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Hidden Cause #16 Why You STILL Have Low Thyroid Symptoms-Peripheral Serotonin Deficiency

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill Thyroid expert, explains how Serotonin can cause Low Thyroid Symptoms.

Hidden Cause #16 why you STILL have low thyroid symptoms even though you may be taking medication and even though your lab tests look normal is…

 A peripheral deficiency in the neurotransmitter Serotonin. 

When I say ‘peripheral’, I’m trying to contrast that to “central,” meaning inside your nervous system, and peripheral, meaning in the nervous system in the rest of your body. 

You have a ton of serotonin outside of your brain. Your GI tract has a huge amount of serotonin. 

In fact, we like to call the GI tract “the second brain” because it really has more neurotransmitters than your brain. 

What would a serotonin deficiency look like? 

  • Intestinal Pain
  • Constipation
  • Diarrhea
  • Bloating

Essentially, any type of GI symptom could be related to peripheral serotonin deficiency.  I realize that’s not  super-specific but it’s the truth.

As for Central Nervous System symptoms of serotonin deficiency….

Classically, the big symptom is “depression.” But what does “depression” look like? 

….losing interest in things that were previously pleasurable

…being sad or down for no reason

…overwhelmed with ideas, can’t manage them

….feelings of inner range and anger

….feelings of unprovoked anger

Those are really what we mean by depression.

If you’re having a few of the above symptoms plus LOW THYROID SYMPTOMS like the following, then Serotonin needs to be on the radar

  • Fatigue
  • Need to sleep excessively just to function
  • Hair loss & hair thinning
  • Dry Skin
  • Constipation
  • Brain Fog
  • Easily Weight Gain
  • Infertility

How does Serotonin affect thyroid hormones?

Research seems to show that Serotonin affects the rate of conversion of T4 into T3. 

And if you remember, T4 needs to be converted into T3 (the active form). 97% of what your thyroid gland makes is T4—so to get T3, you’ve got to “convert” T4 into T3.

Conversion is influenced by how much serotonin activity is going on in the periphery of your body. 

But as I mentioned earlier, we just don’t see a lot of clear signs of peripheral serotonin deficiency other than those that are related to the gastrointestinal system.  So. we have to look more at someone that has central signs of serotonin deficiency (listed above).

What could cause a Central Serotonin Deficiency? 

Since Serotonin is made from the amino acid, L-Tryptophan, you could get into trouble if you weren’t getting enough L-Tryptophan, or absorbing it…

…however, that’s usually NOT the issue.

More often the real problem is LOW Serotonin Activity–in other words, you might be able to make it just fine, but you are NOT making it regularly or consistently…or…your Serotonin RECEPTORS are not responding normally to Serotonin.

Blood sugar regulation and Iron levels are the two critical factors that create Low Serotonin Activity.

If you have low Serotonin symptoms, that doesn’t necessarily mean you need to take L-tryptophan or that you need to take SSRI. 

It DOES mean that the doctor you’re working with has got to put on the detective hat and  figure out what is YOUR problem with Serotonin? 

…Making it (synthesis)

…Using it (receptors)

or both?

This takes some digging.

Im the big picture of Thyroid this hidden cause is pretty darn hidden because it’s  #16 on the list.   Over the last 12 years I haven’t seen that many low thyroid patients with this Serotonin problem–especially compared to the number of women with Hashimoto’s–but they still show up. 

I’ll see a woman who’s been taking thyroid medication because she’s got low thyroid symptoms AND she’s got these serotonin symptoms.

Now, you can guess what happens when she walks into most doctors’ offices.   

She looks depressed. Sounds depressed. So, she gets labeled with “depression.” And is prescribed an anti-depressant–which will not change her thyroid symptoms in the long run.

This is problematic for 2 reasons:

1. If you felt bad for months or years, you might be depressed BECAUSE of that–not the other way around. anyway.

2. A patient can have more than one thing wrong.  This is something that’s very hard to get doctors to understand—doctors of all kinds–that there’s no rule that says a patient can have only one thing.  

You’ll have to look far and wide to find a Doctor that would connect low thyroid symptoms AND low serotonin symptoms to a problem with peripheral Serotonin deficiency.

But the big point is, look, if you’ve got these serotonin symptoms and you feel sad and depressed when there’s no reason for it and you’ve got these low thyroid symptoms, you might need to investigate whether serotonin is an issue for you or not. 

So you’ve got to find someone that would know what to look for and how to help you.  And how to help you is not immediately running out to GNC and buying L-tryptophan.  That’s not necessarily what you need to do.

It’s more complicated than that, and your doctor that you see should know that.

© 2014 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.

Hashimoto’s Autoimmune Thyroiditis and Vitamin D Deficiency

Dr. David Clark, DC — Raleigh-Durham-Chapel Hill, NC– helps you understand the critical connection between Vitamin D Deficiency and Hashimoto’s autoimmune hypothyroidism.

