Overcoming HyOvercoming Hyypothyroidism David BrowDavid ...€¦ · Colorado Thyr Prevalence Stu • 25,862 studied • 10% of people studied10% of people studied undiagnosed abnormal

Overcoming HyOvercoming HyOvercoming HyOvercoming Hy

David BrowDavid BrowDavid BrowDavid Brow

ypothyroidismypothyroidismypothyroidismypothyroidism

wnstein MDwnstein MDwnstein, MDwnstein, MD

Copyright 2011©Copyright 2011©

Welcome to ZRT LaWelcome to ZRT LaWelcome to ZRT LaWelcome to ZRT La

David BDr BrowDr. BrowphysiciapractitioM di lMedicalMedicinBrownsphysiciausing natherapietherapieauthoredThyroidHHormonmany m

boratory’s Webinarboratory’s Webinarboratory’s Webinarboratory’s Webinar

Brownstein, MD wnstein is a Board-Certified familywnstein is a Board-Certified family an and is one of the foremost oners of holistic medicine. He is the l Di f h C f H li il Director of the Center for Holistic ne in West Bloomfield, MI. Dr. stein has lectured internationally to yans and others about his success in atural hormones and nutritional es in his practice Dr Brownstein hases in his practice. Dr. Brownstein has d nine books, including Overcoming d Disorders, The Miracle of Natural

O i A h i i dCopyright 2011©Copyright 2011©

nes, Overcoming Arthritis, and more!

Program GoaProgram GoaProgram GoaProgram Goa

• Discuss the causes and sympto• Explain how to properly diagnExplain how to properly diagnmore than just laboratory tests• Discuss treatment protocols inphypothyroidism and thyroid res• List and explain which nutrien

l i h h id f ievaluating the thyroid function• Explain determining iodine deiodine to optimal thyroid functioiodine to optimal thyroid functio

als and Objectivesals and Objectivesals and Objectivesals and Objectives

oms of hypothyroidismnose thyroid disorders utilizingnose thyroid disorders utilizing

managing sub-clinical g gsistancents must be assessed when

eficiency and the importance of on


on

“Forty percent of the American ped d lt t d ff iand adults—today are suffering n

lack of an ingredient vital for heaNo. Or unavailable? No. For yeayrole of the deficiency in some are

had clues to its great importancknowledge too often has not beknowledge too often has not beused—because of the unreliabilfailed to show the deficiency ev

if t ti l l h imanifestations clearly enough in laboratory tests have erred and

patients, patients

BH

eople—four of every ten children dl l d d i feedlessly and many are dying for

alth. Is the ingredient unknown? ars, medicine has recognized the geas of health and disease and has ce in many other areas. But the een used—and still is not beingeen used—and still is not being lity of laboratory tests that have ven when doctors could see its

ti t b f th A d hilpatients before them. And while d have misled both doctors and s have suffered.”

Broda O. Barnes, M.D. Introduction to Hypothyroidism, The Unsuspected Illness. 1976.

Overcoming ThOvercoming ThOvercoming ThOvercoming Th

•• HypothyroidismHypothyroidism•• Poor T4 Converters and TPoor T4 Converters and T

ResistanceResistance•• Fibromyalgia and ChronicFibromyalgia and Chronic

H th idi d A tH th idi d A t•• Hyperthyroidism and AutHyperthyroidism and Aut•• Natural HormonesNatural Hormones

DietDiet•• DietDiet•• DetoxificationDetoxification•• Coagulation DisordersCoagulation Disorders•• Coagulation DisordersCoagulation Disorders

yroid Disordersyroid Disordersyroid Disordersyroid Disorders

Thyroid Hormone Thyroid Hormone

c Fatigue Syndromec Fatigue Syndromet i Di dt i Di dtoimmune Disorderstoimmune Disorders


Thyroid HorThyroid HorThyroid HorThyroid Hor

•• Affects every cell in boAffects every cell in bo•• Cannot achieve optimuCannot achieve optimuCannot achieve optimuCannot achieve optimu

properly functioning thproperly functioning th•• Hypothyroidism may bHypothyroidism may b•• Hypothyroidism may bHypothyroidism may b

missed diagnosis todaymissed diagnosis today40%40% f h l if h l i•• 40%40% of the population of the population hypothyroidism.hypothyroidism.

monemonemonemone

dydyum health without aum health without aum health without a um health without a hyroid glandhyroid glandbe the most commonlybe the most commonlybe the most commonly be the most commonly yy

h di dh di dmay have undiagnosed may have undiagnosed


Thyroid ProdThyroid ProdThyroid ProdThyroid Prod

ThThThyrThyrT4T4

T3T3

T4T4

T3T3Effects OEffects OEffects OEffects O

ductionductionductionduction

ididoidoid44

33

44

33On BodyOn BodyOn BodyOn Body


Thyroid and OThyroid and OImbalancesImbalances

•• AllergiesAllergies•• ArthritisArthritis

CC•• CancerCancer•• CandidaCandida•• Chronic FatigueChronic Fatiguegg•• Coronary Artery DiseaseCoronary Artery Disease•• Cystic breastsCystic breasts

