Category Archives for "Low Thyroid Research"

Hidden Cause #23 Why You STILL Have Low Thyroid Symptoms–High Homocysteine

 Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains how high Homocysteine causes Low Thyroid symptoms.

Hidden Cause #23 Why you STILL have low thyroid symptoms even though you may be taking medication, and even though your lab tests look normal is:

High Homocysteine causing a sluggish response to thyroid hormone 

What is Homocysteine?

Homocysteine is a naturally occurinng chemical floating around in your body.  And it’s essentially an inflammatory chemical.  It can dock and attach onto different types of receptors in the human body. (think of receptors as antennae, or as a lock waiting for a key).

How does this relate to our thyroid story? 

Homocysteine can dock onto a cell and stop that cell from having a normal response to thyroid hormone. This causes low thyroid symptoms such as this partial list:


  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage
  • high cholesterol

Here’s the kicker… even with these symptoms your thyroid lab tests will look completely NORMAL.

The only thing that might show up on a lab test–if the doctor actually runs the test —is  the homocysteine levels may be elevated. 

What qualifies as “elevated” homocysteine? 

…higher than the lab range (usually 13) is “medically” elevated

….higher than seven is “functionally” elevated. The higher the homocysteine levels are, especially when they’re close to 13 or higher, the more they are relevant to thyroid hormone receptor malfunction.

Remember, T4, T3, T3 Uptake, Reverse T3, Free T4, Free T3….all those may look completely normal. 

This is one of those caught between a rock and hard place situations where you have low thyroid symptoms, but your labs are normal and no one knows what’s causing your symtpoms. 

You can imagine what usually happens.  Your doctor tells you “You’re depressed.  I’ll write you a script for an anti-depressant.” However, she may have high homocysteine causing these symptoms.

What cause high homocysteine levels? 

The big factor is a deficiency of methyl donors (a carbon with three hydrogens).  You don’t have to remember all the chemistry but let me tell you what happens…

The two kinds of people at most risk for methyl donor deficiency—and thus high homocysteine–are women who:

  • take estrogen-based birth control
  • take antacids (of any kind)

Women who take antacids create a situation of low stomach acid. The technical term is hypochlorhydria. The antacids decrease your stomach acid. A low acid environment, over time, can cause low methyl donors (and high homocysteine that messes with your thyroid receptors).

NOTE: Low stomach is not a healthy situation. I know you’re inundated with commercials that demonize stomach….but if  you have low stomach acid you cannot extract minerals (like iron and magnesium) from your food….You cannot appropriately digest your food.  Plus, you can end up with depletion of these methyl donors. 

**Certain mutations in the MTHFR gene (SNPs aka single nucleotide polymorphisms) can definitely cause HIGH homocysteine levels. More on this in another post.

What are the symptoms of low stomach acid (hypochlorhydria)? 

Classic symptoms of hypochlorhydria are:

  • Belching and bloating while you eat
  • A sense of fullness while you eat. 
  • Feeling like your food sits in your belly like a rock and just doesn’t move anywhere. 

Those are good signs of low stomach acid. 

What are the causes of low stomach acid (hypochlorhydria)? 

Now you see what we’re doing here, right?  We’re asking the question why?, why?, why? so that we can get to the root of the cause. 

Here are some common causes of low stomach acid…

Hypoglycemia (low blood sugar)–People that are hypoglycemic have a hard time holding onto their B vitamins.  And B vitamins are some of the co-factors you need  to make stomach acid.  

Hypothyroidism (low thyroid)–low thyroid hormones, or low thyroid hormone receptor response causes decreased digestive secretions. 

H. pylori (helicobacter pylori) infection in the stomach—  This is a bacterial infection that disturbs your stomach acid levels.  The best test to detect it is a Urea Breath Test ( you can also use a test for serum antibodies.)

Almost forgoet to mention gluten sensitivity….

Gluten senstivity can lead to malabsorption of zinc. Zinc is a necessary ingredient to make stomach acid. 

There’s three causes, right? 

These make you have low stomach acid…You can’t get these methyl donors, which means your homocysteine levels rise…

…And homocysteine can slow down the normal response of the cell to thyroid hormone. 

