A study published in December 2012 sheds light on this phenomenon we often see: a patient has elevated TSH but normal T4 and T3. If that person is gaining weight and experiencing fatigue do they also have Hypothyroidism?

By standard definition elevated TSH indicates Hypothyroidism. Usually elevated TSH levels correspond with a decrease in T4. But if the T4 levels are normal, this may indicate abnormal blood sugar metabolism or inadequate blood sugar. This phenomenon is usually referred to as Dysglycemia and includes blood sugar which is too high, Insulin Resistance, or blood sugar that is too low,Hypoglycemia. Both of these conditions may occur simultaneously and may often lead to Type II Diabetes.

One of the markers we look for in our patients who are experiencing weight gain is Dysglycemia. Many thyroid patients  have undiagnosed pre-diabetes or insulin resistance which can lead to elevated TSH levels and guess what? A number of hypothyroid symptoms such as hair loss, brain fog, menstrual irregularity, PCOS, not to mention the weight gain and fatigue!

So most patients who go to the doctor for weight gain and fatigue in which the doctor only sees elevated TSH levels are immediately placed on thyroid hormones. The underlying blood sugar problem never gets fully evaluated and the patient continues to suffer with symptoms because the lab marker was treated and not the PATIENT.

This is what Erin H has to say regarding the care she received from us. ” I am a 32 year old woman who had a long list of thyroid symptoms that many doctors I consulted only gave me a prescription for anti depressants and made me believe I just had to live with the condition. After meeting Dr Gorgas I felt confident that someone was actually hearing me. He ordered specific lab work and x – rays to evaluate my condition. The work up was extensive and he found the cause of my condition. The regimen of supplements, chiropractic adjustments and going gluten free has helped me live my life again. I am sleeping better, losing weight, have better moods and lots of energy. I actually feel my age again”.

This is why we take the whole person approach and make sure you Understand the problems and mechanisms involved so that you can feel and function better.

Most importantly, we care and listen to our patients.

We take a partnership approach to health care and encourage you to play an integral role in your treatment. Our goal is to educate you so that you can manage your thyroid symptoms for life.

Weight Gain and Hypothyroid Symptoms!

To Most people suffering from Thyroid problems, this is a no brainer to figure out. However, it is uncommon for me to encounter a hypothyroid patient that does’t have stomach problems and intestinal abnormalities.

When I consult patients at the San Diego Thyroid Institute with ongoing thyroid symptoms I see a world of possibilities.There are so many things that can go wrong that could be creating the problems. I know that I must start searching to put the pieces together to help that person. One of the first places I look  is the stomach. Gut infections, Dysbiosis ( the over-growth of bacteria or yeast in the small intestine), Leaky Gut Syndrome (LGS) and food intolerance are the most common culprits. These conditions can upset the flora ( good bacteria) in the gut and have the potential to disrupt thyroid function.

These gut microorganisms can affect thyroid function at all levels including:

1.  Thyroid Receptor site resistance – where your hormones can’t actually bind to your receptors. This creates the classic presentation of ongoing thyroid symptoms despite being able to see normal amounts of TSH in your Labs
2. Decreased T3 production
3. Decreased TSH production from your pituitary

All of that from your stomach! Thought you just had a Thyroid Problem didn’t you?

If you experience bloating, constipation or diarrhea, then you must consider the impact of how gut infections, dysbiosis and leaky gut syndrome are affecting your thyroid. dealing with Gut issues is imperative if you want to feel good again.

Here is what Leanne E. has to say about how her health improved. I was diagnosed with Hypothyroidism and had all the symptoms associated with the condition. I was fatigued, frumpy,losing my hair, had daily headaches, neck pain, etc. I had consulted my endocrinologist for years about this symptoms and the problems I was having  with my stomach and bowels. I bloated after every meal and if I wasn’t constipated, I would have lose stools. It wasn’t until I consulted with DR .GORGAS that he shined the light on the cause of my gastrointestinal problems. He also enlightened me on how the nerves also control the function to not just my stomach, but every part of my body. Following  his recommendation protocol of diet change, supplements and Chiropractic adjustments, I started feeling the best I felt in years within two weeks. I can proudly say that my digestion problems have disappeared along with my headaches. Most of all, I am not feeling tired and frumpy anymore.

At the San Diego Thyroid Institute we take a whole person approach making sure that you understand the underlying causes of your problems so that you can feel and function better. Most importantly we care and listen to our patients. Our goal is to educate you so that you can manage your thyroid symptoms for LIFE!

A patient has elevated TSH but normal T4 and T3.

If that person also has symptoms of fatigue do they have hypothyroidism?

By standard definition any elevation of TSH indicates hypothyroidism. Usually this elevated level of TSH corresponds with a decrease in T4. That is the way it normally works in the body.

In this case it may not be a thyroid problem at all.

One of the things we look at in all our patients is dysglycemia (abnormal blood sugar).

