Dr. LaGuardia, How do you treat thyroid conditions like hypothyroidism and other thyroid problems in a collapse scenario when thyroid meds are not available?

YOUR THYROID GLAND AND YOUR HEALTH

Where is your thyroid located and how is it controlled?
Your thyroid gland is a large gland located at the base of the front of your neck, straddling your windpipe,below your Adam’s apple, it is shaped like a thick H. The upright part of the H are the lobes and the cross bar is the isthmus connecting the right and left lobes. Some people have a congenital absence of the isthmus and have two separate unconnected lobes.There are four parathyroid glands embedded in the thyroid gland tissue.

 

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Thyroid hormone is made from a skeleton of tyrosine with iodine added to it. The designation T4 and T3 stands for thyroid hormone containing 4 or 3 iodine atoms. They thyroid gland produces predominantly T4 or thyroxine which is inactive and needs to be converted by enzymes in the tissues of the body to its active form T3 or triiodothyronine by eliminating one of the thyroid atoms. The enzymes that cleave off one of the iodine atoms contain the mineral selenium without which this conversion will not take place. Hence you can readily see the importance of tyrosine, iodine and selenium for proper thyroid function.

Production of thyroid hormone is dependent on two areas of the brain that act together to control thyroid function, the hypothalamus and the pituitary. The hypothalamus at the base of your brain and is the link between your brain and your hormonal or endocrine system via its effect on the pituitary gland. The hypothalamus measures thyroid hormone levels in the circulating blood and if they are low it release TRH or thyrotropin releasing hormone which goes to the pituitary and stimulates it to produce TSH or thyroid stimulating hormone which naturally stimulates the thyroid to produce more thyroid hormones. If the hypothalamus senses that thyroid hormone levels in the blood are high it will release somatostatin which inhibits or decreases production of TSH by the pituitary thereby producing less thyroid hormone. So, in short, the hypothalamus controls the pituitary which controls the thyroid gland which in turn controls the adrenal glands, this complex neuroendocrine (meaning the nerves or brain controlling the endocrine hormone system) system is known as the HPA axis or hypothalamic pituitary adrenal axis. This HPA axis is so essential to all forms of life that it is found in almost all life forms from humans down to single cell organisms.

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The hypothalamus needs the amino acids arginine, glycine and lysine to produce the hormone TRH. Somatostatin uses many different amino acids. Hence, once again to insure adequate thyroid function, your diet must contain adequate amounts of arginine, glycine and lysine at the very least and also must include enough of a variety of proteins to insure an adequate supply of many amino acids which are just building blocks of proteins.

 Why Proteins are so Important for Thyroid and Overall Health 

Proteins are made of building blocks known as amino acids. There are twenty amino acids used by the body, 9 are essential and 11 are non-essential. Essential amino acids must be supplied in our diet;thus, they are essential to us. The non-essential amino acids can be produced by the body and do not have to be supplied in our diets.Know this, if your body does not have a component such a certain amino acid, it cannot produce what it needs and will result in health problems the magnitude of which depends on its importance to the body. In other words you are going to have some health problems if you don’t change your wicked ways.
Most animal based proteins such as meat, fish and eggs contain all the essential amino acids. Plant based proteins usually are missing a few essential amino acids, but you can combine several plants to supply all the essential amino acids. Native Americans did this very well by using corn, squash and beans which became known as the three sisters, thus supplying all the essential amino acids they needed in their diet. Hemp oil from the marijuana or hemp plant contains all the essential amino acids. Quinoa and soy are also exceptions to the plant rule and do by themselves supply all the essential amino acids.
So in essence here is the deal………. you need good organic sources of protein in your diet, of any source either plant or animal. Your body is an amazing biochemist capable of producing between 250,00 and one million different proteins which the body uses for all its needs, literally from head to toe. This is why your diet is so very important, if you give your body what it needs it will unleash its healing potential and amaze you. Minerals and trace elements are also part of the critically important group of essentials, in the case of the thyroid the minerals are iodine and selenium. Fats are also critically important to good health. We have demonized fats for decades in the United States much to the detriment of our health. Your body needs fats and just like proteins there essential fatty acids that must be supplied by the diet. Note there are no essential carbohydrates in your diet, we don’t need carbs, we can make the glucose our body needs for fuel from either proteins or fats. But, we all love carbs and are genetically programmed to love sweet rather than bitter foods. Bitter food taste was your body’s early warning system screaming “Spit this stuff out, it is poison”.
Providing your thyroid, the right amino acids must begin with L-tyrosine which is the backbone structurally of thyroid hormone. The L designation is referring to the isomer or mirror image forms of the protein, just like your two hands are mirror images of each other, so are the two forms of tyrosine. In nature, the L isomers are the most common form. Only one form is useful to the thyroid and that is the L isomer, so we give it the name L-tyrosine. The name tyrosine comes from the Greek word tyros or cheese, it was first isolated in the protein casein in cheese. So, as you might guess, it is found in cheese, milk, yogurt, cottage cheese and also in chicken, turkey, fish, soy, avocado, bananas, lima beans, peanuts, almonds and sesame seeds. Clearly you should be able to easily get a good supply of L-tyrosine in your diet.
In the Thyroid gland follicles, a protein known as thyroglobulin is produced, in it there are proteins bound to either one or two iodine molecules. By an enzymatic reaction within the thyroglobulineither two of the double iodine molecules are combined to make T4 or one double and one single molecule to make T3. The thyroglobulin acts as a storage molecule containing up to ten T4’s or T3’s usually in combination. When needed these are released into the bloodstream. In the blood stream the T4’s and T3’s are bound to a transport protein that carries them in the blood called thyroid binding globulin. Only about 70-75% of the thyroid hormone is bound to this thyroid binding globulin, and this acts as a reserve storing thyroid hormone, the unbound or free thyroid hormone is available immediately for the body and is thus rapidly removed from the blood.
Only the free thyroid hormone, meaning that which is not bound to a carrier protein is active, the bound thyroid hormone is inactive and thus acts as a reserve of thyroid hormone. T4 is also essentially a storage form of thyroid hormone, readily available for the removal of one of its iodine atoms to make active T3.

