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Hypothyroid due to environmental toxins
 
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Hypothyroid due to environmental toxins


EXCELLENT article from "The Townsend Letter for doctors and Patients". Author borrowed heavily from the book "Hypothyroidism Type 2: The Epidemic" by Dr. Mark Starr.

follow the link for complete text:

http://www.townsendletter.com/Dec2008/hypothyroid1208.htm


"...In his book, Starr explains the differences between Types 1 and 2:
• With Type 1 Hypothyroidism, the thyroid does not produce sufficient amounts of hormone to maintain "normal" blood levels of hormones, which in turn will maintain normal blood levels of thyroid-stimulating hormone (TSH) produced by the pituitary. (I will say more about TSH a little later.)
• With Type 2 Hypothyroidism, the thyroid gland produces "normal" amounts of hormone, but the cells are unable to utilize the hormone properly. Some experts call this thyroid hormone resistance (which may be regarded as similar to insulin resistance).

Laboratory tests showing inadequate bloodstream levels of thyroid hormone make it easy to diagnose Type 1 hypothyroidism. However, lab tests fail to detect Type 2 hypothyroidism, because despite adequate bloodstream hormone levels, the cells are unable to accept and utilize that hormone (for a variety of reasons, which I'll address in a moment). Since the main problem lies with the cells that are actually utilizing the hormone, a different approach needs to be taken when testing for – and to a certain extent, when treating – Type 2 hypothyroidism.

Since many more people suffer from Type 2 than Type 1 hypothyroidism, and because Type 2 is widely misunderstood and misdiagnosed, this article will focus on Type 2: its manifestations, the best way to diagnose it (it's not with lab tests), and its treatment. For this article, I have drawn heavily from Mark Starr's book, Hypothyroidism Type 2: The Epidemic.

...How is it possible that the malfunction of one tiny gland can influence so many other functions that do not seem related to each other? Consider the most obvious effect of an underactive thyroid: reduced cell metabolism of proteins, fats, and carbohydrates. This not only means inefficient transport of nutrients into the cell membrane, but also inefficient transport of wastes out. As holistic practitioners well know, inadequate nourishment and the buildup of toxins (regardless of the cause) can exacerbate or outright cause virtually all conditions that we call "disease." The more toxins engorge the cells, the more one becomes susceptible to infections and degenerative conditions. As it turns out, the mitochondria – microscopic energy-burning units of the cell responsible for about 90% of the energy production that our cells, tissues, and organs require for metabolism – are intimately affected by thyroid dysfunction. Starr writes:

Thyroid hormones are responsible for our metabolism. When thyroid hormones are given to animals, trillions of mitochondria increase in size and number. The total membrane surface of the mitochondria increases almost directly in proportion to the increased metabolic rate of the whole animal. My medical school textbook, The Textbook of Medical Physiology, states: "It seems almost to be an obvious deduction that the principal function of thyroxin [thyroid hormone] might be simply to increase the number and activity of mitochondria."

The beneficial symbiotic relationship between mitochondria and thyroid hormone works both ways. Adequate levels of thyroid hormone not only increase mitochondria number and function, but as Starr points out, "mitochondrial mutations appear to be largely responsible for the metabolic defects at the cellular level, which result in a hypothyroid-like condition…. Defects in mitochondria, as well as synthetic toxins, impair thyroid hormone metabolism at the cellular level." Not surprisingly, symptoms of mitochondrial disease are the same as symptoms of hypothyroidism....

...
The Basics of an Epidemic
What do chronic pain, diabetes, heart disease, menstrual difficulties, and sleep apnea have in common? As physician Mark Starr points out in his extensively researched book, Hypothyroidism Type 2: The Epidemic, there's an excellent chance that this apparently disparate collection of disorders – among literally dozens, if not hundreds – indicate abnormally low thyroid function.

The thyroid is a butterfly-shaped endocrine gland located at the throat that produces numerous related hormones: thyroxin (also known as T4), liothyronine (also known as T3), T2, and T1. T4, the most well known of all the thyroid hormones, heats the body and speeds metabolism (of fats, proteins, and carbohydrates) and heart rate. T3, the most active form of thyroid hormone, also heats the body and speeds metabolism and heart rate. At best, T4 is only about one-quarter as potent as T3, and in any case, most is converted into the more active T3 by the liver, kidneys, and other body cells. T2 stimulates metabolism, while one animal study showed that T1 cools the body and slows the heart. Together, all four of these related hormones probably act synergistically in ways that are not yet fully understood.

Thyroid underactivity, commonly called hypothyroidism, was first reported in London in 1875. According to many reliable sources, including doctors Broda Barnes, David Derry, Jacques Hertoghe, and James Howenstine, at least one-third to one-half of the US population suffers from slight to severe hypothyroidism.


