Read an Excerpt

What Your Doctor May Not Tell You About Hypothyroidism

Warner Books

Chapter One

FROM HERE TO OBSCURITY

Maybe you can remember it-a time when your energy and capacity were in sync with
your life. Think back and recapture that sense of moving with relative ease
through the world. Your energy flowed with the pace set by night and day. During
the day, your physical and mental powers were at your service, while nighttime
brought the restful sleep needed for energetic days-and the cycle repeated. You
ate in proportion to your needs, without unexpected changes in weight. For the
most part (heredity notwithstanding), your hair stayed where it belonged- on
your head instead of the shower floor. If you are a woman, you experienced the
normal ups and downs of life's cycles: puberty, menstruation, fertility,
menopause. Aside from the normal changes in life, your outlook was generally
positive.

Then slowly, over time, you began to lose step. A mix of symptoms, ranging from
subtle to incapacitating, burden you. Now you are unable to keep up. You
probablyfeel cold more often. You're the one who always needs to take a sweater
to a restaurant in the summer. For many of you, seasonal and hormonal changes
upset your internal rhythms and send your symptoms into overdrive. You feel
drained of energy, and all you want to do is stay in bed, but a good night's
sleep is just a dream. Insomnia and sudden wakings disrupt your sleep. Not only
has your hair lost its luster, but it is brittle and falling out at the faintest
touch. Your skin feels rough and dry. The area around your eyes looks puffy, and
your voice has deepened or become gruffer. You get muscle cramps, and your
reflexes are weak. Headaches, body aches/joint pain, low blood sugar,
constipation and other digestive problems, severe PMS, unexplained weight
gain-these symptoms may have cropped up.

If you are a woman, your periods might have become heavier and longer, or they
have disappeared altogether. Then there are the emotional and mental effects.
The color seems to have seeped out of your life, and your memory has slipped.
You are no longer nearly as social as you once were, which adds to your sense of
being out of step with the world. You are depressed (who wouldn't be?) and
emotionally unsteady.

In short, you have symptoms of hypothyroidism.

KEEPING PACE WITH LIFE'S CHANGE

Like a flawless dance partner, thyroid hormones are highly sensitive to changes
in your ever-changing environment. They take the lead in setting the metabolic
pace, helping you adapt to changes in temperature, stress, hormonal
fluctuations, and other conditions.

When there are ample amounts of thyroid hormone doing the rounds, the body is
more apt to respond in a realistic and healthy way to changes. When thyroid
levels are low, the body Wslows down, lost in a fog of sensory stimuli that it
cannot detect, much less respond to.

More scientifically speaking, researchers and clinicians know that the hormones
produced by the thyroid, called T4 and T3, are architects of the body's
ever-shifting metabolism. Metabolism is the use of oxygen and nutrients by cells
to make energy. Generally, the higher your metabolism, the more energetic you
feel (when metabolism's too high, you might feel "hyper"). When your metabolism
flags, though, so does your physical and mental vigor.

THE HYPOTHYROID FOG

Certainly, no single person has all of the symptoms described above. Each
individual is unique. Chances are your suite of symptoms differs from another's.
Yet underlying almost everyone's symptoms is what many weary patients describe
as "brain fog": Your energy is zapped, and with it you have lost your memory,
your capacity to think clearly, the color in your life, your personality. As one
of my patients described it, it feels as though someone stuffed cotton between
your ears. You are essentially robbed of your inspiration, your passion, and
your ability to live a full live.

When the hypothyroid fog sets in, the strong, vital internal metronome that once
drove your life forward in sync with your life's distinctive melody-with all the
high notes and low notes that went along with it-has been muted. The fog is not
just a pervasive symptom; it is an apt metaphor for the state of hypothyroidism
treatment today.

This fog has infiltrated the minds and lives of an estimated 27 million
patients, yet only about 75 percent of people with a depleted thyroid are
diagnosed, and many are not adequately treated.

