In a first of its kind crossover study, researchers find for …

Natural Thyroid Success
Surprising results show higher preference for
desiccated thyroid extract compared to synthetic levothyroxine

By Will Block

D on’t you hate the advice that doctors often give? Take this drug and everything will be OK! All too often, that advice neglects side effects, some of which may be injurious to your quality of life [or worse.] That’s because doctors are often captives of the drug industry with its underlying promotive literature. Supportive of this approach, drug studies emphasize various measures of “success testing,” while playing down side effects.

For example, take the use of statins for cardiovascular disease, associated with vascular plaque formation (aka atherosclerosis). Atherosclerotic cardiovascular disease is the major cause of death in Western societies. Statins are widely touted as a panacea, so much so that drug companies have advocated their use for virtually everyone, including children, Yet, adverse effects of statin therapy (such as muscle pain) affect a large proportion of the treated population and have a significant influence on their quality of life.


The best overall medical advice is not
frequently offered. Judge
the outcome based on how you feel.
Whose life is it, anyway?


There are many measures of statin therapy success, such as coronary artery calcification as assessed by computed tomography, carotid artery intima-media thickness, and especially the presence of plaques as assessed by ultrasound. Nevertheless, the absence of vascular pathology assessed by these imaging methods has a very high negative predictive value, and therefore could be used as a method to reduce the number of subjects who may not benefit from statins and only suffer from their side-effects.1

The best overall medical advice is not frequently offered. Judge the outcome based on how you feel. Whose life is it, anyway?

Natural vs. Synthetic Thyroid

Most doctors recommend synthetic thyroid for hypothyroidism, independent of how their patients feel. So it is particularly noteworthy that in a new clinical trial, hypothyroid patients were found to prefer natural full-spectrum thyroid extract over synthetic T4-only preparations.2 This is the first prospective, randomized, double-blind, crossover study of desiccated thyroid extract (DTE) and synthetic levothyroxine (L-T4) therapy in hypothyroid patients. Although the human body produces five different thyroid hormones (T1, T2, T3, T4, and calcitonin), today most patients are treated with levothyroxine (also called L-thyroxine), a synthetic product that contains only one of the hormones, thyroxine (also called L-T4.)

Thyroid Preferences May Increase Weight Loss

In the crossover study,* while there were no differences in documented symptoms or neurocognitive measures, 49% of the volunteers preferred DTE while only 19% preferred the L-T4 hormone (33% had no preference). That’s a preference of more than 2½ times for natural full-spectrum thyroid, indicating that traditional symptoms or neurocognitive measures weren’t revelatory. The differences were found in the researcher’s analysis of those who preferred DTE. In this group, an average of four-pound weight loss was measured.


* As a crossover study, each volunteer essentially acts as his or her own control, by taking both drugs: first one, for eighteen weeks, then the other, for sixteen weeks. Crossover studies also increase the statistical power of a study with a given number of patients.


Of considerable interest, those on DTE treatment lost 3 pounds—1 pound less than those who preferred DTE (not knowing which treatment they were on). If these results are repeated and amplified in other studies, it could be concluded that preferences help determine outcomes. Also, those who preferred DTE reported better concentration, memory, and sleep, along with greater happiness and energy. That could provide a clue.

Switch from DTE to L-T4 Hobbled by Bad Feelings

It has been reported that patients previously treated with DTE, who are switched to synthetic L-T4, do not typically feel as well, despite dosing that achieves equivalent serum thyroid-stimulating hormone (TSH) levels. The goal of the new study conducted at a tertiary care center was to investigate the effectiveness of DTE compared with L-T4 in hypothyroid patients.1

There were 70 subjects in the study between the ages of 18–65 years (53 females, 17 males) who were diagnosed with primary hypothyroidism and had maintained a stable dose of DTE or L-T4 for 6 months. There were only 2 subjects taking DTE (75 and 105 mg/day, respectively) before the study, and the remaining patients were previously on L-T4. The subjects were randomized to either DTE or L-T4 for 16 weeks, following which they were crossed over for the same duration.

