Friday, April 8, 2011

Thyroid & DS Go Hand in Hand

The symptoms of low thyroid hormone are very similar to characteristics of DS. They include (but aren't limited to) slow growth, delayed development, an enlarged tongue, low muscle tone, dry skin and constipation.

Since it is hypothesized that most everyone with Down syndrome will develop hypothyroidism or in a lesser percentage, hyperthyroidism, it's important that you know the symptoms and how and what to test so you can detect it early and treat it before it does permanent damage. (Endocrinologists I have spoken to in person have agreed with this theory, but I've only found in writing that the incidence is as much as 55% http://downsyndrome.about.com/od/medicalissuesinds/a/DSHypothyroid_RO.htm. I'm thinking they are using a more narrow criteria than what is needed in order to properly diagnose hypothyroidism in this population.)
Hypothyroidism is best diagnosed with a combination of blood tests (including TSH, Free T4, Free T3, reverse T3 and thyroid antibodies), clinical examination and evaluation of symptoms. The clinical exam looks for slowed growth, slowed reflexes, slowed heart rate, enlarged neck, puffiness in the face, swelling in hands and feet, and sensitivity to cold, among other clinical signs. (One of Jett's pediatricians said that he obviously didn't have hypothyroidism because he wasn't just laying on the floor in a complete state of lethargy... I didn't know whether to laugh or cry over that statement!)

Although Jett's first thyroid results (at age 3.5 months old) showed numbers in the hypothyroid range, his endocrinologist said he was fine and didn't need to be seen for three months. He said high TSH is "normal in people with Down syndrome." Yes, and since people with DS have hypothyroidism, that makes sense. But it doesn't make sense to use that as an excuse to not treat them!! It's like saying people with diabetes have high blood sugar so it's normal for them and we should leave it untreated....

Needless to say, I wholeheartedly disagreed and never went back to him. Jett had a lot of signs of hypothyroidism (slow growth, cold extremities, dry skin, constipation) and I had a small window of time to get him treated before permanent damage was to take place! Maybe we can't fault the endo's because with DS, we have to be super aware of the thyroid issues? Maybe for a typical child, that kind of (lack of) treatment would be okay? (Which I doubt.) It's just that we want to give our kids the best chance for proper development. We don't need any more strikes against them!
Confused about lab results?

Check out the thyroid lab value information at http://www.stopthethyroidmadness.com/lab-values/. Also check out http://www.riverbendds.org then click on "Medical Series" on the left, then "Thyroid" then "Thyroid Lab Ranges." Typically in hypothyroidism, the T4 will be low and the TSH will be elevated (as the brain is trying to tell the thyroid to get going). Anything above a TSH of 2.0 is cause for concern, especially when it's a child with T21. And some doctors who regularly treat patients with DS, recommend a TSH of below 1. Research demonstrates impaired development in children with DS with a TSH of 5.7 or more. (http://health.nytimes.com/health/guides/test/tsh/overview.html) Why wait until it reaches 5.7? Jett's symptoms disappear when his TSH is around 1.7. So, in my mind, that is the optimal number and is what I aim for.

Some infants and young children have blood tests that show a normal T4 but a high TSH. This condition is called "idiopathic hyperthyrotropinemia." (Jett had this.) While the cause isn't clear, this may reflect a regulatory defect of TSH, or it may be a sign of impending true hypothyroidism. Some endocrinologists will recommend retesting in three to six months, and others will recommend treating as if it were an early hypothyroid state. I chose to immediately treat because he exhibited the tale tell symptoms and because I wanted to prevent permanent damage. (I couldn't find an endocrinologist that would treat Jett, but I found a sports medicine doctor who understood the importance of treating the thyroid aggressively since he had special needs children of his own.)

How is the thyroid treated?

Treatment is the replacement of thyroid hormone with either synthetic thyroxine or natural thyroid. The most common (and popular) medication among physicians is synthetic T4 -- known generically as levothyroxine. Common brand names in the US include Synthroid, Levoxyl, Levothroid and Unithroid. Some patients do better with the addition of the T3 hormone, in synthetic form. The drug lithyronine (Cytomel) can be added to the levothyroxine. The drug liotrix (Thyrolar) combines both synthetic T4 and T3 into one pill and is helpful for some patients.

However, the more holistic and integrative practitioners prescribe natural dessicated thyroid like Armour Thyroid, Westhroid or Nature-throid. Armour is an older natural drug, derived from the desiccated (dried) thyroid gland of pigs. Some practitioners and patients prefer the drug because it includes natural forms of T4, T3, and other thyroid hormones and cofactors. Since Armour has been reformulated and doesn't work as well, here is an updated list of brands of natural thyroid brands that are now being prescribed in its place: http://www.stopthethyroidmadness.com/armour-vs-other-brands/ If all you can find is Armour, keep in mind that the newer version works better if it is chewed.

For adults, the natural hormone replacement such as Armour is preferable. (See stopthethyroidmadness.com) but some physicians believe that children can build up antibodies against it (but I haven't found evidence to back this up), so you might consider going with a T3 and/or T4 compound until you can get your child's thyroid to work on its own.

For Jett, I followed the doctor's advice and put him on the synthetic compound. During that year, he barely grew any at all (1 1/2 inches & 1 pound between the ages of 6 months and 18 months). I took him off and put him on natural dessicated thyroid, Nutri-Meds, (the endo refused to prescribe natural) and he grew two inches and gained two pounds in four months! YEARS later, when I finally got a doctor to prescribe the right stuff, Jett grew 1 1/2 inches in the first 8 weeks on it!