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Minerals and Trace Elements to the Rescue
Minerals and trace elements are the forgotten heroes of your health. They have been ignored for decades and still are by mainstream medicine. Now hear this………there is no road to good health without it being paved with a great supply of minerals and trace elements.
What are the minerals and trace elements I am talking about. The minerals are also called major or macrominerals, these include calcium, magnesium, phosphorus, sulfa, chloride and potassium. These major minerals are needed by your body in large amounts. On the other hand, there are the trace elements or trace minerals iron, copper, manganese, cobalt, zinc, fluoride and selenium. The trace elements or minerals are only needed in very small or trace amounts. You cannot have a robust, vigorous healthy body without all of these minerals and trace elements in their correct amounts. Always remember this, your vitamins and enzymes will not function without the correct mineral or trace element, they are the keys to a healthy disease free body.
In order for your thyroid to function correctly, you need iodine, selenium above all others, and to a much lesser degree you also need magnesium, boron, zinc and copper.

 

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Let’s first discuss the amazing element iodine. Iodine is a member of the halogen family of elements along with fluorine, bromine, chlorine and astatine. More about that later and why these other members are negatively affecting your thyroid gland. Iodine has an entire host of amazing health enhancing benefits that extend beyond the thyroid such as:
1. Iodine is a very potent antimicrobial, meaning it kills all kinds of pathogens from bacteria to fungi and even viruses. It does so very quickly and without the possibility of the development of any resistance. Remember traditional antibiotics only work against bacteria that are susceptible and have not developed any resistance, they do nothing against fungal infections such as candida which is very susceptible to treatment with iodine, they also have no effect against viruses which iodine readily kills. Iodine even works against viruses like herpes, both orally and genitally.
2. Iodine is also a very effective cancer preventative as well as a treatment for certain types of cancer such as thyroid, breast, ovarian, prostate and skin. All of these organs are known to concentrate iodine in their tissues. Low iodine levels contribute to breast, stomach and liver cancers.
3. Iodine is very effective in the treatment of fibrocystic breast disease besides being taken orally it can be painted on to a painful breast cyst for some relief. Any cystic condition in the body is the result of iodine deficiency and will respond to iodine supplementation.
4. Iodine will protect the thyroid gland from harmful radioactive iodine in the event of a nuclear war or accident of some type which releases radioactive iodine. If you flood your body with iodine it will prevent the thyroid gland from taking up the radioactive iodine in the atmosphere. The ongoing Fukushima reactor meltdowns in Japan have been spewing different radioisotopes of iodine into the Pacific and into the atmosphere for the last six years, this is making everyone with low iodine levels very susceptible to uptake of this deadly iodine.
5. Iodine has several hormonal effects. Iodine attaches itself to insulin receptors and thereby improves diabetic control. Iodine regulates estrogen production by the ovaries. Iodine is also known to activate several different hormone receptors in the body.
6. Iodine is used to purify water and has the same effect on our blood. This effect helps improve immunity and keep the blood clear of pathogens of all types.
7. Pregnancy results in the mother’s thyroid gland having to produce fifty percent more thyroid hormone to cover the needs of the mother and the fetus. Iodine deficiency has been known for over a hundred years to lead to cretinism, or a severely retarded deformed newborn since it is critical for normal brain development The flip side of that is if you supplement iodine during pregnancy you raise the IQ of the fetus by twenty points on average! Why is the government not pushing iodine replacement in pregnant women since iodine supplementation during pregnancy is the easiest and most cost-effective way to prevent mental retardation?
8. Iodine is so essential for human health that every cell in the body has receptors for iodine.

