Thyroid Hormone Therapy: Restoring Balance

Submitted By Deanna Catalano

More than half of all people with thyroid disease are unaware of their condition, and the risk increases with age. Hypothyroid individuals may have some or all of the following symptoms but may not be diagnosed for years.

• PMS, Irregular menstrual periods
• Lack of exercise tolerance
• Weight gain (especially in the stomach)
• Hypoglycemia (low blood sugar)
• Fatigue
• Irritability -low self esteem
• Low sexual desire
• Infertility
• Dry skin, eyes and/or hair
• Yellowed skin
• Loss of eyebrows
• Constipation
• Headaches, migraines
• Depression, apathy and anxiety
• Memory and concentration impairment
• Fluid retention -face, legs, eyelids and abdomen
• Slowed metabolism and slowed heart rate
• Cold and heat intolerance -cold hands and feet
• Enlarged tongue, deep voice and swollen neck

What makes women more vulnerable to thyroid imbalances?

• Stress
• Genetics
• Environmental toxins
• Suboptimal nutrition
• Hormonal changes (puberty, birth control pills, pregnancy, menopause, HRT)

Hormone replacement therapy often is focused on other hormones such as estrogens, progesterone, DHEA and testosterone, but optimal hormone balance cannot be achieved without correcting thyroid hormone imbalances. Many symptoms of hypothyroidism and menopause overlap. It is especially important for menopausal women who decide to use hormone replacement therapy (HRT) to have their thyroid function tested, because oral estrogens can lower the amount of bioavailable thyroid hormone. This means that if a woman is already on thyroid treatment, and begins oral estrogens, her thyroid dose may need to be increased.

Thyroid hormone helps the body convert food into energy and heat, regulates body temperature, and impacts reproduction and many other hormonal systems. Thyroid hormone (T4; thyroxine) is produced by the thyroid gland in response to the release of thyroid stimulating hormone (TSH) from the pituitary gland. T4 is then converted in other parts of the body to T3 (triiodothyronine), the form of thyroid hormone that cells use most effectively. In hypothyroidism (underactive thyroid), either the thyroid’s ability to make and release T4, or the body’s ability to convert T4 to T3, becomes compromised, often showing up in the form of elevated TSH.

Thyroid imbalance has a profound effect on cardiovascular fitness because thyroid hormone helps control heart rate and blood pressure. Hypothyroidism also weakens muscles, including the diaphragm so breathing can become less efficient; snoring may start or become worse. With impaired respiration and reduced availability of oxygen, muscles do not strengthen in response to exercise and stamina does not improve. People with hypothyroidism have an increased risk of kidney disease. Also, when thyroid hormone levels drop, the liver no longer functions properly and produces excess cholesterol, fatty acids, and triglycerides, which increase the risk of heart disease. In fact, hypothyroidism is the second leading cause of high cholesterol, after diet. High cholesterol may also increase the risk of Alzheimer’s disease, and severe hypothyroidism can cause symptoms similar to those of Alzheimer’s disease.

The original form of thyroid hormone replacement was desiccated thyroid extract from the thyroid glands of animals (Armour Thyroid) which contained both T4 and T3 and was the only available treatment for hypothyroidism for almost 50 years. A synthetic form of T4 known as levothyroxine sodium has replaced desiccated thyroid as the most common treatment for primary hypothyroidism. Physicians note that despite apparently adequate replacement therapy with levothyroxine, some hypothyroid patients remain symptomatic. Studies suggest that replacement therapy for hypothyroidism with levothyroxine alone does not ensure normal thyroid hormone levels (TSH, T4, and T3) in all tissues, and that a combination of levothyroxine and T3 may be required for optimal thyroid replacement therapy. However, the only commercially available form of T3 for replacement therapy is synthetic liothyronine sodium. This immediate release formulation is rapidly absorbed and may result in higher than normal T3 concentrations throughout the body, causing serious side effects including heart palpitations. Because immediate release T3 is quickly broken down in the body, replacement of T3 with synthetic liothyronine requires multiple daily doses. Research indicates ·there is a need for sustained-release T3 preparations; ask our compounding pharmacist for more information.

Our compounding professionals work together with patients and their health care providers to customize medications in the specific strength and dosage form that is most appropriate to meet each patient’s specific needs and solve medication problems.

We welcome your questions about testing and thyroid hormone therapy.

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