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Women’s Health                                           ®




                                                           ...
Proper thyroid function
requires conversion of T4 to
T3, which is the metabolically
active derivative of T4. This         ...
him, Dr. Barnes promotes
the use of a simple, easy,
temperature test for detecting
                                       ...
Related Diseases                 Reliance solely on blood           may block a clogged artery),
                         ...
Although the predominant
treatment is synthetic T4,           In the majority of cases, it seems that the
some medical pra...
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Is 98.6 ° Really Normal?

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Is 98.6 ° Really Normal?

  1. 1. Women’s Health ® Complimentary Issue IV Is 98.6° Really Normal? During the 1860s, an extensive Understanding study of over 25,000 patients ... an increased preva- Thyroid Function revealed that the average temperature in the “normal” lence of mild to moderate The thyroid gland produces range was 98.6°F. Based on that thyroid hormones that regulate study, we have accepted 98.6° hypothyroidism may be the body’s metabolism. The as our “normal” temperature, principal hormones secreted by with variations being cause for the thyroid gland are: concern of illness or infection. contributing to the lower- s triiodothyronine (T3) However, in the Townsend Letter for Doctors, Dr. Alan Gaby cites ing of our “normal” body s thyroxine (T4). a more recent study, which Because nearly 80% of the determined that the average temperature. In other thyroid gland’s production is body temperature was 98.2°F devoted to T4, thyroxine is often — somewhat lower than what words, “normal” does not called “the thyroid hormone” we typically consider “normal.” (much the same way that Some medical professionals necessarily mean optimal. estrogen is considered “the believe that an increased preva- female hormone”). Nonetheless, lence of mild to moderate hypo- triiodothyronine, or T3, is func- induced by pollutants, and the thyroidism may be contributing tionally the more important possibility that we are evolving to the lowering of our “normal” thyroid hormone. According to into a population with a pro- body temperature. In other Dr. Joseph Mercola, “T3 does pensity for hypothyroidism. words, “normal” does not 90% of the work of the thyroid Dr. Gaby explains that, in the necessarily mean optimal. In in the body.” past, people with mild hypo- fact, using thousands of patients thyroidism typically died from The thyroid, pituitary, and as a basis for study, Dr. Broda fatal bouts of pneumonia or hypothalamus glands all play Barnes (author of the book other infections before their a role in producing thyroid Hypothyroidism: The Unsuspect- thyroid condition was diag- hormones (see figure on page 2). ing Illness) promoted a simple nosed; today, many of these The thyroid gland is stimulated body temperature test as the other illnesses are cured with to produce T3 and T4 by the most reliable indicator of a antibiotics, allowing the pituitary gland’s production of potential thyroid problem. hypothyroidism to surface. Thyroid Stimulating Hormone Subtle hypothyroidism has Therefore, instead of dying (TSH). The pituitary gland, become increasingly common prematurely, these individuals in turn, is regulated by the throughout the 20th century. survive to propagate an increas- hypothalamus. Dr. Thierry Dr. Gaby suggests that this ingly large family tree with a Hertoghe indicates that there apparent epidemic could be tendency toward hypothyroidism. may even be a pre-hypothalamic the result of several factors. It seems that hypothyroidism is influence on thyroid hormone Two such factors are a possible an inherited disorder, especially production, but it is not yet thyroid hormone resistance for women. widely understood. Continued on Page 2 1
  2. 2. Proper thyroid function requires conversion of T4 to T3, which is the metabolically active derivative of T4. This The thyroid, conversion takes place primar- pituitary, and ily in the liver and kidney, hypothalamus and is somewhat sensitive glands all play a to nutrition and a variety of role in producing Hypothalamus thyroid hormones. vitamin, mineral, or hormonal excesses or deficiencies (see The liver and kidney Imbalances That Can Affect T4 are also important to T3 Conversion). If the to thyroid function conversion of T4 to T3 is Thyroid because they impaired such that there is a convert T4 to T3, deficit of T3, symptoms of which is the meta- hypothyroidism may persist, bolically active even with thyroid treatment. derivative of T4. Diagnosis The most common method of Cases of mild to moderate Another problem with using diagnosing thyroid function is hypothyroidism are often missed blood tests to gauge thyroid to measure TSH and T4, and because the range of “normal” function is that the tests sometimes T3, with a labora- test results is overly broad, and typically measure the serum tory blood test. Blood tests may the measurement is not sensitive level, not the “free” or bio- also be