Iodine deficiency is rampant in the United States and worldwide and has been exacerbated in recent years by chemical/industrial farming techniques which have rapidly depleted the mineral and trace element content in our soils especially iodine. Seafood contains a lot of iodine and the further one lives from the oceans the less iodine there is in the soil. In the United States Midwest and mountainous regions have iodine poor soils and as a consequence goiter (an enlarged thyroid gland due to deficiency of iodine) and are therefore known as the “Goiter belt”. The United States government in the 1920’s wisely decided to add iodine to salt in order to provide adequate amounts of iodine to the people, and for many years this iodized salt worked very well to prevent iodine deficiency and its resulting goiter. Morton Salt was the first company to iodize salt. Recent studies in 2008 studied 88 different types of iodized salts in the United States and found that less than half of them contained adequate levels of iodine, this coupled with reduced soil levels and thus lower levels in our food and American’s obsession with low salt diets have created the perfect storm for rampant iodine deficiency. Many people mistakenly believe that seasalt will be high in iodine (which it is not) and have switched to it from iodized table salt. I should point out that sea salt is better for you than sodium chloride or table salt, due to its broad spectrum of minerals, it just is not iodized by law. It is now estimated that over 74 percent of adults in the developed world are iodine deficient.
As if rampant worldwide deficiencies weren’t enough, there is the huge problem of toxic chemicals contaminating our environment such as perchlorate that are endocrine disruptors, meaning it interferes with the endocrine system of glands which includes the thyroid. Perchlorate is an ingredient in many chemicals such as rocket propellants, herbicides, disinfectants and bleaching agents. Perchlorate has a seriously adverse effect on the thyroid by blocking its absorption of iodine and therefore its production of thyroid hormone.

 

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The element bromine is a halogen just like iodine and is right next to it on the periodic table. I am sure you remember that from high school chemistry…….LOL. Why that is important is because of their being members of the same family and in fact very closely related will cause them to have similar properties. That turns out to be a curse for iodine and the thyroid gland because like perchlorate, bromine and bromides (bromine attached to another molecule) are endocrine disruptors and they will fake out the receptors in the thyroid gland and will be taken up by it. The uptake of bromine and bromides replace iodine in the thyroid hormone produced, making it inactive. There is no way to measure that on your blood tests and it will appear that you have enough thyroid hormone, faking out your doctor reading the lab report into thinking you have a normally active thyroid gland. How are you exposed to bromine and bromides in your everyday life? Well, the bad news is quite a lot. Bromine is contained in pesticides, plastics, pool and spa chemicals, fire retardants, toothpastes and ominously in “bromide enriched flours” used in baking, supposedly it makes the dough more pliable for commercial bakers. So, as you can see, you are screwed, unless you take enough iodine daily to flood your receptors and block the uptake of bromine, yet another reason to add iodine to your supplements.
Iodine can be obtained in seafood and is especially highin seaweeds like kelp and bladderwrack where it is concentrated in very high levels. As a supplement you can take potassium iodide tablets,iodoral tablets (12.5 mg), nascent iodine (liquid) . The nascent iodine does not have a specific dose, I take seven drops in water daily. I like almost all of my patients who have hypothyroidism, fibrocystic breasts, ovarian cysts, chronic fatigue, fibromyalgia and any family history of breast cancer or even benign breast masses to supplement with iodine. It has no downside and the upside is outstanding.
My physician colleagues who are endocrinologists seem to universally ignore iodine supplementation, they always resort to warning that it might lead to thyroid toxicity by overstimulation of the thyroid, well that is just a lot of nonsense. When patients are iodine deficient and are supplemented with iodine, some indeed do develop hyperthyroidism, and the reason is that the vast majority of these patients already have autonomously functioning thyroid nodules which just like breast and ovarian nodules are the result of iodine deficiency, these begin to produce thyroid hormone when they are provided with iodine, but as you can see the iodine is not the cause of the excess but rather the nodules themselves. In Japan where iodine intake is the highest in the world, there is very little Graves’ disease or Hashimoto’s thyroiditis, and also very little fibrocystic breast disease or breast cancer (but that all changes when they emigrate to the United States and adopt a western diet low in iodine). So, my advise is to once again ignore the “experts” and provide your body with exactly what it needs to have a healthy functioning thyroid gland.

 

