Category Archives for "Newly Diagnosed Low Thyroid"

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.

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.



Hidden Cause #8 Why You STILL Have Low Thyroid Symptoms

Dr. David Clark, DC -Durham, NC-explains why anti-thyroglobulin antibodies are a hidden cause why you STILL have low thyroid symptoms.

Hidden Cause #8 why you still have low thyroid systems is kind of a cheat.  You’ve probably heard me talk about Hashimoto’s thyroiditis before.  And this hidden cause is related to that. 

Hidden Cause #8 is antithyroglobulin antibodies—you’ve got Hashimoto’s and it’s attacking your thyroglobulin inside your thyroid gland. 

Why are anti-thyroglobulin antibodies a hidden cause of low thyroid symptoms? 

Well, it really shouldn’t be “hidden” because Hashimoto’s is the most common cause of hypothyroidism, bar none.  It’s not iodine deficiency.  It’s not tyrosine deficiency.  It’s an autoimmune condition.  Genes have been turned on that are causing your immune system to target and attack the inside of your thyroid gland. 

What is Thyroglobulin? 

Thyroglobulin is inside your thyroid gland. You use to make thyroid hormones–T4 and T3.  If your immune system is attacking and destroying thyroglobulin, then your ability to make thyroid hormones over time decreases. 

Evenutally you suffer low thyroid symptoms such as:

  • fatigue
  • depression
  • inability to lose weight
  • gaining weight on low calorie diet, or even though  you exercise like crazy
  • dry hair, dry skin
  • infertility
  • high cholesterol.

Because you just can’t make thyroid hormones very well without enough thyroglobulin, you’ll start to develop those low thyroid symptoms at some point. 

On lab testing, your  TSH (thyroid stimulating hormone) levels may go up…. and your doctor may identify the elevated TSH ….and may diagnose you as hypothyroid.  He/she will probably start you on Synthroid® or Armour® or something similar. 

Here’s a problem, though….

If you’ve got Hashimoto’s—and you’ve got the thyroglobulin antibodies—but the doctor doesn’t test for them….then you’re probably not going to feel very different, even if you’re taking the medication.

The replacement hormones don’t do much for the autoimmune attack on thyroglobulin.

This is a hidden cause because most doctors just don’t look for it. 

Why don’t doctors test for anti-thyroglobulin antibodies? 

Because, frankly, they wouldn’t treat you any differently if they found out you had it.  This is the difference between the traditional medical approach and a more functional approach. 

The standard, in-the-box medical approach says it doesn’t matter that you have an autoimmune condition…. It’s good enough to give you thyroid hormones and hope you feel better.

That doesn’t mean your doctor’s trying to make you feel bad. It’s just the limitation of their training. They don’t know that there ARE other things you can do for it.

What should you be doing about Anti-thyroglobulin antibodies? 

If you’ve been diagnosed hypothyroid – I don’t care how long you’ve been diagnosed – and you’ve never had a thyroglobulin antibody test or a TPO antibody test, you need to get those done.

If you’ve got Hashimoto’s you’ve got to jump into action right now. Here’s why….

You must understand that once you’ve got one autoimmune condition (like Hashimoto’s) it’s really easy to get
another autoimmune condition. It’s easy to start attacking more tissues, causing more problems, causing more symptoms.

The other important thing you have to understand about thyroglobulin antibodies is the connection to Mercury toxicity.

A great study recently showed that having only high Anti- Thyroglobulin antibodies–not TPO
antibodies– is associated with high mercury levels.

Hidden Cause #8 is hidden because most doctors don’t look for it.

It’s not hidden to you anymore because now you know it’s something that could be causing all these low thyroid symptoms that you still have…

…Even though you may be taking medication.

…Even though your other lab tests look normal.

Most doctors typically don’t run a full thyroid panel, which includes Anti-thyroglobulin antibodies, because in
their mind they don’t need to because they really only have one tool to offer you: replacement hormones like
Synthroid® or Armour®.

But if you have Hashimoto’s, the replacement hormones aren’t very helpful in the long run.

Sure, you can enjoy a “hormone honeymoon” where you feel good for a few weeks or few months. Over
time, your dosage keeps changing but you still feel bad.

