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Hypothyroidism

Dr. Broda Barnes, called low thyroid function, "The Unsuspected Illness",
because the usual blood tests can be completely normal and the diagnosis can be easily missed.  The correct diagnosis depends on noticing symptoms such as low energy, fatigue and tiredness.  Other symptoms include:  weight gain, cold hands and feet, depression, slowness of thought, headaches, facial swelling, fluid retention, dry skin, brittle nails, constipation, irregular menstrual cycles, and fertility problems.  The body temperature may be low and the patient prefers to set the room thermostat very high (for example, 81 degrees).

The Thyroid Gland and Thyroid Hormone:

The thyroid gland is a small butterfly shaped gland in the neck on either side of the windpipe.  It is responsible for the secretion of thyroid hormone which speeds up the body's metabolism by increasing the number and size of the mitochondria.  The mitochondria are the little microscopic factories which make energy and heat for the cell functions.

Iodine Deficiency:

If the diet is deficient in iodine, the thyroid gland enlarges and forms a goiter along with the usual symptoms of hypothyroidism.  In 1924, iodized salt was introduced into the nation which eliminated the occurrence of goiter in the population.  The recommended daily allowance for iodine in the U.S. is only 150 micrograms.  In Japan, the daily intake of Iodine is 100 times greater and is associated with many health benefits for Japan.  This observation led Drs. David Brownstein and Guy Abraham to suggest that a daily iodine intake closer to the amount in the Japanese diet might also be beneficial for us.

The TSH Thyroid Test:

The thyroid gland's production of thyroid hormone is controlled by the master gland in the brain called the "pituitary gland" which releases TSH (thyroid stimulating hormone).  The TSH then travels in the blood stream to the thyroid gland and instructs it to produce more thyroid (T4) hormone. When the thyroid gland has difficulty making T4 due to Iodine deficiency or damage to the thyroid gland, then the TSH level can be quite high.  High TSH indicates low thyroid function.

Diagnosis of Hypothyroidism:

So, how is it that hypothyroidism can be missed by today's conventional medical system?   That's because we now rely  exclusively on the TSH test and other blood tests to make the diagnosis of low thyroid.  The fact is that the thyroid blood tests may be normal even though there is low thyroid.  In recognition of this problem, the normal ranges for the TSH test have been changed a number of times in the past few years.  (see below). According to Mark Starr, M.D., the best way to diagnose hypothyroidism is with a careful medical history, physical examination and measurement of the basal body temperature.

The Basal Body Temperature: 

Taking basal body temperature is easy. Simply check your axillary (armpit)  or oral temperature with an inexpensive thermometer available at any drugstore.  The best time is first thing in the morning upon waking for three or four consecutive days. If the average temperature is below 97.8 Fahrenheit, then the diagnosis of a low functioning thyroid system is likely.

Treatment of Hypothyroidism with Natural Thyroid Extract:

Once the diagnosis is made based on history, physical examination and the low basal body temperatures, the next step is a therapeutic trial of thyroid hormone.  Dr. Broda Barnes preferred to use a natural thyroid extract such as Armour Desiccated Thyroid Hormone rather than the more widely used synthetic thyroid medication.  Dosage is started low and gradually increased every month while monitoring symptoms, basal temperature and pulse rate.  Dosage is increased while watching for signs of thyroid excess such as nervousness, difficulty sleeping, rapid pulse etc.  Should signs of excess appear, then the thyroid medication is reduced.  Such a trial of thyroid is inexpensive and safe for most patients.  Many doctors mistakenly believe that once thyroid medication is started, that patients must continue for life.  According to Dr. Barnes, this is incorrect, and there are times when a patient may be weaned off their thyroid medication with return of thyroid function.

Benefits of Thyroid Treatment: 

According to Dr. Broda Barnes, hypothyroid patients who receive thyroid therapy benefit greatly from reduced risk of heart disease, arthritis, and cancer.  Dr. Barnes made these statements based upon the review of cause of death for 70,000 autopsy studies from Graz, Austria which is a goiter area. He felt that all patients with coronary artery disease should be checked carefully for low thyroid and treated if found.  Thyroid hormone is often helpful for patients suffering from depression which is unresponsive to other treatments, even when the blood tests are normal.

Changing the Normal Values for the TSH Test:

On November 2002, the American Association of Clinical Endocrinologists changed the normal TSH values.  Previous normal bounds were 0.5 to 5.0, and these were changed to 0.3 to 3.04.  The National Academy of Clinical Biochemistry, wants to change them again and says "In the future, the upper limit of the serum TSH reference range will be reduced to 2.5 mIU/L

"A serum TSH result between 0.5 and 2.0 mIU/L is generally considered the therapeutic target for a standard L-T4 (thyroid hormone) replacement dose for primary hypothyroidism."

Work with your Physician:

As usual, it is important to work in partnership with a knowledgable physician.  To find one in your area, call the AmericanAcademy for the Advancement of Medicine (ACAM) 1-888-439-6891, or visit the web site:  http://www.acam.org/

Recommended Reading:

Hypothyroidism: the Unsuspected Illness, by Broda O. Barnes,M.D., 1976, Harper

http://www.brodabarnes.org/

Hypothyroidism Type 2, the Hidden Epidemic, by Mark Starr, M.D., 2005 Mark Starr Trust, Columbia, Missouri   www.type2hypothyroidism.com

Iodine: Why You Need It, Why You Can't Live Without It, by David Brownstein, M.D. 2005,  http://www.drbrownstein.com

Jeffrey Dach MD
7450 Griffin Rd Suite 180/190
Davie, FL 33314

Phone: 954-792-4663
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