Thyroid: Be a perfectionist

27. July 2009 William Davis (18)
If you'd like to reduce LDL cholesterol with nearly as much power as a statin drug, think thyroid.

When thyroid is corrected to ideal levels, LDL cholesterol drops 20, 30, 40 mg/dl or more, depending on how poor thyroid function and how high LDL are at the start. The poorer the thyroid function (the higher the TSH or the lower the T3 and T4) and the higher the LDL cholesterol, the more LDL drops with thyroid correction.

(For those of you minding LDL particle size, such as Track Your Plaque Members, the "dominant" LDL species will drop: If you are genetic small LDL, small LDL will drop. If you have mostly large LDL because of being wheat-free and sugar-free, then large LDL will drop.)

One of the problems is that many healthcare providers blindly follow what the laboratory says is "normal" or the "reference range," which is usually nothing more than a population average (actually the mean +/- 2 standard deviations, a common method of developing references ranges). In other words, a substantial degree of low thyroid function, or hypothyroidism, can be present when your doctor adheres to the reference range provided by the laboratory.

What does it mean to achieve ideal thyroid status? My list includes:

--Normal oral temperature of 97.3 F first upon arising. (The thyroid is the body's thermoregulatory organ.)
--TSH 1.0 mIU/L or less
--Free T3 upper half "normal" range
--Free T4 upper half "normal" range
--You feel good: mental clarity, energy, upbeat mood. You lose weight when you try.

Iodine replacement should be part of any thyroid health effort. Iodine is not an optional trace mineral, no more than vitamin C is optional (else your teeth fall out). The only dangers to iodine replacement are to those who have been starved of iodine for many years; increase iodine and the thyroid can over-respond. I've seen this happen in 2 of the last 300 people who have supplemented iodine.

In my view, neglecting T3 replacement is absurd. While it is not clear to me why many otherwise healthy people have low T3 at the low range of "normal" or even in the below-normal range, people feel better and have better health--faster weight loss, reduced LDL, reduced triglycerides, they are happier and enjoy more energy--when T3 is increased to the upper half of the reference range. (Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)

It pays to be a perfectionist when it comes to thyroid. Not only do you feel better, but LDL cholesterol can drop with a statin-like magnitude, but with none of the adverse effects.

If interested, Track Your Plaque offers fingerstick blood spot testing that you can perform in your own home. Each test kit will test for: TSH, free T3, free T4, along with a thyroid peroxidase antibody (a marker for Hashimoto's thyroiditis, an autoimmune inflammatory condition of the thyroid).
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Comments (18) -

  • Anonymous

    7/27/2009 1:24:46 PM |

    Interesting... my mother was put on a statin about a year and a half ago due to "hypercholesterolemia" (dx of course by a basic lipid panel).  Around the same time she was also put on thyroid medication.  Her LDL dropped and we all assumed it was the statin...

  • Nameless

    7/27/2009 6:35:06 PM |

    Low carb diets can influence T3 by lowering it. Certain beta blockers can inhibit 5'-deiodinase too.

    What do you think about studies like this one:
    http://www.reuters.com/article/healthNews/idUSTRE55B67D20090612

    Where they theorize that low thyroid function may be linked to longevity? I believe that has been found in certain species of rodents too and low metabolic rates for elephants (as the article researchers comment on).

    I'm not saying everyone should go around being hypothyroid, but am curious what your thoughts are. Perhaps lowered thyroid function is a part of aging?

  • sdkidsbooks

    7/28/2009 1:51:24 PM |

    I'm still wrestling with my pcp over my thyroid. I'm back on Armour 90mgs but my tsh is 5.6, which is needs to be lower, as you say 1.0.  My dr keeps telling me she doesn't want to increase the rx because she's afraid I will get atrial fibrillation. She doesn't test for anything else but tsh

    Currently, my morning temps are 96.3, I have trouble losing weight and my LDL is just at the upper range of normal and my LP(a)is 34. I'm not taking statins and am following all of the heartscan blog diet/supplement recommendations. I want to get my LDL down, lower my LPa and regulate my thyroid. Is it risky to take more Armour to lower my tsh?  I am taking 220mcgs of iodine should I increase that?

    Jan

  • Anonymous

    7/28/2009 4:01:32 PM |

    I'm a little confused about the iodine thing. I Googled around and found several studies implying that iodine supplementation can increase incidences of hypothyroidism.

    Here and here are two of the studies I saw. In the referenced-by section of the last one is an interesting study where excess iodine was found to be the root of goiter and thyroid troubles in some Peace Corps workers in West Africa.

    I started googling more specifically and found more sites that warned about iodine-induced hypothyroidism, but the majority stated the opposite (that iodine can help hypothyroidism).

    I'm not trying to contradict or anything, but I was wondering if you were aware, that's all. I mean, imagine the result if someone on the AAD (with all the prepackaged food) felt hypothyroid symptoms, and was told by a doctor to increase iodine intake, when they really had more than enough intake already...

    Perhaps you've already taken this into account. If you have the time I'd like to know your thoughts on it.

  • Dr. William Davis

    7/28/2009 4:19:18 PM |

    skids--

    Time for a new doctor, one who will listen to reason.

    Anon with question about iodine. Please put "iodine" into the Heart Scan Blog site specific search and you will find the several discussions we've had about this important issue.

    There is no question: We need iodine for health and many--not all--people are deficient.

