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Thyroid Deficiency--what IS normal anyway?
10 years ago
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THE PROBLEM WITH CURRENT REFERENCE RANGES

How to best diagnose thyroid deficiency has been a long-standing medical controversy. Conventional doctors rely on thyroid blood tests, whereas alternative physicians look for signs and symptoms of thyroid deficiency. An article in The Lancet revealed surprising findings about reference ranges that may alter the way physicians assess individual thyroid status.

Before The Lancet article is discussed, the reader should be reminded of the serious consequences of a thyroid hormone deficiency. Aging people encounter a variety of ailments that doctors often attribute to problems other than thyroid deficiency. Some of the most noticeable symptoms caused by low thyroid are poor concentration, memory disturbances, cold hands and feet, accumulation of excess body fat, difficulty in losing weight, menstrual problems, dry skin, thin hair, and low energy levels. Some specific disorders related to thyroid deficiency include depression, elevated cholesterol, migraine headaches, hypertension, and infertility (Stanosz 1992; Saito et al. 1994; Vierhapper 1997; Michalopoulou et al. 1998; Pop et al. 1998; Lincoln et al. 1999; Krassas 2000; Hagen et al. 2001; Spierings 2001).

Broda O. Barnes was a physician-scientist who dedicated more than 50 years of his life to researching, teaching about, and treating thyroid and related endocrine dysfunctions. In his book entitled Hypothyroidism: The Unsuspected Illness, Dr. Barnes described more than 47 symptoms that may be related to poor thyroid function. During his many years of research and practice, Dr. Barnes condemned conventional doctors who ignored obvious clinical manifestations of thyroid deficiency. According to Dr. Barnes: "The development and use of thyroid function blood tests left many patients with clinical symptoms of hypothyroidism undiagnosed and untreated."

In lieu of blood tests, Dr. Barnes advocated that patients measure their temperature upon awakening. If the temperature is consistently below normal ranges, this is indicative of a thyroid deficiency. The Barnes Basal Temperature test, which appears earlier in this protocol, provides specific instructions on how best to measure your body temperature in order to assess thyroid hormone status.

Dr. Barnes believed that 40% of the adult population suffered from thyroid deficiency. Based on the percentage of adults now taking prescription drugs to treat depression, elevated cholesterol, and high blood pressure, Dr. Barnes' observations about the epidemic of thyroid deficiency may now have been validated.

The Lancet is one of the most prestigious scientific journals in the world. It often reports new medical findings that defy conventional wisdom. According to the August 3, 2002, issue of The Lancet, the problem with thyroid blood tests may be caused by inadequate laboratory reference ranges that fail to reflect what the optimal level of thyroid hormone should be in a particular individual (Dayan et al. 2002).

The Life Extension Foundation has discussed the issue of faulty laboratory reference ranges for many years. The problem is that for many blood tests, the laboratories provide a wide range that represents "average" populations, rather than what the optimal level should be to maintain good health.

It is not just blood laboratory reference ranges that fail to provide physicians and patients with optimal numbers. For example, when your blood pressure is checked, a diastolic number up to 90 (mmHg) is considered normal. Yet a diastolic blood pressure reading greater than 85 is associated with an increased stroke risk. A high percentage of people over age 60 have diastolic readings greater than 85, and this is the age group most vulnerable to stroke (Hansson et al. 1998). So when your doctor checks your blood pressure and says it is normal, your response should be that "normal" is not good enough because it is also normal for people over age 60 to suffer a stroke. Instead, you should ask your doctor what is the "optimal" range. In the case of diastolic blood pressure, taking steps to keep it at 85 or below could greatly reduce long-term vascular damage. It is important to note that midlife hypertension predisposes people to stroke later in life, so keeping blood pressure readings in optimal ranges is important at any age.

Scientists are now examining epidemiological data related to thyroid hormone reference ranges, and their findings indicate that it may be time to change the way laboratories report their TSH results.


Thyroid Deficiency--what IS normal anyway? (continued)
10 years ago

THE THYROID STIMULATING HORMONE (TSH) TEST

The standard blood test used to determine thyroid gland hormone output is the TSH test. When there is a deficiency in thyroid hormone, the pituitary gland releases more TSH to signal the thyroid gland to produce more hormones.

When the TSH test is in normal range, doctors usually assume that the thyroid gland is secreting enough thyroid hormone. The question raised by The Lancet authors, however, is whether today's reference range for TSH reflects optimal thyroid hormone status.

The TSH reference range used by many laboratories is between 0.2-5.5 (mU/L). A greater TSH number is indicative of a thyroid hormone deficiency. That is because the pituitary is over-releasing TSH based on lack of thyroid hormone in the blood. Any reading more than 5.5 alerts a doctor to a thyroid gland problem and that thyroid hormone therapy may be warranted.

The trouble is that the TSH reference range is so broad that most doctors will look at a TSH reading as low as 0.2 and think it is as normal as a 5.5 reading. The difference between 0.2-5.5, however, is an astounding 27-fold. It would seem almost absurd to think that a person could be in an optimal state of thyroid health anywhere along this 27-fold parameter, that is, TSH readings between 0.2-5.5.

