Friday, July 20, 2012

a big WHAT IF

Now, i generally don't like to play the "what if" game.  It's usually all about something that DIDN'T happen or COULDN'T happen, and the conversation is usually started by somebody who has a fantastical vision of "wouldn't it be cool if"....  Entre nous, fantasies are rarely attractive to those NOT INVOLVED with the fantasy, and if they ARE widely attractive, they make a lot of money.  Fantasies are all about wish-fulfillment, and if you're not having your wishes fulfilled by somebody else's dream, there's nothing in it for you.

But while reading a blog today about a lady and her thyroid woes, i was struck by something:  she had never had very high TSH levels, but had been practically incapacitated by symptoms generally recognized in hypothyroid people, including low free T3.  BTW, she's also struggling with adrenal issues.

WHAT IF the problem this lady has is not about her thyroid at all -- her symptoms are caused by shortages of ... oh, say, the nutrients in the supplements i've found that help ME?  Her thyroid is doing its job, according to her brain, but suppose her body is converting the available T4 to rT3 to protect her from even more internal stress -- the stress being exacerbated by poor absorption of nutrients?  WHAT IF all she has to do is "get selfish" and remove the impediments to good sleep and peace-of-mind in her life, thus reassuring her body that it doesn't have to hunker down in preparation for a "long winter"?  Would she perhaps not be any more hypothyroid than i am, a borderline case?

Just thinkin'....


  1. Symptomatically it is possible for a person with functional inhibition of thyroid (euthyroid sick syndrome) to have the same, or greater symptoms, as a person with a pathological hypothyroidism such as hashimotos. However, the euthyroid person will not be considered hypothyroid, because the diagnosis of hypothyroidism is medically substantiated by a pathology in either the brain or thyroid gland to work when it otherwise should.

    Primary hypothyroidism would be a failure of the thyroid to respond properly. An example of this is hashimotos and this is the most common type of pathological hypothyroidism.

    Secondary hypothyroidism is when the hypothalamus or pituitary fails to make the releasing and stimulating hormones to tell your thyroid gland to work. Brain injuries and tumors are examples of this sort and it is more rare.

    When a person has a stressful lifestyle, loses weight, constantly under eats calories, fails to sleep well, gets sick , or any of the thousands of reasons functional hypothyroidism may occur, this person does NOT have hypothyroidism but rather they are exhibiting a normal response of the physiological stress adaptation which is healthy and saved our ancestors for gajillions of years. The difference is that in this instance, sleeping well or gaining weight or eating food is going to fix the problem, because the hypothalamic pituitary thyroid axis is in tact , it is only temporarily not working because of adverse environmental condition.

    But otherwise, it is totally possible for the extent of symptoms to be greater in the functional thyroid inhibition case, if the hashimotos case is optimally treated. A well treated thyroid patient should be euthyroid with no hypothyroid symptoms... it only so happens that thyroid treatement sucks and most hypothyroid patients are treated suboptimally and live with symptoms.

    Sort of how, if I develop functional hypothalamic amenorrhea, I do not have a disorder like hypogonadotropic hypogonadism
    The difference is that in FHA, the brain *purposely* fails to make GnRH because of high cortisol and low leptin (i.e. stress + starvation). On the other hand, hypogonadism is a disease, a disorder, where the brain cannot make GnRH because it is damaged by a tumor or some other insult. If I eat a big bag of calories every day my amenorrhea goes away, whereas the other patient will never regain fertility because their brain is diseased and simply can not make GnRH, and they will require GnRH replacement for fertility if they want children, and hormone replacement therapy otherwise.

    These distinctions are important because the therapy is *radically* different between a functional and a pathological endocrine disorder like this.

  2. Endocrinology is nearly as bad as psychiatry in that these problems are still largely terra incognita and hence susceptible to woo, quackery and incompetent doctors throwing l-thyroxine at anything, no matter how inappropriate. Enter Chris Kressers of this world who are ironically right about having to refeed your body after the prolonged stress of starvation (ketosis) to repair functional hypothyroidism but they are right for reasons they don't understand.

    1. "right for reasons they don't understand" -- lol!

  3. Do you guys think the hpt axis might get permenantly damaged even if by only environmental difficiencies if they last long enough? Ive been big since childhood. :( Im makin g great systemic improvements now with diet, but things are slow going (yet steady!)

    1. @Keto

      Some health problems are permanent, yes. Eating the best diet in the world is not going to make some of us thin or healthy. This is why I consider people who promise perfect health and turning on of epigenetic switches QUACKS.

  4. darned good question. my guess is yes, but let's hear what Wooo and Sid say! :-)

    on the other hand, my case is also curious, and i'd like their opinions on it, also....

    diagnosed at 6 mo. as hypothyroid, did poorly for years on Synthroid, settled in well on Armour. when Euthroid (yes, a brand-name, contained t4 and t3) came out, did well on that, but went off the market when i was in my 20s. went round-and-round with Synthroid again, till i got a new doctor who put me back on a natural desiccated thyroid. a few years ago, when the "natural thyroid shortage" came about, i started doing my research and treating myself, and now i'm doing well prescription-free, with over-the-counter dried-thyroid-gland supplements and a big handful of mineral supplements. was it malnutrition all along? my thyroid was just sluggish for 55 years, and suddenly it woke up when i started doing the right things?

  5. Thats facinating Tess! It seems self treatment is very needed in these issues since they're so complex and individualized. Hopefully even with longterm damage it may simply mean a long term recovery. Deep regeneration may take years and years and with medicare on the rocks, every effort can only make our older years less tragic.

    1. KK, i couldn't agree more! those of us who are able to, having time and resources (mental, mostly) to do it, are MUCH more likely to enjoy health than others, who can't take the risks of trial-and-error. even medical specialists are generic in their approach to treatment, and our recent discussions put a spotlight on HOW DIFFERENT we midlife, overweight women are! different hormones are playing games with each of us, and what works for one isn't right for the next....

      if there's ANYTHING i want to accomplish, it's to stabilize my HEALTH at this age -- to minimize the affects of wear and tear. if i can lose weight ALSO, that's gravy!