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The second element that is critical to adequate thyroid hormone production is selenium. Selenium is a mineral/trace element that is an essential micronutrient for animals and many plants. In humans, it is essential for proper thyroid function due to its presence in a class of enzymes known as the deiodinase enzymes which are responsible for the conversion of inactive T4 thyroid hormone to biologically active T3, it does this by removing one of the iodine atoms. The deiodinase enzymes are also responsible for the destruction of old thyroid hormone do its iodine can be recycled by the body. I supplement selenium in all my patients with hypothyroidism (slow thyroid) as well as Hashimoto’s thyroiditis, which is an autoimmune disease of the thyroid, slowing its function. It has been shown that supplementing with 200 mcg of selenium daily in patients with Hashimoto’s will decrease the levels of anti-thyroid antibodies by about twenty percent.
Selenium has other functions in our bodies beyond the thyroid gland. Selenium is also the key element in a family of enzymes named the glutathione peroxidase enzymes. This family of selenium containing enzymes will not function properly without adequate selenium, their job is to protect the body from antioxidants and break down hydrogen peroxide. This antioxidant function of selenium is increased when there are adequate levels of vitamin E, the two work synergistically. Selenium also helps detoxify the body, especially in the case of toxins such as mercury. Selenium also helps the heart function properly, although the mechanism for this is not known, it has been known since the 1930’s that congestive heart failure is associated with low selenium levels. Selenium also has been shown to be associated with both male and female infertility, miscarriages and low sperm motility (the little bastards cannot swim well enough to find the egg and fertilize it). For years, it has been known that areas that have low selenium levels in the native soils have higher cancer rates. Higher selenium intake has been shown to be protective against many types of cancer including bladder, breast, colon, prostate, lung, esophagus and stomach. A study of elderly patients supplemented with 200 mcg of selenium daily for seven years had an incredible overall reduction of all types of cancer by 42 percent when compared to placebo. It has also been shown that the combination of selenium and beta glucans derived from medicinal mushrooms had a very potent anti-cancer effect. Selenium is also contained in seleno-proteins (proteins that contain selenium) which help regulate immunity and reduce inflammation, both beneficial for good overall health.

 

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As always, if possible I prefer my patients to obtain their nutrients from foods rather than supplements. No food is higher in selenium than Brazil nuts which contain a whopping 70-90 mcg per nut, so you could easily meet your selenium needs with three Brazil nuts daily! Other foods that are high in selenium are sardines, wild caught salmon, sunflower seeds, liver, pasteurized organic eggs, chia seeds and mushrooms. Supplementing with selenium is easy and inexpensive, I recommend that you take 200 mcg a day. Be careful, more is not better, selenium can be toxic even at 400 mcg a day, at that dose it also has been linked to an increase risk of diabetes, although the mechanism for that is not clear.
It should be noted that many areas of the United States have selenium poor soils, except three: Northern Nebraska, North and South Dakota, which have high selenium levels in their soil. So, I would be cautious in taking selenium supplements if you live in those areas and eat a lot of locally grown food.

What is the function of the Thyroid?
Thyroid hormones produced by the thyroid gland have several different functions in the body. First, let’s define what a hormone is. A hormone is a protein messenger molecule that is made in one part of the body enters the bloodstream and carries out its function on tissues and organs elsewhere in the body. The thyroid produces three different hormones, triiodothyronine or T3, tetraiodothyronine also known as T4 or thyroxine and calcitonin. Remember the numbers after the T stands for the number of iodine atoms the hormone contains, T3 has three and you guessed it, T4 has four.
The thyroid gland contains follicles which are sacs that are lined with thyroid cells and the center is filled with the precursor (the raw material used to make thyroid hormone) to thyroid hormone. The C cells that lie between follicles produce the hormone calcitonin. Calcitonin works to lower high calcium levels, it does just the opposite of parathyroid hormone which raises calcium levels. Parathyroid hormone is produced in the four parathyroid glands which are pea sized and embedded in the thyroid gland. As you can see, the thyroid and parathyroid work together on bones to control calcium levels in the blood.

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Bone is actually a huge bank of calcium and are constantly being remodeled, this is done by osteoblasts which build bone and osteoclasts which breakdown bone, this constant tug of war between the two is known as bone remodeling. Calcitonin and parathyroid hormone have an opposite effect on bone, calcitonin inhibits the osteoclasts, so they are breaking down less bone, releasing less calcium, thus lowering blood calcium levels. Parathyroid hormone stimulates osteoclasts to breakdown more bone thus releasing its store of calcium into the blood, raising calcium levels.
The thyroid hormones T4 and T3 have various functions in the body. Their first and foremost function is control of metabolism, they do this by controlling the metabolism of every cell in the body. Metabolism is the rate at which calories are burned, thus a slow thyroid or hypothyroid condition will produce less thyroid hormone and thus less stimulation of metabolism and will result in fatigue, weight gain, your gut will slow resulting in constipation and a sensation of being cold all the time (cold intolerance) since your metabolic “fire” is burning less thus producing less heat. The flip side is that if your thyroid is functioning faster than normal or hyperthyroid, then you will have tons of energy, in fact your hands will shake, your pulse will be fast, you will lose weight, and you will feel warm all the time because of your raised metabolism and its resulting burning of more fuel thus producing more body heat.
Other areas of the body affected by your thyroid include:
1. Your heart rate or pulse, if you are hypothyroid it will be slow, hyperthyroid will cause it to be rapid. The force of contraction of the heart is also increased in the presence of thyroid hormone and it also causes blood vessels to dilate or enlarge thereby increasing blood flow to all areas of the body.
2. Body Temperature: since that is primarily driven by your metabolism, it will be high in hyperthyroidism and low in hypothyroidism.
3. The rate food passes thru your gut or GI tract: in Hypothyroidism it will be slow and thus constipation develops and with hyperthyroidism will be fast and diarrhea may develop.
4. Control muscle contraction
5. Controls the rate at which dying cells are replaced by the body.
6. Normal skeletal and muscular development is dependent on a normal thyroid, thus if it is slow the patient will be shorter and less muscular, and the opposite for hyperthyroid. Note: this is also dependent on growth hormone and other factors.
7. Fat Metabolism: thyroid hormone causing the breakdown and burning of fat for fuel. Thus a hypothyroid state will result in weight gain by fat accumulation and increasing cholesterol levels in the blood, and for hyperthyroidism fat will be broken down and burned and therefore you will lose weight and your cholesterol levels will drop.
8. Carbohydrate metabolism: thyroid hormones will stimulate the burning of glucose and also facilitate its entry into the cell as fuel, therefore a slow or hypothyroid patient will have higher levels of blood sugar and a fast or hyperthyroid patient will have low blood glucose levels.
9. Fetal and neonatal brain development is dependent on thyroid hormone (and the iodine it provides). Slow thyroid and the brain is less developed and the patient is a cretin with a small brain and mental retardation. Normal brain needs normal thyroid levels, providing enough iodine via thyroid hormone will result in a much smarter child. My mother took excess thyroid hormone during her pregnancy, and look at the results…………only kidding, I couldn’t resist slipping that in. The alertness of the brain is also improved with more thyroid hormone and with less it causes sluggishness and brain fog.
10. Reproduction is dependent on adequate thyroid hormone, without which one is infertile and incapable of having children.

