INTRODUCTION: About 50% of people with health issues have some sort of endocrine problem. Many have thyroid issues. In primary hypothyroidism, the thyroid is the basic issue. With secondary hypothyroidism, the basic problem is with other glands that affect the thyroid. About 80% of those with thyroid problems are women. American men and women are continually dosed with estrogen or estrogen-like compounds in drugs, food (especially soy), water, and air. Excess estrogen interferes with the conversion of T4 to the active T3. Add to this our exposure to chlorine and fluoride in our water. Both of these block the activity of iodine. Also, most Americans have an iodine deficiency. Many have protein deficiencies. (Many of these concepts are based on research by Dr. Harry Eidenier, Jr., Ph.D.)

DETECTION: This is a combination of looking at symptoms and then tests.

SYMPTOMS: Primary and secondary hypothyroidism have similar symptoms. Symptoms provide about half of the needed information. Look for:

- Morning headaches that wear off during the day.
- Low morning underarm temperature. (Adrenal, pituitary or other issues such as elevated estrogen can also cause this.)
- Depression.
- Dry or brittle hair, or hair that falls out.
- Dry or itching skin.
- Sensitivity to cold. Thyroid is the heater.
- Slow wound healing.
- Joint stiffness.
- Poor circulation.
- Cold or numbness of the hands or feet.
- Loss of the outside portion of the eyebrows.
- Increase in weight even on a low calorie or low carbohydrate diet.
- Reduced initiative.
- Mental confusion.
- Poor memory.
- Ringing in the ears along with decreased blood pressure and/or slow pulse. (This can also be an adrenal problem.)
- Muscle cramps while at rest.
- Catching colds or other infections easily. Difficulty recovering from infections.
- Requiring excessive sleep (more than 8 hours).
- Chronic digestive problems. This is often low stomach acid.
- Edema, especially in the face.
- Constipation.

TESTS: Tests provide about half of the needed information. Out of 100 patients with the above symptoms, about 10 will have genuine (primary) hypothyroidism. The rest will mostly be excessive adrenal (cortisol) output blocking conversion from T4 to active T3, or low pituitary function leading to low thyroid function. Some cases are excess estrogen or low adrenal function.

- TSH. This is the primary test. The healthy range is about 2.0-4.0. With symptoms and a reading above 4.0, this is probably primary hypothyroidism. With symptoms and a score below 2.0, the problem is probably a weak anterior pituitary. If the TSH is between 2.0 and 4.0, look at the T4, T3, and cortisol.

- T4 (thyroxin) should be in the middle or just above the middle of the normal range.

- T3 or T3 uptake should be in the middle or just above the middle of the normal range. If there are symptoms, and the T4 is in the middle or upper part of its range, and the T3 is in the lower part of its range, the person is an under-converter.

- Cortisol from a salivary adrenal stress test. Blood TSH, T4, and T3 may be fine. But if there are symptoms, cortisol may be high because of stress or excess carbohydrates in the diet. If the cortisol is high, the patient is almost certainly making reverse T3 instead of real T3. Reverse T3 is not a functional hormone but it looks like normal T3 on a blood test. This is often treated with T3 and T3 may relieve symptoms. But it may be better treated as a high cortisol issue. At least half of adrenal issues are excess cortisol output!

- Estrogen is best tested from a saliva sample.

- Iodine. Paint a silver dollar size of drugstore tincture of iodine on your skin. If it soaks in quickly (the stain is gone in less than 24 hours), you need iodine unless you have an iodine allergy.

- Basal temperature. The goal is 97.8-98.2.

TREATMENT: Diet should have adequate protein and lots of vegetables. Fewer grains are best for most people. Some fruit. Avoid sugar. Drink reverse osmosis or distilled water and use a shower filter. Use flax oil (3-6 grams a day) or EPA/DHA. Eliminate caffeine and nicotine. Consider Betaine HCl to replace missing stomach acid. Consider digestive enzymes.

Primary hypothyroidism (high TSH) - Biotics GTA and Meda-Stim, 3-6 of each per day. GTA is a thyroid support preparation. Meda-Stim helps convert T4 to T3. These will reduce high TSH 95% of the time. Avoid cabbage family foods and millet.

Weak anterior pituitary (low TSH) - Biotics Thyrostim and Cytozyme PT/HPT. 3-6 of each per day.

Under-converter (low T3) - use Biotics Meda-Stim.

Adrenal - for excess cortisol (reverse T3) use Biotics ADHS, 1 with breakfast and 1 with lunch to lower cortisol. Biotics Meda-Stim, 3-6 per day. This is also a good program for Wilson's Syndrome (Low T3 in the tissues). Consider Biotics Glucobalance. Diet is crucial. Excess carbohydrates will often block progress. If cortisol is low, consider Bezwecken Isocort, 3-6 per day.

Excess Estrogen - Biotics Calcium D-Glucarate (1 twice a day) helps the liver detoxify excess estrogen.

TIME: Symptoms often improve in three weeks or less. If the symptoms and lab values are not improving within 30-45 days, consider natural hormone replacement such as Armour Thyroid or T3. Armour Thyroid contains 4.22 parts of T4 to 1 part of T3. It may take a year for a low basal temperature or TSH to come up. Do not worry too much about a temperature that is slightly low if symptoms are absent. Hormone replacement must be managed carefully and levels must be tested often because excess thyroid hormone can cause osteoporosis and other problems.