C i iC i i•• Cystic ovaries Cystic ovaries •• DiabetesDiabetes•• EndometriosisEndometriosisEndometriosisEndometriosis

Other Endocrine Other Endocrine

•• GoutGout•• HypertensionHypertension•• Hypotension Hypotension •• InfertilityInfertility

M t l Di dM t l Di d•• Mental Disorders Mental Disorders •• Multiple SclerosisMultiple Sclerosis•• ObesityObesityObesityObesity•• P.M.S.P.M.S.•• PsoriasisPsoriasis


Colorado ThyrColorado ThyrPrevalence StuPrevalence Stu

•• 25,862 studied25,862 studied•• 10% of people studied10% of people studied10% of people studied 10% of people studied

undiagnosed abnormalundiagnosed abnormal•• 13 million nationally m13 million nationally m•• 13 million nationally m13 million nationally m

abnormal thyroid funcabnormal thyroid func

AA

roid Disease roid Disease udyudy

were found to havewere found to havewere found to have were found to have l thyroid functionl thyroid function

may have undiagnosedmay have undiagnosedmay have undiagnosed may have undiagnosed ction.ction.

Copyright 2011©Copyright 2011©Archives of Int. Med. Vol. 160, No. 4, 2/28/2000Archives of Int. Med. Vol. 160, No. 4, 2/28/2000

Sunscreen InhibSunscreen InhibSunscreen InhibSunscreen InhibFunctionFunctionFunctionFunction

A i l diA i l di•• Animal studiesAnimal studies•• Rats treated with 4MBC and Rats treated with 4MBC and BB

days found to have significantldays found to have significantldays found to have significantldays found to have significantl•• Weight of thyroid glands incWeight of thyroid glands inc•• All above results prevented iAll above results prevented i

presentpresent

“The work has shown that MBC an“The work has shown that MBC anpituitarypituitary--thyroid hormonal systethyroid hormonal syste

discovered in humans, then we mdiscovered in humans, then we mour children and those with existour children and those with existour children and those with existour children and those with exist

iodineiodine--deficient areasdeficient areas20062006

bits Thyroid bits Thyroid bits Thyroid bits Thyroid

BenzophenoneBenzophenone 2 (BP2) for five 2 (BP2) for five ly increased TSH and lower T4.ly increased TSH and lower T4.ly increased TSH and lower T4. ly increased TSH and lower T4. creasedcreasedif there was adequate iodine if there was adequate iodine

nd BP2 are potent disrupters of the nd BP2 are potent disrupters of the em in rats. If the same effect is em in rats. If the same effect is ay have to rethink how we protect ay have to rethink how we protect ting thyroid problems or those inting thyroid problems or those in


ting thyroid problems or those in ting thyroid problems or those in s from sun exposure.”s from sun exposure.”6. 6. EuropEurop. Congress of . Congress of EndocrinEndocrin. Presentation. Presentation..

Hypothyroidism aHypothyroidism aHypothyroidism aHypothyroidism a

•• 2550 Subjects2550 Subjects•• Subclinical hypothyroiSubclinical hypothyroiSubclinical hypothyroiSubclinical hypothyroi

260% increase in the p260% increase in the pdiseasediseasedisease.disease.

J. Cli

and Atherosclerosisand Atherosclerosisand Atherosclerosisand Atherosclerosis

dism associated with adism associated with adism associated with a dism associated with a revalence of heart revalence of heart

Copyright 2011©Copyright 2011©in. Endocrinol. Metab. 2004;89:3365-3370

Hypothyroidism aHypothyroidism aHypothyroidism aHypothyroidism a

• TSH receptor is expresand adipocytesp y• Elevated TSH may dire

function of coronary ary• Induce ischemic heart di

and Atherosclerosisand Atherosclerosisand Atherosclerosisand Atherosclerosis

ssed on coronary arteries

ectly affect endothelial rteries or fat cellsisease in hypothyroidism.


Hypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism an

•• 169 participants169 participants•• 53 children of mothers w53 children of mothers w53 children of mothers w53 children of mothers w

•• Treated with LTreated with L--ThyroxinThyroxinpregnancypregnancy

•• TSH was only monitor uTSH was only monitor u

•• 116 controls116 controls•• Evaluated at 6, 12 and Evaluated at 6, 12 and

neuropsychological evaneuropsychological eva

nd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopment

with hypothyroidismwith hypothyroidismwith hypothyroidismwith hypothyroidismne shortly before or during ne shortly before or during

usedused

18 months and a 18 months and a aluation at 5 yearsaluation at 5 years

Copyright 2011©Copyright 2011©FP News. 12.1.04FP News. 12.1.04

Hypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism anHypothyroidism an

•• InfancyInfancy•• Children of hypothyroidChildren of hypothyroidChildren of hypothyroidChildren of hypothyroid

abnormal visual procesabnormal visual procesand as well as and as well as sensorimsensorim

•• At age 5, mean IQ 8 poiAt age 5, mean IQ 8 poihypothyroid mothershypothyroid mothers

•• Also had lower scores onAlso had lower scores onwell as verbal and associwell as verbal and associ

nd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopmentnd Neurodevelopment

d mothers found to haved mothers found to haved mothers found to have d mothers found to have sing, deficits in attention sing, deficits in attention otorotor skills and memoryskills and memoryints lower in children of ints lower in children of

n tests of working memory, as n tests of working memory, as iative learningiative learning

Copyright 2011©Copyright 2011©FP News. 12.1.04FP News. 12.1.04

IQ and MaternalIQ and MaternalIQ and Maternal IQ and Maternal

•• Children of mothers withChildren of mothers withhypothyroidism v. mothehypothyroidism v. motheyp yyp yhypothyroidismhypothyroidism

•• IQ scores were 7 pointsIQ scores were 7 pointsIQ scores were 7 points IQ scores were 7 points untreated mothersuntreated mothers

•• 19% of untreated mother19% of untreated mother•• 19% of untreated mother19% of untreated mother<85 compared with 5% o<85 compared with 5% o

N

HypothyroidismHypothyroidismHypothyroidismHypothyroidism

h untreated h untreated ers without ers without

lowered in children oflowered in children oflowered in children of lowered in children of

rs had children with IQrs had children with IQrs had children with IQ rs had children with IQ of othersof others

Copyright 2011©Copyright 2011©N. Eng. J. of Med. 1999;341: 549-55

Low T4 Levels CoLow T4 Levels CoLow T4 Levels CoLow T4 Levels CoNeurodevelopmenNeurodevelopmenNeurodevelopmenNeurodevelopmen

•• 220 Children220 Children•• Neurodevelopmental ANeurodevelopmental ANeurodevelopmental ANeurodevelopmental A•• 22 Children of mothers22 Children of mothers

12 weeks gestation scor12 weeks gestation scor12 weeks gestation scor12 weeks gestation scoron the Psychomoter Deon the Psychomoter Decompared with the othecompared with the othecompared with the othecompared with the othe

orrelated With orrelated With orrelated With orrelated With nt Problems nt Problems nt Problems nt Problems

Assessment at 10 monthsAssessment at 10 monthsAssessment at 10 monthsAssessment at 10 monthss having the lowest T4 at s having the lowest T4 at red significantly worsered significantly worsered significantly worse red significantly worse evelopmental Index as evelopmental Index as ersersers.ers.


ClinClin. . EndocrinEndocrin. . OxfOxf. 2003:59:282. 2003:59:282--88

Thyroid Disease aThyroid Disease aThyroid Disease aThyroid Disease aThyroid Disease aThyroid Disease aThyroid Disease aThyroid Disease a

•• Increased risk of spontIncreased risk of spont•• Women with hypothyroWomen with hypothyroWomen with hypothyroWomen with hypothyro

•• 200% increase risk of p200% increase risk of pthose women that had hthose women that had hthose women that had hthose women that had h

and Preterm Deliveryand Preterm Deliveryand Preterm Deliveryand Preterm Deliveryand Preterm Deliveryand Preterm Deliveryand Preterm Deliveryand Preterm Delivery

taneous abortiontaneous abortionoidism or thyroid antibodiesoidism or thyroid antibodiesoidism or thyroid antibodiesoidism or thyroid antibodiespreterm delivery in preterm delivery in hypothyroidismhypothyroidismhypothyroidismhypothyroidism

Copyright 2011©Copyright 2011©FP News. 1.15.05

HistoryHistoryHistoryHistory

•• AcneAcne•• ArthritisArthritis•• ArteriosclerosisArteriosclerosis•• ConstipationConstipationpp•• Cold ExtremitiesCold Extremities•• DepressionDepressionDepressionDepression•• EczemaEczema•• Fatigue (A M Fatigue)Fatigue (A M Fatigue)•• Fatigue (A.M. Fatigue)Fatigue (A.M. Fatigue)•• HeadachesHeadaches