A review of published findings about TSH levels reveals that readings of more than 2.0 may be indicative of adverse health problems related to insufficient thyroid hormone output. One study showed that individuals with TSH values of more than 2.0 have an increased risk of developing overt hypothyroid disease over the next 20 years (Vanderpump et al. 1995). Other studies show that TSH values greater than 1.9 indicate abnormal pathologies of the thyroid, specifically autoimmune attacks on the thyroid gland itself that can result in significant impairment (Hak et al. 2000).

More ominous was a study s14howing that TSH values of more than 4.0 increase the prevalence of heart disease, after correcting for other known risk factors (Hak et al. 2000). Another study showed that administration of thyroid hormone lowered cholesterol in patients with TSH ranges of 2.0-4.0, but had no effect in lowering cholesterol in patients whose TSH range was between 0.2-1.9 (Michalopoulou et al. 1998). This study indicates that in people with elevated cholesterol, TSH values of more than 1.9 could indicate that a thyroid deficiency is the culprit causing excess production of cholesterol, whereas TSH levels below 2.0 would indicate no deficiency in thyroid hormone status.

Doctors routinely prescribe cholesterol-lowering drugs to patients without properly evaluating their thyroid status. Based on the evidence presented to date, it might make sense for doctors to first attempt to correct a thyroid deficiency (based on a TSH value over 1.9) instead of first resorting to cholesterol-lowering drugs.

In a study to evaluate psychological well-being, impairment was found in patients with thyroid abnormalities who were nonetheless within "normal" TSH reference ranges (Pollock et al. 2001).

Defying the Reference Ranges
The authors of The Lancet study stated that "the emerging epidemiological data begin to suggest that TSH concentrations above 2.0 (mU/L) may be associated with adverse effects." The authors prepared a chart based on previously published studies that provide guidance when interpreting the results from TSH blood tests. Here are three highlights from their chart that may be useful in ascertaining what your TSH values really mean:

  1. TSH greater than 2.0: Increased 20-year risk of hypothyroidism and increased risk of thyroid autoimmune disease (Vanderpump et al. 1995)
  2. TSH greater than 4.0: Greater risk of heart disease (Hak et al. 2000)
  3. TSH between 2.0-4.0: Cholesterol levels decline in response to thyroxine (T4) therapy (Michalopoulou et al. 1998)

Despite presenting these intriguing findings, The Lancet authors stated that more studies were needed to define optimal TSH level as between 0.2-2.0 instead of between 0.2-5.5. For a health-conscious person, however, this type of precise information provides an opportunity to correct a medical condition that has been unresponsive to mainstream therapies or possibly to prevent disorders from developing in the first place.

This means if you have depression, heart disease, high cholesterol, chronic fatigue, poor mental performance, or any of the many other symptoms associated with thyroid deficiency, you may want to ask your doctor to "defy the reference ranges" and try different thyroid replacement therapeutic approaches.


Thyroid Deficiency--what IS normal anyway? Pt III
10 years ago

Measuring Thyroid Hormone Levels
TSH is just one blood test that doctors use to assess thyroid status. Other blood tests measure the actual amount of thyroid hormone found in the blood.

The primary hormone secreted by the thyroid gland is called thyroxine (T4). The T4 is then converted in the peripheral tissues into metabolically active triiodo-thyronine (T3). Doctors often test for TSH and T4 together, but this may not accurately reflect thyroid deficiency in tissues throughout the body. One study found that psychological well-being could be improved if T3 (e.g., the drug Cytomel) were added to T4 (e.g., the drug Synthroid) therapy, while maintaining thyroid function broadly within the standard reference ranges (Bunevicius et al. 1999; Walsh et al. 2001). What this means is that even when TSH and T4 blood tests are within normal ranges, a person can still be deficient in peripheral T3 and benefit from Cytomel therapy.

Because T3 is the metabolically active form of thyroid hormone, some physicians use it exclusively in lieu of T4 drugs like Synthroid. The FDA's recent notice to ban synthetic T4 drugs like Synthroid because of inconsistent potencies helps to validate a statement made by Broda Barnes more than 50 years ago: "Patients taking thyroid replacement therapy have much better improvement of symptoms with natural desiccated thyroid hormone rather than synthetic thyroid hormones."

Although the FDA has found many problems in T4 drugs, the T3 drug Cytomel has produced consistent clinical results and is not a subject of the FDA's proposed ban. Dr. Barnes fought the drug companies against synthetic T4 drugs for years and recommended desiccated thyroid (Armour) drugs as the therapy of choice for most patients.

An article in the New England Journal of Medicine described a study in which patients with hypothyroidism showed greater improvements in mood and brain function if they received treatment with Armour thyroid rather than Synthroid (thyroxine). The authors also detected biochemical evidence that thyroid hormone action was greater after treatment with Armour thyroid (Toft 1999).

Thyroid deficiency occurs when the thyroid gland under-produces the hormones thyroxine (T4) and triiodothyronine (T3) needed to regulate the body's metabolic rate. In some individuals, the thyroid does not properly convert T4 to T3, the metabolically active form. Supplementation with synthetic or animal-derived thyroid hormone is necessary to return hormone levels to normal.

