Hypothyroidism

Hypothyroidism

Jake Ames, MD, HMD

Thyroid disease is one of the most common health problems we face today.  At least 40% of my patients since 1994 have been low on thyroid hormone.  Part of this is due to drinking chlorinated and fluoridated water and eating bread containing brominated flour.  Bromine is also added to hot tubs.  Lack of iodine and other minerals in the diet is the other reason there is an epidemic of hypothyroidism.

Iodine

Iodine is a good halogen that helps displace and remove chlorine, fluoride, and bromine.  Iodine is needed to make thyroid hormone, and 100% of my patients are low on iodine unless they have been supplementing with it.  The iodine in iodized salt is not enough iodine for us.  Also, eating refined salt is not healthy.  We should only be consuming sea salt or Himalayan salt and adding iodine to our drinking water. 

How much iodine do we need?

The U.S. recommended daily allowance (RDA) for iodine is150 mcg daily. The Japanese eat lots of seaweed, and they average around 2-3 mg a day of iodine.  I agree with Dr. David Brownstein who recommends 12.5 mg a day of Lugol’s iodine (5% iodine/10% potassium iodide).  That would be 2 drops per day.  I have some patients taking up to 50 mg a day for a short while when they are poisoned with bromine or fluoride, or when they have an acute or chronic infectious disease.

The iodine added to refined table salt is at 100 parts per million as potassium iodide.  The average American if he does use salt is getting less than 70 micrograms a day.

Lugol’s iodine also works well for fibrocystic breast disease and, a woman can paint her entire breasts daily with Lugol’s iodine, and have her physician paint her entire vagina with Lugol’s iodine, or put the iodine in a spray bottle.  Painting the vagina works the quickest, as well has taking methylselenocysteine 600 mcg a day, eliminating caffeine, and taking evening primrose oil 2,000 mg a day.  Ovarian cysts can also be treated this way.

Taking Lugol’s iodine will also help protect you from radioactive iodine such as radiation caused by the Fukushima nuclear disaster.

Selenium

The second most important mineral for the thyroid gland is selenium.  The thyroid contains more selenium by weight than any other organ.  There are 11 selenium-dependent enzymes necessary for thyroid function and thyroid hormone production.

Selenium converts T4 to T3 (inactive thyroid hormone to active thyroid hormone).  Selenium is very low in our diet, and the selenium we do have is being used up binding to mercury, cadmium, and arsenic.

These heavy metals are damaging our thyroid glands and our thyroid hormone receptors.  To treat this epidemic, I have my patients use the FAR-IR sauna and get EDTA and DMPS chelation to remove chemical poisons and heavy metals.  This over time decreases one’s toxic load, so it helps some patient’s thyroid gland produce thyroid hormone to optimal levels again.

Since we are low on selenium, unless we are supplementing with it, we could develop Hashimoto's disease.  Hashimoto’s disease is an autoimmune disease that is increasing in incidence.  It causes hypothyroidism.  I take my patients 100% off gluten, usually give them methylselenocysteine 600 mcg a day, then after a week, I have them take Lugol’s iodine 5 drops a day.  I don’t see supplemental iodine causing a problem in Hashimoto’s thyroiditis because my patients are taking selenium. Most of these patients can take desiccated pork thyroid.  A small percentage of my patients do better with Synthroid.

The other minerals needed for thyroid gland function are zinc, copper, iron, molybdenum, manganese, and boron.  Vitamins A, D, E, and some of the B vitamins are required for the production or conversion of T4 to T3.  The amino acid Tyrosine is needed to make thyroid hormone.

What are the symptoms and signs of hypothyroidism (low thyroid)?

Sometimes I only see acne as a sign of hypothyroidism, but in general, a hypothyroid patient may have a few to many symptoms depending on how low they are on thyroid hormone.  I have seen all of the symptoms below many times.

I can see fatigue, sometimes worse in the afternoon, dry head hair, loss of head hair and body hair, dry skin, loss of outer eyebrows (Hertoghe’s sign), loss of eyelashes, or eyelashes that won’t grow long, cold hands or cold feet, generalized cold intolerance, sometimes heat intolerance, excess sweating from the hands and axillae, weight gain, difficulty in losing weight, eczema, slowness of thought, forgetfulness, brain fog, heart enlargement (congestive heart failure), low sex drive and libido, erectile dysfunction, difficulty in women and men achieving orgasms, rarely difficulty in gaining weight, muscle pains, anal pain, low hydrochloric acid production, poor metabolism, depression, apathy, anxiety, elevated cholesterol, lack of sweating, longitudinal striations of the fingernails and toenails, thin fingernails and toenails, triangulation of the fingernails, decrease or lack of lunulae in the nails (moons), constipation, poor immune system (frequent head colds, flues, viral and bacterial infections, sinus and bladder infections, pharyngitis), fibrocystic breast disease (also found with low iodine, and excess caffeine), endometriosis, ankle and leg edema (myxedema), slow Achilles ankle reflex.  Really low levels of thyroid hormone may or will cause death.

