Treatment of Hypothyroidism (Low Thyroid Function)

People who have low levels of thyroid hormones experience quite a long list of symptoms because the thyroid hormones direct all the chemical reactions in the body (the metabolism).

Depression
Weight problem
Constipation
Headaches
Brittle nails
Rough or dry skin
Menstrual problems
Infertility
Poor circulation
Diffuse hair loss
Slow speech
Anxiety or panic attacks
Decreased memory
Difficulty concentrating
Muscle or joint pain
Back pain
Morning stiffness
Slow heart rate
Swollen eyelids
Decreased sexual interest
Cold or heat intolerance
Cold hands or feet
Insomnia
Fatigue
Low body temperature
Hoarse or husky voice
muscle weakness
Dry, sparse or coarse hair
Agitation
Carpel Tunnel Syndrome
Drooping eyelids
yellowish skin
Swollen hands or feet

Slow movements
Dull facial expression
Unrefreshing sleep

We can provide missing nutrients that are required for the proper manufacture of thyroid hormones and we can detoxify the body to remove intruders such as heavy metals that are inhibiting their manufacture. Heavy metals also attach to hormone receptors and prevent the hormones from doing their job.

We can identify allergens that contribute to the formation of antibodies.

We can also administer the thyroid hormones themselves. This is often necessary in the first instance to achieve health but is not necessarily a lifelong commitment.

Which thyroid hormones to use

The thyroid hormones are a complex of 4. We call them T1, T2, T3, T4 according to the number of iodine atoms in the hormone.

T4

T4 is the main hormone that the thyroid gland in the lower neck makes. As thyroxine, it is the thyroid hormone that is most commonly prescribed in New Zealand and is funded by the health department. It works well for many hypothyroid people but has to be converted to T3 in order to be fully active. People can be hypothyroid when they do not make much T4 and also when they do not convert T4 to T3 very well. Some people remain unwell and have hypothyroid symptoms even when their blood tests indicate that they are taking enough T4.

T3

Some T3 is made in the thyroid gland but most of it is made in the cells of the body. T3 is also prescribed by doctors but is not funded by the health department so costs more than the subsidised prescription of T4. It is provided by compounding pharmacies.

 

Whole Thyroid Extract

This is desiccated thyroid tissue from pigs. It contains T4, T3, T2 and T1. We know much less about the functions of T1 and T2 which are made in small amounts but studies are showing they do have a role.

May people who do not do so well on T4, feel better on whole thyroid. It is has been described as complimentary medicine and is not funded by the health department but is supplied by compounding pharmacies and can be prescribed by doctors.

The Diagnosis and Monitoring of Hypothyroidism

Blood tests have become the most commonly used way of diagnosing hypothyroidism and monitoring treatment.

However people with hypothyroid symptoms are sometimes told by their doctors after a blood test that their thyroid function is normal when a physical examination would suggest otherwise.

Blood tests are unreliable for several reasons. The levels of thyroid hormones in the blood are not the same as levels inside the cells. For this reason Thyroid Stimulating Hormone (TSH) has become the preferred test for diagnosing hypothyroidism. TSH is made in the pituitary. It tells the thyroid gland to make more thyroid hormone when levels of thyroid hormone inside the pituitary are low.

However TSH is also unreliable because the thyroid hormones cross easily into the pituitary whereas it requires active transport to get them into most other cells of the body. The pituitary can determine that there is plenty of thyroid hormone and it can lower its production of TSH when other parts of the body are deficient and require more hormone to be administered. Therefore a low or normal TSH does not necessarily mean that someone has enough thyroid hormone to be healthy.

While the blood tests are of assistance, they cannot be relied upon to give the final answer. This must come from the full clinical picture: the symptoms of the person, the clinical examination by the doctor and the results of blood test.

Reverse T3

T3 is also made by our bodies in the form of reverse T3 which has the same chemical makeup as T3 but is a different shape and is not able to instruct the cells the way that T3 does. In fact, it competes with T3 for the receptors. Reverse T3 can be measured but this test is not available in New Zealand and not funded. We send blood to Australia to measure it and if the ratio of reverse T3 to proper T3 is too high we treat you with T3 only for a period of time. This prevents you from making reverse T3 from T4.

