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January 14, 2015

Hidden Cause #23 Why You STILL Have Low Thyroid Symptoms--High Homocysteine

 Dr. David Clark, DC - Raleigh-Durham-Chapel Hill thyroid expert, explains how high Homocysteine causes Low Thyroid symptoms.

TriangleThyroidDoctor.com

Hidden Cause #23 Why you STILL have low thyroid symptoms even though you may be taking medication, and even though your lab tests look normal is:

High Homocysteine causing a sluggish response to thyroid hormone 

What is Homocysteine?

Homocysteine is a naturally occurinng chemical floating around in your body.  And it’s essentially an inflammatory chemical.  It can dock and attach onto different types of receptors in the human body. (think of receptors as antennae, or as a lock waiting for a key).

How does this relate to our thyroid story? 

Homocysteine can dock onto a cell and stop that cell from having a normal response to thyroid hormone. This causes low thyroid symptoms such as this partial list:

 

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage
  • high cholesterol

 Here's the kicker... even with these symptoms your thyroid lab tests will look completely NORMAL.

The only thing that might show up on a lab test--if the doctor actually runs the test ---is  the homocysteine levels may be elevated. 

What qualifies as "elevated" homocysteine? 

...higher than the lab range (usually 13) is "medically" elevated

....higher than seven is "functionally" elevated. The higher the homocysteine levels are, especially when they're close to 13 or higher, the more they are relevant to thyroid hormone receptor malfunction.

Remember, T4, T3, T3 Uptake, Reverse T3, Free T4, Free T3....all those may look completely normal. 

This is one of those caught between a rock and hard place situations where you have low thyroid symptoms, but your labs are normal and no one knows what’s causing your symtpoms. 

You can imagine what usually happens.  Your doctor tells you "You’re depressed.  I'll write you a script for an anti-depressant." However, she may have high homocysteine causing these symptoms.

What cause high homocysteine levels? 

The big factor is a deficiency of methyl donors (a carbon with three hydrogens).  You don’t have to remember all the chemistry but let me tell you what happens...

The two kinds of people at most risk for methyl donor deficiency---and thus high homocysteine--are women who:

  • take estrogen-based birth control
  • take antacids (of any kind)

Women who take antacids create a situation of low stomach acid. The technical term is hypochlorhydria. The antacids decrease your stomach acid. A low acid environment, over time, can cause low methyl donors (and high homocysteine that messes with your thyroid receptors).

NOTE: Low stomach is not a healthy situation. I know you’re inundated with commercials that demonize stomach....but if  you have low stomach acid you cannot extract minerals (like iron and magnesium) from your food....You cannot appropriately digest your food.  Plus, you can end up with depletion of these methyl donors. 

**Certain mutations in the MTHFR gene (SNPs aka single nucleotide polymorphisms) can definitely cause HIGH homocysteine levels. More on this in another post.

What are the symptoms of low stomach acid (hypochlorhydria)? 

Classic symptoms of hypochlorhydria are:

  • Belching and bloating while you eat
  • A sense of fullness while you eat. 
  • Feeling like your food sits in your belly like a rock and just doesn’t move anywhere. 

Those are good signs of low stomach acid. 

What are the causes of low stomach acid (hypochlorhydria)? 

Now you see what we’re doing here, right?  We’re asking the question why?, why?, why? so that we can get to the root of the cause. 

Here are some common causes of low stomach acid...

Hypoglycemia (low blood sugar)--People that are hypoglycemic have a hard time holding onto their B vitamins.  And B vitamins are some of the co-factors you need  to make stomach acid.  

Hypothyroidism (low thyroid)--low thyroid hormones, or low thyroid hormone receptor response causes decreased digestive secretions. 

H. pylori (helicobacter pylori) infection in the stomach--  This is a bacterial infection that disturbs your stomach acid levels.  The best test to detect it is a Urea Breath Test ( you can also use a test for serum antibodies.)

