Disease, Medication

Hypothyroidism – being on the backburner.

The thyroid is a very important player when it comes to regulating our metabolism and as a result our energy levels. To read more about what the thyroid does, go here.

Thyroid issues is very common in the industrialized world and an increasing health problem, and about 90% are women. A recent study suggests that up to 10 % of women over 60 suffers from hypothyroidsm, which translates to low levels of Thyroid Hormone (TH).  There are also the opposite, hyperthyroidism, with too high levels of thyroid hormone, but it usually ends in a burn out of the gland and a hypothyroid state.
The focus of this article is on hypothyroidism, the causes, symptoms, measurable blood work and treatment.

The most common underlying cause for thyroid hormones is Hashimoto’s thyroiditis, an autoimmune disease where antibodies from our own immune system attacks the cells of the thyroid. The antibodies are directed towards Thyrosine Peroxidase (TPO), an enzyme that makes iodine biologically accessible for the thyroid cells.
Hashimoto’s has been associated with other autoimmune diseases as Chron’s disease (an autoimmune disease that affects the bowels) and Reumatoid Arthritis (RA). Autoimmunity is more common in women than men, and it is believed to have a connection with the fact that women’s bodies are meant to conceive and carry a baby (in this case a foreign object). So the immune response is tuned in a little differently between men and women.

Symptoms of hypothyrodism:

  • Chronic fatigue
  • Difficulty concentrating
  • Slow speech
  • Feeling low or depressed
  • Hair loss
  • Loss of apetite
  • Easy weight gain
  • Constipation
  • Infections
  • Inability to tolerate cold
  • Muscle weakness and cramps
  • Heavy periods and painful premenstrual periods
  • Discoloration of the skin, a yellow-orange color. Dry, saggy, old looking skin.
  • Goiter (swelling of the thyroid gland)

As you can see, many of these symptoms are pretty unspecific, meaning that they can be attributed to many different conditions and they can also be fluctuations in your normal state. Since none of the symptoms directly points towards a certain disease, ea they are not pathognomonic, it’s important to address if there has been a lasting change. Did you notice a difference 2-3 months ago? Has it continuously stayed the same or become worse? Do you have many of the symptoms? Then that makes hypothyroidism more likely.

TH is crucial for the body to keep it’s systems going and keeping up the metabolism. Without it you will be put on the back burner, and your life tends to be lived in a shade of grey.

Diagnosis
When you go to your doctor with these complaints, some blood samples will usually be drawn. Namely T4, T3 and TSH (for more info about them go here), the main actors on the stage. If the results indicate hypothyrdism – low T4 and/or T3 and high TSH, some additional testing might be done, to look for TPO-antibodies or other antibodies that also might be the culprits of thyroid dysfunction.
Sometimes the results will come back within the range and you will be told that there is no problems with your thyroid and you might even be given antidepressants, because they symptoms are pretty similar. It is important to remember that the blood tests won’t tell us everything. The “normal” ranges that laboratories use is the average of all the tests that they have been doing, and since many people that are being tested have a disease or anomaly, the ranges will be skewed. There are many levels where TH levels can be affected and some of them don’t show up on your tests.
If you have trouble converting T4 to the active T3 in your cells this won’t show up on your normal tests, and sometimes your doctor will  measure reverse T3 (rT3), an inactive version of the T3 hormone. If that is above normal and the other tests are within range, the issue might be on the cellular level. That brings us to the next important point. This hormonal system does not operate as a sovereign entity in the body, it collaborates, is influenced by and influences other organ and hormonal systems in the body. That’s what the body does, balances for all it’s might to keep all of it’s systems in that sweet range of healthy and excellence.

Another system that heavily influences the thyroid is the Hypothalamus Pituitary Adrenal (HPA) -axis. The adrenals are glands situated on top of your kidneys and they secrete, among others, a  stress hormone called cortisol. Cortisol inhibits the conversion of T4 to T3 and pushes it direction of rT3. Another hormone in this same axis, CRH (that stimulates the release of cortisol) inhibits the effects of TSH on the thyroid and through that lowers he amount of available TH. So if having symptoms of hypothyroidism the adrenals should be addressed as well.

Treatment:
The common treatment in modern western medicine today is to add what is missing, in this case thyroxine or T4. Depending on your doctor you’ll be prescribed different versions of the same thing.
Sometimes this is enough to get the symptoms to go back, but the real issue, the dysfunction of the thyroid, haven’t been addressed.

