Against the Grain with Dr. Chad Edwards | Oklahoma City Prolotherapy| Podcast 9 – Part 2
Brian Wilkes: Right.
Dr Chad Edwards: Comes from the anterior pituitary gland and it stimulates the thyroid gland to make more thyroid hormone; T3, T4 all that stuff, which then goes out to the body and does what thyroid does. Again, going back to what I was taught, all you need is a TSH. If the TSH is in this normal range then their thyroid is normal. Really all they do is evaluate the TSH. Now, there’s a number of problems with this.
The first one is go back to our podcast before when we talked about labs and where does normal come from? I will tell you that there are a lot of abnormal thyroid hormone level patients that have what are considered to be normal thyroid hormone or normal TSH levels and I argue- in fact the American Academy of Clinical Biochemists changes the range for thyroid. Most labs are going to be roughly 0.5 to 5 on the TSH. The American Academy of Clinical Biochemists says it’s 2.5 or less.
I’ve seen some stuff talking about the American Academy of Clinical Endocrinology changing it from 0.5 to 5 down to 0.3 to 3. Changing these reference ranges because I think we’re missing people. I think even traditional medicine has latched onto some of that. This thyroid stimulating hormone, when it’s low thyroid hormones themselves tend to be elevated and vice versa.
If you look at the guidelines, what are called clinical practice guidelines for the management of hypothyroidism. Hypo meaning below thyroid, so not enough thyroid hormone, an underactive thyroid gland, these clinical practice guidelines will talk about what’s called subclinical hypothyroidism. Subclinical meaning that we don’t detect any clinical problems. The patient says that they’re doing fine but their TSH is too high. It’s traditionally between 5 and 10. The clinical practice guidelines say that you have to approach that individually and the decision to treat these patients with if it’s less than 10, you got to take all things into consideration, individual, one on one basis kind of thing.
My thought is, aren’t we supposed to do that anyway? Aren’t we supposed to evaluate risks and benefits anyway? I have never seen a patient that felt great with a TSH of 8, I’ve never seen it.
Brian Wilkes: Why are so many- it seems like this is kind of becoming an epidemic, hypothyroid problems? What’s the cause?
Dr Chad Edwards: This will have to be another, that portion has to be another podcast because it can be from a number of issues. You have to look at is this an autoimmune thyroiditis like we call Hashimoto’s thyroiditis and there are a whole host of problems. It can be iodine deficiency, it could be environmental toxins, heavy metals, it can be what some people would call a leaky gut or an altered gut permeability.
Brian Wilkes: It sounds sexy.
Dr Chad Edwards: Does it?
Brian Wilkes: Mm-hmm (affirmative), leaky gut.
Dr Chad Edwards: We’ll have a podcast on sexy Sunday too.
Brian Wilkes: Yeah.
Dr Chad Edwards: Because we’re bringing sexy back.
Brian Wilkes: I love it.
Dr Chad Edwards: Oh come on, that was a doctor joke, come on.
Brian Wilkes: One thyroid patient at a time. It is important to know that I’m looking at some facts here again from our friends at Google.
Dr Chad Edwards: Yes.
Brian Wilkes: It says that an estimated 27 millions of Americans have some sort of thyroid complications.
Speaker 4: If that is a scientific fact …
Brian Wilkes: We think.
Speaker 4: Exactly.
Brian Wilkes: It’s a high number.
Dr Chad Edwards: It is very common. Now the issue for me is some- with the way I was trained again goes back to that TSH and we’re managing TSH. The issue for me is that- one of my heroes is Sir William Osler. He was a physician in the early 1900s and one of his quotes was, listen to your patient, they’re telling you the diagnosis.
Brian Wilkes: That good.
Dr Chad Edwards: When you actually listen to what the patient tells you then you can get a better solution for that patient. I used to have patients come in that say I feel awful. They were on Synthroid and that’s the brand name or one of the brand names of Levothyroxine or synthetically derived commercially available T4 only medications thyroid replacement. They’ll come in and they’ll say, “I feel awful.”
They were started on Synthroid or any of the T4 Levothyroxine or any of the other names of it. They were started on that because that’s what most doctors are trained to do and they are managing their TSH. Their TSH is too high, they’ll out them on Synthroid and they’ll lower the TSH levels. Their TSH gets down to 2, 1½ then voila, you’re fixed. The patient’s like, “No I’m not. My hair is still falling out, my skin still feels like crap, I still feel horrible, I can’t get out of bed. What’s going on?”
Brian Wilkes: Run down, no energy.
Dr Chad Edwards: Then what I hear so often is that the patient is telling me that their doctor said, “Well, it must be in your head, you’re crazy, you’re depressed, you need an antidepressant, there’s something wrong with your hormones.” I mean any number of things and-
Brian Wilkes: It’s hard to believe doctors have the courage to tell women that.
Dr Chad Edwards: Oh but you have no idea. Oh my goodness, I hear it every, every day.
Brian Wilkes: Seriously, there’s got to be some sexism involved there like you’re emotional, you’re just emotional. There’s this perception. “You’re just emotional, get over it,” other than treating some sickness-
Dr Chad Edwards: I don’t know that it’s so much sexism as it is patientism.
Brian Wilkes: Another quote by Sir William Osler said, is that? Osler? Did I get it right? The good physician treats the disease, the great physician treats the patient who has a disease.
Dr Chad Edwards: You are awesome, that’s another one of my favorite.
Brian Wilkes: Tough one, that’s a tough one.
Dr Chad Edwards: Did you look over my shoulder at my notes?
Brian Wilkes: I did, I did.
Dr Chad Edwards: Because I love that one, that’s great.
Brian Wilkes: I cheated.