Almost forgoet to mention gluten sensitivity....

Gluten senstivity can lead to malabsorption of zinc. Zinc is a necessary ingredient to make stomach acid. 

There’s three causes, right? 

These make you have low stomach acid...You can’t get these methyl donors, which means your homocysteine levels rise...

...And homocysteine can slow down the normal response of the cell to thyroid hormone. 

You don’t necessarily have to remember all of that.  Here’s what you need to remember:

If you have low thyroid symptoms...and your labs look normal and people think you’re crazy or depressed...You could have high homocysteine.  

Now, hopefully your doctor would know about this issue and would run a homocysteine to rule this out.  Sadly, not many doctors seem to know this crucial information.  So, you’re going to need to find a doctor who DOES know, and who understands that high homocysteine being high could cause all that stuff I just talked about. 

And then--even MORE importanly--the doctor needs to know what to do about high Homocysteine.

It’s a big job for any doctor to handle. 

Be an advocate for yourself and remember that homocysteine is something that could cause your low thyroid symptoms.

 

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© 2014 David Clark. All Rights Reserved.

Dr. David Clark, DC
Functional Neurologist (FACFN)
Diplomate College of Clinical Nutrition
Board Certified Chiropractic Neurologist
Vestibular Rehab Specialist (ACNB)
919-401-0444
1515 W. NC Hwy 54 Ste 210
Durham, NC 27707

URL: http://www.doctordavidclark.com
Twitter: http://www.twitter.com/DrDavidClark
Facebook: https://www.facebook.com/pages/Dr-David-Clark-Functional-Neurologist/92451382182

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional

January 13, 2015

Hidden Cause #22 Why You STILL Have Low Thyroid Symptoms--Vitamin A Deficiency

 Dr. David Clark, DC - Raleigh-Durham-Chapel Hill thyroid expert, explains how Vitamin A Deficiency causes Low Thyroid symptoms.

TriangleThyroidDoctor.com

Hidden Cause #22 why you STILL have low thyroid symptoms, even though you may be taking thyroid medication...and even though your lab tests look normal is:

Vitamin A deficiency causing thyroid hormone receptor malfunction 

Let's talk about what normally happens...

  1. Inside every cell is a RECEPTOR for T3. 
  2. T3 enters the cell and DOCKS on the receptor (like a key in a lock). 
  3. The cell RESPONDS and a message is sent to the nucleus (where DNA and RNA live)
  4. DNA and RNA start to do their thing and code for proteins that make you NOT have low thyroid symptoms

Vitamin A deficiency SLOWS DOWN THE RESPONSE inside the cell. This creates a sluggish response to T3, and low thyroid symptoms like these:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

This particular kind of problem has nothing to do with your blood levels of T4 and T3, Free T4, Free T3, Reverse T3, or Thyroxine Binding Globulins.  So, blood tests of your "thyroid function" will not show this problem.

Who would have vitamin A deficiency? 

Vitamin A deficiencies should be expected in someone who is iron deficient...or drinks a lot of alcohol...or has liver problems.

Iron deficiency (or Iron need) can be picked up on blood tests by looking at:

  • Ferritin (the most sensitive indicator of your body's iron status)
  • Serum Iron, Iron Binding Capacity and Percent Saturation
  • CBC with Differential 

NOTE: the lab ranges are REALLY wide and forgiving. I use a "functional" or optimal range.

Liver dysfunction can be detected by testing  "transaminases" or "liver enzymes":

  • AST
  • ALT
  • GGT

If these markers are above the lab range, there's probably some kind of liver inflammation going on, and the cause has to be tracked down.

Again, in this scenario of Vitamin A Deficiency affecting Receptors and Response, the thyroid blood tests will look normal.

A woman will usually go to see her doctor because of those low thyroid symptoms I listed above.

And if the doctor runs a T4 and TSH, they’re not going to see anything wrong.  They may even run a "full thyroid" panel (which usually just means testing a Free T4 or Free T3).

