Archive | October, 2013

Hidden Cause #14 Why You Still Have Low Thyroid Symptoms-Leaky Gut Causing Low T3

Hidden Cause #14 why you still have low thyroid symptoms even though you may be taking thyroid medication, and even though your lab tests are normal is…

  A Leaky Gut causing Low T3. 

Normally when I tell this T4/T3 story, I get to a certain part and then I kind of drop off…It’s because I usually don’t talk about the gut connection with T3.

So let me explain how the gut (gastrointestinal tract) affects thyroid hormones.

About 40% of the T4 that your thyroid gland makes gets converted into  Reverse T3 Reverse T3 is biologically inactive.  It doesn’t do anything.

About 20% of T4 gets converted into active T3.

Another 20% of T4 gets converted into T3 sulfate and T3 acetic acid.  This is what we’re interested in today.

Here’s why T3 Sulfate and T3 acetic acid are important:

In your GI tract T3 acetic acid and T3 sulfate can be acted upon by an enzyme called sulfatase.  When this happens, T3 acetic acid and T3 sulfate are converted back into T3.

Cool, huh?

So, out of the total available T3 that you have access to, a big chunk of that – 20% – is dependent on you having a healthy GI tract.

If you have:

  • dysbiosis (bacterial overgrowth, yeast or fungal overgrowth)
  • a leaky gut (intestinal hyperpermeability)
  • any kind of GI inflammation (from infection, food sensitivities etc)

…then you will have trouble making sulfatase. Without enough sulfatase you can’t convert T3 acetic acid and T3 sulfate into T3.

And you can end up with low thyroid symptoms, such as:

  • depression
  • hair loss
  • weight gain on a low calorie diet
  • requiring excessive amount of sleep
  • muscle pain and joint pain
  • brain fog
  • dry skin, dry hair
  • infertility
  • high cholesterol. 

You could suffer any or alll of these low thyroid symptoms  if you do not have a healthy gut.

What makes a healthy gut? 

Think of a healthy gut as a healthy garden.  A garden has lots of vegetables in it but not a lot of weeds…same for your GI tract. The good bacteria that live there, they are your defenses.  They are like your army.  They also help make some of your B vitamins.

And the health of that garden is what allows you to take T3 acetic acid and T3 sulfate and convert them into usable T3.

If you don’t have good GI health because of inflammation, leaky gut, parasitic infection, or food sensitivity…this will decrease sulfatase and your ability to convert T3 acetic acid and T3 sulfate into T3.

The other point I want to make about this is that there’s not a test you can currently do to look at T3 acetic acid and T3 sulfate.

And to be fair, if you had a drop off of 15% to 20% in your total available T3, that decrease might not be enough to change anything that you could measure on your blood work.

So having this problem is a sticky situation because your labs really do look “norma”,l but you don’t feel normal, and truthfully, your thyroid hormones aren’t normal.

How do you know if you have this problem with T3 acetic acid and T3 sulfate? 

If you have low thyroid symptoms and Gastrointestinal symptoms such as:

  • diarrhea
  • constipation
  • cramping
  • bloating 30 minutes or later after you eat
  • abdominal pain
  • stool is malformed
  • stool is greasy or oily

…then there is a probability that this gut-thyroid connection could be an issue for you–it at least needs to be checked out. It may be a hidden cause for your low thyroid symptoms.  It’s  “hidden” because your doctor has really got to dig for it.

How do you find this problem? 

You evaluate the GI tract.  You could certainly run tests for gluten sensitivity. The best current test is Cyrex Labs Array 3 ( I have no financial interest). But… you should save your money and probably just go gluten-free anyway because there’s a good chance you’ll test positive for some kind of gluten sensitivity.

You could also do a leaky gut test (the best one also being from Cyrex Labs–Array 2).

You could also look for yeast/fungal overgrowths, parasitic infections, or bacterial overgrowths.

Your doctor (or you) can pay for all that testing, but your doctor’s still has to know what to do with the results. Spending lots of money on tests is fine as long your doctor knows what to do if the tests are unclear or don’t make textbook sense.

But, you don’t treat a lab test.  What you’re supposed to do is treat the person. 

So, a good doctor should be able to take care of you without relying too heavily on a lab test.

