Thyroid – Ultimate Guide To Getting Lean
By: Dr. David Ryan
Whether you are the weekend athlete, soccer mom or a professional physique athlete your overall appearance is based on the same factor of a tiny little gland called the thyroid. This tiny little gland in your neck controls your hair, skin, eyes and every cell in the body.
In your quest to become ultra lean or just shed a few pounds, your success is controlled by the tiny little organ. Several factors can go wrong and leave you bloated or just stuck on a treadmill confused about how you can drop those simple first four pounds. Making sure that your body is ready to get lean is one of the first steps of losing excess body fat.
If you are having trouble losing body fat or you have hit that body weight plateau and cannot get your last few pounds off, then it is time to learn more about the ultimate factor controlling your bodyweight. Many other health conditions are closely associated with thyroid conditions.
Thyroid problems often lead to hormonal problems, which can be very difficult to correct if left undetected. Several of our own habits can lead to a dysfunctional thyroid.
The Basic Thyroid
The thyroid is a very small gland, shaped like a butterfly, it weighs less than 1 ounce and is usually located in the middle of the lower neck. The thyroid receives its information from the hypothalamus and pituitary glands. These are two glands located in the center of the brain. The pituitary gland stimulates the thyroid by producing a hormone called Thyroid Stimulating Hormone TSH.
The thyroid produces two hormones that affect every single cell in the human body. Both of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), speed up your body’s metabolism by affecting every cell at the cellular level.
You’re thyroid produces approximately 80% T4 and 20% T3. The affects of T3 on your body are very-very powerful and small amounts of the hormone have a powerful affect on your metabolism. Your body produces these hormones; the quality and quantity is monitored and controlled by the pituitary gland.
The pituitary gland acts like a thermostat in your home and senses a high concentration of the T3 and/or T4 in your bloodstream. Once it senses a high-level of thyroid hormones, the pituitary produces very little TSH, if the blood levels are very low, then it produces larger amounts of TSH.
The TSH stimulates the thyroid to absorb iodine and make T3 and T4. Various problems occur with the thyroid – Currently, the Centers for Disease Control indicate that approximately 20 million Americans have some form of thyroid disease. People of all ages, races and sexes can get thyroid disease – Women are approximately 8 times more likely than men to have thyroid problems.
What Causes The Thyroid Disease?
There are several different causes of thyroid disease. At birth, the thyroid is located at the rear of the tongue and it migrates down to the middle of the lower part of the throat as a person matures. In some cases the thyroid does not migrate properly, although rare the displacement of the gland leads to various metabolism dysfunctions. Currently, science is looking at the exact location of the thyroid gland how that might relate to various diseases.
More common causes of thyroid disease world wide is the lack of iodine in the diet. Other causes are ultraviolet radiation, medications and trauma round off the top list. In this article you will find that anything that affects the pituitary, hypothalamus or adrenal glands will have an affect on the thyroid.
The Four Gland Endocrine Loop
Clear | Hypothalamus | Pituitary | Thyroid | Adrenals
The Following Conditions Cause Hypothyroidism:
* Iodine deficiency is a problem affecting approximately 100 million people around the world. Iodine is used by the thyroid to produce thyroxin (T3 & T4). In the 1950s the US virtually wiped out iodine deficiencies by using iodine salt.
* A nonfunctioning thyroid gland affects one in 4000 newborns. The child is either mentally and/or physically retarded if the problem is not corrected.
* Postpartum thyroiditis occurs in approximately 8% of women after giving birth. In most cases it is a temporary condition.
* Thyroiditis is an inflammation of the thyroid gland. This can lower or raise the amount of hormones produced.
* Hashimoto’s thyroiditis is a painless disease of the immune system that is usually hereditary, but has been linked with carpet cleaning.
Common hypothyroidism symptoms include:
o Frequent-heavy menstrual periods
o Weight gain
o Dry course hair and skin
o Hoarse voice
o Intolerance to cold
o And others
The Following Conditions Cause Hyperthyroidism:
* Graves’ disease results in the entire thyroid gland being overactive and producing too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland) and is often associated with a condition known as “BUG EYES.”
* Nodules are often associated with an over active thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while several nodules are called a toxic multi-nodule goiter.
* Thyroiditis is an inflammation of the thyroid gland. This can raise the amount of hormones produced. More commonly associated with women after child birth, the painful or painless disorder results in hormones being stored in the thyroid gland and causes hyperthyroidism symptoms for up to several months.
* Excessive Iodine is found in many drugs such as some cough syrups (example: Amiodarone). The body often reacts by producing too much thyroxin to remove the excess iodine.
