Low Thyroid and Plaque

3. December 2008 William Davis (12)
Having now tested the thyroid status of several hundred patients over the last few months, I have come to appreciate:

1) That thyroid dysfunction is rampant, affecting at least 25% of everyone I see.
2) It is an enormously effective means to reduce cardiovascular risk.


I'm not talking about flagrant low thyroid dysfunction, the sort that triggers weight gain of 30 lbs, gallons of water retention, baggy eyes, sleeping 14 hours a day. I'm talking about the opposite extreme: the earliest, subtle, and often asymptomatic degrees of thyroid dysfunction that raises LDL cholesterol, lipoprotein(a) (Lp(a), a huge effect!), and adds to coronary plaque growth.

Correcting the subtle levels of low thyroid:

1) Makes LDL reduction much easier

2) Facilitates weight loss

3) Reduces Lp(a)--best with inclusion of the T3 fraction of thyroid hormone.

Recall that, 100 years ago, the heart implications of low thyroid weren't appreciated until autopsy, when the unfortunate victim would be found to have coronary arteries packed solid with atherosclerotic plaque. It takes years of low thyroid function to do this. I advise you to not wait until you get to this point or anywhere near it.

I find it fascinating that many of the most potent strategies we are now employing in the Track Your Plaque process are hormonal: thyroid hormones, T3 and T4; vitamin D (the hormone cholecalciferol); testosterone; progesterone; DHEA, pregnenolone. Omega-3 fatty acids, while not hormones themselves, exert many of their beneficial effects via the eicosanoid hormone pathway. Elimination of wheat and cornstarch exert their benefits via a reduction in the hormone insulin's wide fluctuations.

We haven't yet had sufficient time to gauge an effect on coronary plaque and heart scan scores. In other words, will perfect thyroid function increase our success rate in stopping or reversing coronary plaque? I don't know for sure, but I predict that it will. In fact, I believe that we are filling a large "hole" in the program by adding this new aspect.
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Comments (12) -

  • Stephan

    12/2/2008 10:17:00 PM |

    I suspect gluten sensitivity could play a role in many thyroid cases.  Celiac disease associates with autoimmune thyroid problems.  About 12% of Americans are verifiably gluten sensitive.  The number may actually be much higher if you include people who have a less pronounced immune reaction to gluten.  What do you think of this idea?

  • Fitness blogger

    12/3/2008 2:58:00 AM |

    That is very concerning. What are the typical symptoms of a low thyroid. I must get it checked.

  • Anonymous

    12/3/2008 3:03:00 AM |

    Dr.Davis,
       This post has convinced me that
    your eventual protocol will be THE
    standard MO in just a few short
    years.Many thanks for your blog.

  • Anonymous

    12/3/2008 2:34:00 PM |

    Now the question is, how to get a doctor to treat you for low thyroid function?  I went from doctor to doctor for a number of years complaining of most of the clinical symptoms of low thyroid.  Since my labs were "within the normal range", not one of them would prescribe any form of thyroid.

    Finally, in desperation, I went to a "wellness" doctor who did put me on a trial of Armour thyroid.  MAGIC!  I suddenly had some energy, the gray clouds lifted, and I was finally able to begin to lose some weight... which eventually led to a 50 pound weight loss, which had been impossible before treatment.

    Unfortunately, by then I had achieved a heart scan score which put me in the high 90th percentile for a 55 year old woman.  Thanks docs!!!

    The average doctor out there seeing patients is still treating based solely on lab numbers, NOT on the (obvious) clinical symptoms sitting in front of them.  Such a patient is far more likely to be given a script for an antidepressant... I had plenty of doctors who were MORE than willing to write scripts for those!

    I hope the TYP treatment protocol will eventually begin to make a dent in this situation.  I now know that years of untreated low thyroid certainly contributed to my high heart scan score.

    Thank you, Dr. Davis, for Track Your Plaque!

  • rnikoley

    12/3/2008 6:24:00 PM |

    Dr:

    I have recently been reading your blog lately, and referring lots of readers from my own blog.

    I'd be interested to get your "take" on this -- not diagnosis.

    'Bout 18 months ago, I was at 230 (5'10) and looked awful. I was on Omeprezol for years for gastric reflux, a variety of prescription meds since early 20s for seasonal sinus allergies, culminating finally in the daily, year round squirts of Flonaise-esque sprays (the best for control without noticeable side-effects), and finally, Levothroid for about the last 7 years or so, as I had elevated TSH (around 9ish).

    My BP was regularly 145-160 / 95-110.

