February 2006
It can be tricky to put your finger on. In fact, I tell my patients it’s sort of like finding that needle in the haystack. First of all, its main symptoms-constipation, mild depression, stubborn weight gain, and dry skin-are things we’ve all had at one time or another, and they can all be linked to lots of other conditions. So it’s not always easy to connect the dots on your own.
What’s even worse is that if your doctor is a stickler for the guidelines laid out in his medical school textbooks, even he may not realize you’re suffering from hypothyroidism. But I’m getting ahead of myself.
First, let’s take a couple of minutes for a crash course on the thyroid gland and why it’s so important to have it functioning at peak performance. Fair warning-the terminology does get a bit technical, but hang in there: It’s critical information for figuring out what might really be causing some of those nagging, unexplained symptoms you’ve been experiencing.
Finding out if your thyroid needs a kick in the pants
Your thyroid is a butterfly-shaped gland at the base of your neck. It produces, well, thyroid hormone, which comes in two forms, T4 and T3. About 80 percent of the thyroid hormone in your body is the T4 type, but the T3 form is the active form and is 200 times stronger. T4 is converted to T3 in the thyroid, liver, brain, and other tissues. It regulates your body’s energy production.
If your thyroid isn’t making enough of these hormones, other systems in your body don’t have the energy they need to function properly: Your digestive system slows down, which can cause constipation; your metabolism slows down, which can cause weight gain and fatigue; and even your mood can take a downturn. Generally, you just feel sluggish-mentally and physically.
Your body has a built-in system designed to combat this situation. TSH, made by the pituitary gland in the brain, stands for thyroid stimulating hormone. If your thyroid is sluggish, your pituitary produces more TSH-a kind of kick in the pants for the thyroid. In other words, if your thyroid isn’t operating at peak performance, your TSH level goes up.
So the best way to measure your thyroid function is to have your doctor draw a blood sample and have it tested for TSH.
But this is where it can get tricky.
There’s a lot of disagreement over what TSH level indicates a problem. Some doctors believe your thyroid is okay if your TSH is below 5.0-regardless of whether or not you have all the classic symptoms. Others, including many specialists, regard 3.0 and below as normal. And some will treat patients until it’s below 1.0, if necessary for symptom relief.
When I have a patient with any of the above symptoms, I always at least consider hypothyroidism. However, I usually don’t treat it with prescription thyroid hormone replacement therapy unless the person’s TSH is over 3.0. Remember, the higher the TSH, the less active the thyroid gland.
Another reason not to like Brussels sprouts?
There are a few different causes of hypothyroidism, and finding out which one (or which combination) is at the root of your problem is the best place to start when it comes to treatment.
Hypothyroidism is often an autoimmune disorder, which means that your immune system is attacking your thyroid and preventing it from doing its job, making T4 and T3. This form of hypothyroidism is called Hashimoto’s disease.
Stress can also suppress your thyroid. And it’s possible that large amounts of soy products, peanuts, or raw cruciferous vegetables (broccoli, cabbage, Brussels sprouts, etc.) may slow down the thyroid. Personally, I think this is debatable: I’ve never seen it be the cause in any of my patients, so don’t use it as an excuse to dump the broccoli just yet.
6 ways to jump start your thyroid
Most specialists, including some holistic-minded doctors, use synthetic T4 (Synthroid or Levothyroxine) to treat hypothyroidism. This approach is meant to replace what your own thyroid isn’t making. Response is usually pretty slow, so your doctor will probably wait six to eight weeks before checking your TSH again.
Nutritional support can also help. Selenium (200 micrograms a day) and adequate vitamin D levels are important for thyroid hormone production. Iodine also plays a big role in thyroid hormone production: The body uses this nutrient to make T3 and T4. Adding sea vegetables to your diet is a great way to get this important mineral safely and naturally. Try nori, hijiki, dulse, arame, kombu, or wakame.
And, of course, reducing stress, or at least finding constructive, healthy ways to deal with it, is crucial with most health problems, and hypothyroidism is no exception. In fact, it’s probably even more important here.
Nutritional support and stress reduction are all some folks need. But if you’re already on prescription T4, sometimes, the added boost of the prescription medication Cytomel can help the healing process along even more. Cytomel gives the body extra T3, the more active form of thyroid hormone.
