August 2004 Newsletter

FHN Complementary Medicine Monthly Newsletter August 2004

Chronic Fatigue and Thyroid Medications

At Complementary Medicine we see a lot of patients that are fatigued, chronically and otherwise. Many of them have normal TSH levels and some are already taking a levothyroid product. Some are even taking a combination of levothyroid and T3 therapy.

We work with those patients from a nutraceutical standpoint (containing no active thyroid hormone) many times supporting the adrenal gland function. While we have success with some of those patients there are times when some don’t respond.

So let’s talk TSH and ….Armour Thyroid, I can hear gnashing of teeth already.

While TSH has become the ”Standard” for thyroid function measurement I don’t believe it tells the whole story. Interestingly enough the American Association of Clinical Endocrinologists has recommended that the upper limit of TSH be changed from 5.0 to 3.04mU/L. Which means that over 15% of the population who were formally “normal” are overnight hypothyroid. If the TSH is normal and we still have clinical symptoms we need to look farther, including running a reverse T3 along with T4 , T3, Anti TG, and Anti TPO. In addition determining basal metabolic rate (basal temps, or electronic measurement) will add light to the picture.

As I stated before a percentage of the population don’t get symptomatically better using the current T3 and T4 analogs, even when the TSH returns to normal. For those who don’t get better Broda Barnes M.D. has found that over 80% felt better using Armour thyroid. So let’s look at some of the objections to Armour thyroid.

It’s hard to dose because of variations between natural thyroid sources.

That may have been true 50 years ago, however manufacturing processes and quality control methods now produce a product that is consistent dose to dose. In fact a study of two year old product still was consistent with the initial assay.

Using T3 containing preparations causes serum T3 concentration to rise to supraphysiological levels.

In the dosages found in normal desiccated thyroid (9mcg T3 per 60 mg ) this has not been found to be the case. It was found that the T3 levels only rose marginally high when the total thyroid dosage was too high. Cutting back on the total dose took care of the problems.

So what’s the bottom line of this newsletter? We are not advocating using armour thyroid for every one. In fact in thyroid suppressive therapy this does not work well.

We are saying that, in some cases, where clinical symptoms warrant Armour may solve the problem. Of course the patient needs to be closely monitored by their physician to make sure that the dose is correct.