Maybe this doctor is really sharp and they run all of the thyroid tests you can order....and the results come back as normal---but you still have low thyroid symptoms. 

Now, the big mistake-- is to give you thyroid hormone medication like Synthroid® or Levothyroixine anyway---Even though your quantities of hormones are clearly normal.

I believe if the doctor is going to give you something (medicine, supplement, whatever) they need to have a reason for why they’re giving it to you. 

I mean, the doctor that looks at those normal numbers and says, “Take iodine.”  Mistake. 

The doctor who looks at those normal numbers and says "Take tyrosine." Mistake.

There’s nothing there.  The doctor needs to consider that there IS another reason for your symtpoms.

What is a symptom vitamin A deficiency? 

The absolute classic sign of vitamin A deficiency is problems with night vision.  Even though you don’t have an astigmatism.  Night vision difficulty with no astigmatism is classic vitamin A deficiency. 

Vitamin A deficiency has to be suspected in someone who has that symptom...

....especially if that person ALSO has iron deficiency, elevated "liver enzymes" or is drinking a lot alcohol.

This particular hidden cause is fraught with a lot of challenges for the clinician and a lot of challenges for the patient.  You have low thyroid symptoms but your thyroid numbers literally do look normal. 

NOTE #2:  please don’t start taking vitamin A without some guidance.  If you take a lot of vitamin A, it can suppress the activity of Vitamin D.  And you can get yourself in a lot of trouble.

My recommendation:

You need to find a doctor who understands that there’s a lot of moving pieces on the chess board here--not just looking at your bloodwork and saying:

"Everything looks fine. You must be fine." 

This isn't good enough....because there ARE some causes for low thyroid symptoms in which all the labs look fine.  Vitamin A deficiency could be one of them in your case. 

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© 2014 David Clark. All Rights Reserved.

Dr. David Clark, DC
Functional Neurologist (FACFN)
Diplomate College of Clinical Nutrition
Board Certified Chiropractic Neurologist
Vestibular Rehab Specialist (ACNB)
919-401-0444
1515 W. NC Hwy 54 Ste 210
Durham, NC 27707

URL: http://www.doctordavidclark.com
Twitter: http://www.twitter.com/DrDavidClark
Facebook: https://www.facebook.com/pages/Dr-David-Clark-Functional-Neurologist/92451382182

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

January 12, 2015

Hidden Cause #21 Why You STILL Have Low Thyroid Symptoms--High Cortisol Blocking Receptors

 Dr. David Clark, DC - Raleigh-Durham-Chapel Hill thyroid expert, explains how high Cortisol causes Low Thyroid symptoms.

TriangleThyroidDoctor.com

Hidden Cause #21 why you STILL have low thyroid symptoms even though you may be taking thyroid medication, and even though your lab tests may look normal is...

High cortisol suppressing thyroid hormone receptors.

Now, we’ve talked before about cortisol doing a couple other negative things in terms of thyroid hormone chemistry (affecting conversion and the pituitary).

But this one today is one in which cortisol levels are too high and suppress the receptors for T3. 

What symptoms would high cortisol dampening these receptors cause?

It would cause low thyroid symptoms like these:

  • brain fog
  • depression
  • hair loss
  • weight gain
  • constipation
  • dry skin, dry hair
  • muscle pain
  • infertility
  • high cholesterol. 

If you have those symptoms and go to your doctor--and they order a TSH and T4--you might get diagnosed as hypothyroid and start taking medication like Synthroid® or Armour®....

But, if you have this cortisol problem, you won't feel any better.

This happens all the time...

So, you could have all the medication you want floating around in your bloodstream.  But even if the hormone docks onto the receptors, nothing happens. Nothing "clicks."

Another way of talking about this is to call this "resistance."

