Everybody knows about hypothyroidism. The prefix “hypo-” means “less than.” So hypothyroidism is when the thyroid gland activity is less than normal. Hypothyroidism is by far and away the most common thyroid problem. The one you’ve probably heard the most about. But it is not the only one.
The opposite of “hypo-” is “hyperthyroidism.” The prefix “hyper-” means “more than.” Hyperthyroidism means that the thyroid gland is overactive, and is making too much thyroid hormone. Hyperthyroidism is not nearly as common as the hypo version, but it is every bit as serious.
Hypothyroidism usually happens in people in the over 50 crowd. And it occurs equally in men and women. Hyperthyroidism is different. It mostly hits women in their 30s and 40s. The most common form of hyperthyroidism is Graves’ disease. Graves’ disease is one of many diseases called autoimmune disorders. These are conditions in which the immune system misbehaves. Let me explain.
Normally, the immune system acts to protect us against viruses, bacteria, and other foreign substances that invade the body. In Graves’ disease, the immune system mistakenly acts on the thyroid gland, and causes it to produce too much hormone. In some cases, it also attacks the tissue behind the eyes and the skin of the lower legs over the shins.
Like with all autoimmune disorders, the cause of Graves’ disease is thought to be unknown. For sure, there is a genetic predisposition. There may very likely be a viral component as well.
Typical symptoms of Graves’ disease are: sudden weight loss, fatigue, rapid heartbeat (tachycardia), irregular heartbeat (arrhythmia), pounding of the heart (palpitations), nervousness, and a fine trembling in the hands and fingers. Sometimes the symptoms are marked, and sometimes, especially in older folks, they are subtle. Physical signs include an enlarged thyroid gland, a bugging out and/or an irritation and redness of the eyes called exophalmus, and thickened reddish skin over the shins.
Once a doctor suspects Graves’ disease, it’s easy to diagnose it with simple blood testing. The thyroid hormones T3 and T4 will be high, and the pituitary hormone TSH will be low. Graves’ disease is what Jackie had.
The Danger of Just Treating Symptoms
I met Jackie in June of 2006. She was a 45-year-old schoolteacher, who like so many of my patients had a very interesting story to tell. When she was 41, her doctor gave her a routine TSH test, which was abnormally low. The doctor wanted to give her a drug to suppress the thyroid. But Jackie said that she was “in the best condition of my life,” and she was not interested in taking any drugs. She wanted to correct the condition by eliminating the cause, not just Band-Aid the symptoms.
Over the next year-and-a-half, she developed two symptoms which kept on getting worse each month. One was heavy and painful menstrual cycles, something she had never had before. The other was severe breast tenderness.
Jackie saw her doctor and he prescribed two very nasty drugs, etonogestrel and ethinyl estradiol.
Several months later, Jackie had to stop her “technological breakthrough” because of side effects. So her doctor started her on a different drug. Two months after that she had a mammogram and an ultrasound of the breasts, and was told she had fibrocystic breast disease. Fibrocystic disease is a common problem. It is the presence of multiple fluid-filled cysts in the breasts, which are very painful.
So now her doctor gave her an altogether new pill. This one was supposed to provide birth control as well as help her with her menstrual and breast symptoms, which it did.
Then over the next year, Jackie developed something else the doctors did not understand. Her fingernails became increasingly dry and cracked. They didn’t give her any treatment for this, so she just put up with it. She also continued to have problem with cysts in her breasts, and ultimately had to have some of the cysts drained. The birth control drugs had helped with the breast pain, but the cysts just became progressively worse. You will soon see why.
The “Nuclear” Plan of Action
Four months later, Jackie’s doctor repeated the TSH test. It was low again. In addition, both of her thyroid hormones, T3 and the T4, were elevated. Her hyperthyroid state was getting worse. Her doctor recommended that she have radioactive iodine treatment. This is a way of killing off the thyroid gland. It’s a sort of who-cares-what’s-bothering-the-thyroid-let’s-just-kill-it plan. Jackie turned down this option. Instead she opted for less toxic treatment. It involved taking the drug propylthiouracil (PTU).
Doctors commonly use PTU to treat hyperthyroidism. It works by interfering with the way that the thyroid gland makes hormones. It can cause hepatitis, neuropathies, skin disorders, bleeding disorders, kidney disease, hair loss, and a life threatening blood disease called agranulocytosis. Agranulocytosis first shows up as a low white blood cell count.
