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22 FIFTH STREET
SUITE 201
STAMFORD, CT 06905
203 324 4747
BY APPOINTMENT
22 FIFTH STREET
SUITE 201
STAMFORD, CT 06905
203 324 4747
BY APPOINTMENT
Thyroid Myths
Myth #1: The TSH (Thyroid Stimulating Hormone) blood test is the only way to diagnose hypothyroidism/low thyroid.
Facts: First, there is no perfect test in medicine—not the TSH or any other. Second, nearly a century before the TSH test was developed, doctors made the diagnosis of hypothyroidism without any tests at all. They listened to their patients and examined them. Since then, there have been many tests that have been blindly followed until they proved to be unreliable and were discarded.
To this day, there are at least three types of hypothyroidism for which the TSH test does not even test. The TSH is not a useful test for hypothyroidism caused by dysfunction of the pituitary gland or of the hypothalamus (part of the brain,) or for hypothyroidism caused by "tissue resistance" to the effects of thyroid hormone.
My conclusion: The TSH test can miss the diagnosis of hypothy-
roidism. To most accurately identify hypothyroidism, I start with the approach that has worked for over a century. I listen to the patient and look for evidence of low thyroid function. If the patient appears hypothyroid, I order blood tests including the TSH, but I also (1) check basal body temperature,1 and (2) check the urine thyroid hormone levels.2 I then interpret all test results in the context of the
individual patient.
Myth #2: Normalizing the TSH (Thyroid Stimulating Hormone) blood test is the best way to treat hypothyroidism.
Fact:Many studies have shown adjusting thyroid doses to normalize the TSH blood test leaves many patients with symptoms of low thyroid. World-renowned thyroid specialist, Sir Anthony Toft, MD, discussed this sad fact in 2002. In a speech to the British Endocrine Society, Dr. Toft reviewed some of the evidence that demonstrated that the modern TSH-centered approach was ineffective. He concluded, "...the treatment of hypothyroidism is about to come full circle"—going back to the approach that worked so well before all of our modern tests and treatments were invented.3
My conclusion: Using the patient as my guide, I focus on reversing the signs and symptoms of low thyroid function while avoiding side effects or signs of thyroid excess. When the TSH is normal but the patient continues to be symptomatic, I prefer to err on the side of treating the patient—not normalizing the blood test.
Myth #3: Thyroid treatment that reduces the TSH to below the normal range (TSH suppression) has been shown to be harmful, causing atrial fibrillation (a heart rhythm abnormality) and bone thinning.
Facts: When thyroid hormone is given to a patient, TSH levels decrease. Some say that thyroid treatment that reduces the TSH to below the normal range causes bone thinning and atrial fibrillation.
Before the TSH test was invented, generations of patients flourished on doses of thyroid medicine that routinely suppress the TSH. To this day, patients with thyroid cancer who are given doses to intentionally suppress the TSH, do very well on this regimen. In 2004, after review of the scientific literature, the US Preventive Services Task Force—a leading authority—addressed the question and concluded that despite the multitude of studies, there remains no proof that TSH suppression
is dangerous.4
My conclusions: Listen to the patient, examine the patient and adjust treatment until the patient is well. A century of medical experience and scientific evidence indicate that giving a patient enough thyroid hormone to make them well is a reasonable and safe approach. Blood tests, urine tests and tracking body temperatures all provide additional information, but no one test should be blindly followed.
Myth #4: Natural thyroid extracts are dangerous because they are not regulated and not consistent in dose.
Fact: Natural thyroid extracts such as Armour Thyroid are FDA approved prescription medications that contain all 4 human thyroid hormones (T1, T2, T3 and T4.) They are prepared in accordance with the U.S. Pharmacopeia.5 Synthetic thyroid extracts, such as levothyroxine contain only T4 and are also FDA approved.
Ironically, synthetic T4 preparations seem to have had many more problems with dose consistency than has Armour Thyroid. FDA records show repeated problems with potency and consistency for T4 products including Synthroid.6,7
My conclusion: There is no evidence that natural thyroid extracts such as Armour Thyroid are unsafe or any more dangerous than synthetic thyroid treatments. In fact, my experience is that natural thyroid extracts are much more effective at restoring normal metabolism and, therefore, very likely better for one's health.
Myth # 5: Once you start thyroid hormone, you need to take it for the rest of
your life.
Fact: Taking thyroid hormone will not permanently shut down the
thyroid gland.8
My conclusion: Be aware that suppression of thyroid function—which can occur during treatment—is only temporary and will not create a permanent dependency.
Thyroid References
Adrenal Myths
Myth #1: Cortisone is not natural.
Facts: Cortisone is a natural hormone that is made in the adrenal glands. A form called cortisol or hydrocortisone is one of the most important hormones in the human body, helping to keep us alive
every day.
My conclusion: Cortisol (a.k.a. hydrocortisone) is a natural adrenal hormone of great importance.
Myth #2: Cortisone is dangerous.
Facts: It is too much or too little cortisol that is dangerous. Having the right amount is necessary to stay alive. Harvard-trained endocrinologist, William McK. Jefferies, MD, spent the last 50 years of his life making this point. He demonstrated that taking cortisol at levels needed to restore health and metabolism is extremely safe.1 Many studies have supported this view.2 In fact, when the head of Rheumatology at Emory University reviewed the decades of evidence, he concluded that low doses of synthetic cortisone were actually safer and more effective than ibuprofen-type medications.3
My conclusion: Dr. Jefferies was correct. Hydrocortisone is extremely effective for a wide variety of conditions ranging from autoimmune diseases to allergies to chronic fatigue and more. Side effects are generally due to excessive doses or to ignoring deficiencies of other hormones such as thyroid hormone and DHEA.