There are many things that can influence the health of your thyroid, including gut issues, high inflammation, very low blood sugar, high amounts of fluoride or other toxins to mention a few. Iodine and Selenium are also two very important elements for a healthy thyroid.
So the most important thing is to make sure you live in a way that supports your body. Eating a nutrient dense diet, giving you all the nutrients you need without a heavy toxin load. This means getting away from processed food, cooking from whole foods, preferably organic and locally grown/produced. Stay low on the sugar/starches, moderate on high quality protein (grass fed beef, small fish, shellfish, pastured chicken etc)  and get a lot of good fats (butter, coconut oil, olive oil, avocado oil). Be sure to use salt with iodine. Drink enough of clean, filtered water.
Make sure you get to exercise and use your body daily, get fresh air and sunlight if possible. Clean up your life, make sure you do what you want to do, make room for silent moments and time to heal. Meditate, do yoga, do some kind of inner work. Let your self relax and have fun. As you could read earlier in this text, your thyroid is heavily influenced by the stress level in your body. Get enough good sleep.

Eating good food, low in sugars, drinking enough water, enjoying the outdoors, exercising, sleeping enough, being mindful, relaxed and having fun can take you a long way and help you correct minor thyroid imbalances and prevent thyroid issues in the future.
And even if you need to use drugs, giving your body what it needs will keep you as healthy as possible, even with your disease.

There are discussions if substituting with Iodine and Selenium could be beneficial or even have healing effects on hypothyroidsm, but I haven’t found any clear data or recommendations on this. It’s an interesting thought to keep in mind, and I’m sure there will be a blog post on that pretty soon.

If you have symptoms of hypothyrodism or know you have it, I highly recommend you work with a professional, an MD or a naturopathic physician that is willing to discuss both the medication and life style changes as well as supplementation that you can make. Sometimes medications are necessary, so having a health care provider that you trust and can discuss with is of uttermost importance for your optimal health.
Don’t be afraid to ask and discuss with your doctor, it’s your life and you deserve to have the best life you can possibly imagine!

Recommended reading:http://chriskresser.com/?s=thyroid
http://blog.cholesterol-and-health.com/search/label/Thyroid
http://www.saragottfriedmd.com/adaptogen-herbs-to-heal-your-thyroid-and-boost-metabolism/

Please tell me your story, post your questions, or just tell me what you think in the comments. I’m looking forward to hear from you!

Medication, Training

Why go for drugs when you can benefit from training?

Recently a new study showed that the benefits of exercising might be impaired by the commonly prescribed, lipid lowering statins (named Zocord, Simvastatin and Crestor etc).

Cholesterol lowering drugs are commonly subscribed to people with, what in medicine is called, elevated blood cholesterol levels. Usually life style changes, like increased exercise, is enouraged.
Some doctors even suggest people over 50 should take these drugs for preventive reasons.

People who are overweight, sedentary, in the middle-age with an increased risk for heart disease are the ones who would benefit most from aerobic exercise. But they are also the ones that usually have elevated blood lipid levels and would be put on statins.
A common side effect of statins are muscle aches, and athletes with high demands on their muscular system might have such difficulties with the statins that they need to go on other alternative medications. http://www.ncbi.nlm.nih.gov/pubmed/22036108
This is widely known among doctors, but until now there has been no or very little research on the mechanism behind this.

In this study a group of people that hadn’t been exercising regularly the last year, with signs of metabolic syndrome (wide waistlines/excess abdominal fat and increased blood pressure), and with slightly elevated blood cholesterol levels were divided into two groups.

Both groups were put on a regular, supervised 12 week, exercise program, visiting the university clinic five times/week, walking or jogging on a treadmill for 45 minutes in a speed about 65-70 % of their individual aerobic maximum.
Their aerobic fitness was measured and muscle biopsies were taken before and after the trial. No changes in diet were allowed.
One group started taking 40 mg of Zocord, a commonly subscribed statin, at the beginning of the trial.

The unmedicated group improved their aerobic ability with 10 % on average, and muscle biopsies showed an increase in an enzyme produced by the mitochondria – the energy producing machine in the muscle cells, indicating the normal response to exercise in muscle.
In the group taking statins the average improvement was 1 %, and for some participants it sank below their starting point. When looking at their muscles the levels of the enzyme hadn’t increased as much or even lowered compared to the base line.

These findings suggests that statins might impair the benefits of aeorbic exercise. The medication might actually lower the number of mitochondria in muscle cells, making it more difficult to exercise.
This is a concern, since the level of aerobic fitness is more closely correlated to the risk of the premature death in heart disease than cholesterol levels.

This calls for careful thinking before anyone should start with lipid lowering statins. Both prescriber and patient should be cautious. Is this really needed? How high is the risk, and is it really lowered by drugs?

If you can do it on your own, why take medicines with the risk of all the side effects, especially if it blunts your own efforts?
Have a discussion with your doctor before you get on them. And if you already are on medication, discuss if you really need it! You might do better with some regular exercise when it comes to lowering your risk for heart disease, and also enjoy the benefits of feeling strong and healthy!

Go natural as long as you can – that’s my suggestion!

Sources: http://www.ncbi.nlm.nih.gov/pubmed/23583255