Six Patterns of Hypothyroidism
This is the way most Medical Doctors view hypothyroidism. It is a valid way to treat Primary Hypothyroidism which is the first of six common patterns of hypothyroidism and is caused by a thyroid gland that does not create enough thyroid hormones.
In this pattern, decreased thyroid hormones (T3 and T4) in the blood stimulates the hypothalamus which stimulates the pituitary gland to release thyroid stimulating hormone (TSH). TSH stimulates an enzyme in the thyroid gland called Thyroid Peroxidase to use iodine to create more T3/T4 which is realeased into the blood. The increase in T3/T4 stop the hypothalamus which stops the pituitary from releasing TSH which stops the production of T3/T4.
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In Primary Hypothyroidism, the thyroid gland does not produce enough T3/T4 which means there is chronically low amounts of the hormones circulating in the blood. This causes the hypothalamus to continually send signals to the pituitary which is continually releasing larger and larger amounts of TSH.
Patients with blood test results that show high levels of TSH are prescribed synthetic thyroid hormones to increase the amounts of circulating thyroid hormones and shut down the stimulation of the hypothalamus/pituitary. This decreases the amount of TSH and “normalizes” your blood tests.
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Roughly 93% of the thyroid hormones is in the form of T4 which is an inactive form and must be converted to T3 before the cells of the body can use it. 7% is made into T3 and can be immediately transfered to cells by thyroid binding glubulin proteins.
In the liver, around 60% of the inactive T4 is converted to T3. Another 20% gets converted to reverse T3 which is inactive and exctreted from the body. The last 20% is converted to T3S and T3AC which are inactive forms of T3. T3S and T3AC are then converted into the active form of T3 by bacteria located in the gastrointestinal tract. It can then be used by the cells of the body to fuel metabolism.
Pattern 2: Hypothyroidism Secondary to Pituitary Hypofunction
If the doctor only tests for TSH, he/she would assume that thyroid function was normal (which it would be if there was enough TSH) even though the patient was presenting with signs and symptoms of hypothyroidism. If prescription thyroid medication is used, it may initially help symptoms. However this is a dangerous course of treatment.
Flooding the system with thyroid hormones causes the pituitary to be suppressed even further. Larger amounts doses of hormones are prescribed and the increase of hormones in the system causes cells to become resistant to thyroid hormones (similar to pre-diabetics being insulin resistant). Eventually the pituitary/thyroid communication could be permanently lost requiring a lifelong dependance to prescription medications.
Post-partum depression is another cause of a suppressed pituitary. The stresses of pregnancy and birth can rapidly suppress the pituitary leading to symptoms of hypothyroidism.
The cause of under-conversion is once again chronic stress. Chronic infections or inflammation can also play a role in thyroid underconversion by damaging cell membranes which plays an integral role in T4 to T3 conversion.
Additionally, a sluggish liver, which converts 60% of T4 to T3, can lead to thyroid under-conversion.
Dosing with prescription thyroid medication is often futile. Synthroid, a common thyroid prescription, is a synthetic form of T4. It still needs to be converted to T3 before the body can use it. The patient may find temporary relief if prescribed T3, but the increased levels of circulating hormones may cause the suppressed pituitary situation similar to what occurs in pattern 2.
The high levels of T3 in conjunction with low TBG causes cells to become resistant to T3. They close the doors and do not allow anymore T3 into the cells. TSH levels will be normal even though the patient is showing signs of hypothyroidism
This pattern is similar to insulin resistance. In fact, patients with thyroid over conversion often also present with insulin resistance and polycystic ovary syndrome (PCOS) which is also caused by increased testosterone levels. Managing blood sugar is extrememly important. Since there is already too much T3, prescription thyroid medication will not help in this pattern.
Pattern 5: Thyroid Binding Globulin Elevation
High estrogen levels from oral contraceptives, hormone replacement therapy, our food supply, or hormone creams increase the level of TBG. TSH levels are still normal due to the circulating hormones.
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