Thyroid Function: Revisiting a Forgotten Illness

The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Seaway News newspaper in Cornwall, Ontario, Canada. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.


Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine

A study conducted by Harvard medical school in 2000 commented that it believed as much as 75 % of North Americans (though it was only an American study!) are 'sub-clinically' (not detected by usual investigations) hypothyroid (meaning their thyroid is not working 'up to speed'). The symptoms associated with such a state include (but are not dependent upon) weight gain, general fatigue, general coldness (especially of hands and feet), hair loss, mental confusion (and poor memory), migraine headaches, skin problems, menstrual problems, arthritis Sounds pretty much like everyone doesn't it? That's exactly their point.

So, all you need is some blood work to know if the above applies to you right ? Once again, not so. Routine blood tests conventionally used only screen for a hormone called Thyroid Stimulating Hormone (TSH) and, occasionally, for a second hormone called T4. The problem here is that neither of these represent the active thyroid hormone in your body (which actually controls your metabolism). Trying to oversimplify this issue, a thumbnail sketch goes something like this. TSH (in you brain) stimulates your thyroid to secrete T4 which then travels out into your body and is converted into T3 (primarily in your liver). The T3 is the active hormone and a critical piece of the investigation puzzle. Its rarely if ever checked for, despite the reality if the above mentioned physiology. In fact, a full thyroid investigation should look for levels of TSH, T4, T3, T3u and on it goes. Many are told their thyroid is o.k. without a full investigation of these other fundamental hormones. In fact (to illustrate) there are actually 3 types of 'hypothyroidism' (primary, secondary and teriary). TSH is usually elevated with the 'primary' type and decreased with the other two types. One could not even diagnose the exact type of hypothyroidism (let alone euthyroidism, hyperthyroidism, thyroidtoxicosis etc.) without a full investigation.

The dilemma with the above comment is that even with a full thyroid blood test, the results must be taken with a grain of salt. Someone may have 'normal' findings but still be 'sub-clinically' hypothyroid. Their tests are normal, but their thyroid function is not! The patient's usually know this by insisting that something is 'wrong'. A medical doctor by the name of Howard Hagglund recently wrote (Townsend, 2002; Feb;80-81) that " never be fooled by a normal thyroid blood test - it never was any good and never will be".

Confused yet ? It doesn't stop there. The conventional treatment for hypothyroidism is prescribing a drug that provides more T4 ( not the active T3) to the body. The problem, as pointed out by the Harvard study, is that T4 can not be converted into the necessary T3 by many individuals. Giving more T4 is simply not the answer.

A known drug of this kind is 'Synthroid'. Recently, the American FDA (agency that regulates drugs on the market) pulled Synthroid from the U.S. market (November of 2000) after 46 years on the market. It turns out it had never been properly tested and was 'grandfathered' into the FDA act. In a statement dated March of 2001, the FDA said that Synthroid " has not shown to demonstrate consistent potency and stability" and "thus, is not generally recognized as safe and effective".

So, what do you do if you are concerned about your thyroid function? First, see a physician who tests for all thyroid hormones (such as those at Millennium Health Centre) as a starting point. Second, explore dietary and herbal supplements to see if they provide relief. Thirdly, if these interventions do not help, licensed practitioners who utilize thyroid supplements that give not only T4, but also the critical T3, should be consulted.

Furthermore, other health issues associated with thyroid dysfunction should be treated. These include osteoporosis (which has been indicated to be a side effect of many conventional thyroid treatments). As always, this subject is a complicated matter (perhaps too much so for the space herein). Pay attention to your symptoms, do your research, get as many opinions as possible and insist upon complete health care. Otherwise, you may fall into the 'forgotten' class of thyroid sufferers.