•• HypercholesterolHypercholesterol•• HypertensionHypertensionypyp•• Infertility Infertility •• Menstrual disordersMenstrual disorders•• Ovarian cystsOvarian cysts•• PMSPMSPMSPMS•• Poor memoryPoor memory•• PsoriasisPsoriasis


•• PsoriasisPsoriasis•• Recurrent infectionsRecurrent infections

Hypertension anHypertension anHypertension anHypertension anHypertension anHypertension anHypertension anHypertension an

•• Dr. Barnes felt there wDr. Barnes felt there wb.pb.p. and hypothyroid. and hypothyroidpp yp yyp y

•• Reviewed his records oReviewed his records o•• Of 95 patients who preOf 95 patients who pre•• Of 95 patients who preOf 95 patients who pre

hypertension and hypohypertension and hyposhowed a significant deshowed a significant deshowed a significant deshowed a significant deafter treatment for hypafter treatment for hyp

nd Hypothyroidismnd Hypothyroidismnd Hypothyroidismnd Hypothyroidismnd Hypothyroidismnd Hypothyroidismnd Hypothyroidismnd Hypothyroidism

was a link between high was a link between high

over 10 year periodover 10 year periodesented withesented withesented with esented with othyroidism, 95% (90) othyroidism, 95% (90) ecline in blood pressureecline in blood pressureecline in blood pressure ecline in blood pressure pothyroidismpothyroidism


Further ResearcFurther ResearcHypertension/HHypertension/H

• Dr. Barnes followed 1,5treated for hypothyroidyp y

• Incidence of hypertensi(the same as in the gene(the same as in the gene

• Only 12 new cases of Hnext 20 yearsnext 20 years• Approximately 225-375

develop HTN as they agdevelop HTN as they ag

ch on ch on HypothyroidismHypothyroidism

500 patients who were dismion initially was 10% eral population)eral population)

HTN developed over the

5 patients were expected to ged


ged

Physical ExamPhysical ExamPhysical ExamPhysical Exam

•• Anemia Anemia •• Dry skinDry skinyy•• EdemaEdema•• GoiterGoiter•• Hair loss Hair loss •• HypertensionHypertensionHypertensionHypertension

m Signsm Signsm Signsm Signs

•• HypotensionHypotension•• MacroglossiaMacroglossiagg•• PeriorbitalPeriorbital edemaedema•• Poor eyebrow growthPoor eyebrow growthy gy g•• Puffy facePuffy face•• Sluggish reflexesSluggish reflexesSluggish reflexesSluggish reflexes


Copyright ©1997 The Endocrine SocietyCopyright ©1997 The Endocrine Society ZulewskiZulewski, H. et a, H. et aal. J al. J ClinClin EndocrinolEndocrinol MetabMetab 1997;82:7711997;82:771--776776

Lab WorkLab WorkLab WorkLab Work

•• Blood TestsBlood Tests•• TSH, T4 total, T3 total,TSH, T4 total, T3 total,, , ,, , ,

•• 24 Hour urine testing24 Hour urine testing•• Serum FerritinSerum Ferritin•• Serum B12 (>450pc/ml)Serum B12 (>450pc/ml)

•• Clinical Pearls, March 1997, Vol. 7, NClinical Pearls, March 1997, Vol. 7, N

Reverse T3 Reverse T3

No. 3.No. 3.


TSH and ThyroidTSH and ThyroidTSH and ThyroidTSH and Thyroid

•• 50 50 euthyroideuthyroid subjects undsubjects und•• 1/3 found to have thyroid 1/3 found to have thyroid yy

•• Higher mean TSH Higher mean TSH (1/5mIU(1/5mIUbenign disease (1.01miU/mlbenign disease (1.01miU/ml

•• 8.7x increase risk of thyroid8.7x increase risk of thyroidupper three quartiles of TSupper three quartiles of TSthe lowest quartile (0.34the lowest quartile (0.34--1.11.1q (q (

•• T3 levels lowered T3 levels lowered in those din those d(113ng/dl) as compared to t(113ng/dl) as compared to t(130 /dl)(130 /dl)(130ng/dl).(130ng/dl).

d Cancerd Cancerd Cancerd Cancer

ergoing ergoing thyroidectomythyroidectomycancercancer

U/L) as compared to those with U/L) as compared to those with l)l)d cancer d cancer in subjects with TSH in in subjects with TSH in H values (1.2H values (1.2--3.7) compared to 3.7) compared to

1)1)))diagnosed with thyroid cancer diagnosed with thyroid cancer those with benign disease those with benign disease