This approach is controversial because most studies show only a modest benefit from adding T3 to the mix. But those studies are hardly conclusive, and I’ve seen good results in my own patients who use this approach.
Some people have had great results using a product called Armour Thyroid, which has both T4 and T3. (It’s made from ground-up pig thyroids, which isn’t an image most people like to think about-but, all unpleasantness aside, it can work very well.) You’ll need a prescription from your doctor to get it, and you’ll have to follow up with him regularly to figure out the right dosage and monitor your progress. But, depending on how bad and how persistent your symptoms are, it may be well worth the effort. J
Your step-by-step guide to waking up a lazy thyroid
#1.) Find out your TSH level. You may want to consider visiting a specialist, called an endocrinologist, for testing and follow-up. Endocrinologists tend to take a broader approach to diagnosis and treatment than most other doctors.
#2.) If your TSH is over 3.0 and you have any of the symptoms I mentioned earlier, you may benefit from treatment with prescription thyroid hormone replacement. Generally, the higher the TSH the more likely you are to benefit from treatment.
#3.) Try 200 micrograms of selenium and 1,200 IU of vitamin D. These nutrients play an important role in the production of thyroid hormone.
#4.) Include some sea vegetables in your diet a few times a week. You can find nori in most health food stores or Asian grocers. Chop it up and throw it in your salads, soups, or stir frys.
#5.) Work on coping with stress more effectively. Easier said than done, I know, but there are actually lots of resources available to help you with this. One of my favorite techniques is deep breathing. I often recommend either joining a Yoga class or doing Dr. Andrew Weil’s excellent CD program BREATHING: The Master Key to Self Healing. Any form of regular exercise can also help reduce stress. In more severe situations, I’ll refer patients to a psychotherapist.
Lose weight, boost energy, and more with the herbal breakthrough of the 21st century
There’s a supplement available right now in just about every health food store in the country that has been shown to safely improve mood, memory, weight loss, energy, and athletic performance. Yet this “superherb” has gone unnoticed in these parts–until recently.
Rhodiola Rosea, also know as Arctic Root, is an adaptogen harvested from mountain slopes in Russia. It has a long history of improving all the factors listed above.
Russian cosmonauts, soldiers, Olympic athletes, and busy octogenarians have all benefited from its effects. And as you’ll see, rhodiola is a veritable herbal powerhouse with the potential to help just about anyone.
Keep stress from making you sick and fat
First, let’s back up a step and talk about adaptogens in general. Adapt-ogens are plants that normalize body functions and help you adapt to stress. If you’re too cranked up, they’ll calm you down. If you’re sapped of energy, they act as restoratives.
Specifically, rhodiola balances the release of stress-related hormones like adrenaline and cortisol. In small doses, these hormones are good for you, but you don’t want them chronically elevated by stress.
If they stay too high over long periods of time, it actually suppresses your immune system and makes it harder for you to fight off infections. Stress hormones also make your body store fat, so it’s harder to lose weight if your levels are constantly high.
But rhodiola helps your body help itself by evening out that stress response. Then your immune system can do its job, producing more natural killer cells and T-cells to ward off bacteria, viruses, and other germs. And by balancing the body’s stress response system, you produce less of the fat-storing stress hormones while promoting the burning of fat as energy.
And speaking of energy, rhodiola can also increase physical work capacity and quicken recovery after physical exertion. It helps your body and muscle cells take in and use oxygen more efficiently.
Think fast
Of course, if you’re handling stress better, you’re also going to feel better emotionally and perform better mentally.
Rhodiola can boost mood on its own, but when you consider all the other benefits, it’s really no wonder people who take it report enhanced well-being. Plus, it can enhance the effects of antidepressants and help relieve some of their more troubling side effects, such as loss of sex drive.
Several promising studies also demonstrate rhodiola’s ability to improve mental performance under stress. In one study I saw, students taking a proofreading test made significantly fewer errors when given rhodiola beforehand.
The main reported side effects are excess stimulation and jitteriness. You can avoid this by starting at a low daily dose and slowly increasing it over time.
