Archive | June, 2013

Hidden Cause #11 Why You STILL Have Low Thyroid Symptoms – Low Progesterone

Dr. David Clark, DC- Center for Low Thyroid Solutions Raleigh-Durham-Chapel Hill, NC – explains how low levels of progesterone can cause low thyroid symptoms.

Hidden Cause #11 why you still have low thyroid symptom–even though you’re taking medication and even though your lab tests are “normal”– is:

A progesterone deficiency causing depression of the enzyme thyroid peroxidase (TPO).

Thyroid Peroxidase is an enzyme in your thyroid gland; and it’s one of the enzymes you use to manufacture T4 and T3.  So, if you don’t have good activity of this enzyme, then over time you’re just not going make enough T4 and T3. At some point, you’ll start suffering low thyroid symptoms such as:

  • Fatigue
  • Weight gain
  • Hair loss on the scalp or eyebrow
  • High Cholesterol
  • Infertility
  • Brain Fog
  • Depression
  • Constipation
  • Joint and muscle pain

How does progesterone play into this scenario? Well, normally, progesterone up-regulates TPO function.

Here’s what normally happens ( a bit of physiology, here):

In the second half of the menstrual cycle, when she ovulates, there’s s surge of progesterone. 

  • This surge of progesterone causes an uptick in the activity of TPO so that you make more T4 and T3.
  • This is why a woman has an increase in her body temperature when she ovulates because there’s a surge of progesterone.
  • That progesterone affects TPO in the thyroid gland, and that ultimately increases her metabolic rate and the temperature increases.

What happens when you don’t have enough progesterone? 

Well, when you don’t have enough progesterone, it’s pretty simple…TPO activity goes down and therefore, the amount of T4 and T3 you make goes down.

Here’s the key thing I want you to know about all this:

When a woman doesn’t have enough progesterone, she can have symptoms related to that progesterone deficiency (I’ll explain them in a second)–BUT, the progesterone deficiency may never cause the thyroid lab numbers to look “abnormal.”

This is why a lot of times a women will go to her doctor and be suffeirng low thyroid symptoms such as depression, hair loss, weight gain, high cholesterol, infertility, constipation, brain fog…

The doctor will run some kind of thyroid blood tests (usually woefully insufficient such as only a TSH and T4).  The doctor says, “Looks pretty normal to me.”  And if you have Low progesterone as your hidden cause for your low thyroid symptoms…there’s not much the tests could pick up on lab work. Why?

Because when a woman is not making sufficient progesterone for her needs, it may not necessarily be reflected in an abnormal T4 or T3 or TSH that’s below or above the lab range on blood work.

That’s why low progesterone is definitely a hidden cause because the doctor that you’re working with has to be able to recognize that you’ve got progesterone symptoms AND low thyroid symptoms.

What are the typical low progesterone symptoms? 

Many of these have to do with the menstrual cycle and getting pregnant so here they go:

  • irregular menstrual cycles and periods
  • menstrual cramping.  water retention before your period begins.
  • heavy menstrual bleeding
  • migraines in the second half of the menstrual cycle
  • early miscarriage
  • infertility
  • depression.
  • breast tenderness

If you have three or four of these symptoms…AND… and you’ve also got low thyroid symptoms, then low progesterone affeccting thyroid peroxidase in your thyroid gland could be a HUGE factor for you.

What do you do about this progesterone-thyroid problem? 

The most common cause that I see for low progesterone is a depressed level of luteinizing hormone (LH) in the brain caused by a stress response or a blood sugar problem.

If you want to boil it down, you can have low thyroid symptoms and low progesterone symptoms that are ultimately being caused by unstable blood sugar levels.  Blood sugar levels should be very stead…NOT up and down…peaks and valleys.

That’s a little bit beyond what we want to talk about today, but here’s the takeaway:

Whomever you’re working with…an MD, DC, ND, LAc…whomever… that person needs to be able to recognize if you’ve got low progesterone symptoms AND low thyroid symptoms.

What makes this more complex and difficult for many doctors is the fact that some of these symptoms overlap.

  • Low thyroid hormones (hypothyroidism) is a known cause of Infertility, miscarriage and depression. 
  • Low Progesterone is a known cause of Infertility, miscarriage and depression.

Your doctor must able to ask the right questions…do the right detective work and determine if Low Progestorone is a hidden factor your symptoms.

What do you about low progesterone? What’s the next step?

I’m not a big fan of people taking hormones unless, of course, they absolutely need them.  And I’ve got to tell you that most women that I’ve seen they didn’t need to actually take progesterone in a prescription,  nor progesterone in a supplement.  What they needed to do was work on fixing their blood sugar—and that’s a whole other topic for another day.

If you have progesterone deficiency…or just low, non-optimal levels of progesterone causing a down-regulation of thyroid peroxidase (TPO)…this can cause low levels of thyroid hormones.

So you need to find someone that understands this relationship and knows how to look for both low progesterone AND low thyroid at the same time.