You don’t necessarily have to remember all of that.  Here’s what you need to remember:

If you have low thyroid symptoms…and your labs look normal and people think you’re crazy or depressed…You could have high homocysteine.  

Now, hopefully your doctor would know about this issue and would run a homocysteine to rule this out.  Sadly, not many doctors seem to know this crucial information.  So, you’re going to need to find a doctor who DOES know, and who understands that high homocysteine being high could cause all that stuff I just talked about. 

And then–even MORE importanly–the doctor needs to know what to do about high Homocysteine.

It’s a big job for any doctor to handle. 

Be an advocate for yourself and remember that homocysteine is something that could cause your low thyroid symptoms.

© 2014 David Clark. All Rights Reserved.

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

Hidden Cause #19 Why You STILL Have Low Thyroid Symptoms-High Testosterone & Resistance

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains another way that high Testosterone causes Low Thyroid symptoms.

Hidden Cause #19 why you still have low thyroid symptoms even though you may be taking thyroid medication and even though your lab tests look normal is…

Elevated Testosterone causing low thyroxine binding globulins and too much T4 and T3 leading to resistance.

Let’s pause and take a breath…

The basic problem in this hidden cause is you’ve got too much testosterone…and it’s lowering the amount thyroxine binding gloubins (aka TBG).  TBGs are like little taxicabs that carry T4 and T3 around your body.  You’ve got to have them. 

When there’s too many taxi cabs (TBGs), then the hormones can’t get out of the taxicabs and get into a free-form state. “Free” hormones get into the cells.  If the thyroid hormones aren’t free, you can’t use them.

In this hidden cause you have too few taxicabs… you’ve got tons of “free” hormones floating around…and they cause resistance, which leads to MORE low thyroid symptoms.

Think of Resistance like this… you’re growing a plant. The plant likes to have a little bit of water, but it doesn’t like to have a floord of water because you’ll drown it.  You’ll kill it. 

Well, thyroid hormone receptors  are like that.  They like to have enough thyroid hormones in order to dock and make them work. 

But if you bombard them with lots of thyroid hormones, they shut down and become resistant…

….which means you can have all the T4 and T3 in the world floating around,  trying to get onto this receptor, but it can’t. 

Or… alternately, the hormones can dock on the receptor, but the response to the docking is blunted.

For comparison, another example of “resistance” is women who take Cytomel® T3 and then become more hypothyroid. You’re bombarding the receptors.  There’s too much there and they shut down.

Here’s what high testosterone causing low binding globulins leading to resistance looks like….

A women has totally normal thyroid lab numbers (except maybe her T3 Uptake is >38) but, has these low thyroid symptoms:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

Those are all low thyroid symptoms that can be caused by thyroid hormone resistance–even though your lab numbers look okay.
Of course, this assumes that your doctor is actually running all the numbers you need to look at.  If they just run a TSH and T4, they’ll never pick up this problem.  It will never show up. 

If your doctor also funs free T4, free T3 and T3 uptake, then this might show up. 

Your T3 uptake might  be outside the lab range…this would mean your binding globulins (taxi cabs) are low, and your “free” hormones are probably high.

High Testosterone is the main cause of low binding globulins (and high “free” hormones leading to resistance)

How would a woman get too much testosterone? 

The most common reason is from high blood sugar levels and insulin resistance.  Women that have chronically high blood sugar get surges of insulin in an attempt to get rid of that blood sugar. 

That surge of insulin causes them to make more testosterone…and that testosterone is what causes these binding globulins to drop, leading to excess amounts of “free” hormones—>Resistance—>Low thyroid symptoms.

If the doctor doesn’t run all the tests, or get a complete history, he/she may not see the problem. 

The doctor would need to actually run the T3 Uptake (and it’s low) and Free T4 and Free T3 (and they’re high)…then understand what it means if those numbers are abnormal (or at least functionally abnormal).  

What causes irregular blood sugar?

What you’re eating is a HUGE factor. 

If you’re overeating simple carbs (breads, pastas, grains)….

