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Insidious Hypothyroidism (1/5)

 

"Insidious Hypothyroidism" is pandemic. To prevent it, the following supplements are recommended --- Collagen, Vitamin D3, α-GPC, Shell Ginger, Omega 3 Unsaturated Fatty Acid, Selenium, zinc, manganese, vitamin B.

You may suffer from one of the 4 types of "Insidious Hypothyroidism" --- “Hidden Hypothyroidism", "Overlooked Hypothyroidism", "Subclinical Hypothyroidism", and "Estrogenic Hypothyroidism".

It was 1986 when I traveled in Ethiopia, I saw a lot of women who had goiter (a swelling of the neck or larynx resulting from enlargement of the thyroid gland).
Probably it was due to lack of iodine from seaweed because Ethiopia doesn't have sea. Since then I have been intrigued by thyroid problems. And recently I realized that really many people are suffering from thyroid problems insidiously.

1) What is Insidious Hypothyroidism?

In last 30 years, the body temperature especially of female has often been found to be lowered to less than or equal to 36°Celsius (96.8°Fahrenheit). The lower body temperature is the source of many kinds of diseases.

Common to these people are fatigue, sluggishness, depression, constipation, increased sensitivity to cold, slow pulse, poor concentration, forgetfulness, memory lapses, dry skin, hair loss, coarse hair, brittle nails, a puffy face, unexplained weight gain, joint pain and stiffness, muscle weakness, enlargement of the tongue, excessive or prolonged menstrual bleeding, erectile dysfunction, and so on. They are having some of these symptoms at the same time.

These modern malaise symptoms are often caused by decreased function of the thyroid. Usually doctors check TSH (Thyroid-Stimulating Hormone), T3 (Triiodothyronine), and T4 (Tetraiodothyronine or Thyroxine). And often three of them are "Within Normal Range". Therefore doctors think the patients are free from thyroid problems.

T3, T4 and rT3 are the three types of thyroid hormones. T3 has stronger activity to that of T4. rT3 is the mirror image isomer of T3 and “r” indicates reverse. Its function is almost zero compared with that of T3. Thus, we consider T3 as the main thyroid hormone. But in normal blood analysis, rT3 is regarded as the same as T3, and the analysis comes up as T3, because ordinary check cannot distinguish rT3 from T3. Consequently the check reports "T3 + rT3" as total T3. So, even if "T3 + rT3" consists of "10% T3 + 90% rT3", the result shows that the patient's T3 is "Within Normal Range”.
But if rT3 is 90%, the thyroid function is very weak. Routine test, however, does not examine rT3. Moreover, TSH also comes to be normal in some cases. And doctors say to you, "Your thyroid function is OK".

In addition, in some people even though T3, T4 and TSH levels are really normal, they might be suffering from chronic thyroiditis (Hashimoto's disease), or contrary to it, Graves' disease (hyperthyroidism), which can be detected after conducting tests for TgAb (anti-thyroglobulin antibody) and TPOAb (anti-thyroid peroxidase antibody). In other words, even if there are pathological lesions in the thyroid gland, the thyroid hormone levels seem to be maintained, masking the underlying problems. These two antibodies test are not carried out in ordinary, other than at the thyroid specialist clinics. So, if you have any suspicions about your thyroid, I recommend you to always consult the specialists and have these antibodies test done.

I call these medical conditions as "Hidden Hypothyroidism". Females with family history of thyroid problems are most likely to get it. But it even occurs in male.

A male patient with psoriasis came to me. He was using a disposable hot patch in mid-summer. As a precaution, I recommended him to carry out echo and get his thyroid functions checked by a thyroid specialist.
The result showed his TSH slightly higher than the normal value, a symptom of mild Hashimoto's disease, for which medications are not usually prescribed.
Psoriasis and Hashimoto's disease are not directly related to each other. But he had been under observation of dermatologists for 10 years and the dermatologists didn't notice that he was suffering from Hashimoto's disease. Hypothyroidism is likely to be missed like this.

As hypothyroidism is relatively more common in women compared to that of men, it might be easily overlooked in men. So, there might be the more cases of "Overlooked Hypothyroidism" than women. In men, laryngeal prominence (the so-called Adam's apple) is significant to that of women. Thus, the thyroid enlargement might have been mistaken for Adam's apple in an unexpectedly high rate.

In this case of the patient with psoriasis, if T3 and T4 levels were normal, specialists would call it as "Subclinical Hypothyroidism". Since TSH is very sensitive, the anomaly comes first to this hormone. This condition is pretty much popular, estimated to be 4% to 10% of the general population, and it is confirmed that the prevalence rate will be higher and will exceed 20% for elderly people. Regarding the necessity of treatment of "Subclinical Hypothyroidism", there are guidelines, and doctors decide whether to treat or not by prescribed drugs based on the guidelines. In most cases, patients kept under observation and only in case of pregnant women or those women who try to have a baby, the treatment begins immediately.

We may have higher cases of Hidden Hypothyroidism, Overlooked Hypothyroidism, and Subclinical Hypothyroidism than we think.

If you are feeling depression or unexplained melancholia, you might be suffering from thyroid problems. So, better meet a thyroid specialist before moving to psychiatry and psychosomatic medicine. If you are diagnosed with Subclinical Hypothyroidism or mild Hashimoto's disease or you are in border region of normal value, doctors tell you, 'You don't need any treatment now. Let's see'.
Similarly, even if you have abnormal TgAb and TPOAb values but normal T3 and T4, then it is thought you don't need any treatments. And probably your medical insurance doesn't cover if you want to check more the slightest change in thyroid hormones. So, in order to get rid of the depressive mental symptoms, you may reluctantly go for psychiatric and psychosomatic medicine. But, of course, the antidepressants are never effective, because your problems are from thyroid, not mental. And doctors increase the dose of the drugs more and more and you will become intoxicated by the drugs themselves, and finally you would suffer from true psychosis by unnecessary drugs.

I saw this tragic case often.


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