I’m going to explain why Vitamin D deficiency is connected to Hashimoto’s hypothyroidism.

Vitamin D is a critical regulator of your immune system and research has already established that Vitamin D deficiency is highly associated with other autoimmune diseases like Multiple Sclerosis and Type I Diabetes.

And Vitamin D deficiency IS associated with Hashimoto’s hypothyroidism–another autoimmune condition.

What is Hashimoto’s? 

Hashimoto’s is an autoimmune attack on the inside of your thyroid gland.  Over time, your immune system destroys the inside of your thyroid gland—so much, that you can’t make enough thyroid hormones and you suffer low thyroid symptoms.

What low thyroid symptoms does Hashimoto’s hypothyroidism cause? 

Here’s a short list:

  • weight gain
  • constipation
  • hair loss
  • brain fog
  • a need to sleep excessively in order to function
  • high cholesterol
  • infertility
  • joint pain.

Last year a great scientific study looked specifically at Hashimoto’s patients and Vitamin D.
 

The researchers took 161 confirmed Hashimoto’s patients (meaning these people had positive TPO antibodies and/or positive TGB antibodies) and measured their Vitamin D levels. 

The results of their study are downright scary.

92% of the Hashimoto’s patients had Vitamin D deficiency. 

This study defined Vitamin D deficiency as less then 30 ng/dl.

148 out of 161 had Vitamin D deficiency.  Crazy, right?

It gets worse. 

They even broke down the results into three categories of Hashimoto’s patients:

  • Overt Hypothyroidism
  • Subclinical Hypothyroidism
  • Euthyroid

Let me explain what those mean. 

Overt Hypothyroidism Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their TSH is high
  3. The person has low thyroid symptoms (I see these every day).

Subclinical Hypothyroidism Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their TSH is high
  3. The person does NOT have low thyroid symptoms ( I don’t see many of these).

Euthyroid Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their thyroid lab test numbers are “normal.” (I see quite a few of these people in my practice).

Now here’s how they broke it down.

94% of Overt Hypothyroid Hashimoto’s patients had Vitamin D deficiency. 

98% of Subclinical Hypothyroid Hashimoto’s patients had Vitamin D deficiency.

86% of Euthyroid Hashimoto’s pateints had Vitamin D deficiency. 

(The researchers say that it’s not statistically significant in the euthyroid group.  But I’m telling you it is clinically, practically significant.)

Look at those numbers again….see how many of those Hashimoto’s patients had Vitamin D deficiency? Huge.

We know for sure that Vitamin D has something to do with Hashimoto’s. But what exactly does Vitamin D do?

Here’s the short answer… 

Vitamin D is a critical regulator of your immune system. 

Without Vitamin D your immune system can become over-exuberant. Without Vitamin D your immune system easily  can become unbalanced.  Vitamin D deficieny can lead to an expression of an autoimmune attack on a tissue.

So for example in Hashimoto’s….

if you carry the gene for Hashimoto’s and you become Vitamin D deficient your gene can turn on and you can start expressing it and start attacking your thyroid.  Over time you become low thyroid and you develop low thyroid symptoms.

And then…you go see a doctor who probably doesn’t test you to see if you’ve got Hashimoto’s (Medical doctors have nothing to offer but replacement hormones anyway).   They just put you on Synthroid® or Armour®

…but in the long run you end up not feeling much different because the replacement hormones just don’t do much for the underlying autoimmune process.

Sadly, this is exactly what usually happens to a woman with Hashimoto’s. 

Does this mean that you should buy Vitamin D and start supplementing? 

No, it doesn’t. 

Because even though Vitamin D is relatively harmless, you don’t know how much you need.  Plus, there’s a complex situation in which if you take the wrong dosage of Vitamin D— read carefully— if you take the wrong dosage of Vitamin D you can actually make yourself worse. 

Taking the wrong dose of Vitamin D can make you have MORE low thyroid symptoms—even if you really are Vitamin D Deficient.

That scenario nvolves something called 1, 25-dihydroxy vitamin D, and is a little bit beyond what I want to explain here. 

The takeaway message….

Even though there’s a 90% chance that you’re Vitamin D deficient if you have Hashimoto’s— this doesn’t mean you should go out and start supplementing Vitamin D. 

You need to find someone who understands exactly what I’ve been telling you about, someone that understands there’s other things to look at… and that Vitamin D, even though it’s important, is not the magic bullet.

In my practice we see a lot of people that need Vitamin D but some people need more or less than others–and many times it’s the difference between the person feeling good or feeling worse.  A small number people can’t take Vitamin D at all—even though they’re defiicient.

