Dr. Murphree's Health News
By the author of TREATING AND BEATING
Fibromyalgia and Chronic Fatigue Syndrome
Summer (June, July, August) 2004
New Criteria for Diagnosis
Increases Hypothyroid Population by 100%
According to the American Association of Clinical Endocrinologists (AACE) doctors have typically been basing their diagnoses on the "normal" range for the TSH test. The typical normal levels (at most laboratories) has fallen in the 0.5 to 5.0 range.
The new guidelines (2003) narrow the range for acceptable thyroid function and the AACE is now encouraging doctors to consider thyroid treatment for patients who test the target TSH level of 0.3 to 3.04, a far narrower range. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder but have gone untreated until now.
At a press conference, Hossein Gharib, MD, FACE, and president of AACE, said: "This means that there are more people with minor thyroid abnormalities than previously perceived."
AACE estimates that the new guidelines actually double the number of people who have abnormal thyroid function, bringing the total to as many as 27 million, up from 13 million thought to have the condition under the old guidelines.
Past Normal Adult Range: .5 - 6 miliIU/L
NEW OPTIMAL RANGE FOR ADULTS: .5 - 3.04 miliIU/L
Lab Values and what they mean
Thyroid-stimulating hormone (TSH) - produced by the anterior pituitary gland, causes the release and distribution of stored thyroid hormones.
When T4 and T3 are too high, TSH secretion decreases. A TSH below .5 suggests a hyperthyroid (over active thyroid).
When T4 and T3 are low, TSH secretion increases. A TSH above 3.04 suggests hypothyroid (low thyroid function).
Millions of Americans Have Been Misdiagnosed
In the last year, the lab values for measuring TSH have dropped from 6 to 3.04. This is an almost 50% reduction. Dr. Broda Barnes, a pioneer in treating thyroid disorders, has been advocating a reduction in the TSH level for decades. Millions of Americans have been misdiagnosed with normal thyroid function based on the old test parameters. Individuals who had a TSH blood levels between 3.05 and 6 were told that they were normal.
Some doctors think TSH levels should be reduced even further. They believe that TSH levels above 2.0 should be treated as hypothyroid.
Over 20 million Americans suffer from thyroid dysfunction. More than 10 million women have a low-grade thyroid dysfunction, almost 8 million people with low thyroid go undiagnosed. (1) Over 500,000 new cases of thyroid disease occur each year.
The thyroid gland is shaped like a butterfly and is located in the lower front part of your neck (just above the breast bone). The thyroid gland is responsible for secreting thyroid hormones. A hormone is a chemical substance formed in the body that is carried in the bloodstream to affect another part of the body. Thyroid hormones travel through the blood stream and help cells convert oxygen and calories into energy. Thyroid hormones control a person’s metabolism. Metabolism is defined as the sum of all physical and chemical changes that take place within the body; all energy and material transformation that occur within living cells.
Every cell in the body depends on having enough thyroid hormone.
If your thyroid gland becomes dysfunctional
every cell in the body begins to suffer.
This is why thyroid disorders can cause so many symptoms (see below).
• When your thyroid gland produces too much thyroid hormone this is known as hyperthyroid.
• When your thyroid doesn’t produce enough thyroid hormone you become hypothyroid.
Symptoms Associated with Hypothyroid
Do you suffer from fatigue, headaches, dry skin, swelling, weight gain, cold hands and feet, poor memory, hair loss, hoarseness, nervousness, depression, joint and muscle pain, and or burning or tingling sensations in the hands or feet?
Skin may become yellow, especially the hands, from a build-up of carotene. This is because the process that converts carotene to vitamins is slowed by hypothyroidism.
Numbness or tingling in the feet is caused by hypothyroid neuropathy (a degenerative nerve disease). Carpal tunnel syndrome (medial nerve neuropathy) may also be caused by hypothyroidism.
Hypothyroidism can also cause problems with balance and equilibrium. You may experience an unsteadiness on your feet or a lack of coordination.
Constipation occurs from the slowed metabolism associated with hypothyroid.
Of course, the most profound symptom associated with hypothyroidism is fatigue.
Statistics show that as many as 10 million Americans suffer from borderline hypothyroidism.
Many scientists, researchers, and physicians believe that up to 40% of the United States population suffers form low thyroid function. (2)
Studies have shown that up to 70% of fibromyalgia and CFS patients have hypothyroid. Recent research showed that T3 (prescription Cytomel) administered at high doses (120mcgs daily) could resolve all symptoms of fibromyalgia. (3)
Do you have any of the symptoms below?