Important Note: Armour is readily available for the thyroid to use but synthroid takes 1-2 weeks to become available in the system. So if you are switching from natural to synthetic, you may consider taking both for a little while. You can track the temperature and watch for symptoms.
Iron, calcium and magnesium within a multi-vitamin or other supplement will cause absorption problems if taken within 4 hours of thyroid hormone.

As a precaution, I'd be prepared for possible hypothyroidism by purchasing the desiccated porcine thyroid now and have it handy if your child starts to show symptoms. It may be weeks or months or years (in Jett's case) before you can find someone to treat your child. Make sure you get the bloodwork done before you use it so you have record that s/he indeed has it. Be sure to research thoroughly before giving any medication yourself. Stopthethyroidmadness.com has a step by step guide.

Jett was first on dessicated porcine thyroid, which I had to give him myself until I found someone to treat him. Now he is on a T3 compound. In three weeks after taking the T3, he gained a pound, his skin was no longer dry, his body temperature went back to normal and his constipation went away. After being on T3 for 3 months, his TSH level is the same that it was when I gave him the desiccated thyroid medicine. (1.7) Now, since he stopped growing on the synthetic thyroid medicine and since I can't find a doctor to prescribe natural thyroid (I'm still looking), I'm back to giving him the natural, desiccated thyroid.

The dose is managed by watching sequential blood tests to see how the thyroid responds. Treatment is usually needed for life, but I'm working now to ween Jett off his thyroid meds with the following plan my doctor help me come up with.

If you find he has a problem, until you find someone to listen to you, there is plenty you can do help to get his thyroid working properly.

The plan I've worked out with my integrated doctor:

1) Stop all soy & goiterific foods until thyroid is stable.

2) Add Epsom salts to his bath.

3) Massage with coconut oil or just give a teaspoon a day. See below for why coconut oil works.

4) Get a urine test to see how much iodine he needs (too much iodine is dangerous) and the appropriate blood tests to check the thyroid function as well as the levels of zinc & selenium. See below how iodine works.

5) Keep track of his basal body temperature to check for signs of hypo/hyperthyroidism.

6) Monitor his heart rate for a week with a pulse oximeter since he's had heart surgery and his heart rate may increase if he's taking too many meds when his own thyroid takes over. (You have to watch symptoms of hyperthyroidism as he's gradually eased off the meds.)

7) Once the test results are back, supplement appropriately. For iodine, he recommends applying a 2 inch square on his skin and reapply when it disappears. Follow the instructions at http://breastcancerchoices.org/iprotocol.html. He also recommends 100 mg of l-tyrosine (100 mg is in Nutrivene, but your child has to weigh 80 lbs to get up to that dose). The combo of tyrosine & iodine will help heal the thyroid. Iron levels should be at least at 50 for the thyroid to work properly. A free guide on how to use iodine:
The Guide to Supplementing with Iodine by Stephanie Buist, ND HC

These work together to make his thyroid work again. It's amazing because you can watch his temperature gradually rise to normal. But, you don't really have time to wait for it to heal... you need to get it working NOW.

How to test the thyroid yourself

A big clue to the function of a normal thyroid is body temperature. A normal axillary temperature is around 98° F. Normal rectal temperature is no greater than 100.2° F.

It's best to take the temp first thing in the morning, before he gets out of bed (basal body temp). Food, drink, room temperature, etc. can all change body temperature. If his thyroid isn't working properly, his temperature will run low.

I took Jett's temperature everyday. It was consistently around 98.6. Then one morning his hands felt cold and when I took his temperature that day and thereafter, it was consistently a degree lower. He also developed constipation, dry skin and wasn't growing.

To take his temperature, go to http://www.stopthethyroidmadness.com/temperature/ for details. This is a great site, but it's not for children and not for our children so there are some different things we would want to do to treat the thyroid.

If you have become used to a calm, sedate child who is hypothyroid, once the thyroid is treated, it may seem as if your child has suddenly become hyperactive, when in fact your child is returning to his or her "natural" state! I thought Jett was very active until his thyroid was fixed and I was shocked by how much more active he'd become. After three weeks of treatment, he gained a pound and his temperature rose to a normal 98.6.

From an experienced Mom:

Thyroid supplementation is tricky.

Steps:
1. Determine why you are having trouble with thyroid hormone levels
2. Determine what the course of treatment will be (supplements/full suppression/partial suppression)
3. Determine which thyroid hormone you will use
4. Monitor constantly (with blood tests/temperature/symptoms)

*First*, you must determine WHY you are having trouble with thyroid hormones. Is it auto-immune, is it a failing thyroid, cancer of the thyroid, growing nodules in the thyroid, poor conversion due to bad nutrition, celiac disease which will cause poor nutrient uptake and therefore poor conversion, overall gluten sensitivity which will cause poor conversion, iodine deficiency, etc.

You need to know the state of your body. Have you been so hypo for so long that you have thrashed your adrenals? Are you anemic? Are you lacking in other minerals/vitamins?* If you go on thyroid medication too quickly with any other deficiencies, you will crash and burn.* You could have heart palpitations, etc. In any case, you need to work up slowly on thyroid hormones...small amounts adjusted every 6 weeks or so to keep from overwhelming all the rest of the body. There truly are physical reasons why throwing high doses of thyroid hormone at a person suddenly can cause massive problems. But, that goes beyond the scope of this discussion.

