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Food Allergy Solutions ReviewNews, Ideas & Strategies to Improve Your HealthOctober 2003
Fatigue, Thyroid Function and Hypothyroidism
Hypothyroidism is a serious condition found in people with and without food allergies. However, people with food allergies, particularly those with celiac disease (a gluten allergy), frequently suffer from hypothyroidism.
Hypothyroidism causes fatigue and weight gain as well as other problems, and is often overlooked and misdiagnosed due to complexities in thyroid testing and symptoms which may overlap or contradict the symptoms of food allergies. These issues are discussed in this article.
What Is the Thyroid Gland?
The thyroid gland sits in the neck in front of and on both sides of the trachea and secretes thyroid hormones. These hormones regulate metabolism and thus affect many aspects of health.
What Are the Symptoms of Hypothyroidism?
Lack of adequate thyroid hormone production may result in one or more of the following symptoms: fatigue, weight gain, constipation, cold extremities, inability to focus, forgetfulness, dry skin and depression.
How Is Hypothyroidism Typically Diagnosed?
Most physicians measure thyroid function not by testing thyroid hormones, but by testing levels of TSH. TSH stands for Thyroid Stimulating Hormone. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones.
As thyroid hormone production drops, TSH levels are supposed to automatically increase to compensate for low thyroid hormone levels. Therefore a higher than normal TSH level indicates a hypothyroid condition.
Why Does Hypothyroidism Frequently Go Undiagnosed?
Unfortunately, TSH doesn’t always respond correctly to low thyroid hormone levels. If the actual thyroid hormones themselves (called T4 and T3) are not checked, hypothyroidism can be missed. I’ve seen several cases of hypothyroidism with low thyroid hormone production and a normal TSH level.
Also, most physicians are using old data and a normal reference range that is too large when determining whether or not the TSH level is normal. This means that many people are being told that they have a normal thyroid when, according to the latest scientific standards, they are actually hypothyroid.
What Is the Current Standard for Determining Hypothyroidism?
The American Association of Clinical Endocrinologists recommends that the normal reference range for TSH be reduced by nearly half, down to 0.50-2.50. The old range is 0.50-5.00. (The higher the number, the more hypothyroid you are.) This means that thousands of people are being misdiagnosed and are actually hypothyroid. Unfortunately, most physicians have been slow in adopting these new standards and many people continue to be misdiagnosed.
Autoimmune Hypothyroidism and Hashimoto's Thyroiditis
Many hypothyroid conditions are caused by an autoimmune reaction that attacks the thyroid gland. One of the most important of these is called Hashimoto’s Thyroiditis.
What Thyroid Tests Should Be Run?
An initial evaluation of thyroid function must include not only TSH, but thyroid hormones as well. Whenever there is a diagnosis of hypothyroidism, or when the TSH level fluctuates, it is also important that autoimmune thyroid antibodies be measured. This is especially true for people with food allergies, since there is a higher association of autoimmune hypothyroidism in these people.
How Is Hypothyroidism Treated?
Once the problem is properly diagnosed it is relatively simple to correct with thyroid hormone replacement. However, it is important to have thyroid levels monitored regularly to make sure that the prescribed dosage is correct. This is particularly true in people with autoimmune thyroid conditions and those with newly diagnosed food allergies, as their thyroid levels are susceptible to frequent swings.
If you are concerned about the possibility of having hypothyroidism or are wondering about the interpretation of previous lab results, please call the clinic at 206-264-1111 to schedule an appointment for a thorough evaluation of your thyroid function.
Hypothyroid Case Studies
Case #1: 30 year old woman with complaints of fatigue, weight gain and forgetfulness. These had become progressively worse over the last 2 years. Patient was previously told that her thyroid was normal. Retesting demonstrated that she was in fact suffering from hypothyroidism. Treatment with thyroid hormone completely solved her energy shortage resulting in weight loss and much better cognitive function.