You can start by taking as little as 25-50 mg a day, about 20 minutes before breakfast and/or lunch. Increase your dose by 100 mg every three to seven days until you hit your ideal dose (up to 300 mg per day). Don’t expect immediate results. It can take anywhere from two weeks to two months for rhodiola to take full effect. A couple of high-quality products I recommend are Rosavin from Ameriden and Rhodiolaforce from New Chapter.
The best source of information on rhodiola I’ve seen is a book called The Rhodiola Revolution by Richard Brown, M.D. Check your local library to see if they have a copy. If not, it’s available in most bookstores. J
10 Facts you should know about PROBIOTICS
The single smartest way to live longer-and healthier
We’ve all been conditioned to think of bacteria as the enemy. Sure, they’re the culprit behind all sorts of problems-from food poisoning to bronchitis to dental cavities. But that’s only half of the bacteria story.
There are thousands of strains of bacteria out there-and many of them are good for you. In fact, your life literally depends on the good bacteria, called probiotics, that live in your gastrointestinal tract.
Children delivered the old-fashioned way (i.e. not by Cesarean section) and then breast fed get a good dose of probiotics from the birth canal and in mother’s milk. These healthy bacteria colonize in the infant’s gut and contribute to good health throughout his life.
But there are a lot of things that happen along the way to bring our levels down-poor diet, chronic emotional stress, and drugs (antibiotics, oral contraceptives, steriods like prednisone, cortisone, etc.). And those things can result in a condition called dysbiosis. In turn, dysbiosis can lead to all sorts of health problems, including fatigue, flatulence, poor complexion, bloating, inability to lose weight, constipation, diarrhea, abdominal cramps, poor digestion, and spastic colon-just to name a few.
Probiotics promote a healthy balance of good vs. harmful bacteria in your gut, support good digestion, boost immune function, increase resistance to infection, and help keep your cholesterol levels healthy. Basically, getting enough probiotics is one of the single smartest ways to encourage good health and longevity.
Some of the best sources are foods that you probably already eat on a regular basis, including yogurt, kefir, sour cream, sauerkraut, and miso (fermented soy). But you may need an extra boost every now and then. That’s why there are also numerous probiotic supplements available. As I mentioned earlier, there are lots of different strains. Some of the most common are lactobacillus acidophilus, lactobacillus casei, and bifidobacterium.
So here are 10 facts about the benefits of using probiotics for optimal health, along with some tips that can point you in the right direction when it comes to finding the right probiotic supplement:
SUPPORT HEALTHY DIGESTION
Probiotics help make sure potentially harmful substances in your food are safely processed instead of sneaking through into your blood. They also help B vitamins work better and enhance the absorption of important minerals like calcium and magnesium.
REDUCE INFLAMMATION
When unwanted bits from your food sneak into your blood, the result is bodywide inflammation (increased immune system activity). Probiotics can help prevent and repair a “leaky gut” and the inflammation it fosters.
GET RID OF DIARRHEA
By re-establishing healthy bacterial balance, probiotics naturally address the underlying cause of many forms of acute diarrhea and offer a safe treatment and cure.
FIX GAS AND BLOATING
Probiotics work extremely well for alleviating the common and annoying symptoms usually associated with so-called irritable bowel syndrome.
TREAT YEAST INFECTIONS
Regular long-term probiotic use is an excellent strategy for putting an end to chronic recurrent yeast infections for good.
CALM ALLERGIES
Children exposed to probiotic bacteria in the birth canal suffer fewer allergies and less eczema. Regular supplementation with probiotics in infants-especially babies born by C-section-is a smart move. Makes sense for teens and adults, too.
PROTECT AGAINST ANTIBIOTIC SIDE EFFECTS
We all know antibiotics save lives. They work by killing off bacteria that’s causing infection. But they also kill off all the good bacteria in your system-the body’s natural supply of probiotics-along the way. In the short term this causes symptoms like diarrhea. But long- term overuse of antibiotics may contribute to more serious health problems, such as cancer and heart disease. Probiotics help protect against these adverse effects by repopulating your intestines with “good guy” bacteria. Take a probiotic two to four times a day on an empty stomach while you’re taking your antibiotic. Continue taking the probiotics for up to a week after you’ve finished your course of antibiotics.
