JUNE 2006: Hormonal Optimization

Making sure you have the right hormones can add plenty of energy, well being

In past articles we have explored Testosterone Replacement Therapy (TRT), and my articles regarding the same are still available in H&F's excellent website archives.

by Dr. John Crisler, All Things Male

While the previous subject matter pertained exclusively to men's health, this month we explore medical information useful to BOTH men and women.

Another hormone important to optimize is that produced by the thyroid gland. While many people have been properly diagnosed as suffering hypothyroidism ("hypo" means "under", or "low"), a significant portion of the population fall within laboratory "normal" range for the tests used to assess thyroid function, yet still suffer the physical symptoms of not having enough thyroid hormone. These symptoms include fatigue, weakness, irritability, depression, weight gain and cold intolerance.

Learning a bit about how the body works, and the tests doctors order, will tell us why their labs look normal, but they still feel so lousy.

Most of the hormone produced by the thyroid gland is a form called T4. But T4 must then be converted by the body into another form called T3, which is by far more active, in order to bring full effect. It is also important to know that much of our hor

mones (not just thyroid) in the bloodstream are firmly stuck—and therefore rendered inactive—to what are called carrier proteins. It is only those which are still floating around in a "free" state, or only loosely bound to other proteins, which actually do the work.

Combining these facts with the realization there is wide variation in quality of life within what is accepted as "normal" range on laboratory tests (the same is true for testosterone, as well), we find that many people are either not being treated adequately for their hypothyroid state, or are in fact being denied the medications which could make all the difference in the world in how they feel.

Now let's add in one more, extremely important fact: many people do not convert T4 into T3 well. Remember, T3 is the thyroid hormone we most need. What inhibits this all important conversion? Number one is probably stress (no shortage of that in today's world), but also nutritional deficiencies, high protein diets (quite the rage these days) and even birth control in women, amongst others.

So what are we to do with this information? First, let's learn how to properly assess thyroid function. We must test thyroid hormone levels by their "free" state—BOTH T4 and T3. Numerous scientific studies have shown that people are healthiest and happiest when their Free T3 is in the upper half of "normal" range. New thinking also directs us to manage TSH (the hormone that stimulates the thyroid to produce its products, commonly ordered by today's physicians) to below 2.0—this is well toward the bottom of its normal range, and has been revised downward just lately. That way we know the thyroid doesn't have to work too hard to provide us with what we need.
Should Free T4 be in a good range, but Free T3 still found lacking, supplementation then should include extra T3—not just the T4 which is most often solely prescribed (i.e. Synthroid, Levoxyl, etc).

A wonderful, totally natural, product which supplies the right balance of T4 and T3 is Armour Thyroid (of the hotdog fame), which is actually desiccated pig thyroid. As it turns out, pig thyroid hormones are like human, and produced in an optimal ratio of T4 and T3. For those who, for allergic, moral or religious reasons must avoid pork, other commercial T4/T3 blends (Thyrolar) are also available, including those supplied by compounding pharmacies. I cannot tell you how many patients I have switched—dose for dose—from, for instance, Synthroid, to Armour Thyroid. Nearly every one of them reported greatly increased energy levels, general health and sense of well being.