…or you’re eating “crap” food (from a drive-thru or out of a box or bag)

…or drinking sugary drinks (sodas, coffee drinks)

There’s a good chance you’ll end up insulin resistant and have high blood sugar.

Inflammation–from any source– can also make you insulin resistant.  

This could be a bacterial infection (like H. Pylori in the stomach)…Small Intestinal Bowel Overgrowth…food sensitivities…anything that’s inflaming you can lead to this testosterone problem. 

If a woman has Low thyroid symptoms + labs look “normal” + she has insulin resistance symtpoms = must consider high testosterone causing low binding globulins leading to resistance.

The Classic insulin resistance symptoms is getting tired/sleepy 15 to 30 minutes after you eat. 

Other symptoms of insulin receptor resistance include:

  • Crave sweets after you eat. 
  • Hard time going to sleep 
  • Wake up in the morning feeling completely beat up as if you didn’t sleep at all. 

Those are all pretty good signs of insulin resistance.

If you’re getting sleepy after you eat PLUS you’ve got those low thyroid symptoms, THEN insulin resistance might be the issue here…and testosterone could be causing you to have not enough binding globulins, causing too many “free” hormones, which leads to resistance, which causes low thyroid symptoms. 

I know that’s a lot of steps, so it’s really important you find a doctor who knows what I’m talking about.  It’s not as simple as running only a  TSH and T4, or saying “everybody’s got Hashimoto’s” or “all thyroid patients are iodine deficient!

To make this even a little more complicated…

You could really have Hashimoto’s AND this testosterone scenario. Why?

There’s no rule that says you can only have one thing wrong. You have whatever you have…however complicated…howeve simple…

…and you may have Hidden Cause #19: too much testosterone causing too many “free” hormones and resistance.

© 2014 David Clark. All Rights Reserved.Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #18 Why You STILL Have Low Thyroid Symptoms-High Testosterone & Overconversion

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains how high Testosterone causes Low Thyroid symptoms.

Hidden Cause #18 Why you STILL have low thyroid symptoms, even though you may be taking thyroid medication and even though your lab tests are normal is…

Elevated Testosterone causing Over-conversion of T4 into T3 leading to Resistance. 

Okay, that’s a mouthful.  There’s a couple of different concepts we have to understand so let’s first talk about “Over-conversion.

A lot of times you’ll hear me talk about “under-conversion”…under-conversion of T4 to T3 that leads to low levels of T3.

Well, now we’re talking about something being too high.  If you remember the thyroid story…

…97% of what your thyroid gland makes is T4.  T4 is basically inactive. It must be converted into T3.  T3 is the active form of your thyroid hormones.

Conversion primarily happens in the liver, primarily through an enzyme called 5-deiodinase.  

Here, we’re talking about Over-conversion–something is speeding up the conversion of T4 to T3 leading to something called “resistance.” 

Think of Resistance like this… you’re growing a plant. The plant likes to have a little bit of water, but it doesn’t like to have a floord of water because you’ll drown it.  You’ll kill it. 

Well, thyroid hormone receptors (for T3) are like that.  They like to have enough T3 in order to dock and make them work. 

But if you bombard them with lots of T3, they shut down and become resistant…

….which means you can have all the T3 in the world floating around,  trying to get onto this receptor, but it can’t. 

Or… alternately, the hormone can dock on the receptor, but the response to the docking is blunted.

For comparison, another example of “resistance” is women who take Cytomel® T3 and then become more hypothyroid. You’re bombarding the receptors.  There’s too much there and they shut down.

Here’s what high testosterone causing over-conversion leading to resistance looks like….

A women has totally normal thyroid lab numbers but, has these low thyroid symptoms:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

Those are all low thyroid symptoms that can be caused by resistance–thyroid hormone resistance.

I’ll  back up and explain it again (there’s a lot of moving parts). 

T4 has got to get converted to T3.  When you over-convert, you get lots of T3…and T3 can bombard the receptor and shut it down…making you have more low thyroid symptoms.

Now, I said “testosterone causing overconversion leading to resistance.”  Where does this testosterone come from?

In a woman, the #1 cause for abnormally elevated testosterone is blood sugar instability–insulin resistance. 

