RATIONALE:
There is considerable evidence that blood tests fail to detect many causes of hypothyroidism (under-active thyroid). It appears that many individuals have ‘tissue resistance’ to thyroid hormone. Therefore, their body may need more thyroid hormone, even though the amount in their blood is normal or even on the high side of normal. A low axillary temperature suggests (but does not prove) hypothyroidism. We frequently recommend a therapeutic trial with thyroid medication in individuals with typical hypothyroid symptoms and low body temperature. This approach to thyroid therapy in controversial and is currently outside the medical mainstream.
SIGNS AND SYMPTOMS ASSOCIATED WITH HYPOTHYROIDISM:
Fatigue, depression, difficulty concentrating, difficulty getting up in the morning, cold hands and feet or intolerance to cold, constipation, loss of hair, fluid retention, dry skin, poor resistance to infection, high cholesterol, psoriasis, eczema, acne, premenstrual syndrome, loss of menstrual periods, painful or irregular menstrual periods, excessive menstrual bleeding, infertility (male or female), fibrocystic breast disease, ovarian cysts.
INSTRUCTIONS:
1.) If using a Mercury Thermometer, shake it down to 96 degrees or less before going to bed. In the morning, as soon as you wake up, put the thermometer deep in your armpit for 10 minutes and record the temperature.
2.) If using a Basal Digital Thermometer, in the morning, as soon as you wake up, place it under your tongue until it beeps. Do this before you get out of bed, have anything to eat or drink, or engage in any activity. This will measure your lowest temperature of the day, which correlates with thyroid gland function.
3.) The normal basal temperature averages 97.8-98.2 degrees F. We frequently recommend treatment if the temperature averages 97.6 or less. The temperature should be taken for five days. However if the temperature is 97.0 degrees or less for three consecutive days, you do not need to take the last two temperatures.
4.) For pre-menopausal women, the temperature should be taken starting the second day of menstruation. That is because considerable temperature rise may occur around the time of ovulation and give incorrect results. Do not do the test when you have an infection or any other condition which would raise your temperature.
DAY 1 _____ DAY 2 _____ DAY 3 _____ DAY 4 _____ DAY 5 _____
Please bring in this completed form at the time of your next visit.
Hello doctor, I am 23 year old girl and suffering from hypothyroidism but problem is that i am too skinny. After having proper meal still having weakness. Got my TSH tested but everytime vits somewhere between 7-15.Rightnow I am taking 25mg Thyroxin tablets. Please suggest me something to handle this.
Lisa
Hi Lisa,
This sounds like quite the dilemma. There are a number of ways to approach diagnosis and treatment for something like this, and it’s best to go through your history and make some decisions about how to proceed. Please give the office a call and set up a telemedicine visit with one of our functional medicine providers so we can get you feeling better soon. Our scheduling staff can be reached at 773.296.6700.
My best,
Dr M
cliffmaurer
Hello doctor, For the last 3 years I’ve been trying to figure out what is wrong with me. I started having severe anxiety, fatigue, mood swings, slight depression, forgetfulness, constant feeling cold. I was diagnosed with PCOS. I thought all my symptoms would be hypothyroidism, but my doctor ran labs while I was not fasted and said my thyroid was normal, but my cholesterol was high and I was considered obese for my height so he put me on phentermine for weight loss, metformin for preventing type 2 diabetes as I was considered high risk because of the pcos, clonazapam and beuproprion for anxiety and spironolactone to block testosterone. None of it makes sense! Ive never even had an ultrasound to check if I have cyst on my ovaries. Today I went to a new doc and after describing my symptoms he said he wants to check my thyroid levels tomorrow. I’m just so confused! I feel like a mental patient and can’t seem to get my head on straight.
Adel Zamarron
Hi Adel –
We hear stories like this frequently. You’re not alone! Please consider calling in and scheduling a telemedicine visit with one of our functional medicine providers. 773-296-6700.
We’re looking forward to speaking with you!
-Dr M
cliffmaurer
Your dose needs an upward adjustment. You’ll need to find a doctor who will do this without being overly obsessive about your test results
Best info: stopthethyroidmadness.com
Read Janie’s book and the site also has a means for finding that doc
Dr. E.
I have a couple questions. I was diagnosed with hypothyroidism right out of college (16 years ago) and put on levothyroxine. It has been adjusted up periodically until my thyroid levels are within normal range on the blood tests, but no matter the adjustments, it never has helped with the symptoms (Fatigue, depression, difficulty concentrating, difficulty getting up in the morning, cold hands and feet or intolerance to cold, constipation, fluid retention, dry skin, poor resistance to infection, high cholesterol, acne, loss of menstrual periods, painful or irregular menstrual periods, excessive menstrual bleeding, ovarian cysts)! I have yet to find a doctor who will do anything further for treatment because the blood test says it’s now within normal range. But my normal temperature is 96.9° F and even when I am very sick (recently, I had malaria while visiting Congo), my temperature doesn’t go above 99.8° and so doctors rarely take me seriously when i say i have a fever!
