Why hypothyreose symptoms, when blood-tests are normal? According to a growing number of doctors there are at least two major categories of patients needing thyroid hormones: Hypothyroidism Type I and Type II. Type I is the classical problem: low thyroidhormon in the blood,Type II is heterogenic group where thyroid hormone tests are normal but the function of the hormones on the cells are sadly failing! These are the patients who have “normal tests”, suffer from the symptoms of lack of hormones and get better from thyroid hormone therapy.
Hypothyroidism from the mainstream into the light!
The historical proof.
A major problem today is the doctor’s reliance on lab -test’s instead of trusting their eyes, ears, hands and brains. Hypothyreose, in earlier days of medicine called myxedema, is largely a clinical diagnose. Ever since the first description of myxedema and its identification as caused by an injured thyroid gland as early as 1873, the diagnose has been done by clinical investigation. The great thyroid expert of past generation professor Broda Otto Barnes in USA relied nearly 100% on clinical examination plus taking the morning temperature. In his now classic book Hypothyroidism; The unsuspected Illness[i] from 1976 he could look back on 40 years of successful scientific research and clinical work. His conclusions rests on the meeting with thousands of myxedemic patients, today called hypothyreosis or even better called : hypometabolic patients due to thyroid hormone failure.
Thyroid problem a part of the greater picture of energy-failure.
Before going further I should mention the new trends emerging mainly from clinical and theoretical work by doctor John C Lowe [ii]also USA. Low followed in the footsteps of Barnes but with access to a far more advanced science he could explain in detail what Barnes could only experience in daily practice when giving thyroid hormones to patients with low basal temperature plus symptoms of clinical hypothyreose. Having the privilege to be given inspiration and personal advices by Lowe in my own clinical work here in Norway I came to appreciate the importance of believing the patients more than the lab. I also came to understand even more by investigating in depth more than 2000 patients that what we see is this: Myxedema later called hypothyroidism is a manifestation in a decay in energy-production in the cells of the body due to lack of thyroid-hormone effects on the cells.
The energy function puts things straight.
Failure to produce biological energy( E)[iii] results in a proportional decay in metabolism which is the name we use for a cells ability to do work (W). Doing work cells also produce heat, measured as temperature. Since the universal law of energy is:
Energy = Work + Temperature[iv]
We see that less energy leads to less Work and a colder body, precisely as Broda Barnes described. Ability to do work is called metabolism, so having less energy available leads to hypo-metabolism.
Since thyroid-hormones makes cells produce energy faster from free fatty acids, glucose, Oxygen, water and nutrients, more thyroid hormones are increasing Energy and accordingly metabolism. When thyroid hormone effect falls we enter a hypo-metabolic state which is typical for lack of energy as that which goes with less thyroid hormone effects! Therefore hypothyreose leads to hypo- metabolism; but metabolism is not always cased by hypothyroidism, if we bay that means less available thyroidhormoner due to a thyroid gland defect!
Hypometabolism more than just low thyroid hormones in blood.
As a matter of fact there are many causes for hypometabolism, but interesting enough the majority leads to a reduced effect of thyroidhormones, therefore the majority of hypometabolic states are also in a way hypothyroidism; but with the exception that apart from pure/classical hypothyroidism , the majority of other states have enough thyroid hormones. But because other factors such a depleted adrenal glands, estrogen -dominance, use of anabolic hormones, malnutrition and so on leads to a weakening of thyroid hormones on the cells; one can if ignoring the cause, improve patients health with thyroid hormone supplements. This is of course not attacking the problem, but it is a temporary relief. This is what professor Broda Barnes observed in a period when lab tests were sparse; that as much as 40% of all hypometabolic patients improved their health by using thyroid hormones. Later research proved that 2-20% of all hypometabolic patients had thyroid hormone deficiency (depending on population, gender, age, nutrition etc.)!![v] This caused a schisma that doctor Lowe tried to solve 30 years after Broda Barnes period by introducing the concept of Thyroid Hormone Resistance (THR): enough hormone in the blood but unresponsive cells. The situation could be fixed with addition of extra thyroid hormones!!
