Thyroid Dysfunction

One of the most common clinical problems I seein my practice is thyroid dysfunction. Nearly twenty years ago, while working in Sri Lanka, it was common to see people, the great majority of them women, walking about with huge lumps - some the size of a tennis ball, some closer to a bowling ball - under their chins. These goitres, or enlarged thyroid glands, were for the most part a result of malnutrition, specifically a lack of iodine in the diet.

At the time I was working as an acupuncturist in a rural clinic, and it was possible to achieve considerable success in treating this condition through nutritional advice and acupuncture. The thyroid problems I see today in this country, though, are of a different sort. Rarely are they caused by a simple iodine deficiency.

Instead, there appears to be a number of factors related to internal as well as external toxins, emotions and nutrition that, individually or in combination, are the underlying cause for most modern day thyroid problems.

Before exploring these issues further, let?s review a bit about the thyroid itself. This pair of glands is located in the neck around the voice box and they control the overall metabolic rate of the body. Malfunctions of the thyroid can have a profound impact that ripples through the entire body. Sometimes the disturbances are very clear and easily diagnosed. Often though, they can be rather subtle and easily overlooked.

If the metabolic rate is running high ? hyperthyroidism ? then a person generally becomes hot, restless, feels heart palpitations and loses weight despite developing an enormous appetite.

In hypothyroidism, or low function of the thyroid, the opposite is true. A person becomes chilly, tires easily, finds it hard to get up in the morning and hard to fall asleep at night, and starts to put on weight for seemingly no reason at all.

Checking out the thyroid is a little like monitoring the idle of a car engine. You don't want it to be too revved up and you don't want it to be conking out. A generation or two ago, a conventional medical practitioner might palpate the gland and ask some questions to diagnose a thyroid disorder.

Today, thyroid function is assessed through one of several types blood tests which measure levels of various hormones. Without positive results, a conventional practitioner is unlikely to diagnose or treat a patient for thyroid problems.

Yet, the diagnosis of thyroid imbalance is not always so clear cut. Blood tests and hormonal panels are not always the most definitive method to determine whether the thyroid is malfunctioning.

For instance, the term subclinical hypothyroidism, which was coined by a researcher turned physician named Broda Barnes nearly a half century ago, refers to a situation where the thyroid is low functioning - but not low enough to be picked up by conventional diagnostic procedures.

What complicates the picture even further is that even the are conventional division of thryroid disorders into either the 'hypo' or the ?hyper? can be misleading. For instance, it is not altogether uncommon for they thyroid to be 'disregulated' - swinging back and forth between hypo- and hyper-functioning. This might occur as a response to an underlying stress where the gland is unable to hold a hormonal balance and instead compensates by going up and down.

Conventional therapies, usually suppression or impairment of glandular function through drugs, radiation or surgery in the case of hyperthyroidism, and the use of synthetic thyroid hormones in hypothyroidism, rarely address the problem at a causal level. In effect, these strategies are symptomatic, sometimes toxic, and can even aggravate the condition while superficially providing a sense of normalcy.

One of the more memorable instances of hyperthyroidism that I have treated was the case of a young woman who was thrown into this condition by an acute grief she had suffered. As a nurse, she had initially focused on reporting the clinical and diagnostic information, without sharing much else about herself. Ultimately, it turned out that the pain she felt at the death of her dog had been the immediate cause. Once I was able to understand this and provide her with an appropriate homeopathic remedy based her inner state, the condition resolved in a timely fashion.

Another factor - one amongst many - that has been linked to thyroid dysfunction is the coxsackie virus. This is actually a group of viruses that are a common source of infection in children which are transmitted primarily by touch. The most common symptoms are fever, fatigue, and a rash. Some people develop ulcers in the back of their throat, called herpangina. More serious complications involving the heart due occur but they seem to be uncommon.

