Whole Thyroid For Improved Cognition and Mood
By Dr Gail Valentine
A recent double-blind, placebo-controlled study published in the mainstream medical literature compared the results of giving subjects with hypothyroidism (low thyroid production) thyroid hormones: either thyroxine (T4) or T4 plus triiodothyronine (T3).1 The findings were significant enough to disrupt the cart of clinical complacency . . . unless you consider cognitive performance to be of little value and/or unless you think that mood improvements are delusions.
In the world of medical orthodoxy, the most usual treatment for hypothyroidism is T4, even though both T4 and T3 are secreted by the normal thyroid gland. Because T3 has been considered physiologically unimportant by conventional medicine, treatment has relied on just T4. Conventional medicine has banked on the notion that because T4 is converted by the body into T3 when there is a need for it, the conversion process should be sufficient to supply enough T3 for the body's needs. But there is plenty of literature indicating that this is not the case in certain tissues of the body,2 and additionally, that conversion is a functional problem which increases with age.3 All this new incoming data, hitting mainstream medicine has prompted a study for whole thyroid. And the findings are clear. When T3 was given along with T4, significantly higher cognitive scores resulted, along with improved mood.
Low Thyroid is Frequently Misdiagnosed -- An Invisible Epidemic
The standards of conventional medicine, when diagnosing or ruling out a low functioning thyroid, give too much consideration to laboratory figures and computations rather than to a person's symptoms. This disposition is somewhat consistent with the impersonal and hurried processing that has been the hallmark of medicine as it has become more bureaucratized. The time-consuming task of listening to what the patient is feeling has been overruled by the expedient option of the lab report.
When T3 was added to T4, the results were elevated mood and cognition.
It has long been obvious that the symptoms associated with low thyroid are a wide-ranging proverbial constellation of symptoms. These symptoms can include depression, fatigue, mental confusion, memory disturbances, and the inability to concentrate easily. Also to be counted are sensitivity to cold, cold hands and feet, a tendency toward weight gain or obesity, resistance to weight loss, dry skin, thin hair, brittle nails, low energy levels, headaches, and for women, menstrual problems. Added to symptoms can be health concerns: hypoglycemia, atherosclerosis, diabetes, infertility, and even acne. Symptoms, whether related to overt thyroid disease or to age-related thyroid decline, can be slow to evolve and can be so insidious that they go undetected or unnoticed. Often, patients themselves don't recognize there is anything wrong. Or some, patients and their doctors alike, just write off decreased quality of life to "normal aging."
In his book, Hypothyroidism, the Unsuspected Illness, Broda Barnes, MD explains that thyroid problems are far more universal than most doctors imagine and that up to 40% of the population is clinically hypothyroid. If this is true, clinical hypothyroidism cannot be considered a disease,* an abnormal process that must be viewed as falling outside the norm.
Are Your Symptoms Really "Normal" for Your Age?
Strangely, many of these symptom-ridden patients do not show abnormal thyroid levels on laboratory testing. Many doctors, who subscribe to the standard test results for diagnosing low thyroid function, find normal results and then turn to investigate other causes. But if some other diagnosis is not found, some of these doctors may attribute the symptoms to the idea that it's "all in their patient's head." When doctors believe they have exhausted all the possible diagnoses for a given symptom(s), finding nothing wrong, it is logical for them to consider psychosomatic explanations. Yet the question remains: How, then, can a person have many of the symptoms of a low functioning thyroid and not be diagnosable as such?
In raising the question about the invisibility of the hypothyroid epidemic, we are confronted with the fact that in contemporary medicine, doctors do not take enough time to listen. We must also confront the problem of how illness has been traditionally defined. Defining an illness by its relativity to age, rather than comparing it with an objective standard, leaves the "afflicted" without any option but acceptance of their affliction when there are options available for an improved quality of life. A common example would be to dismiss a complaint because of a person's age: "Your symptom is normal for your age," or, "Relative to your age, there is no problem." If you start out with an appropriate idea of what it means to be healthy, you're never stopped by test results if symptoms are present.
Whether it's arthritis or cognitive decline or even cardiovascular problems, people are told to be "patient" because at their age, their problems are normal. Yet in younger people the same problems would be considered diseases, and cause for alarm.
Most Patients Feel Better with Addition of T3
At the end of the T4 plus T3 study, patients were asked which treatment they preferred. Twenty patients out of 33 said they preferred the T4 plus T3 treatment, while 11 had no preference either way, and only two preferred T4 alone. The 20 patients who preferred T4 plus T3 reported that they had more energy, improved concentration, and just felt better overall. Probably, the most important finding of the study was the conclusion that T3 combined with T4 "improved the quality of life for most patients."