These are women who have chronically high blood sugar.  The classic symptom of “insulin receptor resistance” is getting sleepy/drowsy within 15 to 30 minutes after you eat. (Not 2 hours later). Other symptoms of insulin receptor resistance include:

  • Crave sweets after you eat. 
  • Hard time going to sleep 
  • Wake up in the morning feeling completely beat up as if you didn’t sleep at all. 

Those are all pretty good signs of insulin resistance.

In insulin resistance you get surges of insulin when you eat…this surge up-regulates an enzyme that makes women make more testosterone. 

Testosterone can cause this Over-conversion that bombards the receptor that leads to resistance and low thyroid symptoms. 

…I know that’s kind of a long story, but that’s what happens.

Women with insulin resistance are often diagnosed with Polycystic Ovarian Syndrome.  The insulin resistance leads to elevated testosterone. 

So, blood sugar instability is often the underlying cause of this high testosterone that we’ve been talking about.  What you eat, when you eat and inflammation are ALL factors that can cause insulin resistance.

We’ve got a lot of pieces on the chessboard…pieces that a good, effective doctor must looking at and thinking about all at one time.

Now, another way that you can develop elevated testosterone is simply if you are using it…or if your husband or your boyfriend is using topical testosterone.  Testosterone gel easily rubs off on you and will can cause this Over-conversion. 

Your doctor’s got to be able to evaluate all of those different possibilities.

Treatment depends on what the actual mechanism is for each individual patient.  If it’s insulin resistance, chances are you’ll have to change your what you’re eating and when.  You have to look for food sensitivities…inflammation (from all possible sources). 

For successful treatment, you’ve got to do ALL the above simultaneously. 

I see a ton of PCOS and Insulin resistance caused by diet and inflammation.

Now, back to the thyroid to wrap it up….

The reason high testosterone causing Over-conversion leading to resistance and more low thyroid symptoms is a hidden cause is because there’s so many links in the chain.

Your doctor needs to have the skills, experience and determination to find these links.

© 2014 David Clark. All Rights Reserved.

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

Hidden Cause #17 Why You Still Have Low Thyroid Symptoms – Peripheral Dopamine Deficiency

Dr. David Clark, DC - Raleigh-Durham-Chapel Hill Thyroid expert, explains how low dopamine can cause low thyroid symptoms

Hidden Cause #17 Why You STILL Have Low Thyroid Symptoms even though you may be taking thyroid medication, even though your lab tests look normal is...

A peripheral deficiency in the neurotransmitter Dopamine

What would that look like? Well, there’s really not a lot of peripheral signs of dopamine deficiency.

Most of dopamine deficiency signs happen because of it's effect on your central nervous system and how your brain is working....and those are typically things that look like ADHD: so we’re talking about

  • distractibility
  • impulsivity
  • can’t focus
  • can’t stay on task

But there’s also some sort of, you know, emotional symptoms that go along with that.

Let's clarify "deficiency." In most people, absolute low quantities of dopamine are not the problem. In most people the problem is low activity of the neurotransmitter.

Deficiency implicates that you’ve got absolute low levels, but it could be that your levels are fine...and it’s just that the receptors for the dopamine are not doing their job.

So with that in mind, what are some of the emotional signs that go along with dopamine being low activity or deficient?

  • Preferring to isolate oneself
  • Anger under stress

My favorite example of this last one is my own personal example. It was about 16 years ago....

I was in the kitchen cutting up an apple, and the apple fell in the sink and I yelled a 30 second stream of expletives.

My wife ran into the kitchen, struck with terror...“Oh my God, what happened? Are you hurt?”

I screamed back:  "This APPLE FELL in the sink!"

Well, you understand that’s completely out of proportion, right? I had a little bit of stress and I got very angry. That's a good sign of a dopamine issue.

How would dopamine and thyroid symptoms show up in someone that has that problem?

Well, first thing they could have are low thyroid symptoms:

  • hair loss
  • brain fog
  • fatigue
  • high cholesterol
  • gain weight easily
  • infertility
  • constipation.

Those are those low thyroid symptoms.

