Hypo-Thyroidism

“Jane” visits her doctor complaining of fatigue, muscular weakness, pain and joint stiffness. She also tells her doctor that her memory isn’t what it used to be, her thinking seems to be “fuzzier” and she is having difficulty concentrating.

She has put on weight in the past year or two although she actually eats less than she used to; and no matter what she does, she simply cannot lose weight. Her skin is dry and scaly, her hair is falling out and her fingernails are cracked, thin and grooved.

Her menstrual periods are more irregular and heavier than they used to be, even though she is only 35 years old. She also seems to be depressed more often even though nothing has radically changed in her personal life.

After doing a quick, general physical, her doctor orders blood tests including a complete blood count and metabolic chem, lipid and thyroid panels. The results come back and, except for elevated total cholesterol levels, all the others are within normal limits.

The doctor prescribes a cholesterol lowering drug and tells her everything else is OK. Jane leaves the doctor’s office with all the symptoms she originally had, and her depression and symptomology grows worse, while taking a drug she doesn't really need..

What was missed? Doctors must not treat lab results. They must treat the patient. Jane’s signs and symptoms suggest strongly a state of hypo-thyroid (low thyroid) function. There are many people who are not being properly treated for low thyroid function because their thyroid levels (Total T4, free T4, T3 and TSH) are within the normal range.

The hypothalamus secretes TRH (thyrotropin-releasing hormone), a signaling hormone that notifies the pituitary to secrete TSH (thyroid-stimulating hormone). TSH is released from the pituitary gland and tells the thyroid gland to produce T4. T4 is a thyroxine molecule with four Iodine molecules attached (hence T4) which is mainly inactive thyroid hormone. The body uses an enzyme (deiodinase) to remove an Iodine molecule from the thyroxine and converts T4 to T3, which is the active thyroid hormone. Most of the conversion from the inactive hormone (T4) to the active hormone (T3) occurs outside the thyroid in body tissue. To make the conversion properly, a person needs enough thyroid hormone (T4) and the converting enzyme (deiodinase) in order to produce enough T3.

In the classic hypothyroid condition, TSH will be elevated and the thyroid hormones will be low. But, a person also can have low TSH and low thyroid hormones but can also have normal TSH and normal thyroid hormone lab results. This was the case in Jane’s visit, and it is the danger of relying on a blood thyroid panel only to diagnose a hypothyroid condition.

When a lab comes back the persons results are compared to a normal "range" which represents 90% of lab results from "healthy" individuals. This range is often called "normal" but can be quite erroneous in representing actual health conditions. That is why it is imperative for doctors to treat patients and not lab results!

Many naturopathic physicians use a patient’s basal body temperature (BBT) to help diagnose a hypothyroid condition. People with hypothyroid have a low body temperature. Normal body temperature is between 98.4 and 98.8 degrees.
To test your body temperature, place a basal thermometer under your arm for five to 10 minutes upon awakening and before getting out of bed in the morning. Record the temperature in a journal. Take your temperature again at 10 a.m., 1 p.m. and 4 p.m. and record temperatures. After your 4 p.m. temperature check, average your temperature for the day. Do this for three days in a row (but not the three days before your menstrual cycle, if you are female).

If your average daily axillary basal body temperature is less than 98.0 degrees, you may be hypothyroid and should discuss treatment with your doctor.

There also are some foods that interfere with thyroid hormone production and therefore contribute to a hypothyroid state. These foods are called "goitrogens". Foods that are goitrogenic include turnips, cabbage, mustard, soybeans, peanuts, pine nuts and millet. Cooking these foods usually inactivates their activity; but, if you have a hypothyroid, you may want to avoid them, altogether.

If you are diagnosed with hypothyroidism, treatment can include diet, supplements, stress reduction, exercise and/or medications. Naturopathic physicians often use Armour Thyroid, a prescription drug that provides both T3 and T4. By providing both T4 and T3 Armour Thyroid will be effective in patients who do not produce enought converting enzyme deiodinase. Synthroid is a T4 replacement, but may not be effective in patients unable to convert T4 to active T3, which is why so many patients do not respond favorable to Synthroid.

If you have symptoms similar to Jane’s; and, if your basal body temperature is low even when your blood labs appear normal, consult with a naturopathic physician who will look beyond the lab results and treat you, the individual.

Alpha Lipoic Acid (ALA)

Alpha lipoic acid

The universal antioxidant

Alpha lipoic acid (ALA), also known as thioctic acid, is a potent antioxidant. It is both fat-soluble and water-soluble, thus it has been called the "universal antioxidant". It is absorbed readily from an oral dose and is effective in both its oxidized and reduced forms; unlike other compounds, such as glutathione, that are effective only in reduced forms.

ALA is capable of regenerating vitamins C and E. Researchers also have found that ALA increases intracellular glutathione and coenzyme Q10 levels. It appears to have the ablility to chelate certain metals such as copper, manganese and zinc. It also has been found to protect from arsenic poisoning, reduce liver damage from cadmium and chelate mercury from the kidneys.

ALA is used in many therapeutic situations including treatment of diabetes, cataracts, glaucoma, amanita mushroom poisoning, alcoholic liver disease and other liver diseases.

Diabetes: ALA is known to protect the pancreatic islet cells (which produce insulin) from destruction by free radicals. It also has been found to increase glucose uptake by muscle cells in a similar manner as insulin (i.e., it moves glucose from the blood into the cells). ALA is used extensively in Germany for diabetic neuropathy, a condition where distal nerves (in feet, legs and hands) are damaged and loss of feeling and burning are experienced. There are many medical studies which show the effectiveness of this therapy.

Cataracts: The enzyme aldose reductase plays a major role in the development of cataracts. ALA has been shown to inhibit aldose reductase activity, thus reducing the incidence of cataract formation.

Glaucoma: Double-blind studies have shown that the administration of ALA at 150mg daily for one month, showed improvement in visual function in patients with glaucoma.

Amanita mushroom poisoning: ALA is effectively used in patients who have been poisoned by amanita mushrooms. In a study from 1974 to 1978, 89 percent (67 of 75 patients) recovered after an ALA infusion as compared to 10 to 50 percent of those who did not receive the infusion.

Liver diseases: ALA is used in all liver diseases, including alcoholic liver disease (fatty liver), cirrhosis and hepatitis. As an antioxidant, it helps protect the hepatocytes (liver cells) from damage from free radicals and viruses.

It can also be used cardiac conditions such as atherosclerosis, for detoxification from drugs, heavy metals and pollution.

ALA appears to be safe. Allergic reactions are minimal, except for an occasional skin reaction. The only "side effect" which I have observed in clinical use is a strong, sweet odor to the urine. This means the ALA has been absorbed. There are no studies demonstrating its safety during pregnancy, so use it cautiously if you are pregnant.

The recommended dosage of ALA, if you have an active condition is 600mg per day in divided doses, i.e. 200mg three times a day, or 300mg twice a day. If you do not have an active condition but want to take it as an antioxidant, take 200 to 300mg per day. Since ALA is water soluble (removed by the kidneys), it is important to take all doses in divided daily doses in order to maintain therapeutic blood levels during the day.

For diabetic neuropathy I would treat the patients with doses from 1,800 mg to 3,000 mg a day, again in divided doses.