Case #2: 40 year old man with fatigue, weight gain and constipation. This patient complained of feeling very sluggish. Testing showed that he had a hypothyroid condition. Treatment with thyroid hormones quickly turned around his fatigue, resolved the constipation and made it possible for him to lose weight.
Case #3: 51 year old woman (M.M.) diagnosed with hypothyroidism 2 years ago and recently diagnosed with celiac disease. TSH testing showed fluctuating thyroid levels for over 2 years, resulting in repeated changes in dosage of thyroid medication. More recent testing demonstrated high autoimmune thyroid antibodies, explaining the fluctuations in thyroid levels. This patient continued to experience abdominal pain, nausea and weight loss until the celiac disease was diagnosed. Avoidance of gluten may stabilize thyroid problem.
Case #4: 35 year old man (N.P.) diagnosed with celiac disease approximately 2.5 years ago. He was very tired and had trouble focusing and remembering. He was also approximately 50 pounds overweight. Lab tests revealed significant hypothyroidism and very high thyroid antibodies. Thyroid medication has quickly begun to restore this patients energy and clarity of thought and he is doing much better.
Case #5: 70 year old woman (M.K.) diagnosed with hypothyroidism 4 yrs. ago. Finally diagnosed with celiac disease in 2003. She continued to experience many problems, (including fatigue, weight loss, and diarrhea) until both problems were diagnosed and properly treated.
Dairy-Free Cheese and Dairy-Free Margarine
Most soy cheese is not dairy free and contains casein, a dairy protein. For people with a dairy allergy this is important to know. The only brand of soy cheese that is truly dairy free is Tofutti (www.tofutti.com). Tofutti produces several types of dairy free cheese, including Mozzarella, Cheddar, Jalapeno, Parmesan, and Italian Herb, as well as sour cream and cream cheese. There are also several cookbooks that discuss how to make dairy free cheese. These are available by searching online.
People often assume that margarine is the obvious dairy free alternative to butter. However, a quick read of the ingredients dispels this myth. Almost all margarine contains dairy, usually in the form of whey, lactalbumin, or even buttermilk, unless stated otherwise.
Two truly dairy free margarines currently on the market are Earth Balance Natural Buttery Spread and Spectrum Naturals Organic Shortening. These products are especially good because they also have no hydrogenated fats or trans fatty acids, which are bad for your health.
These products are available at finer grocery stores in the Seattle area. Nucoa Margarine, a dairy free but less healthy alternative, is also on the market.
If you have a food allergy, don’t assume anything about food that has been processed. Always read ingredients. As a reminder, don’t confuse “lactose free” with “dairy free.” Lactose free products generally have lots of dairy in them and shouldn’t be eaten by people with a dairy allergy. And just because you think that you only have a lactose intolerance doesn’t mean that you don’t have a dairy allergy. You must be tested in order to know for sure.
Pharmaceutical Ads in Medical Journals Are
The study of about 100 promotional claims for blood pressure and cholesterol-lowering drugs in medical journals found that references to research studies did not support the advertisements’ claims 44 percent of the time.
For blood pressure medications, references were misleading 69 percent of the time, and about 20 percent of ads for cholesterol-lowering medication were misleading. These ads referenced studies that had involved specific groups of people, such as people who had just had a heart attack, but then recommended the use of the involved medications for a different group of people or the general population.
Drug companies spent more than $19 billion last year to promote their products to consumers and doctors. That is nearly double the amount that was spent four years ago.
Americans will spend over $500 billion on drugs this year.
Does anyone out there really believe that Americans are getting half a trillion dollars of benefits from these drugs? Drug companies are not doing this by accident. They have also been able to change the rules so they can now market to consumers directly, as you’ve seen on TV. It is no wonder why two-thirds of doctor visits result in a drug prescription.
Source: Lancet. January 4, 2003;361:10-11,27-32 TopReturn to Food Allergy Solutions Review Archive
Dr. Stephen Wangen
1229 Madison St., Suite 1220 · Seattle WA 98104 · 206-264-1111
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