Wednesday, August 25, 2010

Mastering the Thyroid

Greetings everyone! I hope this most recent of blog finds each and everyone of you filled with health and vitality, and certainly more informed with less confusion on at least the topics that I have attempted to address up to this point. Earlier this month (August 13-15) I attended a 3-day conference entitled "Mastering the Thyroid", which was a meticulously organized comprehensive course designed to help clinicians master the concepts of thyroid physiology, assessment, and clinical applications. All course content and instruction was the exclusive outcome of Dr. Datis Kharrazian's in depth investigation over the last decade of thyroid glandular dysfunction, as he brilliantly integrated his clinical experience and expertise with the exhaustive body of scientific literature that presently exists in the research journals of today.

Dr. Kharrazian states as the preamble to his Introduction in the course teaching manual:

"Every cell in the body has receptor sites for thyroid hormones. Thyroid hormones are responsible for the most basic and fundamental aspect of physiology, the basal metabolic rate. Lack of ideal thyroid hormone leads to global decline in cellular function of all bodily systems. The thyroid is the central gear in the complex web of metabolism and extremely sensitive to minor imbalances in other areas of physiology. An astute clinician should always ask what else is going wrong, as a result and cause, when they identify a thyroid imbalance."

Areas of instruction and discussion included the following topics:
  • Thyroid-Immune-Nervous System-Immune crosstalk and its clinical implications
  • The impact of thyroid hormones on every major physiological process
  • A step-by-step approach to conducting a thyroid physical examination
  • A complete review of the literature on natural supplements that support or disrupt thyroid function
  • Identify 24 common and newly highlighted patterns that lead to thyroid imbalances on lab test with clinical applications

Particular emphasis was placed on the condition that has hit, not hitting, but has hit epidemic proportions in the United States and is considered to be the most prevalent autoimmune disorder in our country today: Hashimoto's Autoimmune Thyroiditis. Published reports of the total number of Americans afflicted by this autoimmune (AI) disorder are estimated to be roughly 24 million! The female to male ratio between the ages of 35-55 (some sources say 20-60...regardless) is a staggering 30:1, clearly correlating uniquenesses in female endocrine output as an underlying trigger that makes women so much more susceptible to becoming a victim of this AI attack on the thyroid gland. Additionally, Hashimoto's Disease has been found to be the underlying mechanism in 90% of today's cases of hypothyroidism, with one study finding that up to 7-8% of the U.S. population has antibodies against their thyroid!
(ACTA BIO MEDICA 2003;74;9-33
Update on autoimmune polyendocrine syndromes (APS)

Now, here's where the rubber meets the road folks: from a medical perspective, if you, the patient, have been diagnosed with Hashimoto's Autoimmune Thyroiditis, chances are that you are in all likelihood being treated exclusively as though you are an underactive thyroid case, i.e., hypothyroidism. Incidentally, this would be the case if the timing of your laboratory tests happened to be ordered at a point in time when your thyroid gland was in fact in an underactive state and you were diagnosed as hypothyroid, AND the appropriate AI confirmation tests were also ordered at the same time . Since this is how your condition is perceived by the medical community, i.e. you have a sluggish thyroid gland, you are going to have prescribed for your hypothyroid state any of a variety of thyroid hormonal replacement therapies inclusive of any of the following or possibly a combination thereof: Synthroid, Levothyroxine, Cytomel, Armour Thyroid, to name but a few. As mentioned in previous blogs, we as practitioners tend to treat our patients according to our training...makes perfect sense, right? Thus, do not expect a holistically based or science guided nutritional approach and management of this state of thyroid-immune system dysregulation if you happen to be trapped in the medical paradigm. The entire basis and determination of the successful medical management of this condition is based upon the reduction of an elevated Thyroid Stimulating Hormone (TSH) to the acceptable laboratory reference range. For those of you that are in fact caught in this "web", unless you are the exception to the rule (and there are those exceptions that exist), then you can confirm that what I am stating is in fact exactly the way that your case has currently been medically managed.

Depending upon the level of destruction of your thyroid gland cells and the degree of underactivity, thyroid replacement hormones will be administered in an effort to reduce your elevated TSH level and to raise your reduced Thyroxine (T4) level, which may be both fully warranted and clinically necessary, maybe not...BUT! without ever having the fundamental cause of your hypothyroid state being either investigated or addressed, the underlying condition and its cause will continue to advance and in some instances progress to the stage where other tissues become involved.

For all intents and purposes, as far as I am concerned, the nature of this autoaggressive disorder left uncorrected will result in a "metastasis" of sorts! I do not use this word in the same context as "metastatic" cancer for those of you who are familiar with the strict medical use of this term, but in many individuals there will be NUMEROUS tissue sites that also become "targets" of this AI reactivity, therefore the condition does in fact advance and "spread" to additional body components. The end result of this infiltration of additional tissue sites results in what is referenced in the current body of scientific literature as "polyendocrine nature". The cerebellum is amongst the most frequent of additional sites victimized by this autoimmune response/attack. The cerebellum is that component of your brainstem which is responsible for a broad spectrum of activities ranging from balance, coordination and gait functionality to regulation of emotional states such as fear and pleasure. This exceedingly vital component of the central nervous system can actually become collaterally damaged in this very volatile state of autoimmunity. According to Dr. Datis Kharrazian's clinical research that is based upon serological tissue antigen/antibody testing, such attack is relatively commonplace!!!

