Dr. Craig Reese, DC, PC

Last month I talked about hypothyroid and some of the symptoms and lab work. This month I want to continue with information on hyperthyroid and Hashimoto’s disease.

Hyperthyroid

Though it was a relatively rare condition in the past, it has become more prevalent these days. It seems pretty strange that a thyroid which has been working perfectly well for 40-50 years would suddenly become hyperactive. Usually as we get older our glands tend to be less active and we have to work to keep them operating at normal levels but not in this case. Some hyperthyroid cases are caused by an attack on the thyroid by our own antibodies (Grave’s Disease). Most doctors believe that there is no known cause for this but it just happens. If there is no environmental aspect to this ailment and it is purely your body deciding to attack itself, isn’t it interesting that both George and Barbara Bush and their dog developed Graves Disease within a 16 month period while in the White House? At the time they thought it might have been something in the water but they never figured out what caused it. We know it wasn’t caused by broccoli (Bush hated it)!

Possible Causes

Since the standard medical treatment for a hyperthyroid is to kill or remove the thyroid, you want to make sure you really have this condition and not just a bad blood test. A TSH below .5 is usually found on blood work. I have seen in the past people who have had an acute virus create a low TSH for a few weeks and then it went back to normal. It has been proposed by some naturally oriented doctors that other causes may be due to parasites, lack of iodine, rarely an excess of iodine, systemic infections, food allergies, increased exposure to estrogen or estrogen-like substances (xeno-estrogens) and chemical poisoning especially petroleum products. Dr. Lee wrote about the effect of damage to a gland causing the release of the internal cellular components and the body making antibodies to attack them. So there is usually an environmental or systemic problem that has been attacking the thyroid first before it went into hyper function. These systemic problems are the things we can help you with.

Symptoms

Weight loss, heat intolerance, fast or erratic heartbeat, increased appetite and bowel movements, perspiration, always warm, tremor of the fingers, brisk tendon reflexes, exophthalmia (eyes bulging ), eye pain, swollen red shins and goiters. Goiters are caused by a lack of sufficient iodine or rarely an excess of iodine.

On blood work:
The TSH is below the normal range with a high T3 and T4 or in the upper range of normal alkaline phosphates increased due to the attack on the bone gastrin increased due to increased metabolism (seldom tested anymore) serum glucose is increased
CPK increased (CPK isoenzymes test measures the different forms of creatine phosphokinase (CPK) in the blood. CPK is an enzyme found mainly in the heart, brain, and skeletal muscle)
Cholesterol and other blood lipids are decreased

Treatment

Supplements that can help are: Thytrophin (from Standard Process), iodine, Vitamins A and E, thymus, low dose lithium, minerals, carnitine and essential fatty acids. You can eat more of the foods that we mentioned last month that help suppress the thyroid like cabbage, soy and millet plus increase your intake of protein and good fats. If the blood work does not improve in a month or two then you are going to have to go the route of drugs, surgery or radioactive iodine to kill the thyroid. This condition is hard on the body and is not something you want to leave untreated for very long.

Hashimoto’s Disease

(The following info is by Mary Shalom)
Hashimoto's disease, sometimes known as Hashimoto's thyroiditis, autoimmune thyroiditis, or chronic lymphocytic thyroiditis, is an autoimmune disease. In Hashimoto's, antibodies react against proteins in the thyroid gland, causing gradual destruction of the gland itself, and making the gland unable to produce the thyroid hormones the body needs.

Diagnosis

Hashimoto's disease is typically diagnosed by clinical examination that demonstrates one or more of the following findings:

• Enlargement of the thyroid, known as a goiter
• High levels of antibodies against thyroglobulin (TG) and thyroid peroxidase (TPO), detected via blood test
• Fine needle aspiration of the thyroid (also known as a needle biopsy), which shows lymphocytes and macrophages
• A radioactive uptake scan, which would show diffuse uptake in an enlarged thyroid gland
• Ultrasound, which would show an enlarged thyroid gland

Symptoms

Symptoms of Hashimoto's can vary. Some people have no symptoms whatsoever, and will have no demonstrable symptoms of the underlying condition. For many Hashimoto's patients, the thyroid becomes enlarged, a condition known as a goiter. The goiter can range from slight enlargement, which may have no other symptoms, to a substantial increase in size.
Some people with Hashimoto's, especially those with a larger goiter, may feel discomfort in the neck area. Scarves or neckties may feel uncomfortable. The neck may feel swollen or uncomfortably enlarged, even sore. Sometimes the neck and/or throat are sore or tender. Less commonly, swallowing or even breathing can become difficult if a goiter is blocking the windpipe or esophagus.