Regarding thyroid misdiagnosis: As more data is gathered, it becomes clear that, even though skepticism remains high in conventional medicine, taking thyroid supplements dissipates symptoms. Large numbers of people continue to report that, even though they do not fit the conventional lab diagnosis for thyroid "illness" (the only criteria for which they could be prescribed thyroid supplementation by their doctors to enhance their quality of life), when they take thyroid supplements their problems just go away.
Home Testing for Indication of Low Thyroid Function
Dr Barnes recommends the measurement of body temperature in order to make a meaningful judgement about a low functioning of hypothyroid. All you need to do is shake down a thermometer before you go to bed and leave it by your bedside. As soon as you open your eyes in the morning, before moving, put the thermometer under your arm. After leaving it under your arm for seven minutes, read and record your temperature. The ideal temperature, according to Dr Barnes, is in the range of 97.8-98.2. For women this procedure should begin after or on the second day after menstruation. For both men and women, the process should be repeated for 5-6 days. According to Dr Barnes, if your average axillary morning temperature is under 97.8 you may be a good candidate for thyroid replacement therapy.
Supplements Available for Age-Related Thyroid Decline
Whole thyroid is available by prescription by the name of Armour Thyroid®. However, you can acquire it only by a visit to your doctor. He or she may not be willing to give it to you unless your lab tests indicate you have low enough thyroid levels. I recommend that you still see a physician for a physical and get baseline lab testing for thyroid function. Another alternative would be to seek out a nutritionally-educated/natural hormone replacement-educated physician.
Whole thyroid is also available in a low-dose nutritional supplement for age-related thyroid decline, standardized at just 1/4 grain of thyroid and containing other glandular extracts that should work in tandem with natural thyroid. All the thyroid hormones, including T4, T3, T2 and T1, decline with age. Dr Wright recommends supplementation for people over 40 who have no overt endocrine disease. He points out that, even if one is not experiencing symptoms, all endocrine glands are beginning to slow down at this stage of life. According to Dr Wright, the most common comment he gets from his patients on 1/4 grain of natural thyroid is, "I just feel a little more energetic overall. My thinking seems a little clearer and my bowel function is a little better."
How to Take Thyroid for Age-Related Thyroid Decline
It may be desirable to take mixed thyroid or natural thyroid which contains not only T4 (such as Synthroid®, the most widely prescribed thyroid hormone), but also contains T3, T2, and T1. It should make sense that our bodies need all of the thyroid hormones normally present in the body.
It is still a good idea to have a check up with your doctor just to make sure there aren't any conditions that require medical attention. And again, baseline thyroid function testing is desirable. This is not imperative for individuals without medical problems, but it can sometimes be useful for comparing before and after supplementation.
There are varied approaches as to how much thyroid to start with and when to increase the amount. Here are some guidelines to consider: Sensitive or cautious individuals may want to start with 1/4 grain of natural thyroid for a few months and increase to 1/2 grain if symptoms have not improved. Others can start with 1/2 grain. If you feel adequately improved, stay at that level. It is not uncommon for many, especially older individuals to be on one full grain of natural thyroid for optimal benefits. It is very unlikely that taking amounts as low as 1/4 grain, or even one full grain for older individuals, will abnormally elevate thyroid test levels. If your symptoms persist above one grain after a few to several months, you may want to be re-examined by your doctor. Periodic thyroid testing can be informative and basal body temperature monitoring at home may be helpful.
Too much thyroid may cause hot sensations, nervousness, insomnia, and rapid pulse, among many other symptoms that bear a resemblance to drinking too much coffee. Nevertheless, it is preferable to work with an experienced physician when contemplating a thyroid hormone supplementation program. It is possible that too much thyroid can manifest with no noticeable symptoms.* Clinical in this context refers to diagnosis and/or treatment based on observation, subjective patient reporting, etc. as distinguished from data or facts obtained from tests.
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- Bunevicius R, Kazanavicius G, Zalinkevicius R, Prange AJ Jr. Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in Patients with Hypothyroidism N Engl J Med. February 11, 1999;340(6):424-429.
- Visser TJ, Leonard JL, Kaplan MM, Larsen PR. Kinetic evidence suggesting two mechanisms for iodothyronine 5'-deiodination in rat cerebral cortex. Proc Natl Acad Sci 1982;79:5080-4.
- Pekary AE, Hershman JM, Sugawara M, Gieschen KI, Sogol PB, Reed AW, Pardridge WM, Walfish PG J. Preferential release of triiodothyronine: an intrathyroidal adaptation to reduced serum thyroxine in aging rats. Gerontol 1983 Nov;38(6):653-659.
- Dratman MB, Gordon JT. Thyroid hormones as neurotransmitters. Thyroid 1996 Dec;6(6):639-47.
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