GOOD FOR CHOLESTEROL
Regular probiotic supplementation is a good addition to any heart-health regimen. Probiotics have modest but meaningful cholesterol-lowering effects. Plus, they reduce inflammation. But unlike most statin drugs, probiotics are safe (after all, we’ve been ingesting these bacteria in our foods for thousands of years), cheap, and confer clear general health benefits.
PROTECT AGAINST CANCER
Probiotics help prevent cancer indirectly by improving general immune system function. But research indicates that they may also help remove cancer-causing compounds directly from the body. Although we don’t have definitive evidence, study results are promising–especially in regard to colon and breast cancer.
PROBIOTICS TASTE GOOD!
Even though you may get less healthy bacteria in foods than in supplements, they can be just as effective. That’s because in food they work more as a coordinated team. Yet another good reason to look to food as your primary source for healthy nutrients.
Which products?
Live probiotic products offer broader benefits than freeze-dried products. Both have favorable effects on the immune system, but the live product is much better for repairing a “leaky gut.” The live versions need to be kept cold, so you’ll find them in the refrigerated section of your local health food store. I usually recommend products that contain multiple strains of good bacteria.
I like the probiotic formulas from Yarrow and Nature’s Way, which are available in just about any health food store. I also get good results with a widely available freeze-dried product called PB8.
Dannon also has a new product on the market called Activia, which is yogurt fortified with a unique strain of bifidobacteria that can be helpful in a variety of digestive complaints. It’s worth a try.
For most common ailments, I aim for 4 billion colony forming units (CFUs) a day. A single dose two to four times a day on an empty stomach more than meets that goal. Continue for two weeks to a month. When you start to notice some improvement, back off to supplementing only on the weekends for the longer term. You won’t need to take it as often once you’re feeling better because the probiotics usually stay in the gut for seven to 10 days.
It’s safe and reasonable to continue supplementing with probiotics permanently-in fact, I recommend it. Of course, if you’re eating yogurt or other fermented foods on a regular basis, you can skip the pills, unless you come down with an acute ailment. J
Feed your probiotics
Prebiotics are forms of insoluble fiber found in many fruits and vegetables. Probiotics (good bacteria) use prebiotics for food. They’re found in bananas, onions, asparagus, and many other plant foods. Most Americans get about 2 grams of prebiotics a day-but that’s less than half of what you should be getting. So try to find ways to get more of those fruits and vegetables in your diet.
Big Pharma, big money-big mistake
How one Harvard doctor would fix American medicine
America is almost off the charts with its combination of poor health and high healthcare costs. The reason behind this enormous problem? Well, in short, we’ve all been bamboozled by the drug companies and the doctors they hire into believing more drugs equal better medicine. In fact, the real scientific evidence tells us that many of the things you can do for yourself-safe, natural things-are more effective than drugs. For example, like we talked about last month, a healthy diet beats cholesterol-lowering statin drugs, hands-down.
So why the big push for drugs? Because they make lots of people lots of money-pure and simple (well, maybe not so pure, but that’s the bottom line).
This situation has one prominent M.D. named John Abramson-from Harvard’s medical faculty no less-irritated. Enough so that he wrote a book about it called Overdosed America: The Broken Promise of American Medicine.
Dr. Abramson has cared for thousands of patients and has a background in research and statistics. Based on his personal experiences and observations, he insists commercial interest, not patient care, dominates the research that guides doctors. And the result is that most doctors have been duped by the drug companies, just like their patients.
In the book, Dr. Abramson proposes we clean up our research, reward good care, and not let the government stand by as a paid off sugar daddy to the drug companies. And yes, he also believes that patients should take more responsibility for their health.
Dr. Abramson has done his homework. His book is a quick read and easy to understand. I highly recommend you read it. Check your local library for a copy. If they don’t have it, you can find it in your local bookstore or on amazon.com. When you’re done reading it, give it to your doctor. J
HOMETOWN HEALING
Being scared to death could save your life
I see Big Bill in my office every three months. He’s 58. Only Big Bill isn’t so big these days. He lost 60 pounds a couple of years ago, when he learned he had diabetes. Now he’s down to 175 pounds-the same amount he weighed back in high school. But I didn’t even have to put him on a diet to get him to this point. He did it all on his own.