I just wish that doctors would check for these things. I wish more doctors knew that there was something you can do for Hashimoto’s on top of giving thyroid hormones:

  • Changing diet  
  • Make sure the GI tract is healthy–not leaky
  • Decreasing inflammation and cytokine levels
  • Improving Brain function

You have to be an advocate for yourself.

You have some powerful information now, so go find someone to get you tested.

And find someone who’ll know what to do if you show up abnormal. Okay?

That’s the second half of the battle; finding someone that knows what to do with Hashimoto’s.

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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.

Hidden Cause #7 Why You STILL Have Low Thyroid Symptoms

Dr. David Clark, DC – Durham, NC – explains why Hashimoto’s is an overlooked and ignored cause of chronic low thyroid symptoms in women whose labs may look “normal.”

Hidden cause #7 why you still have low thyroid symptoms even though your lab tests are normal–and even though you’re taking medication—is…

You have Hashimoto’s and your immune system is attacking thyroid peroxidase. 

Now, I’m sort of cheating on this one because Hashimoto’s is the most common cause of
hypothyroidism.  So, maybe it’s really not “hidden” per se but it could be hidden to your doctor. 

I have found that lot of the women that I see in my office, they’ve never been tested for Hashimoto’s.  They’ve probably had Hashimoto’s undetected for 15, 20 years and its been sabotaging their life,–ruining their life–making them feel crummy.  And they’ve never been tested for it.  And that’s why I’m calling it “hidden.”

What is TPO?

TPO stands for thyroid peroxidase.  It’s an enzyme inside your thyroid gland that you use to make thyroid hormones, T4 and T3. 

So, let me give you the thyroid story, the background science….

Your pituitary gland sends a signal to your thyroid gland called TSH, thyroid stimulating hormone.  And I’m sure you’ve had this tested before.  The TSH then tells the thyroid gland to make T4 and T3.  About 97% of what your thyroid gland makes is T4–T4 is inactive.  It doesn’t do anything.  It’s got to be converted by your body into T3.  Thyroid peroxidase is what you must have in order to make T4.  

In Hashimoto’s your immune system is mistakenly attacking and killing your thyroid peroxidase.  Over time, if you kill enough of the thyroid peroxidase, it slows down your thyroid gland–like a factory with no workers. 

Slowly, your levels of T4 drop lower… and lower…. and lower….

And you start to feel bad and have low thyroid symptoms. 

Just to note—you can feel bad anytime during that slow decrease, not just at the end.

TPO Antibodies are a hidden cause because a lot of doctors don’t check for it.

They just think:

“You’re hypothyroid. Your TSH is high.  Your T4 is low.  I’ll just give you some Synthroid® or Armour®.  And I’ll see you back in six months.  Hope you do okay. “

The problem with the approach is: you might have Hashimoto’s…and it might have been detected if the doctor had actually ran the TPO antibody test.

In Hashimoto’s, taking thyroid hormones doesn’t do much for this autoimmune attack.

There can be a “hormone honeymoon” where you feel pretty good for a couple weeks or a month.  (I’ve seen this a thousand times.

But over time, you have to increase your dosage to feel good (or just NOT bad). 

Or even at the same dosage, after awhile you just don’t feel good.  You still have these low thyroid

  • depression
  • constipation
  • dry hair
  • hair loss
  • fatigue
  • brain fog
  • high cholesterol
  • can’t get enough sleep
  • infertility. 

You STILL have these awful symptoms even though you’re taking medication.

Hidden cause #7 is when you’re attacking TPO. 

Now,  what can be for Hashimoto’s? 

First, let’s ask this question: Why would this happen?

For a couple of reasons. 

Hashimoto’s is a genetic condition that can be turned on at a couple of different times in a woman’s life…primarily:

  • perimenopause
  • pregnancy
  • puberty. 

Other factors can trigger (turn on) Hashimoto’s….

….If you have a bad illness. 

….If you have a car wreck. 

….If you go through a stressful divorce or
some other psychological stressor. 

Those are all things that can turn these genes on and—pow!—now you’ve got Hashimoto’s. 

The reason this is hidden—and I’m going to stress this for the fourth time—is because doctors don’t look for Hashimoto’s. 

Because for them, from the medical approach, it doesn’t matter if you’ve got Hashimoto’s because all they’re going to do is give you the same hormones.  They’re not going to do anything specific for that autoimmune problem. 

Ignoring Hashimoto’s can be dangerous.