Practitioners utilizing non-conventional forms of diagnosis such as electro-dermal screening have often seen that the remnants of this virus - what might be called its ?'energetic footprints' - often migrates to the thyroid, disrupting the glands capacity to regulate the metabolism. This can only be resolved by erasing this footprint through the use of appropriate detoxification protocols.

Part II

The pair of thyroid glands located on either side of the voice box is the body's metabolic general. As regulators of the metabolic rate of the entire body, there are few physiological processes that are are somehow related to it. Thyroid function influences energy formation, circulation, immune function, the metabolism of all the organs, blood sugar regulation, emotional stability, and hormonal balance.

Low thyroid function is associated with a host of symptoms, some of which are: fatigue, weight gain, low motivation and ambition, heat and/or cold intolerance, headaches and migraines, dry skin and hair, hair loss, fluid retention, unhealthy nails, brittle nails, constipation, irritable bowel syndrome, asthma, allergies, slow healing, acne, hives, carpal tunnel syndrome, low sex drive, insomnia, irritability, anxiety and panic attacks, depression, decreased memory and concentration.

Overactive thyroid function often manifests with symptoms such as weight loss coupled with increased appetite, heart palpitations, increased body heat, bulging eyes, restlessness and anxiety.

Something so essential to the proper workings of the organism is involved in a number of feedback loops, which allows the thyroid to monitor the metabolism of various areas and systems in the body and respond according. This central role and the incoming information of the feedback loops - in the form of hormonal and neurological messengers - means that the thyroid is influenced by any number of stimuli, healthy or otherwise, and make it quite susceptible to a variety of disruptions that cause it to malfunction.

Amongst the factors that can disrupt thyroid function, there are several large categories: deficiencies, nutritional toxins, environmental toxins, microorganisms, iatrogenic disorders ('iatrogenic' meaning a disease or medical condition caused by a medical procedure or drug), and hormonal imbalances.

The most common deficiencies that affect the thyroid gland are of iodine, the B vitamins, various minerals, especially the trace minerals, the amino acid tyrosine, taurine and glutamine and Vitamins A,C and E .

Nutritional toxins are foods that for one reason or another act as thyroid antagonists, impairing its function. Soy isoflavones are a type of phytoestrogen compound (that is, plant estrogen compound), that have weak estrogenic activity. Ironically, it is partially because of the high content of isoflavones, that soy products are currently heralded as such a healthful food source, especially for menopausal women. Yet for some people, these isoflavones are potent thyroid inhibitors and must be avoided at all costs. Other potential thyroid disruptors are members of the brassica family - broccoli, cauliflower, cabbage, brussels sprouts - when eaten raw.

There are any number of external environmental factors that influence the thyroid. Agricultural sprays that a person comes in direct contact with through farming or living in a heavily farmed area, or even through residues that are contained in many foods are one source. There are many other chemicals on and in food as well as in our water that can have similar affects. Chief amongst them are the chlorine and fluorides in water.

Another ubiquitous source of toxicity is radiation. Sources range from nuclear plants and high power lines, to common household items such as microwaves, TV's, computers, water beds, electric blankets, some electrical appliances. All have the potential of affecting the thyroid.

A third common environmental factor are heavy metals including but not necessarily limited to mercury [found in the external environment as well as in amalgam tooth fillings], cadmium, iron, and arsenic.

Previously, I mentioned the effect of residues of the coxsackie virus on the thyroid. Aside from this one viral influence there are any number of viruses, bacteria, yeast, flukes, and parasites that produce inflammation in various parts of the body, resulting in the formation of antibodies which can cause autoimmune activity that ultimately destroys thyroid tissues.

Perhaps the most common problem in this group is the pathogenic overgrowth of candida, a member of the yeast family. This fungus is a normal inhabitant of a healthy colon, but it can also proliferate in the intestines because of several factors, including stress, lowered immune system, antibiotic overuse, oral contraceptives, and use of cortisone or prednisone. Changing from the harmless noninvasive, sugar fermenting yeast like organism to the mycelial, or fungal, form with long, root like structures, candida can penetrate the membrane lining of the digestive tract. It can become so prolific that it escapes the confines of the intestinal tract altogether and cause havoc throughout the rest of the body.