Reverse T3
Just when you thought the thyroid couldn’t get more complicated, let me tell you about reverse T3. Your thyroid normally makes T4,T3, calcitonin….and also T1 and T2 in small amounts that are inactive. They thyroid also makes a hormone known as reverse T3 in small amounts. The quantity of reverse T3 that it makes increases with uncontrolled diabetes, cirrhosis of the liver, renal failure, Lyme disease, chronic inflammation, stress, severe illness, trauma and starvation. Nutritional deficiencies especially in selenium, zinc, B complex vitamins, vitamins A and C. Other lesser known reasons for increased reverse T3 levels is high or low cortisol from chronic stress. Iron deficiency is another cause, with less blood available to move T4, thus the blood levels of T4 go up and the body wants to render it harmless by converting it to inactive reverse T3, so the levels increase. Unlike its mirror image cousin T3, reverse T3 is inactive and binds to the T3 sites on the cell surface and in effect blocks these sites, denying access to T3.

 

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Symptoms of elevated reverse T3 are the same as hypothyroidism, since it is blocking the active T3 from functioning.Reverse T3 is in reality an “Anti-thyroid” hormone. Reverse T3 has been described as a hibernation hormone since it lowers your body’s metabolism, just as if an animal is hibernating, thus drastically lowering its energy requirements. Reverse T3 is a marker for low intracellular T4 and T3 levels that often times is not picked up on a standard TSH, T4 and T3 blood test.
The treatment for high reverse T3 levels is its mirror image molecule T3, which is active and thus will reverse the blocking/anti-thyroid effects of reverse T3.

Thyroid Diseases and Malfunction
Many things can go wrong with the thyroid, resulting in a slow or hypothyroid, or a fast or hyperthyroid condition. There are also several autoimmune conditions that may affect the thyroid, either slowing it down as in Hashimoto’s thyroiditis or speeding it up as in Grave’s disease. Nodules can develop on the thyroid gland sometimes destroying much of the gland and resulting in hypothyroidism or a nodule or group of nodules may be producing too much thyroid hormone and a hyperthyroid state could develop. Cancer can also develop in the thyroid, of which there are several different types.

Slow Thyroid orHypothyroidism and Myxedema

Under the section explaining thyroid function I basically showed how a slow or hypothyroid condition could affect your body, let me list them again for you:
1. Fatigue
2. Weight gain
3. Cold intolerance (feeling cold all the time)
4. Constipation
5. Hair loss
6. Periorbital puffiness (swollen areas around your eyes)
7. Slow pulse
8. Infertility
9. Brain fog
10. Depression
11. Goiter (swelling of the thyroid gland): only if hypothyroidism is accompanied by low iodine levels.
12. Decreased appetite

Hypothyroidism is usually diagnosed by blood tests which confirm either a high TSH and/or a low T4 or T3 or both. Another way that was traditionally used to diagnose hypothyroidism before the advent of these lab tests was by measuring basal body temperature.
Basal body temperature is your temperature upon awakening in the morning, before any activity might raise your temperature. To do this, keep a thermometer at your bedside, upon first awakening take the thermometer and shake it down below 96 degrees F (if it is the old mercury type, which is the type I recommend you have in a post apocalypse scenario, since you won’t have to worry about batteries.). Place the thermometer in your armpit and measure your temperature for four consecutive days. A normal axillary or armpit temperature should be in the 97.8 to 98.2 degree F range. If your temperature is below 97.8 then you are very likely suffering with hypothyroidism. Use this along with the clinical symptoms listed above and you can fairly accurately make the diagnosis of hypothyroidism. If you are a menstruating female, to obtain an accurate diagnosis you should only measure your basal body temperature on the first four days of your menstrual cycle.