  • Nameless

    7/28/2009 5:31:33 PM |

    I have read in a number of places that iodine can worsen Hashimoto's, although Dr. Davis feels it won't. Maybe he is right too, but he has never explained why high dose iodine is typically stated in various thyroid articles as something to avoid if you have an  autoimmune disease (besides potentially causing a hyper flare).

    The mechanism for worsening Hashimoto's would be:  iodine increases thyroid hormones, which in turns increases thyroid antibodies, which  then slowly kills off your thyroid quicker. Typically synthetic T4 or armour is used for hashimoto's, which can result in lowered antibodies (usually). I know of two studies where low-dose T4 decreased inflammation + antibodies in Hashi people too.

    I don't doubt that supplementing iodine if you are deficient is a good thing. But I am  not sure if large doses are a good idea if you have an autoimmune issue going on.

  • Kismet

    7/28/2009 7:35:55 PM |

    Anon read:
    Iodine: Deficiency and Therapeutic Considerations
    http://www.thorne.com/media/Iodine13-2.pdf

    The paper makes a compelling case that iodine is not necessarily the culprit. The hypothyroidism & life span data has me still worried, though. But that's nothing new.

    From a purely CVD perspective T3 & T4 look like an interesting target...

  • Dr. William Davis

    7/29/2009 2:51:17 AM |

    Nameless--

    I said nothing about Hashimoto's. I am talking about people in general. Perhaps you noticed that I am not sitting in front of you providing personal information!

    You are correct: If you are in the throes of active Hashimoto's thyroiditis, you should not take iodine, no more than a raging fire requires more kindling.

    Let me restate: Iodine is--in the general population-- a necessary trace mineral. Humans cannot live without it.

  • Nameless

    7/29/2009 3:32:38 AM |

    Dr. Davis,

    I didn't mean to infer that you should provide detailed info here, or were even mentioning hashimoto's at the moment.

    I just know it came up in past iodine threads, and the autoimmune issues weren't really spoken about in detail then. Since someone here asked about it, I thought I'd make a comment. People sometimes don't get fully tested if they have a thyroid issue (actually based on how doctors treat thyroid people, I'd say most don't get proper testing). I just had a concern that if someone has an autoimmune thyroid issue, excess iodine could be a rather bad thing. So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses.

  • Anna

    7/29/2009 1:36:01 PM |

    "So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses."

    This is definitely true, but in reality, in conventionally practiced medicine,  it hardly ever happens.  I have been treated for hypothyroidism with T4 (and sometimes T3) for more than three years.  For almost 15 years my thyroid function has been tested, initially with just TSH, then with TSH and total T4, then finally the past few years with free T4 and free T3 tests.  Only my new doctor ever tested for thyroid antibodies.

    And autoimmune hypothyroidism usually presents quite differently from plain hypothyroidism - with stops and starts to the symptoms, or even periods of hyperthyroidism.

  • liverock

    7/29/2009 2:10:03 PM |

    Dr Davis
    Re your comment on what stops T4 to T3 conversion.

    Adequate selenium is required to form thyroid hormone and with the increasing amounts of heavy metals (which are selenium antagonists,)we all are absorbing, selenium levels are dropping.

    "Selenium is a cofactor for 5’-deiodinase, the enzyme required to convert T4 to T3. A low 24 hour urinary selenium level likely correlates with overall selenium deficiency and decreased tissue availability of T3 due to decreased conversion of T4 to T3."

    Rocky Mountain Analytical Lab Report.
    www.rmalab.com/index.php?id=16

  • trinkwasser

    7/29/2009 6:18:46 PM |

    "Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one."

    Statins? (grins)

    Agreed, if there's something we could avoid to prevent this it would majorly benefit all those poor folks whose doctors refuse to treat hypothyroid. Who are legion.

  • Dennis Mangan

    7/30/2009 12:58:09 PM |

    Anyone interested in the topic of iodine supplementation and who wants lots of detail ought to read Dr. Guy Abraham.

    http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

    Will answer any conceivable question you thought you had.

  • Jessica

    8/4/2009 11:08:04 PM |

    I was going to post a response to your question:

    "(Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)"

    But it looks like LiveRock already posted 1/2 of what I was going to post and that is that selenium is needed to convert T4 to T3.

    The other 1/2 of the problem of T4 to T3 inhibition is Vitamin D. My dad (family physician) said that the 5'deiodinase enzyme is a D dependent enzyme. Crank up the D and add selenium and see if the conversion problem still exists.

    He almost always puts patients on iodine PLUS selenium (no more than 400 mg) as well as several of the B vitamins (riboflavin, etc) for thyroid management.

    Have you read Dr. Brownsteins book, "Iodine: Why you need it, why you can't live without it?" it's a fantastic read.

  • dearthyroid

    8/14/2009 2:42:16 PM |

    Thanks so much for this post.  It's always so interesting to me to read up on iodine in relation to thyroid health.  I have Hashimoto's myself and know that there's so much controversy surrounding iodine... I don't know quite what to believe just yet.  Either way, thank you for your explanations about thyroid levels and cholesterol and treatment. The thyroid and liver are connected in a very powerful way that often gets overlooked.

    Thank you!

    Liz Smile

  • grace

    8/28/2009 12:16:47 AM |

    Great post!thanks for sharing.now i know that low carb diets can influence T3 by lowering it,try to put some thyroid medication by thyroid kits.

  • lightcan

    10/16/2009 10:55:45 AM |

    What about fluoride? I've read that it affects the thyroid. Is there a mechanism by which it might affect the conversion of T4 to T3?

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