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    Hypothyroidism

    (READING TIPS:  For fast reading, scan through the topic headings in BOLD BLACK, important conclusions in BOLD BLUE, and " Must Know " in BOLD RED. To jump to specific sections in this article, click on the respective LINKS in the Contents.)

    Contents
    Thyroid Basics
    Causes of Hypothyroidism
    Risk of Hypothyroidism
    Associated Disease
    Symptoms of Low Thyroid
    Diagnosis: Standard Laboratory Test
    New Diagnostic Reference Standard for TSH
    Free T3 and Free T4
    New Laboratory Reference of Hypothyroidism
    Treatment
    What to do if you are already on Synthroid?
    Summary



    More than 10 million Americans have been diagnosed with thyroid disease, and another 13 million people are estimated to have undiagnosed thyroid problems. About 10 percent of the adult population is afflicted with this frequently overlooked disease of epidemic proportion. A dysfunctional thyroid can affect almost every aspect of health. It is one of the most under-diagnosed hormonal imbalances of aging, together with estrogen dominance and syndrome X.

    Thyroid Basics

    Thyroid is a small butterfly-shaped gland that wraps around the windpipe. The cells inside the thyroid takes in the iodine, obtained through food, iodized salt, or supplements, and combines that iodine with the amino acid tyrosine. The thyroid then converts this into the hormones thyroid hormones called T3 and T4.

    Once released by the thyroid, the T3 and T4 travel through the bloodstream. Under normal conditions, 80 percent of thyroid hormones are in the form of and T4 and 20 percent in the form of T3. T3 is the biologically more active and is several times stronger than T4. The conversion of T4 to T3 takes place both inside the thyroid as well as in some organs other than the thyroid, including the hypothalamus, a part of your brain.

    The thyroid gland acts like the body's barometer. Its main function is to help cells convert oxygen and calories into energy. It regulates:

    · Heart rate
    · Blood pressure
    · Body temperature
    · Metabolism
    · Growth



    Thyroid, like other hormones, is regulated by an extensive negative feedback system. The system starts in the hypothalamus of the brain that releases Thyrotropin-releasing Hormone (TRH). TRH signals the pituitary gland to release Thyroid Stimulating Hormone (TSH).  TSH in turn instructs the thyroid gland to make thyroid hormones and release them into the bloodstream. When the level of thyroid hormone in your body is high, a negative feedback system exists to reduce the production of TSH, and vice-versa. Therefore, a high TSH is indicative of hypothyroidism, while a low TSH can be indicative of hyperthyroidism.


    Causes of Hypothyroidism


    There are a variety of factors that can contribute to the development of thyroid problems:

    · Exposure to external radiation such as occurred after the Chernobyl nuclear plant accident.

    · Over-consumption of isoflavone-intensive soy products such as soy protein or powder. Isoflavones act as potent anti-thyroid agents, and are capable of suppressing thyroid function, and causing or worsening hypothyroidism.

    · Some anti-thyroid drugs, such as lithium and the heart drug cordarone.

    · History of radiation treatment to the head and neck area.

    · Over-consumption of uncooked "goitrogenic" foods, such as broccoli, turnips, radish, cauliflower, and Brussels sprouts.

    · Radioactive iodine treatment for hyperthyroidism/Graves' Disease.

    · Post-surgical removal of all or part of the thyroid due to nodules or cancer.

    · Adrenal insufficiency (commonly caused by chronic stress).

    · Mercury intoxication (amalgams are 50% mercury). Amalgam fillings have been associated with a variety of problems such as Alzheimer's disease, infertility, neurotransmitter imbalances, and thyroid problems.



    Risk of Hypothyroidism

    You have a higher risk of developing thyroid disease if, among a variety of factors,

    …You have a family history of thyroid problem
    …You have a history of  Chronic Fatigue Syndrome
    …You are a  female and over menopausal
    …You are over age 60
    …You have been exposed to radiation or certain chemicals   (i.e., perchlorate, fluoride)

    Associated Disease

    As many as 10 percent of 98 million Americans with high cholesterol and high LDL ("bad") cholesterol may not know that their cholesterol is high due to undiagnosed thyroid problem. Older women with sub clinical or under-active hypothyroidism was shown to be twice as likely as women without this condition to have heart attacks.

    Thyroid disease is also intricately  tied to adrenal gland and ovarian function.



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    Michael Lam, MD, MPH, ABAAM, CNC
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