You can see, the thyroid hormone is very important, and every patient from a baby to the elderly should have their thyroid hormone tested routinely.

How to test for low thyroid hormone?

My teachers in medical school taught me to always treat the patient and use the lab result as a guide.  This goes for diagnosing low and high thyroid hormone.  Unfortunately, the majority of physicians around the world, including most endocrinologists, are diagnosing, treating, and managing their patient’s thyroid condition mainly on blood lab results.

A physician must ask patients if they have any of the above symptoms I listed.  This is the number one thing he should do.

Next, have the patient measure their oral temperatures for 5 days from 2-6 PM, at least two hours after eating since food can increase temperatures.  A patient must have a very accurate thermometer.  This is called a basal thermometer.  A digital basal thermometer must be accurate to one/one-hundredths of a degree.  A basal mercury thermometer, where they are still legal should have a range from 96 to 100 degrees Fahrenheit.

The ideal body temperature ranges in human are 98.2-98.6 degrees Fahrenheit or 36.7.37.0 degrees Celsius. 

Broda Barnes, M.D. preferred patients do AM (upon awakening) axillary basal temperatures.  He insisted on this, because many patients who are hypothyroid got sinus infections, and this can heat up the mouth.  His basal axillary temperature range was 97.8 to 98.2 degrees Fahrenheit.

The last way, not the first way to diagnose hypothyroidism is the blood test.  If your physician is just using your blood test to diagnose and adjust your thyroid medications, he is doing you a disservice, and I would find another physician who really understands thyroid hormone, and who has treated thousands of patients for hypothyroidism.

I order free and total T3 and T4.  Some doctors just order free T3 and free T4.  I want to know the total levels of thyroid hormones, so I also order a total T4 and T3.

I order a TSH (thyroid stimulating hormone) blood test.  Most labs have too high a reference range cut-off.  A typical labs reference range is 0.5 to 5.0 mU/L.  Some labs now have their high as 4.0 mU/L.  I suspect hypothyroidism if the TSH is over 3.0 mU/L.

When I treat patients with thyroid hormone, I try to keep the TSH below 2 mU/L.  We are taught in medical school that a low TSH indicates hyperthyroidism (too much thyroid hormone), and an elevated TSH indicates hypothyroidism (too low thyroid hormone).

In patients age 12 or older, I routinely order thyroid autoantibody tests, Thyroid peroxidase antibody (TPO) and Thyroglobulin antibody (TGAb).  If I don’t look for an autoimmune disease, I won’t find it.

I order a reverse T3 (rT3) which may be high with infections and chronic heavy metal burden.

Treatment

I use desiccated pork thyroid in 90% of my patients. Usually, Armour Thyroid, Nature Thyroid or Westhroid.  Sometimes patients do better with a compounded desiccated pork thyroid, and other times they do better with a compounded T4, T3 combination.  Ten percent of my patients do better with Synthroid (T4).  Some patients need to have Cytomel (T3) 5 mcg twice to four times a day added to the Synthroid.

I’ve treated thousands of patients for hypothyroidism, and there is no rule that works 100% of the time.  Basically, I prescribe the thyroid hormone which works the best.  I’ve had people on Synthroid, Armour Thyroid and Cytomel together.  Start low, and work up.  Some patients need to take their thyroid hormone twice a day.  I had a patient who needed to take thyroid hormone 4 times a day.  Some patients may need a time-released compounded thyroid hormone.

Too much thyroid hormone may cause a rapid heartbeat, excessive sweating, heart arrhythmia, anxiety, and insomnia.  If this happens, you need to decrease the dose. A low TSH once the patient has been taking thyroid hormone may mean, but not always mean, that the patient is getting too much thyroid hormone.  Cytomel (T3) releases so quickly, it may lower TSH despite the patient being euthyroid (normal thyroid). Some chemically sensitive patients at times do not make TSH or they only make a little of it.  Use common sense, and look for signs of excess thyroid hormone.

© 2017Jake Ames, MD, HMD  All Rights Reserved