Baseline biochemical and neurocognitive tests were taken before and after each treatment period. As already stated, there were no differences in symptoms or neurocognitive measurements between the 2 therapies. Also, as mentioned above, the subjects on DTE treatment lost 3 lb. At the end of the study, 34 patients (48.6%) preferred DTE, 13 (18.6%) preferred L-T4, and 23 (32.9%) had no preference. And, as also mentioned, those patients who preferred DTE lost 4 lb during the DTE treatment, and their subjective symptoms were significantly better while taking DTE as measured by the general health questionnaire and thyroid symptom questionnaire.

The Grounds for Preferring Natural Thyroid

Five variables were predictors of preference for DTE. Those were the thyroid symptom questionnaire, serum T3, resin uptake, free T4, and sex hormone-binding globulin (SHBG). SHBG is related to thyroid function. DTE therapy did not result in a significant improvement in quality of life; however, DTE caused modest weight loss and nearly half of the study patients expressed preference for DTE over L-T4.

In 2012 the American Thyroid Association published guidelines advising doctors, “there are no controlled trials supporting the preferred use of desiccated thyroid hormones over synthetic-L-thyroxine in treatment of hypothyroidism or any other thyroid disease.” This new study should cause them to reconsider.

Why Do People Feel Better on Natural Thyroid?

Both human and cow thyroid glands or pig thyroid glands (from which DTE is derived) produce T1, T2, T3, T4, and calcitonin. T4 is a storage hormone that must be converted into T3 to be metabolically active. Calcitonin regulates blood levels of calcium. No one is sure what the value of T1 and T2 may be and they are widely believed to have no clinical value. Studies show only trace amounts of T2 inside the thyroid, because T2 and T1 are actually produced by peripheral deiodination (conversion) outside of the thyroid gland.

Mainstream medicine preaches that it is sufficient to supplement only with T4; that the body will convert an appropriate amount of T4 into T3; and that T1, T2 and calcitonin aren’t needed. While this may be true for some hypothyroid patients, clearly there are many others who improve only when they take DTE. Mainstream exponents disparage DTE, saying, “The use of thyroid extract became associated with those whose medical practices deviated in many ways from standard care,” and “Those prescribing it were considered to be unscientific and irrational practitioners.”

Conventional Medicine’s Assumption Challenged

Much rests on the assumption of conventional medicine that the body will convert enough T4 into T3, although many things can interfere with the conversion process. According to Overcoming Thyroid Disorders, a book authored by David Brownstein:3

Nutritional deficiencies such as iodine, iron, selenium, zinc, vitamin A, riboflavin, pyridoxine, and B12, along with the use of certain medications including beta-blockers, birth control pills, estrogen, iodinated contrast agents, lithium, phenytoin, and theophylline, can inhibit the conversion of T4 into T3. Other factors that can cause this inhibition include aging, alcohol, alpha-lipoic acid, diabetes, fluoride, lead, mercury, pesticides, radiation, stress, and surgery.


49% of the volunteers preferred DTE
while only 19% preferred the L-T4
hormone (33% had no preference).


Another problem, finds another researcher, is that too much T4 can convert to something called “reverse T3,” which has only 1% of the effect of T3, but also binds to the T3 receptor, thus blocking T3 from doing its job:4

Factors that may lead to a preferential conversion to reverse T3 include high cortisol, glucocorticoids, stress, excess estrogen, and nutritional deficiencies such as selenium, iodine, zinc, and iron.

Myriad of Common Factors

Aging, stress, and other common degenerative factors are so omnipresent that it seems likely that many thyroid patients are inadequately converting T4 to T3, thus there is a need for a thyroid preparation that contains some T3. Then there is the possibility that T1 and T2 are performing functions in the body that we are not yet aware of, and that they need to be supplemented along with T3 and T4 (as they are with DTE).

