-IBIS-1.7.0-
tx
endocrine system
hypothyroidism
Nutrition
dietary guidelines
eating principles:
Low sugar
Low fat diet of unsaturated fats
Calorie percentages: 70% complex carbohydrates, protein 12-15%, fat 15-18%
High fiber
Low cholesterol
therapeutic foods:
Kelp, foods rich in Iodine: seaweed, artichokes, onions, garlic (Shefi)
Foods rich in Iodine, Silicon, Phosphorus: kelp, dulse, Swiss chard, turnip greens, egg yolks, wheat germ, cod roe, lecithin, sesame seed butter, seed and nuts, raw goat milk (Jensen, p. 61)
fresh juices:
Carrot
Pineapple juice, egg yolk, wheat germ, and dulse (Jensen, p. 61)
Black cherry concentrate, egg yolk, and chlorophyll (Jensen, p. 61)
avoid:
Goitrogens: turnips, cabbage, mustard, soy, peanuts, pine nuts, millet. Cooking inactivates goitrogens
Therapeutic consideration:
Mercury (Hg) amalgam removal: Dr. Roy Kupsinel believes that heavy metal toxicity can adversely effect the thyroid gland, particularly mercury. He has seen many people who have had their thyroid function return to normal and also their BBT go up after having their mercury-based amalgam fillings removed. Removal of mercury amalgams is a complicated process and should not be done randomly without proper evaluation and then only by a practitioner skilled in their removal; special damns and air filtration along with special techniques are essential to the safe removal of amalgams. (Marz, p. 410, 1997)
supplements
Armour thyroid hormone: see discussion below
Glandular, non-USP, thyroid products: There are a number of products available that contain thyroid tissue but are not supposed to have actual thyroid hormone in them. In the past the FDA has confiscated a number of these over the counter health food preparations containing glandular thyroid after they had been assayed and were found to possess measurable levels of thyroid hormones. The FDA has since increased restrictions on what can be sold in health food stores (over the counter) but it is likely that many of the products being used still contain low levels of thyroid hormone. These products are often called "protomorphogens," meaning that they are the whole gland in a more crude state such that they might contain a number of compounds that could theoretically nourish or stimulate the thyroid and enable it to increase production of thyroid hormone. Many physicians have used these supplements in the past with considerable success. See note below. (Marz, p. 409, 1997)
Tyrosine: 500 mg three times daily This is the precursor amino acid for thyroid hormone synthesis.
Iodine: 400-800 IU per day If low certainly should be used to treat goiters or hypothyroidism (see Materia Medica for list of foods with iodine).
Zinc: 20 mg twice daily (Marz, p. 410, 1997)
Copper: 2 mg twice daily. (Marz, p. 410, 1997)
Vitamin B6 25 mg per day
Vitamin B-complex
Vitamin C
Vitamin E (Kirschmann, 1984)
Wilson Syndrome treatment: Many practitioners recommend Dr. Manual as the best resource on Wilson Syndrome. The basic treatment plan requires taking daytime temperatures and seeing how low they average. Some practitioners use 98.2° F or below as being low, again supported by signs and symptoms. Treatment best uses a timed or sustained release of T3 (this can be made up in compounding pharmacy). Dr. Wilson proposes that doses of T3 should be taken exactly 12 hours apart the same time each day. Start with 7.5 mcg twice daily and every 2 days go up by 7.5 mcg. Daytime temperatures must be taken to determine the therapeutic effect of the treatment. Temperatures should reach at least up to 98.6°;. If they do not then the dose should be continuously increased every two days until the temperatures have risen. Once the temperatures have risen to the desired level, the dose should be maintained for a period of 5 days and then lowered by the same increments that the dose went up except that the drop should be every 3 days on the way down. Ideally the temperature should continuously stay up. If it does not then another cycle of T3 is indicated. The goal is to keep the temperature at the ideal level 98.6°. Clinical results with patients using this protocol have been mixed. Temperatures often do not stay up. Some practitioners believe that certainly there is something worth investigating here, but you might contact Dr. Wilson's staff to acquire his reference manual or talk to him in person. (Marz, p. 409, 1997)
Armour thyroid hormone: The patient should start with a small amount, usually 30 mg (1/2 grain), taken first thing in morning, at the same time each day, away from any food. It is best not to have any food so that the medication can be maximally absorbed and not be bound up by or interfered with food components. Initiating treatment with a small dose of thyroid will significantly reduce the risk of an adverse reaction. Also, if the patient slowly increases the level of thyroid medication, the body can adapt to it and there will be decreased risk that the hypothalamus will respond as if there are excessive levels of thyroid hormone. Thus the hypothalamus might not decrease its production of TSHRF and there could be an added effect to the body's own endogenous production. It is important to always monitor the patient's signs and symptoms as well as blood pressure, heart rate, Achilles return reflex and basal body temperatures throughout the treatment. The dose of the thyroid medication can be gradually increased by 1/2 grain every 2 weeks until the symptoms change. If there are any signs or symptoms of excessive thyroid then the dosage needs to be stopped or reduced. An increase in basal body temperatures is desired, but may not always result. Broda Barnes states that the temperatures always will go up. From my experience with thousands of patients I have not found this to be true, at least not up to the desired level; many other practitioners have also had the same experience. Patients will usually get up to levels between 1-3 grains before they start to experience positive benefits. Cautioun is recommended regarding raising the dosage to levels higher than 1-3 grains although many physicians have had people on doses up to 6 grains per day, and occasionally as high as 10-12 grains per day. In relation to potential adverse effects, patients can be advised to watch for symptoms similar to those they might experience if they drank too much coffee. Potential adverse reactions to excessive dosages of thyroid medication include palpitations, feeling too warm, problems sleeping, rapid heart beat, feeling jittery, tense or wired, and increased blood pressure.
