Why am I so tired? Thyroid Issue May be the Cause

thyroid

Every week people arrive at my clinic wondering if their thyroid is okay. They’ve often had their conventional doctor check their thyroid, and are told that everything is fine. However, they aren’t convinced. They feel tired, cold, achy, and gain weight easily. They have headaches, depression or constipation, all symptoms that may reflect low thyroid function. Experience has taught me that evaluating the thyroid is complex. Low thyroid function can be caused by the immune system itself and by the dysfunction of other hormone glands in the body. It can be also affected by stress, toxins, and nutritional deficiencies. Evaluation of the thyroid is so much more than just running one test.

The thyroid gland is a small gland in the front of the neck that produces the hormone that sets the metabolic rate of every cell in the body. These hormones tell your body how fast to burn calories, influence stomach acid production, determines moisture levels in the skin and so much more. The thyroid gland is also the most common site of autoimmune disease in the body. The immune system can sometimes attacks the thyroid gland and interferes with its ability to provide the hormones needed for normal tissue function and repair. I had a patient who had gained 47 pounds in one year, despite good diet and regular exercise. Her doctor insisted that her thyroid was functioning properly, according to the one test, the TSH level, that he can run. We ran further tests which showed that she did indeed have antibodies to her own thyroid that were blocking her thyroid from making the hormones she needed to burn calories normally. Once that deficiency was corrected, she had to work hard to lose weight, but it was possible for her to do so.

Another patient came to the clinic already taking thyroid replacement medication but reported feeling as tired and achy as she had when she was first diagnosed as hypothyroid years ago. Again, her TSH test was normal. We dug a little deeper and ran a reverse T3 test. This test determines if her thyroid hormone was being converted to active T3 or a dud version called reverse T3. Elevations of reverse T3 are important if you are sick and need to conserve energy and rest. However, there are other conditions that can trigger this downstream activation of reverse T3. High stress levels, low iron levels, and chronic inflammatory states can all drive up reverse T3 and make you feel unnecessarily tired. In this case, the patient had experienced chronic stress and had an elevated reverse T3. We changed her thyroid medication slightly and gave her additional natural medicines to balance all her thyroid hormones, thus giving her back the vitality she was missing.

Naturopathic physicians prefer a full panel of thyroid hormones to accurately diagnose thyroid problems. This panel includes the relatively stable pituitary hormone TSH, free T4 (inactive thyroid hormone), free T3 (active thyroid hormone), reverse T3 and a thyroid antibody called TPO. Often we are able to unveil issues in the complex dance of the thyroid hormones, which can then be treated in a variety of ways, both holistic and pharmaceutical.

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. 250 897-0235 or www.getwellhere.com

Eight Important Lab Tests You Should Know About

lab imageMany of us go to the doctor and just get the basic blood work they recommend.  We may or may not hear back from the doctor regarding the results.  I recommend that patients take a more active role in their health by learning about blood tests and getting copies of their results.  (Locally, Lifelabs offers patients online access to most blood work.)  It is helpful to understand which tests to request from your conventional or naturopathic physician and optimal levels you should be aiming for.

Thyroid:  For patients dealing with fatigue or depression, I often recommend a full thyroid panel.  The thyroid governs metabolism, affecting energy and weight loss. Typically just a TSH test is run, but sometimes imbalances in the thyroid can be picked up by testing free T4, free T3 and thyroid antibodies.  If the thyroid hormones levels are borderline, I recommend supporting the thyroid non-pharmaceutically.

Ferritin:  Another important test for fatigue and depression is ferritin.  This test measures iron stores.  Lack of iron can cause anemia, which can cause fatigue.  It can also lower dopamine levels in the brain, which affects mood, motivation and food cravings.  Too much ferritin can be a sign of excess iron storage which can damage the cardiovascular system and many organs.