Iodine deficiency is the greatest cause of hypothyroidism worldwide. Another cause is from autoimmunity resulting in Hashimoto’s thyroiditis. Hashimoto’s is more common in women and is not always associated with hypothyroidism, depending on how much of the gland is destroyed. Five percent of the population in the United States has Hashimoto’s which is named by the Japanese doctor who first named it in 1912. Hypothyroidism can also be caused by exposing the thyroid gland to radiation, as was done in the 1950’s and 1960’s to treat acne, resulting in destruction of the thyroid. It can also be caused by removal of part or the entire thyroid for cancer. Hypothyroidism is also less commonly caused by problems with the hypothalamic-pituitary-thyroid axis, from either problem with the hypothalamus or the pituitary and the resulting drop in the TRH or TSH levels respectively.

 

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Severe cases of hypothyroidism sometimes referred to as myxedema. Myxedema is the result of longstanding hypothyroidism left untreated. Myxedema is usually accompanied by several physical signs such as swelling of the skin of the face and other areas of the body such as the lower limb where it is known as pretibial myxedema. There is often ascites or swelling of the abdomen and around the eyes, hands and feet. The tongue may also be thickened and result in slurred speech. Myxedema frequently causes slowing of mental function, lethargy and extreme fatigue and may result ultimately in myxedema coma and death if left untreated. Myxedema is a medical emergency and should be considered life threatening and must be treated immediately with thyroid hormone replacement.

 

 

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 Typical Face of a Patient with Myxedema
Ironically, myxedema can also be found in cases of hyperglycemia such as Grave’s disease where the pretibial myxedema is a classic sign, along with bulging of the eyes or exophthalmos.
Hypothyroidism is typically treated by administering thyroid hormone to augment or increase the levels of thyroid hormone present. Thyroid hormones of any type must be taken on an empty stomach since food interferers with their absorption. Most physicians use Synthroid, which stands for synthetic thyroid and is all T4. This comes with other brand names such as Levoxyl or levothyroxine. The overwhelming preponderance of endocrinologists use these synthetic thyroids and scoff at the use of desiccated thyroid extract, which is made from pig thyroid and contains T4, T3 and even some calcitonin. It is much more difficult to prescribe since it comes in grains which usually contain 60 mcg (micrograms) each. I like it, but then again, I practice outside the box and am almost always alone bucking the herd! Patients prefer the natural desiccated (which means dried) forms of thyroid medicine, the most common known as Armour Thyroid, other less common names are NP thyroid, Nature-throid, Westhroid. The Armour company that makes Armour thyroid pills not surprisingly was the largest meatpacker in the United States and was very happy to find a use of what was previously discarded as offal or waste from their slaughter. The mix of T4 and T3 usually is about 80 percent T4 and 20 percent T3, these days all desiccated thyroid comes from pigs. That 4:1 mix of T4 to T3 is different in pigs than the 11:1 ratio of T4 to T3 produced by the human thyroid, and thus is cited by many endocrinologists as unnatural. However, T4 is inactive and most of it is converted in the body to T3 by selenium dependent enzymes, remember the section on the importance of selenium. I find that it is a little more work, but well worth it from patient’s standpoints, many of whom suffered with classic hypothyroid symptoms despite their being treated with synthetic thyroid hormone, and these rapidly disappear using the desiccated natural thyroid or Armour thyroid. If you use desiccated thyroid extract then you need to monitor TSH, T4 free and total and T3 free and total to get the proper picture of your thyroid function.
Sometimes, I only use T3, if a patient is low in T3 and has normal T4 levels. Or sometimes I add T3 to synthetic T4. T3 comes in synthetic form also under the brand name Cytomel, there is also a generic form available known as liothyronine. When you give T3 to a patient, you must be careful, many people are sensitive to it, since it is all thyroid hormone in its active form and many will get palpitations, tachycardia, sweating and symptoms of hyperthyroidism. As with most medications, I prefer to start with a low dose and raise it slowly. In the case of Cytomel I use either 5 or 10 mcg and check T3 free and total levels and adjust it as I need to, raising it cautiously to prevent side effects. Another option for T3 replacement is using a compounding pharmacy to make a slow release form of T3, this often has less side effects since it comes closer to mimicking the body’s natural release of T3 as it needs it all day long.
Naturally, since I am a holistic practitioner I like to treat the entire picture, so in cases of hypothyroidism I also make sure the patient has adequate tyrosine intake which can be supplemented, as well as iodine and selenium. I usually give Iodoral for the iodine at a 12.5 mg dose and 200 mcg of selenium, this way I am sure they have all the proper ingredients for their thyroid to function properly.

