MORE ABOUT YOUR THYROID

As I explained last week, the thyroid hormone is virtually involved with everything your body does. All human cells have a “thyroid receptor site”, so when you have an insufficient amount of thyroid hormone, eventually you’ll get a signal that something is wrong. That “something” can be VERY subtle, and total reliance on a not-very-good lab test (TSH) or a hurried physician can leave your problem undiagnosed/untreated for years.

What’s been especially interesting (to me, at least) is how more and more physicians are seeing the usefulness of adding a small dose of thyroid to whatever specialty treatment they happen to be experts about.

One group who has been picking up on this is psychiatrists. For example, one manifestation of hypothyroidism (under-active thyroid) is clinical depression. If you’re depressed and hypothyroid, “talk therapy” may help somewhat, but it won’t be enough. You might be given an antidepressant (Lexapro, sertraline, etc.) and you’re a little better. But when someone, either your psychiatrist or your primary care, gives you some thyroid, suddenly the world is sunny again. Here’s an article for the curious.

Rheumatologists and neurologists are the main referral points for chronic fatigue syndrome (CFS), and unfortunately, most patients hear, yet again, the phrase “all your tests are normal”. But now, and perhaps out of sheer frustration, I am seeing more and more patients being prescribed thyroid hormones, especially T3 (liothyronine), even when their thyroid tests are in the normal range. Actually, CFS patients often have abnormal thyroid tests, but unfortunately, those tests are rarely ordered. Specifically, reverse T3 and serum iodine. And for the curious, here’s an article.

A Nurse Practitioner, employed at a fertility clinic here in Chicago, told me that not only does every new patient get a full battery of thyroid tests and answer a battery of thyroid symptom questions, but most leave with a prescription for thyroid. She and her colleagues know that if the thyroid is off just a little bit, pregnancy can be impossible.

Hair thinning and hair loss are terrifying prospects for many people, especially women. Dermatologists see plenty of them. The three commonest causes of hair loss: emotional stress, under-active thyroid, iron deficiency anemia, and now, more recently COVID (which fortunately recovers fairly quickly). Even with fairly normal-looking thyroid tests, dermatologists are starting thyroid. Here’s a link for more information: What to know about thyroid function and hair loss.

You wouldn’t think gastroenterologists would have a lot of use for thyroid hormone until you remember that chronic constipation is one of the major symptoms of hypothyroidism. The sluggishness of the large intestine that defines constipation manifests as bloating in the small intestine, which is the main symptom of small intestine bacterial overgrowth (SIBO) and reflux (GERD) in the esophagus. All three, GERD, SIBO, and chronic constipation are called “motility disorders” and are linked so frequently by hypothyroidism, that more and more gastroenterologists are simply placing their patients with recurrent symptoms on this harmless medication.

Fibromyalgia is handled by pretty much everyone these days, from primary care providers to rheumatologists, chiropractors to trigger point therapists. There have been endless back-and-forth arguments about making a ‘fibro’ diagnosis. There is a recent but largely unaffordable blood test, sometimes covered by insurance ($1,100), but we really don’t know if what the test is measuring (inflammatory markers called cytokines) are the cause of fibro or being triggered by something else.

Over twenty years ago, Dr. John Lowe, a pain management specialist, spent years researching fibromyalgia. He wrote a 2,000-page textbook attributing the chronic pain of fibro to a complex inflammatory process triggered by each cell’s resistance to thyroid hormone itself. To treat fibromyalgia successfully, you needed to take higher and higher doses of liothyronine (T3). This medication for thyroid was immensely unpopular at the time as doctors had become devoted to Synthroid (Levoxyl, T4), which Lowe said simply was ineffective for fibro patients.

Two factors brought this intriguing work to an end. Dr. Lowe found a publisher who priced his book at $750, which, allowing for inflation, would be $1,300 today. He was killed in a motorcycle accident several months after publication. BTW, after 20+ years, the book is much less expensive on eBay.

If any of you are interested in thyroid treatment for your health issues, please call or request an appointment online with any of our WholeHealth Chicago locations.

Be well,

David Edelberg, MD