Articles

Body Temperature and Your Thyroid

By Paul Hueseman, Pharm. D.

It is estimated that approximately 20 million Americans have a thyroid disorder which means 1 in every 10 people¹. Hypothyroidism is caused from decreased production of thyroid hormone which results in decreased metabolism¹. Hypothyroidism occurs more commonly in women as compared to men. Hypothyroidism is also more common in menopausal women.

The primary cause of hypothyroidism is the failure of the thyroid gland termed primary hypothyroidism. There are several causes of primary hypothyroidism such as Hashimoto's disease (inflammation of the thyroid by an autoimmune mechanism)¹, iatrogenic hypothyroidism such as after radioactive iodine therapy, iodine deficiency, enzyme defects, underdevelopment of the thyroid gland, and substances that cause goiters. A less common cause of hypothyroidism is from pituitary or hypothalamic disease called secondary hypothyroidism. Another cause of thyroid disorder, commonly overlooked or dismissed by the traditional medical community, is Wilson's Thyroid Syndrome (WTS).

While simple blood tests generally will identify thyroid disease, there are some controversies as to what is "normal" and what is not. Many patients have normal blood tests, but classic symptoms often correlated with thyroid imbalance, and have a low basal body temperature that averages less that 97.6. In Wilson's Syndrome, the thyroid levels appear normal although the patient is still experiencing symptoms of low thyroid. Symptoms include hair loss, weight gain, cold extremities, low body temperature, low blood pressure, irregular menstrual cycles, infertility, premenstrual syndrome, unexplained and chronic fatigue, osteoporosis, hypoglycemia, constipation, headaches and migraines, depression, irritability, fluid retention, anxiety and panic attacks, poor memory, poor concentration, low sex drive, unhealthy nails, dry skin and hair, low motivation, low ambition, insomnia, and muscle cramps². These symptoms worsen in periods of physical or emotional stress. Possible stressors include childbirth, surgery, divorce, death in family, or job and family stress. These symptoms persist even when the stressors have passed.
Body temperature often correlates the best with symptoms. Therefore, thyroid system evaluation or management that does not take body temperature patterns into account is often ineffective. Many patients who have hypothyroidism (low thyroid gland function) may also be suffering from Wilson's Thyroid Syndrome. And if the WTS is left untreated those patients will continue to experience troublesome symptoms.⁴

Triiodothyronine (T3) is formed from the breakdown of thyroxine (T4) in the peripheral tissues. In comparing the two hormones, T3 is the more active, therefore T3 plays the primary role in regulating metabolic activity within the body. The thyroid's growth and function is maintained by TSH (thyroid stimulating hormone). The thyroid is regulated by several mechanisms. First the anterior pituitary gland secretes TSH which regulates the thyroid hormones. Also the process of removing iodine from T4 and T3 is regulated by many factors which include nutrition, drugs, illness, and other non-thyroid hormones.

In Wilson's syndrome there is a problem converting T4 to T3. In normal thyroid function, T4 converts to T3 in the active form and reverse T3 (RT3) in an inactive form. The enzyme that is used to convert T4 to T3 is inhibited by stress, acute and chronic illness, fasting and the stress hormone cortisol. In times of stress, the body produces more T4 to RT3 to conserve energy for stress. A vicious cycle then occurs with more RT3 than T3 being produced.⁴

The therapy approach to WTS is the Wilson's T3 Protocol. The Wilson's T3 protocol is aimed at depleting RT3 levels in the tissues of the body, for a time. This is accomplished by reducing T4, its only source. T4 is reduced by reducing TSH (Thyroid Stimulating Hormone). TSH is reduced by giving patients pure T3 directly. In this fashion, the body senses it has enough hormones and decreases production of T4, which decreases production of RT3. Treatment only lasts for a couple of weeks or months. Sustained release T3 seems to be best tolerated in twice daily dosing. Immediate release T3 is marketed under liothyronine (Cytomel), but does not appear to work as well as sustained release T3, which a compounding pharmacy would have to prepare. Dessicated porcine thyroid (Armour thyroid) has also been used since its main constituent is T3 although it has T4 as well. However, for WTS, Armour Thyroid may still not be the best option due to the T4 component. Levothyroxine (Synthroid) is not a good option for WTS because it only contains T4. Thyroid treatment for WTS according to physicians who are experts at treating WTS is T3 that has been properly compounded with a sustained release agent. The T3 is compounded (made by pharmacists) into capsules that are designed to be taken twice a day, every 12 hours. The T3 capsules must be prescribed by a doctor.⁴
Nonpharmacologic treatment includes getting plenty of rest, eliminating as much emotional stress as possible, moderate exercise for stress control, and eating a well balanced diet. Also, adding Selenium may help with thyroid conditions, as selenium helps in the conversion of T4 to T3. We recommend Selenomax® (Selenium) 200 mcg capsules taken as one capsule once to twice a day. Click here to find out more about this product.

The purpose of the treatment is not so much to give patients' thyroid glands a rest (although that does happen), as it is to clear RT3 (by clearing T4) out of the tissues so that their thyroid systems can get de-bogged, cleaned out, and reset. This appears to be what enables the patients' thyroid systems to function well on their own again. Wilson's T3 therapy does not need to be taken for life, rather usually only a few weeks or months.

How to take your basal body temperature

• Use an old-fashioned mercury thermometer.
  
• Shake down the mercury before going to sleep and place the thermometer on your bedside table with paper and pen.
  
• When you awaken, place the bulb of the thermometer in your armpit and leave it there for 10 minutes. Lie back and relax, keeping your armpit closed over the thermometer.
  
• After 10 minutes, record your temperature.
  
• Repeat for five days and then take an average.
  
• If you menstruate, measure your basal body temperature on the second day after your period starts.
  

References:

1. Armour thyroid web site. Hypothyroidism. [resource World Wide Web]. URL: http://www.armourthyroid.com. Available from internet. Accessed 2004 Sept 16.
   
2. Diamonte, M. The new approach to low thyroid conditions. To your health: the magazine of healing and hope [online]. 1997 Sept/Oct [cited 2004 Sept 22]. Available from : database Alt HealthWatch
   
3. Reasner CA, Ralbert RL. Thyroid disorders. In: Pharmacotherapy a pathophysiologic approach. 5th ed. Dipiro JT, Talbert RL, Yee GC, etal., eds. New York: McGraw-Hill;2002:1359-1378.
   
4. Wilson's Syndrome [resource World Wide Web]. URL:http://www.wilsonsthyroidsyndrome.com. Available from internet