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The Mysterious Thyroid Epidemic

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Is there an invisible epidemic sweeping the country? Thyroid dysfunction is one of the most common health problems in America and no one knows why it has become so widespread.

At last count, about 100 million prescriptions were filled annually for thyroid hormone in the form of levothyroxine (Levothroid, Levoxyl, Synthroid, Unithroid) or Armour Thyroid. That makes thyroid medication one of the most dispensed drugs in the pharmacy.

Did our ancestors also suffer from thyroid disorders at a high rate? Some experts think they did, but went undiagnosed.

Others blame environmental chemicals. Hormone-disrupting chemicals including flame retardants and stain repellents have been associated with underactive thyroid (Environmental Health Perspectives, online, March 27, 2012).

The iodine-containing contrast medium used in some CT scans and heart procedures can also disrupt thyroid function (Archives of Internal Medicine, Jan. 23, 2012). In high doses the active ingredients in soy products (isoflavones) may also affect the thyroid.

Whether or not these environmental factors are contributing to thyroid disease, many patients feel frustrated by the difficulties they encounter in diagnosis and treatment. One reader wrote: "My doctor doesn't believe my thyroid is causing my symptoms of fatigue, feeling cold all the time, thinning hair, dry skin and brittle nails. I cannot lose weight no matter how little I eat. My TSH is 4.7 and my doctor says that's normal, but I feel terrible."

A husband wrote to inquire about his wife's symptoms of fatigue, joint and muscle pain, poor sleep, hoarseness, cold hands and feet and inability to lose weight even with exercise and diet. He wondered if such symptoms could be thyroid related. The symptoms described by both readers are classic for hypothyroidism.

There is significant controversy within medicine about diagnosing thyroid dysfunction. The standard approach is to assess TSH (thyroid-stimulating hormone). Elevated TSH suggests that the thyroid gland is underperforming.

The controversy concerns the cut-off at which TSH is considered high. When the normal range was first established, it ran from 0.4 to 5. Now, many endocrinologists think that a more appropriate range tops out at 3 or even 2.5. And TSH may not be the only relevant test.

For more details on the controversies around diagnostic testing and treatment of thyroid problems, readers may wish to listen to our one-hour interview of three thyroid experts. It can be streamed for free from PeoplesPharmacy.com (#853) or downloaded from iTunes. An interview on the effect of iodine-containing contrast for CT scans or angiograms was included in show 855.

If you who would prefer a CD of our one-hour radio interview about the latest information on thyroid disorders so you can listen at any time or share it with a friend, here is a link to our shopping cart for Show # 583.

Treatment of low thyroid can be just as controversial as diagnosis. Conventional wisdom maintains that a prescription for levothyroxine, known as T4, solves the problem. But many patients report that pure T4 doesn't eliminate their symptoms. Some physicians prescribe a combination of T3 and T4 either as desiccated thyroid (Armour Thyroid) or a slow-release formulation compounded for the individual patient.

Correcting thyroid dysfunction can dramatically improve quality of life. Even if doctors don't yet know what's causing the epidemic, they still can work with each patient to ease symptoms. You can learn more about diagnosis and treatment of thyroid problems from our Guide to Thyroid Hormones.


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24 Comments

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I had a total thyroidectomy last November. I take Thyroxine. What type if diet should I follow to help me lose weight? I have gained weight and have tried Weight Watchers. Now I am trying a low carb. Which is the best?

This may seem off the wall, but I wonder if anyone has performed a study comparing the time when the Catholic Church stopped mandating fish on Fridays (after Vatican Council II, 1962-1965) to epidemiological changes in thyroid dysfunction. Up until that time, all (or at least most) Catholics ate only fish (no meat) on Fridays.

Not only Catholics were affected by the mandate, however, although they represented a significant proportion of the population. Most restaurants used to routinely feature fish on their menus on Fridays, and I would venture to guess that more people ate fish then than they do now, simply because it was available and had become a life-long habit.

If no such study exists, perhaps it would make an interesting research project for some enterprising young student? Just a thought.

My Doctor finally diagnosed thyroid dysfunction after I gained 15 pounds, was not sleeping, was irritable and just felt miserable. He put me on Synthroid, I suffered terrible side effects and changed the medication to Armour Thyroid. I have done well with this medication and feel like myself again. I take 30 mg or 1/2 grain. Both are the same. Thinking back, I had several CT Scans and I feel this is why I developed a Thyroid problem. I sincerely hope this is helpful to someone else.

Back in the 20's and 30's, goiter (thyroid enlargement) was nearly epidemic in some sections of the country. How did they solve it---ever hear of iodized table salt? The cure was to add trace iodine to a commonly used condiment--salt---goiter problem solved. Since salt has become anathema and similar to garlic to vampires and picket fences to werewolves---guess what--the problem is back. The answer is the same as it was eighty years ago---Trace iodine. Available in your local health food store as Kelp.