Treatment of Adrenal Deficiency as well as thyroid deficiency

Successful thyroid treatment relies on adequate adrenal hormones.

1.    Cortisol from the adrenals is necessary to make the thyroid receptors

2.    If cortisol production is poor, then when thyroid hormones are administered the adrenals will spring into action with adequate adrenaline but without the cortisol to balance it and people will feel over stimulated.

Vitamin D

Vitamin D activates the thyroid receptors. Thus a vitamin D deficiency may be a cause of poor thyroid activity even though thyroid hormone levels may be adequate. Toomuch vitamin can cause excess calcium in the blood which can result in porr conversion of T4 to T3.

 Symptoms of thyroid overdosing include:

·       Increased resting pulse rate above 80 beats per minute (when calm & inactive)

·       Irregular heart rate

·       Increased nervousness or irritability

·       Excessive heat production

·       Excessive weight loss with increased appetite

·       Trembling fingers

·       Insomnia

·       Palpitations (awareness of your heart beating)

Note: symptoms that occur 1-2 days after starting or increasing the dose & are mild and are usually a normal adaptation that subsides after 1-2 days.

Problems with a low TSH when taking thyroid hormones

A low TSH may mean that you are taking too much thyroid and that your thyroid hormone needs to be reduced to prevent the problems associated with hyperthyroidism as above - in particular, those on your heart. Low thyroid function can also cause heart problems.

After menopause our estrogen levels plummet and we do not have the same amount of hormonal instruction to keep our bones healthy. In the absence of estrogen TSH plays more of a role. So there is concern that while your thyroid activity can be good with a low TSH your bone mineral density may not be if you are postmenopausal. Before menopause it is not a problem.

Therefore if you are postmenopausal requiring a low TSH for adequate thyroid function you should also be taking the estrogen and progesterone as prescribed by Karanga Health Centre.

If you have osteoporosis extra care must be taken and we may have to compromise thyroid function to protect your bones.

 

 An Holistic Approach

Hormones work by turning on or off certain genes. The genes then instruct the cell to make a protein. 50% of our proteins are enzymes that drive a chemical reaction and this is how the hormones make things happen.

The enzymes are proteins so it is important to have adequate protein in our diets and also to be digesting it well.

The enzymes have cofactors that are necessary for their proper function and these cofactors are mineral and vitamins. Thus it is also necessary to have adequate micronutrients – mineral and vitamins. Many people are not eating a diet that can adequately supply these things and take supplements to make up for it.

 

Reasons for Poor Conversion of T4 to T3

§  Deficiency of Minerals: zinc, selenium, manganese, iron, iodine.

§  Deficiency of Vitamins: A, B2, B6, B12.

§  Medication: Beta blockers, Oral Contraceptives, Lithium, Phenytoin, Theophylline, Chemotherapy.

§  Fluoride, Lead, Mercury, Copper, Calcium excess

§  Pesticides, Dioxins, PCBs, Radiation.

§  Stress, aging, xs alcohol, surgery.

§  Inadequate production of adrenal hormones

§  Diabetes

§  Over supplementation with Alpha lipoic acid.

§  Excessive soy, walnuts, cruciferous vegetables.

§  Low protein, fat or cabohydrate diet.

 

Websites

www.nahypothyroidism.org

This is the website of the National Academy of Hypothyroidism and gives scientific reasons for disputing the orthodox information seen on

www.thyroid.org

The website of the American Thyroid Association

How Karanga Health Was Named

Prior to the opening of Karanga, Tessa Jones was suddenly rendered immobile by muscle spasm in her lower back. Attempts to change this failed until a Maori healer came to visit and used her special powers. She asked Tessa if there was a question she was struggling to answer and Tessa replied that she didn’t know what to call the new health centre. The healer asked her ancestors for advice and they gave the name “Karanga”. Tessa felt honoured by this name but also inadequate and concerned that she might be considered pretentious or disrespectful.

The term Karanga refers to the exchange of calls that occur between Maori women when visitors are welcomed to a marae. It pays tribute to the departed and introduces the reason for the visit. The healer said that Tessa was calling people to come for their health and that it seemed appropriate.

The healing was successful but Tessa remained in awe of the name until a week or so later when she was at the wedding of a friend and the guest next to her whispered that the ceremony was like a Karanga.