So, supplementation with everything else first or concurrently with your thyroid hormone is necessary to truly be successful. It is a slow process with constant rebalancing as you go.

*Second*, Are you going to go for mere supplementation? Or, are you going for complete shutdown of the gland with full replacement. In cases of cancer and auto-immune, the new idea is to shut down the gland completely with full replacement. It is even written up in Synthroid's product insert as such.
Not that I think Synthroid is the best answer, but if they are saying complete replacement is necessary, then doctors should be listening. However, many doctors don't read the product insert and fail to be notified by the reps when there are changes.

And, I do know there are several theories on this one. Some people go for complete shut down in auto-immune. Others are having great success in treating the auto-immune with iodine and such. I think the people who do poorly on iodine with auto-immune may be suffering from undiagnosed adrenal fatigue. In any case, there are competing theories and you would be best served by researching this thoroughly for yourself. And, it is absolutely necessary to do something about those antibody levels due to the high correlation between thyroid auto-immune antibodies and lymphatic cancer. Just noting that. Don't let any doctor tell you high antibody levels are normal and will eventually burn out your thyroid, but that is to be expected! There are bigger implications.

As an interesting note, there is some evidence to suggest that gluten antibodies attack your thyroid tissues. So, if you are auto-immune to gluten, chances are you have antibodies attacking your thyroid gland as well.


*Third *the question comes to what type of thyroid supplementation:

And an important note: *Do NOT, NOT, NOT, take your thyroid hormone within 4 hours of calcium or iron supplements if you are taking the hormone by swallowing it.* DO NOT!!!!!! These vitamins will bind with the hormone and render it inactive. You could take it all day long and have no effect. This seems to apply more to the actual supplements you swallow than to food products. Here you get into chemistry....so research it if you are curious as to why. Doctors just don't seem to understand this, so I try to shout it from the rooftops!

Porcine/Pharmaceuticals: My preference is porcine. It gives Free T3, Free T4, calcitonin, and small amounts of T2 and T1. One of the advantages of natural thyroid is you can take them sublingually (dissolve them under your tongue). The advantage to this is that you do not have to wait one hour after taking the hormone to eat or drink anything. If you eat or drink too soon, you risk absorbing less of the hormone. Note, if you have been swallowing them, do not switch suddenly to sublingual dosing. You can cause problems due to increased absorption.

Amongst porcine, you have several options:

Armour:
Armour was reformulated several years ago. They changed the filler from a sugar based filler to a cellulose based filler. Somehow this change prevented the uptake of the thyroid for some people. They theorize that the thyroid hormone does not cross the blood brain barrier without the
sugar...but that is only a theory. In any case, for some people (me included) the reformulated Armour caused terrible problems. Here is an updated list of brands of natural thyroid that can replace Armour:
http://www.stopthethyroidmadness.com/armour-vs-other-brands/

Compounded:
So, now there are several compounding pharmacies making a comparable product to Armour. If you find a compounding pharmacy, they typically do not take insurance, but you can submit the receipts to your insurance for reimbursement. *Make sure they are using porcine ingredients*. Many of them
are making synthetic but "bio-identical" hormones. These are NOT natural thyroid and will NOT give you the same hormones as the natural products

Erfa:
Canadian brand of the old Armour thyroid. You can have your doctor write a prescription for thyroid and have it filled by a Canadian pharmacy. They will ship it to you. It is the same as the old Armour thyroid. They purchased the Armour recipe from the company. So, there you go!

Glandulars such as Nutri-med:
Typically these do contain all of the same ingredients as the prescription products. However, since many people do these products without a doctor, you must know to work up slowly and watch temperature/heart/symptoms. Best done with a natural doctor's supervision. You can get into trouble quickly if you don't watch what you are doing. But you can order blood tests on line in most states so you can monitor what is happening to your body. I took an adrenal glandular once and had a problem immediately with my heart. But, I was so out of balance in other areas that I had no business trying that by myself. Everything must balance in all of these equations or you will get yourself into trouble quickly. I don't really think I can emphasize this enough. Caution and care when using these is absolutely necessary. But, I do know many people who utilize this option and do quite well because they make it their full time job to know what is going on. Here is a guide on how to use Nutri-med.


Then we get to Synthetic options:

With synthetic, you have to take this 30-60 minutes before you eat. It REQUIRES stomach acid to break down the bonds between the chemicals in the synthetics (although I do have to ask how people on acid inhibitors break down these bonds...but that is another discussion!)

T4 goes by a number of names, the most popular one being Synthroid. The T3 is Cytomel. I don't prefer these products because they do not have the full range of thyroid hormone. But, some people, although I don't know many, do well on this.....I don't really have much to say on this because I simply believe they could do better on natural...if they were balanced in other areas. My problem is that if you are only getting T4 you must have all other body systems working normally so you are converting from the T4 to other forms of thyroid. If you are not perfectly functioning in other nutrients (and honestly, how many hypo thyroid patients are functioning in other areas
perfectly!!!!) then you will fail to convert properly. Your TSH will show normal, you may even have enough Free T4 in your system, but you may be failing to convert further due to nutrient deficiencies and many doctors will NOT check for this conversion factor. So you will slowly get worse and
worse while having normal blood tests.

Synthetic vs. Natural Thyroid Treatment


This same mom's notes on my plan:
You need to get his ferritin levels up higher. He needs to have ferritin up at 60-80 in order for his body to utilize his hormone levels and convert thyroid form T4 to T3. Low ferritin stores can cause many of the same symptoms as hypothyroid.