Having Hashimoto’s–an autoimmune problem– predisposes you to developing another autoimmune condition.
Another attack on more and different tissues.

Having one autoimmune condition makes it easier for you to developing an attack on, for example, your pancreas or your stomach.  Expanding autoimmune attacks can cause of web of symptoms that really
make your life terrible–as if having low thyroid symptoms wasn’t bad enough. 

So, what should you do? 

    1. If you’ve got any type of low thyroid symptoms or you’ve already been diagnosed hypothyroid and you’re still not feeling good, you need to get tested to see if you’ve got Hashimoto’s.  
    2. And then you need to find someone who knows what to do about Hashimoto’s.  

Find someone who understands the “functional approach” to autoimmunity—who understands what autoimmunity means…what are all the factors make it worse…what makes it better. What foods, herbs etc should you avoid like the plague.  What you should  take.

There are a lot of things that you can do to help you feel better–Even while you’re taking medication.

Hidden cause #7.  It’s anti-TPO antibodies. 

You’ve got Hashimoto’s.  And it’s hidden because most doctors don’t look for it. 

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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.


Are Iodine Supplements Safe for Low Thyroid?

Dr. David Clark, DC – Center for Low Thyroid Solutions Durham, NC – educates women with low thyroid on the potential dangers of iodine supplements.

Are iodine supplements safe for low thyroid?  Listen very closely to what I’m about to tell you.

Iodine is important for thyroid hormone metabolism.  You must have iodine to make T4 and T3.  T4 (inactive) is converted into T3, the active form of thyroid hormone.

There is one….ONE kind of hypothyroidism in which iodine works very well…

…and that’s called Primary Hypothyroidism. (There are about 24 different ways that thyroid hormone chemistry can go wrong).

In Primary Hypothyroidism, the thyroid gland is not excreting and not manufacturing sufficient T4.  This is the type of hypothyroidism that responds very well to drugs such as Synthroid®, Levothyroxine®, and Armour®.

But—Primary Hypothyroidism not the most common cause of hypothyroid.  The most common cause of hypothyroid in America (and the world),  is called Hashimoto’s Autoimmune Thyroiditis.

In Hashimoto’s, your immune system is attacking and trying to kill your thyroid gland. Specifically, your immune system targets:

1. Thyroid Peroxidase (TPO) -an enzyme used to make T4 and T3.

2. Thyroglobulin (TGB) -a protein used to make T4 and T3.

Here’s where we talk about two issues with Iodine…

Issue #1 with Iodine:

Iodine stimulates the manufacture of TPO inside the thyroid gland. If you are already attacking TPO (have Hashimoto’s) then increasing levels of TPO is like throwing wood on the fire.

Issue #2 with Iodine:

If you don’t have Hashimoto’s, taking Iodine can cause Hashimoto’s autoimmune thyroiditis. Iodine triggers Hashimoto’s.  This is without a doubt, there’s no question.  There’s a ton of research studies on this topic that prove that iodine is a trigger for Hashimoto’s.

How do they know?  In many countries around the world they’ve given people prophylactic iodine, meaning, “Hey, we think our citizens in this area don’t have enough iodine in their blood.  Their TSH levels look weird, they have goiters.  Let’s give them all iodine and correct that.”

In almost 100% of the cases, when they give iodine,  they also cause Hashimoto’s in all of those people.

That is a horrible thing to do to someone because once you have one autoimmune attack, the chances are you’re going get another one.  In Hashimoto’s, the autoimmune attack  can move very quickly into the parietal cells of the stomach, casing pernicious anemia….into the pancreas causing blood sugar problem…and intp the cerebellum, causing dizziness, vertigo, balance problems.

So please read this next part very closely…

There’s thousands of people on Yahoo! Groups and chat groups saying, “I’ve treated my hypothyroidism with iodine, therefore iodine is good for low thyroid symptoms.”

No, Iodine is not.  You must to get tested first to make sure you do not have Hashimoto’s. A very simple test to do.  You get what’s called a TPO antibody test and you get a TGB antibody test.

If either one or both of those antibody tests come back positive, DO NOT TAKE IODINE.  It’s very simple.

When a person has Hashimoto’s and they take iodine, their symptoms get worse. I’ve lost count how many times I’ve read this in a patient’s history.

