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Guest Column. . .
January is the American Association of Clinical Endocrinologists' Thyroid
Awareness Month. We're very lucky to have Joan Hedman, an accomplished writer to
use this forum to bring some of that very awareness to our low carb community via the
Low Carb Luxury Online Magazine.
If you've been following the low carb way of life but aren't seeing the weight
loss results you'd like to see, there may be an explanation beyond your diet.
It could be your thyroid.
My Story
I'm 39 years old, a full-time mother of three and part-time freelance writer.
I'm "pre-diabetic" (insulin resistant), and I have PCOS. I've been
controlling both of those conditions through low-carbing with tremendous
success for nearly four years now. But just a few months ago, I began a slow
deterioration that I successfully ignored until a specific complaint sent me
the gynecologist. The diagnosis brought into focus all the symptoms I had
been brushing off: I am hypothyroid.
The Thyroid Gland
The thyroid is a butterfly-shaped gland that lies just above your collarbone,
below the Adam's apple, in the front of your throat. It is part of the body's
endocrine system, which produces and regulates the hormones that control all
the chemical processes that take place in the body. The thyroid's job is to
regulate metabolism. If you have too much thyroid hormone circulating in your
system, you are hyperthyroid, with associated symptoms like palpitations,
insomnia, and nervousness. Your metabolism is in overdrive.
If, on the other hand, your thyroid gland is not producing enough thyroid
hormones, you are hypothyroid. Your metabolism can barely shift out of
neutral. Some of the most common symptoms of hypothyroid are fatigue, weight
gain or an inability to lose weight in spite of diet and exercise, dry skin,
"brain fog", and low body temperature. In women, irregular menstrual cycles
and prolonged and/or heavy bleeding can also be caused by hypothyroidism. In
my case, I was physically and mentally exhausted, cold all the time, and
experiencing abnormal menstrual bleeding. My skin was dry, my lips constantly
chapped, and my hair was falling out. All these are classic symptoms of
hypothyroidism.
Diagnosis and Treatment
There are many underlying causes of thyroid dysfunction, including transient
infections, autoimmune conditions in which the body attacks the thyroid
(Hashimoto's Thyroiditis, Graves' Disease), thyroid nodules (benign tumors) or
cancer, or problems in the pituitary or adrenal glands.
Initial diagnosis, however, is nearly always as simple as a blood test. The
most common test determines your level of thyroid stimulating hormone (TSH).
TSH is produced by the pituitary gland in response to the levels of thyroid
hormones it detects in your blood. If you have too much TSH, you are
hypothyroid: the pituitary is producing more TSH than is usual, in an effort
to get your thyroid to make more thyroid hormones. This is contrary to what
you might think at first, but remember that TSH is not itself a thyroid
hormone, it's the thyroid hormone "requestor".
If TSH is elevated, doctors should also measure the amounts of actual thyroid
hormones (T4 and T3) circulating in your blood stream, since it's possible
that your thyroid is actually fine and there's something amiss in the
pituitary gland. In the ideal situation, diagnosis will be made on the basis
of your symptoms as well as your lab results. Some people feel fine with an
elevated TSH, others are barely able to make it through the day.
Treatment of hypothyroidism, regardless of underlying cause, is thyroid
hormone replacement. Yes, that sounds a bit scary, but the reality is you
take a pill or two first thing in the morning, or for some patients, twice a
day, to replace the hormones that your thyroid gland is unable to produce.
Initially patients are started at a low dose, and then they are re-evaluated
after 6-8 weeks, including rechecking TSH and thyroid hormone levels. It
takes that long for the body to adjust to the new levels of hormones, so
testing before 6 weeks will not yield an accurate assessment. It may take
several rounds of adjustments before the optimal levels are found.
Some patients feel almost immediate relief when treatment begins; for others,
it's a slow process of regaining lost energy, finally being able to lose
weight, and "becoming my old self" again. Another common symptom or side
effect of hypothyroidism is depression, and this can sometimes be the worst
after diagnosis when the initial treatments don't provide an instant fix. It'
s important to stay focused and confident. There is no reason that you can't
get your life back!
Hypothyroidism, Metabolism, and the Benefits of Low Carb Living
If you're following the low carb way of life, you're probably already familiar
with the term insulin resistance. It describes a state in which our bodies
respond to carbohydrate intake by producing too much insulin, which results in
a host of unpleasant side effects such as food cravings caused by blood sugar
crashes, and extra calories being stored as fat. Insulin resistance is an
endocrine system disorder, just as hypothyroidism is. There's a growing body
of evidence that shows if your endocrine (hormonal) system is out of whack in
one area of your body, there's a good chance that things may go haywire in
your other systems, too.
For hypothyroid sufferers, there are a couple of "broken" mechanisms that lead
to weight problems. Mary J. Shomon, in her book, Living Well With
Hypothyroidism, describes how the under-functioning metabolism fails to signal
the brain when we are full, leading to weight gain. Shomon also discusses how
our bodies establish a metabolic set point, the level at which we need to
operate to maintain weight. In a healthy person, when weight gain is
detected, the body will put up some resistance and increase the metabolic rate
to shed the excess pounds. In hypothyroid sufferers, this metabolic
resistance is weak or non-existent, making it very difficult to lose weight.
While the entrenched health establishment still can't come right out and
advocate low carb diets, everyone agrees that high glycemic foods should be
eliminated. All of the nutritional advice starts out with the recommendation
to drop sugar, flour, and foods made with them. If you're already following a
low carb way of life, you're ahead of the game. Controlling insulin
resistance can go a long way towards relieving some of the symptoms of
hypothyroidism, including fatigue, dizziness, and unrelenting hunger.
What About You?
The American Academy of Clinical Endocrinologists estimate that more than 13
million Americans have thyroid disease and remain undiagnosed. Thyroid
disease can have a negative impact on quality of life, but the consequences of
failure to treat over the long term are deadly serious. Left untreated,
thyroid disease can lead to elevated cholesterol, heart disease, osteoporosis,
infertility, and depression. Testing is simple and inexpensive, treatment is
easy and can be life-changing. If any of the symptoms described above sound
familiar to you, take a few minutes to read about hypothyroidism in more
detail at the links below, and make an appointment to follow up with your
doctor.
I've been on thyroid hormone therapy for a few weeks now. Within a few days,
the abnormal bleeding stopped and my cycle returned to normal. My energy
level is improved although I still become easily fatigued. I anticipate there
will be a few rounds of adjustments to my medications, but I'm hopeful that in
a few months I'll be my old self again. and it won't take me quite so long to
write an article like this!
LINKS AND REFERENCES:
Association of American Clinical Endocrinologist, Thyroid Awareness Month
press release:
http://www.aace.com/pub/tam2003/press.php
Endocrine Web's Thyroid main page, excellent advice for thyroid patients,
including information on diagnosis, testing, and treatments:
http://www.endocrineweb.com/thyroid.html
Mary J. Shomon's Thyroid Info site, from which you can subscribe to her
newsletter, Sticking Out Our Necks: http://www.thyroid-info.com/
Also visit Mary's Thyroid site at About.com, which includes many articles and
a lively and supportive forum: http://thyroid.about.com/
Joan Hedman is the owner/editor of FarscapeWeekly
and encourages you to watch the last 11 episodes of Farscape on the SCI FI Channel, Fridays at 8 PM and 12 Midnight Eastern time,
beginning January 10th.
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