An underactive thyroid can cause symptoms like those of depression or menopause.
Question: I've been diagnosed with depression and menopause and prescribed Prozac and hormone replacement therapy. My thyroid test, TSH, was normal at 4. Could I still have hypothyroidism?
G.I., Culver City, California

Answer: The signs and symptoms of hypothyroidism, or an underactive thyroid, can mimic those of other diseases such as depression or menopause. The TSH test is an excellent screening for hypothyroidism. If you have hypothyroidism, your TSH level is high.

Most labs say the normal blood level of TSH ranges from 0.5 microunits/ml to 5 microunits/ml. I have had quite a few patients with symptoms of hypothyroidism and a TSH of greater than 3 but not more than 5. In these cases I have given them enough thyroid hormone to lower their TSH to less than 3 microunits/ml. The American Association of Clinical Endocrinologists says that a TSH level between 3 microunits/ml and 5 microunits/ml should be considered representative of hypothyroidism.

The TSH laboratory test you were given is one of the most accurate tests for measuring thyroid function. Another is the "free T4 blood test." It is the best way to measure the amount of free thyroid hormone in the blood.

Most physicians order the total T4 test; however, the majority of the hormone measured is inactive because it is bound to a protein. The free T4 measures the amount of T4 that is not bound to a protein and is thus free to exert its effect on the cells.

Because your TSH level was 4 and you have symptoms of hypothyroidism, I recommend that you find a doctor who prescribes natural thyroid hormones. Most doctors prescribe the synthetic thyroid replacement T4 hormone Synthroid as their first choice.

Yet many people continue to have hypothyroidism or still have many symptoms of it even though they take a replacement T4 hormone. They might benefit from taking a natural thyroid hormone, which contains both T4 and T3.

Another option would be to continue taking a synthetic T4 medication such as Synthroid, and add a small amount of the more active hormone T3, which can be compounded by a compounding pharmacy into a sustained-release preparation.

To recap, I recommend that you take the time to locate a physician who (1) will prescribe a thyroid medication for you; and (2) will prescribe either a natural product such as Armour Thyroid or a combination product such as Synthroid with a small amount of T3 sustained release.

Question: I have Graves disease, and my doctor has recommended that I take radioactive iodine. Are there natural means for controlling my thyroid?
T.H., Orlando, Florida

Answer: Graves disease is an autoimmune disorder of the thyroid gland that causes hyperthyroidism, or an overactive thyroid. Symptoms include weight loss, enlargement of the thyroid gland, rapid heart rate, tremors of the hands and fingers, frequent bowel movements, and eye problems such as exophthalmos--a bulging of the eyes.

I have helped many individuals with Graves disease avoid radioactive iodine. The anti-thyroid medication I commonly use is methimazole (Tapazole).

I generally start with 5 mg (milligrams) of Tapazole three times a day and monitor the patient's free T4 levels every four to eight weeks. I start these individuals on Natur-Leaf or Moducare, which are plant sterols and immune modulators.

I also start these patients on adrenal glandular supplements such as DSF because adrenal functions usually are diminished. Most patients will stay on Tapazole for approximately a year to see if their thyroid can be controlled without medicine. I make sure they are monitored regularly with a CBC test as well as liver-function tests.

I also place them on a hypoallergenic diet and have them include two quarts of filtered water a day, eight hours of sleep and a mild exercise program.

My book The Bible Cure for Thyroid Disorders (due March 2004 from Siloam Press) will explore this topic further.

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