Copyright 2011©Copyright 2011©Thyroid. Vol. 18. N. 9, 2008. 943-952

Reverse T3Reverse T3Reverse T3Reverse T3

ThThThyrThyrT4T4

T3T3

T4T4


ididoidoid44

33

44Reverse T3Reverse T3



TSH Is A Poor TTSH Is A Poor TTSH Is A Poor TTSH Is A Poor T

“The“The biologicalbiological effeceffecthethe peripheralperipheral tistisconcentrationsconcentrations-- reflereflehypothyroidismhypothyroidism.. AAyp yyp y(thyroid(thyroid hormone)hormone)guidedguided byby clinicalclinical ananandand thyroidthyroid hormonehormoneandand thyroidthyroid hormonehormonebyby serumserum TSHTSH conceconce

TestTestTestTest

ctscts ofof thyroidthyroid hormoneshormones atatssuesssues-- andand notnot TSHTSHectect thethe clinicalclinical severityseverity ofofAA judiciousjudicious initiationinitiation ofofjj

treatmenttreatment shouldshould bebendnd metabolicmetabolic presentationpresentationee concentrationsconcentrations andand notnotee concentrationsconcentrations andand notnot

entrationsentrations..””

Copyright 2011©Copyright 2011©BMJ 2003;326:311BMJ 2003;326:311--312312

TSHTSHTSHTSHTSHTSHTSHTSH

“TSH above 2.0mU/L is a risk fahypothyroidism, especially when Thypothyroidism, especially when Tin the absence of thyroid antibodiefficacy of treating subclinical hyp

on the TSH reference range aloneon the TSH reference range alone, TSH elevation with patient-specific

of TPO an

actor for future development of TPO is detected. This is true evenTPO is detected. This is true even ies. Ultimately, the diagnosis and pothyroidism should not be based but should integrate the degree ofbut should integrate the degree of

c risk factors and the concentration tibodies.”

Copyright 2011©Copyright 2011©FP NEWS. 6.15.07

Fetal Death, ImpFetal Death, Impand Neonatal Hyand Neonatal Hy

•• 9,403 Women9,403 Women•• TSH measured during sTSH measured during sTSH measured during sTSH measured during s•• 2.2% had TSH >6mU/L2.2% had TSH >6mU/L

R f f l d hR f f l d h•• Rate of fetal death was oRate of fetal death was owith elevated TSHwith elevated TSH

aired Development aired Development ypothyroidismypothyroidism

econd trimesterecond trimesterecond trimesterecond trimester

4 hi h i4 hi h iover 4x higher in women over 4x higher in women

Copyright 2011©Copyright 2011©J. Med. Screen. 2000;7:127-30

TSH and WeightTSH and WeightTSH and WeightTSH and Weight

•• Women:Women:Framingham study. 2407 parti

•• Weight increased by 2.3kgWeight increased by 2.3kgin TSH concentrationin TSH concentration

•• Men: Men: •• Weight increased by 1.1kgWeight increased by 1.1kgWeight increased by 1.1kgWeight increased by 1.1kg

in TSH concentrationin TSH concentration

“Change in serum TSH concentratiChange in serum TSH concentratirange) was strongly and linearly as

tttt

cipants followed for 3.5 years.

g for every 1g for every 1--unit increment unit increment

g for every 1g for every 1--unit incrementunit incrementg for every 1g for every 1 unit increment unit increment

ons over time (within reference

Copyright 2011©Copyright 2011©Arch. Intern. Med. Vol. 168 (No. 6), 3.24.08

ons over time (within reference ssociated with weight gain.”

TSH and ADHDTSH and ADHDTSH and ADHDTSH and ADHD

•• 4 year old children4 year old children•• TSH levels and neurobehavTSH levels and neurobehav•• High normal TSH levels (>7High normal TSH levels (>7

associated with memory andassociated with memory andskills skills •• Positively associated with hyPositively associated with hy•• TSH >2.2 presented lower TSH >2.2 presented lower nene

as higher risk of attention andas higher risk of attention andsymptoms.symptoms.y py p

ioral changesioral changesgg7575thth Percentile) negatively Percentile) negatively d verbal and quantitative d verbal and quantitative

yperactivity/impulsivity symptomsyperactivity/impulsivity symptomseurodevelopmentaleurodevelopmental scores as well scores as well d impulsivity/hyperactivity d impulsivity/hyperactivity

Copyright 2011©Copyright 2011©Clin. Endocrin. Oxf 2007. Jun;66(6): 890-8

Thyroid FunctionThyroid FunctionDiseaseDisease

•• 209 Participants209 Participants•• 12.7 years follow12.7 years follow--upupyy pp•• Women in the lowest (<Women in the lowest (<

(>2.1(>2.1 mIUmIU/L) of serum T/L) of serum T( 2.1 ( 2.1 mIUmIU/L) of serum T/L) of serum Tincreased risk of Alzheimincreased risk of Alzheimto those in middleto those in middle tertiletertileto those in middle to those in middle tertiletertile