I was just diagnosed with a thyroid nodule and had a biopsy. Waiting on results, but doctor wants me to remove nodule whether cancer or not. I have mild hoarseness and trouble swallowing but not so bad that I want to have surgery and in turn be on meds for the rest of my life. Not sure what to do.

This is a very interesting observation. How do you use the kelp?

Interestingly, I have a 19 year old CAT who came down with thyroid problems about 4 years ago, and her Vet, (a wonderful doctor-I wish I could find one as good for me) told me that thyroid problems in cats are also going through the roof. Sounds like the environment to me.

Is there any thyroid treatment that makes eyebrows "normal"? Do doctors even learn about the thyroid/eyebrow connection?

Thank you for addressing something I have been dealing with for the past year and a half. However, why was there no mention of Hashimoto's Thyroiditis, the autoimmune disease that, according to everything I have read, is responsible for 90% of hypothyroidism cases?

What is the basis for the “controversy” among the medical community regarding diagnosis of thyroid dysfunction? Without more information, it’s hard to tell whether or not there really is a controversy or whether some doctors just aren’t practicing science-based medicine

I too have been diagnosed with Hashimoto's Thyroiditis, yet when I mention it to people, they look at me like I have made it up! No one ever talks about it. I was diagnosed by a new integrative doctor I just started seeing. He recommended that I keep my regular doctor and when I told her what he had diagnosed my with and that he put me on Amour Thyroid... well, let's just say she isn't a believer of integrative medicine! I wish there was more info out there on Hashimoto's!

I started gaining weight in May of last year. At that time I also developed SEVERE cystic acne and sores in my mouth. I watched in horror as my body became puffy-looking and my weight continued to climb, despite being a very active and healthy young woman; I went from 9% body fat at 117 pounds to 20% and 145 pounds in a matter of months. I had my thyroid checked in July, when I had already gained >/= 10 pounds and it was 2.4.

By January I was sleeping 12 hours a night and taking 2 hour naps during they day, and I needed a pot of coffee to get moving in the morning and espresso to keep moving in the afternoon. When I had my TSH re-checked in January it was 4.6 and they told me it was "creeping up," but normal, and that "it just happens in some people."

I can't understand why my doctor doesn't care or understand that the symptoms are distressing and debilitating. I went from extremely fit and healthy and outgoing, to depressed, tired, and thirty pounds heavier than I'm used to in a matter of months. Needless to say, my doctor put me on generic synthroid and I didn't notice any alleviation of the symptoms, at least not much.

I've recently switched to Armour because I have read repeatedly that it's better than synthroid, but I have yet to see any significant changes. I was crying so much, my boyfriend of 1 year broke up with me because he couldn't deal with it, or so he says. My endurance is still significantly poor and I am completely wiped out after a 9 hour day of work.

I have lost ONLY 4 pounds in the last five months despite eating fruits, vegetables, whole grains; no dairy, no meat, no sugar, nothing processed, and that can fly back up to 140 or higher if I'm not very careful. Why aren't people in the medical community more concerned and better educated? Any questions I present to my doctor he dismisses, such as adrenal fatigue and goitrogenic foods. I want to know what has caused my hypothyroidism so I can be sure I'm not continually reintroducing the toxin in my system. I know I'm doing the right things, but I'm so distressed. This has been going on for a year now and I just want my life back. :'(

There's a book titled: "How I Reversed My Hashimoto's Thyroiditis Hypothyroidism" written by Robert T. Dirgo. ISBN 0-595-16708-X

He talks about changing his diet and supplement program. He took Enzymes, Probiotics, CoQ10 and blue-green Algae.

Perhaps his book will shed new insight for you.

My suggestion for those diagnosed with overactive thyroid (Graves Disease with goiter) is to NOT have surgery OR have the goiter (along with your thyroid gland) removed. My endocrinologist at a large university hospital told me there were three options: surgery (after which you will have to take artificial hormones for the rest of your life), radiation to "kill the thyroid gland (and whatever else those beams decide to attack (after which you will again have to take artificial hormones for the rest of your life), or take a hormone pill for a while to try to kick-start a renewed balance of your endocrine system.

I chose the latter. After several years, he indicated it was time to try to get off the pill. We stopped it, but my thyroid went out-of balance again. Fortunately for me, although he indicated that it was not standard practice, he allowed me to take the pill for several years again. Voila. My body was finally able to take over and balance itself.

SOOOO glad that I didn't do anything more drastic. The only residual problem I have had is difficulty attending/concentrating. For a long time thereafter, I was prescribed anti-depressants although I kept trying to convince them I was NOT depressed. Finally, I got a doctor to listen. I have been taking Adderral now for about 10 years. While I wish I didn't have to depend on it (and I have "weaned" myself down from 20 mg to 5 mg), I can tell by 10 am if I have forgotten to take it.

The truth is: there is SOOO much that medical doctors do not know. We have to each trust our knowledge about our own bodies and continue to be strong advocates for ourselves. The less invasive we are with everything we do to our bodies, the better!