Now, if you had those PLUS dopamine sypmptoms, the two could be directly related because what dopamine seems to do to thyroid hormones.

Research seems to say that Dopamine controls the rate of conversion of T4 into T3.

That's a very big deal because T4 is inactive. T3 is the active thyroid hormone. 97% of what your thyroid gland makes is T4-- and so a lot of that has got to get converted to T3 in order for you to have enough T3 for your body to work correctly.

That process is  conversion. And dopamine seems to influence how well you can convert T4 into T3. When you don’t have enough dopamine peripherally (outside the central nervous system) you may not convert very well...

You may develop those low thyroid symptoms. The problem is when you walk into a doctor’s office in saying, “Hey, I can’t focus. I’m distractible. I can’t follow through on things.” Bonk! You're going to get labeled ADHD and offered a prescription.

But the dopamine medication is going to work mainly CENTRALLY and not work peripherally. You might have an improvement of some of your distractibility and your focus problems, but your low thyroid symptoms may stay exactly the same.

The key is finding a doctor that understands that dopamine has an impact on how thyroid works.

You could be taking thyroid medication. You could have lab tests that look totally normal because when this situation happens your T4 and your T3 don’t really necessarily change a lot to be outside of the lab range, but they can change enough to affect how you feel.

And it becomes very difficult for most doctors to do because they want to treat the labs.

I think a really good doctor/good clinician  doesn’t treat the lab. They treat YOU.

They use the lab for guidance.

So if you have dopamine symptoms plus low thyroid symptoms, then your doctor really should have that on the radar and think: what could cause dopamine deficiencies?

The two things that cause low dopamine activity/deficiency: blood sugar irregularity and iron deficiencies.

And that makes you go down another rabbit hole because...

..."why would you be iron deficient?"

...Do you have a parasite?

Do you have an H. pylori infection?

What’s up with your blood sugar? Are you eating? Are you not eating?

There’s a ton of factors to start investigating and thinking about....

And that’s another thing that a lot of doctors just don’t want to do. They just don’t want to think. They’d much rather you come in with your ADHD signs, give you medication for that and hope everything works out.

And when you come back six months later and it’s not working out... it’s YOUR fault, the patient.

Find someone that understands the complexity of that situation and understands that dopamine can be a hidden cause of why you still have low thyroid symptoms.

© 2014 David Clark. All Rights Reserved.

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


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.


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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Why Isn’t My Doctor Doing Anything About the Autoimmune Part of My Low Thyroid Problem?

Dr. David Clark, DC – Center for Low Thyroid Solutions Durham, NC -explains the 3 surprising reasons why your doctor isn’t doing anything for the autoimmune part of Hashimoto’s.

Every day I get asked the question, “Why isn’t my doctor doing anything about the autoimmune part of my low thyroid problem?”  There are three reasons why your doctor isn’t doing anything about it…

1. Your doctor may not know that you have autoimmune problem.  If they have not tested you for Hashimoto’s, then they don’t know you have  an autoimmune thyroid problem.

2. What you have to understand is if that even if your doctors knows for sure that you’ve got Hashimoto’s autoimmune hypothyroidism— the only treatment your doctor has for you replacement thyroid hormones.  They don’t have any other tool to offer you.

3. The more sinister reason–your doctor doesn’t really understand Hashimoto’s in the first place. They haven’t read an scientific article about Hashimoto’s in years. They’re out of touch with current science. (The current record for admitted out-of-touchness by my patients former doctors is TEN years.)

I see a lot of people in my practice that have Hashimoto’s, which is an autoimmune attack on the thyroid gland.  And most of these people have already been taking thyroid hormones for a year or two years or three years, but they still feel bad.

They still have:

  • constipation
  • depression
  • hair loss
  • brittle nails
  • dry skin
  • severe fatigue
  • sleep problems (not enough, insomnia).
  • low libido
  • infertility.

The reason why they still have theses low thyroid symptoms?

When you have Hashimoto’s and all you do is give the person replacement thyroid hormones like Synthroid®, Levoxyl® or Armour® — it does very little for what’s actually happening in Hashimoto’s.

