Despite “normal" laboratory tests, low thyroid can still be the cause of your symptoms. There are some types of thyroid hormone resistance that are not clearly identified with laboratory tests currently available. As I mentioned above, I hold the opinion that “Reverse T3" is not reliably tested and is not sensitive enough to detect all patients that have this problem. So despite a “normal" test, I cannot “rule out" this phenomenon from existing.

There are also other tests for thyroid hormone resistance such as Thyrotropin-Binding Inhibitory Immunoglobulin, Anti-T3 Autoantibody, and Anti-T4 Autoantibody. When I have spoken to the pathologists specializing in endocrinology at the Nichols Institute, they have not encouraged me to order these tests, as there still are problems to be worked out with the reliability of the assays currently used.

Just because one can’t reliably test for thyroid hormone resistance, it doesn’t stop the hormone resistance from occurring, and it should not stop the clinician from offering effective treatment. This concept is not new. In adult-onset diabetes, insulin hormone resistance is the hallmark. Most doctors do not know what causes this condition (Dr. Diana Schwarzbein, M.D., is perhaps one of the closest to tweaking this out), but that doesn’t stop doctors from giving extra hormone (insulin) when other less aggressive treatments fail.

Unlike thyroid – they know better than to test levels of insulin hormone, but instead test insulin’s effect on the body (it’s ability to regulate blood sugar levels). When I suspect thyroid hormone resistance (whether proven by positive thyroid antibodies or not), I stop testing levels of thyroid hormones and monitor thyroid’s function instead (patient symptoms, body temperature, and physical findings).

A Final Word: Beware the “Tack Rule"

One of the biggest problems that my patients have to deal with requires them to understand that they may have more than one underlying condition causing their symptoms. Some people only have one concern (such as low thyroid), but most of my patients have let their condition progress to the point that they now have multiple causes for their problems and complaints. Dr. Sidney Baker, MD describes “The Tack Rule". If you sit on a tack, removing it makes you feel a heck of a lot better. But if you sit on two tacks, removing one does not result in a 50% improvement.

Along with low thyroid, I often see other hormone imbalances of the adrenal glands (adrenalin, DHEA and cortisol), imbalances of sex steroid hormones (estrogen, progesterone, testosterone and DHEA), and insulin resistance. Vitamin and mineral deficiencies are common and can be both the cause and effect of low thyroid function. Toxicities of heavy metals such as mercury and cadmium can affect thyroid function, and low thyroid can predispose to infections of candida (yeast) and other bad bacteria and parasites.

Yes, hypothyroidism is distressingly becoming more prevalent in the United States and the rest of the civilized world; but the same is true for diabetes, adrenal fatigue, and other “Western" diseases. So, just because you were fortunate to find a clinician who was able to diagnose your thyroid condition, do not forget about these other potential issues as well.

ABOUT KENNETH WOLINER, MD
Dr. Kenneth Woliner is a board-certified family physician in private practice in Boca Raton. Though he often recommends vitamin supplements, he does not sell them due to conflict of interest concerns. He can be reached at

Holistic Family Medicine, 2499 Glades Road #106A,
Boca Raton, FL 33431; 561-620-7779.
E-mail: knw6@cornell.edu

Reprinted with permission.
Article originally published online.