Hidden Cause #14 is poor conversion of T4 into T3 because you have gut inflammation/ a leaky gut that’s causing a problem with the enzyme sulfatase…and that is decreasing your ability to convert T3 acetic acid and T3 sulfate back into usable T3.

It’s kind of a long pathway, I know– but it’s very real because a lot of women have it. And remember, you can have more than one problem at the same. You need to find a doctor who knows to look for 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 #13 Why You STILL Have Low Thyroid Symptoms-Underconversion from Selenium Deficiency & High Cytokines

Hidden Cause #13 why you still have low thyroid symptoms even though you may be taking thyroid medication, and even though your lab tests look “normal” is ..

Underconversion of T4 into T3 caused by a deficiency of co-factors and high levels of cytokines. 

What is “conversion?”

About 97% of what the thyroid gland makes is T4, which is bascally inactive.  T4 must be converted into T3, which IS active.

How does conversion happen? 

An enzyme called 5′-deiodinase performs the “conversion.” Conversion takes place primarily in the liver. Certain important co-factors must be present in order for this enzyme to work correctly.  The #1 co-factor for this conversion is selenium. (You may have heard of selenium).

What are the symptoms of underconversion (low conversion)? 

Typical symptoms are your “classic” low thyroid symptoms:

  • depression
  • hair loss
  • weight gain
  • brain fog
  • dry skin
  • dry hair
  • high cholesterol (may not be from your diet. T3 is is the “co-factor” to convert cholesterol into your hormones).
  • constipation
  • infertility 

What does underconversion/low conversion look like on blood tests?

On lab tests (assuming the doctor is actually ordering these)…you may notice that the Reverse T3 is low.  That’s one little indicator of how much conversion is happening.

But you might also see:

  • Free T4 low
  • Free T3  low
  • Or you may see total T3 levels low

Or you may not see any abnormal lab results.  You may have only the low thyroid symptoms.
What could cause a deficiency in selenium ( or a “need” for selenium)? 

The #1 suspect is malabsorption.

Then you have to ask “Why would someone not be able to absorb selenium?”

First thing you have to consider is insuffficient stomach acid, called hypochlorhydria. Now, not too much stomach acid,  but not enough stomach acid.

If you don’t have enough stomach acid, you can’t demineralize your food.  You can’t suck the minerals out of it, and over time you’ll have depleted selenium levels.  Selenium wont’ be present in sufficient quanitiy to be  a co-factor for 5′-deiodinase to convert T4 into T3.

What would cause low stomach acid?

The first thing you look at is a Helicobacter Pylori bacterial infection.  The best test to check for this, in my opinion,  is a Urea Breath Test.  Hopefully, the doctor you’re working with will know about this issue and also know how to help you eradicate it, if you’ve got it.

Increased levels of cytokines is the second factor that causes  low conversion of T4 into T3, and low thyroid symptoms. 

Cytokines are immune system messengers.  They are part of inflammatory process.

So, if you have gastrointestinal inflammation or arthritic inflammation in a joint…

…or if you have any autoimmune disease like Hashimoto’s, rheumatoid arthritis or multiple sclerosis…you will have a high level of circulating cytokines.

Cytokines block conversion of T4 into T3 by slowing down enzyme 5′-deiodinase enzyme.

This next part is critical for you to understand:

You can have two problems at the same time.

For example, a person can have Hashimoto’s that’s destroying their thyroid gland from the inside out…AND…simultaneously have high levels of cytokines that are blocking the conversion of T4 to T3. 

You can have two problems at once.  There’s no rule that says you can only have Hashimoto’s.  You can also have side effects of Hashimoto’s.

Or the inflammation from another problem such as rheumatoid arthritis, or gluten sensitivity or a leaky gut can be causing the cytokines to be high and slowing down conversion.  A good doctor has to do a inflammation scavenger hunt to track down the possible source of inflammation.

Here’s the take-away:

If you have any of the following, your doctor should be suspecting a conversion problem:

  • low thyroid symptoms
  • low reverse T3 on blood test
  • low T3 or low free T3
  • You were prescribed Cytomel® because you didn’t get better on Synthroid® or levothyroxine. Synthroid® and levo are T4 and must be converted into T3. Taking Cytomel® bypasses the need for conversion…but…does NOT address the underlying problem that cause the converstion problem in the first place.

Underconversion/low conversion can be caused by a selenium deficiency, which makes us look at H. pylori and gut malabsorption….or underconversion can be caused by cytokines blocking the activity of 5′-deiodinase.

Who has high cytokines?  Persons with inflammatory conditions.

What are inflammatory conditions?  Hashimoto’s, rheumatoid arthritis, multiple sclerosis, psoriasis, persons with food sensitivitites.

You’ve got to put on your detective badge and your thinking cap and start looking for these things.

So if you’re still having low thyroid symptoms, this is something that should be considered, so you need to find someone who knows how to look for them and knows what to do if they find them.

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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 #12 Why You STILL Have Low Thyroid Symptoms-TPO co-factor deficiency

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

Hidden Cause #12 why you still have low thyroid symptoms even though you may be taking thyroid medication and even though your lab numbers may look normal is:

A deficiency of co-factors causing decreased activity of thyroid peroxidase (TPO) 

Thyroid peroxidase is the enzyme in your thyroid gland you uses to make T4 and T3.

So, if you don’t have enough activity of TPO, then eventually your aren’t going to make enough T4 and T3….and you’re going to have low thyroid symptoms.

Low thyroid symptoms include:

  • hair loss on the top of the head or the eyebrows
  • depression
  • brain fog
  • constipation
  • high cholesterol
  • joint pain
  • needing excessive sleep in order to function

Thyroid Peroxidase is frequently a cause for low thyroid symptoms because it is attacked in a condition called Hashimoto’s, an autoimmune condition. Hashimoto’s is the MOST COMMON CAUSE of Hypothyroidism.

But we’re not talking about Hashimoto’s today.  We’re talking about a situation that’s a little less common than Hashimoto’s.  The situation today is a deficiency of co-factors.

Co-factors are the vitamins, minerals and hormones that have to be present in the chemical mix in order for TPO to work correctly– and work quickly enough– to manufacture normal amounts of T4 and T3.

What are these important co-factors for normal Thyroid Peroxidase activity?

Let’s start with the minerals .  They include

  • zinc
  • copper
  • magnesium
  • selenium.

Then you have the B vitamins:

  • niacin
  • riboflavin
  • pyridoxine.

What I want you to understand is what groups of people would be at risk for having a deficiency in these co-factors.

Anytime you have a deficiency in minerals, the first 2 things to consider are

  1. poor stomach acid (hypochlorhydria)
  2. poor absorption in the intestines.

What could cause low stomach acid?

A common cause is a stomach infection with Helicobacter Pylori.Your doctor needs to screen your for an H. Pylori bacterial infection. H. Pylori loves to cause decreased stomach acid. I don’t really have time to go beyond that statement except to say that low stomach acid makes it VERY difficult to extract the mineral out of your food.

What could cause the malabsorption?

The most common culprit is gluten sensitivity (I”m talking about celiac and non-celiac gluten sensitivity).  I’ve got plenty of videos on that topic,  so make sure you are being CORRECTLY evaluted for gluten sensitivity — not just for “celiac disease.”

As for a deficiency in the B Vitamins, the first 2 things on the radar are:

  1. Methyl donor deficiency
  2. Reactive hypoglycemia (low blood sugar)

Methyl donors are the B vitamins.

Who’s at risk for low levels of methyl donors? 

  • Women taking birth control pills
  • People that use antacids,
  • People that have H. pylori infections,

These are all people that can have methyl donor problems.

Ultimately,  there’s not enough of methyl donors in the chemical mix to help Thyroid Peroxidase function normally…leading to decreased levels of T4 and T3…causing low thyroid symtpoms.

Reactive Hypoglycemics are on the list because they have a very difficult time holding on to their B vitamins–they lose B Vitamins.  Reactive Hypoglycemics are people that get shaky, lightheaded and irritable in between meals.  They can have a hard time staying asleep at night.  They  “crash” between like 2:00 pm and 5:00 PM.

If you have any of  those symptoms of low blood sugar…

…or you haven’t been checked for H. Pylori, hypochlorhyrdria, gluten sensitivity..

…Then this could be a hidden reason why YOU still have low thyroid symptoms.

Hidden Cause #12 is a deficiency in co-factors, vitamins and minerals, leading to decreased activity of thyroid peroxidase.

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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.