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Hypothyroidism
Michael Lam, MD, MPH
www.DrLam.com
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
Primary vs. Secondary 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.
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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 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 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 varieties of factors that can contribute to the development of
thyroid problems:
- Exposure
to external radiation such as occurred after the Chernobyl nuclear plant explosion.
- Over-consumption of isoflavone-intensive soy products such as soy protein
or powder because 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.
- A history of radiation treatment to the head and neck areas.
- Over-consumption of uncooked goitrogenic foods, such as broccoli,
turnips, radish, cauliflower, and Brussels sprouts are all substances that suppress the function of the thyroid gland.
- 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 (due to dental amalgams which are 50 percent 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 problems
- …You have a history of Chronic Fatigue Syndrome
- …You are a female and over menopausal
- …You are over the age of 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 an undiagnosed
thyroid problem. Older women with sub-clinical or under-active hypothyroidism
are 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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