    I decided to get busy. I modified diet somewhat, cutting lots of junk carbs, and began working out -- brief, intense, heavy twice per week. BP began coming down immediately, such that within only a couple of weeks I was borderline rather than full blown high. Then after about six months, a year ago, I went to full blown low-carb, high fat, cutting out all grains, sugar, veg oils, etc, and replacing with animal fats, coconut, olive oil. You know the drill. Then, first of the year I felt great and simply stopped all meds, including the thyroid. I also began intermittent fasting, twice per week, and for a twist, I always do my weight lifting in some degree of fast, even as much as 30 hours.

    That's when the weight really started pouring off. Take a look:

    http://www.freetheanimal.com/root/2008/09/periodic-photo-progress-update.html

    http://www.freetheanimal.com/root/2008/08/faceoff.html

    In July I figured it's about time for a physical. Here's the lipid panel, demonstrating am HDL of 106 and Try of 47, great ratios all around:

    http://www.freetheanimal.com/root/2008/07/lipid-pannel.html

    However, my TSH was even higher -- 16ish. It seems odd that I was able to lose 40-50 pounds of fat (10-15 pounds of lean gain for a 30 pound net loss at that time -- now an additional 10 pounds net loss).

    One disclosure is that I was drinking too much, almost daily, and quite a bit (gotta save some vices...). Anyway, I'm at the point now where I want to drill down. I know I need to see an endocrinologist and have T3 and T4 looked at, but in advance, I wanted to see if the recent changes I've made could make a difference:

    1. Stopped all alcohol.
    2. Stopped most dairy, except ghee and heavy cream, and cheese is now used as a "spice," i.e., tiny quantities -- no more milk.
    3. 6,000 IU Vit D per day.
    4. 3 grams salmon oil, 2 grams cod liver oil.
    5. Vit K2 Menatetrenone (MK-4) -- side story: getting off grains reversed gum disease for which I have had two surgeries, then supplementing the K2 DISSOLVED calculus on my teeth within days -- hygienist and dentist are dumbfounded. Stephan (Whole Health Source), who comments here, has an amazing series on K2.

    Well, that's about it. I'd be interested in your general take on this.

  • Dr. William Davis

    12/3/2008 8:26:00 PM |

    Stephan--

    I suspect that there is indeed a connection.

    I personally feel that wheat, for a variety of reasons, has NO place in the diet whatsoever.

  • Hannah

    12/4/2008 3:18:00 AM |

    I agree with anonymous. It is incredibly difficult to find a doctor who'll will diagnose and treat hypothyroid, whether mild or not. There are many people whose FT3 and FT4 levels are low (whether the lab considers them in range or not) yet their TSH is "normal" either because their pituitary gland has not responded to the situation yet or because the lab range for normal is outdated.

    Many labs still use a TSH range of 0.3 - 5.0, when the American Association of Endocrinologists has recommended 3.5 be the upper limit, with many individual thyroid specialists pointing out that the healthy population's TSH readings have a mode of about 1.0 and a TSH of 2.0, or even 1.5 in older people, can be considered suspect when there are symptoms. And of course if someone has hypopituitarism the TSH range has no meaning at all.

    So we have an unknown number of people in various stages of dysfunction because many doctors aren't knowledgeable about what the TSH reading means. Not to mention issues like T3 resistance. They are often misdiagnosed as having chronic fatigue, fibromyalgia, depression, and so on, or just told to go lose weight. I know personally of one lady who went to her doctor - she is overweight, 46, had the symptoms of early hypothyroid, and tested for high cholesterol and elevated blood sugar. The doctor told her she had diabetes and wanted her to begin metformin. Luckily, she went for a second opinion and low thyroid levels were found. She's feeling much better now with T4/T3 combo therapy.

    There are also a lot of hypothyroid cases that aren't receiving adequate treatment. Some people receive relief with synthetic T4 replacement, some need a combination of T3 and T4, and others seem to need dessicated thyroid (eg Armour). Go to any thyroid support group and you will find people desperate for relief, their doctors are telling them their Synthroid is adequate, they must just be depressed or not eating well. Often the person will need to be treated for adrenal or pituitary function as well - as you have stated the hormones are all linked.

    If anyone believes they are having thyroid problems, do your best to shop around for a doctor who believes in testing Free T3 and Free T4 thyroid hormones and treating based on symptoms not strict lab results. Doctors who are both traditional practitioners as well as having an interest in "holistic" or "alternative" medicine may be the best place to look. But be wary of alternative health practitioners who claim they can cure hypothyroid with diet or homeopathic remedies, etc. A certain diet free of goitrogens will certainly help support your recovery but treating your hormones is necessary.

  • Dr. B G

    12/4/2008 5:50:00 AM |

    R Nikoley,

    Thank you so much for your efforts in promoting TYP at your informative health site! I've been keeping up with your blog posts and love your approach to optimal health and exercise regimens. Congrats with the incredible body recomposition shifts.  

    Your experience with butter oil and vitamins ADEK2 are esp informative for me.

