So why is there more hypothyroidism? Is it more awareness or is something different in the population? Well one reason is that hypothyroid children will now survive whereas before better sanitation, antibiotics perhaps they didnâ€™t, so hypothyroid children will survive and live to reproductive age then they may be attracted to another hypothyroid mate who shares the same slow lifestyle and they might reproduce and then we could have more hypothyroid genes in the population. Environmental toxicity, heavy metals, xenoestrogens, thereâ€™s more autoimmune thyroiditis than ever and also previously it may have been underdiagnosed.
Now the causes can be rare, like failure of pituitary control with low TSH secondary hypothyroidism, well if youâ€™d just looked at TSH youâ€™d never pick that one up huh? Or you could have failure of hypothalamic control, also rare low TRH. Primary is the most common thyroid failure; part of this is failure of conversion of T4 to T3 and you can have a receptive failure, thatâ€™s this quote â€˜type 2 hypothyroidismâ€™ where thereâ€™s thyroid in the serum but patients are resistant to it and need higher doses. And then thereâ€™s the concept of the thyroid and adrenals working in tandem. Adrenal insufficiency theyâ€™ll be lowered cortisol so theyâ€™ll be decreased thyroid production, decreased conversion and decreased receptor function and so unless thereâ€™s adequate adrenal function, thyroid might not work.
And thereâ€™s different concepts of treatment in the anti-aging preventive regenerative community; there are those who have had the best results and advocate treating patients what I call in series. First solve adrenal problem, then thyroid then move onto hormone by hormone. Which nothing wrong with that, except Iâ€™m kind of impatient, I want patients to feel good as soon as possible. And I think I can successfully treat the patients in parallel, addressing the various hormone deficiencies, not neglecting them, but treating them all at once. So you should treat adrenal fatigue nutritionally or those in the subset that need it bioidentical hydrocortisone. See low thyroid output is a stressful situation, so again itâ€™s the situation of lots of cortisol at first and then you burn out. When you treat with only T4, things get worse. The stress situation can actually get worse because this poor conversion and this might work for a while and then thereâ€™s adrenal fatigue. So always think of adrenals simultaneously with the thyroid.
Now we all know the hundreds of symptoms of hypothyroidism, sometimes itâ€™s obvious right when you meet the patient instantly the handshake test, thereâ€™s a cold hypothyroid type of hand. Fatigue, patients complain of fatigue, dry skin, constipation, canâ€™t lose weight, we know the whole thereâ€™s hundreds and hundreds of symptoms. The weight gain, patients are unable to metabolise the calories and donâ€™t feel like exercising, thereâ€™s of course lowered body temp, and you know they can have heat intolerance as well as a cold intolerance, you could have either one. The fatigue could have an adrenal component, it could be fluid retention, depression, again we talked yesterday somehow a lot of times psych diagnoses are really hormone deficiencies and itâ€™s how depression can be actually hypothyroidism. Cognitive dysfunction generally inflammatory state, aching everywhere, headaches, dry skin, thin hair, hoarse voice, plus hundreds of more.
So thyroid hormone is built on a double tyrosine ring and the terminology T4 depends on how many iodine molecules are stuck onto this double tyrosine ring. So T4 has 4 and T3 has 3 and reverse T3 is the mirror image.
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