To introduce and familiarize Members with the using Iodine and Basal Body Temperature to improve Thyroid Health and earn the Cureality Improve Thyroid Health Proficiency Award.
Learn the Essentials
Because we cannot (at least at present) extract or undo the effects of a lifetime of organochemical or wheat exposure, we do what is second best: Supplement thyroid hormones when necessary. Most people are subjectively happier—better mood, increased energy, improved tolerance to cold, better bowel function, thicker hair, more successful weight loss—when both T3 and T4 are included either as combination tablets, such as Armour thyroid or NatureThroid, or as two separate tablets of liothyronine (T3) and levothyroxine (T4). Incredibly, the majority of endocrinologists and primary care physicians neglect the T3 thyroid hormone, choosing to only prescribe levothyroxine (Synthroid), even if depression, weight gain, water retention, intolerance to cold, and other phenomena of hypothyroidism persist. It therefore means that it is often necessary to seek out a healthcare practitioner (e.g., a functional medicine practitioner) to obtain full correction of thyroid status that includes T3 assessment and treatment. For many people with thyroid dysfunction, this aspect of thyroid health is crucial and can be sufficient to make or break overall health.
Getting thyroid status “just right” is important. Some simple rule-of-thumb measures that suggest that thyroid status is just right include: - TSH of approximately 1.0 mIU/L (or less than 1.5 mIU/L)
- Both free T3 and free T4 in the upper half of the “reference range” (which differs from lab to lab)
- Feeling good: i.e., good energy, good mood, freedom from excessive and inappropriate coldness
- Oral temperature of 97.3° F immediately upon awakening (lower temperatures suggest hypothyroidism)
Correction of hypothyroidism is also accompanied by many positive side-benefits: people feel more energetic; they are happier; weight loss is accelerated; LDL cholesterol, triglycerides, and Lp(a) values are reduced; and more people enjoy better control over coronary disease risk. The first step in achieving correction of thyroid function is to ensure adequate iodine intake. This is especially important for people who avoid use of iodized salt, exercise or work in hot environments, in people with the low free T4/high TSH pattern, and people with any degree of thyroid enlargement.
The conventional approach to thyroid management, as practiced by most primary care physicians and endocrinologists, is not ideal for health. Given experiences like the HUNT Study, we aim to keep TSH 1.5 mIU/L or less, along with free T3 and free T4 levels in the upper half of the reference range; this has maximized lipid and lipoprotein benefits, generally maximizes a sense of well-being, and has proven practical and effective.
It is also sometimes necessary to look beyond thyroid testing measures to gauge the adequacy of thyroid function. TSH serves as an unreliable index of thyroid function in some people and can be falsely low or “normal” even when hypothyroidism is truly present. Recent data appear to support this argument, with one recent study, for instance, showing that, as we age, the increase in TSH with low thyroid function is 75% less compared to younger people, making TSH an increasingly unreliable index of thyroid function as we age. Attention to symptoms is therefore essential for detecting persons suffering from hypothyroidism underestimated by standard laboratory testing.
Synthetic T4 (e.g., Synthroid®) is not sufficient to resolve symptoms of hypothyroidism in a substantial proportion of persons with hypothyroidism, since not everyone converts T4 to active T3 with equal efficiency. Indeed, low-T3 has been documented to be a predictor of death in patients with congestive heart failure. T3 supplementation has positive effects on psychological symptoms of hypothyroidism with several studies showing that well-being, mood, and cognitive functions are improved; weight loss may also be greater with added T3. T3 supplementation tailored to symptom relief can also address the issue of reverse T3 by providing an external source of effective T3.
Claims that synthetic T4 drugs are superior to natural thyroid drugs in consistency, potency, and stability are false, largely driven by drug industry marketing efforts. The hormones found in porcine (pig) thyroid are chemically identical to that found in humans. Worries over consumption of the animal proteins in desiccated pig thyroid are also unfounded, as they are regularly consumed whenever eating ham, pork chops, or bacon. While this may pose a problem on religious grounds for some people, it offers no impediments on medical grounds. Claims of impurity are also misrepresentation propagated by pharmaceutical marketing. In fact, both Synthroid (synthetic T4) and Armour Thyroid (porcine thyroid) have both had similar struggles with potency and stability in past. Unfortunately, many doctors and patients have only heard about problems with Armour Thyroid. The Department of Health and Human Services has twice issued cease and desist orders to the manufacturer of Synthroid for misleading advertising. Prior to the development of synthetic T4 in the 1950’s, natural thyroid hormone products were the only treatment for hypothyroidism since their introduction in the late 1800’s. In that time, they have developed an extensive track record for safety and efficacy, and products such as Armour Thyroid are now produced under the same USP standards as synthetic T4.
In the Cureality experience, we favor symptom management over TSH, assessment of T3 as well as T4, and the use of natural thyroid preparations like Armour Thyroid over levothyroxine or Synthroid. For anyone who wishes to add T3 but wants to avoid the animal-sourced product, a synthetic T3, liothyronine or Cytomel, is also available (by prescription).
Summary
Thyroid dysfunction, especially hypothyroidism, is an increasingly common impairment to overall health. This trend is most likely due to increasing exposure to industrial organochemicals and alterations in modern wheat that trigger greater potential for thyroid autoimmunity. Correction of thyroid status that includes measures TSH, free T3, free T4, and reverse T3 may therefore uncover thyroid dysfunction that can contribute to failed weight loss, low energy, mental “fog,” depression, hair loss, and other health issues.
Some people with hypothyroidism have iodine deficiency as an underlying cause; correction of this deficiency can sometimes return thyroid function to normal.
Key to regaining thyroid health is to identify a healthcare practitioner who can assist your efforts. Unfortunately, most conventionally-minded practitioners do not aim to achieve ideal thyroid status; a search to identify a functional medicine practitioner, naturopath, holistic health practitioner, or other like-minded provider may be necessary. |
