Happy Sunday To All!
First, in an earlier post, I had mentioned my affinity for Rush Bowls, the little place that makes the smoothies and veggie/fruit bowls. They were kind enough to give our patients a 20% discount on their first order, so if you ever wind up there, show the coupon attached below. I go to the Glastonbury location, but the coupon should work in any of their stores.
Next, as I promised to get back into some clinical discussions, let’s jump into some important points about thyroid function. Some of you know that if I encounter a patient who claims they are following the CFL Program to a “T”, but progress seems not to be what it should, my first thoughts go to either depressed thyroid function, followed by insulin resistance. In these cases, we run lab work when indicated; however, the studies I ask for are a bit different than most physicians, and even many endocrinologists. Your PCP would normall run a TSH (thyroid stimulating hormone) which is secreted by the pituitary gland in your brain, telling your thyroid gland how much hormone to secrete. If you’re lucky, they’ll also ask for a T4, the actual hormone itself, thyroxine. If these are within normal limits, they pretty much write off the thyroid as functioning normally, but in my book, the job is hardly complete. Other things can be awry downstream, which are rarely investigated…you see, you can have perfectly normal TSH and T4 values, while still suffering from underactive thyroid function.
The next step in the physiological process is that your secreted T4 gets circulated to your liver, where it is there converted into T3 (triiodothyronine), which is the form of hormone which actually binds to your cells and does all the work. So, the next obvious step it to include a T3 level in the lab panel. Still not done! T3 can be within normal limits, and your thyroid function can still be underactive! How? In some folks, when the liver is converting T4 to T3, there exists a genetic mutation which results in the T3 to be in a different form (called an enantiomer), called Reverse T3…which does not function as normal T3 should. So…my panels will also include a Reverse T3 level, which if low, can then be supplemented with exogenous T3 medication. Almost home…the final tests I include are either a TPO (thyroid peroxidase) or Thyroid Antibody level, either of which will indicate a possible autoimmune condition (some call Hashimoto’s Disease) with can attack the gland throw thyroid function fully astray.
Are you seeing why a simple TSH or T4 won’t cut it?
Sorry, but there’s one more level down this rabbit hole; let’s say all of the above is normal, yet there’s still evidence of low thyroid function. There is a little-known syndrome, but more common than you’d think, in which the iodine your thyroid gland uses to make its hormone, is knocked out and replaced by other halogens, such as chlorine, fluorine, or bromine, creating a poorly functioning hormone. This can happen due to high ingestion of fluorine from public water supply, or added bromine from plastics and other contaminated products. We can test for this and treat accordingly using a specific urine test, and a natural supplementation protocol which replaces the iodine, resulting in functioning hormone.
Now we’ve dug deep enough to uncover all the possibilities and reach valid conclusions rather than taking pot shots further upstream. This, to me, is a really good example of how all diagnostics should be performed, and I’m fortunate enough not to practice within a system which forces me to hurry through processes without landing on specific answers. It does take time and effort most physicians cannot afford due to the system, but it’s my curse (or blessing) that I cannot leave a job half-done, especially when patient health is at stake..
Well now you have more clinical info…be careful what you ask for, you may get it!
Please enjoy the balance of your Sunday; follow my lead, and when searching for answers, never stop before you reach the prize!