Treatment of Hypothyroidism

The Treatment of Hypothyroidism (Low thyroid Function) at Karanga Health Centre

People who have low levels of thyroid hormones experience quite a long list of symptoms because the thyroid hormones direct all the chemical reactions in the body (the metabolism).

Depression
Weight problem
Constipation
Headaches
Brittle nails
Rough or dry skin
Menstrual problems
Infertility
Poor circulation
Diffuse hair loss
Slow speech
Anxiety or panic attacks
Decreased memory
Difficulty concentrating
Muscle or joint pain
Back pain
Morning stiffness
Slow heart rate
Swollen eyelids
Decreased sexual interest
Cold or heat intolerance
Cold hands or feet
Insomnia
Fatigue
Low body temperature
Hoarse or husky voice
muscle weakness
Dry, sparse or coarse hair
Agitation
Carpel Tunnel Syndrome
Drooping eyelids
yellowish skin
Swollen hands or feet
Slow movements
Dull facial expression
Unrefreshing sleep

We can provide missing nutrients that are required for the manufacture of thyroid hormones and we can detoxify the body to remove intruders such as heavy metals that are inhibiting their manufacture.

We can identify allergens that contribute to the formation of antibodies.

We can also administer the thyroid hormones themselves and this is often necessary in the first instance and may be a lifelong commitment.

Which thyroid hormones to use

The thyroid hormones are a complex of 4. We call them T1,T2, T3, T4 according to the number of iodine atoms in the hormone.

T4

T4 is the hormone that the thyroid gland in the lower neck makes most of. As thyroxine, it is the thyroid hormone that is most commonly prescribed in New Zealand and is funded by the health department. It works well for many hypothyroid people but has to be converted to T3 in order to be active. People can be hypothyroid when they do not make much T4 and also when they do not convert T4 to T3 very well. Some people remain unwell and have hypothyroid symptoms even when their blood tests indicate that they are taking enough T4 .

T3

Some T3 is made in the thyroid gland but most of it is made in the cells of the body. T3 is also prescribed by doctors but is not funded by the health department so costs more than the subsidised prescription of T4. It is provided by compounding pharmacies.

Whole Thyroid Extract

This is desiccated thyroid tissue from pigs. It contains T4, T3, T2 and T1. We know much less about the functions of T1 and T2 which are made in small amounts but studies are showing they do have a role.

May people who do not do so well on T4, feel better on whole thyroid. It is has been described as complimentary medicine and is not funded by the health department but is supplied by compounding pharmacies and can be prescribed by doctors.

 

The Diagnosis and Monitoring of Hypothyroidism

Blood tests have become the most commonly used way of diagnosing hypothyroidism and monitoring treatment.

However people with hypothyroid symptoms are sometimes told by their doctors after a blood test that their thyroid function is normal when a physical examination would suggest otherwise.

Blood tests are unreliable for several reasons. The levels of thyroid hormones in the blood are not the same as levels inside the cells. For this reason Thyroid Stimulating Hormone (TSH) has become the preferred test for diagnosing hypothyroidism. TSH is made in the pituitary. It tells the thyroid gland to make more thyroid hormone when levels of thyroid hormone inside the pituitary are low.

However TSH is also unreliable because the thyroid hormones cross easily into the pituitary whereas it requires active transport to get them into most other cells of the body. The pituitary can determine that there is plenty of thyroid hormone and it can lower its production of TSH when other parts of the body are deficient and require more hormone to be administered. Therefore a low or normal TSH does not necessarily mean that someone has enough thyroid hormone to be healthy.

While the blood tests are of assistance, they cannot be relied upon to give the final answer. This must come from the full clinical picture: the symptoms of the person, the clinical examination by the doctor and the results of blood test.

Reverse T3

T3 also come in the form of reverse T3 which has the same chemical makeup as T3 but is a different shape and does not produce the same energy manufacture in the cells that T3 does. It competes with T3. Reverse T3 can be measured but this test is not available in New Zealand and not funded. We send blood to Australia.

Treatment of Adrenal Deficiency as well as thyroid deficiency

Successful thyroid treatment relies on adequate adrenal hormones.

  1. Cortisol from the adrenals is necessary to make the thyroid receptors
  2. If cortisol production is poor, then when thyroid hormones are administered the adrenals will spring into action with adequate adrenal but without the cortisol to balance it and people will feel over stimulated.

Symptoms of thyroid overdosing include:

  • Increased resting pulse rate above 80 beats per minute (when calm & inactive)
  • Increased nervousness or irritability
  • Excessive heat production
  • Excessive weight loss with increased appetite
  • Trembling fingers
  • Insomnia
  • Palpitations

Note: symptoms that occur 1-2 days after starting or increasing the dose & are mild and are usually a normal adaptation that subsides after 1-2 days.