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© 2013 David Clark. All Rights Reserved.Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #10 Why You STILL Have Low Thyroid Symptoms – Antibodies to Your Own T4 & T3

Hidden Cause #10 why you STILL have low thyroid symptoms even you’re labs are “normal,” and even though you’re taking medication is:

An Autoimmune attack on your own T4 and T3 thyroid hormones. 


Now, this situation happens very commonly in people that already have some type of autoimmune condition (like Multiple Sclerosis, Celiac Disease, Rheumatoid Arthritis) and specifically it happens frequently in people that have Hashimoto’s.

So let’s give a little background…

Hashimoto’s is by far the most common cause of low thyroid or hypothyroidism—by far.  It’s an autoimmune condition.

Ironically, a lot of people will get tested for Hashimoto’s—and the test will show positive for Hashimoto’s, but…crazily…

Doctors don’t really do anything about the autoimmune problem other than give you replacement hormones like Synthroid®, Armour® or Cytomel®.

And to be fair, the replacement hormones will help some—but typically what happens over time is you end up feeling the exact same way you did before you were taking the thyroid hormones.

You have

  • constipation
  • depression
  • fatigue
  • hair loss
  • brain fog
  • nfertility symptoms
  • joint pain & muscle pain
  • sleep problems

Those symptoms are STILL with you even though you’re taking the medication the way you’re supposed to. How you react when you take the medication can be a clear sign and indication that you’ve got an attack on T4 and T3.

So here’s what I mean…

So let’s say you have those low thyroid symptoms.  You go to your doctor.  You get diagnosed as hypothyroid—but they don’t test for the Hashimoto’s antibodies–and they give you Synthroid®.

You take Synthroid®  but it doesn’t really do anything for your symptoms. So you read some article on the Internet about “bio-identical” thyroid hormones being superior to synthetic.  The internet information says Nature-Throid® or Armour® is the way to get releif.  You think:

“That sounds logical. Bio-identical is better because it’s natural.  I’m going to try it.”

When you take the Bio-identical thyroid hormones…suddenly you have a huge flare-up of symptoms,  a bad reaction to this bio-identical thyroid hormone that’s supposed to be better than synthetic.

What the heck is going on?

The first thing that’s probably happening, especially if you’re suffering swelling or headaches, pain, is you are attacking your own thyroid hormones.

Armour® and Nature-Throid® are bio-identical, meaning they look a lot like your own T4 and T3 hormones. If you’re already attacking the T4 and T3 that you make — and then you start to take some hormones that looks just like it–it’s just like throwing kerosene on a burning fire.  That’s why you get this sudden flare-up and feel worse.

Why would you be attacking your own T4 and T3? 

It’s usually the result of a progression of autoimmunity.  First, you’ve attacked the inside of your own thyroid gland–and you’re attacking thyroid peroxidase and/or thyroglobulin inside the thyroid gland.

Now, once that happens, the normal tolerance to yourself is broken. It’s gone.  Now your immune system can attack any other tissue, gland or hormone.

And it’s easier and quicker for your immune system to attack what’s in close proximity to the thyroid peroxidase and the thyroid globulin– the T4 and T3 hormones you’re making inside your gland.

This happens to a lot of people that develop undiagnosed Hashimoto’s.  No doctor diagnoses them with Hashimoto’s, and they don’t really find out they’ve got Hashimoto’s (or autoimmunity at all) until… they switch from a synthetic medication to a bio-identical.  That’s one scenario.

Here’s a second scenario that I really hope doesn’t happen to you.

A woman has these low thyroid symptoms.  She’ll get diagnosed hypothyroid.  They don’t test for Hashimoto’s, and she’ll be taking Synthroid or Levothyroxine for awhile.

And then she just decides that she wants to try something  else and see if it works better. Keep in mind.she actually feels “olay” on the synthetic thyroid hormones, but  she wants to see what might work better.

She consults that information wonder the Internet and reads something about Armour® and Nature-Throid® being superior. So she switches from synthetic to bio-identical and suffers this huge flare-up, bad reactiion.

The reason I’m bringing that up is if you’ve already got a medication that’s working for you…you’re feeling really good or, at least not bad, on synthetic medication…don’t switch.

Because if you switch, there’s a 50/50 chance you’re going to  have a really bad reaction.

If you do have a bad reaction to this bio-identical, that’s a sure sign that you’ve got autoimmunity and that you’re attacking your own T4 and T3. And, that before the T4 and T3 attack happened, you were attacking your own Thyroid Peroxidase and Thyroglobulin.

This is a hidden cause because most doctors have no idea what’s going on if you have a bad reaction to Armour® ,or a bad reaction to the Nature-Throid®.  I don’t care if they’re a DC, MD,  ND, whatever.  It confuses them.  They don’t understand why that’s happening.  If you’re having a reaction to that, it’s probably because you just threw some gasoline on the fire.

It’s the same thing as if you were to take iodine if you had Hashimoto’s.  Why is that?  Because iodine stimulates the production of TPO, which is what you’re attacking in Hashimoto’s. So you’re just giving your immune system more things to attack.