used to rule out other enough. In addition, thyroid chemically available portion potential causes for a thyroid hormone levels are not static. of the thyroid hormones. The imbalance, such as a pituitary They vary significantly through- majority of the thyroid hor- or adrenal deficiency. However, out the day and are influenced mones circulate in the blood- some healthcare practitioners by a variety of factors, such as stream, bound to a carrier feel that these tests are some- the potential imbalances that can protein. However, only the what limited for determining result from diet and lifestyle, as unbound or “free” portion of thyroid function, and that their identified in the box below. the hormone is available for results can be misleading. use by body cells. Furthermore, conventional thyroid blood tests account for only the thyroid and pituitary glands’ roles in the process. There are other Imbalances That Can Affect T4 to T3 Conversion aspects of thyroid function that Excesses can go wrong, which such tests Nutrition: High-fat Diet, High-protein Diet do not measure. Trace Minerals: Cadmium, Lithium According to Dr. Barnes, Hormones: Estrogen (natural or synthetic), “More information often can Stress-related hormones such as Cortisol be brought to the physician Deficiencies with only the aid of an ordinary Nutrition: Fasting, Starvation, Anorexia, thermometer than can be ob- tained with all other thyroid Protein Calorie Malnutrition function tests combined.” Trace Minerals: Selenium, Iodine, Iron, Zinc With years of study and Vitamins: Riboflavin (B2) the successful treatment of Hormones: T3, T4, TSH thousands of patients to back Continued on Page 3 2
  3. 3. him, Dr. Barnes promotes the use of a simple, easy, temperature test for detecting Basal Temperature Test thyroid problems (see Basal Almost 60 years ago, Dr. Broda Barnes developed a simple Temperature Test). While Dr. temperature test for detecting thyroid problems. This easy test Barnes admits that it is not a can be performed at home, and has proven to be even more perfect test for determining reliable than blood tests for detecting cases of mild to moderate thyroid function, it has proven hypothyroidism. to be quite reliable at detecting Menstruating women should take this test only on the second or mild to moderate hypothy- third day of their menstrual flow. Young girls (pre-puberty), post- roidism. In his experience, menopausal women, and males can take this test at any time of he noted that relatively few the month. other conditions lower the basal temperature below normal (including pituitary or adrenal Here’s how you do it: deficiencies, starvation, and 1. Shake an ordinary thermometer down as far as some drugs), but these can be it will go before placing it next to your bed. fairly easily ruled out. 2. In the morning, upon awakening and with as little movement as possible, place the Symptoms thermometer under your armpit and lie quietly Undetected thyroid problems for ten minutes. have plagued people for years, and continue to be an under- Here’s what it means: lying cause for a variety of If your temperature is 97. 97.8°F to 98.2 F , your 98.2°F ailments that doctors hear thyroid is probably functioning normally. about today. The onset of hypothyroidism is subtle, If your temperature is above 98.2 F , you may 98.2°F with symptoms gradually have an overactive thyroid (hyperthyroidism), worsening over time, making or an infection. it more obvious as people age. If your temperature is below 97.8 F , you may 97.8°F To further complicate matters, have low thyroid function (hypothyroidism). the symptoms of hypothyroid- ism are varied, affecting each individual differently, including: s Excessive fatigue s Course or brittle hair, with s Infection, especially s Increasing sensitivity to cold, slow growth or excessive respiratory infections feeling chilly even at normal hair loss s Muscle weakness room temperature s Skin problems such as dry, s Joint pain s Slow, rapid, or irregular rough, scaly skin heartbeat s Mental impairment, including Unfortunately, many health- s Menstrual problems, with depression, inability to care professionals still do not possible infertility concentrate, and poor memory recognize these symptoms as being potentially related s Weight-related problems, s Decreased or minimal to thyroid function. This is including difficulty losing perspiration, even in hot another reason that hypothy- weight, or unexplained weather or during exertion roidism is often overlooked, weight gain or weight loss s Constipation that is resistant remaining undetected until s Fluid retention, especially to laxatives or magnesium more severe symptoms around the eyes supplements develop. Continued on Page 4 3