Consequently, there are nearly 80 distinct toxins (known as endotoxins because they are produced within the body) produced by candida. It is closely related to to other conditions such as irritable bowel syndrome and leaky gut. Candida is known to induce a 2000% increase in IgE antibodies resulting in allergies, fatigue, and many common symptom complexes which may be misconstrued as emotional or depressive.

Medical intervention such as surgery, radioactive iodine and suppressive drugs often preclude the possibility of the thyroid ever regaining normal functioning. Most drugs, including synthetic thyroid, suppress thyroid function, and can have the long range affect of weakening the capacity of the thyroid to operate on its own.

Chief amongst the disruptive hormonal influences on the thyroid is the overabundance of estrogen. This syndrome mostly commonly affects women during perimenopause is most often a result of diet, poor liver function, environmental factors such as the abundance of ?estrogen mimics? in chemicals, and anovulatory cycles (menstrual cycles in which no ovulation has occurred) before menopause. Estrogen dominance not only suppresses thyroid function but it also can dispose a person to cancer.

With all these potential harmful influences, it is no wonder that thyroid imbalances are so common.

Part III

Thyroid dysfunction is a frequent problem that is often overlooked as the cause of a variety of ailments. Awareness of the most common symptoms related to the overproduction (hyperthyroidism), underproduction (hypothyroidism) or irregular output of thyroid hormone is often a first step in pinpointing the problem.

These are: poor circulation, menstrual problems like PMS with bloating and soreness, cramps, irregularity; other gynecological problems like uterine fibroids, cysts, infertility, miscarriage; poor memory and concentration; dry, itchy skin and hair; irritability, anxiety, low moods; low blood sugar, weight gain, excessive or low appetite; arthritis, joint and muscle pains; poor sleep; heart palpitations; headaches; delayed development in children.

When thyroid involvement is suspected as a potential factor in any complaint, the next step is to measure the activity of the gland. Checking thyroid function is a little like monitoring the idle of a car engine. You don't want it to be too revved up and you don't want it to be conking out.

A generation or two ago, a conventional medical practitioner might palpate the gland and ask some questions to diagnose a thyroid disorder. Today, conventionally thyroid function is assessed through one of several types blood tests which measure levels of various hormones. Two types of thyroid hormones are easily measurable in the blood, thyroxine (T4) and triiodothyronine (T3). It is easier and less expensive to measure the T4 level, so T3 is usually not measured on screening tests.

The Total T4 test shows the total amount of the T4. High levels may be due to hyperthyroidism, however this may be artificially raised when estrogen levels are higher due to pregnancy, birth control pills or estrogen replacement therapy. A Free T4 which directly measures the free T4 in the blood is more reliable , but a little more expensive test.

The Free Thyroxine Index is a mathematical computation which shows how much thyroid hormone is free in the blood stream to work on the body. Unlike the T4 alone, it is not affected by estrogen levels.

The Total T3 tests the total amount of T3 in the bloodstream and is usually not a screening test, but used to evaluate known thyroid disease. T3 is the more potent and shorter lived version of thyroid hormone. In some cases of hyperthyroid the T4 can be normal and the T3 high, and the TSH low.

Free T3 measures only the portion of thyroid hormone T3 that is "free", that is, not bound to carrier proteins.

A test of the Thyroid Stimulating Hormone (TSH) measures the level of this protein hormone secreted by the pituitary gland and regulates the thyroid gland. A high level suggests your thyroid is underactive, and a low level suggests your thyroid is overactive.

The problem is that many, if not most, cases of mildly underactive thyroid function - what is termed subclinical hypothyroidism - can be missed through these tests.

Fifty years of work on the human thyroid led a research physician named Broda Barnes to conclude that millions of people in this country are in this category. He also developed a fairly simple way to diagnosis it by measuring the basal body temperature (BBT). The BBT measures the body temperature when a person has been quiet for a good period of time and therefore will give a good assessment of the rate at which the body is "idling".