•• Lowest Lowest tertiletertile: 239% in: 239% inHi h tHi h t t tilt til 215% i215% i•• Highest Highest tertiletertile: 215% in: 215% in

Arch. Int. Me

n and Alzheimer’s n and Alzheimer’s

1.0mIU/L) and highest 1.0mIU/L) and highest TSH concentration hadTSH concentration hadTSH concentration had TSH concentration had mer’s disease compared mer’s disease compared ee (0.5(0.5--5.0mIU/L)5.0mIU/L)ee (0.5(0.5 5.0mIU/L)5.0mIU/L)creasecrease


ncreasencreaseed. Vol. 168, No. 14, 7.28.08

TSH and Heart ATSH and Heart ATSH and Heart ATSH and Heart A

•• 17,311 women and 800217,311 women and 8002•• Without thyroid or cardioWithout thyroid or cardioWithout thyroid or cardioWithout thyroid or cardio•• ALL participants had norALL participants had nor•• Median followMedian follow--up of 8 3up of 8 3Median followMedian follow up of 8.3 up of 8.3 •• Women stratified into thrWomen stratified into thr

•• TSH 0 5TSH 0 5--1 4mIU/L1 4mIU/LTSH 0.5TSH 0.5 1.4mIU/L1.4mIU/L•• TSH 1.14TSH 1.14--2.52mIU/L2.52mIU/L•• TSH 2.5TSH 2.5--3.5mIU/L3.5mIU/L

AttacksAttacksAttacks (1)Attacks (1)

2 men2 menovascular diseaseovascular diseaseovascular diseaseovascular diseasermal TSH (0.5rmal TSH (0.5--3.5)3.5)yearsyearsyearsyears

ree groups:ree groups:

Copyright 2011©Copyright 2011©Arch. Of Int. Med. Vol. 168. N. 8, 4.28.08

TSH and HeartTSH and HeartTSH and HeartTSH and HeartTSH and Heart TSH and Heart TSH and Heart TSH and Heart

•• In women, significant differencIn women, significant differencrange and the mid and upper rrange and the mid and upper rMid (TSH1 14Mid (TSH1 14 2 52) 42 52) 4•• Mid range: (TSH1.14Mid range: (TSH1.14--2.52): 42.52): 4cardiovascular deathcardiovascular death

•• Upper range: (TSH 2.5Upper range: (TSH 2.5--3.5): 63.5): 6Upper range: (TSH 2.5Upper range: (TSH 2.5 3.5): 63.5): 6cardiovascular deathcardiovascular death

“Thyrotropin levels within the refery plinearly associated with CHD mortathat relatively low but clinically normthe risk of fatal CHD ”the risk of fatal CHD.

AttacksAttacksAttacksAttacksAttacks Attacks (2)(2)Attacks Attacks (2)(2)

ce between women in the lower ce between women in the lower ranges.ranges.41% i i k f41% i i k f41% increase risk of 41% increase risk of

69% increase risk of69% increase risk of69% increase risk of 69% increase risk of

rence range were positively and g p yality in women. The results indicate mal thyroid function may increase

Copyright 2011©Copyright 2011©Arch. Of Int. Med. Vol. 168. N. 8, 4.28.08

How To Check THow To Check THow To Check THow To Check TTemperatureTemperatureTemperatureTemperature

•• Shake thermometer down Shake thermometer down •• In A.M., take axillary temIn A.M., take axillary tem, y, y

10 minutes10 minutes•• Menstruating women shouMenstruating women shou

on days 2on days 2--4 of cycle4 of cycle•• Normal axillary temperatuNormal axillary temperatu

The Basal Body The Basal Body The Basal Body The Basal Body

at nightat nightperature before arising for perature before arising for p gp g

uld take their temperatures uld take their temperatures

ure is 97.8ure is 97.8--98.298.2


Diagnosing HypDiagnosing HypDiagnosing HypDiagnosing Hyp

•• HistoryHistory•• Physical examPhysical examPhysical examPhysical exam•• Basal Body TemperatuBasal Body Temperatu

Bl d TBl d T•• Blood Tests.Blood Tests.

pothyroidismpothyroidismpothyroidismpothyroidism

uresures


Comparing ThyComparing ThyComparing ThyComparing Thy

Desiccated ThyroidDesiccated Thyroid•• T1 T1 •• T2T2•• T3T3•• T4T4•• CalcitoninCalcitonin•• Diuretic EffectDiuretic Effect•• Diuretic EffectDiuretic Effect•• SeleniumSelenium

yroid Medicationsyroid Medicationsyroid Medicationsyroid Medications

Levothyroxine SodiumLevothyroxine Sodium•• T4T4


Other Thyroid RxOther Thyroid RxOther Thyroid RxOther Thyroid Rx

•• NatureNature--ThroidThroid and and WestWest•• CornCorn--free, desiccated thyfree, desiccated thyCornCorn free, desiccated thyfree, desiccated thy

•• Compounded DesiccatedCompounded Desiccated•• No fillersNo fillers•• No fillersNo fillers•• Adjust dosageAdjust dosage

C d d T3C d d T3•• Compounded T3Compounded T3•• Slow releaseSlow release•• No fillersNo fillers

x Choicesx Choicesx. Choicesx. Choices

tthroidtthroidyroid hormoneyroid hormoneyroid hormoneyroid hormoned Thyroid Hormoned Thyroid Hormone


Synthroid and LevoSynthroid and LevoDrugs According toDrugs According to

“…no currently marketed ora“…no currently marketed oralevothyroxine sodium produclevothyroxine sodium produclevothyroxine sodium produclevothyroxine sodium producdemonstrate consistent potedemonstrate consistent poteno currently marketed orally no currently marketed orally sodium product is generallysodium product is generallysodium product is generally sodium product is generally effective.”effective.”

Federal RegisterFederal Register

othroid Are Inadequate othroid Are Inadequate o FDAo FDA

ally administered ally administered ct has been shown toct has been shown toct has been shown to ct has been shown to

ency and stability and thus, ency and stability and thus, administered levothyroxine administered levothyroxine recognized as safe andrecognized as safe andrecognized as safe and recognized as safe and

r: August 14, 1997 (Vol. 62, Num 157)r: August 14, 1997 (Vol. 62, Num 157)


Desiccated ThyrDesiccated ThyrDesiccated ThyrDesiccated Thyr

•• Adults: Start at ½ graiAdults: Start at ½ grai•• Elderly heart disease hElderly heart disease hElderly, heart disease hElderly, heart disease h

and go slowlyand go slowly•• Monitor basal temperaMonitor basal tempera•• Monitor basal temperaMonitor basal tempera

physical exam signs anphysical exam signs an

roid Treatmentroid Treatmentroid Treatmentroid Treatment

ininhistory: Start at ¼ grainhistory: Start at ¼ grainhistory: Start at ¼ grain history: Start at ¼ grain

atures lab workatures lab workatures, lab work, atures, lab work, d symptoms.d symptoms.


Overcoming ThOvercoming ThOvercoming ThOvercoming Th

•• HypothyroidismHypothyroidism•• Thyroid Hormone ResistaThyroid Hormone Resista

ConvertersConvertersConverters Converters •• Fibromyalgia and ChronicFibromyalgia and Chronic•• Hyperthyroidism and AutHyperthyroidism and Autyp yyp y•• Natural HormonesNatural Hormones•• DietDiet•• DetoxificationDetoxification•• Coagulation DisordersCoagulation Disorders

yroid Disordersyroid Disordersyroid Disordersyroid Disorders

ance and Poor T4 ance and Poor T4

c Fatigue Syndromec Fatigue Syndrometoimmune Disorderstoimmune Disorders


Thyroid HormThyroid HormThyroid HormThyroid Horm

ThyroThyro

T4T4

T3T3

Effects OnEffects On

mone Resistancemone Resistancemone Resistancemone Resistance

idid

n Bodyn Body



•• Target tissues of body hTarget tissues of body hresponsiveness to thyroresponsiveness to thyrop yp y

•• First described in 1967First described in 1967

•• Can occur with adequaCan occur with adequaqqhormonehormone

•• Analogous to adult onsAnalogous to adult onsAnalogous to adult onsAnalogous to adult onsLaboratory tests willLaboratory tests will


have reduced have reduced oid hormoneoid hormone77

ate production of thyroid ate production of thyroid p yp y

set diabetesset diabetesset diabetesset diabetesl be inaccurate!l be inaccurate!



•• Genetic anomalies of thGenetic anomalies of threceptorsreceptorspp

•• Autoimmune, oxidativeAutoimmune, oxidativethyroidthyroid--hormone recephormone recepthyroidthyroid hormone recephormone recep

•• Competitive binding toCompetitive binding toreceptors by pollutantsreceptors by pollutantsreceptors by pollutantsreceptors by pollutants


hyroid hormone hyroid hormone

e, or toxic damage to e, or toxic damage to ptorsptorsptorsptorso thyroido thyroid--hormone hormone s food additives etcs food additives etcs, food additives, etc. s, food additives, etc.


T4 ConversioT4 ConversioT4 ConversioT4 Conversio

ThThThyrThyrT4T4

T3T3

T4T4


on Blockon Blockon Blockon Block

ididoidoid44

33

44



Lowered T3 LeveLowered T3 LeveAssociated With: Associated With:

•• Lowered attentionLowered attention•• DepressionDepressionDepressionDepression•• Increased mortalityIncreased mortality

L d bili fL d bili f•• Lowered ability to perfLowered ability to perfliving.living.