Insulin:  For patients with weight issues, dementia and some hormonal imbalances, checking fasting insulin is an excellent tool to understanding how the body is dealing with blood sugar.  Adult onset diabetes is characterized by insulin resistance at the cellular level.  Therefore, it takes a lot of insulin to help carry sugars from the blood to the cells.  Even before elevated blood sugar is detected, this high insulin can be a sign of insulin resistance.  High insulin levels promote fat storage and are hard on the circulation.  Programs that reverse insulin resistance can accelerate the process of weight loss, protect the cardiovascular system and more.

Homocysteine:  Patients who have a personal or family history of cardiovascular disease or dementia  / Alzheimer’s are wise to have their homocysteine levels checked.  This amino acid, if elevated, is a risk for increased strokes and Alzheimer’s. The “normal” range is stated as being under 11 umol/L, but studies show that the risk of Alzheimer’s is increased in people whose homocysteine is over 7 umol/L.

Vitamin D3:  The rate of vitamin D3 deficiency in Canada is staggering. Gerry Schwalfenberg, an assistant clinical professor in the department of family medicine at the University of Alberta, said testing showing that “the fact that 60 to 70 per cent [of Canadians] have inadequate levels [is] not good,” given that vitamin D insufficiency is being linked to so many chronic diseases.  Vitamin D is an important preventer of autoimmune disease, viral illness, cancer, heart disease, diabetes, osteoporosis, MS and more.  Having your levels checked is therefore wise.  The optimal level of vitamin D is over 125 nanomoles/litre.

C Reactive Protein (CRP):  Inflammation is an important risk factor for cardiovascular events, like strokes and heart attacks, and it creates an environment that supports cancer growth.  It is a symptom of autoimmune disease, obesity, diabetes and other important health conditions.  The C Reactive Protein in our blood is a reflection of general inflammation levels.  While the normal range is under 5.0, the optimal range is under .8 for men and under 1.5 for women.  Breast cancer survivors are wise to monitor CRP since elevations are associated with higher reoccurrence rates.

Vitamin B12:  The levels of this important nutrient can diminish with age as absorption becomes more difficult.  Vitamin B12 can be depleted by many medications, such as metformin (diabetes), birth control pills, and antibiotics.  I am most concerned about acid blocking medications that many of my patients use for long term management of acid reflux.  I much prefer to treat the cause of this problem than to manage it with a medication that impairs the digestion and absorption of a number of important nutrients.  Acid blockers also can set up a more alkaline pH that promotes the growth of a weakened, dysfunctional set of intestinal bacteria.

Small Intestinal Bacterial Overgrowth Testing (SIBO):  SIBO is a condition in which the wrong bacteria are growing in the small intestine, creating abnormal fermentation of carbohydrates into methane and hydrogen.  SIBO patients suffer from gas, bloating, digestive concerns and many other health conditions.  When indicated, I test patients through a university laboratory in PortlandOregon.

Be proactive with your health care by getting the blood work you need to understand your health and take steps to prevent illness.

Dr. Deidre Macdonald is a naturopathic physician who has practiced medicine in downtown Courtenay for 17 years. For more information, contact The Macdonald Centre for Natural Medicine at 250 897-0235 or via www.getwellhere.com

 

 

My doctor says my thyroid is normal but…

Every week people arrive at the clinic wondering if their thyroid is okay.  They’ve often had their conventional doctor check their thyroid, and are told that everything is fine.  However, they aren’t convinced.  They feel tired, cold, achy, gain weight easily, have headaches, depression and more symptoms that seem to reflect low thyroid function.

As a naturopathic physician, I offer these patients a full thyroid panel.  When we test further, we often find that the thyroid really isn’t working optimally.  Why the different in approaches?

Our MSP system only allow conventional doctors to run one test to screen for thyroid problems.  Naturopathic physicians prefer a full panel to test for TSH, T4 (inactive thyroid hormone), T3 (active thyroid hormone) and a thyroid antibody called TPO.  Often we are able to unveil issues in the complex dance of the thyroid hormones, which can then be treated in a variety of ways, both holistic and pharmaceutical.

Our philosophy is to try to determine if your thyroid is working optimally, not just wait until it is diseased.

Curious about your thyroid?  You can book an appointment by emailing back or calling Terry at (250) 897-0235.