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Is Your Thyroid Dysfunctional?

A small, butterfly-shaped gland situated in the front of the neck, the thyroid is a little organ with a very big job: It primarily produces hormones that regulate body metabolism — energy produced through the food you eat. These hormones act as messengers that tell your tissues when to burn energy and how to develop.

Two hormones that emanate from the brain — thyrotropin-releasing hormone (TRH), made in the hypothalamus, and thyroid-stimulating hormone (TSH), produced by the pituitary gland — control the thyroid gland’s release of its two main hormones: thyroxine (T4) and triiodothryonine (T3).

T4, the most abundant and long-lasting thyroid hormone, is used as a precursor to make T3, which is the more potent thyroid hormone. It has a shorter half-life and the majority is produced from T4 within peripheral tissues. Reverse triiodothyronine (rT3) is an inactive isomer (a compound sharing a similar molecular formula but differing in structure) of T3, which blocks the effect of T3 at the receptor site.

As you age, you are more likely to experience thyroid dysfunction. It is estimated that 3% to 8% of the general population suffers from sub-clinical hypothyroidism or mild thyroid failure1— a condition where the thyroid does not produce adequate amounts of the hormones thyroxine (T4) and triiodothyronine (T3) to suit individual needs. The majority of those afflicted with sub-clinical hypothyroidism tend to have high-normal serum TSH values and low-normal free T4 and free T3 levels.

Since thyroid levels may not appear obviously out of range, this type of thyroid dysfunction can be quite difficult to diagnose. For practitioners who rely solely on a TSH measurement, often considered the gold-standard for assessing thyroid status, making an accurate diagnosis can be even more challenging. Unfortunately, a patient who has been experiencing symptoms of sub-clinical hypothyroidism and has undergone repeated blood testing may never receive proper treatment because many physicians will view the patient’s blood levels as “normal.”

Normal is NOT Optimal

Laboratory reference ranges are a set of values that have been assigned to specific biochemical measurements within a given medium (blood, saliva, tissue) in the body. These intervals were established from population studies conducted by laboratories many decades ago and have not been upgraded since.2 In fact, it is very likely that the selection criteria did not exclude those with sub-clinical disease.

The problem with relying solely on the TSH test for diagnosis of sub-clinical hypothyroidism is that by the time it becomes relevant, the disease already could be ravaging the tissues, leading to substantial destruction and dysfunction. A combination of blood testing and symptom recognition could have identified the condition early on, thus preventing significant damage. Diagnosing thyroid dysfunction should not be limited to examining just TSH levels, but should also include free T4, free T3, and thyroid antibodies — TPO and antithyroglobulin (TgAb).

Approximately 80% of those suffering from sub-clinical hypothyroidism will test positive for thyroid antibodies3 — proteins that stimulate an inflammatory immune response and cell destruction. Recent studies have shown a greater presence of thyroid antibodies in those with a TSH level between 3.0 and 5.0, and a trending shift toward developing overt clinical hypothyroid disease.4 People with the lowest incidence of thyroid disease/autoimmune thyroiditis had an average, optimal TSH of 1.18µIU/mL.5 There is a major discrepancy between an “optimal” TSH level of 1.0 and a “normal” TSH that falls somewhere between 0.45 and 4.0 µIU/mL. You’re not crazy: You feel sick because your thyroid levels are not optimal for what your body needs!

What can I do?

If you suspect you are suffering from sub-clinical hypothyroidism, monitoring your health is essential. First, keep track of your symptoms: Be especially aware of how you have been feeling and take your basal body temperature each morning. An initial indicator of an under-active thyroid is a lower body temperature.6 Document this information in a journal if you tend to forget. Schedule an appointment with Victory Weight Loss & Wellness to share this information with your practitioner.

Common symptoms of sub-clinical hypothyroidism include:

  • Fatigue
  • Feeling Cold
  • Headache
  • Weight Gain
  • Dry Skin/Coarse Hair
  • Depression
  • Constipation
  • Muscle and Joint Discomfort

Second, take a blood test to measure your levels of thyroid hormones and antibodies — a full-spectrum panel that includes TSH, free T4, free T3, reverse T3, and thyroid antibodies. As mentioned previously, the goal is not to be “normal” but to be “optimal.” A TSH level between 1.0 and 2.0 µIU/L is IDEAL and has a lower association with disease risk. Corresponding optimal free T4 and free T3 levels should be situated within the upper-third of the reference interval. Ideal reverse T3 values should be <20 ng/dL or <200 pg/mL. A negative to low-level presence of antibodies is also ideal.

Managing Sub-clinical Hypothyroidism

After a thorough evaluation of your chief complaints and objective data, including labs, Victory Weight Loss & Wellness may suggest various treatment options. In cases where medication or prescription-strength resolutions are warranted, we may opt for a bioidentical glandular T3/T4 combination called Nature-Throid or Armour Thyroid. Using one of these compounded formulas is the most effective way to optimize both T4 and T3. Keep in mind, however, there are unique situations where you may respond better to the traditional thyroid medications: Levothyroxine (Synthroid/T4) or Liothyronine (Cytomel/T3). With either option, be sure to keep track of any changes in symptoms and continue monitoring your thyroid levels so dosing can be adjusted if needed.