The Role of TSH

Thyroid-stimulating hormone (TSH) is secreted by the pituitary gland, and stimulates the thyroid to release thyroxine. T3 and T4, through negative feedback inhibition on the pituitary and hypothalamus, influence the secretion of TSH. If thyroid hormone levels are too high (hyperthyroidism), TSH is suppressed; conversely, if thyroid hormones are too low (hypothyroidism), TSH levels are high. Consequently, most physicians use TSH as a screening test for evaluating thyroid function. However, the pituitary can sometimes fail to produce enough TSH (even when thyroid levels are low), in which case a “normal” TSH level would give a false impression that there is plenty of thyroid hormone. For this reason, a number of years ago the American Association of Clinical Endocrinologists—recognizing that many patients are misdiagnosed—lowered the upper end of acceptable TSH levels from 5.0 to 3.0. This doubled the number of people needing treatment for hypothyroidism. Many of these people had been denied treatment, despite predisposing family histories and symptoms such as weight gain, depression, fatigue, hair loss, constipation and high cholesterol—all of which can be caused by low thyroid function.

Testing by Underarm Temperature Test

In the 1940s, Dr. Broda Barnes, a pioneer thyroid specialist, realized that thyroid blood tests were notoriously inaccurate. Consequently, he developed a simple test to confirm suspected low thyroid function using an ordinary thermometer. He found that normal underarm or oral temperatures, immediately upon awaking in the morning (while still in bed) are in the range of 97.8 to 98.2 degrees Fahrenheit. He believed that a temperature below 97.8 indicated hypothyroidism.

Dr. Barnes recommended that the underarm temperature taken immediately upon awakening be used to diagnose hypothyroidism. However, a ten-minute underarm temperature (using a mercury thermometer) is the same as a two-minute oral temperature (in the absence of oral infection). Since mercury thermometers have been replaced with digital electronic devices, temperatures can now be taken in seconds. The underarm temperature is an unnecessary ritual—and oral temperature is equally accurate.

Subclinical Hypothyroidism

Hypothyroidism entails a wide range of common symptoms, including sluggishness, weakness, mental depression, headaches, high or low blood pressure, low heart rate, high cholesterol, weight gain, constipation, aching joints, poor memory, sensitivity to cold, declining libido, dry skin or acne, and brittle nails and hair. In subclinical hypothyroidism, these symptoms can be so subdued and gradual in onset that they can easily be overlooked, attributed to something else, or dismissed as elements of “normal aging.”

Here is a more precise definition of subclinical hypothyroidism (let’s call it SCH for short) than that given above: SCH is a disease in which TSH levels may or may not be elevated, thyroxine levels may be within the normal range (albeit usually near the low end of that range, as the “hypo” in hypothyroidism suggests), and the patient exhibits a spectrum of hypothyroid symptoms that are responsive to an appropriate dose of thyroid hormone.

Will Your Doctor Tell You about Statins and Cataracts?

In one of the largest studies ever done on the subject of statins and the risk for cataracts, researchers found that statin takers have a significantly increased risk for cataracts.

Published online in JAMA Ophthalmology, scientists examined 13,626 statin users and 32,623 nonusers, between the ages 30 to 85, who were cared for in a military health care system.1 On average, the users had been using statins for about two years. The collected data were adjusted for a wide variety of health and behavioral factors. Those who took statins had a 9 to 27 percent increased risk for cataracts.


Those who took statins
had a 9 to 27 percent
increased risk for cataracts.


Statins’ effects on the oxidation process, wrote the researchers, may influence the formation of cataracts. Also, the cholesterol-inhibiting properties of statins might interfere with cell regeneration in the eye’s lens, which requires cholesterol to maintain transparency.

