11 Jun Thyroid Health a Naturopathic Perspective in Treatment
Dr. Broda Barns wrote a book called Hypothryoidism: The Unsuspected Illness, the premise of which was that blood tests were insufficient and body temperature can be a good indicator of thyroid health. He was an advocate of T4 thyroid hormone medication and his approach to thyroid managment was an eye-opening moment for many integrative physicians including Dr. Wilson, an expert in thyroid health and the author of The Wilson’s Syndrome.
Why doesn’t subclinical hypothyroidism show up on blood tests?
The thyroid hormone goes into the nucleus of the cells and tells how fast the DNA needs to live. According to Dr Wilson, the key to understanding thyroid health is that the faster we live, the higher our temperature and the slower we live, the lower our temperature. In his estimation therefore, there is no way to test for this on standard blood tests. So he considers the thermometer our speedometer using the analogy that when we see it’s cold outside, we see that the air molecules are moving slower; and when we boil water, the molecules are speeding up until it reaches escape velocity and turns into steam.
When you put a thermometer in your mouth, you’re actually measuring metabolism and it’s not just a good measure of metabolism, Dr. Wilson argues it’s an exact measure of the metabolic rate because we are measuring how fast our body is living. Body temperature he argues, is the best indicator of thyroid function and the blood tests help us narrow down the source of the problem if there is one.
There’s two ways you can have low body temperature:
1) If you have low hormone supply or, 2) If you have a conversion problem. These things can happen before you have a body temperature change, so a blood test can be a good place to start.
An ideal temperature should be 37C. The body changes temperature according to its needs but 37 C is a good baseline temperature where many people feel they are symptom free.
The reason doctors get so fixated on thyroid hormone blood tests is because if someone had their thyroid gland removed, their TSH would go up and they essentially would go into coma. But Dr. Wilson feels putting too much stock in this test isn’t helpful because health cannot be fully incapsulated from a single blood test marker.
What’s behind the ‘thyroid epidemic’ ?
Thyroid conditions are pervasive. Everyone has a thyroid issue it seems. It’s postulated that this may be because of toxins from our environment and food supply as well as stressful lifestyles, including our eating habits. Blue light is a very recent postulated influence because it stimulates the adrenals and contributes to cortisol dysregulation.
Are there symptoms that show up in people before the thyroid is affected?
In clinical practice it’s very common to observe that when treating people for adrenal function their thyroid symptoms improve. This is because the body is an organic whole, not quasi-mechanical parts that operate independently. So when one part suffers, the other suffers as well. As a Naturopathic physician, I almost always treat the adrenals if I’m treating the thyroid.
What is Adrenal Fatigue?
When a person goes through stress, the body goes into an alarm phase that has a flight or fight response using hormones that help deal with stress: cortisol, adrenaline, norephinephrine…these in particular are hormones that help us deal with significant stress.
Sometimes in our modern world we get these hormones pumping out, but we don’t do any fighting or running, instead we just sit and stew. Also in the modern world, the stressors can be endless with one stress after another. This cascade of ongoing events and poor coping mechanisms can lead to adrenal resistance and as more and more hormones pump out until eventually the adrenal system can begin to ware out at this point a person enters adrenal fatigue or exhaustion.
It’s not that everyone who has stress gets into adrenal fatigue: if the stress occurs and it’s handled in a balanced, proactive way that includes a balanced lifestyle where work includes time for play, regular wake sleep patterns, and a healthy healthy diet…all these things can help avoid adrenal fatigue.
Intermittent fasting can be very revitalizing as well. This means having time when you eat and time when you don’t eat. I will write more about this and how it can optimize mitochondrial function to help treat fatigue, dementia, weight gain and heart disease in a later blog post.
Adrenal fatigue symptoms: chronic fatigue, troubles sweeting, poor tolerance to stress, sleep disturbance, anxiety, hair loss, anyone with a story of stress that’s months or years ongoing.
Low temperature symptoms: fatigue, depression, dry skin, dry hair, migraines, panic attacks, low sex drive, hard time with word recall.
Functional tests to conclude adrenal fatigue: in my clinic the treatment is the test. This includes the right combination of herbs and nutrients. Sometimes I will run a 4 tube salivary cortisol that measures cortisol throughout the day, but generally I’m more clinical in my assessment and management of adrenal health.
Conventional treatment for hypothyroidism usually is Synthroid medication. But my first line therapy with someone that has hypothyroidism (vs low body temperature) involves looking at TSH, free t3, free t4 and body temperature, I am assessing not only the supply but the conversion as well.
If a person has a thyroid hormone supply problem, I don’t like giving t4 containing medicine like Synthroid or Armour (aka Erfa) as my first choice unless their body temperature is normal or they have had a thyroidectomy. If they had a supply problem then I tend to give t3 therapy and if their TSH was normal, I may simply give them herbs and nutrients first and if that approach doesn’t work, then turn to t3 therapy to lower their t4 and up-regulate and refresh their pathways to help reboot their thyroid gland.
If someone has been on Synthroid for a long time can they come off of it?
The first question I’d ask is what was your TSH when you first started therapy? If it was < 4 (within normal limits) then most of these people could transfer to natural thyroid hormone therapy (with physician supervision). That said, even if a person had a high TSH at starting Synthroid, it doesn’t mean that their TSH would be that high now if they came off. **Anyone wanting to discontinue medication must do this with the guidance of a physician.
What about Hashimoto’s and Graves?
The other realm of thyroid conditions are the people that have auto-immune conditions: Hashimoto’s, Graves. There is a suggestion that a lot of autoimmunity are coming from toxins particularly with people that have leaky gut. Auto-immunity can lead to low temperatures. But low temperatures can also lead to autoimmune issues as well. This is because every enzyme in the body is dependent on body temperature. Enzymes catalyze changes in the body, including immunity and inflammation. T3 therapy for example can decrease inflammatory markers, so when you say autoimmune it means inflammation is out of balance and thyroid hormone can be beneficial here.
Wilson’s Temperature Syndrome Defined:
Wilson’s Syndrome means you can have a normal TSH test but have lowered body temperature and the symptoms of hypothyroidism. It’s defined as having a conversion problem versus a supply issue. Specifically a conversion of t4 to t3. According to Dr. Wilson, when treating these people with desiccated thyroid, you can expect 60% to get better and 40% not to. Also, when the hormone is discontinued, many will see their symptoms return.
Using t3 hormone therapy, Dr. Wilson has observed 80-90% of people improve and their symptoms and temperature improve even when weened off the hormone therapy. With Wilson’s Syndrome, thyroid symptoms are the result of a temperature issue which is a reversible problem generally within 2-3months. The adrenal component can take longer, six months or more.
How do people take their temperature?
It’s best to take temperature every 3 hours, starting 3 hours after you wake up and 3 times throughout the day. The best route is oral and using a glass thermometer ( because they don’t get de-calibrated). Take the temperature 20 mins away from eating and it takes only 2-3 mins to register a temperature with a glass thermometer. Average the 3 temperatures together and continue tracking for 2 – 3 days to get a good picture of your body’s temperature.
I don’t worry about travel or other events includes menses during the tracking time because though a lot of people have low body temperature, we’re looking for quite a low body temperature and this won’t be significantly impacted by life events.
If you or someone you know suffers with hormone issues, feel free to drop me a line on the “contact us” page on this site. I treat patients locally at my Naturopathic practice in Vancouver, B.C. and worldwide via phone or Skype.
To your best health!
Dr. Tasnim Adatya
Naturopathic Physician, Menopause Clinician, Acupuncturist, and Health Educator