Find someone that knows what to do, because Vitamin D deficiency and  Hashimoto’s  are almost the same thing.

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© 2014 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.

The Link Between Hashimoto’s Autoimmune Thyroid and Chronic Urticaria

Dr. David Clark, DC – Raleigh-Durham, Chapel Hill, NC- explains why chronic idiopathic urticaria, a skin condition, is forever linked with Hashimoto’s autoimmune hypothyroidism.

Let’s talk about the connection between chronic urticaria and Hashimoto’s autoimmune hypothyroidism. 

Chronic idiopathic urticaria is a condition in which you get itchy wheels on your skin that can vary in size and number.

“Chronic” means that the condition has been going on for a quite a while, versus just a day or two.

“Idiopathic” means that the cause is unknown (or at least not known yet).

Urticaria can be caused by food allergies or medications–but Chronic Idiopathic Urticaria appears NOT to be related to those mechanisms.

Chronic Idiopathic Urticaria (CIU) can be brought on by exercise or stress–and as we’ll see in just a minute, Hashimoto’s autoimmune hypothyroidism.

About 30 years ago there was the first research to see the connection between CIU and autoimmune thyroid disease.  Now, a study released in 2011 picked up that topic again.

What is the connection between Chronic Idiopathic Urticaria and Hashimoto’s? 

The research shows that anywhere between 45% to 55% of people with Chronic Idopathic Urticaria ALREADY have an autoimmune condition...they are making antibodies to IgE (immunoglobulin E) or the IgE receptor. IgE is a part of your immune system.

So, in many CIU patients, their immune system is attacking a part of their immune system! 

If you’re making antibodies to a piece of yourself and you’re attacking it—that is autoimmunity. 

Interestingly, the authors of this 2011 paper didn’t really understand how there could be a connection between CIU and autoimmune thyroid. But, one of the researchers they quote described thyroid autoimmunity and CIU as “parallel autoimmune events.” (I love that description).

In other words, Hashimoto’s and Chronic Idiopathic Urticaria are both autoimmune conditions that can happen at the same time.

I look at that like this…

If you’ve already broken the tolerance to yourself, then you can start attacking anything. 

And if you’ve already developed a situation in which you’re attacking your thyroid… Hashimoto’s, which causes low thyroid symptoms such as depression, constipation, weight gain, hair loss and brain fog…

…if you’ve already got Hashimoto’s it’s not that big of a leap to think that you could develop something like chronic urticaria because it’s another autoimmune condition.

Likewise, if you first develop the skin problem of Chronic Idiopathic Urticaria, and then develop low thyroid symptoms you most likely have Hashimoto’s as an autoimmune cause for your hypothyroidism. 

FYI — Hashimoto’s is the most common cause of hypothyroidism in the U.S.

The 2011 study found that 25% of chronic idiopathic urticaria patients had positive antibodies for Hashimoto’s – 25%!

That is significant. 

I wanted to share this with you because many times a woman will have symptoms and not realize that they’re crucial clues about what’s really causing their problems.

If you’ve ever been diagnosed with chronic idiopathic urticaria and you’ve now developed low thyroid symptoms, there’s a good chance you have Hashimoto’s. 

Likewise, if you’ve already got Hashimoto’s and you develop these short-lasting or even long-lasting itchy wheals that come and go–now you understand they likely are another symptom of your autoimmune condition.

These may be a sign that your autoimmune condition has expanded a little bit into another tissue—not a good sign.  We don’t want the autoimmune process to do that. 

You need to find someone that can help you deal with the total package. Unfortunately, taking Synthroid® or Cytomel® or Armour®or NatureThroid® for Hashimoto’s doesn’t do much to stop the raging fire of he autoimmune condition.

The same thing goes for the urticaria…

You can take steroids for it but that doesn’t really solve the problem, right?  It just temporarily suppresses your immune system.  

Chronic urticaria and Hashimoto’s…”parallel autoimmune events.”

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© 2014 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.

Woman with Hashimoto’s, Celiac & Pernicious Anemia Is 80% Better-Daily Energy, Clear Mind

The odds were stacked against Lisa.

She has 3 autoimmune conditions:

  • Hashimoto’s
  • Celiac Disease
  • Pernicious Anemia.

If that wasnt bad enough, she has the MTHFR mutation and genetic Hemochromatosis. She suffered muddy thinking, no energy and bloating.

Hear how she beat the odds with our protocol.

© 2014 David Clark

Relief for PhD Candidate with Hashimoto’s Brain Fog and Fatigue

Natalia suffered with Hashimoto’s hypothyroid brain fog and fatigue even though she was taking thyroid hormone medication. Her symptoms were so bad she couldn’t write her doctoral dissertation, couldn’t deal with her children.—And, in her words “I felt so Inert.”