Myth #3: Cortisone routinely suppresses the immune system.
Facts: Cortisone is necessary for a healthy immune response. Too much or too little can harm the immune system. For example, Prednisone, the most common synthetic form, has only been shown to suppress the immune system at doses greater than 10 mg per day when taken over long periods.4 (This equals about twice the dose of hydrocortisone recommended by William McK. Jefferies.)
My Conclusion: Only excessive amounts of cortisone suppress the immune system.
Myth #4: There is a perfect way to test for cortisol deficiency.
Facts: There is no such thing as a perfect test. Cortisol is particularly difficult to test because blood levels can vary by the minute. Some people are even resistant to the effects of this hormone.5,6 So, even "normal" levels may not be enough to keep some people healthy. In his book, Dr. Jefferies addresses this difficulty and recommends that a "therapeutic trial" is often the best approach.7 Jefferies is reported to have told anyone within earshot, "When in doubt, treat the patient."
My Conclusion: Use appropriate testing, but "when in doubt, treat the patient" and closely monitor for benefits and/or side effects.
Adrenal References
Medical Myths
Myth #1: People who eat less fat, live longer.
Facts: After over 50 years and hundreds of studies, researchers remain unable to prove that a low-fat diet is good for your health. A few years ago, researchers at the Cochrane Collaboration decided to review the medical literature and see what it said. They looked at the results of the 26 best studies and found that low-fat diets didn't help people live longer. The researchers found that people on low-fat diets were 2% more likely to die than those in the comparison groups.1 More recently, the Journal of the American Medical Association published their results of three huge studies attempting to show the benefits of a low-fat diet on breast cancer, colorectal cancer and coronary heart disease. Again, the studies failed to show significant benefit.2 In light of such findings, the British Medical Journal editorialized:
"Despite decades of effort and many thousands of people...there is still only...inconclusive evidence of the effects of modification of total, saturated, monounsaturated, or polyunsaturated fats on cardiovascular morbidity and mortality."3
My opinion: The low-fat diet has never been proven to be good for your health, and it probably doesn't provide much benefit for most people. In fact, low-fat diets may be the main cause for skyrocketing obesity and diabetes over the last 30 years. The increase in obesity rates began in the 1970s, about the same time that the original food pyramid was introduced. This starch-based pyramid was designed to help Americans avoid animal fats. Unfortunately, high intake of starch and other carbohydrates increases blood sugar and insulin levels. These increases can, in turn, lead to the production of more body fat. So, a low-fat, high carbohydrate diet could actually make you fatter and less healthy.
Myth #2: Salt is bad for your health.
Facts: Salt has been widely used by many people for thousands of years without any obvious harm. On the other hand, salt is considered harmful because it contains lots of sodium which is supposed to raise blood pressure, leading to heart disease. It is true that cutting salt can lower blood pressure slightly, but we still don't know if cutting back on salt is actually good for your health. In fact, the British Medical Journal recently reported that overall, "data on the effect of dietary sodium intake on subsequent morbidity and mortality are limited and inconclusive."4 Many studies even suggest that low-salt diets could be bad for you. In particular, two of the biggest studies found that people with the lowest salt intake had the shortest life spans.5, 6 Yes, the people who ate the least salt, died the soonest, on average. But, how could cutting back on salt be harmful? Well, studies show that restricting salt can cause potentially harmful changes in metabolism, including increases in blood sugar, insulin and adrenalin levels.7, 8
My opinion: It is possible that some people can improve their health by consuming less salt, but is very unlikely that salt restriction is good for most people's long-term health. Until someone can prove that cutting back on salt actually improves most people's health, I believe that we've got more important things to worry about then getting everybody to restrict their salt intake.
Myth #3: Everyone with high cholesterol should take medicine to lower it.
Facts: Cholesterol is a natural substance in the human body. It is a component of every cell and a building block for many of our hormones. The "statin" drugs that are most commonly used to lower cholesterol work by disrupting normal cholesterol production. It is not surprising to learn then, that they have significant side effects including damage to muscle, the liver, and kidneys.
On the other hand, according to some of the best sources, statin drugs are only proven to help only one specific group of people live longer—men with heart disease. Researchers at the University of British Columbia concluded that "statins have not been shown to provide an overall health benefit in...prevention trials."9 European researchers came to virtually the same conclusion, noting, "prevention with statins provides only a small and...hardly relevant improvement of cardiovascular morbidity/mortality."10 And according to the Journal of the American Medical Association, taking medications for high cholesterol does not improve life expectancy for any group of women—even women with heart disease11
My opinion: Cholesterol-lowering medications have many side effects and should be used with caution. I believe that these medications should be reserved for people who are likely to improve their lifespan by taking them. Basically, that means men who already have heart disease. For all the others with high cholesterol, I believe that addressing the underlying causes of their problem is more important. In most such cases, identifying and treating conditions such as hypothyroidism, insulin resistance and excess body weight is a better approach.
(Visit our site again…there are More "Myths" to come...)
References: