Untreated Hypothyroidism: The Silent Killer

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By Brian J. Shiple, D.O. & Kelly P. Shiple, PA-C

The majority of the American population experiences problems with low energy levels, difficulty losing weight, poor concentration, and memory issues on a daily basis. Struggling with these problems while trying to get through the stressors of daily life can be a constant uphill battle. This ongoing fight for many leads to decreased motivation, depression, and a sedentary lifestyle. Long-term, these issues contribute to increased risk of obesity, high cholesterol, heart disease, and even death. The underlying issue here is the high incidence of undiagnosed hypothyroidism.

Subclinical hypothyroidism (SCH) is a commonly undiagnosed type of underactive thyroid. SCH is defined as a serum thyroid-stimulating hormone (TSH) above the upper limit of normal with a normal serum free thyroxine (T4) level. Many doctors only check a free T4 level. The standard thyroid lab panel only includes TSH and free T4 levels. The problem is many practitioners do not check a serum free triiodothyronine (T3) level. Research has shown that a low free T3 level in the face of a normal TSH and/or free T4 level causes persistent underactive thyroid symptoms. This is not to mention other conditions that cause hypothyroidism and are commonly missed such as Hashimoto’s thyroiditis and Wilson’s Reverse T3 Syndrome.

The next problem is that the standard treatment of choice for hypothyroidism no matter what the type or cause, is Synthroid (levothyroxine), which is made of T4 only. Your thyroid makes T0, T1, T2, T3, and T4. T4 only is prescribed because when your thyroid is functioning properly it is supposed to be able to convert T4 to T3. T3 is the active form of thyroid hormone that helps relieve hypothyroid symptoms. However, many people with a persistently underactive thyroid have difficulty converting T4 to T3. This leads to a build-up of a byproduct called reverse T3, which blocks T3 from entering cells and the cycle of fatigue, brain fog, and weight gain continue. When you tell your doctor you are not feeling well they may increase your dose of Synthroid or offer to put you on an antidepressant. This may help improve your symptoms for short periods of time, but you always seem to fall back into that cycle. No matter what you tell your doctor, they keep telling you your levels are ‘normal’. Sound familiar?

As this cycle continues, what seems to be a minor issue of hypothyroidism can become a more major health condition. Persistent low free T3 levels increase the risk of high cholesterol and are a strong predictor of heart disease and heart attack incidence. Untreated low normal thyroid levels are equivalent to the risk of smoking in regards to heart disease risk. Low free T3 levels are also an indicator of increased risk of mortality.

This cycle persists because as clinicians, we are taught to treat numbers and not patients’ symptoms. Many patients actually need their thyroid hormone levels and dosages pushed higher than the way physicians are customarily trained. At Chadds Ford Wellness, we address all treatable thyroid hormones, especially T3, by prescribing a bioidentical, natural form such as Armour, Nature, or desiccated thyroid. This helps to increase free T3 while suppressing TSH levels. The controversy in treating the thyroid this way is the idea that we are forcing the thyroid to become overactive and as a result causing bone turnover and increased heart rate. However, studies have shown that even high doses of thyroid hormone do not cause bone loss or abnormal heart rhythm in most patients. Thyroid hormone levels are closely monitored along with a urine test to check for bone loss to make sure that a safe level of thyroid hormone is prescribed on a case-by-case basis.

Over the course of the first four weeks of the above treatment, energy levels increase, moods improve, weight drops, and brain fog disappears. When this cycle is finally reversed, patients begin to feel like themselves again. Isn’t it time to break the cycle?

“I have been an overall healthy person my entire life. Once I hit 40 everything stopped working. No matter how healthy I ate or how often I worked out, the scale just would not budge. I began working out 5 days a week with a trainer and eating a Paleo style diet. I still couldn’t lose a pound. My performance at work also began to decline. I couldn’t retain any information that was given to me. My boss asked if I had ADD. I began to feel frustrated and down on myself. I could easily take a nap in the middle of the day. By the time I got home from work I was ready to crash. It was then that my husband found Kelly Shiple at Chadds Ford Wellness. After an in depth review of my history, symptoms, and labs we finally figured out that not only did I have hypothyroidism, I had an autoimmune component along with an inability to convert T4 to T3. At my next visit after starting treatment with Kelly we realized I had lost 15 lbs. in two months. My diet and exercise routine did not change, but the weight finally came off. My energy levels improved and my ability to function at work was so much better. I am so grateful to finally have my life back after years of suffering.”  – C.L.

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