I get called a murderer and all kinds of whacko things when I talk about iodine, but it’s true.

I’m not telling you that iodine doesn’t work on some people because clearly, it does.  It works on those people that have Primary Hypothyroidism, but that’s not the most common kind of Hypothyroidism.

Do yourself a favor and be safe.  If you’ve got classic low thyroid symptoms like

  • fatigue
  • unexplained weight gain
  • constipation
  • dry skin, brittle nails
  • sluggish mental speed
  • brain fog
  • infertility.

Don’t try to supplement yourself, which is the same as medicating yourself.  Find someone that understands these things I’m talking about.  Find someone who understands a functional perspective, a functional way of looking at hypothyroidism.  Hopefully will be a good detective and will find out what is actually causing those low thyroid symptoms (because maybe they’re not even low thyroid symptoms.  They might be adrenal gland symptoms or brain symptoms.)

That person is going to have to do some tests. There’s over 24 different ways your thyroid hormones can go wrong and iodine only really helps one of those  Yes, probably 20 of those are fairly rare, but the most common is  Hashimoto’s.

In the scientific journals Iodine + Hashimoto’s has been called “an explosive mix”.

I’ve seen too many  people get into trouble over the last four years trying to self supplement and using iodine.  Women come in and I find out they’ve taken iodine and felt awfula and smartly stopped it. Or, worse they’ve never really recovered from it.

This is serious business were talking about here.  You can make yourself worse.

Iodine is not safe for low thyroid symptoms until you find out if you’ve got Hashimoto’s or not…and it might not even be safe then because iodine can trigger Hashimoto’s.

© 2012 David Clark.

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Which Thyroid Hormone Is Best For Hashimoto’s? Synthetic or Bioidentical

Dr. David Clark, DC -Center for Low Thyroid Solutions Durham, NC- guides Hashimoto’s sufferers through the debate about synthetic vs. biodidentical thyroid hormones.

Let’s talk for a second about the debate between what is best for Hashimoto’s – synthetic thyroid hormones versus bioidentical thyroid hormones.

The answer is… neither one of them is best.

This is a real red herring of a debate that I see a lot of people that are suffering with Hashimoto’s and low thyroid symptoms get sucked into.  They get sucked into this debate over, you know, which is better – synthetic or natural.  The answer is there is no better one.  It depends on what works for the individual.

In reality, the answer to the question to what hormone you should be on if you have Hashimoto’s is only about 10% of the battle.  The other 90% of the battle is what are you going to do to calm down this autoimmune response? 

Unfortunately, there is a lot of doctor’s who don’t understand Hashimoto’s.  They don’t understand autoimmune.  They don’t understand really what triggers it, what perpetuates it.

So instead we get stuck on these useless moot debates about Synthroid versus Armour.  Levoxyl versus Nature-Throid, and it doesn’t matter.

Just this past week, I had to give this speech…

I was talkng with a women whose TSH is over 10.0.  She was never diagnosed with Hashimoto’s.  We ran the tests….she’s got Hashimoto’s, but she just doesn’t want to be on a medication.  She doesn’t want to be on a “synthetic medication.”  She wants to try one of the “natural things,” but she doesn’t know what to do.

I said “Kim, you know, you’re killing yourself.  You’re really punishing yourself for no reason.  I mean, if you had a leg that was amputated, if you wanted to walk again, you’d get a prosthetic leg.  Right?  You wouldn’t just hobble around and crawl on the floor.  You’d get a prosthetic leg.  They make prosthetic legs to help that exact situation.”

In Hashimoto’s it’s the same situation. 

In Hashimoto’s you’re going to lose pieces of your thyroid gland, and you’re never going to get them back.  And being worried or having some kind of idealistic problem with being on a medication for that problem means you’re unnecessarily punishing yourself. 

You deserve to have some kind of thyroid function.  Right? You deserve to be free of low thyroid symptoms like:

  • constipation
  • hair loss
  • brain fog
  • depression

If you’ve got Hashimoto’s, there’s a really good chance – I mean a really good chance– you’re going to have to be on some type of thyroid hormone replacement at some point.  But what kind of thyroid hormone replacement is going to vary from person to person.  Let me explain why.

Some people do great on synthetic thyroid hormones.

However, if you go to the internet and you starting looking in chat rooms, you’re going to see that people say “Synthroid is awful.”