Within a month of starting the PTU, Jackie’s doctor discovered that although her thyroid levels were better, her blood count was getting low. He suggested that she continue the drug and recheck the level in another month. That was when Jackie came to see me.
Looking for Causes
When I first saw Jackie, she complained of loose stools, anxiety, and depression. These symptoms are typical for Graves’ disease. She also had neck and shoulder pain, heavy menstrual bleeding, and very painful breasts. She told me that four months prior she had stopped the latest birth control pill.
The first thing I did was to look at her iodine levels. Why? Because all of her symptoms were classical signs of iodine deficiency. Fibrocystic breast disease is evidence of an iodine deficiency. So are Graves’ disease, menstrual cramps, heavy menses, and brittle fingernails. Jackie had every indication of a low iodine condition.
So I ordered an iodine loading test. This test involves measuring how much iodine the body absorbs after a 50 mg tablet of iodine is administered. I did the loading test because this is the most accurate way to find an iodine deficiency. Simply looking at the level of iodine in the blood or urine without a loading dose usually misses the diagnosis. Here’s why: As the body becomes deficient in iodine, it adjusts to the lower amount, and the blood and urine levels remain normal.
Jackie should have shown an iodine saturation of greater than 90%. Instead her level was 61%. Now she had both clinical and laboratory evidence of iodine deficiency. This was probably why she developed her Graves’ disease, her fibrocystic disease, and all of her other symptoms. So I started her on a combination of iodine (one drop of Lugol’s solution), along with 9.6 mg of lithium ortate. The reason for using iodine is obvious. But why the lithium?
You may have already heard about lithium. Doctors have used it for decades as a treatment for manic depression. This is a form of depression that has episodes in which the patient’s mood dramatically swings to the opposite of depression, a condition called mania. When a person is manic, they have an unrealistically inflated attitude about themselves and their abilities. Whereas depression is a hypo mood state, mania is a hyper mood state. The mental manifestation of mania is similar to what is seen in hyperthyroidism. So it is reasonable to suspect that hyperthyroidism might be caused at least in part by a lithium deficiency.
The other thing about lithium is that it works on the mitochondria of the cells. This is where the thyroid hormones work, too.
Finally, researchers have observed that very high doses of lithium carbonate can suppress the thyroid. I chose to use lithium ortate instead of the carbonate version because it is carried into the mitochondria of the cell much better. This means I can prescribe a lower dose. And that’s important because lithium can be toxic in doses that are too high.
Jackie responded quickly to this treatment. One month later, all three of her thyroid tests were normal, and she was feeling good for the first time in a long time. Her only complaint was that she had been losing hair during the previous six weeks. No doubt this was caused by the PTU. At that point, I stopped the PTU. It was time for Jackie to have a little party. It was the first time in over two years that she had been completely off drugs.
Still More Problems to Overcome
But Jackie still had a ways to go. Over the next six months, when her breast disease and the heavy periods persisted, I knew there was a problem other than iodine deficiency.
Another common cause of both these symptoms is a low level of the hormone progesterone. So I checked her progesterone levels and, sure enough, I found a deficiency. Progesterone deficiency is a common problem in young women, but it is almost always an issue in women in their 40s. I should have thought of it sooner. Ultimately, these conditions responded to a combination of progesterone replacement, vitamin B6, and magnesium. I prescribed the B6 and magnesium because it works with progesterone. And is often needed in progesterone deficiencies.
The other issue was that her thyroid gland was steadily healing. So I had to adjust her lithium and iodine levels every two to three months to the changes in her thyroid status. And then a year later, while checking her metabolic rate, I discovered that she needed thyroid hormone replacement. Why thyroid hormones? Didn’t she already have too much thyroid hormone?
Well, yes, at one point she did. But now, a year later, the Graves’ disease was stabilized. In fact, her thyroid was starting to become more like the thyroid of the average 48 year old — an under-functioning thyroid.
In the last two years she had gone full circle, from being hyperthyroid to being hypothyroid. I started adding in some natural thyroid hormone in November 2007.
Lithium ortate is available online. Natural thyroid is available only through prescription, so you’ll need your doctor’s help to get it. Grave’s disease is one problem that you do not want to treat on your own. Here are some referral sites where you can find a doctor who might be able to help you with this natural approach to the disease:
aaot.us,
www.acam.org,
www.a4m.com,
www.naturopathic.org,
www.abihm.org,
www.faim.org,
www.ahha.org,
www.amfoundation.org,
www.aihm.org,
www.aaimedicine.com,
www.icimed.com, and
www.imholistichealth.org.