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

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

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

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

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

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

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

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

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

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

What happens when you don’t have enough progesterone? 

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

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

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

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

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

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

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

What are the typical low progesterone symptoms? 

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

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

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

What do you do about this progesterone-thyroid problem? 

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

So let’s give a little background…

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

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

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

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

You have

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

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

So here’s what I mean…

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

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

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

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

What the heck is going on?

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

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

Why would you be attacking your own T4 and T3? 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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© 2013 David Clark. All Rights Reserved.

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

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

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

That was a mouthful.  Let me say it again.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Now here’s where it gets really confusing…

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

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

Then you get hyperthyroid symptoms.

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

Follow what I’m saying….

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

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

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

If you look like you have Hashimoto’s.

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

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

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

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

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

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

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

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© 2012 David Clark. All Rights Reserved.

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


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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Low Thyroid Brain Fog, Memory Problems, Hair Loss Eliminated

Corey shares her success with Low thyroid Brain Fog, short term memory problems and Hair loss.