Also check Vit D, B12. Both are necessary for proper functioning of hormones...not just thyroid hormones. Typically, a hypo person will have lower than normal Vit D levels which can cause some of the symptoms, especially depression.

Watch for extreme fatigue with his Epsom salt baths. They can cause too rapid detox and really wipe you out. Just back off a bit if that happens.

Watch heart function with T3 that high. (This was when Jett was on the synthetic.) You may be seeing heart palpitations etc. with high T3. There are so many problems with T3 only supplementation. You have to divide the dosage and give it every 3-4 hours because it leaves the body after that time. If you don't, you dose all at once, elevate the T3 too high for those 3-4 hours and then cause the body to crash after the T3 leaves the body. And, because the body's T4 is so low, you don't have enough to use for natural conversion. So, you go through this see saw effect. Not pleasant. Too much energy....too little energy...to much energy...The body really doesn't know what to do with that! If you gave the dosage and then had the blood draw right after that, you may only have elevated T3 levels due to the supplementation. You won't really be seeing what is going on after the T3 has dissipated from his body.

From Q. Fish's book, Down Syndrome What You CAN Do:

Doc Don, Downs, and Hypothyroidism

The Major Handicap

As infants, they begin life with a host of handicaps. Their mothers are usually advanced in age. Indeed, their risk of their illness increases with each passing decade of their mother’s age at conception.

Infancy is difficult as they tend to be less active than healthy newborns, often feed poorly, and growth is usually sluggish. Bowel movements are frequently a problem, and constipation can be so bad that rectal prolapse is not rare.

They lag behind their peers with linear growth being more retarded than their tendency to gain weight. If the diet includes adequate carotene, there might well be a yellow-orange tinge to their thickened, puffy skin. They retain fluids easily, and may have dry and scaly skin.

Mental and physical retardation are the most common outcomes, and parents are frequently frustrated by the difficulty getting health professionals to help. They are prone to frequent illnesses, obesity, hearing problems, and delays in mental, emotional, physical, and sexual development.

The above is pretty much a classic textbook description of Cretinism that is Undiagnosed, Untreated, HYPOTHYROIDISM in childhood. Also, it is very similar to descriptions of Down’s Syndrome (DS). Indeed, these conditions overlap often enough that some investigators feel that Hypothyroidism is not only the cause of many of the problems associated with DS, but that it may indeed be a causative factor in DS. (David Derry, MD, PhD, personal communications)

If an infant is born without a well functioning thyroid gland, the physician has a matter of weeks to figure out what is wrong and fix it. If the doctor misses this Golden Window, that child is condemned to a lifetime of mental and physical retardation; and even good treatment later in life cannot make up for the missed critical time for maturation. The window lengthens as the child matures, but the severity of the consequences is always much greater for the underdeveloped brain than for the adult.

It’s Everywhere And Affects Everything...

Because thyroid hormone activity regulates how many calories each cell is allowed to burn into energy, for its own use; that small, butterfly shaped gland weighing less than an ounce sits in your throat and controls virtually every function in your body. Thyroid disease plays a major (if not the major) role in: conception, fetal development, pregnancy and delivery, ongoing growth and maturation, cardiovascular diseases, stroke, brain development and thinking, skin and hair texture and growth, and any other health concern one could imagine. (You might like to read, “Solved: The Riddle of Illness” by Langer, MD.)

Thyroid Disease Is Common...

Some parts of the Country have always had an abundance of thyroid problems. The Great Lakes Basin has long been called the “Goiter Belt.” (A goiter is an enlarged, probably malfunctioning thyroid gland.) Iodine is critical for adequate thyroid function. The use of fluorides in the water, tooth paste, and plastics, and many drugs has seriously contributed to an increase in thyroid disease by preventing iodine utilization. (And, incidentally, there is NO reasonable evidence that adding this dangerous, toxic industrial waste to drinking water helps teeth.)

The chlorine that is put in water to “purify” it, actually displaces iodine in the diet and prevents adequate uptake, as well. (Incidentally, it reacts with impurities in water to form known carcinogen; and it is not banned in Europe where ozone-activated oxygen does the same job, safer and cheaper.)

Iodine was used in bakery goods as a dough conditioner, and a slice of Wonder Bread (for all of its evils) could easily provide a reasonable supply of dietary iodine to prevent a goiter. But, that is not allowed, and instead, bromine which is another iodine antagonist is now used. (“Iodine: Why You Need it, Why You Can’t Live Without It” by David Brownstein, MD does a great job with the role of iodine in health.)

In addition, many of the chemicals used in plastics and foods prevent adequate thyroid function. For all the problems most people have, DS makes successful adaptation to Hypothyroidism even more difficult. Communication difficulties coupled with low expectations from health care professionals often condemns the DS child to one more unnecessary difficulty.

There Is No Money In Treating Not Thyroid Illness...

If a doctor adequately treats thyroid illness, the patient gets markedly better in a relatively brief period of time and uses cheap medicine. There is no thyroid replacement that is still expensive and on patent, and no well patient will want to come in more that every few months. Your doc is not going to get neat gifts from the thyroid replacement (about 30-50 cents a dose) people that Prozac ($2 to $5 a dose) or Lipitor ($5 or more a dose) people pass out. And, adequate thyroid replacement can solve many depressions and many problems with elevated cholesterol so that people don’t need frequent trips back to the doc.