The protocol is simple: place an oral thermometer by ones bedside at night, then first thing on waking in the morning, take the temperature in the armpit for about ten minutes.

The "normal" range is said to be somewhere in the 97.2 to 97.8 range although individual researchers do vary somewhat in what they consider to be within normal limits. Typically there is some fluctuation anyhow, especially in women, that corresponds to hormonal changes.

Measurements consistently below 97.0, suggest low thyroid function. (Obviously, the same can be said for high temperatures and high thyroid function.) In Barnes experience this extremely simple, low cost procedure was the most accurate way to determine thyroid status.

Parenthetically, today there is a more sophisticated procedure to reveal even mild low thyroid known as the TRH (Thyrotropin Releasing Hormone) test. It requires an injection, followed by one or more blood draws at 15, 30 and 45 minute intervals. This test is accurate, but is expensive and inconvenient for both patient and the lab.

Lately, some experts think Barnes’s underarm method is outdated because many people can be one degree low when taking it there. They believe taking the oral temperature (that is, in the mouth) is much more accurate, and that people using the underarm method have been found to be taking too much thyroid.

According to this line of thinking, taking an oral temperature with a mercury thermometer between 11 am and 3 pm is best. Optimum oral temperature should be 98.0 in the morning before arising and should rise to 98.6 to 99 degrees for about 10 hours a day - from 8 am until 11 am. Lower temperature readings, which can sometimes dip from 1 to 3 degrees below normal indicate hypothyroidism.

Curative - as opposed to symptomatic - treatment of thyroid imbalances must aim at underlying causes. Stimulating the gland with synthetic hormones, which is the norm for conventional management of hypothyroidism, or reducing hormone output through radioactive or surgical impairment of the gland, which is the norm for conventional management of hyperthyroidism, are symptomatic at best. Often, aggressive or long term conventional treatment weaken the gland irreparably, making a true cure almost impossible to attain.

Having said that, there is no single cure for thyroid imbalances because the causes can vary so greatly.

Vitamin, mineral and amino acid deficiencies can be addressed through supplementation. For people sensitive to the thyroid inhibiting effects of foods, adjustment to the diet by eliminating soy products and raw brassicas - broccoli, cauliflower, cabbage, brussels sprouts -

Every reasonable effort must be made to avoid the residues of agricultural sprays and other chemicals in and on food sources. This includes chlorine and fluorides in our water

To rid the body of residues already present in the body in general and the thyroxine gland in particular, there are homeopathic, herbal and nutritional protocols that flush the toxins out of the cells and promote healthy lymphatic drainage to flush them out of the body altogether.

Inflammations caused by viruses, bacteria, yeast, flukes, and parasites which can cause autoimmune activity that ultimately destroys thyroid tissues must be diagnosed and treated. Diagnosis can be done through a variety of methods, from conventional blood tests to electrodermal screening (see former columns on “EAV testing”), though long-term, low grade inflammations ar almost always missed through conventional testing.

Where possible, precautions should be taken to avoid radiation from nuclear plants, high power lines, microwaves, TV’s, computers, water beds, electric blankets, some electrical appliances. Likewise, homeopathic, herbal and nutritional protocols exist which cleanse the body and the thyroid of radioactive toxicity.

The effect of heavy metals such as mercury [amalgam tooth fillings], cadmium, iron can be neutralized through holistic dental work, along with homeopathic, herbal and nutritional protocols.

Regulation of digestive function, especially intestinal, along with the removal of internal toxins such as candida yeast and parasites, also can profoundly effect thyroid function.

Amongst the most effective treaments are ones which address the vitality of the entire body as opposed to focusing on a single causative factor. These include constitutional homeopathy, acupuncture and oriental medicine, as well as some systems body.

Lastly, as much as possible, suppressive drugs and radiation or surgical treatments should be avoided.