And it may be awful for that person who made the post…but synthetics do great for some people….and for some people bioidenticals are awful.  They have a horrible time with bioidentical thyroid hormones.  And here’s why…

When you have Hashimoto’s, you have an autoimmune attack on your thyroid gland.  You start destroying the inside your thyroid gland.  You start destroying the enzyme thyroid peroxidase and/or and you destroy thyroglobulin.

When you have autoimmunity and you’ve already targeted and attacked one tissue, the taboo is broken…your whole body is on the menu now.   

The autoimmune attack can now progress beyond TPO and beyond Thryoglobulin…progress to now attacking your own hormones–T4 and T3. 

If you’re that person who is now attacking your own T4 and T3, and you start taking Armour or Nature-Throid…and you have a really bad reaction to it…There’s a really good chance that what happened is you just put more wood on the burning fire.

You were already attacking your thyroid hormones, and now you just gave your immune system a whole bunch more fuel to attack.

I hope that makes sense.

That person usually does great on synthetic thyroid hormones.

But some people don’t do well on synthetics, and here’s why.

Synthroid, for example, contains fillers. These fillers can stimulate your immune system to be more out of balance, and you can have a reaction to them.  You can feel inflamed, oir have more low thyroid symptoms.

That’s the basic two scenarios that happen—attacking your own hormones, or being wrongly stimulated by the fillers.

The fact is, if you’re watching this, you’re just going to have to find a doctor who’ll work with you, and you’re going to find which one works best for you.

Don’t get sucked into the debate about natural versus synthetic.  That is so a waste of your time.

What you really have to do is focus on “what am I going to do to get this autoimmune thing under control?”  Because the thyroid hormone replacement is going to do very little to address the autoimmune process. 

And your autoimmune attack could keep on progressing and can move into other tissues. This is dangerous. Your immune system can attack your cerebellum, your pancreas….any tissue….and cause a more symptoms that are way worse than what you’re already feeling, and those are bad enough.

So you’ve got to find a doctor who understands that it synthetic or bioidentical doesn’t really matter… just find out which one works for you. This doctor should understand that you could react badly to either kind, and if you do– does NOT ignore it.

More important for your long term heatlh—you’ve got to find a doctor who understands how to get this Hashimoto’s autoimmune tissue attack under control and help balance your immune system.

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©2011 David Clark.

Hashimoto’s Causes Suffering Even if TSH Levels Are “Normal”

Dr. David Clark, DC – Center for Low Thyroid Solutions Durham,NC – shares important new information about how Hashimoto’s autoimmune thyroiditis can make you feel bad, even if your TSH, T4, T3 are normal.

I’m going to tell you why Hashimoto’s negatively affects your quality of life even if your TSH and your hormone levels are normal.

First,  is Hashimoto’s really a big deal?  A lot of doctors say,

“Eh, Hashimoto’s is no big deal.  You take the medication.  You live with it. There’s nothing you can do.”

That’s not true. They’re saying that it’s no big deal because they only have one thing to offer you…and too bad if it doesn’t help.

If you’re suffering with Hashimoto’s, you know how bad it is….

  • Constipation
  • dry skin
  • vaginal dryness
  • muscle weakness
  • feeling cold all over all the time
  • frequent sweating
  • hair loss
  • depression

These are classic low thyroid symptoms.

And Hashimoto’s is the most common cause of low thyroid. (NOT iodine deficiency or tyrosine)

New research out this year proves that when women have TPO antibodies–which, along with anti-thyroglobulin antibodies are what you test for when you’re lookng for Hashimoto’s-have a decreased quality of life even if their TSH and their hormone levels are normal.

Case in point…. just yesterday I was talking to a new patient and she told me she just found out from her endocrinologist that she has a “raging” case of Hashimoto’s….

But the doctor  “can’t do anything” for her because her TSH is normal.


I was floored.  It’s like her doctor thinks she’s handcuffed….

I know you’ve got these antibodies, but I can’t do anything for you because of some bogus artificial “rule” that the pateint’s TSH must be higher than X number etc.

The doctor could do something for her,  IF the doctor had training in non-drug management.

But I guess in fairness the only thing that her doctor has is to give her hormone replacement.  And the doctor’s guideline is that if your hormone levels are normal, even if you’ve got antibodie, then the doctor can’t do anything for the patient.