Before and after dessicated thyroid therapy
Source: Hertoghie, Eugene. The Practitioner. Jan. 1915, Vol XCIV, No. 1.
Reprinted with permission.

In his book, Starr explains the differences between Types 1 and 2:
• With Type 1 Hypothyroidism, the thyroid does not produce sufficient amounts of hormone to maintain "normal" blood levels of hormones, which in turn will maintain normal blood levels of thyroid-stimulating hormone (TSH) produced by the pituitary. (I will say more about TSH a little later.)
• With Type 2 Hypothyroidism, the thyroid gland produces "normal" amounts of hormone, but the cells are unable to utilize the hormone properly. Some experts call this thyroid hormone resistance (which may be regarded as similar to insulin resistance).

Laboratory tests showing inadequate bloodstream levels of thyroid hormone make it easy to diagnose Type 1 hypothyroidism. However, lab tests fail to detect Type 2 hypothyroidism, because despite adequate bloodstream hormone levels, the cells are unable to accept and utilize that hormone (for a variety of reasons, which I'll address in a moment). Since the main problem lies with the cells that are actually utilizing the hormone, a different approach needs to be taken when testing for – and to a certain extent, when treating – Type 2 hypothyroidism.

Since many more people suffer from Type 2 than Type 1 hypothyroidism, and because Type 2 is widely misunderstood and misdiagnosed, this article will focus on Type 2: its manifestations, the best way to diagnose it (it's not with lab tests), and its treatment. For this article, I have drawn heavily from Mark Starr's book, Hypothyroidism Type 2: The Epidemic.

Dr. Starr became interested in the subject for both personal and professional reasons. More than a dozen years ago, he embarked on a quest to heal his own chronic pain, fatigue, and allergies after receiving no relief from the majority of physicians with whom he consulted. Professionally, while treating thousands of people who suffered chronic pain alongside a wide range of disorders, he discovered a pattern. The underlying cause or contributing factor to their pain was low thyroid function. Dr. Starr's book is the result of over a decade's worth of intensive research and writing about the history, problems, politics, personnel, literature, case studies, and treatment related to hypothyroidism. I had the opportunity to visit Starr's new clinic, which is near my home, so at the end of this article, I will also give a brief description of his practice.

Endless Disease Conditions
Most people (correctly) regard the thyroid as responsible for proper metabolism. However, this gland plays a major role in hundreds of bodily functions. Here is just a sample of the many symptoms and conditions that can be caused, indirectly or directly, by an under-functioning thyroid gland:
• Appetite disruption (heightened or diminished)
• Autoimmune conditions, including allergies, lupus, and Rheumatoid Arthritis
• Blood Sugar disorders, such as diabetes, hypoglycemia, or a combination of the two
• Cancers, all kinds
• Cardiovascular abnormalities, including high cholesterol, poor circulation, heart palpitations, hypertension (high blood pressure), and hypotension (low blood pressure)
• Dental problems, including chronic gum infections, receding gums, and TMJ or Temporomandibular Joint dysfunction (clenching of the teeth, leading to chronic inflammation and pain in the temporomandibular joint)
• Fatigue and lethargy
• Gastrointestinal disorders, including irritable bowel syndrome, and impaired digestion leading to constipation and nutritional disorders
• Heart conditions, including coronary artery disease from accelerated atherosclerosis (hardening of the arteries), arrhythmia (irregular heartbeat), abnormal blood pressure (either too high or too low), diminished cardiac output, weakness of the heart muscle, and congestive heart failure
• Hoarseness of voice, difficulty in swallowing, swollen enlarged tongue, and sleep apnea
• Immune response malfunction, leading to increased infections (including Candida albicans) in all parts of the body
• Mental and emotional problems, including difficulty in cognition, and anxiety, depression, memory loss, manic depression, psychosis, and schizophrenia
• Metabolism malfunctions, leading to weight gain (usually) or weight loss (occasionally)
• Muscular disturbances, including ataxia (lack of coordination), carpal tunnel syndrome, fibromyalgia, and weakness
• Neurological impairment, including but not limited to ear conditions (deafness, tinnitus, and vertigo), headaches and migraines, Multiple Sclerosis, and paresthesia (numbness and "pins and needles" in nerves)
• Pain in joints and muscles, including Arthritis and fibromyalgia
• Perspiration reduction
• Reproductive disorders, including birth defects, cysts in breasts and ovaries, endometriosis, infertility, and menstrual disturbances
• Respiratory conditions, including asthma, emphysema, pneumonia, and chronic sinus infections
• Skin disorders, including acne, alopecia (hair loss), boils, dryness, eczema, hives, and psoriasis
• Sleepiness and sleep apnea.
• Slowed movement and speech
• Structural weaknesses/deformities and impaired ability to repair damaged tissues, manifesting in brittle nails, brittle or scant hair (including baldness), degenerating bones (osteoporosis), malformed bones (scoliosis), and thinning and loss of eyebrows, notably the outer third
• Temperature regulation malfunction: intolerance to heat, and excessive coldness, particularly in extremities.
• Urinary tract problems, such as urinary infections and especially kidney failure from shrunken, scarred kidneys