See, there's a receptor on the inside of the cell.  And when the hormone comes along and docks, it causes some changes inside the cell because messages go to the nucleus of the cell and DNA starts to produce different proteins. 

High cortisol basically shuts down the message from traveling from the receptor into the nucleus of the cell.  

So, if you’ve got the type of scenario in which you were diagnosed hypothyroid but you’re taking medication AND the labs look normal BUT you still feel low thyroid-- well, then this could be one of the reasons why.  


There's another scenario in which you never got diagnosed hypothyroid in the first place  because your lab numbers look totally normal the whole time. 

This actually happens quite a bit. 

You still have those low thyroid symptoms we just talked about.  But your T4, TSH, T3, all that looks normal. 

Blood tests don’t look at receptors.  Blood tests can look at levels of T4, T3 etc.  They can look at levels of thyroxine-binding globulins.  They can look at Reverse T3.  But there’s no way for blood tests to look at what’s going on at the level of the receptors. 

So, finding this hidden cause is a process of elimination. 

What causes high cortisol? 

...The three big reasons are:

  1. Inflammation
  2. Stress
  3. Diet

#1 - So, let’s start with inflammation...

Anything that inflames you can cause high cortisol throughout your body. Things like these:

  • Food sensitivities (you probably don't know you have)
  • Leaky Gut
  • Infections (parasites, viruses, bacteria)
  • Dybiosis (bacterial/fungal/yeast imbalances & overgrowths in the small or large intestine)

...they can all cause you to have HIGH cortisol and suppressed thyroid hormone receptors and low thyroid symptoms. 

#2 - Psychological and emotional stress are a big source of high cortisol. 

Who doesn’t have stress?  The problem is if you have too much stress over the long term...or a super large single stressful event, like a divorce or a trauma...that causes you to secrete a lot of cortisol. 

That cortisol can flood the body...suppress the activity of the thyroid receptor...and you suffer low thyroid symptoms.  

#3- A bad diet can also create HIGH cortisol.  

Eating lots of refined sugars, stimulants (caffeine & artificial sweeteners) and simple carbs will cause high cotisol that will shut down those thyroid hormone receptors. 

High cortisol messing with your thyroid hormone receptors is a hidden cause--and it’s quite a ways down on our list because to find it, your doctor has to eliminate all other possibilities.  

To do THAT,  your doctor has got to be able to give your history a thorough review--not just spend 5 minutes without even looking you in the eye. Your doctor would need to be able to RECOGNIZE what you’ve already tried that didn’t work. 

Or realize that even though your lab tests are "normal", you could legitimately still have  low thyroid symptoms. Your doctor needs to spend some time really thinking hard about your case
.

Sadly, that's two things  a lot of doctors don’t want to do: spend time and think. 

Based on the stories my patients tell me, there's a LOT of doctors out there who would really like for you to just show up, pay, leave and the doc never have to talk to you. 

I’ve met doctors like that. 

And I’m beginning to think there’s more and more of them.  I think they all still want to help.  They just don’t want to exert a lot of effort. 

So, to get help you must find someone that understands this fact: there’s a lot of reasons why you can have low thyroid symptoms.  And then tries to work through the possibilities.

How? By AT LEAST asking for a  complete history to discover what you've already tried (meds, supplements etc) that has or has not worked.  

Next, obtaining the necessary lab tests to investigate the possibilities I've listed above. 

Your doctor has got some work to do. 

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© 2014 David Clark. All Rights Reserved.

Dr. David Clark, DC
Functional Neurologist (FACFN)
Diplomate College of Clinical Nutrition
Board Certified Chiropractic Neurologist
Vestibular Rehab Specialist (ACNB)
919-401-0444
1515 W. NC Hwy 54 Ste 210
Durham, NC 27707

URL: http://www.doctordavidclark.com
Twitter: http://www.twitter.com/DrDavidClark
Facebook: http://www.facebook.com/pages/Dr-David-Clark-Functional-Neurologist/92451382182

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

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