There’s thousands of women who are suffering with Hashimoto’s…who feel helpless….because no one will help them.

If you’re reading this and you’ve got positive TPO antibodies or positive TGB antibodies, here’s some piece of mind…

….Understand that the research shows that you can have

  • constipation
  • dry skin
  • hair loss
  • vaginal dryness
  • weakness
  • feeling cold all the time
  • requiring excessive amounts of sleep to function….

..AND your thyroid hormone levels be “normal” (aka “euthyroid.”

This study I mentioned gave approximately 600 women questionnaires, and the researchers found out that…

Women with positive TPO antibodies are having a horrible time with symptoms even though they’re not classically “hypothyroid.” 

They also analyzed the kinds symptoms in two groups of these women–those with TPO antibodies  less than 121 or TPO antibodies greater than 121.  What they found out is these women are suffering in all domains: social roles, their zest for life, their physical ability, their pain.

If you’ve ever been made to feel that you’re crazy, or “just depressed” because you’ve got these TPO/TGB antibodies–but you’re not low thyroid… so the symptoms you’re having can’t be due to Hashimoto’s….

Well, now you can go back to that doctor and say…

“Why don’t you read this study? Why don’t you read something that’s up to date? There is a reason I feel bad.”

What will happen next? 

Well, the doctor’s probably not going to be able to give you thyroid hormones because based on your lab work–and using their goofy rule—you don’t need them. So that MD is probably not going to be able to help you.

What you’re going to have to do next is find someone who can look at your thyroid problem and this Hashimoto’s autoimmune tissue reaction,  from a functional perspective. A doctor who understands that there are steps to take so you can feel better, and there are things that you should and should not do.

I’m talking about specific diet changes. Specific lifestyle changes.  Specialized testing that could be done to get to the bottom of why you’re attacking your thyroid gland.

It becomes complicated.

You should walk away today knowing you’re NOT crazy.  There is a reason why you feel bad even though your thyroid hormone tests are “normal.” 

Thousands of women have TPO antibodies and/or Anti-thyroglobulin antibodies PLUS low thyroid symptoms…but their TSH isn’t elevated or their T4 isn’t low.

Those women are in a medical wasteland. Feeling frustrated and abandoned.

Now you know you still need to find help…fast.

You’ve got to find someone who understands that Hashimoto’s negatively affects your quality of life in all areas, whether your thyroid hormones are normal or not.

© 2011 David Clark. All Rights Reserved.

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Just Diagnosed Hypothyroid? You Must Do This Next

If you’ve just been diagnosed with hypothyroidism by your doctor, here’s what you have to do next.

You have to go back to your doctor and demand that he/she run two tests –

  1. TPO antibodies (thyroid peroxidase antibodies)
  2. TGB antibodies (thyroglobulin antibodies)

Why should you yell and scream until your doctor orders these two tests?

Because the most common cause of low thyroid in America is a disease called Hashimoto’s.  It’s an autoimmune condition that can devastate your entire body –not just your thyroid gland.

Elevated TPO antibodies or elevated TGB antibodies indicate that your immune system is targeting and attacking your thyroid gland. Only ONE of the two antibodies needs to be positive to indicate Hashimoto’s.

Low thyroid symptoms are bad enough:

  • hair loss, hair thinning
  • constipation
  • sleep problems – feeling you could sleep 8 hours all over again
  • dry, flaky skin
  • depression
  • brain fog – feeling like your mental responses are slow
  • infertility
  • weight gain -even if you exercise and eat “right”

But, Hashimoto’s can lead to breakdown in the cerebellum, cartilage, nerves, pancreas or stomach.

Most GPs, family practitioners–even endocrinologists–don’t test for Hashimoto’s.  The only reason they ever seem to test for it is to shut up an insistent patient.

Hashimoto’s is an autoimmune condition in which your immune system targets your thyroid gland and literally eats it up – chews it up.  You lose pieces of your thyroid gland and you never get them back.

End results is, you can’t make thyroid hormones and you get low thyroid symptoms like depression, thinning hair, dry skin, constipation, brain fog, infertility, high cholesterol, okay?

If you have just got diagnosed with low thyroid, the next thing your must find out – whether your doctor thinks you should or not – is whether or not you have Hashimoto’s.

Hashimoto’s is a whole other ball game.