  4. 4. Related Diseases Reliance solely on blood may block a clogged artery), testing for determining as well as increased blood Hypothyroidism is also thyroid deficiencies, coupled pressure and excessive fatigue often associated with other with the development and — all factors that can increase diseases, such as menstrual use of synthetic thyroid the risk of stroke or heart disorders (including infertil- hormones, has caused many attack. ity), heart disease, and menstrual-related thyroid osteoporosis. disorders to go untreated, Osteoporosis according to Dr. Barnes. He Years ago, there was some Menstrual Disorders believed and practiced that, concern that thyroid treatment The fact that many menstrual without evidence of an organ- could lead to osteoporosis. irregularities are related to related cause, most menstrual Even though this has not hypothyroidism has been problems (including miscar- proven to be true, women are commonly accepted for quite riage and infertility) could be still warned about it today. some time. As far back as remedied with proper thyroid In fact, according to Dr. Ray 1914, Dr. Eugene Hertoghe, therapy. His book, Hypothy- Peat in the Townsend Letter for a distinguished Belgian roidism: The Unsuspecting Doctors, the opposite is more endocrinologist, noted “The Illness, contains numerous likely to be true. He states, thyroid has a great influence anecdotes, examples, and case “Hypothyroidism, whether on menstruation, pregnancy, studies that demonstrate Dr. natural or promoted by lactation, and even uterine Barnes’ success rate. Some of administered thyroxine, involution after childbirth.” this success was due to the retards bone modeling and And in 1982, Dr. Broda Barnes fact that he looked at both tissue repair in general.” confirmed that “There are members of a couple (not just Osteoporosis may result from many possible causes for the woman), and thereby hypothyroidism itself, or from menstrual difficulties. recognized hypothyroidism thyroxine pills (which are only Among them are ovarian in the father as a potential T4) if there is poor conversion of cysts, fibroids, and cervical part of the problem. T4 to T3. Dr. Peat contends that polyps, [as well as] endome- Over the past few decades, the risk of osteoporosis is triosis … But in the vast it has been well documented likely to be greater without majority of women, there is that infertility is on the rise. administering the proper no evidence of any [organ- There may be a link between thyroid hormone therapy, related] problem. What is the rise in untreated hypo- as explained below. commonly evident if it is thyroidism and the rise in sought is low thyroid infertility. This possible function.” Treatment connection warrants further Dr. Barnes continued, research, especially in light The current method of treat- “Forty years ago, … of the success Dr. Barnes had ment for hypothyroidism is leading gynecologists … with treating infertile couples. some form of thyroid hormone were reporting that thyroid replacement (synthetic or [therapy] had cured more Heart Disease natural) that provides either menstrual disorders than all T3 or T4, or a combination of Heart diseases may also be other medications combined. the two. related to hypothyroidism. Unfortunately, that lesson Thyroid secretions also The most commonly prescribed seems to have been largely control cholesterol levels, thyroid therapy is synthetic lost.” Even more unfortu- which means that hypo- levothyroxine or L-thyroxine nately for the many women thyroidism may be a primary (with brand names such as who suffer from menstrual contributor to atherosclerosis. Synthroid®, Levothroid®, or problems, that lesson still Thyroid deficiencies can also Levoxyl®), which contains only seems lost today, almost lead to accelerated blood T4. Synthetic T3 is available as twenty years later. clotting (producing a clot that Cytomel®. 4 Continued on Page 5 4
  5. 5. Although the predominant treatment is synthetic T4, In the majority of cases, it seems that the some medical practitioners question the value of T4-only significance of T3 — the biochemically treatment. In fact, a recent New England Journal of Medi- active thyroid hormone — is being cine article reinforced the significance of T3 in treating ignored during diagnosis, treatment, and hypothyroidism, which lends support to those practition- subsequent treatment monitoring. ers’ concerns. thyroid hormone — is being well as other potentially For example, Dr. Mercola ignored during diagnosis, active thyroid hormones (see states that many people being treatment, and subsequent Is There a 3rd Thyroid Hormone? treated for hypothyroidism treatment monitoring. below). Because T3 is both with T4 are actually being fast-acting and has a short undertreated. He suggests As mentioned previously, half-life, some practitioners that the excessive reliance on there are many factors that encourage administering single-thyroid treatments (T4) can impair conversion of T4 natural thyroid treatments and the subsequent blood to T3. A significant number of twice daily instead of once. test results that indicate a patients do not convert T4 to “normal” TSH level are the T3 at a sufficient rate (or at One reason synthetic T4 primary reasons for the all), necessitating a treatment persists as the conventional oversight. that combines both hormones. treatment is a perception that In fact, some practitioners do it may be more stable than the Ray Peat, PhD, adds that “If use compounded mixtures natural thyroids. However, the liver is the main source that include both T3 and T4. Dr. Peat states that “Armour of the thyroid problem, then thyroid, USP, is often said to thyroxine pills [which are Another alternative is natural be of imprecise dosage, but in only T4] can make the prob- thyroid therapy, which is fact every batch is biologically lem worse …” because the desiccated (or dried) animal standardized, and studies liver is not converting T4 to thyroid, with brand names have shown it to be reliably T3, and the treatment is such as Armour® thyroid. within 1% of the labeled further suppressing T3 pro- Some practitioners believe the potency. The best known duction from the thyroid. In natural thyroid more closely brand of the supposedly the majority of cases, it seems resembles the entire range of chemically precise levo- that the significance of T3 — human thyroid hormones, thyroxine, however, was the biochemically active including both T3 and T4, as for a long time 30% below the labeled potency.” Is There a 3rd Thyroid Hormone? Over the course of his many years in practice, the late Dr. Barnes Conclusions noted that many patients who were being treated with synthetic Overt hypothyroidism is thyroxine (T4) or a combination of T3 and T4 complained of fairly easy to detect. But, residual symptoms, specifically dry skin and retention of fluid. for the majority of people However, when their therapy was modified to the natural Armour who have this disease in dessicated thyroid, which more closely resembles the full range of mild to moderate forms, the human thyroid hormones, both symptoms disappeared within diagnosis is often missed. one to two months. These observations suggested to Dr. Barnes Once diagnosed, proper that “there may be a diuretic factor in the thyroid gland separate thyroid hormone replacement from T4 and T3.” He suggested that the possibility of additional therapy can remedy the thyroid hormones warrants more research. majority of symptoms. Continued on Page 6 5
  6. 6. ® PRESORTED Get Connected . . . STANDARD U.S. POSTAGE $ Yes! Please send me a one-year subscription to Connections. Connections is published four times a year and is PAID MADISON, WI PERMIT NO. 953 available for $12.00. Mail your check payable to: Women’s Health Connection P.O. Box 6338 Women’s Health Connection Madison, WI 53716-0338 P.O. Box 6338 Madison, WI 53716-0338 Address Service Requested Name ________________________________________ Address ______________________________________ City, State, Zip ________________________________ Call 1-800-366-6632 to put subscription on Mastercard or Visa. This subscription form may be photocopied. Connections is a publication of Women’s Health Connection, an educational division of Women’s International Pharmacy. Published four times per year, Connections is dedicated to the education and management of PMS, menopause, infertility, postnatal depression, and other hormone-related disorders. This publication is distributed with the understanding that it does not constitute medical advice for individual problems. Although material is intended to be accurate, proper medical advice should be sought from a competent professional. Publisher/Editor: Constance Kindschi Hegerfeld, Executive Vice President, Women's Health Connection. Connections is printed on recycled paper. 5/2000 Not all people with hypothyroidism will exhibit the s Dr. Joseph Mercola, Optimal Wellness Center same symptoms. The symptoms that do surface will website (http://www.mercola.com) affect people to different degrees, from very severe s Dr. Thierry Hertoghe, “Nutritional Influences on to very mild. In addition, thyroid hormone levels Hormone Levels” at the Broda O. Barnes, MD are not a reliable indicator of how bad (or good) Foundation, Inc.’s Annual Spring Conference, you feel. Some people with very “mild” deviations March 1996. in their laboratory thyroid test results will feel just s Dr. Broda O. Barnes, MD, PhD, “Is There a Third fine, while others will have any number of symp- Hormone in the Thyroid Gland? Which toms. Therefore, it is important for both you and Preparation Should be Used for Treatment?”, your healthcare practitioner to keep in mind that Journal of IAPM, November 1982. the goal is not necessarily to force the blood test s Ray Peat, PhD, “Thyroid: Misconceptions,” results into the “normal” range, but to make Townsend Letter for Doctors, November 1993. you feel better as well! s Drs. Bunevicius, Kazanavicius, Zalinkevicius and Prange, “Effects of Thyroxine as Compared with For More Information Thyroxine Plus Triiodothyronine in Patients with If you would like to learn more about hypo- Hypothyroidism,” New England Journal of Medicine, thyroidism, you may refer to the following sources 1999; 340:424-9. used in researching this article: s Stephen E. Langer and James F. Scheer, Solved: The Riddle of Illness, Keats Publishing, April 1995. s Dr. Alan R. Gaby, MD, “Literature Review & Com- mentary,” Townsend Letter for Doctors, July 1997. s Dr. Broda O. Barnes, MD, and Lawrence Galton, This article was written by Kathleen McCormick Hypothyroidism: The Unsuspecting Illness, Harper and of McCormick Communications, with illustration Row, Publishers, New York, 1976 by Amelia Janes. 6

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