If you do surgery, it is even more lucrative to not treat thyroid problems. If a women comes in with “Periods from Hell,” (Crampy, clotty, heavy menses that go on for 7-10 days and end with passing “things that look like calf’s liver,” as a patient explained to me.) adequate thyroid replacement usually resolves it. End of story, end of financial gain. However, don’t treat; and she will eventually return begging for a hysterectomy. That is about 4 grand for a morning’s work. You do the math. Coronary Artery disease is far more common in hypothyroid people, and bypass surgery or a stint is even more lucrative than a hysterectomy that could have been avoided with a 50 cent a day pill.

In general, almost all medical problems are more common in hypothyroid people. Heart disease, obesity, cancer, stroke, and infectious diseases all occur much more often in the person with low thyroid function.

Not Much Is Expected From DS Kids...

When I used to do Psychiatry, nothing would anger me quite as much as when another physician would ignore my patients’ valid complaints with a shrug and, “(what do you expect) they’re a Psych patient.”

I feel the same way about doctors who ignore valid complaints of weight gain, constipation, increased infections, decreased alertness, and slowed mental and physical maturation with the rationalization that it’s because “they have Down’s.”

This sin is especially frequent when the DS kid has one of the many sorts of hypothyroidism which cannot be diagnosed by labs alone. I have people come from all over the country because they could not find a doctor smart enough to shut up and listen to the very cogent argument that they made for Hypothyroidism, just because the lab could not do the thinking that the other doctors should have.

Thyroid Labs Or The TSH, Full Speed Ahead...

When this chapter was suggested to me, I think that I was supposed to help parents second guess doctors and other lab jockeys with the numbers that the labs crank out. More important than that is to realize a thyroid condition cannot be diagnosed by labs alone, and there are NO labs that can rule out the presence of a thyroid
problem. Anytime a doctor is looking for a Diagnosis (That’s fancy for “What’s wrong?”), 85% of the information comes from the History (What has been happening to my patient before they came to the office?); about 10% comes from the Examination (How does this person appear to the, hopefully, well trained eye?); and the Labs, in reality, only contribute about 5% to most diagnoses. This formula is the one we are all taught in Medical School, has been the model of Good Medical Care since Hippocrates, and which no reasonable doctor would deny. Yet, all this good sense is totally ignored daily by physicians dealing with thyroid problems.

Normal Means You Are Like Other Sick People...

On the average lab slip, you will see a number which is your value, and next to it a Range which the doctor is supposed to look at to tell if your number is “normal.” Something like this is common on lab slips:

Free T3 2.4 2.4-4.4 pg / mL

Free T4 0.80 0.80-1.80 ng /dL

TSH 4.0 0.4-4.3 mIU / L

In the “Good Old Days,” they would make the doctor look at each number and each range to see if your number was between the little number and the big number. Now they print abnormal values outside the normal column, and to be sure that you don’t screw things up, they will put an “H” or an “L” next to the abnormal value.

Ranges will vary from time to time and from lab to lab. While the above lab work is “Normal,” it is not necessarily healthy. Actually, if this was my lab work, I probably could not walk around the block under my own steam. That “Normal” range represents the middle 95.5 % of the scores of the (sick) people who we send to the lab because we suspect their thyroid is too high or too low. (Technically, “2 Standard Deviations either side of the mean of the scores.”) And if, by some fluke of luck, you are sicker than those other 95.5% of the people, you will lower the average, and it will then become that much harder for the next poor soul who comes along.

“We are People, NOT lab values” Mary Shomon

The next problem is that the lab values do not have anything to do with the state of health of the patient. Those same labs could have come from a living patient or a dead one, and there is no way to tell from the labs. The lab values are merely the lab’s estimate of the amount of various chemicals in the blood. And, those chemicals may, or may not, be related to the health of the patient. There are countless conditions that could allow identical labs
and a range of patients from moribund to relatively healthy.

And Those Estimates Are Not Always Good Ones.

To further muddy the waters, labs do not always do a reasonably good job. When the Centers For Disease Control has sent out standardized laboratory specimens to hospital and commercial laboratories, between 8 and 25% of those tests come back with erroneous results, according to an article in The American Medical News (Langer, op cit).

Turn Around And Look At The Tree!

To pay attention to lab slips, instead of to your patient, is as foolish as looking at the shadow of a tree, instead of looking at the tree. When I was in Medical School, back in the 60’s, if we dared to base treatment solely on a lab slip while ignoring the condition of our patient, we would earn a glare with admonition from staff, “Doctor, around here, we treat patients, not lab slips!” and we would be lucky to pass that rotation. Today, it is done routinely and is called “Standard of Care.” Be advised: your life and the lives of those you love are far more important than any lab slip. If the doctor you hire will not maintain your priority, it is time to look for another doctor.

Labs are NOT a substitute for brains

Labs cannot diagnose anything! The labs only know what is healthy from what is sick because Clinicians have told the lab those things. Hypothyroidism was treated (more adequately) for more than a hundred years before the Clinical Lab was anything more than a place to ‘taste’ urine to detect diabetes. (Diabetes Mellitus means “passing through sweet” referring to the sweet taste of the urine of uncontrolled diabetics.) Physicians, who now think that they can use the lab instead of acumen, are crippling and killing countless patients. But, that keeps patients ill and is good for the Medical-Pharmaceutical complex.