___ chronic sinus infections
___ sweating abnormalities
___ heat and/or cold intolerance
___ low self-esteem
___ irregular periods
___ fluid retention
___ severe menstrual cramps
___ low blood pressure
___ panic attacks
___ frequent colds and sore throats
___ hair loss
___ decreased memory
___ ringing in the ears
___ decreased concentration
___ slow wound healing
___ decreased sex drive
___ easy bruising
___ unhealthy nails
___ acid Indigestion
___ low motivation
___ cold hands or feet
___ inappropriate weight gain
___ dry skin
___ dry hair
___ falling asleep during the day
___ increased skin infections/Acne
___ changes in skin pigmentation
___ carpal tunnel syndrome
___ high cholesterol
___ loss of outside portion of eyebrows
If you checked more than five of the above symptoms,
you might be suffering from hypothyroid dysfunction.
A Short-Course on Thyroid Hormones
The hypothalamus stimulates the pituitary gland (both are contained in the brain) to produce thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid to produce and release thyroxine (T4). T4 is then converted into triiodthyronine (T3), which is vital for life and four times more active than T4. This conversion of T4 to T3 takes place in the cells. You can live without T4 but not T3. The body must have T3.
Many of my patients have reported that they have been tested for low thyroid but the blood tests were all normal.
They have all symptoms of a low thyroid: hair loss, low moods, can’t lose weight (even on starvation diets), fatigue, cold hands and feet, skin, etc. Even their doctor believes they have low thyroid - until the tests come back normal. Then the patient is told, “all your blood work looks normal, you just need to increase your anti-depressant medication.”
Euthyroid is a medical term for patients who have normal thyroid blood tests but have all the symptoms associated with hypothyroidism: fatigue, low metabolism, headache, etc.
Why Thyroid Blood Tests are Often Inaccurate
Euthyroid patients often have a problem with T4 converting into active T3, even though blood tests show normal levels. (1) Stress can cause the body to release a hormone known as Reverse T3. Reverse T3 blocks T4 from converting to T3. Unless special thyroid tests are run, this dynamic will be missed. The blood work will look normal but the patient will be suffering from thyroid dysfunction.
This also explains why some individuals might take prescription synthetic thyroid hormones (like Synthroid, which contains T4 only), and not feel any better.
The T4 is not converting into T3, so they continue have the symptoms of low thyroid even though their lab work looks normal. (2)
Thyroid blood tests measure how much thyroid hormone (T4, T3, TSH) is in the bloodstream one second out of one minute, out of one hour… However thyroid hormone (specifically) T3 doesn’t do anything in the bloodstream, it only becomes active once it is the cell. This is like driving by a crowd of people waiting in line to enter a store. Even though you didn’t see them enter the store, you assume they’ll soon be inside the store. What if the people can’t get in for some reason (T4 turns into Reverse T3)? How would you know?
Blood tests are not very accurate for thyroid disorders. There are tests that are much more accurate at diagnosing thyroid disorders, but most doctors don’t use these special tests.
The thyroid-releasing hormone test (TRH Test) is the most accurate blood based thyroid test.
Metabolism, and Thyroid Hormones
Blood tests for thyroid function measure the amount of TSH, T4, and T3 in the bloodstream. But thyroid hormones don’t operate within the bloodstream; the action takes place in the cells themselves. What good is a blood test that only shows what is racing around the bloodstream one second out of a day? It’s inadequate for measuring true thyroid hormone levels.
Self-test for Low Thyroid
Dr. Broda Barnes was the first to show that a low basal body temperature was associated with low thyroid. His first study was published in 1942 and appeared in The Journal of the American Medical Association. This study tracked 1,000 college students and showed that monitoring body temperature for thyroid function was a valid if not superior approach to other thyroid tests. (3)
Dr. Barnes’s testing protocol
You’ll need a mercury thermometer (digital thermometers can be used but aren’t as accurate).
1. First thing in the morning before getting out of bed. Take your temperature by placing a mercury thermometer underneath your arm for 10 minutes.
2. Record your temperature.
3. Repeat these steps for 7 days.
4. Return your daily recordings to your doctor.
Women who are still having menstrual cycles should take their temperature after the third day of their period.
Note: If you can’t find a mercury thermometer (they’ve been withdrawn from the market) and have to use a digital thermometer, take your temperature 3 times a day under the tongue.
Add one point to underarm temperature readings (if 97.2 under the arm, add 1 degree and it equals 98.2).