Many thyroid patients have undiagnosed pre-diabetes and as this newly published article points out, pre-diabetes can lead to elevations in TSH.

And guess what?

Pre-diabetes causes many of the same symptoms as low thyroid.

So most patients that go to the doctor with fatigue and the doctor sees elevated TSH then they immediately get put on thyroid hormone.

The underlying blood sugar problem never gets fully investigated and the patient continues to suffer with symptoms because a lab marker was treated and not the patient.

That is why we take a whole person approach and make sure we understand the problems and mechanisms so we can help our patients feel and function well.

References:

Indian J Endocrinol Metab. 2012 Nov-Dec; 16(6): 958–961. doi: 10.4103/2230-8210.102999

1. They were diagnosed with hypothyroidism at some point in their lives.
2. They take some form of thyroid hormone replacement.
3. They continue to experience some degree of thyroid symptoms despite conventional treatment.

That third factor is important because the patients that respond well to hormone replacement don’t continue to search for answers. Why would you pursue further treatment if simply taking a pill seems to take care of the problem?

Actually there is the rare patient that understands that getting to root causes and taking a functional approach is important and those patients are a pleasure to work with. So if you fall into that category don’t check out yet.

The subject of this and future series of posts is going to be: “Did they consider this ….”

When I consult with a patient with ongoing thyroid symptoms I see a world of possibilities. There are so many things that can go wrong that could be creating the problem. I know I must start searching and begin putting the pieces together if I am going to help that person.

Sadly I think conventional medicine views most thyroid patients the same way. They see a patient with thyroid symptoms and prescribe thyroid hormones.

Problem solved! (except the patient still doesn’t feel good, and they still have no real understanding of what went wrong in the patient)

Taking some form of thyroid replacement is just the first step. But did they consider other possible mechanisms that could be contributing to your problem? Probably not.

Since no one has taken the reigns and helped you understand all of this I will teach you about some of these mechanisms so you can take some action on them or find somebody who will help you.

So here goes part 1. Did they consider that stomach and GI abnormalities can affect your thyroid in many ways?

It is uncommon for me to encounter a hypothyroid patient that doesn’t also have to stomach problems. Gut infections and a condition called dysbiosis, where there is an abnormal balance of normal flora in your gut, have the potential to release lipopolysaccharides (LPS).

These gut microorganisms can affect thyroid function at all levels including:

1. Thyroid receptor site resistance – where your hormone can’t actually bind to your receptors. This creates a classic presentation of ongoing thyroid symptoms despite being able to see normal amounts of hormone in the blood stream.
2. Decreased T3 production
3. Increased reverse T3
4. Decreased TSH secretion from your pituitary

All of that from your stomach. Though you just had a thyroid problem didn’t you?

If you ever experience bloating, gas, constipation, or diarrhea and you also have thyroid symptoms then you have to consider the impact that gut microorganisms are affecting your thyroid. Dealing with the gut issue is a necessity if you want to feel good again.
References:

1. Ritig MG. Smooth and rough lipopolysaccarides phenotype of Brucella induce different intracellular trafficking and cytokine/chemokine release in human monocytes. Journal of Leukocyte Biology. 2004; 5(4):196-200.
2. Van der Poll T, Endert E, Coyle SM, Agosti JM, Lowry SF. Neutralization of TNF does not influence endotoxin induced changes in thyroid hormone metabolism in humans. Am J Physiology. 1999; 276:357-62.
3. Van der Poll T, Van Zee KJ, Endert E, et al. Interleukin-1 receptor blockade does not affect endotoxin-induced changes in plasma thyroid hormone and thyrotropin concentrations in man. J Clinical Endocrinology Metabolism. 1995; 80(4):1341-1346.

“My thyroid was removed by my doctor X number of years ago but I still have symptoms. Is there any way you can help me?”

There are two reasons why people typically have their thyroid removed:

1. Graves Disease (autoimmune Hyperthyroidism)
2. Cancer

Regardless of why the thyroid gland was removed what happens is that you immediately become hypothyroid after the surgery or radioactive iodine treatment.

You no longer have a gland to produce hormones on your own so you would forever be dependent on external thyroid hormones like Synthroid or Armour. That is a fact and there is nothing that can be done to change THAT aspect.

But what happens when taking the hormone doesn’t resolve the symptoms of low thyroid?

What if you continue to have weight and metabolism issues, hair loss, brain fog, and fatigue no matter how much or which thyroid hormone you take?

If you still have low thyroid symptoms then we know that there is another culprit that is affecting your ability to use those hormones. Until we discover what that culprit is and change/fix it, you will always struggle with those symptoms.

So if you have had your thyroid removed and you still have symptoms then you need our type of functional approach more than anybody.

Our functional approach gets to the root causes of the symptoms and will help you feel and function better. We will discover what is interfering with you ability to use the thyroid hormone that you are taking every day.

The first step is to schedule a consultation in our office to discuss the specifics of your case. Click Here to Schedule Now.