Why So Many Conditions?
How is it possible that the malfunction of one tiny gland can influence so many other functions that do not seem related to each other? Consider the most obvious effect of an underactive thyroid: reduced cell metabolism of proteins, fats, and carbohydrates. This not only means inefficient transport of nutrients into the cell membrane, but also inefficient transport of wastes out. As holistic practitioners well know, inadequate nourishment and the buildup of toxins (regardless of the cause) can exacerbate or outright cause virtually all conditions that we call "disease." The more toxins engorge the cells, the more one becomes susceptible to infections and degenerative conditions. As it turns out, the mitochondria – microscopic energy-burning units of the cell responsible for about 90% of the energy production that our cells, tissues, and organs require for metabolism – are intimately affected by thyroid dysfunction. Starr writes:

Thyroid hormones are responsible for our metabolism. When thyroid hormones are given to animals, trillions of mitochondria increase in size and number. The total membrane surface of the mitochondria increases almost directly in proportion to the increased metabolic rate of the whole animal. My medical school textbook, The Textbook of Medical Physiology, states: "It seems almost to be an obvious deduction that the principal function of thyroxin [thyroid hormone] might be simply to increase the number and activity of mitochondria."

The beneficial symbiotic relationship between mitochondria and thyroid hormone works both ways. Adequate levels of thyroid hormone not only increase mitochondria number and function, but as Starr points out, "mitochondrial mutations appear to be largely responsible for the metabolic defects at the cellular level, which result in a hypothyroid-like condition…. Defects in mitochondria, as well as synthetic toxins, impair thyroid hormone metabolism at the cellular level." Not surprisingly, symptoms of mitochondrial disease are the same as symptoms of hypothyroidism.


Before and after desiccated thyroid therapy
Source: Lisser, H. and Escamilla, R.F. Atlas of Clinical Endrocrinology: Including Text of Diagnosis and Treatment. C.V. Mosby Company, 1957. Reprinted with permission.

There are scores of environmental toxins that interfere with every aspect of thyroid metabolism and cause the mitochondria to malfunction. These include petroleum and petroleum byproducts; pesticides, herbicides and fungicides; heavy metals, among them mercury, arsenic, lead, aluminum, barium, and cadmium; organic solvents, including benzene, toluene, trichloroethylene, and dichloromethane; and numerous other synthetic chemicals. Fat-soluble toxins lodge in the fat cells that lie beneath the skin and surround internal organs. Women, whose bodies contain more fat than men's, hold proportionately more toxins in their systems and thus, one might assume, suffer from hypothyroidism in much greater numbers than do men. Statistics show this to be true.

Faulty thyroid receptors on the cell membranes as well as mitochondrial mutations can cause a hypothyroid condition. "Defective thyroid receptors," Starr writes, "may prevent a sufficient supply of hormones that are circulating in our blood from reaching the mitochondria and other crucial sites such as the nucleus of the cell. The nucleus is where the thyroid hormones activate genes and stimulate protein synthesis, among a host of other tasks" [emphasis added]. This explains why so many people with underactive thyroids have brittle nails and hair, and even bone defects. If the body cannot utilize amino acids to create new, properly formed tissue, the cells will be imperfect and cause structural abnormalities...

...Treatment for Type 2 Hypothyroidism

1. Replacement Hormone
Whether the person's thyroid gland is not producing enough hormone or the cells are unable (for whatever reason) to process what the gland is producing, the treatment is the same: replacement hormone. From the perspective of conventional medical training, flooding the system with thyroid hormone, in amounts greater than what laboratory blood tests might indicate are useful or prudent, may seem questionable. But consider the highly dysfunctional state of the mitochondria and/or cell receptors. If you saturate the tissues with enough hormone, for a long enough period, even malfunctioning mitochondria and stubborn receptor sites will start processing and utilizing the hormone. Once the body begins to function correctly, it has the potential to self-correct. Then, conceivably, the hormone dosage can be reduced. This points to the need for careful monitoring of people with Type 2 hypothyroidism. It's easy to assess a body that is starting to heal, Starr maintains. "The increased basal temperature that results from administering desiccated thyroid is a direct result of enhanced mitochondrial activity."

What type of pharmaceuticals work best? Up until the 1960s, people suffering from hypothyroidism were given desiccated thyroid derived from pigs. This means the entire dried gland and its contents – all four forms of thyroid hormone, RNA, DNA, and other co-factors. But by the 1970s, isolated thyroxin (T4) was introduced as the "gold standard" of thyroid medications. By definition, thyroxin is only a portion of the thyroid hormone complex. Since it does not contain the synergistic effects of the entire glandular material, not surprisingly, it proved less effective clinically than the desiccated thyroid.

