HYPOTHYROIDISM
Under active thyroid function, medically termed hypothyroidism, is a very common problem. It is increasingly likely as people age and can be subtle in onset. The hormone chemical thyroxin, also called T4, is made by the small thyroid gland in the neck below the Adam’s apple. The amount of hormone made is regulated by another hormone called TSH (thyroid stimulating hormone). This hormone is secreted by the pituitary gland located at the base of the brain. The TSH level is often used by physicians as a screening test to diagnose possible low or high thyroid function.
Thyroid hormone is the main regulator of the body’s metabolic rate (how fast it burns food for energy). A low thyroid condition will usually cause fatigue, weight gain, dry skin, brittle nails, elevated cholesterol, intolerance to cold, edema, menstrual irregularities, infertility, low sex drive, muscle weakness, joint pain and depression. In the past, lack of iodine in the diet was the principal cause of goiter (enlarged thyroid gland) and hypothyroidism. Iodized salt has largely eliminated that cause. The most frequent cause today is Hashimoto’s thyroiditis. This is an autoimmune condition whereby the body’s immune system makes antibodies against the thyroid tissue and prevents T4 being made by the gland. The cause of this autoimmune condition is unknown at present.
In the past, before availability of biochemical tests, clinical symptoms, basal body temperature and a delayed Achilles tendon reflex evaluated thyroid function. Unfortunately, most doctors now rely only the blood tests of hormone levels. Many people have the signs and symptoms of hypothyroidism but are told by their physicians that the thyroid is fine since the blood tests are “normal”.
Many alternative physicians have learned that treating these patients with replacement thyroid hormone leads to an improvement in how they feel and function. If this is carefully done with regular checkups to measure blood levels and monitor for signs of over treatment, it can be very safe and effective. This is the art of clinical medicine, which treats the patient, not just the blood tests. A common reason people have low thyroid conditions despite normal blood tests is low adrenal gland function. The adrenal glands support normal thyroid function and many people have undiagnosed weakness of the adrenals.
Therapy of hypothyroidism uses either synthetic T4 or desiccated thyroid preparations from cow thyroid glands. There are pros and cons about both medications but some people do much better on one medication than the other one. An excellent book by an endocrinologist (hormone gland specialist) is Ridha Arem’s “The Thyroid Solution”.
Daniel Blodgett MD