I think Quest now offers a T4 and T3 antibody test, but I’ve got to tell you there’s really no point in running that because the ranges are so ridiculously wide that I’ve seen that you’re probably not gonna show up positive for it anyway.

if you have a bad reaction to Armour® or a bad reaction to Nature-Throid® or another bio-identical, you probably have an autoimmune attack on your own T4 and T3 thyroid hormones…and you probably have Hashimoto’s as well.

You need to find a doctor that understands what to do with that Hashimoto’s and autoimmune problem because you are probably going to nned to switch back to synthetic. However — switching is not going to address the autoimmune problem.  That autoimmune fire is still burning, so you’ve got to find somebody that can help you deal with it.

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© 2013 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #9 Why You STILL Have Low Thyroid Symptoms – TSH Receptor Antibodies

Hidden Cause #9 Why you still have low thyroid symptoms is you have anti-TSH receptor antibodies.

That was a mouthful.  Let me say it again.

Hidden Cause #9 why you still have low thyroid symptoms even though your labs are “normal” and even though you take medication…is you have antibodies against the receptors for thyroid-stimulating hormone.

Now, this is semi-technical but I’m going to explain it to you this way:

Normally the pituitary gland sends a signal to your thyroid gland called TSH (Thyroid Stimulating Hormone). The TSH then tells the thyroid gland to make T4 and T3.

Hidden Cause #9 is an autoimmune situation that affects TSH.  The more common autoimmune cause of low thyroid symptoms is, of course, Hashimoto’s, which we’ve talked about.  But you can make antibodies to the little receptors for TSH.

This antibody is often called a thyroid-simulating immunoglobulin.  Typically, people that have antibodies against this TSH receptor are thought of as having Graves’ disease.

Graves’ disease is a hyperthyroid condition. It’s completely different than low thyroid.  So why am I saying this is a hidden cause for low thyroid symptoms?  Because there’s no rule about what these antibodies are going to do to that TSH receptor.

In Graves’ disease, they attach onto the receptor and they stimulate more  TSH and more thyroid hormones causing hyperthyroidism.  But there’s no rule that they’re going to do that every time.

TSH receptor antibodies also show up in people that have Hashimoto’s. 

TSH receptor antibodies can bind to TSH receptor and block it…Meaning it’s like you’re not getting any TSH.  And if you’re not getting any TSH, you’re not going to make any T4 and T3 and you’re going to become hypothyroid.

What kind of symptoms would you have?  You would have the classical hypothyroid symptoms:

  • constipation
  • depression
  • hair loss
  • fatigue
  • brain fog
  • high cholesterol
  • infertility
  • joint pain

Those are all things that you could have if you had TSH receptor antibodies.

Very few doctors check for these antibodies in someone that has LOW thyroid symptoms.  If you ask endocrinologists, GPs, naturopaths, acupuncturists, or even a doctor who understand functional medicine….

…and you ask them “What kind of symptoms would make you want to run TSH receptor antibodies?”  They would not say low thyroid.  What they would say are symptoms like increased heart rate, racing heart, racing pulse, racing thoughts, feeling shaky.  Those are all Graves’ disease symptoms.

Now here’s where it gets really confusing…

A person with Hashimoto’s can swing back and forth between low thyroid symptoms and periodic, temporary hyperthyroid symptoms.

The reason that swing is happening in Hashimoto’s  is because you get a flair up and the immune system attack that’s going on inside your thyroid gland, and it explodes a little segment of your thyroid gland…and dumps active free-state hormones into your blood.

Then you get hyperthyroid symptoms.

TSH receptor antibodies are typically thought of as something that you only check for in Graves’ disease.  And this is why it’s a hidden cause.

Follow what I’m saying….

You could have negative TPO antibodies.  You could have negative TGB antibodies.  But you could have positive TSH receptor antibodies and still be a Hashimoto’s case— And still be low thyroid.

I would be very surprised if you found a doctor in any field who would run that test and interpret it that way.  But that’s just the fact.  That’s what the literature shows.

How common are TSH receptor antibodies in Hashimoto’s?  Not very common but that’s also why it could be hidden.

If you look like you have Hashimoto’s.

If you act like you’ve got Hashimoto’s.

If people think you’ve got Hashimoto’s but they won’t do anything for you because they can’t prove you’ve got Hashimoto’s….then you might need this TSI or TSH receptor antibody test.

If the TSI or TSH Receptor antibodies are positive– and you’re hypothyroid, then you may have Hashimoto’s.  That’s when you have to take quick action.

Because now you’ve got an autoimmune condition.  And there a tone of things that can be done for that.  There’s things you need to avoid like the plague.  You must find someone that can help guide you through that like a detective.  Because there’s a lot of mistakes you can make along the way.

Trust me.  I see people in here every day that make mistakes like taking iodine, taking tyrosine.  These are mistakes until you find out what’s going on with you.

Hidden Cause #9 is TSH receptor antibodies, also called thyroid-stimulating immunoglobulins.  These antibodies can bind or block the receptor and cause you to have hypothyroid symptoms.

15% of Hashimoto’s patients test negative for TPO and TGB.  But some of these same people test positive for TSH receptor antibodies.  The moral of the story is get tested.  And then find someone that knows what to do to help you.

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© 2012 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.