Archive for the ‘Women’s Health’ Category

Hypothyroidism: How To Feel Happy, Healthy, and Energetic

Hypothyroidism

The thyroid gland controls metabolic rate and is the energy powerhouse of every cell in your body.  Proper thyroid function influences digestion, circulation, brain chemistry, skin quality, energy, and much more.  Think of thyroid hormone essentially being the gas pedal that drives metabolism.  If that gas pedal eases off, it slows down the function of your whole body.

Approximately 30 million women and 15 million men in this country have been diagnosed with hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone.  Common symptoms of hypothyroidism include fatigue, weight gain, poor memory, difficulty concentrating, constipation, low libido, intolerance to cold, dry skin, hair loss, depression, gynecologic issues, cardiovascular conditions, skin problems, and lots more.

There are several theories as to why hypothyroidism is so prevalent.  Potential contributing factors include environmental toxins like Bisphenol A (BPA) from plastics, heavy metals like mercury and lead, living in our fast-paced high stress society, and pesticides and fungicides in our food supply.

Subclinical Hypothyroidism

Currently, the most accurate way to diagnose hypothyroidism is to measure the amount of thyroid stimulating hormone (TSH) in the blood.  For overt cases of hypothyroidism the TSH is a reliable test.  The problem with this test however is that it does not identify people in the grey area with less pronounced disease.  Hypothyroidism is not a condition of you either have it or you don’t.  Many people have an under-functioning thyroid gland with many symptoms of hypothyroidism but their lab tests come back normal.  We classify these people as having “subclinical hypothyroidism.”  In my experience, people experiencing hypothyroid symptoms with a TSH between 3.0 and 5.0 (within the normal range) often profoundly benefit from thyroid treatment.

Hashimoto’s

Hashimoto’s Thyroiditis is the most common cause of overt hypothyroidism.  It is an autoimmune condition where the body’s own immune system is attacking the thyroid gland and through this destruction, causes a decrease in thyroid hormone production.

Anyone newly diagnosed with hypothyroidism should be screened for Hashimoto’s with a simple blood test looking for thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies.  If you have Hashimoto’s make sure your physician is working with you to not only replace your thyroid hormone, but also to decrease your thyroid antibodies.

Treatment Options

To understand your treatment options for hypothyroidism you must first understand how thyroid hormone works in the body.  T4 is the less active thyroid hormone and constitutes the majority of thyroid gland secretion.  As T4 circulates throughout the body it is converted to T3, the more active form of thyroid hormone which drives metabolism.  Along with T4, the thyroid gland also secretes some T3 as well as the less recognized hormones T1 and T2.

The most widely used treatment for hypothyroidism is replacement with synthetic T4 hormone.  Some people do fine on this replacement and never need another option.  Others will see their labs normalize, but they do not feel significant improvement in their symptoms.  I have found the majority of these people will feel much better with desiccated thyroid hormone that contains 80% T4 and 20% T3 as well as trace amounts of T1 and T2.

Conclusions

If you are experiencing fatigue, brain fog, difficulty losing weight, or other symptoms of hypothyroidism and your thyroid labs have always been within the normal range, you may have “subclinical hypothyroidism.”

If you are taking synthetic thyroid replacement but still do not feel well, you may benefit from a trial of dessicated (natural) thyroid hormone which contains all four thyroid hormones instead of just T4.

Hashimoto’s is a very common cause of hypothyroidism and can sometimes be overlooked in the initial work-up of hypothyroidism.  If you are hypothyroid make sure your physician has tested for thyroid antibodies.  If you have Hashimoto’s make sure your physician is working with you to decrease your autoimmune response as well as treat your low thyroid function.

In Health,

Dr. Ryan Sweeney

Naturopathic Medical Doctor at Root Natural Health, Flagstaff, Arizona

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Preventing Heart Disease- Beyond Cholesterol

Heart disease is the number one cause of death in the United States.  There is a growing body of research demonstrating that cholesterol levels are no longer the best indicator of a person’s risk for a heart attack or stroke.  In fact, half of the people who suffer a heart attack have completely normal cholesterol levels.  Recent studies have shown that lowering cholesterol alone had no benefit on preventing a person’s first heart attack or stroke.  Medical research is showing that far better indicators for risk of heart attack or stroke are oxidative stress, size of lipid particles, and inflammation status.

