Saul Marcus, ND - Naturopathic Doctor

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10. Low TSH and Subclinical Hypothyroidism

We typically think that symptoms are bad. Treatment is therefore directed at stopping the bad symptoms.

However, symptoms for the most part represent the body's attempt to maintain health in response to stress. True healing is thus not about fighting symptoms. It's about facilitating the body's self-regulating/self-healing mechanisms so it doesn't need to produce symptoms.

Consider a fever. It may make us uncomfortable. Drugs such as Tylenol are commonly used to lower fevers. However, the body produces the fever because to help fight off infection. Suppressing a fever may give the appearance of improved health, but actually aids infection. In fact therapies that help the body to produce a fever may be most helpful. Unless a fever is dangerously high, taking drugs to lower it actually works against the body.

With this in mind, we should not think that hypothyroidism is a disease that randomly strikes out at people, or the result of poor genes. Rather it is the body's response to some stress.

Consider all the excessive stress, poor foods, environmental toxins, emotional stress lack of sleep and other factors that rob people of their health. The body only has so many resources and energy. If it uses it all up just coping with stressors there won't be anything left to actually feel well.

And what does thyroid hormone do? It set's the body's metabolic rate. It makes every cell of the body do more. Increasing thyroid hormone is like stepping on the gas in your car. Decreasing it is like stepping on the brakes.

When the body is pushed too hard lowering thyroid hormone is a way of putting on the brakes. This is a self protective mechanism.

For some people who are not able to make thyroid hormone, it's important to replace what their bodies can not make on their own. But for others, taking thyroid medications will only make things worse.

This concept that hypothyroidism is a logical reaction to stress comes straight from the medical textbook:

"Overall the changes are apparently geared to limit the impact of T3 on its target organs, which from a teleologic point of view might be a beneficial adaptation during starvation and illness to conserve energy and substrates and minimize excessive tissue catabolism." [59]

In other words, when someone is starving (deprived of proper nutrition) or has an illness, in order to stop tissue catabolism (the breakdown, or wasting of the body) T3 (thyroid hormone) is reduced in order to lower the metabolic rate and slow down damage to the body.

We have already reviewed how hypothyroidism can be a consequence of poor digestive function and molecular mimicry. In the following section we'll see how the following causes decreased production of active T3.

Therefore, improving thyroid function, by correcting the above factors should a major treatment goal.

Should thyroid hormone be prescribed?

There are two causes of low TSH: hyperthyroidism and euthyroid sick syndrome. In hyperthyroidism thyroid hormone is elevated, along with numerous systems (heart palpitations, weight loss, heat intolerance) that are not common in hypothyroidism, so these two conditions are not likely to be confused.

Euthyroid sick syndrome refers to low thyroid output despite there being nothing wrong with the thyroid gland itself. Rather the brain is producing less TSH, in order to tell the thyroid to make less thyroid hormone. It does this as a self-protective mechanism (as discussed above).

Often hospitalized patients who have just gone through a major physical stress with have Euthyroid Sick Syndrome. Medical doctors know this is a stress response and that it should not be treated with thyroid hormone.

Many people have low-normal TSH levels (somewhere between 0.5 and 1.0), low thyroid hormone, and numerous symptoms. Low TSH indicates that the body is reducing thyroid hormone in response to stress. What is needed is holistic evaluation and treatment for whatever their individual stress is. Some supplements can be used to stimulate the production of TSH. However, thyroid hormone (synthetic or natural) should not be used. Since the body is already trying to lower metabolic rate as a self protective mechanism, forcing metabolic rate up with thyroid hormone is not a long term solution.