WHAT DOCTORS MAY NOT TELL YOU ... BECAUSE THEY DO NOT KNOW

Much of what you read in this book will probably be new to you. You might assume
that your doctor certainly would have tried this approach, or at least told you
about it. The fact is that your doctor may not know about my approach-or any
other that deviates from his or her knowledge. Too often, physicians follow the
conventions of their field and never look to see what might work better. I
developed this method based on what I learned in medical school and then what I
learned from my patients. I observed them closely and studied what works, then
adjusted therapy accordingly. Everything I do would be approved by the Food and
Drug Administration, and there are many articles in well-regarded medical
journals that support my concepts. However, in spite of the growing demand for
new approaches and the groundswell of information supporting them, too few
doctors seem to pay attention. As a result, most doctors hold close the three
tenets of treatment for hypothyroidism that have left many patients suffering.

Three Flaws in the Conventional Approach to Hypothyroidism

In my view, there are three serious flaws with the conventional approach to
hypothyroidism:

1. Conventional medicine bases diagnosis on a test that does not detect all
patients. The only certain way to diagnose hypothyroidism is with a trial of
thyroid that is fine-tuned to patient response.

2. Mainstream doctors endorse only one treatment: the synthetic thyroid hormone
T4. If you continue to feel poorly, most doctors will tell you that your
symptoms have another cause, because "you are on a thyroid medicine and your
test numbers are good." They seldom make use of other highly effective options:
T3 and natural thyroid extract.

3. When it is employed, T3 is rarely used in the right proportion. In more than
two decades of treating hypothyroidism, I have seen these mistakes over and over
in patients who come to me looking for confirmation that their symptoms have a
cause, and looking for a way to end years of misery. As a result, I've come to
see hypothyroidism in a different light than my conventional colleagues do.

WHY I WROTE THIS BOOK

It may seem simple and obvious to treat patients as individuals and to use all
of the therapeutic tools available. But my approach, though rooted in common
sense and the best of today's clinical knowledge, is virtually unknown by the
vast majority of hypothyroid patients and their clinicians. That's why I felt
compelled to write What Your Doctor May Not Tell You About Hypothyroidism.

This book was written for the individuals who are looking for a simple,
clinically safe, and patient-proven way to end their symptoms. For the first
time in any book, you will find a description of how hypothyroidism affects
individuals-women and men-at every life stage. You'll also find how my
treatment helps where others have failed, both in my words and in the words of
my patients.

This book was written for the millions of people whose symptoms have been
dismissed by other doctors because their lab tests were "normal"-and who were
misdiagnosed and treated, often unnecessarily, for other conditions with
potentially harmful drugs. All the while their hypothyroidism and its symptoms
continue untreated, contributing to fatigue, weight gain, and potentially
dangerous heart problems-to name just a few. This book will give you hope that
your symptoms are not all in your head. You are not doomed to a lifetime of
thyroid symptoms because there is an approach that works for you-and for the
millions of others like you.

Last but not least, I wrote this book for open-minded physicians who have sensed
that the conventional approach may work for some patients, but not for all, and
are looking for a new tactic. Herein you will find the clinical rationale behind
my approach, and a clear step-by-step outline of my strategy. My unique 2
percent T3 solution has allowed me to help thousands of patients. It is my hope
that it will give doctors the tools to effectively treat millions more.

KEEPING UP WITH THE TIMES

Importantly, thyroid rhythms change over time with our bodies' metabolic needs.
Our bodies and environments are in constant flux. It is the job of the thyroid
and related endocrine (hormonal) system to be exquisitely sensitive to changes
in the body's internal and external environment and to help our bodies keep a
metabolic balance that accommodates these changes.

As the body's needs change, so does its need for thyroid hormone. The challenge
is finding a good match and continually fine-tuning treatment to changing
rhythms. I am honored that my patients' health is the most convincing testimony
to this alternative approach. Michelle is one example.

The term "slow motion" is the last one Michelle would use to describe herself.
She is a fit and glowing mother of three children and the director/teacher of a
thriving yoga center. But those are the words she used to describe her life
before discovering yoga and receiving my thyroid treatment.

When she first came to see me at the age of thirty-nine, Michelle was overweight
and mentally foggy, and she suffered from insomnia. Her face was swollen, and
she had terrible acne. In our first input session, Michelle traced her symptoms
back to her teenage years-as so many of my patients do! She remembered often
feeling lethargic and depressed. She was formally diagnosed as hypothyroid at
the age of eighteen based on a high level of thyroid-stimulating hormone (TSH).