Hashimoto's typically involves a slow but steady destruction of the gland that eventually results in the thyroid's inability to produce sufficient thyroid hormone -- the condition known as hypothyroidism. Along the way, however, there can be periods where the thyroid sputters back to life, even causing temporary hyperthyroidism, then a return to hypothyroidism. This cycling back and forth between hypothyroidism and hyperthyroidism is characteristic of Hashimoto's disease. So, for example, periods of anxiety/insomnia/diarrhea/weight loss may be followed by periods of depression/fatigue/constipation/weight gain.
In some cases, the onset of Hashimoto's and elevation of antibodies will be accompanied by a variety of symptoms, including anxiety, difficulty sleeping, fatigue, weight changes, depression, hair loss, muscle/joint aches and pains, and fertility problems, among others.

Treatment

If a goiter causes difficulty swallowing or breathing, or is a cosmetic problem, then thyroid hormone replacement drugs (i.e., levothyroxine or natural desiccated thyroid) will usually be given to help shrink the thyroid. If drug treatment does not work, or the goiter is too invasive, then surgery to remove all or part of the thyroid may be recommended.
Except in the case of a goiter, most endocrinologists and conventional physicians will not treat Hashimoto's disease, as diagnosed by elevated antibody levels, unless other thyroid function tests such as TSH are outside the normal range.
There are, however, some endocrinologists, as well as holistic MDs, osteopaths and other practitioners, who believe that Hashimoto's disease -- as confirmed by the presence of thyroid antibodies -- along with symptoms, are enough to warrant treatment with small amounts of thyroid hormone.
The practice of treating patients who have Hashimoto's thyroiditis but normal range thyroid function tests is supported by a study, reported on in the March 2001 issue of the journal Thyroid. In this study, German researchers reported that use of levothyroxine treatment for cases of Hashimoto's autoimmune thyroiditis where TSH had not yet elevated beyond normal range (people who were considered "euthyroid") could reduce the incidence and degree of autoimmune disease progression.
In the study of 21 patients with euthyroid Hashimoto's Thyroiditis (normal range TSH, but elevated antibodies), half of the patients were treated with levothyroxine for a year, the other half were not treated. After 1 year of therapy with levothyroxine, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, the antibody levels rose or remained the same.

The researchers concluded that preventative treatment of normal TSH range patients with Hashimoto's disease reduced the various markers of autoimmune thyroiditis, and speculated that that such treatment might even be able to stop the progression of Hashimoto's disease, or perhaps even prevent development of the hypothyroidism. Hashimoto's typically involves a slow but steady destruction of the gland that eventually results in the thyroid's inability to produce sufficient thyroid hormone -- the condition known as hypothyroidism. Along the way, however, there can be periods where the thyroid sputters back to life, even causing temporary hyperthyroidism, then a return to hypothyroidism. This cycling back and forth between hypothyroidism and hyperthyroidism is characteristic of Hashimoto's disease. So, for example, periods of anxiety/insomnia/diarrhea/weight loss may be followed by periods of depression/fatigue/constipation/weight gain. http://thyroid.about.com/cs/hypothyroidism/a/hashivshypo.htm

Other Treatments

Again they Thytrophin from Standard Process will help take the antibody attack off the thyroid and allow it to heal. Minerals, Vitamin D, other thyroid supplements are all tested to see what your body wants. Using supplements on a thyroid that is showing antibodies but is still in normal range may keep it from being totally destroyed and instead get the thyroid back to normal function. Don’t just “wait and see” what happens because your gland is under attack and needs support. We can help.

Office News

Dr. Reese will be out of the office on Friday Feb. 19. The staff will still be in the office from 9-noon if you need anything. Happy Valentine’s and President’s days!