As stated previously, today's peer-reviewed, scientific literature abounds with discussion of this so-called polyendocrine or polyglandular nature of Hashimoto'sDisease. This premise states that there is a signicant level of probability that other components of the endocrine system will be secondarily involved in the immune system's autoaggressive attack elsewhere in the body. Here is one such study from 2003:

ACTA BIO MEDICA 2003;74;9-33
Update on autoimmune polyendocrine syndromes (APS)

52% of patients with thyroid autoimmune disease can be considered affected by autoimmune polyendocrine syndromes.

Hence, one readily understands that the age old question "WHY?" is this happening to the jeopardized individual must be addressed and resolved, if we as clinicians are to enjoy any genuine success in the handling of this type of endocrine disorder, with the patient reaping the reward of both his/her own labor in conjunction and coordination with the clinician's diagnosis and administration of the appropriate therapies.

What this means plainly and simply from the perspective of a holistic health care practitioner such as myself, is that you are NO longer solely a case of hypothyroidism, but instead, with significantly higher clinical pertinence and relevance, you are an AUTOIMMUNE (AI) case that requires appropriate lifelong management because of the nature of AI disorders! I hope that this is making perfect sense to everyone reading this and that you clearly understand that I am not suggesting nor advocating that anyone runs into their kitchen or bathroom and throws their thyroid replacement hormones in the trash. Instead, I implore you to understand that if in fact you do not first and foremost get to the "environmental trigger" as the cause and root it out, your disease process will continue to make your everyday life very challenging.

Incidentally, while I am presently discussing the so-called "environmental trigger", the jury has convened, the jury has arrived at a verdict, the jury has entered the courtroom, the jury's verdict has been handed to the bailiff who has handed it to the judge, and the judge has read the verdict and swung his gavel...GLUTEN! Yes GLUTEN, is irrefutably the most preponderant internal environmental irritant that causes the immune system to behave erratically and is therefore the foremost causative agent in what has resulted in this epidemic prevalence of Americans afflicted with Hashimoto's Disease. This is in part why you are now hearing so-much in alternative health care circles today regarding what is clinically referred to as GLUTEN INTOLERANCE and how and why an individual's health can be impacted by this protein that is found predominantly in wheat, rye, oat, barley, and spelt, amongst a handful of other obscure grains. Hence, for anyone and everyone that is reading this and has been officially diagnosed with Hashimoto's Disease, and if you know anyone with this diagnosis and you love them...remove those prime offenders that contain GLUTEN (technically GLIADIN) from your diet!!! Patients invariably want to know the most cost effective way to facilitate their recovery on the road to health, well this is as cheap as it gets folks...CHANGE YOUR DIETARY INTAKE THROUGH THE SPECIFIC ELIMINATION OF GLUTEN CONTAINING FOODS! and subsequently begin to improve the quality of your health and therefore your life!

As you recall from one of my previous blogs, I discussed the "three-pronged" approach to favorably impacting your clinical concern (what is referred to as the "chief complaint" in health care circles). The trifecta that I described was simply enough:

  1. DIET

To reiterate, if you will discipline your mind to regulate what leaves your hand and enters your mouth, you will unequivocally regulate and modulate your immune system's behavior. You in turn will have taken the reigns back into your own hands, and placed yourself "smack dab" in the center of the road to recovery.

In closing, suffice to say that this is an exceedingly vast and complicated topic that I have attempted to introduce you to this evening. If I were to be cliche and say "this is only the tip of the iceberg", I would not only be fully justified in that statement but I might be understating the enormity of concern that I have for America at large when you consider that the statistical data base is the representation of the population that has been to some type of primary care physician...what about those individuals that have miserable energy levels and horribly dysfunctional metabolic rates that have yet to be clinically investigated? The actual numbers are irrefutably more harrowing than those that the health care community at large has knowledge of, which leads me right back to the earlier blog where I referenced "the walking wounded". So, if you are wondering why you can feel so rotten everyday and you have simultaneously been told by your primary care physician that your lab values are all perfectly "normal" (or even a holistically "bent" alternative health care physician for that matter, as it is not my intent to indict the medical community alone), there is a whole lot more than a sliver of hope for you as a patient here in the Boca Wholistic Health Center. I have been sucessfully managing both functional hypothyroid and medically diagnosed hypothyroid conditions for over 20 years. Today, more than ever, perhaps as a consequence of the explosion of this medical condition, we have at our fingertips the most expedient tools to swiftly, accurately, and INEXPENSIVELY diagnose thyroid glandular disorders.

Unresolved symptoms of chronic fatigue, inability to lose weight, inexplicable hair loss (particularly in females and especially in post-partum females), intestinal sluggishness and constipation, poor circulatory system function characterized by coldness of the hands and feet, dryness of the skin (classically manifests as cracking and fissures in both of your heels)...these are all classic signs and symptoms of HYPOTHYROIDISM!, and in most instances, your life can be fully restored and your health handed back to you with the appropriate clinical interventions being employed. You the patient do hold in your hands the reigns that will restore your health!

May the peace of God be upon all of you.

Dr. Theodore J. Bloukos


  1. It is a bright idea to take care of the thyroid glands. To do this, one can rely on the porcine thyroid supplements that will help maintain the health of the thyroids.

  2. It was very interesting for me to read this blog. Thanks the author for it.