Subclinical Hypothyroidism, the Silent Epidemic
by Dr. Konrad Kail
Are you more tired and sluggish than normal? Do you have drier skin or hair than normal; sleep more than usual; have weaker muscles? Are you colder than others; do your muscles cramp more than usual; have you noticed that your memory is poorer; are you more depressed? Is your thinking slower, is math more difficult; are your eyes more puffy, is your voice hoarser or deeper? Are you constipated more often; is your hair coarser; do you have puffy hands and feet; do you gain weight easily; are the outer third of your eyebrows thin?
If you are experiencing any of these symptoms your thyroid function may be low. If your doctor already checked your thyroid blood tests and they were normal, you still may be hypothyroid. Subclinical hypothyroid is when your thyroid blood tests are normal but your thyroid function is not. This occurs because the test that most doctors use to evaluate thyroid conditions, the Thyroid Stimulating Hormone (TSH) test is not an accurate indicator of patient status. Many doctors don’t worry about this because their patients are just a little low so it probably doesn’t hurt them. WRONG !!!
Risk Associated with Sub-Clinical Hypothyroid is Huge
1. CARDIOVASCULAR RISK
INCREASED: cholesterol and other blood fats, C-reactive protein and homocysteine (associated with sudden death events), coronary heart disease, hypertension, blood vessel damage, coaguability,
DECREASED: stroke volume and cardiac output
2. DIABETES RISK
Increased dysglycemia, insulin resistance, disruption of GLP-1 signaling
3. ARTHRITIS, INFLAMMATION AND AUTOIMMUNITY
Increased risk of Hashimoto’s thyroiditis, Grave’s disease, and other rheumatoid related diseases (lupus, polymyalgea rheumatica)
4. NEUROLOGICAL RISK
Hoffman’s syndrome (weakness and stiffness),
Dupuytren’s contracture, carpal tunnel syndrome, polymyositis-like syndrome
Parkinson’s disease, hearing loss, anxiety and depression. Doubles risk of Alzheimer’s.
5. PREGNANCY
Fertility issues, 3 Fold increase in placenta previa, 2 Fold increase in premature delivery, may affect mentation of offspring.
6. BONE RISK
Increased bone breakdown in hyperthyroid
Thyroid is bound by calcium, but there is no calcium metabolism problem in hypothyroid. Take thyroid meds at least 45 minutes away from calcium.
If you think about what diseases cause the most illness and death in this country, then it is easy to see from this list that what is considered by many physicians to be a relatively mild problem may be what is driving the epidemic of chronic disease that plagues our society.
Thyroid is one of the prime regulating glands in the body. It is involved in immunity, blood sugar regulation, thinking, mood, fat metabolism, sex hormones and fertility. It dictates how fast your body burns calories (resting metabolic rate) so it greatly affects ability to maintain normal weight. Thyroid blood tests are useful to tell if you are very high or low in thyroid activity, but, they are a measure of how much hormone is available to your receptor sites and may tell you something about conversion of the storage form of thyroid (T4) to the active form (T3); but they are not the gold standard. Resting metabolic rate (how fast you burn calories) is the gold standard because it is the final endpoint of thyroid activity and represents what actually happened to thyroid function after the hormone got to the receptor site.
Thyroid is also one of the glands most affected by stress. Small stresses like a single episode of low blood sugar may impede thyroid function for up to 18 hours. Stronger stresses, like surgery or any acutely severe illness, may inhibit thyroid function for up to 60 days. Many medications interfere with thyroid function especially seizure medications lithium, beta blockers and amiodorone. Nutrients like iodine and foods like soy may interfere with thyroid function.
So many things may upset thyroid function that it is estimated that those people with subclinical hypothyroid may represent the majority of Americans over the age of thirty-five. This statistic can not be verified because doctors don’t use the tools that are available to identify those at risk, because they mistakenly believe that the TSH test is accurate, because the current “clinical guidelines” say that it is; but, that is not what medical studies reveal. Most people with subclinical hypothyroid are unidentified and untreated.
If you can’t use blood tests what can you use? Symptoms, such as those listed above are the starting place. Physiologic measurements are much better indicators of thyroid function than serum (blood) measurements. Basal body temperatures (average of 5 days waking axillary temperature before getting out of bed) less than 97.5 degrees Fahrenheit are a good indicator, but respond very slowly to treatment. Resting metabolic rate is the gold standard but few doctors have the equipment for testing this and it is about $75.00 per test. The best measurement to find subclinical hypothyroidism and adjust thyroid medication dosage is brachioradialis (wrist) reflex measurements.
Back in the late 1950’s it was found that the speed of reflexes is correlated with resting metabolic rate and thyroid function. If your reflexes are slow, your resting metabolic rate and your thyroid function is low. This is a non-invasive, inexpensive (average $35.00) way to accurately manage hypothyroid patients. The Thyroflex™ brachioradialis reflex device was developed by Dr. Konrad Kail and Dr. Daryl Turner in conjunction with Noraxon Inc. (world leader in EMG Technology and Sensor Systems). The device is being evaluated in a clinical trial which to date has over 1,800 patient interactions. It is being marketed by NiTek International, Inc., a Scottsdale based company.
Findings show that it takes about 30 days to equilibrate on a new dose of thyroid. It is recommend that you measure reflexes and increase thyroid dosage every 30 days until the reflex measurements are normal and let the blood measurements fall where they may. Using this protocol, the TSH test gets very low (indicating too much thyroid) but remember that this test has bad “normal values” that don’t really reflect thyroid function. When you look at an elderly population (over 65) they live longer, have more energy, think better and perform better if their TSH is in the hyperthyroid range (too low). The only downside is increased bone breakdown, which can easily be compensated for by giving ipriflavone 300 mg three times a day. Patients respond very well to this protocol. They have more energy, can think clearer, their hair quits falling out and they start to lose weight.
If you think that your thyroid function is low, ask about our Thyroflex test.