Holtorf Medical Group
Are all CFS patients low thyroid?
It is clear there are a distinct hormonal disturbance in Chronic Fatigue Syndrome (CFS) patients, with a general suppression of the hypothalamic-pituitary-adrenal axis (HPA axis). It is the pituitary which is the “conductor of the endocrine orchestra.” If the pituitary is malfunctioning like in CFS patients, then this will affect the thyroid gland, adrenal gland, sex hormones, possibly the pineal (produces melatonin for normal sleep), as well as hormones for growth and urine production.
Hypothyroidism symptoms are very similar to the ones experienced by CFS sufferers. Lethargy, sensitivity to cold, heat intolerance, mood swings and depression, poor memory, and concentration, joint pains and morning stiffness, headaches, vertigo and deafness, pre-menstrual tension, voice changes, loss of libido, and susceptibility to viral infections are all found with both conditions.
Visible signs experienced by hypothyroid sufferers are: weight gain, fluid retention, puffy face, puffy eyes, hair loss (classically the outer third of the eyebrows), cold extremities and dry skin, rashes, eczema, and boils, and enlargement of the tongue. One may also suffer from hoarse voice, hypoglycemia, constipation, menstrual problems, skin problems and tendency to infections, slow pulse, goiter, infertility, digestive problems, slowed Achilles tendon reflex, and carpal tunnel syndrome.
Studies demonstrate that in addition to an increased incidence of primary hypothyroidism in CFS, there is a combination of secondary, tertiary, and thyroid resistance in the overwhelming majority of CFS patients, despite having normal thyroid tests. Why is this happening?
These latter forms of tissue hypothyroidism are not detected by standard thyroid function tests. Thus, many CFS patients are erroneously told that their thyroid levels are fine. In fact, standard thyroid tests fail to detect tissue hypothyroidism 80-90% of the time in patients with CFS. There are multiple abnormalities in CFS that result in undetectable tissue hypothyroidism, such as:
As you see, the combination of factors present in CFS, including hypothalamic and pituitary dysfunction, diminished T3/rT3 production ratios, and thyroid resistance results in most, if not all, CFS patients having inadequate tissue thyroid effect.
T4 preparations such as Synthroid and Levoxyl rarely work and Armour thyroid, a pig glandular product, is somewhat better, but definitely not adequate for most patients. The treating physician must know when to use a T4/T3 combination or straight T3. T3 works the best for many of these patients, but Cytomel, a very short-acting T3 available at normal pharmacies, is also a poor choice because the varying blood levels can cause significant side effects.
Compounded timed-release T3 is usually the best treatment. However, to achieve significant improvement, the treating physician must be very knowledgeable about T3 and must realize that when on T3, a standard blood test will lead one to dose incorrectly and not obtain significant benefits. This includes doctors who previously felt that they were thyroid experts and had been using thyroid in CFS patients for a long time.
Ultimately, it is the expertise and dosing of the T3 or T4/T3 combinations and the makeup of the medications that determines the optimal treatment regimen and is one major component in the treatment of CFS. The experts at Holtorf Medical Group can help with your CFS and thyroid treatment.
At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your CFS and low thyroid, optimize your health, and improve your quality of life. Contact us to see how we can help you!
Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.