Cholesterol

Cholesterol plays several important roles in the body.  It is the backbone of all steroid hormones including testosterone, estrogen, cortisol, and vitamin D which are responsible for blood sugar regulation, mineral balance, blood pressure regulation, libido, and much more.  Cholesterol is a component of bile salts which help us to properly digest fats and it’s role in the brain makes it vital for learning and memory.  Cholesterol is the major component of the cell wall and is responsible for maintaining the integrity of every cell in the body.  It is so vital for health that every cell in the body has the ability to produce cholesterol and we could not survive without it.

Eighty percent of the cholesterol in your blood was actually produced by your own body,  the other twenty percent comes from the diet.  As more cholesterol is consumed in the diet, the body makes less.  Studies have actually shown very little correlation between the amount of cholesterol consumed in the diet and blood cholesterol levels because of this regulatory system.

That is not to say that eating an unhealthy diet full of greasy burgers and french fries will not lead to heart disease, quite the contrary.  But the cause is not about the amount of cholesterol so much as how these foods effect blood sugar regulation, fat deposition, inflammation, lipid particle size, and oxidization of fats.

Oxidative Stress

When oxygen is processed by the body, reactive oxygen species (free radicals) are formed.  Under healthy conditions, the body neutralizes the majority of these metabolites with circulating antioxidants.  When there is not a sufficient quantity of antioxidants available to limit oxidative damage, reactive oxygen species can cause damage to local tissues.  In the cardiovascular system this is especially important because when vessels are damaged plaques can form leading to atherosclerosis and heart disease.

Methods of reducing oxidative stress include eating a colorful whole foods diet, reducing inflammatory substances like trans-fats, cigarettes, alcohol and sugar and, when necessary, taking antioxidant supplements.

Size of Lipid Particles

Low Density Lipoproteins (LDL) are often referred to as the “bad cholesterol.” Under oxidative or inflammatory conditions, LDL particles can embed into vessel walls and form plaques that lead to heart disease.  Gathering evidence is demonstrating that assessing the size of LDL particles is a far better predictor for heart disease than the shear amount of LDL in the blood.  Smaller denser LDL particles have been strongly correlated with heart disease risk where larger “fluffier” LDL particles are not.  Two people with the same LDL levels can have much different risks of developing atherosclerosis depending if their LDL particles are small and dense or large and fluffy.

Inflammation

Inflammation is the body’s attempt to repair.  Think about what the healing process looks like when you cut yourself.  The skin gets red around the cut and slowly over time lays down new tissue until eventually the wound is closed and healed.  The same process happens when internal organs experience injury from extraneous sources.  A poor diet, chronic stress, smoking, inactivity, and poorly controlled blood sugar are just a few sources of chronic inflammation and repair deficit which greatly increase the chance of developing atherosclerosis and heart disease.

Summary

Anyone still taking a cholesterol lowering drug should discuss with their doctor whether it is still appropriate given the lack of evidence to support the efficacy of these drugs in preventing first time cardiovascular events.

The following tests can help determine individual risk of heart attack or stroke with better predictive value than cholesterol alone:  CRP-hs (inflammation), Homocysteine (detoxification and methylation), Oxidized HDL and LDL, and LDL Subfractions (lipid particle size).

References

1. Austin MA, Breslow JL, Hennekens CH, Buring JE, Willet WC, Krauss RM. Low-density lipoprotein sublass patterns and risk of myocardial infarction. JAMA 1988;260(13):1917-21.

2. Ridker PM et al. N Engl J Med. 2002;347:1557-1565.

3. Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006;83(suppl):456S-60S.

4. J Korean Med Sci 2009; 24 (Suppl 1): S115-S120

5. G Ital Cardiol (Rome). 2007 Jun;8(6):327-34. [High sensitivity of C-reactive protein in primary prevention]. Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, U.O.C. di Cardiologia, Cattedra di Malattie Cardiovascolari, A.O.U.P. Paolo Giaccone, Palermo.

6. Fernandez ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Curr Opin Clin Nutr Metab Care. 2006; 9(1): 8-12.

7. New York Times, “Drug Has No Benefit in Trial, Makers Say,” January 14, 2008

8. New York Times, “Cardiologists Question Delay of Data on 2 Drugs,” November 21, 2007

9. BusinessWeek.com, “Do Cholesterol Drugs Do Any Good?” January 17, 2008