Chapter 12 HORMONE SECRETS--THYROID BASICS AND POLITICS

Thyroid “quarterbacks” the entire metabolism. It regulates and activates many body processes and is essential for energy and weight control. Borderline low or “hypothyroid” conditions are common, under-treated, and seven times more likely in women. Treatment is safe and should be general primary care rather than being stashed in a subspecialty. 

Judy is 40 years old: When I was 35, I started getting depressed and was chronically exhausted. I was losing my hair and felt cold all the time. I was constipated, grumpy, and had no interest in sex. I had to direct my kids from the couch because I didn’t have the energy to chase them around. All my doctors insisted my tests were normal, and that I was a hypochondriac. They finally gave me pork thyroid. After a month, my energy went from a two to a nine out of ten, and I got my husband back.

Treatment benefits: Thyroid supplementation for appropriate patients protects against heart disease, diabetes, and memory loss. It improves hair, nails, and skin. Balancing the thyroid improves menopause symptoms, and studies have shown lower death rates for treated people. 

When thyroid is low, people get fat, tired, inactive, disinterested in sex, and are more likely to develop heart disease. Erectile dysfunction is more frequent. Other symptoms include dry skin, hair loss, insomnia, brittle nails, constipation, bone and joint pain, poor concentration, trouble getting started in the morning, and cold extremities with cold intolerance. 

Untreated hypothyroid patients often have medical problems including depression and coronary artery disease. Vertebral fractures are more likely, especially over 50 years old. Hypertension, premature births, rheumatoid arthritis, and metabolic syndrome have all been linked to low thyroid conditions. 

Two kinds of bio-identical thyroid hormones are used for replacement, and both are vital for health. T3 has three iodine molecules and T4 has four. Desiccated pork thyroid has both types along with a few inconsequential pig thyroids. According to hormone doctors, it is the most bio-identical thyroid medication available. Physicians have used this inexpensive drug since the late 19th century. 

Endocrinologists and other mainstream doctors mainly prescribe pure T4 made in the lab, which was until 2004 a patented drug. T4 converts to T3 in the body, and they believe that this creates adequate T3. But it does not work well for everyone, especially women over 40. Since T3 is far more active than T4, people who cannot convert properly have poor results when they take only T4.

For these patients, endocrinologists prefer to add synthetic T3 to the synthetic T4 instead of using the pork type, which contains both in one pill. When carefully dosed, these manufactured medications work fine, but they may not be as well absorbed as the other one. They are useful for people with a pig allergy and for Jewish or Muslim people who are not supposed to eat pigs.

T3 is stronger and shorter-acting than T4, so patients sense its effects sooner than T4. Since getting patients to return for follow-up is sometimes difficult, using a drug containing T3 may help them understand the process is worthwhile. Since the thyroid’s effects are long-lasting, the medication should be adjusted about once a month.  

Endocrinologists train for three years in internal medicine after four years of medical school, then spend a fel

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