It is possible to have reactions with other hormones such as adrenal hormones and it is advisable to evaluate the adrenals as well, as low adrenal function and low thyroid function can produce similar symptoms. In some cases thyroid dose can be lowered if adrenal function improves.
(Marz, p. 409, 1997)
Note: The use of the glandular form of thyroid is a controversial point. Most conventional physicians seem to share a similar opinion, which seems to be a verbatim assessment that the Merck Manual states concerning the treatment of hypothyroidism. In essence the argument can be paraphrased thus: glandular thyroid is obtained from thyroid tissue removed from pig carcasses; its constituents are highly variable and unpredictable from batch to batch. While this statement may be repeated often it has some underlying weaknesses. USP glandular thyroid has been assayed to meet certain standards, so the dose should not be so varied from batch to batch. Even if that were true, some physyicians would counter that this potential variablility is not highly problematic as the treatment is direct ed toward the individual patient and their symptoms and their response is the most important parameter for evaluating the effectiveness of the therapy. Treating just blood tests until they come into the normal range does not mean that the thyroid is getting into the cells. It is always best to look to see how the patient is responding to the treatment. Monitoring blood tests can be helpful if a patient has too much thyroid in their blood and certainly they should be monitored carefully if they have too much. However many physicians have observed that quite often thyroid blood tests do not accurately relect expected or reported changes after increasing doses of thyroid hormone. Certain physicians believe that when using glandular USP thyroid, e.i. Armour thyroid, blood tests do not accurately correlate with thyroid hormone levels in the cells. Many physicians have noted that some patients taking synthetic thyroid hormones, such as thyroxine, will report experiencing adverse side effects before they start to derive any benefit from the hormone. Very often after such a report from the patient, the prescribing physician wil interpret this as resulting from too high a dose of the medication so they lower the dose back down to a non-therapeutic level. The patient may then take this dose for a prolonged period of time and not experience any benefit at all! The physician may then check blood levels which might come back in the so called normal range and the physician leaves the patient at the non-therapeutic level. Obviously if they were low to begin with and their symptoms were caused by the low thyroid, they should have at least experienced some sort of benefit. (Marz, p. 408, 1997)
It should be noted that there are some people who may respond well to the synthetic T4 hormone. Again clinical judgement should prevail. If someone has been taking the T4 and they have responded well you may decide to leave them on it. I would strongly consider switching if however there is little or no response. Other hormones can also be used in treatment such as Euthroid® (combination of T4 and T3) or Cytomel® (T3). T3 is much more potent than T4 (4x more) and its half life is only 21/2 days compared to 71/2 days for T4. Uncommonly people have been known to be sensitive to the pork proteins found in the USP thyroid. In such cases the synthetic thyroid would be more indicated.
The following is a list of thyroid derivatives and their approximate equivalent doses:
Armour or other USP thyroid 1 grain
L-thyroxine (T4) 0.1 mg or 100 mcg
Euthroid® (T3 and T4) 1.0
Triiodothyronine or liothyronine (T3) 25 mcg (also known as Cytomel)
Many physicians who have patients on thyroid medication tell them they need to be on the thyroid hormone for life. As with any therapy this should certainly be monitored and the least dose that is effective should be used. It is possible to come off thyroid hormone, but care must be taken to come off very slowly and gradually (over a period of months). Monitor symptoms as always. The more slowly one comes off the easier the body will have a chance to adapt to the new thyroid levels and start making its own to compensate.
(Marz, p. 408, 1997)
» drug interactions:
Note: There have been several adverse effects to attributed to excessive doses of thyroid hormone. So far they have involved the synthetic derivatives of thyroid (T4). It is possible that Bp can go up (often it has gone down if people are high to begin with however. Osteoporosis has also been reported but the studies are questionable. If you are not sure about the diagnosis and your thyroid hormone treatment doing bone densiometry is an ideal way to monitor bone density very precisely. (Marz, p. 410, 1997)
Thyroid medication [dessicated thyroid, Synthroid (T4), Cytomel (T3)]: causes increased urinary excretion of Calcium (Paul, et al., 1988; 259: p. 3137-3141; Kung and Pun, 1991; 265: p. 2688-2691; Adlin, et al., 1992; 128: p. 210-213)
footnotes