Treating the Thyroid Patient
All these chronically ill patients, they have what's really a chronic non-thyroidal illness. What we do is we'll check everyone with a Thyroflex, I don't know if anyone uses that, but it's a device that measures the speed of the relaxation phase of the brachialradialis. The British Medical Journal showed that a knowledgeable doctor looking at someone's ankle reflex was a better test for thyroid than blood test. A normal reflex goes up and down, but the slower the relaxation phase, the lower the tissue level of thyroid.
We'll also check everyone's basal metabolic rate, where it measures the oxygen utilization over ten minutes, and then extrapolates it. We find that most chronically ill patients, anyone who's dieted for significant amounts, and some of the studies show, three significant cycles of dieting, their metabolism drops, their thyroid drops, and it doesn't go back to normal even when they start eating normally again. People say I've wrecked my metabolism. They have.
But the thing is, you'll see a low normal TSH, a high normal T4, because basically, the thyroid, we used to think that just diffuse in the cell, but it's active transport and they have low mitochondrial function. T4 is more energy dependent than T3. So you get high T4 because it's not getting into the cell.
All these patients are low thyroid and they need T3, not T4. If you have certain number of symptoms, your chance of being low thyroid is like 95%. But they even found that immune modulation will actually make them feel even better than giving thyroid. Thyroid bioregulator is really cool and nice study showing that you basically have Hashimoto's patient, you give them thyroid, lowers the antibodies somewhat, and then if you give the thyroid bioregulator, it dramatically lowers the antibodies and then add that with LDN.
One warning I always preach to my nurse practitioners, and even my patients is that, if they're on thyroid replacement therapy and we start LDN, we have to be careful that we don't overdo it. LDN will help lower TPO titers and thyroid globulin titers and make things work even at the receptor level better.
Bring people back. Don't just give them a prescription for a year and send them on their way. Bring them back in three to six months. I'm not advocating over testing, but just some subjective feedback on how are you doing? They'll be very grateful.