Synthetic hormone supplementation, prescribed by a physician, includes synthetic T4 (Synthroid, Unithroid, and Levoxyl), synthetic T3 (Cytomel), and a combination of synthetic T3 and T4 (Thyrolar).

Natural glandulars (by prescription), such as Armour Desiccated Thyroid Hormone, Nathroid, and Westhroid, derived from the thyroid gland of the pig, contain T4 and T3, and most closely resemble natural human thyroid hormone.

Suggested supplements and their dosages follow:

  1. Iodine, 1 mg perday
  2. Selenium, 200-600 mcg perday
  3. Tyrosine, 500-1000 mg perday
  4. Melatonin, 300 mcg-6 mg at bedtime
  5. DHEA, 25 mg 1-3 times perday (refer to DHEA Replacement Therapy protocol)
  6. CoQ10, 100-200 mg daily
  7. Life Extension Mix for vitamin A, vitamin B complex, magnesium, manganese, selenium, and zinc, to be taken as directed
  8. Thyroid & L-Tyrosine Complex, 2 capsules 3 times daily

FOR MORE INFORMATION

Contact the Thyroid Foundation of America, (800) 832-8321. For more information on natural glandulars or the basal body temperature test, contact the Broda O. Barnes, M.D. Research Foundation, P.O. Box 98, Trembly, CT 06611, (203) 261-2101.

 

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I hope this article helps shed some light on certain things...I found it quite enlightening, myself. I rather wish it had explained some of the more technical stuff (like the complicated measurement symbols) but oh well...what's important is that the info is there...


Blessings and Good Health,
Kat ^.^
Thank Kat
10 years ago

A few things about your suggested daily doses.

I have a web-site that I go to --- the PHD suggests to have DEHA levels checked before getting on this, you could make matters even worse if not checked first. As far as the other ingredients im not sure.  I'm just starting a wellness plan with a great Fibro-Fatigue Center located in most major cites.

fibroandfatigue.com

I have that nasty varmit Fibromyalgia-Fatigue (wich is pretty much is thyroid deficiency) it takes will power to get thru somedays with all the pain.  I have seen to many men that have this, it really makes me wonder how women can tolerate it.

I have a friend that was looking for a Care2 group to join for fibro- may I invite her?

Scott

Invite as many as you please!
10 years ago
Scott,

Invite as many as you please! The more the merrier!

Blessings and Good Health,
Kat ^.^
Hey Kat!
9 years ago

Just a question for you....In the above post is there a website??? I have hypothyroid and I am currently on synthroid...not getting very good results....I would like to approach my doctor with this info and my blood test in hand...maybe they will change their approach...

Pam

Hey Kat!
9 years ago

Just a question for you....In the above post is there a website??? I have hypothyroid and I am currently on synthroid...not getting very good results....I would like to approach my doctor with this info and my blood test in hand...maybe they will change their approach...

Pam

9 years ago

Thanks for the info!

I went to the doc back in the fall with what I felt were very strong thyroid based problematic symptoms... he ran a bunch of bloodtests (of which he disclosed nothing but his final interpretation) wherein I was declared "normal"... or rather "everything came back negative"... he then proceeded to say "if you still have symptoms, I can write you a prescription for Prozac".... erm, my #1 complaint (followed closely by fatigue) was lack of libido... somehow I didn't see that as a good idea....

I seemed to get better for a time but the fatigue is back, my fingernails are a mess (chipping and deep deep ridges -despite getting a lot of calcium and proteins and other nutrients - doing my best to cut back or out white processed sugars and starches), libido is still frustratingly low and I just don't know what normal is anymore... I'm too the point where I have to perhaps accept feeling so tired, worn out, and such as normal and I don't like it... so, considering getting a second (or even third) opinion, not that I WANT to find a problem but what's with the doc that so easily tosses anti-depressants around like they're candy (he said I could try it for a month to see if it helped - he was so darned casual about it)...

Anyway, your info helps me feel justified in seeking a second opinion, instead of a feeling like a hypocondriac LOOKING for problems where none may exist...

Anonymous
9 years ago

A word about Life Extension.

I have done extensive research on their recommendations and their interpreation of the scientific literature.

They use 'scientifc language' to sound authentic but they tend to twist the results of published studies, to cite unpublished studies and to make enormous leaps in their interpretation of the scientific studies.

I have sent them many emails poking holes in their reviews of the scientific literature.

They are not to be trusted. All they seem to care about is selling supplements that haven't been tested for safety and effectiveness for long term use.

They have a supplement tha thas 20 mg of leutin in it! Guess what? You get 2000 mg of leutin from eating fruits and vegatables very easily!

Rather than telling people to eat blueberries they sell blueberry extract. The problem with that is you are not getting everything that is in blueberries and it is very, very easy to get everything you need from blueberries by EATING them.

They do this over and over again. The same thing with green tea. they don't suggest that people drink green tea, no, they SELL green tea supplements when it is more healtht and much cheaper to simply DRINK green tea!

Don't throw your money away on Life Extension supplements!