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Insidious Hypothyroidism (4/5)

 

4) Problem of how to interpret blood analysis.

For example, your blood test result for FT4 shows a value of 0.81 ng/ml. Reference value for FT4 is 0.80 to 1.6 ng/ml. In this case, 0.81 is within the reference value, and your thyroid function is regarded as normal. However, if the result is 0.79, as it falls short of reference value, this case is treated as hypothyroidism. Where on earth is so much difference between 0.79 and 0.81? Depending on the physical condition of the body, the numbers might fluctuate between 0.79 and 0.81 in the same person. These kinds of factors are not considered at all during inspections as just the numbers are considered.
As a result, thyroid function seems to be apparently normal and if your mood is heavy and depressive, doctors recommend you to go for psychosomatic medicine or psychiatry. This can be disastrous in particular if it is diagnosed as depression. Many doctors like to prescribe anti-depressants (as it increases the revenue) , but it ruins the patient's life.

Even in your 50's, 60's, as far as you are healthy, you can recover from most of the fatigue after good sleep. However, if you suddenly start feeling abnormal fatigue when you wake up after a good sleep, please consider the possibility of hypothyroidism.

Thermometer
Please measure your body temperature every morning after you get off your bed. You can use an ordinary thermometer. The cut off temperature should be 36.2°Celsius (97.16°Fahrenheit) in armpit. If your thermometer shows less than 36 degrees, there is a high possibility of hypothyroidism. (Please pay attention. Use at least two thermometers for measurement as even two thermometers bought from the same place at the same time may differ by as much as 0.5 degrees.)

ALP↓+ Cholesterol↑ ≒ Hypothyroidism ?
Another easy way to find a decrease in your thyroid function. In medical examination a routine blood test is carried out to check liver function and cholesterol. The resulting values of ALP and cholesterol level can be used for analysis.

ALP (alkaline phosphatase); It shows abnormal values when abnormalities of gall bladder / bile duct/ liver system, bone metabolism etc. occur. In many cases, attention is urged when it is higher than normal value, comments such as requiring precise examination of the liver and the gall bladder or bone following general medical examination. However, when it shows a low value, it is easy to be neglected. Because, except zinc or magnesium deficiency (e.g. alcoholism), ALP shows lower values only when you are suffering from "hypothyroidism", or "hereditary hypophosphatasia". The latter is a very rare disease that occurs only to about one in 100,000 people.

Cholesterol ; Hypothyroidism reduces the synthesis of bile acids from cholesterol in the liver. This results in increased blood cholesterol.

If the decrease in ALP level and rise in cholesterol level happen at the same time, it will be smart to visit a clinic keeping hypothyroidism in mind and get it scrutinized.

Here we take a specific case:

45 Years old Woman
ALP 87U/L (reference value: 104-338)
Total Cholesterol 272mg/ dl (reference value: 150-219)
HDL Cholesterol 125mg/dl (reference value: 40 to 90)

Main complaints of this patient are obesity, serious forgetfulness, fatigue, and hair loss. Doctor seemed indifferent to thyroid gland. Thus the thyroid hormone test was not done. As other numerical values were normal, she had been recommended to take anti-hyperlipidemic agents based on above test results. Since the symptoms did not go away, she went to another hospital and found out that she was suffering from mild Hashimoto's disease.

Everyone should look again at the blood test result of medical examination taken last year. And if "ALP ↓+ Cholesterol ↑" with fatigue, sluggishness, constipation, slow pulse, poor concentration, obese even after exercising, puffy face, missing eyebrows, stiff hair, dry skin, ED (male), menstruation irregularities (female), you might have considerable probability of hypothyroidism.

If you took statin drugs such as pravastatin, simvastatin, atorvastatin, fluvastatin, etc. to reduce cholesterol before you check your thyroid function, it would make the problem much worse. Because the side effects of statin drugs include muscle weakness and memory lapses. Then, you and your doctors cannot know which is the true cause for these symptoms, hypothyroidism or side effect of statin.

* When ALP is higher than normal range, you should check not only the liver and the gallbladder but also the bone. ALP has 6 isozymes (ALP1~ALP6), and if ALP3 is too high, you may suffer from hyperthyroidism or hyperparathyroidism. Please do visit thyroid and parathyroid specialists.


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