A reading below the normal 98 (after adding 1 degree to under the arm temperature) strongly suggests hypothyroid. A reading above 98.2 may indicate hyperthyroidism (overactive thyroid).
Dr. Barnes recommends patients take a desiccated glandular (derived from pigs) prescription medication known as Armour Thyroid, which was used before synthetic medications such as Synthroid were introduced. Armour Thyroid and other prescription thyroid glandular medications (including Westhroid), contain both T4 and T3 (80% T4 and 20% T3).
What Causes Thyroid Disorder
Stress, viruses that attack the thyroid, environmental and dietary toxins can all cause the thyroid to malfunction.
Corticosteroids (prednisone) and lithium can suppress TSH and prevent the conversion of T4 to T3.
Certain foods including Brussels sprouts, rutabaga, turnips, cabbage, radishes, broccoli, cauliflower, millet, kale, and soy products can all contribute to low thyroid hormone production.
Vitamin and mineral deficiencies can also contribute to low thyroid function.
The amino acid L-Tyrosine is the precursor for T4 hormone. Vitamins B1 and B2 are essential for proper thyroid function. The mineral selenium activates an enzyme that helps convert T4 to T3.
Depression is the most common condition seen in general medical practice. It is estimated that 10 percent of the population suffers from depression.
Stress, depression, anxiety, tiredness, and other emotional problems can all mask a thyroid disorder. Research now shows that depressed patients have reduced levels of a protein transthyretin, which normally carries T4 from the bloodstream into the brain. Treatment with a prescription of Cytomel, a T3 medication, (or naturally with GTA, see below) could help circumvent this problem. (3)
“Increasing evidence indicates that T3, the most active form of thyroid hormone, is an effective antidepressant, when used in conjunction with a conventional antidepressant.” Ridha Arem, M.D.
Options for Those with Hypothyroid
If you suspect you have a thyroid dysfunction you may want to consult your doctor for testing. If your TSH is above 3.04 your doctor should recommend thyroid replacement therapy. They’ll usually prescribe Synthroid or Levothyroid. These medications contain synthetic T4. If your body is having trouble converting T4 into T3 you may not notice a difference taking these medications. If so, you may want consider adding an over-the-counter thyroid glandular supplement called GTA (see below).
I’ve found patients usually do better when taking Armour thyroid (a combination of T4 and T3). I suggest you ask your doctor to prescribe Armour, Westhroid or Nuthroid, all of these contain T4 and T3. If they are reluctant, ask them to consider the study below.
A study by the New England Journal of Medicine showed that patients who received a combination of T4 and T3 were mentally sharper, less depressed and felt overall better than a control who received T4 only. (4)
If you have trouble getting your family doctor to work with you, you might want to try using one of the thyroid products I use in my practice (see below).
Glandular Thyroid Supplements
Thyroid glandular supplements can also be used to correct low thyroid function. Thyroid glandular (taken from the glands of cows or pigs) supplements have been used since the beginning of thyroid treatment. Dr. Barnes used Armour Thyroid (harvested pig thyroid glands), which was the original thyroid prescription medication.
However, over-the-counter thyroid glandular supplementations are also available.
Since these thyroid glandular tissue concentrates contain T4 and T3, they can be used as a first line of treatment for low to moderate low thyroid dysfunction.
Thyroid glandular supplements are not easy to find. Most manufacturers shy away from selling thyroid glandular supplements. They’re concerned over FDA scrutiny of any products that may contain patented drug ingredients (read red rice and statin drugs).
Biotics Research has been manufacturing glandular supplements since the 1980’s.
There glandular products are prepared strictly from USDA inspected bovine and porcine tissues and are certified BSE-free.
I’ve just started using their thyroid glandular supplements. I’m getting very good results with my patients on GTA (see below). I’m encouraged by the research they’ve done on their products. Since they are a pharmaceutical company they can sell a superior form of thyroid glandular. They remove all T4 from their thyroid glandular supplement (GTA).(5)
GTA or natural T3 Therapy
GTA is a porcine (pig) thyroid glandular supplement (5mg). Pig hormones are almost identical to human hormones. T4 has been removed. This supplement contains straight T3.
For the American Biologics glandular take 1 tablet twice a day, up to 2 twice a day.
If using the GTA (straight T3) start with 1 a day in the morning. If needed, increase to one twice-a-day. Make sure these supplements don’t interfere with your sleep.
1.The Thyroid Solution, Ridha Arem, M.D.
