What is Hypothyroidism?

After the national outcry following the Good Housekeeping’s rather insulting and poorly researched article about thyroid disease and hypothyroidism, Dr. Erika Schwartz, a leading expert in thyroid balance and Chief Medical Officer of AgeMD talks about the symptoms of hypothyroidism that patients experience when suffering with hypothyroidism. She also talks about how the condition can be properly diagnosed and treated by clinicians. When diagnosed properly, thyroid disease and hypothyroidism can be treated safely and effectively with the proper thyroid hormone therapy.

What is Hypothyroidism?

What a sad state of affairs for the health of America's women. Thyroid disease -- undiagnosed and mismanaged -- is rampant. Many women complaining of fatigue, weight gain, insomnia, depression, poor concentration, hot flashes, fuzzy thinking and hair loss are being misdiagnosed and mismanaged by doctors relying solely on standard blood testing to diagnose hypothyroid as a problem.

In one extreme case a patient came to our offices after visiting 10 other doctors. None of the doctors listened to her and refused to treat her even though she showed strong signs for symptoms of hypothyroidism which affected her life and included: chronic fatigue, insomnia, perpetually feeling cold, weight gain, depression, hair loss and foggy thinking. Each doctor, after reviewing her blood work and seeing normal TSH levels, refused to diagnose hypothyroidism and thus did not treat her. No one checked her basal metabolic rate or her temperature that consistently were in the 1100 kcal and 96.5 range respectively.

What is the function of the Thyroid?

Thyroid hormone levels affect your metabolism, energy levels, attention, emotions and temperature. Centrally located in the neck, between the brain and the rest of the body, the thyroid is our master gland directing metabolic and hormonal interaction throughout your body.

What is a Hypothyroid?

Low Thyroid levels or Hypothyroidism is caused by thyroid underproduction of the thyroid main hormone thyroxine (T4) or the ability of the peripheral tissues to use the active form of thyroid (T3). Any interference in the production of T4 can stop the normal conversion of T4 into its active form, triiodothyronine (T3) and lead to symptoms of hypothyroidism.

What are the symptoms of hypothyroidism?

Thyroid imbalance may cause fatigue, insomnia, poor concentration, hair loss, brittle nails and weight gain and multiple other symptoms. Many physicians and patients blame these symptoms on aging, lack of exercise or stress and while these are contributing factors the main culprit may easily be thyroid hormone imbalance or hypothyroidism.

Some estimate between 20-60 percent of women experience some level of thyroid hormonal imbalance and the majority of these women are not treated and go under diagnosed with horrific impact on their lives. Much of this is due to an outdated and controversial blood test called Thyroid Stimulating Hormone (TSH) that is still considered by too many physicians the only way to diagnose hypothyroidism.

The test was created and endorsed by the American Endocrine Society more than 50 years ago as the gold standard of hypothyroidism. TSH ranges for diagnosing low thyroid function are inadequate and statistically too broad thus creating situations where clearly clinically hypothyroid people are considered due to the “normal” range TSH results thus missing an opportunity to help them feel better if thyroid disease therapy is instituted appropriately.

Essentially, the TSH test identifies how the pituitary gland in the brain perceives the level of circulating thyroid hormones in the blood. Low circulating thyroid levels cause the TSH to read high, yet factors such as low selenium, stress, high cortisol and estrogen levels may suppress TSH levels and allow hypothyroid symptoms to continue untreated.

The Role of Hormones

Hormonal imbalances with the onset by perimenopause and menopause are often connected to thyroid hormone imbalance, mostly hypothyroidism. During perimenopause and menopause the production of the sex hormones: estrogen, progesterone and testosterone decline. Typically, progesterone is the first to decline leaving estrogen dominance. Many researchers believe that hormonal imbalances created by decreased levels of progesterone and estrogen dominance inhibit the actions of the thyroid hormone and cause symptoms of hypothyroidism.

What tests should doctors be performing?

Thyroid deficiency is extremely common but often goes undetected because standard blood tests miss a majority of low thyroid patients. Most doctors are trained to only test TSH levels of patients, and if these appear normal the doctor will not diagnose thyroid disease regardless of symptoms. More comprehensive testing including free T4, free T3 reverse T3, clinical picture, basal metabolic rate and body temperature, help provide a comprehensive picture of the thyroid function.

Alternative Treatment: Thyroid Imbalance

Rebalancing hormone levels of progesterone, estrogen, testosterone, exercising, managing stress and nutrition are key to parsing out thyroid problems from other issues

Bioidentical hormone replacement therapy (BHRT) with natural hormones provides a gentle, safe and effective way to restore hormonal balance, relieving many of the symptoms associated with aging and resulting in the recovery of vitality and disease prevention

Proper nutrition and supplements that support thyroid function can also play an important role in maintaining balanced thyroid levels and overall health, helping people to avoid problems such as hypothyroidism

Thyroid treatment should always occur under the supervision of a trained clinician with the proper combination of T3 and T4 in the appropriate combinations for the patient’s individual needs.

To assess your symptoms and to learn more about how bioidentical hormones and the other safe and effective tools of Age Management medicine can lead to hormonal balance, thyroid balance and well-being, contact a certified AgeMD doctor in your area.