse pain of fibromyalgia is identified as a series of painful points on the body called trigger points. A doctor, such as a rheumatologist, makes the diagnosis of fibromyalgia based on the presence of 11 of 18 specific trigger points that elicit pain when pressed. The diagnosis also includes six months or more of persistent related signs and symptoms. Another significant complaint is extreme fatigue. Fibromyalgia is often found in conjunction with a diagnosis of “chronic fatigue.” Fibromyalgia may also result in sleep disturbance, weight gain, skin complaints, and irritable bowel syndrome, to name a few. Cognitive dysfunction is evident by anxiety, depression, and a common “brain fog” referred to as “fibro fog.” Symptoms are extremely varied in intensity but often render the patient handicapped by interfering with normal daily activities. Doctors often have difficulty in agreeing on a diagnosis for fibromyalgia due to a lack of significant supportive laboratory evidence. Due to fibromyalgia’s nonspecific presentation, it is often considered a diagnosis of exclusion or a diagnosis made when no other disease pathology is found.

Fibromyalgia’s wide spread effects and most doctor’s inability to properly assess related laboratory evidence, makes it necessary to identify the underlying cause to effectively treat this complicated disease. At the core of fibromyalgia lies either undiagnosed or poorly treated hypothyroidism or “resistance” to what thyroid hormone is present in the body. “Thyroid hormone resistance’ means the body cells cannot use the thyroid hormone effectively even though adequate thyroid hormone levels are present. It is similar to Type II Diabetes, or “Insulin resistance”, where insulin is present in adequate amounts but is unable to do its job effectively, resulting in elevated sugar levels. Clinical evaluation includes assessing the patient’s symptoms and the symptoms of fibromyalgia almost perfectly match the clinical presentation of hypothyroidism. When a doctor knows how to properly assess the patient’s metabolic and endocrine functioning, which is almost invariably low in patients with fibromyalgia, a diagnosis and course of effective treatment become possible.

Hypometabolism can only be determined through analysis of blood thyroid hormone levels (beyond what is often done conventionally), measuring basal metabolic rates, assessing nutritional status, and by thorough clinical examinations of medical history, and symptoms and signs. This type of thorough examination is often by-passed by physicians because they inappropriately rely on a simple blood test that measures the TSH (Thyroid Stimulating Hormone) level. It is this mainstream practice of relying on a TSH reading alone to evaluate thyroid function that has resulted in many patients inaccurately being dismissed by their physician as having “normal” thyroid function, whether they are diagnosed as hypothyroid with concomitant treatment or not.

When undergoing proper metabolic evaluation and treatment, the patient must use a holistic metabolism-raising approach that includes thyroid hormone replacement, diet modifications and nutritional support, exercise, mental and emotional support, soft tissue manipulative medicine, and when medically appropriate, avoidance of metabolism lowering medications such as pain medications and antidepressants. It is through appropriate hormonal support coupled with a holistic, comprehensive approach, that the patient achieves full body recovery.

Many fibromyalgia patients are already being treated for hypothyroidism with thyroid hormone medication in the form of inactive T4, most commonly Synthroid® or synthetic levothyroxine. If a patient finds that they are already being treated for hypothyroidism, they should not be satisfied with the use of a thyroid product containing only T4. Most hypothyroid or fibromyalgia patients will not recover if their thyroid hormone treatment includes the use of a T4-only product. Most patients find greater success on a product containing the active form of thyroid hormone called T3. A common thyroid hormone medication that has decades of successful treatment is natural desiccated thyroid such as Armour® thyroid or Naturethroid®. At times, plain synthetic T3 is necessary for fibromyalgia patients to achieve full recovery.

Fibromyalgia, although presently considered an incurable condition, has the potential to be effectively controlled. Focusing treatment on the underlying cause of the hypometabolism, rather than attempting to dissect the condition into seemingly unrelated symptoms with ineffective drug therapy, will help ensure successful and permanent results. Patients and physicians must understand that fibromyalgia is ultimately a hypometabolic condition dependant on diminished thyroid hormone levels or a resistance to the hormone that is present. Fibromyalgia patients must remain hopeful and understand that the condition can be treated effectively if the hypometabolic state is properly addressed.

For more information contact Dr. Bosch by email at [email protected]

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