* Excessive long term use of stimulants (including thermal stimulants).
* Excessive long term high protein, low carb diets.
Common symptoms of hyperthyroidism include:
o Muscle weakness
o Infrequent short duration of menstrual periods
o Weight loss
o Sleep disturbances
o Enlarged thyroid gland
o Vision problems or conjunctivitis
o Heat sensitivity
o And others
Other factors affect your thyroid and include:
o Outside/inside temperature
o Barometric pressure
o Exposure to Sunshine (Ultraviolet radiation)
o Emotions (Good and Bad)
o Sleep (Too much or not enough or improper sleep)
o Environmental factors (toxins mostly)
o Diet and eating habits
o Sex-male or female
Now if you suspect a thyroid problem, many times your family physician is the best place to start. More complicated issues are handled by doctors of internal medicine or endocrine specialist. Thyroid problems are very difficult to diagnose and other conditions often mask themselves as a possible thyroid problem.
Most often they will ask for a thyroid blood test that will include the thyroid stimulating hormone test or TSHT. This test often can identify several thyroid disorders before you even get any of the above symptoms.
If you can get one, you should always ask for a thyroid blood test, even if you don’t have any symptoms, since this allows for some base information to go off of later in life.
The Journal of the American Medical Association (JAMA) has reported that the screening for even mild thyroid dysfunction in men over 35 and women of all ages is cost-effective for the more common test such as high cholesterol or high blood pressure. Remember that fact if the insurance company refuses to pay for the testing.
There are newer updated levels of thyroid TSH. Please ask your physician to update your test even if you were told you were normal in the past 6 months.
New Light On The Subject
Much of the problems associated with thyroid conditions-treatment-research are the same problems that follow many other diseases. We are treating people based upon the “Old School” of thinking.
Unfortunately previous statistics and research have been based upon poorly worded protocols. If you do research on patients who have not been properly diagnosed, then publish the results, the information is screwed up and passed on to the next research trial.
For example, not until 2003 did the North American spine society offer measurable definitions as to the distinction between disc bulges and disc herniations. Sounds silly, but the research for back pain has suffered tremendously due to improper use of terms and clinical trials have obvious suffered.
Similarly, thyroid problems are often ill-defined and not well understood. Treatments are often skewed by improper terminology utilized by the medical professions.
More and more articles are surfacing relative to these types of poor protocol. Dr. John C. Lowe, editor in chief of Thyroid Science has distinguished many of these points in the recently published article, “How the False Beliefs in Conventional Clinic Thyroidology Came About.” Thyroid Science 1(12):E1, 2006
Another hormone that needs testing is the Thyroid Binding Globulin (TBG). This hormone carries the thyroid hormone around in your blood stream. If you don’t have enough TBG, then your thyroxin has nothing to carry it to the cells.
Your levels of thyroid hormone will be second place and there will be very little benefit of testing for your levels of T3 and T4. If your levels of TBG are too high, then too much of the thyroid hormones are linked up and can’t get to the cells.
Other Major Hormonal Factors
The female ovaries produce three different forms of estrogen and only one progesterone. That allows for the estrogen to become dominate very quickly. Thyroid hormones allow our cells to produce energy. Having high levels of estrogen causes the body to produce high levels of TBG. That estrogen dominance will quickly upset the balance of hormones. We will discuss that shortly.
Many drugs are artificial and often lead to severe side effects. Bio-identical drugs are best to replace deficient hormonal production. This is the new phase of medication and pharmacological research that is present today. Making drugs, or using supplementation that is very similar to what your body naturally uses, allow for better absorption and less side effects.
Cortisol For Men & Women:
The adrenal glands produce another important hormone called Cortisol. Without Cortisol, you will soon die from the slightest change in room temperature. Some of the effects of low cortisol levels are hypoglycemia, low blood sugar, but mostly fatigue. The effects of high cortisol hyperglycemia, elevated blood sugar, diabetes, excessive weight gain-primarily around the belly.
Individuals with adrenal fatigue usually function reasonably well when life is stable but fall a part when stress is added. “Roid Rage” is often related to the adrenal fatigue, since the adrenal gland cannot balance the body’s hormonal levels when artificial steroids are being used.
The upset balance levels your system off and the control of changes is off. Pre Menstrual Syndrome (PMS) is another example of the poor effects of adrenal fatigue. These individuals are more likely to be vulnerable to infections and heal slower than those individuals with healthy adrenal glands.
Other common side effects include headaches, joint or muscle pain, heart palpitations and other allergy type symptoms. Individuals with allergies should follow up with an endocrinologist for testing before they are doomed to living on allergy medications their whole lives.