One such study on the superiority of desiccated thyroid over thyroxin was conducted in Belgium and was published in 2001 by endocrinologist Jacques Hertoghe and his colleagues in the Journal of Nutritional and Environmental Medicine. Subjects showed marked improvement when they began taking desiccated thyroid instead of only T4. The hallmark symptoms of low thyroid – constipation, headache, joint and muscle pain, muscle cramps, depression, cold intolerance, and fatigue – were reduced by 70% after they switched from T4 to desiccated thyroid. "Symptoms of the patients already taking T4," notes Starr, reviewing the study, "did not differ from those of the group of untreated patients" [emphasis added].

Occasionally, Dr. Starr has found, some people require compounded T3 or T4 only or combinations of the two, because they are either allergic to, or unable to tolerate, desiccated thyroid. Or, they don't want to take the desiccated pork product for religious reasons. Whatever replacement hormone product is used, it's crucial that the client be monitored on a regular basis. This includes self-monitoring. The doctor must be willing to work closely with the client as well. And the client must be willing and able to detect physiological changes that indicate too little or too much hormone and regularly report to the doctor.

Significantly, as one's metabolism becomes more efficient, perspiration will increase, allowing for the elimination of more toxins. As more toxins are eliminated, the better the cells – including the mitochondria and hormone receptor sites – will function. This suggests that mitochondrial defects can be corrected, given enough time, patience, and dedication. (See below.)

2. Detoxification
Some of the most significant stressors of mitochondria are heavy metals. Mercury is particularly insidious, as it's everywhere in our environment and affects the system in devastating ways. It can also be difficult to eliminate. Intravenous chelation therapy has proven effective, but is expensive and time-consuming. Less expensive but effective alternatives include the oral ingestion of broken cell wall chlorella, liquid zeolite, alpha lipoic acid, and certain amino acids in the correct proportions, often in combin ation with each other.

The fact that a good portion of the T4 to T3 conversion takes place in the liver also points to the need for a good detox liver protocol, as this organ is primary in converting systemic and environmental poisons into less noxious, more easily excretable substances. An overall excellent – and easy – means of detoxifying is sweating. Sweating reduces the waste removal burden on the kidneys, liver, and eliminative organs. Numerous studies have shown vastly decreased levels of mercury and other toxins after even only a few weeks of regular sauna therapy. In fact, subjects have been known to blacken their towels with the metals excreted through the skin during sweating. My book, The Holistic Handbook of Sauna Therapy, discusses sauna protocols in depth: the mechanism of sweating; the three types of heat, including details on far infrared; what types of heating elements and sauna building materials are best for people with particular sensitivities and needs; how to take a sauna and avoid heatstroke; which medical conditions can be relieved by sweating; when one should not use the sauna at all; and when one may use the sauna with medical supervision; pregnant women and children in the sauna; and specific detox protocols.

Be aware that sauna therapy can achieve opposite effects with regard to medication. On the one hand, some medication may be sweated out of the system. On the other hand, the elimination of toxins increases the metabolic efficiency of the cells, which means that in many cases a drug is more efficiently absorbed into the cell – and therefore will be needed in reduced amounts. Whatever detox protocol you use, it needs to be consistent. Sometimes it can take longer than desired to eliminate toxins from deep inside the tissues.

3. Nutritional Support
Iodine is essential for proper thyroid function. Potassium Iodide is absorbed directly by the thyroid gland, whereas Iodine tends to be more heavily concentrated in the breasts, reproductive organs, and respiratory tract (including the sinuses). Both forms of Iodine are necessary for optimal functioning. Some types of seaweed added to the diet, such as dulse, provide large quantities of iodine.

To assist in the conversion of T4 to T3, supplementation with selenium, zinc, and vitamins E and B6 are usually indicated. Manganese, known to protect the thyroid and liver, is sometimes called the "anti-pear nutrient," so named because it helps eliminate the faulty weight distribution pattern common with hypothyroid people. Thyroid hormone increases the enzyme levels in the body. Since vitamins are essential constituents of both enzymes and co-enzymes, increased thyroid hormone levels require a higher intake of vitamins.

4. Glandular Support
Adrenal and thyroid function are intricately related. Sometimes, hypothyroid subjects are unable to tolerate even sub-therapeutic amounts of thyroid hormone due to adrenal fatigue. (In their attempt to raise the energy of the body and compensate for the under-activity of the thyroid gland, the adrenals have overworked and are now exhausted.) Therefore, support for the adrenals, other glands, and even the hypothalamus may be indicated during or even before beginning thyroid hormone therapy..."



 

 
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