Hypothyreose type I and II
We thus have the following clinical situation
- Clinical picture identical to hypothyreose + Lab tests show low thyroid hormones in blood + Gets better from thyroid hormone therapy = Hypothyreosis I
- Clinical picture identical to hypothyreose + Lab tests show normal thyroid hormones in blood + Other tests not normal +Gets better from thyroid hormone therapy = Hypothyreosis II
What are the other lab tests that are abnormal? Having tested more than 2000 hypometabolic patients we today starts to get a fair knowledge of the terrain. It is complicated and very intricate and demands a long experience to understand and convert into practice. It will be dealt with later on.
As for now: remember: Hypometabolism is the name for the underlying phenomena appearing as hypothyroidism or hypothyroid-like states. Of these as previously mentioned approximately 2-20% are Hypothyroidism I (depending on age ,nutrition, medication of the population investigated. ), the remaining 20-38% are Hypothyroidism II. Both will be relived by thyroid hormone therapy, but Hypothyroidism II should definitively be treated by removing what blocks the thyroid hormone effect by all means. In many cases this is possible and making it unnecessary to use thyroid hormone therapy; but when the ideal goal is not reached some thyroid hormones has to be added.
Out of the stagnant pool of industrial medicine.
Revolution means evolving again, anew. Hypothyroidism has for years been a stagnant pool if we are to trust the stories from more than 2000 patients I myself have personally in depth interviewed and the reports written by brave pioneers like professor Broda Otto Barnes and doctor John C Lowe. This stagnation is not due to lack of intelligence or integrity of the generation we could call the “industrial generation of doctors” when medicine turned away from clinical work to the current New Public Management Medicine where there is a high reliance on labwork; without necessary skepticism to its usefulness.
To befree oneself from the stagnant pool and doing justice to the genius of ones own creative abilities one has to look at the situation from a different angel: the clinical situation[vi].
Treating patients the doctor of the new area questions the sick, uses his/her eyes and ears and hands to collect data. The doctor then collects labdata from a variety of body parameters (more than 50 oftentimes) including body-temperature measurements done by patients at home and then the doctor adds all the factors together and finally settles on thyroid-hormone therapy or not plus other chemicals needed to correct the situation.
When going through such a process a doctors archive will eventually over the years contain two groups of patients if he sorts the sick according to one parameter: patients getting better from thyroid hormone or not.
Looking back the doctor will get a very simple definition of his/her patients: People needing thyroid therapy to get better or healed, and those for whom thyroid therapy has no effects. So instead of the tedious feuds in the stagnant pool we simply end up with a new and fruitful situation: Sicknesses that can be improved by thyroid therapy or not. So we now ask: Who will improve their quality of life using thyroid therapy?
This is nothing different than asking: Who benefits from cortisone therapy? This also befree us from the problem of what type of product and how much is best! We simply look to the clinical results and observe how labdata change as we approach and finally reach the correct dose.
End of part I
[ii] Lowe John C : · McDowell Publishing Company; 1st Edition (Februar 1, 2000)
[iii] – Horst W. Doelle BIOTECHNOLOGY – Vol. I – Cell Thermodynamics and Energy Metabolism
[iv] For thos with intrest in physics: W= w(Xi) is called th Work function and Xi is a tensor –notation indicating a n-deminsional space where X1 is denoting E, for energy produced by intracellular mitochondrias. W is defending on several factos such as functiron of alfa and beta receptors, cll membrane potential etc. T = t(Y1 ) is the tempraturefunction to be dealt with likewise.In a later paper we will deal with these functions that appears to be nonlinearl renasorfamtions.
[v] Vanderpump Mark P: The epdidemiology of Thyroid disease. British Medical Bulletine, , June , 2011,http://bmb.oxfordjournals.org/content/99/1/39.full.pdf+html
[vi] R., Heimdal, A., Karlsen, K., . . . Wyller, T. B. (2013). Ta faget tilbake! Tidsskrift for Den Norske Legeforening, 133(6), 655–659. Aarre, T. F. (2010). Manifest for Psykisk Helsevern. Oslo: Universitetsforlaget.