Sadly, your medical doctor is probably not going be able to help you with the autoimmune process. They really only have one way to work with any thyroid problem: thyroid  hormone replacement.

POINT: Almost all Hashimoto’s patients are going to require some replacement at some point because they are losing pieces of their thyroid gland.

Problem is —There’s at least 24 different ways that your thyroid hormones can go wrong.  Only one of the 24 responds well to thyroid hormone replacement.  That’s why there’s millions of women who still feel lousy even though their lab tests are normal…Even though they’re taking the thyroid medication like they’re supposed to.

They still feel bad because most of them have Hashimoto’s. And the autoimmune part of the problem has been ignored.

I want you to have hope that you can feel better.  If you’ve been newly diagnosed hypothyroid, you need take action.

You’ve got to stand up for yourself and demand those tests: TPO Antibodies and TGB Antibodies.

What to do when the TPO antibodies and TGB antibodies test results come back….

If TPO & TGB antibodies are negative, two things:

  1. 15% of Hashimoto’s patiens are seronegative–meaning they never test positive for the antibodies but have Hashimoto’s anyway. Keep reading below.
  2. There are 23 other reasons why you could have low thyroid symptoms. Find a doctor to investigate these 23 other causes.

If TPO & TGB antibodies are positive…

You must find a doctor that understands how to approach Hashimoto’s from a functional perspective…someone who understands that there’s even more testing that has to be done.

See, there are triggers for Hashimoto’s…factors that perpetuate Hashimoto’s–keep the fire burning—and we have to investigate and uncover them.

You have to put together the whole jigsaw puzzle and figure out…

  • Why your immune system is out of balance.
  • What’s fueling the fire in your body?

Hashimoto’s low thyroid reality check…

Once you have an autoimmune condition (like Hashimoto’s), chances are good that you will end up with another autoimmune condition.

Here’s what I mean by that…

Normally you’re not supposed to attack and kill yourself, right?  That’s called self-tolerance – when you don’t attack yourself.

I mean, we all make a few antibodies to different tissues.  An antibody is like a little strobe light that your immune system makes to tag what it thinks is an invader…or a dead cell that needs to be cleared out…or a cancer cell.

Then your T cells come by – and they see the strobe light and they attack it and kill it.

Well all of us make a little bit of antibodies to various organs and tissues…but we’re not supposed to make a lot of them.

Because when you make a lot of antibodies, then your T cells – your SWAT team – targets your tissue and kills it.

Depending on what tissue is being attacked, you suffer different symptoms .

In Hashimoto’s self-tolerance is broken.  It’s like a taboo’s been broken.  So now your SWAT team – your immune system – can attack anything it wants.

And it will.  Your immune system can now attack your…

  • cartilage — causing joint pain that looks like arthritis, tendonitis, bursitis
  • ovaries — causing female hormone imbalance, infertility
  • pancreas — causing the blood sugar regulation problems, you might even get diagnosed with Type 1 Diabetes or Type 2 Diabetes
  • lining of your stomach — causing inability to absorb B12 that makes you pernicious anemic.
  • cerebellum in your brain –causing vertigo, dizziness, nausea, car sickness

If you have Hashimoto’s, you need to realize that you have a problem bigger than your thyroid. 

You have an autoimmune condition that needs to be slowed down. This has to be managed correctly or you’ll  end up with problems beyond (and worse) than just low thyroid symptoms. And I know those are awful enough by themselves.

But imagine….

…having depression AND no energy because you’re B12 deficient/ Pernicious Anemic

…having fatigue AND peripheral neuropathy because you have autoimmune diabetes. 

…having hair loss AND car sickness-vertigo-nausea so severe you can’t take a trip to the grocery store

Horrible to think about–even for a second.

This is why the first thing you must do if you’re newly diagnosed hypothyroid  is demand your doctor do those tests –or find somebody else to do them.

If those tests come back negative, there’s about 23 other reasons why you could still have low thyroid symptoms.  And you need to  find a doctor that understands this fact.

If you’ve just been diagnosed with Hypothyroidism,  don’t give up hope.

Don’t get scared into blindly taking thyroid hormones without investigating whether you have Hashimoto’s. Hashimoto’s can and does lead to other autoimmune conditions that can devastate your quality of life.

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© 2011 Dr. David Clark, DC. All Rights Reserved.