Thyroid

I have been noticing a peculiar trend over the last couple of decades with patients, their temperatures are dropping. Back when I was growing up and through my schooling years the normal temperature of your average human was 98.6 degrees. This is what is still taught in school. Yet when I check patients or they relate to me what their average temperature is, they are running in the 97s and 96s. I have a few patients whose average body temperature runs around 95.6. What is going on here? Why are folks running cooler? Is this some weird response to global warming? What is going on?

First I had to do a reality check to see if I was alone in noticing this phenomenon. A paper was written three years ago examining this topic and it concluded that we are indeed running cooler. They were looking at changes in base body temperatures over the last 200 years which showed there was indeed a drop of around one degree over that time. They had an interesting explanation which seems unlikely to me — that people were less healthy in the past and therefore more inflamed. The idea was that people had more infectious diseases in the past and would therefore have higher temperatures. Infectious disease tends to produce a spike in temperature, not a chronic slight rise. A second idea they offered was that we have temperature-controlled living and working environments today which means our body does not have to be as metabolically active to stay warm or to cool off. This sounds more plausible, but it does not relate to lower temperatures noticed over just the last couple of decades.

In years past, I would have patients check their basal temperature first thing in the morning for 10 days to evaluate their thyroid hormone status. Under the arm, basal temperature should run around 97.6 degrees. Lower temperatures indicate lowered thyroid hormone function. It is your thyroid hormone that controls your resting body temperature. In fact, it is your thyroid hormone that regulates your metabolic rate all over your body. That means that it controls how much energy you make and the speed at which you metabolize fats, carbs, and proteins in every cell in your body. It controls the rate at which the machinery of everything in your body operates. All these processes produce the heat that you measure when you take your temperature. So that means that when your temperature is lower, your cellular body machinery is moving slower and doing less work.

The most common issue regular folks associate with low thyroid function is weight gain caused by a lowered metabolic rate. For myself, however, my biggest concern was its impact on memory and cognitive function. Back almost 20 years ago I was noticing a lot of memory loss. You know, the kind where I go to the store to pick up three things and can only remember one of them once I get to the store. My kids used to tease me a lot over this. Ultimately, this led me down the autoimmune rabbit hole when I did the in-depth lab testing of hormones that showed me that I had Hashimoto’s thyroiditis. My immune system was attacking my thyroid gland and my thyroid hormones. Fortunately for me, I was learning about Hashimoto’s from a functional medicine expert who literally wrote the book on the 27 varieties of thyroid disease and how to treat them naturally. Standard medicine, even today, teaches that Hashimoto’s is genetic and that the only treatment is to take thyroid replacement hormone. Sadly, this is the advice most thyroid patients get. There are approximately 15 to 20 million Hashimoto’s patients in the US alone, and that is the only information they get.

I was able to put my Hashimoto’s into remission by tackling the underlying issue; the autoimmune condition causing it. Most autoimmune conditions begin in the gut, and this is where it has to be healed. Autoimmune is simply an overly reactive immune system attacking your own cells because it thinks they have become an enemy. This process begins with a leaky gut formed by bad bacteria, fungi, and viruses weakening the gut lining combined with certain food molecules like gluten unzipping the junctions between the gut wall cells and creating openings. Then tiny toxic bits of these negative bacteria called lipopolysaccharides drift through the gut wall and trigger a massive immune response. Gluten and other food molecules also get into the bloodstream instead of being properly broken down and attach themselves to various tissues in the body making them appear to be invaders to the immune system. The immune system attacks and bingo you now have an autoimmune disease. The answer is to heal the gut and calm down the immune system. That is what I did and within a couple of years, my thyroid hormone levels were normal.

The understanding of thyroid hormone issues has advanced tremendously over the last 50 years. Back then doctors basically gave iodine or replacement hormones for low thyroid and surgery for high thyroid or thyroid cancer. The state of the art for thyroid was pretty basic. Historically large parts of the country endemically suffered from low thyroid due to low iodine levels in the soil. This would produce the classic goiter, a large swelling of the thyroid gland in the lower throat. The answer back then was the elegant and simple solution of adding iodine to salt. The remedy ended up on everybody’s dinner table. We are starting to see low iodine showing up again as folks switch to non-iodized salt like pink salt or Celtic sea salt. If you have switched to these, be sure you have another source of iodine in your diet. The traditional source in many cultures is sea vegetables, also known as seaweed.

The flip side of low or hypothyroidism is hyperthyroidism – too much thyroid hormone being produced. This will ramp up a person’s metabolism and make them hyper and nervous. This may produce rapid heartbeat, weakness, tremors, loose bowels, weight loss, mood swings, and sometimes affect your vision. A classic obvious sign is the eyes bulging out. I mention this here because it can be caused by too much iodine, as well as inflammation from autoimmune conditions and other sources. The autoimmune version is called Grave’s disease. Hyperthyroidism can also be caused by taking too much thyroid medication/ replacement hormones. Notice that inflammation and autoimmune inflammation in particular can cause your thyroid hormone to go both too high and too low. I have had patients on this back-and-forth roller coaster with symptoms and hormone levels.

Thyroid cancer is often initially confused with simple thyroid nodules formed when thyroid hormone gets trapped in the gland and forms internal blisters filled with incomplete hormone. To tell the difference an ultrasound is used to see if the nodules are solid (as in cancer) or hollow (as in filled with hormones). Sometimes radioactive iodine is used to see if it collects in these nodules. If it does then these are called hot nodules. Most of the time (95%) these nodules are benign but may produce enough hormone that it will suppress the TSH hormone from the pituitary that is supposed to be controlling total thyroid output.

How do you check your own thyroid at home? Pick up a basal thermometer at the store or online. First thing in the morning before you get up out of bed take your temperature under your arm (or rectally). Record this temperature for 7 to 10 days. Add up all those temperatures and then divide that number by the number of readings you took. The final number should be around 97.6. If your number is a degree lower than normal then you might have low thyroid. Higher than normal might indicate high thyroid (or you have been sick). Either way, the next step is to have blood tests done to measure several things. Check TSH, T4, Free T4, T3, reverse T3, thyroglobulin antibody(Tg), and Thyroid peroxidase antibody (TPO). With these tests, we can diagnose most thyroid conditions.

Lack of energy is the number one complaint doctors hear from patients. The most fundamental driver of your energy levels is your thyroid gland. A lot of things can affect your thyroid, and most of them come down to inflammation from various sources. This can be addressed most of the time without drugs or surgery. Self-testing at home is easy and straightforward to get the process started. If you need to do follow-up blood work, I can order that for you through the office account to get a much better price. Generally, your doctor will refuse to do a full thyroid panel. So if you want a more complete picture because you want to approach things from a functional medicine level, that is available to you.

Take care,

David

Ellen 

We are trying a new dietary adventure, purple sweet potatoes. I came across an article about how the very high levels of the good stuff called anthocyanins that makes the purple color helps to change the gut microbiome to a friendlier state. The purple chases away the negative gram bacteria and supports the growth of the good positive gram bacteria. So we are eating a purple sweet potato every day for a month to see what good stuff happens.