After only 30 days of treatment, her foggy brain disappeared, and then her energy improved and she felt like her old, active self. After 120 days, she says she’s 80% improved.

Natalia summed up her experience so far with this statement:
“Don’t believe the doctor who tells you that there’s nothing you can do for Hashimoto’s, because that’s NOT true.”

Many women with Hashimoto’s, like Natalia, STILL suffer these low thyroid symptoms even though they take medications like Synthroid®, Armour® and Cytomel®…and even though their lab results are “normal.”

  • Hair loss
  • constipation
  • weight gain
  • infertility
  • sleep problems
  • depression

 

Hidden Cause #15 Why You STILL Have Low Thyroid Symptoms-Low Conversion Caused by High Cortisol

Dr. David Clark, DC- Raleigh-Durham-Chapel Hill, NC Natural Thyroid doctor- explains how high levels of the stress hormone cortisol can cause low thyroid symptoms.

Hidden Cause #15 why you STILL have low thyroid symptoms even though you may be taking thyroid medication, and even though your lab tests look normal is…

Low conversion of T4 into T3 caused by high levels of cortisol.

Here’s what I mean: 

97% of what your thyroid gland makes is T4.  T4 is basically inactive.  It doesn’t do much.  It must be chemically converted into T3–the “active” hormone. 

Conversion happens primarily in the liver due to the action of the enzyme called 5′-deiodinase. 

Simply stated…

Elevated levels of the stress hormone cortisol shut down this enzyme that is necessary for normal converstion.  When cortisol slows down conversion, you produce less T3 than normal…and with abnornal low levels ot T3 you can suffer low thyroid symptoms like these:

  • brain fog
  • fatigue
  • depression
  • constipation
  • dry skin and dry hair
  • hair loss on the scalp
  • thinning eyebrows
  • a need to sleep 10 or more hours just to function
  • weight gain even though you eat low calorie and exercise
  • trouble losing weight

Those are the things that happen when cortisol is too high and you don’t make enough T3. 

What is cortisol? and why would it be too high? 

Your adrenal glands make the hormone cortisol. If you spend just a little time searching the internet you’ll see that people try to paint cortisol as “evil.” But cortisol just does what you tell it to do. Cortisol is necessary for normal, healthy function. The problem is when there is too much or too little cortisol.

It’s kind of like cholesterol.  There is no “bad” cholesterol.  Cholesterol just does what your body is telling it to do.

What causes high cortisol?

High cortisol is typically caused by

  1. Psychological Stress
  2. Inflammation

Let’s talk about the psychological stress response….

A person under a lot stress typically has high cortisol levels–at least in the short term. And who has stress? Everyone.

When the stress is CHRONIC — happening day in and day out–that’s a big problem.

When the stress lasts a short time, but is HUGE–that’s a big problem.  In either situation, cortisol can shut down the enzyme causing low thyroid symptoms.

Inflammation also causes high cortisol.So, anything that is inflammatory…that inflames…that causes the immune system to respond…can cause the release of cortisol.

What causes inflammation?

It’s a along list…here’s s a few:

  • Infections–viral, fungal, parasite, bacterial (some of these infections are hidden)
  • Autoimmune disease such as Hashimoto’s, Vitiligo, RA, Multiple Sclerosis
  • Food sensitivities – gluten, milk, celiac etc

Those are all things that could cause elevated cortisol And elevated cortisol will shut down the conversion of T4 to T3 and produces those low thyroid symptoms.

So what do you do about this cortisol problem? 

That depends on what is actually going on in your case. 

The first thing I can tell you – and this is something that would be good for everybody – is that if you know you have a lot of psychological stress, you may not be able to change what stresses you, but you can change how your body responds to it. 

I recommend you learn how to do the  Relaxation Response.

This was first discovered and refined by a Harvard medical doctor named Herbert Bensen.  (You can look him up).  It’s a very simple, semi-meditative technique…kind of like doing a mental flush.  It’s very effective.  Research has shown the Relaxation Response lowers blood pressure 20 to 30 points in people with high blood pressure– without using medication. It’s something you can learn how to do yourself.

As far as ferreting out where inflammation is…that’s up to a good doctor who’s knows what to look for…how best to look for it, and what to do when he/she finds it.

So remember that list from earlier…

  • Infections–viral, fungal, parasite, bacterial (some of these infections are hidden)
  • Autoimmune disease such as Hashimoto’s, Vitiligo, RA, Multiple Sclerosis
  • Food sensitivities – gluten, milk, celiac etc

Your doctor MUST able to look for all of these. (and know what to do when he/she finds them).

Hidden Cause #15 is when you have low conversion of T4 into T3 caused by high levels of cortisol. High levels of cortisol are typically caused by stress and caused by inflammatory events.

Oh, and don’t forget to look up how to do that Relaxation Response.

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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 #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.