Fast Thyroid or Hyperthyroidism
Hyperthyroidism is caused by Grave’s disease, which is an autoimmune disease, in around 90 percent of the cases in the United States. This disease causes antibodies to attack the thyroid gland, what triggers it is unclear but may be genetic, iodine excess (usually from eating excessive amounts of seaweed or kelp), infections, pregnancy and other environmental factors. Essentially any of the triggering factors result in antibodies against the TSH receptors in the thyroid resulting in release of large amounts of thyroid hormone, predominantly T4 with about 9 percent T3. Other causes of hyperthyroidism are excessive iodine intake, excessive thyroid hormone intake (usually synthroid), infections, and tumors on the thyroid or the pituitary. Postpartum thyroiditis is found in about 7 percent of women after they give birth.

 

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  The photo above shows a classic sign of hyperthyroidism: lid retraction

 

My personal favorite for a cause of hyperthyroidism is hamburger thyrotoxicosis. Thyrotoxicosis means hyperthyroidism specifically caused by the presence of excess thyroid hormone. Hamburger thyrotoxicosis used to occasionally be caused by a practice of butchering the meat in the neck of slaughtered animals also known as “gullet trimming”. This meat from the neck was mixed with other meat and ground into hamburgers, thus mixing the thyroid gland which was red and blended nicely with the normal hamburger meat. This would sometimes result in a patient eating a hamburger that was full of thyroid hormone and thus provoking their hyperthyroidism. The practice of gullet trimming has been banned by law in the United States thus eliminating this cause of hyperthyroidism. In a survival situation where there was infrastructure breakdown and non-availability of thyroid meds, then ingesting pig , chicken or bovine thyroid might be an option for patients who have no thyroid gland or are severely hypothyroid.
The signs and symptoms of hyperthyroidism include the following:
1. Tremors
2. Tachycardia (fast heart rate, greater than 100)
3. Sweating
4. Weight loss
5. Diarrhea
6. Heat intolerance (you are hot all the time)
7. Enlargement of the thyroid (goiter)
8. Exophthalmos (bulging eyes)
9. Nervousness and irritability
10. Fine brittle hair
11. Insomnia
12. Thinning of the skin
13. Muscle weakness
14. Low cholesterol levels
15. Lid retraction (as in the above photo)
16. Pretibial Edema : an orange peel appearance of the skin of the lower leg in Grave’s disease

Treatment of hyperthyroidism depends on the underlying cause. If it is excessive intake of thyroid hormone or iodine containing foods such as kelp or iodine supplements, then that is easy to rectify by stopping whatever is triggering it. Treatments include radioactive iodine which destroys the thyroid gland (and therefore will require thyroid hormone orally), there are oral medications such as methimazole which block the production of thyroid hormone, beta blockers are pills that can be taken to help control some of the symptoms such as tachycardia (rapid pulse), surgery is rarely needed unless there is a tumor that is unresponsive to other treatments.

Thyroid Nodules
Thyroid nodules are lumps on your thyroid, they typically arise in a normal thyroid gland, and only a small percentage of which ever become thyroid cancers. Thyroid nodules may be hollow fluid filled lumps usually from the breakdown of a benign thyroid tumor, or they may be solid masses or lumps. The vast majority of these nodules are benign and not malignant. Sometimes they produce thyroxine or T4 and result in symptoms of hyperthyroidism.
Thyroid nodules can be caused by iodine deficiency, benign tumors known as adenomas, cysts on the thyroid (also caused by iodine deficiency), chronic inflammation of the thyroid as in cases of Hashimoto’s thyroiditis and multinodular goiter which is a large number of nodules causing goiter or enlargement of the thyroid.
Thyroid nodules can lead to hyperthyroidism and also may develop eventually into thyroid cancer, although the number that do so is pretty small.
Once you are diagnosed with thyroid nodules by your doctor he will usually order an ultrasound of your thyroid, this will tell him if the nodules are solid or cystic (hollow). Often he will perform a fine needle aspiration of your thyroid to obtain some thyroid tissue to evaluate for cancer. In some cases, your doctor will order a thyroid scan, which means they inject you with radioactive iodine and then the more active tissue will take it up readily and register as “hot” due to this activity, hot nodules are almost never malignant. Cold nodules on the other hand are not that active in uptaking iodine since they are not producing much hormone, these may be malignant and will need a ultrasound guided biopsy to diagnose cancer or not.
The treatment for the vast majority of thyroid nodules is “tincture of time”, which is “doctor speak” for doing nothing and just observing them. I usually follow it up with an annual ultrasound of the thyroid to determine if they have changed during the last year. If they are large and pressing on your throat causing problems with breathing or swallowing, then surgery is an option. One school of thought is to give thyroid hormone to suppress the pituitary and decrease the production of TSH, therefore stimulating the thyroid less. If there is a nodule that is producing excess thyroid hormone, then the treament is the same as treating hyperthyroidism.