JAMAJAMA

els in Elderly els in Elderly

f i i i f d ilf i i i f d ilform activities of daily form activities of daily

Copyright 2011©Copyright 2011©A. 12.1.04;Vol. 292, No. 21A. 12.1.04;Vol. 292, No. 21

Thyroid HormoneThyroid HormoneTissue and IodineTissue and Iodine

•• Iodine deficiency in ratIodine deficiency in rathypothyroid picturehypothyroid pictureyp y pyp y p•• Elevated TSH with normElevated TSH with norm

Despite normal T3 levels cardiac tDespite normal T3 levels cardiac tDespite normal T3 levels, cardiac tDespite normal T3 levels, cardiac tT3. T4 therapy was unable to corT3. T4 therapy was unable to cor

presence of iodpresence of iod

e Levels in Cardiac e Levels in Cardiac e Deficiency e Deficiency

ts resulted in subclinical ts resulted in subclinical

mal T4 and T3mal T4 and T3

tissue was found to be deficient intissue was found to be deficient intissue was found to be deficient in tissue was found to be deficient in rrect the cardiac deficiency, in the rrect the cardiac deficiency, in the dine deficiency.dine deficiency.

Copyright 2011©Copyright 2011©ActaActa. . EndocrinEndocrin. (. (CopenCopen). 120;490). 120;490--98.198998.1989

J. J. ClinClin. Invest. 96;2828. Invest. 96;2828--38, 199538, 1995

T4 to T3 InhibT4 to T3 InhibT4 to T3 InhibT4 to T3 InhibT4 to T3 InhibT4 to T3 InhibT4 to T3 InhibT4 to T3 Inhib

Nutrient Deficiencies•• IodineIodine•• IronIron•• SeleniumSelenium•• ZincZinc•• Vitamin AVitamin A•• Vitamin B2Vitamin B2•• Vitamin B2Vitamin B2•• Vitamin B3Vitamin B3•• Vitamin B6Vitamin B6Vitamin B6Vitamin B6•• Vitamin B12Vitamin B12

bitorsbitorsbitorsbitorsbitorsbitorsbitorsbitors

Medications•• Beta BlockersBeta Blockers•• Birth Control Pills Birth Control Pills •• EstrogenEstrogen•• Iodinated Contrast Agents Iodinated Contrast Agents •• LithiumLithium

Ph t iPh t i•• PhenytoinPhenytoin•• SSRISSRI•• TheophyllineTheophylline


•• TheophyllineTheophylline


•• AgingAging•• AlcoholAlcohol•• AlphaAlpha--LipoicLipoic Acid Acid •• ChemotherapyChemotherapy

Ci tt S kiCi tt S ki•• Cigarette Smoking Cigarette Smoking •• Cruciferous Vegetables Cruciferous Vegetables •• DiabetesDiabetesDiabetes Diabetes •• FastingFasting•• FluorideFluoride

bitorsbitorsbitorsbitorsbitors bitors (2)(2)bitors bitors (2)(2)

•• Growth Hormone Deficiency Growth Hormone Deficiency •• HemochromatosisHemochromatosis•• LeadLead•• Low Adrenal StateLow Adrenal State

MM•• MercuryMercury•• PesticidesPesticides•• SoySoySoy Soy •• StressStress•• Surgery Surgery


g yg y•• RadiationRadiation


Nutrient Deficiencies•• IodineIodine•• IronIron•• SeleniumSelenium•• ZincZinc•• Vitamin AVitamin A•• Vitamin B2Vitamin B2•• Vitamin B2Vitamin B2•• Vitamin B6Vitamin B6•• Vitamin B12Vitamin B12Vitamin B12Vitamin B12

bitorsbitorsbitorsbitorsbitorsbitorsbitorsbitors

Medications•• Beta BlockersBeta Blockers•• Birth Control Pills Birth Control Pills •• EstrogenEstrogen•• Iodinated Contrast Agents Iodinated Contrast Agents •• LithiumLithium

Ph t iPh t i•• PhenytoinPhenytoin•• TheophyllineTheophylline


Thank you for pThank you for pThank you for pThank you for py py pour Weour We

y py pour Weour We

www.zrtwww.zrt(866) 60(866) 60

participating in participating in participating in participating in p p gp p gebinar!ebinar!p p gp p gebinar!ebinar!

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Documents

Overcoming HyOvercoming Hyypothyroidism David BrowDavid ...€¦ · Colorado Thyr Prevalence Stu • 25,862 studied • 10% of people studied10% of people studied undiagnosed abnormal