2.Life Extension Foundation's Disease Prevention and Treatment Protocols, 3rd edition
3. J.C. Lowe, R.L Garrison, A. Reichman, et al., “Triiodothyronine (T3) Treatment of Euthyroid Fibromyalgia: A Small-N Replication of a Double Blind Placebo Crossover Study,” Clinical Bulletin of Myofascial Therapy 2, no, 4(1997):71-88
4.A.J. Hatterer, J. Herbert, C. Hidaka, et al., “Transthyretin in Patients with Depression,” Amer Jour of Psychiatry 150 (1993): 813-15.
5. The Thyroid Solution, Ridha Arem, M.D.
6.Hypothyroidism: The Unsuspected Illness by Broda Barnes, MD, and Lawrence Galton; 1976
7.Wilson's Thyroid Syndrome by Dennis Wilson, MD, 1991
8. From A Clinician’s View of Biotics Research Products a lecture by Harry O. Eidenier, Jr., Ph.D. July 2003.
In the News
University of Missouri Columbia researchers found that people increased their serotonin (happy hormones) levels and decreased their cortisol (stress chemicals) levels when playing with dogs.
CoQ10 Cuts Migraine Attacks in Half
Recent research shows that adding CoQ10 cuts the occurrence of headaches experienced by migraine suffered by 50%. Peter S. Sandor Univ Hospital in Zurich.More Good News About Glucosamine
Newly published research shows glucosamine slows and even stops the progression of osteoarthritis (wear and tear arthritis).
Bruyere O Pavelka K, Rovati LC, et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from 3 year studies. Menopause. 2004 Mar-April;(2):138-143.
Glucosamine increases the production of glycosaminoglycans and proteoglycans, which along with other cellular elements, builds and repairs cartilage. Glucosamine has already been shown to be a powerful anti-inflammatory and studies have shown that it can be very beneficial in alleviating the symptoms of osteoarthritis.
McAlindon TE, LaValley MP, Guilin JP, Felson DT. Glucosamine and chondroiten for treatment of osteoarthritis: a systemic quality assessment and meta-analysis. JAMA 2000 Mar 15:283(11):1469-75
Click here to learn more about glucosamine
SAMe Helps Boost the Effects of Antidepressants
Prescription antidepressants fail to work for fifty percent of those take them. One way to boost the beneficial effects of antidepressant medications is to take them with SAMe (S-adenosyl-L-methionine). Research has already shown that SAMe increases both serotonin and noriepinephrine levels (brain chemicals) and is a potent antidepressant by itself. Now researchers have shown that combining SAMe with prescription antidepressants reduces the failure rate by 43%.
SAMe has become one of my favorite nutritional supplement. I’m using it more and more in my practice for depression, fatigue, and pain disorders. SAMe elevates endorphin levels. Endorphins are the body’s natural pain killers and are stronger than morphine.
Mass General Hosp, Maurizio Fava
Click here to learn more about SAMe
Diets High in Fruits and Vegetables may cut the Risk for Non-Hodgkins Lymphoma by 40%
Diets high in fruits and vegetables such as tomatoes, broccoli, cauliflower, green beans, and apples may help reduce the risk of Non-Hodgkins Lymphoma. A study conducted between 1995 and 2001 reveals that just such a diet can reduce the risk by 40%.
Please eat more fruits and vegetables!
Zheng T, Holford TR, Leaderer B, et al. Diet and nutrient intakes and risk of non-Hodgkins lymphoma in Conn women. Am J Epidemiol, 2004 Mar 1:159(5):454-66.
New study demonstrates CLA supplementation reduces body fat by 9% and increases lean muscle mass by 2%.
From a one-year study released at The 94th Annual Meeting of the American Oil and Chemical Society (May 4-7, 2003) “Efficacy and Safety of One-Year Supplementation of Conjugated Linoleic Acid in Moderate Overweight.”
(CLA)-1,000MG supplying minimum of 750mg per soft gel capsule. 90 capsules Recommended dose is 1 capsule 3 times-a-day 30 minutes before each meal. CLA is a naturally-occurring derivative of linoleic acid (omega 6 fatty acid) and has physiological effects on fat metabolism and the immune system. CLA helps burn fat and build muscle. CLA helps block a substance in your body called lipoprotein lipase that helps store fat in your body.
Reducing your body fat by close to 10% could make a big difference in your health. Excess body weight and fat are associated with an increased risk in heart disease, stroke, diabetes, and many other chronic illnesses.
Similar CLA products sell for $40 or more. We are committed to offering the highest quality products at the best prices. This is why this high quality, high potency supplement is normally priced at half the price of other CLA products.
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