  Thyroid Cancer
Remembering your thyroid structure will help understand the different types of thyroid cancers. Some thyroid cancers arise from the thyroid follicles and are known as follicular thyroid cancers, papillary thyroid tumors. Papillary cancers are the most common type, comprising over 80 percent of thyroid cancers and are the most common type found in children and people who were exposed to radiation. Both follicular and papillary thyroid cancers are well differentiated, meaning the cells are not primitive which is a sign of a more aggressive cancer. The third type is known as medullary thyroid cancer and arise from the C cells that lie in the connective tissue of the thyroid and produce calcitonin, it has a strong hereditary component and is therefore found in families. The last type is known as anaplastic thyroid cancer and is poorly differentiated and therefore very aggressive and less responsive to treatment, the good news is that this one is rare and comprises about 1 or 2 percent of thyroid cancers.

Depending on the type of thyroid cancer and its severity, it is usually treated with surgery plus some radioactive iodine treatments to destroy the remaining thyroid gland tissue. If one lobe or half of the thyroid is removed this is known as a lobectomy, if the entire thyroid is removed it is a total thyroidectomy, if almost all the gland is removed but a small area is spared this is called a near total thyroidectomy. If the thyroid is removed or destroyed you will need lifelong thyroid replacement or you will die.

How To Treat Hypothyroidism if No Thyroid Medications are available
Hypothyroidism is very common with a preponderance of patients being female, the vast majority of patients are undiagnosed due to the poor practice of just testing TSH or TSH and T4 only. If you have already been diagnosed and are on thyroid medications then you will have a major problem in the event of some natural disaster that prevents you from obtaining your meds. Most of the terrible medical prepping books out there will give the same tired advise………stockpile your medications. Well, anyone who has ever been on longterm medications of any type knows that insurance companies do not allow you to even fill your prescriptions a week early, much less allowing you to stockpile a supply of meds.
I guess the good news, if there is any is that you can survive with an underactive or hypothyroid condition and it will not be life threatening. On the other hand, if you have had your thyroid removed surgically or destroyed by radioactive iodine treatments and are incapable of producing any of your own thyroid hormone then you are in trouble and will need to find some form of thyroid hormone to survive. If that is your situation then the section above where I discussed Hamburger Thyrotoxicosis might be your only lifeline to survive. If you remember the process of “gullet trimming” was mixing thyroid tissue with chopped meat resulting in the unwary person ingesting active thyroid hormone from the chopped up thyroid gland. I don’t mean to make this sound like something simple to accomplish. You will need a steady supply of animals to slaughter and remove their thyroid gland, chop it up and allow it to dry (become desiccated) and then ingest small portions of it daily to replace your complete lack of thyroid hormone. The tricky part is, how much do you need and how much do you take daily? That is the million dollar question and something you will have to experiment with to achieve a baseline dose that will insure your survival.
For all the other patients with hypothyroidism, you will have to either learn to live with your symptoms and if they become intolerable then you will have to find your own sources of porcine (pig) or bovine (cow) thyroid glands, I am not sure how big a thyroid chickens have, but that might be a good renewable source of thyroid hormone for you. Short of that , you will need to optimize the function of your thyroid gland by stockpiling ahead of time all the things you need for thyroid hormone production. This naturally will include tyrosine, iodine in its various forms, selenium and to a lesser degree B vitamins including folate, zinc, vitamins A and C. I would especially stockpile iodine, selenium and tyrosine since they are the most important for adequate thyroid hormone production, and will support your underactive thyroid and help it maximize its production of thyroid hormone.
A much more viable option for stockpiling your thyroid medications might be sitting right at your feet, your dog or cat. Dogs and cats both have thyroid glands which produce the same thyroxine or T4 that humans produce. There is no difference in its structure and function, they typically need much less thyroxine than humans and therefore use a lower dose. If your pet is on thyroid meds you can certainly use it, just adjust the dose to meet your needs. Since these veternarian meds are not typically covered by third party insurance companies, then there are no controls on the amounts you can get. If you have a good relationship with your vet ask him to write you a prescription for a large quantity of your thyroid meds and stockpile them. If you have a non functioning thyroid, such as one surgically removed or destroyed by radioactive iodine then this might be the easiest and safest option for you to obtain your thyroid meds. If you have typical hypothyroidism then your thyroid is producting thyroid hormones, just not enough of them, so you can supplement your native thyroid hormone production with these veternarian medications, and might very well be able to get enough to last you for quite some time. It may make a huge differnece in how you feel and ultimately may save your life.
Another option for those who want to stockpile some thyroid medications is to use glandulars. Glandulars refers to the use of dried animal glands (usually pig, cow or sheep) or extracts of these tissues that are dried, ground up and available in pill form. There are many brands available over the counter without a prescription, one I have used in the past is Raw Thyroid. Typically these contain the thyroid gland and other ingredients for thyroid support. The problem is that with most of these “raw thyroid glandulars” you are not sure how much if any actual thyroid tissue they contain. The flip side of that argument is if you are in a grid down survival situation and you have no other thyroid medicine to take these products could very well save your life. They are inexpensive and I would stockpile a year or two supply of them, it could very well save your life. Call me crazy but I think it is also much easier than trying to get your own thyroid medicine from the raw glands of animals you have slaughtered.

 

This disclaimer provides that such medical information is merely information – not advice. If users need medical advice, they should consult a doctor or other appropriate medical professional.