You see, Bill got the fright of his life when he got diagnosed with diabetes. He knew if he didn’t do something for himself he’d be a goner like his dad-dead at 65 of a heart attack. He also didn’t like the idea of going blind, losing a leg, ending up on dialysis, or dying 10 or 20 years prematurely. So he took matters into his own hands.
Bill has never been one for prescriptions if he can possibly avoid them, so he knew he had to start with lifestyle changes.
So he cut out the junk, learned to cook, and upped his intake of fruits and vegetables. One big change Bill has made in his eating habits is to make sure that he has a big breakfast every day. Then he snacks on nuts mid-morning and late-afternoon. Those two simple strategies keep him full longer so he doesn’t want those sugary snacks from the vending machine at work.
The other thing Bill’s done is start exercising. He lifts weights twice a week and does a lot of walking. He also bought himself a bike at WalMart. It wasn’t the most high-tech, but he didn’t care how fancy it was or how fast it went-just that it went.
It sounds like a lot-and it is. But Bill told me it wasn’t too hard to find the time for it once he cut back on his TV viewing. Plus, he says its well worth missing a show or two to know that he took control of his health and his future.
Now he shows up for each appointment with his daily blood sugar and blood pressure numbers charted in neat columns on a computer spreadsheet. And those numbers are rock-solid normal.
On his last appointment he seemed a little warm and slightly winded. Turns out he rode his WalMart clunker to his appointment-that’s 15 miles one way. Now that’s what I call taking life by the handlebars! J
Simple tips for making your own diabetes-defying lifestyle changes
#1) Eat a healthy breakfast every day. Focus on foods high in protein or whole grains, like oatmeal or scrambled eggs cooked in olive oil. Your body takes longer to process them, so they’ll keep you satisfied longer than refined carbs like cold cereal or a bagel.
#2.) Have a handful of almonds or walnuts around 10 am and again around 2 or 3 pm so you’re not starving by lunch or dinner.
#3) Give up two TV shows a day. I know it seems like I’m asking a lot, but trust me, after a couple of weeks without “Wheel of Fortune” and “Entertainment Tonight,” you won’t even miss them. And it will give you at least one extra hour that you can use for a health-promoting activity. For example, you might want to…
#4) Take a cooking class. Most community colleges offer inexpensive courses in the evenings, and often you’ll even find classes designed specifically around healthy foods.
#5) On nights you’re not in cooking class, use your extra hour to take a walk, go dancing with your husband or wife, join a bowling league, or any other type of physical activity. It doesn’t have to be tedious, or even seem like exercise. As long as you’re up and moving, it’s good for you.
Your Questions Answered
Put an end to bad habits and get a good night’s sleep
Q: Help! I don’t sleep well. I have no trouble falling asleep, but wake up in the middle of the night and sometimes stay awake for hours. And I’m not even stressed out most days…except about my sleep.
–P.L., Boca Raton, FL
A: Most problems with insomnia are brought on by bad habits and are best addressed by changes in behavior and attitudes. Treatment approaches focus on sleep hygiene-reserving the bedroom for sleep, avoiding stressful evening TV, not lying awake in bed, waking up at the same time every morning, and the use of sleep journals.
I also recommend an excellent new book called Say Good Night to Insomnia, by Gregg D. Jacobs, Ph.D., who developed the highly successful Behavioral Medicine Insomnia Program at Harvard. An interactive six-week program based on this approach is available for just $35 from www.cbtforinsomnia.com.
As for sleeping pills, they may work as a short-term fix, preferably not for more than one or two weeks at a time. Ambien, the new Lunesta, Trazadone, and even Ativan can all help. But beware of rebound insomnia, where you don’t sleep well the first night off the medication. The brand new Rozerem works with the melatonin receptors in your brain’s pineal gland and may be a better choice for occasional use. But keep in mind that even if a drug is declared to be non-habit forming, you can still become psychologically dependent on it.
The herb valerian can also be quite effective, but you need to give it up to two weeks to work. Then don’t plan to use it for more than one to two months. When you quit, taper off over two weeks. I prefer Nature’s Way Standardized Valerian Extract. Take one or two capsules before you go to bed.
The text contained herein does not constitute medical advice. America’s Country Doctor advises that you consult your own physician before acting on any recommendations contained within this publication.
Posted in Newsletter.