By the time she was thirty, Michelle was diagnosed with Hashimoto's autoimmune
thyroiditis, the most common cause of hypothyroidism. Severe headaches had led
her to neurologists who identified a venous stricture in her brain. Another
neurologist diagnosed epilepsy; she subsequently experienced a toxic reaction to
antiseizure medications. Just a few in a long, long decade of "worse and worse
stories," culminating in the prospect of a brain surgery, thyroidectomy (removal
of the thyroid gland), and exploratory surgery on her colon.

Then two events changed her life: yoga and effective thyroid treatment. With
yoga, Michelle immediately felt the mental fog lift, and she slept better-the
beginning of her road to wellness. "The other part of the equation was Dr.
Blanchard," she says, whom she discovered through the Web site of Mary J.
Shomon, thyroid patient advocate and published educator, at
thyroid-info.com.

As is customary, I took a complete history. Based on Michelle's symptoms, my
recommendation was a combination of natural thyroid extract (Armour) and
levothyroxine (Synthroid), also known as T4. My aim with Michelle was to replace
the missing thyroid hormone in physiologic doses-that is, a dosage to restore a
healthy balance of thyroid hormones. A short trial with my regimen quickly
uncovered a problem: skin irritations and outbreaks. Many people with
Hashimoto's thyroiditis have multiple immunologic problems, including allergies.

The skin problems cleared up when I switched Michelle to a dye-free dosage form
of Synthoid. "Other doctors would have sent me to a dermatologist," says
Michelle. Michelle relies on me to keep the chemistry in balance, and she
balances out with yoga. Together we make a good team. Because our bodies are
constantly changing, I encourage all of my patients to stay tuned to changes in
their symptoms and to let me know about them so that I can make the necessary
dosage adjustments. "For me, the first things to go are my digestive system,
sleep patterns, and mental clarity," Michelle says. "I'm sensitive to even
slight changes," which she takes as warnings for a change in dosage.

Over the course of six months, Michelle went from a woman not living up to her
potential to a woman embracing and acting on her abilities. The impact on her
family, her marriage, and her professional life has been enormous. Today she is
symptom-free and able to live her life fully.

Many of my patients have learned to take their symptoms seriously and insist
that their doctors do the same. I encourage my patients to be active partners in
their treatment. It is my hope that this book will instill a similar sense of
confidence and empowerment in my readers-to give them the confidence to trust
their feelings and to persist in finding a doctor who gives them the same level
of respect.

Most doctors would probably have never given Michelle thyroid treatment, because
her tests were normal. If she had followed the recommendations of various
specialists, she may have been misdiagnosed and ended up with unneeded
treatments, a shunt in her brain or a double bowel resection, while her
hypothyroidism persisted, untreated or poorly treated with 100 percent T4.

As this and many other cases show, what you don't know about hypothyroidism can
hurt you. This is a critical lesson that we'll explore in more detail throughout
this book, so that you will have the knowledge to seek out an accurate diagnosis
and the treatment you need.

WHAT DOCTORS MAY NOT TELL YOU ABOUT DIAGNOSIS

The American Academy of Clinical Endocrinologists (AACE) is the governing body
for endocrinologists, the doctors who specialize in hormone problems like
hypothyroidism. Over the past two years, they have twice revised the ranges
considered normal for thyroid function. Basically, they continue to expand the
lab test range for the TSH to include more patients with hypothyroidism.
According to a 2003 AACE press release, "The prevalence of undiagnosed thyroid
disease is shockingly high, particularly since it is a condition that is easy to
diagnose and treat."

It's great that doctors are being encouraged to test more often and to heighten
their awareness of hypothyroidism. The unfortunate fact is that diagnoses will
continue to be missed by most physicians when they base it solely on their
recommended "easy to diagnose" testing method, rather than on how the patient
feels.

TSH Tests: The Good, the Bad, and the Irrelevant As far as tests go, the TSH is
a very accurate (in labese, "sensitive") test for what it is designed to
measure: thyroid-stimulating hormone. Doctors can feel confident that it will do
what it should. The problem is how the results are used.

Depending on the laboratory, most physicians suspect hypothyroidism if the TSH
levels are above the normal range.

Continues...

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Excerpted from What Your Doctor May Not Tell You About Hypothyroidism
by Kenneth Blanchard with Marietta Abrams Brill
Copyright © 2004 by Ken Blanchard, M.D. and Marietta Abrams Brill.
Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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