    Your TG + HDLs ROCK!

    I'm stopping/limiting alcohol as well -- I think the health benefits can be immense.

    I have some questions for you:
    --Have you considered getting a heartscan eval?
    --Have you considered all the causes of Hashimoto's/HLA DR5 allele association? (it's an autoimmune disease just as HDL B27 is assoc with alkylosing spondylitis in many men; my sister had Grave's which is HDL DR 3 associated)
    --Have you had the vitamin D level evaluted? goal 25(OH)D 60-80 ng/ml
    --Have you had iodine testing? Deficiency leads to Hypothyroidism
    --Have you considered the role of casein as a food allergen (subsequently triggering the immune system to continue to attack the thyroid gland -- effectively killing it off like Oklahoma bombings)? Cream has casein -- though minute enough to trigger autoimmunity reactions.
    --Have you considered resumption of Levothroid or Armour Thyroid to control TSH to goal 1.0 to prevent further inflammatory responses?
    --Other factors related to Hashimoto triggers are: stress, high cortisol, adrenal depletion, zinc deficiency, iodine deficiency, B-vitamin deficiencies,  vit ADEK deficiencies, food allergies (wheat barley rye corn/maize egg whites casein), heavy metal accumulation (mercury, lead, etc).

    Hope that helps! I find it spectacular you cured your own gum disease.

    -G

  • Dr. B G

    12/4/2008 5:50:00 AM |

    R Nikoley,

    Thank you so much for your efforts in promoting TYP at your informative health site! I've been keeping up with your blog posts and love your approach to optimal health and exercise regimens. Congrats with the incredible body recomposition shifts.  

    Your experience with butter oil and vitamins ADEK2 are esp informative for me.

    Your TG + HDLs ROCK!

    I'm stopping/limiting alcohol as well -- I think the health benefits can be immense.

    I have some questions for you:
    --Have you considered getting a heartscan eval?
    --Have you considered all the causes of Hashimoto's/HLA DR5 allele association? (it's an autoimmune disease just as HDL B27 is assoc with alkylosing spondylitis in many men; my sister had Grave's which is HDL DR 3 associated)
    --Have you had the vitamin D level evaluted? goal 25(OH)D 60-80 ng/ml
    --Have you had iodine testing? Deficiency leads to Hypothyroidism
    --Have you considered the role of casein as a food allergen (subsequently triggering the immune system to continue to attack the thyroid gland -- effectively killing it off like Oklahoma bombings)? Cream has casein -- though minute enough to trigger autoimmunity reactions.
    --Have you considered resumption of Levothroid or Armour Thyroid to control TSH to goal 1.0 to prevent further inflammatory responses?
    --Other factors related to Hashimoto triggers are: stress, high cortisol, adrenal depletion, zinc deficiency, iodine deficiency, B-vitamin deficiencies,  vit ADEK deficiencies, food allergies (wheat barley rye corn/maize egg whites casein), heavy metal accumulation (mercury, lead, etc).

    Hope that helps! I find it spectacular you cured your own gum disease.

    -G

  • Anonymous

    12/5/2008 12:59:00 AM |

    Dr.Davis no where on your site do I see the importance of Vitamin C mentioned.Are you aware of the work of Linus Pauling concerning Vit C and the amino acid Lysine on calcification?
    Paulibng summarised that subliminal Scurvy was to blame and the RDA for Vitamin C is far too low.
    Ps. He did win a Nobel Prize for his research.
    Many thanks for a very interesting and informative site.

    http://www.vitamincfoundation.org/vitcheart.htm

  • Ryan W.

    3/1/2010 6:42:44 AM |

    Two things;

    1. Dr. Davis, can you provide any evidence that supplementing D3 will decrease arterial calcification? From what I've read, increased D3 (especially absent K1 menaquinone/K2) leads to increased calcification. It seems quite likely that the low levels of 25D3 observed in people with heart disease may be due to overconversion to calcitriol rather than lack of intake.  

    2. Anon wrote; "Dr.Davis no where on your site do I see the importance of Vitamin C mentioned."

    Ascorbate uses the same transporter as glucose (sodium mediated, IIRC.) Most animals make ascorbate from glucose and if your blood sugar is high, your body won't absorb vitamin C. So while mild scurvy may very well be a component of diabetes, it's questionable how well increasing oral intake will fix that problem, if the nutrient is simply not absorbed.

  • Anonymous

    3/11/2010 3:53:04 PM |

    I've come to believe my MANY health problems are hormone related but it's extremely difficult getting effectively tested and treated. I finally have some symptoms lessened by desiccated thyroid and am trying to sneak bioidentical low-dose estradiol, progesterone, DHEA past my migraine sensors. Hormones seem to be the most basic part of your system--if they could be in proper balance.

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