In Hashimoto’s your immune system is destroying your thyroid gland.  The replacement hormones don’t stop that. 

It’s the same as if  I were to come home and my house is on fire, but the firefighters give me a key to a hotel room…but NEVER try to put out the fire. What are we going to do to put out the fire? Ignore it. Let it burn and hope everything works out OK?

To me, that’s asinine.  I’m shocked that more physicians aren’t trying to do something more.

You can’t tell me that all these doctors don’t know something’s not working when their patients are coming back every six months saying, “I still feel awful.”  I mean what are the doctors doing?  In their mind, what are they thinking? 

Well, I’ll tell you what they might be thinking.

  • A lot of doctors think your nuts.
  • A lot of them think you’re not complying.
  • A lot of them think you’re overeating etc.

I’ve come to the conclusion that a lot of the doctors that treat these women suffering with Hashimoto’s think that you go home and eat ice cream & bonbons while sipping a milkshake. And that’s why you’re still gaining weight.

Seriously, I think that’s what some of them think.  But I don’t understand why they don’t try to do something about it.

If your the doctor, I just don’t understand how someone can show up to your office and say, “I still feel bad.”

And you say, “Well, time to give you more of the same thing I already gave you that didn’t work.”

That just doesn’t make any sense to me.  But that’s what a lot of these doctors are doing; and I think it’s because they don’t understand Hashimoto’s.  They don’t understand that it’s an autoimmune condition.

A lot of doctors have stopped reading.  When they got their diploma and they got their degree, they stopped reading medical journals.  They certainly stopped reading about anything that has to do with natural management or non-drug methods.  They’re not reading any of that.

It just saddens me.

I see hundreds of these people – thousands of these people that are taking thyroid medication just like they’re supposed to.  Their labs are normal, but they still have low thyroid symptoms while they’re taking that medication.  And it’s because the medication not helping their underlying problem.

Many times, when I’m here in my office talking to people, I get really angry at what doctors are telling people….

That can’t have anything to do with it,”

“Gluten can’t have anything to do with your Hashimoto.  There’s nothing you can do for this, you just have to live with it.”

Trash that doctors spit out as a defense mechanism. But they’re really not getting you better in the process.

And that’s why your doctor’s not doing anything about the autoimmune part of your thyroid problem.  They either

A. Don’t know you’ve got it, so then you’ve got to get tested for it. 

B. Even if you did get tested for it, they’re the hammer and you’re the nail. 

They only have one tool and their hammer is thyroid replacement hormones.  Most of them don’t have any training in what to do with autoimmunity.  They have no idea about what modulates it, what makes it better.  And they’re terrified, terrified that they’re ignorance is going to be exposed.  Most of these people are just terrified that you’re gonna ask them some question that they don’t know the answer to, which is why they say, “Oh, you can’t do that.”   They’re gonna poo-poo things they don’t understand.

If you’ve found a doctor that can tell you, “Look, I don’t know about that,  It’s not my field.”  That I can accept.  It’s the doctors that act like they do know what they’re talking about but really have no basis for their opinion… that infuriates me.

There is help.  You have to find a doctor  who understands all these things I’m just telling you.

Someone who understands and has been trained on how to functionally deal with this autoimmune problem and get it calmed down and get your immune system under control.

If you don’t get the right help, that autoimmune problem can expand into more tissues, more organs, and cause more problems that are ten times worse than the awful thyroid symptoms you’re suffering right now.

©2012 David Clark.

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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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Low Thyroid and Iodine Is A BAD Idea

I’m going explain why iodine supplementation is still a bad idea if you have low thyroid symptoms.

Earlier this year a new study was released about iodine supplementation  in Denmark.  Many years ago,  Denmark began fortifying their salt with iodine.

After a few years of salt iodination, the government assessed the results and were unhappy. They passed a rule to increase the amount of iodine put in the salt–a mandatory increase in iodine.

Well, some sharp researchers though..

“Let’s see if there’s a relationship between iodine and antibody production against the thyroid.”

To put it another way:

Does iodine cause Hashimoto’s Thyroiditis?

So let me back up and explain that.