Don’t Believe Any Doctor Blindly, Not Even Me

I advise all my patients to bring someone with them when they go to the doctor, listen carefully, ask lots of questions, and take notes or record the session. Then, learn as much about their problem as they can. Finally, decide what treatment and which doctor they want to work with. Your health is too important to risk on someone who doesn’t listen, understand, respect, and explain. No one can be as interested in your health as you and your loved ones. You would never take your car to a mechanic who insults your intelligence, makes things worse, charges an arm and a leg, and refuses to hear your real complaints. Give your health as much respect!

If You Think Hypothyroidism Is A Problem

Excellent books include: Hypothyroidism: The Unsuspected Illness by Broda Barnes, MD; Solved the Riddle of Illness by Langer, MD; Iodine: Why You Need It, Why You Can’t Live Without It by David Brownstein, MD.

Great web sites include: http://thyroid.about.com Mary Shomon who knows more about thyroid disease than any two Endocrinologists I have met;

www.wilsonssyndrome.com/ A good look at a different kind of Hypothyroidism that is not found with labs.

www.drrind.com/ Dr. Rind has a good understanding of the interaction of thyroid disease and Adrenal Fatigue, a common illness that few doctors find.

www.dmichaelmd.com a chance to look at some interesting materials and an opportunity to share ideas.

A prayer that you and your loved ones get what is needed to get well.

D. Michael, MD, PC
(AKA Doc Don) © 2008


Info about coconut oil & the thyroid:

This link explains about hypothyroidism and coconut oil (and much more): http://www.naturodoc.com/library/nutrition/coconut_oil.htm

This is an excerpt:

General aging, and especially aging of the brain, is increasingly seen as being closely associated with lipid peroxidation.

Several years ago I met an old couple, who were only a few years apart in age, but the wife looked many years younger than her doddering old husband. She was from the Philippines, and she remarked that she always had to cook two meals at the same time, because her husband couldn't adapt to her traditional food. Three times every day, she still prepared her food in coconut oil. Her apparent youth increased my interest in the effects of coconut oil.

In the 1960s, Hartroft and Porta gave an elegant argument for decreasing the ratio of unsaturated oil to saturated oil in the diet (and thus in the tissues). They showed that the "age pigment" is produced in proportion to the ratio of oxidants to antioxidants, multiplied by the ratio of unsaturated oils to saturated oils. More recently, a variety of studies have shown that ultraviolet light induces peroxidation in unsaturated fats, but not saturated fats, and that this occurs in the skin as well as in vitro. Rabbit experiments, and studies of humans, showed that the amount of unsaturated oil in the diet strongly affects the rate at which aged, wrinkled skin develops. The unsaturated fat in the skin is a major target for the aging and carcinogenic effects of ultraviolet light, though not necessarily the only one.

In the 1940s, farmers attempted to use cheap coconut oil for fattening their animals, but they found that it made them lean, active, and hungry. For a few years, an anti-thyroid drug was found to make the livestock get fat while eating less food, but then it was found to be a strong carcinogen, and it also probably produced hypothyroidism in the people who ate the meat.
By the late 1940s, it was found that the same anti-thyroid effect, causing animals to get fat without eating much food, could be achieved by using soy beans and corn as feed.

Later, an animal experiment fed diets that were low or high in total fat, and in different groups the fat was provided by pure coconut oil, or a pure unsaturated oil, or by various mixtures of the two oils. At the end of their lives, the animals' obesity increased directly in proportion to the ratio of unsaturated oil to coconut oil in their diet, and was not related to the total amount of fat they had consumed. That is, animals which ate just a little pure unsaturated oil were fat, and animals which ate a lot of coconut oil were lean.

In the 1930s, animals on a diet lacking the unsaturated fatty acids were found to be "hypermetabolic." Eating a "normal" diet, these animals were malnourished, and their skin condition was said to be caused by a "deficiency of essential fatty acids." But other researchers who were studying vitamin B6 recognized the condition as a deficiency of that vitamin. They were able to cause the condition by feeding a fat-free diet, and to cure the condition by feeding a single B vitamin. The hypermetabolic animals simply needed a better diet than the "normal," fat-fed, cancer-prone animals did.

G. W. Crile and his wife found that the metabolic rate of people in Yucatan, where coconut is a staple food, averaged 25% higher than that of people in the United States. In a hot climate, the adaptive tendency is to have a lower metabolic rate, so it is clear that some factor is more than offsetting this expected effect of high environmental temperatures. The people there are lean, and recently it has been observed that the women there have none of the symptoms we commonly associate with menopause.

By 1950, then, it was established that unsaturated fats suppress the metabolic rate, apparently creating hypothyroidism. Over the next few decades, the exact mechanisms of that metabolic damage were studied. Unsaturated fats damage the mitochondria, partly by suppressing the repiratory enzyme, and partly by causing generalized oxidative damage. The more unsaturated the oils are, the more specifically they suppress tissue response to thyroid hormone, and transport of the hormone on the thyroid transport protein.

Plants evolved a variety of toxins designed to protect themselves from "predators," such as grazing animals. Seeds contain a variety of toxins, that seem to be specific for mammalian enzymes, and the seed oils themselves function to block proteolytic digestive enzymes in the stomach. The thyroid hormone is formed in the gland by the action of a proteolytic enzyme, and the unsaturated oils also inhibit that enzyme. Similar proteolytic enzymes involved in clot removal and phagocytosis appear to be similarly inhibited by these oils.

Just as metabolism is "activated" by consumption of coconut oil, which prevents the inhibiting effect of unsaturated oils, other inhibited processes, such as clot removal and phagocytosis, will probably tend to be restored by continuing use of coconut oil.