“If a patient takes this medication because he is at high risk for heart disease, or already has heart disease, the proven benefit of statins is much greater than the suspected risk of cataracts,” states Dr. Ishak Mansi, the senior author, and a professor of medicine at the University of Texas.2 “But they have side effects, and doctors should not prescribe this medication lightly.”

References

  1. Leuschen J, Mortensen EM, Frei CR, Mansi EA, Panday V, Mansi I. Association of Statin Use With Cataracts: A Propensity Score-Matched Analysis. JAMA Ophthalmol. 2013 Sep 19. doi: 10.1001/jamaophthalmol.2013.4575. [Epub ahead of print]
  2. Bakalar N. Statins Tied to Cataract Risk. The New York Times, September 25, 2013. Accessed: September 26, 2013.

SCH is an age-related disease. Its incidence in the adult population of the United States is estimated by even the most conservative of orthodox physicians to be 4.3%; its prevalence is about 10% in women over 60 years of age, and somewhat less than that in men.5 Most alternative physicians experienced in using natural thyroid would estimate that the incidence is much higher—and agree with Dr. Barnes that it approaches 40% of the adult population.6 During the century or so since SCH became recognized as a disease, most orthodox physicians believed that it did not require treatment, especially since its symptoms—if any—are so mild. Their lack of concern is giving way, however, to a newfound appreciation for the fact that SCH is a “stealth” disease whose long-term consequences, especially on cardiovascular function, can be severe.

Thus, more and more physicians are embracing the idea that SCH should be treated. Most physicians who practice alternative and complementary medicine recommend using extracts of whole natural thyroid from livestock, which contains not just thyroxine but also the other hormones produced by the thyroid gland, in their biologically normal proportions. (As with synthetic thyroxine, the animal hormones are chemically identical to their human counterparts.)

Thyroid Alert

Recently, thyroid patients on DTE were thrown a loop when the two major makers of DTE both experienced mysterious shortages and could not meet demand at the same moment. Many patients spent hours on the phone, calling pharmacy after pharmacy to find a source of DTE. Fortunately, compounding pharmacies were able to fill in, as they can make DTE in any dose, using the same raw materials (although at a higher price).

There is a bill moving through Congress to outlaw certain compounded medications.7 This bill is a concealed move by pharmaceutical companies to wipe out the competition from compounding pharmacies, thereby leaving hypothyroid patients with no choice but to buy the mass-marketed version of the drugs. That would lead to future shortages of DTE, when people might be forced to switch to the T4-only preparations.

The bill in the Senate is S.959. Call your Senators so that we don’t lose access to the important therapies supplied by compounding pharmacies. Do it today.

And don’t forget to have your thyroid checked, preferably by the Dr. Barnes under-the-arm temperature measurement strategy.

References

  1. Keidar S, Gamliel-Lazarovich A. Viewpoint: personalizing statin therapy. Rambam Maimonides Med J. 2013 Apr 30;4(2):e0008.
  2. Hoang TD, Olsen CH, Mai VQ, Clyde PW, Shakir MK. Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol Metab. 2013 May;98(5):1982-90.
  3. Brownstein D. Overcoming Thyroid Disorders. West Bloomfield, MI: Medical Alternatives Press; 2004:19-21:26-27.
  4. Paoletti J Rph. Differentiation and Treatment of Hypothyroidism, Functional Hypothyroidism, and Functional Metabolism. Int J Pharm Compd. 2008 Nov-Dec;12(6):488-497.
  5. Rodondi N, Aujesky D, Vittinghoff E, Cornuz J, Bauer DC. Subclinical hypothyroidism and the risk of coronary heart disease: a meta-analysis. Am J Med 2006;119:541-51.
  6. Barnes B, Galton L. Hypothyroidism: The Unsuspected Illness. Crowell, 1976.
  7. Tavernise S. More Sway for F.D.A. Is Object of New Bill. The New York Times, September 25, 2013. Accessed: September 26, 2013.


Will Block is the publisher and editorial director of Life Enhancement magazine.

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