Adrenal gets its’ Latin roots from “ad” meaning-near; “renal” meaning kidney. The glands sit on top of the kidneys and have an internal area called the medulla and the outer called the cortex. The inner medulla responds quickly to stress and produces epinephrine also called adrenaline.
The outer cortex produces cortisol to handle long term stress. This allow for a quick response and a slower time released response to help us better cope with our changing environments.
Cortisol primarily produces gluconeogenesis, which is the conversion of fats and proteins to sugar. In addition the presence of cortisol helps adrenaline elevate your body’s heart rate. Cortisol is a corticosteroid, but unlike the other steroids in that same family, it is quite safe when prescribed at higher levels.
Commonly prescribed for individuals who have Addison’s disease, a relatively rare condition in which the adrenal gland is unable to produce enough cortisol.
Symptoms & Signs Of Adrenal Fatigue:
o Dizziness or light headedness upon standing
o Muscle and/or joint pain
o Irregular menstrual cycles
o Low libido
o Chronic fatigue
o Low blood sugar (hypoglycemia)
o Low blood pressure (hypotension)
o Hair loss
o Heart palpitations
o Cold and heat intolerance
o Anxiety or panic attacks
o Dry skin
Obviously several of the symptoms some very similar to those of hypothyroidism. Both are clinically distinct conditions and blood work testing is conclusive to differentiate the two. Once again, high levels of estrogen or estrogen dominance can often times contribute to adrenal insufficiency.
Another adrenal hormone is dehydroepiandrosterone (DHEA). The amount of DHEA produced by the adrenal cortex is greater than any of the other adrenal hormones, which includes androgens and the estrogens.
Most individuals decrease their production of DHEA by the age of 30. Supplementation of DHEA is recommended past the age of 30 and also three to 6 mg of vitamin C per day to help boost immunity. Avoid caffeine, thermal stimulants, and alcohol; all of which stresses the adrenal glands.
Adrenal insufficiency and/or adrenal fatigue affect about one out of four people in the US. It affects patients of all ages and both sexes. It will not present itself until 80 to 90% of the adrenal gland has been destroyed.
In the United States about 70% of the primary adrenal insufficiency is due to auto immune processes. The rest of the 30% of the adrenal damages due to other causes such as:
o Tuberculosis (which is the most common world wide cause)
o Bacterial, viral and fungal infections
o Adrenal hemorrhage
o Spread of cancer to the adrenal glands
It is rarely caused due to genetic abnormality of the adrenal glands.
Lastly, the adrenal insufficiency can be caused due to a decrease in the production of the pituitary hormone known as adrenocorticotropic hormone (ACTH). ACTH is a pituitary messenger and it tells the adrenal cortex to produce cortisol. A pituitary tumor or other cause will result in the cortisol production being not stimulated. Long-term prednisone therapy will likely result in disruptions to the normal production of ACTH.
You can quickly understand the complexity of the hormone system and how balance is the key element of control.
Back To The Thyroid
Most of the time, patients will obtain a thyroid test and be told that there are levels are within a normal range. As you can tell by the past few pages, testing a thyroid involves several factors and requires an expert to put together all of the results for proper interpretation.
Testing the thyroid requires a T3 and T4 free and fixed. Testing should also require a TBG, cortisol, estrogen, testosterone, progesterone, DHEA (when applicable) and other general factors to rule out other systemic diseases/conditions.
You should realize that the standard ranges have been recently recalculated and new ranges have been published since Jan. 2007. You should also take note that several physicians may not be using the proper protocol and/or terminology.
Thyroid conditions are extremely difficult to diagnose and treat. Importance has been shown in using bio-identical medications instead of artificially syndicated and synthesized drugs that have significant side effects.
This table will help you to understand how doctors use blood test to rule in and rule out various conditions based on blood test.
Disease Cortisol ACTH
Cushing disease (pituitary tumor making ACTH) High High
Adrenal tumor High Low
“Ectopic” ACTH (ACTH made by a tumor outside the pituitary, usually in the lung)
Addison’s disease (adrenal damage) Low High
Hypopituitarism Low Low
This science is extremely complicated and physicians have to be on top of their game to be able to help you with these types of conditions. Just like with anything, some physicians are better than others at dealing with these types of problems.
A through and intense case history and family history are the correct steps to beginning a successful hormone replacement therapy. Most of the time you should see a difference in the period of couple weeks.
Make sure that she gave your physician lots of feedback and remember that they “practice medicine.” Your results are not often as easy as a cookbook recipe. Trial and error will often result in a successful hormone situation.