Treatment of Estrogen & Progesterone Deficiencies in Postmenopausal Women

HRT has been found to increase the risk of breast cancer and some other unwanted problems. Bio-identical Hormone Supplementation (BHS) does not do this and the following 2 articles from medical journals present the evidence for this.

 

The Bioidentical Hormone Debate by Dr Kent Holtorf MD

 

The Effects of Compounded Boidentical Transdermal Hormone Therapy on Haemostatic, Inflammatory, Immune Factors; Cardiovascular Biomarkers; Quality of Life Measures; and Health Outcomes in Perimenopausal and Postmenopausal Women by Dr Kenna Stephenson MD, FAAFP et al.

 

The first article looks at the scientific studies and concludes that the physiological data and clinical outcomes demonstrate that bio-identical hormones are associated with lower risks including risks for breast cancer and cardiovascular disease. He also concludes that they work better than their synthetic and animal-derived counterparts.

The second article looked at 75 women and measured their hormones and blood for indicators of inflammation and clotting. They also asked them questions about their quality of life with respect to mood, energy etc. They then gave the women Estrogen, Progesterone, testosterone and DHEA in a human-identical form mimicking our natural physiology. The quality of life scores improved as did their blood markers for disease.

Estrogen deficiency can cause the following symptoms:

·       Fatigue

·       Depression

·       Poor libido

·       Poor memory

·       Hot flushes (fluctuating Estrogen levels)

·       Droopy breasts

·       Irregular periods

·       Light or absent periods

·       Uncomfortable intercourse due to poor lubrication

·       Decreased vitality of vulva & vaginal area

·       Recurrent bladder infections

·       Stress incontinence

·       Joint stiffness & discomfort

·       Dry eyes & mouth

·       Small sharp wrinkles above upper lip & corner of eyes

 

Estrogen deficiency is associated with the development of these health conditions:
Infertility, premature aging, osteoporosis, cardiovascular disease, Alzheimer’s disease

Progesterone naturally counterbalances the effects of Estrogen.
Most of the symptoms of Progesterone deficiency are also symptoms of Estrogen excess.

 

Progesterone deficiency (Estrogen excess) can cause:

·       Muscle & nervous tenseness

·       Irritability (as in Premenstrual syndrome PMS.)

·       Anxiety, anger, outbursts of panic or rage

·       Sleeping problems

·       Increased pain sensitivity

·       Premenstrual tension with breast tenderness & swollen breasts

·       Premenstrual abdominal bloating

·       Heavy periods

·       Reddish face/ swollen face

·       Enlarged breasts

·       Breast cysts

·       Swollen ankles

 

Note: a minimum level of Estrogen is required for symptoms of Progesterone deficiency to show up.

Progesterone deficiency has been associated with the following conditions
Breast cysts, uterine fibroids, enlarged uterus, infertility, breast cancer, PMS.

Tips for using Biest Cream

·       Spread a thin layer on a large surface area

·       Non hairy, non-fatty areas: upper chest, neck, inner arms, behind the knees. The face is also good because Estrogen acts against fine wrinkles and facial hair.

·       Avoid other creams & lotions where the Biest is applied

·       Avoid eating large amounts of cereal fiber (depletes Estrogen)

·       Don’t stop when being treated for anything else like an infection

The Story of Little Ms. Estrogen and Her Big Sister Ms. Progesterone

Ms. Estrogen is childlike in her exuberance for making things happen. She has little awareness of the effect of her actions. She is happy just to be doing something – anything. This is where big sister Progesterone comes in. Progesterone follows Estrogen around and tidies up after her, creating order out of chaos. When Estrogen goes to the beach she makes a big sand castle which is a blob. It’s up to Progesterone to define the doors, windows, turrets and moat.

These sisters depend on each other. Estrogen feels insecure without boundaries and gets herself into trouble with her friends and family because of her impulsiveness and lack of consideration. She tends to blame everybody else for life’s problems without being able to put a brake on herself. She needs Progesterone to put things in perspective.

Progesterone is able to be rational and creative in a constructive way, but she can’t do this on her own. She needs Estrogen to put the big blob of sand there before she can start shaping it. Estrogen grows in any direction, Progesterone defines the type of growth. Estrogen makes body cells grow and keep growing. Progesterone tells them to die off at the right time and let new ones take their place.