What do you recommend I do to truly overcome these symptoms? And since I don’t have a normal temperature, at what point, when I feel sick, should I go to the doctor?
Any advice would be greatly appreciated!! I would just love to feel “well” finally!
Rebekah Smith
Hi Denise
You need to see a physician who specializes in Functional Medicine for these issues. They do this type of testing routinely.Go to ifm.org and click the Find a Practitioner tab
Dr. E
Hi, can you have adrenal insufficiency without fatigue? What do you take for it, if so? Is there anything out there like Armour for thyroid? I’m trying to figure out my digestive problems and it’s difficult. I’m thinking SIBO or adrenals. Thank you.
Denise
Can anyone recommend a practitioner in the Northeastern Kansas area, specially in Topeka KS?
Cynthia Turnbull
Hi Cynthia – we don’t have a particular recommendation for this area, but I often refer patients to this website to find functional medicine providers. https://www.ifm.org/find-a-practitioner/
Best wishes to you,
Dr M
cliffmaurer
Do you know of any colleagues in San Francisco who use this approach for hypothyroidism?
My wife has developed many of the symptoms of hypothyroidism and her current doctors aren’t being helpful.
By the way, I used this exact protocol to diagnose and treat my hypothyroidism after my doctors blew me off. The improvement was night and day. Even after these results, my doctors said that there was no medical basis for my recovery, so it had to be a placebo effect!
Michael Kydonieus
Hi Michael – we don’t recommend anyone in particular in the Bay area, but we use this site a lot when referring to providers out of state: https://www.ifm.org/find-a-practitioner/
Hope this is helpful!
-Dr M
cliffmaurer
You don’t need a Skype consult, but you do need a shot of B12. If the normal range in the UK is the same as US (200-900), you will definitely develop symptoms of deficiency.
You should get tested for Intrinsic Factor Antibody to see if there is an issue with B12 absorption called pernicious anemia AND get tested for the MTHFR gene to determine the type of B1 best for you.
I am pretty sure youcan order your own SIBO test from Genova Labs http://www.gdx.net
Good luck!
Dr E
Wow this website is a Godsend, thanks for the fabulous info!
I’ve been diagnosed with adrenal fatigue and home testing cortisol shows I spike massively first thing in the morning (6am) (top of the tst range) then drop and flatten out just below normal levels.
I’ve also been diagnosed with fibromyalgia but I have so many symptoms of SIBO, hypothyroid although my TSH is .33 and T3 and T4 are ‘within normal range’. I was also very low ferritin, folic acid, B12 (244 although they don’t consider that low in the UK even though I had facial, scalp tingling, and a gazillion symptons), Vit D. My breath also stinks (loved your articale on that btw). To be honest I’m overwhelmed!
I have started to feel much better with increasing supplements of B12, Kelp, Iron, Folic Acid, Vit c, B6 and zinc I still suffer horrendous bloating etc. I also seem to have no stomach acid using the 5 min belch test.
Do you do Skype appointments as I’m based in the UK and you guys seem like the only people who would have all bases covered and might be able to guide me in the right direction….
Any pointers to start with? I’m looking into home testing for SIBO.
Lyn G
There’s no “which one first” requirement. Start your thyroid as prescribed by your doctor and also start an adrenal glandular. Likely you’ll have to remain on the thyroid but usually the adrenal can be dicontinued in 2-3 months
Dr E
I also tried to leave a message on your glandular post but it wouldn’t post. I wonder if you could clear up some confusion I have… After recently being diagnosed with low thyroid and told I need a thyroid drug, I also learned that I have an adrenal issue. I heard that it is important to address the adrenals first before treating thyroid. I’m wondering if this is true? Not sure what to do!
Raine
Hi Chris
I would look at where in the “normal” range the T3 and T4 actually are. Generally if T3 is low, I add a small amount of T3 (like 5 mcg of cytomel)
Dr E
This sounds like great advice and a good protocol. But I wish the article included more discussion about treating with thyroid hormones when blood tests show high levels of thyroid hormones (or, alternatively, extremely low or even suppressed TSH).
Why? Because I’ve a relative who, like me, has diagnosed hypothyroidism, and like me, takes Armour. Her TSH is very low, and free T3 and T4 levels are in the normal range. But her temps usually run cool even at the height of her day–around ~96-97ish. When her temp actually gets to 98 or 99, she feels feverish–because for her, that’s a fever. She also has diagnosed adrenal insufficiency and takes HCL for that. She’s been suffering a LOT of fatigue, and in particular, extreme difficulty waking, getting going in the morning. She can sleep 10 hours and wake up exhausted.
Her relatively competent endo (a rarity in mainstream medical industry) lets her keep her TSH low, but might not want her to take even more Armour. But it might be just what she needs.
Can you recommend more information on this concept, since you acknowledge that it’s outside the mainstream?
Christopher Gagnon