Brain tissue is very rich in complex forms of fats. The experiment (around 1978) in which pregnant mice were given diets containing either coconut oil or unsaturated oil showed that brain development was superior in the young mice whose mothers ate coconut oil. Because coconut oil supports thyroid function, and thyroid governs brain development, including myelination, the result might simply reflect the difference between normal and hypothyroid individuals. However, in 1980, experimenters demonstrated that young rats fed milk containing soy oil incorporated the oil directly into their brain cells, and had structurally abnormal brain cells as a result. Lipid peroxidation occurs during seizures, and antioxidants such as vitamin E have some anti-seizure activity. Currently, lipid peroxidation is being found to be involved in the nerve cell degeneration of Alzheimer's disease.

Hypothyroidism is a condition in the body that is caused by a reduction in the levels of the thyroid hormone. The thyroid gland is situated in the neck just below the Adam's apple and it is this gland that produces the thyroid hormone which determines the body's metabolism or the rate at which it burns calories.

Sometimes the thyroid gland may produce a quantity of the thyroid hormone much less than that required by the body to function normally and this results in a slower metabolism which shows physical signs manifesting itself in what most people call the symptoms of hypothyroidism.

Coconut oil acts as a catalyst to the metabolic activities of the body. It not only regulates, but the proper dosage will bring to moderation all the functions necessary to burn energy and consume calories. Coconut oil consumption creates a hormonal balance and raises the stamina and energy and also brings about mood stability.

If coupled with a healthy diet and reduced intake of toxins (such as wheat flour, potatoes, refined sugar and other foods that rate high on the glycemic index) then the results will be immediate and physically noticeable. Not only do the symptoms of hypothyroidism disappear but the body will feel fit and rejuvenated in comparison to the state of lethargy that is generally caused by a low hormonal level.

Coconut oil however should be taken in amounts that are befitting to your age and body structure. Most companies put on their coconut oil packages or cartons, an approximation or a suggestion for dosage and this is indicated with the use of a chart.

From what I've read, a tablespoon a day is sufficient for a child.



Iodine is the treatment of choice for hypo- and hyperthyroid problems-with or without goiter.

Doctors could get as high as a 90% cure rate with hyperthyroid (overactive thyroid) by using what would be considered high doses of iodine daily. doses of six to 37 mgs daily seemed equally effective in resolving cases of hypothyroid (underactive thyroid). These doses, once considered normal, are now considered high by most people in the medical profession.

Whole body iodine sufficiency is also a critical means to counter the side effects of thyroid hormone medications (synthroid, etc.). Long-term use of these drugs is associated with depletion of thyroid and tissue iodine levels, as well as increased rates of cancer. Fluorescent scanning of the thyroid clearly shows how drug and other medical thyroid therapies deplete the gland and body of critical iodine.

Therefore, synthroid or thyroid-destructive therapies should never be taken without iodine therapy-something you will never hear from your endocrinologist. If all thyroidologists and endocrinologists were forced to fluorescence scan their patients' thyroid glands, they would then have to fess up to the damages they are causing to these glands and their patients!

In addition to thyroid therapy, all thyroid patients should be on iodine therapy, with the goal to reach a whole body iodine sufficiency. when this state is reached, the following results (gathered using sophisticated lab testing, fluorescence screening, clinical measurements, and a host of other high-tech medical testing procedures) have been observed:

Goiter is reduced or eliminated.
Stress on the pituitary gland with resultant high TSH readings is eliminated.
Increased excretion of thyroid poisons and heavy metals occurs via the kidneys.
The liver's detoxification mechanisms are enhanced.
Obesity is more easily overcome-in fact, iodine therapy may be a critical and unknown factor in obesity.
Diabetes and high blood pressure are more easily controlled.
Breast tissue normalizes with decreased occurrences of fibrocystic breast disease.
Menopausal symptoms are improved.
Polycystic ovary syndrome can be cured.
Brain function is better, with less brain fog.
Heart function is better, with reduced arrhythmia problems.
Cancer rates, especially of the thyroid and breast, are reduced.

Additionally, through the iodine project studies, Dr. Abraham discovered that even patients with complete thyroidectomy (removal of the whole gland) benefited from iodine therapy. Therefore, it became known that iodine not only improved the thyroid gland, but the other target areas of the body where iodine and thyroid hormone are active.

The doctors in the project found that patients who achieved iodine sufficiency were often able to resolve diabetes problems without insulin. They could normalize blood pressure without medication. goiters were resolved and those taking thyroid hormone medication could greatly reduce or completely eliminate these drugs.

Heart, arrhythmias, fibrillation

As you have read over and over in health alert, there is an epidemic of cardiac arrhythmias and atrial fibrillation in this country. Expert thyroidologists like Dr. Abraham are convinced that the medical iodine phobia has a great deal to do with this phenomenon. Adequate stores of iodine are necessary for a smooth heartbeat.

Amazingly, while medicine shuns iodine therapy, their most popular anti-fibrillation drug, amiodarone, actually is iodine in a toxic, sustained release form. this drug can produce a smooth heartbeat when the body has accumulated about 1.5 grams (1,500 mgs) of iodine. this is exactly the same amount of iodine retained by the human body when iodine sufficiency is achieved by natural iodine supplementation.

The problem with amiodarone is that this form of iodine (which the medical profession has a penchant for) is extremely toxic. the side effects are most often too great for patients to regain a normal heartbeat.