The first half of the female menstrual cycle is dominated by Estrogen who grows the lining of the uterus for implantation by an embryo and builds receptors for Progesterone. The second half of the menstrual cycle is dominated by Progesterone who either supports a pregnancy or allows the menstrual period to flow. If the hormonal balance is wrong then various problems occur. PMS (Premenstrual Syndrome) is quite common and refers to anything unpleasant that occurs regularly before and during the period each month.

PMS can occur when there is not enough Progesterone in the second half of the cycle – from ovulation (around day 14) to the menstrual blood flow (day 1) or not enough Estrogen in the first half -from bleeding (day 1) to ovulation (day 14).

Whilst women have these 2 hormones in or out of balance, men have just one, Mr. Testosterone. Life is a bit easier for Mr. Testosterone in this way. With only one sex hormone to contend with, he tends to be steadier. Testosterone has a calming, loving protective nature. He does well when he feels his love returned. He can find it very confusing when Ms. E and Ms. P are not in balance and his confusion and feelings of rejection can turn to anger. A mature Mr. T can recognise the symptoms of PMS and use his calming, loving influence to advantage until things right themselves with the flow of blood.

In a lesbian relationship, things can be more difficult if both women have PMS at the same time. On the other hand there can be more understanding of a direct nature.

More about Estrogen

 

Once upon a time on a church steeple, I saw a large and lofty piece of graffiti. It said “Eve was framed”. I sometimes think I would like to write a similar graffiti somewhere which says “Estrogen has been framed”.

Estrogen is probably the most complicated of hormones and very important being in charge of reproduction and the survival of the species. She herself is not just one hormone. There are 3 different types. We call them E1, E2 and E3.

E1 on its way out of the body goes down 3 different pathways:

2hydroxyE1

4hydroxyE1

16hydroxyE1

These last 2 when they dominate can change things in such a way that hormonal cancers grow.

They dominate under the influence of plastics, pesticides, BPAs. These environmental Estrogen disruptors and a diet low in important nutrients found in whole foods are the problem – not our precious Estrogen. GM foods that allow “Round Up” to be used in agriculture without destroying the crops are dangerous. “Round Up” or glyphosate, we were told broke down quickly in the environment. No, it is in the rain, the rivers, the soils and our bodies. It is an Estrogen disruptor. The World Health Organisation produced a report in 2012 that pointed to an excess of 800 Estrogen mimickers in the environment.

 

Health professionals are in a difficult position being asked to return people to health when it is our environment and our lifestyle that is contributing to so many of our problems. If it is too expensive to buy organic food, then somehow we must find a way to grow our own. We must eat whole clean foods that are rich in nutrients and not wrapped in plastic.

Testosterone and Estrogen

Men make Estrogen out of their testosterone and are also vulnerable to the Estrogen disruptors. As men age and when they have not enough zinc they tend to make more Estrogen. When women have stopped having periods they tend to have less Estrogen than men.

Treatments for Hormonal Imbalance and Deficiency

When people have health issues that seem likely to be, at least in part, due to hormonal issues we can do tests to determine the levels of hormones. If we find that Progesterone is deficient in the second half of the menstrual cycle we can treat the deficiency using Progesterone in the same form that the body makes it. This is natural Progesterone and works as described above to keep Estrogen in control.

We can also measure the different types of Estrogen (this test is not government funded) and adjust the diet to aid the production of the healthier types of Estrogen.

Menopause

When our ovaries stop making eggs and our periods stop, usually around the age of 50, our Estrogen levels are then much lower than we have been used to. This is a shock which is experienced as hot flushes and other unpleasant symptoms. which can be debilitating at a time of life when women often have important responsibilities.

·       Estrogen can be used in a form that is the same as the healthy Estrogens and balanced with Progesterone. This has been shown to be safe and effective.

·       Estrogen and Progesterone can be taken in the “bio-identical” form safely into “old age” with a view to having a healthier old age.

·       Estrogen helps to protect against dementia, arthritis, osteoporosis, heart disease etc. Estrogen is also associated with happiness.

 

I have told this story in a way that is hopefully easy to understand without losing accuracy.

Dr. Tessa Jones