Thyroid Thursday Episode 53: How Hypothyroidism Develops Part 2
How Hypothyroidism Develops Part 2.
Hi, everybody. It’s Doctor Eric Balcavage. We’re back with another edition of Thyroid Thursday. Today is episode 53 and this is part 2 of how hypothyroidism develops. We’re continuing the discussion of how somebody develops hypothyroidism. How they go from feeling great to then developing hypothyroid symptoms, then be diagnosed with a hypothyroid condition.
Last time, we talked about some key things. Today, we’re keeping on that discussion, I will cover a couple of key points for today’s video as well. First, hypothyroid symptoms are the result of low thyroid hormone levels in the cell. This is a key point. It’s not about what the gland makes because we can destroy the gland, we can remove the gland, and if we give you a prescription thyroid hormone and that hormone gets absorbed and gets transported into the cells, and the thyroid hormone binds to the receptors, it can stimulate metabolism and you can feel great. We see that happen with people all the time so it’s not about the gland at all. It’s all about how much thyroid hormone gets into the cells, converted into T3, binds to receptors and stimulates metabolism.
Second point. Hypothyroid conditions typically start at the cellular level. I think this is where a lot of functional medicine doctors and I would disagree with a lot of conventional medicine doctors regarding thyroid physiology. In the conventional model, when you have hypothyroid symptoms, the doctor’s going to look at glandular function. He’s going to look at TSH, maybe T4, and if those values are normal, he’s going to say, “You don’t have a thyroid condition,” and to some degree, he’s right.
You don’t have a glandular problem at that point but if you have all the symptoms of hypothyroidism then you have a hypothyroid problem but it’s at a cellular level, not at the glandular level. The gland is producing enough, there’s enough in the plasma (blood), but it’s not getting transported into the cell, converted into active thyroid hormone, and binding to the receptors appropriately. I’ll be explaining why that doesn’t happen in the next videos in the series. But, if your hypothyroid symptoms start at the cellular level, this creates problems because you can have symptoms without gland problem.
When you see a conventional medical doctor or an endocrinologist, they are testing gland function. They’re looking at TSH. TSH represents essentially how much thyroid hormone is getting to the pituitary gland and saturating the thyroid hormone receptors. The more T3 binding to thyroid receptors in the pituitary the lower the TSH.
The assumption is, if TSH is elevated, the gland isn’t making enough T4 and T3 to optimally support the pituitary gland. The pituitary is being driven to make more TSH to drive the thyroid to make more thyroid hormone. It was assumed for years (and still is by many) that the pituitary thyroid levels corresponded with thyroid hormone levels in the rest of the body. They don’t necessarily correlate.
If you go to your conventional doctor and tell him all your symptoms (tired, fatigued, thinning hair, weight gain, depression, etc) he may think you have hypothyroidism and write a script for bloodwork to confirm his diagnosis.
If the TSH is within normal range, even though you have all those symptoms that he assumed were a hypothyroid condition, he’s going to say, “Well, the gland is fine, TSH is fine. You don’t have a hypothyroid condition”, because he’s not aware of the cellular state of thyroid hormones.
What’s going to happen is you’re going to get diagnosed with something else. You’re going to be diagnosed as adrenal fatigue, depression, anxiety, you eat too much, or you don’t exercise enough. You’re going to get diagnosed with some other condition. They’re going to say you don’t have a thyroid condition, and to some degree, your doctor’s right.
You may not have a gland problem. The gland may make enough thyroid hormone but not enough thyroid hormone is being transported into the cell, converted to active T3, and stimulating the receptors. I’m going to explain why that doesn’t happen in some of these future videos.
So how do you determine if there is cellular hypothyroidism (insufficient thyroid hormone getting to the receptors within the cells)?
You can look at the T3 / reverse T3 ratio. That number, in a healthy state, should be greater than 10, so if your ratio is less than 10, then there’s probably cellular hypothyroidism going on. You can also look at free T3 / reverse T3 and that ratio, in a healthy state, should be greater than 0.2. If your levels are less than 0.2, then again, cellular hypothyroidism is probably going on. You’re making more reverse T3 than the active form of T3 / free T3.
You could also just look at reverse T3. Reverse T3 is an inactive form of thyroid hormone. If reverse T3 is elevated above lab range, you’re making way too much. It’s an inactive form so the thyroid hormone isn’t going to get to the nucleus to stimulate metabolism.
Lastly, we want to look for signs of chronic stress response: are you a person who has had chronic physical stress, falls, accidents, injuries, trauma? Are you overtraining, excessively training, not allowing enough rest and recovery because you’re not sleeping enough, you’re staying up trying to do too much? If there are physical stressors, they can trigger cellular hypothyroidism. Your body’s trying to shut down your metabolism.
There could be chemical stressors: the foods we eat, cigarettes/smoking, chemicals in the air, the air quality in our home, the things that we eat or drink could all be things that could be toxic to the cellular system. If toxins can get into the cells of the body, things like heavy metals, they will stimulate a cell danger response and induce cellular hypothyroidism.
Emotional stress. If you’re bombarded and you’ve had a lifetime of emotional stress, that can trigger a stress response at the cellular level and induce cellular hypothyroidism. If you have stinking thinking, you’re always thinking about what could go wrong, what is wrong, how you aren’t happy with life, or you’re just not a happy person, you may want to be happy person on the outside but in between the six inches of your ears, you constantly have negative programming, negative thoughts going on, that will induce a chronic stress response, the chronic stress response will induce cellular hypothyroidism.
Lastly, we have microbes. You could have microbial stress: bacteria, viruses, parasites, organisms, yeast, or fungus. Once they get into the cells of the body, they can induce a stress response at the cellular level. In a normal, healthy immune response, if there’s a stress response at the cellular level, the cells will induce cellular hypothyroidism as a normal immune response. We’re going to talk about cell induced hypothyroidism (the cell danger response is what it’s called) in one of the upcoming videos, okay?
So this was part 2 of How Hypothyroidism Develops and in this video, I talked about how hypothyroidism, in most cases, starts at a cellular level. TSH levels will be normal, you must look at more complex panels. We must look at T3, free T3, reversed T3. We must look at a person’s health history. Look at their timeline of their history. What’s your current lifestyle like? If we have any indicators of chronic stress, our ratios are out of range, or reverse T3 is too high, this is a person who has cellular hypothyroidism and has symptoms that we associate with hypothyroidism, even when the gland is normal.
Alright. Take care. Look for the next edition of how hypothyroidism develops in part 3.