Risk Factors

In addition to Down syndrome, there are a number of risk factors and hypothyroidism symptoms that should be evaluated if observed in infants:

___ The infant drinks soy formula
___ Infant has family members (parents, siblings) with thyroid disease, or any autoimmune disease
___ The infant has a puffy face
___ The infant has a swollen tongue
___ The infant has a hoarse cry
___ The infant has cold extremities
___ The infant has mottled skin
___ The infant has low muscle tone
___ The infant is not eating well
___ The infant has thick course hair that goes low on the forehead
___ The infant has a large soft spot
___ The infant has had prolonged jaundice
___ The infant has a herniated bellybutton
___ The infant is lethargic
___ The infant sleeps most of the time
___ The infant appears tired even when awake
___ The infant has persistent constipation
___ The infant is bloated or full to the touch
___ The infant has had little to no growth

Some hypothyroidism factors that should be evaluated if observed in children include:

___ The child took soy formula as an infant
___ The child has family members (parents, siblings) with thyroid disease or any automimune disease
___ The child is not keeping up with growth charts for height
___ The child has been diagnosed with attention deficit disorder
___ The child is having a delayed puberty
___ The child is unusually fatigued, exhausted, or sleeping far more than usual
___ The child is gaining weight gain inappropriately
___ The child is severely constipated
___ The child is sensitive to cold
___ The child's hair is rough, coarse dry, breaking, brittle
___ The child's hair is falling out more than usual
___ The child's eyebrows or eyelashes are falling out
___ The child's skin is rough, coarse, dry, scaly, itchy and thick
___ The child's voice has become hoarse, husky or gravelly
___ The child is complaining of pains, aches and stiffness in various joints, hands and feet
___ The child seems depressed
___ The child seems restless
___ The child has difficulty concentrating
___ The child seems be losing interest in normal daily activities
___ The child seems more forgetful lately
___ The child complains of strange feelings in neck or throat, or difficulty swallowing
___ The child seems to have some sort of fullness or growth in the neck area
___ The child gets more frequent infections, or infections that last longer
___ The child is snoring more lately
___ The child yawns frequently to get oxygen
___ The child has puffiness and swelling around the eyes and face
___ The child has swollen feet, hands or eyelids

More info
http://einstein-syndrome.com/2009/04/19/15-treat-the-thyroid/


Thyroid Forum
http://forums.about.com/ab-thyroid

Related Posts
L-tyrosine: Building Block for Neurochemicals
Coconut Oil Info and Recipes
Why supplement and monitor zinc?
Celiac Disease & Down Syndrome

9 comments:

Teresita Green said...

It is my professional opinion that natural thyroid products are excellent choices for many thyroid sufferers. Some people do better on these dessicated animal gland medicines than they would ever do on any brand or combination of synthetics.

Andi Durkin said...

That seems to be the consensus among adults. But, the link is to the bovine dessicated thyroid, most people prefer the porcine thyroid unless, for religious reasons, they are avoiding pork.

AndreaN said...

Hi Andi,

Your site has been a great resource for me and my family. We have an 8 month old little girl with Ds. Her name is Hope. She is our 10th baby and we are in love.

We just received her tests back for thyroid and her TSH was 4.551. Of course her pediatrician is not concerned because it falls in the normal range, but after doing quite a bit of reading concerning the importance of thyroid function, I am a little anxious. The only other symptoms that Hope has are occasional constipation. She has an odd looking belly button, but I have no idea if it's herniated.

Hope does not have any other health issues. I would love to hear your recommendations as to how to follow up on this. I want to make sure that I am not missing anything. Thanks for your time and hope to hear from you soon.

Andrea Nelson

Andi Durkin said...

Andrea,
Please email me so I can respond in length. Click "view my complete profile" for my email address.

Andi Durkin said...

My email address is this but with no spaces:
andi andi 222 (at) gmail (dot) com

Holly Mackenzie Cupp said...

Hi I'm so glad that I stumbled on your blog. I was searching for swollen feet in down syndrome because I've noticed my daughter's feet have been swelling lately. I haven't got the results back from her latest labs yet so I guess I'll see if that (dosage change needed) might be the problem tomorrow when I call to find out. She has hypothyroidism. Thanks.

http://hollydollyfashion.blogspot.com

Laurie Kowalski said...

My son is 16 years old and we have been dealing with his thyroid for several years. We went the endocrinologist route and synthroid for many of those years, but now we are seeing a MD who is into natural approaches. He is on a iodine supplement and VitD. I have to add some others as well. My son's behavior and demeanor is great right now, but we haven't gotten the TSH down to a level that the doctor is comfortable with. The next step is Armour or something like it. In my opinion, Synthroid was horrible for my son.

Andrey Tovchigrechko said...

Dear Andi,
Could you please tell - how much mg of Nutri-Meds Thyroid Health have you given to Jett daily, when you started?
We've got today similar lab results for our 11month son, TSH 7.3 while FreeT4, T3 are in normal levels. And, exactly as you experienced, doctors don't have enough experience in that, they suggest levothyroxine. I think we'd like to skip this and go for Nutri-Med. But I am don't know what is the right dose? One capsule is 130mg, it seems a lot.

Andi Durkin said...

Andrey,

Please email me. Go to the right of the screen where it says "complete profile" and under "contact" is my email. You can either click "email" or just scroll over the word "email" and look at the bottom left of your screen and you can see my email address.

Thanks!