Unless you are on adequate thyroid hormone replacement, no diet will be sufficient. Unexplained weight gain is one of the symptoms of thyroid hormone insufficiency. Most doctors will put you on synthetic T4 (Synthroid) but some find Armour or Nature-Throid which are naturally derived and have other thyroid hormones as well, to be more effective. Basically if you are still having symptoms you probably need more treatment and sometimes that requires a different doctor.

Sounds exactly like my story- took me years to find a doctor who actually listened to me. I'm now on 90 mg of Armour a day and feeling fantastic. It took about 6 months of adjusting/raising the dose, but now that we've found the right amount it's really a miracle.

So how did you find a doctor? I have asked the Walmart pharmacy in my town if ANY doctor here prescribes Armour thyroid and was told "no." I have tried through the internet to find such a doctor, and it seems I'd have to drive a hundred miles or so. My own doctor must have gone to a seminar given by the makers of Synthroid. He thinks if my TSH is okay, I am okay.

I am pregnant and just got diagnosed with something that can be an autoimune disease on the thyroid.... Good to learn about this website. I wonder what is causing this?

What is the recommended dosage? I have been on armour thyroid for years..my dosage is 60-90mg/day.

I eat as close to a "paleo" diet as I can and have for a number of years now with very good results. I was pretty well until two years of extreme stress brought down first my thyroid and then my adrenal glands. I'm on Armour Thyroid and a lot of supplements and doing MUCH better. If you want more info on the "paleo" idea, go to Mark's Daily Apple. That's the best site I've found for all-around accurate information and support. Good luck!

Perhaps you need to look at changing your diet again. Get rid of the whole grains, rice, etc. and eat meat, vegetables and a few roots/tubers like sweet potatoes. Good fats would be of help, too, like coconut oil, butter or ghee, sesame oil and olive oil. Do not eat vegetable oils or margarines. I've been eating the "paleo" way for a number of years now and my health is, except for my thyroid, excellent. Blood tests prove it and the general doctors I've seen are soooooo puzzled. My MD/naturopath/endocrinologist laughs when I tell her how regular doctors react! :) Check out Mark's Daily Apple (website) for accurate, easy to understand posts about eating this way. Lots of great stories from folks who have had remarkable health improvements, too. (No, I'm not affiliated with MDA or anyone else!) Good luck and I hope you feel better, soon!

KA- it is September... how are you doing now? by chance- are you on any birth control? estrogen disrupts the thyroid. That may be a factor as well. I have found no one thing that has helped my 5 year long journey; but a group of things. hope you are doing better!

I have Hashi I went undiagnosed for nearly 20 years even though my mother has it and attends the same Dr practice (I blame incompetent GP'S as I had lots of obvious signs) after 6 major abdominal opps inc hysterectomy all now linked to Hashi feel I've lost the best years - been on synthetic T4 and T3 for a few years put on 2 and half stone - gone to new endo and now on Armour just 4 days so not sure what the outcome will be?

Anyway years ago before diagnosis I had a blood test coz I thought my symptoms were allergy related and it highlighted wheat and gluten my new endo told me to give up gluten asap as it irritates the stomach and stops absorption of meds (all hashi sufferers are intolerant to gluten). I have given it up and must admit to feeling better after 1 week please try x

someone please help me out if you can!


In 2011 I was diagnosed with hyperparathyroidism. Also I have high calcium. With a list as long as someone who is around 70 with health issues:( problem is I am only 30 close to 31. After my third daughter was born I had aching bones and broke my arm I have also torn my acl in the past and have had kidney stones 3x with my gallbladder also removed!! severe heartburn daily (take prilosec) and (adderall) along with a pain med (loratab) they want to open me up and do exploratory surgery because they do not know for sure if I have a tumor they "think" they something glowing in there but believe a piece of my thyroid gland may have developed in my chest in utro cause they see something there also.

After a lot of research I found this site which is very new the rest are from a few yrs back:( has anyone ever heard of this?? really confused as to what to do I'm suppose to go to the u of m for surgery here very soon and don't feel comfortable doing it cause I feel like it may be something I'm doing. I want to believe its from the adderall been on it for the past 7 yrs. on and off I've lowered my dose but haven't been tested enough to know if it had anything to do with it as I wasn't paying much attention! My pth is at 143 right now, in jan of 2012 it was 231 my calcium is 11.3 usually is a little high but seems to be climbing higher each time, I first found out my calcium was high in 2005 never took care of it until they checked my pth and that was off.

I have been to several doctors who passed me to the next doc I'm getting a little scared I know doctors don't know everything but if I had a tumor on my thyroid wouldn't it be growing? and why would my levels be going down? I will check it again in 3 months and I guess see where it is at! I guess I'm more asking if there is a medicine for me? I don't really see anything anywhere about "hyperparathyroidism" the weird thing too is I don't fit the "description" for this as I have been gaining weight not losing weight! I went from 140 in 2007 to 205 2012 I did have children but really watch what I eat and get exercise so who knows any info would be great thank you so much~

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