For years, well-established, credible scientific data have shown that when you give people supplemental iodine —and this may be in a frankly iodine deficient area—you cause an autoimmune attack against the thyroid.

TPO antibodies and thyroglobulin antibodies are how you determine if there is an autoimmune attack on the thyroid gland.

The researchers from Denmark ran these exact tests in their quest to determine if iodine caused an autoimmune attack on the thyroid gland.

Here’s the citation so you so you can take a look at it.

Clinical Endocrinology (2011) 75, 120–126

(You would be shocked at the hate mail I get when I talk about iodine and it’s possible negative effects. It’s clear by their comments that they are either not actually reading, or they simply dont’ understand my point.)

This is my point about iodine, low thyroid symptoms and Hashimoto’s…

if you have low thyroid symptoms, you need to find out if you have Hashimoto’s or not. Because if you have Hashimoto’s, taking iodine is like taking toxic waste.

Iodine will make you worse.

Let me tell you a quick real life story about iodine…

Recently I had a patient, Kim.  She’s 36 years old and she had been taking iodine for seven years – for seven years—because some well-meaning but totally wrong alternative practitioner told her to take iodine for her low thyroid symptoms.

Quick Review of Low Thyroid Symptoms

  • gain weight easily, even if you exercise and eat “right” (low calorie)
  • hair loss, hair thinning on the scalp, eyebrows
  • dry, flaky skin
  • depression
  • brain fog, slow mental response
  • constipation
  • high cholesterol
  • infertility
  • sleep problems – can’t get enough sleep; sleep is not restorative

Turns out, that in all these years of suffering low thyroid symptoms…and after all these years of seeing doctor after doctor… Kim had never been tested for Hashimoto’s. 

For seven years Kim has felt bad.  In the last year and a half she’s got worse and worse.  Her hair’s been falling out, she’s gaining weight.

And all I did was say, “You know what?  Why don’t we just find out for sure if you’ve got Hashimoto’s?  Let’s find out if you’ve got these antibodies.”

Sure as heck, she’s got them.  It explains why she feels so bad.


Iodine is a huge risk factor for Hashimoto’s. 

In Denmark, where larger amounts of iodine have been put in the salt by law, the researchers  discoverd a shocking increase in elevated thyroid antibodies in the youngest age group of women – 18 to 45.

Denmark passed a law that’s given a huge part of their population Hashimoto’s Autoimmune Hypothyroidism.

This might sound strange, but…

Hashimoto’s is actually the least of your worries. Why?

Because once you have one tissue under attack from your immune system–pay close attention—your entire body is now on the menu. 

You can now attack your cartilage and develop rheumatoid arthritis…

…Or attack myelin and develop multiple sclerosis symptoms.

…Or attack your ovaries and develop infertility and various other polyglandular endocrine symptoms.

This is the new, real information about iodine and Hashimoto’s.

But I will probably still get flooded with hate mail or have people threatening to kill me and calling me a “murderer” because they don’t like what the research shows.  This is the truth, folks.

If you’ve got lot thyroid symptoms such as hair loss, weight gain, constipation…

If you’re taking thyroid medication like Synthroid®, Armour®, Naturethroid®, Levoxyl® or Cytomel® — and you STILL feel bad…

Then, you’ve got to find somebody to do these simple, non-exotic tests for TPO antibodies and thyroglobulin antibodies.

But here’s the catch…

If the results show you do have those elevate antibodies…you have a Hashimoto’s autoimmune attack on your thyroid….

Taking replacement thyroid hormones is only one tiny piece of the solution.

You need to find someone that understands the autoimmune situation. Someone who can help you get your immune system back into balance and slow down the autoimmune process (this can be done).

So to go back where I was at the beginning….low thyroid and iodine is a bad idea.

Yes, iodine is necessary to make thyroid hormones.  But, scientific data AND practical experience have proven again and again that iodine is dangerous.

Until you know whether you’ve got an autoimmune situation, I suggest you do NOT take iodine.

If someone is  telling you to take iodine for low thyroid symptoms (no matter who they are), it’s time they read a recent article with recent information.

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© 2011 Dr David Clark, DC