At Victory Weight Loss & Wellness we focus on the whole you, and helping you achieve and live a healthy lifestyle.  If you believe you may be experiencing an issue with your thyroid contact our office today.  We have several options available including modern thyroid function testing and natural thyroid replacement to help you get back to living the life you want.

 

References

  1. Endocrinol Metab (Seoul). Mar 2014;29(1):20–29.
  2. Am J Clin Pathol. 2010;133(2):179.
  3. Mayo Clin Proc. 2009 Jan; 84(1):65–71.
  4. Subclinical Hypothyroidism. http://www.patient.co.uk/doctor/subclinical-hypothyroidism. Published 2015. Accessed May 19, 2015.
  5. J Clin Endocrinol Metab. 2005 Sep;90(9):5483-8.
  6. P R Health Sci J. 2006 Mar;25(1):23-9.

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Four Key Hormones and How to Keep Them Balanced

You’ve probably been hearing a lot of about hormones these days.  But did you know, hormones are a very important part of your overall health?  Here are four key hormones you need to know about and tips for keeping your levels normal.

 

Testosterone

Testosterone is widely known as a male hormone, but females have it too, just at much lower level.  In the right amounts, testosterone can help increase muscle mass and strength, and may increase brain function.  A low level of testosterone can lead to be detrimental, leading to ill effects as one ages.  The most commonly known is a lower sex drive, but more significant changes may include a higher level of fat storage and an increased risk of cardiovascular disease.

 

How to Optimize Your Levels:

As with most hormones, your everyday lifestyle is a large factor on your level of testosterone.  Maintaining a healthy weight with diet and exercise along with proper sleep can help.  One study has shown that saturated and monounsaturated fat were powerful predictors of levels.  Intense exercise has also been shown to boost your testosterone levels.

 

Estrogen

Like testosterone in males, estrogen is typically thought of as a female-only hormone, but is actually present in males at a much lower level.  At regular levels, estrogen helps to regulate female reproductive cycles.  Some studies have suggested that estrogen may affect muscle recovery and brain health.  While those benefits aren’t confirmed, one thing we do know is that estrogen levels can impact how fat is stored in the body leaving you with extra fat tissue.

 

How to Optimize Your Levels:

Regular exercise and a healthy diet are the best way to fight estrogen imbalances.  Women will experience a natural shift in estrogen post-menopause.  But, that isn’t to say they lack control over their estrogen levels in the meantime.  Moderating the consumption of phytoestrogens such as soy may help to keep levels balanced.  Work with your physician to keep your body composition levels at a healthy range, which may also help maintain a proper estrogen level.

 

Insulin

Best known for its role in diabetes, insulin actually plays a significant role in your metabolism.  Insulin is an anabolic hormone, meaning it helps the body to build complex molecules.  When you eat during the day, the carbohydrates in the food enter your blood stream.  The body then releases insulin, which opens up your cells to uptake blood sugar (referred to as glucose).  The cells, in turn, can build up their energy stores while keeping blood sugar in check.  Poor dietary habits can lead to an over-releasing of insulin allowing our bodies to develop an insulin resistance.  Insulin levels that are not properly maintained can lead to Type II diabetes.

 

How to Optimize Your Levels:

Besides mindful eating practices, a regular exercise routine can be a huge help.  In the short-term, a single workout session can mimic the effects of insulin on the body, helping to open up cells and shuttle in glucose.  A long-term plan and consistent exercise can have a tremendous impact and help mitigate the symptoms of insulin resistance.

 

Cortisol

Cortisol controls energy levels in times of stress.  Periods of stress cause the body to break down proteins and release glucose into the blood stream.  These increases in energy are meant to help us escape danger or recover from extreme effort.  Cortisol spikes can also be experienced during intense exercise, and continues to rise as the workout session goes on.  Short spikes are necessary and normal.  The issue is when cortisol levels are always high, which can a symptom of overtraining or being overstressed.  Studies suggest a constant elevated level of cortisol have been shown to cause cardiovascular issues as well as a possible change in eating habits.

 

How to Optimize Your Levels:

The good news is that you aren’t powerless against stress.  Running, strength training and other forms of exercise can help decrease stress levels.  The key factor is moderation, both for frequency and intensity. Too many hard sessions in a row could lead to overtraining and chronically high levels of cortisol.  Meditation is another powerful antidote for combatting stress.

 

At Victory Weight Loss and Wellness we focus on the whole you, and helping you achieve and live a healthy lifestyle.  If you believe you may be experiencing a hormonal imbalance of these or other hormones, contact our office today.  We have several options available, including pallets or creams, to help you treat trouble areas.  We’ll also help you create and stick to a plan of action for a healthier you.

 

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Exercising in Summer Heat

It seems the hot and humid days we’re used to in the Tri-State have finally arrived.  After a month of endless rain, we’re now dealing with thick and sticky weather.  For active exercisers, summer heat and humidity can wreak havoc on your daily routine.  After you get past the mental block of “But it’s too hot!” there are several things to keep in mind when trying to get in a summer walk or run.

Our friends at Active.com have provided these 8 tips for exercising in summer heat.

8 Tips for Exercising in Summer Heat