Your Thyroid and Human Growth Hormone

Even though 10 million Americans have been diagnosed with thyroid problems, millions more live with lethargy, muscle weakness, depression, menstrual irregularities, low sex drive, and weight gain due to an undiag­nosed thyroid condition. Doctors used to estimate that as many as 13 mil­lion people had some form of hypo- or hyperthyroidism and didn’t know it. However, at an international Consensus Development Conference held by the College of Integrative Medicine in 2003, the number of undiag­nosed cases was reported to be closer to 50 million if looking at the whole clinical picture, which includes not just the standard lab tests but the phys­ical exam, the patient’s symptoms, and his or her basal body temperature. This was in alignment with the position taken by the late Dr. Broda Barnes, a well-known pioneer in the field of thyroid disease and author of Hypothyroidism, the Unsuspected Illness. Barnes estimated that at one time or another approximately 40 percent of the population will suffer from clinical hypothyroidism.

The thyroid is the master gland at regulating metabolism. It is a small butter­fly-shaped gland wrapped around the windpipe behind and below the Adam’s apple area. The thyroid produces two key hormones, triiodothyro­nine (T3) and thryroxine (T4), which act like engines, getting oxygen into every cell in your body so that your cells get the energy they need to function.

When the thyroid is functioning properly, 80 percent of the hormones it releases will be T4 and 20 percent T3, which is considered to be the more biologically active of the two. The liver, the kidney, and the cells fur­ther break down T4 into T3.

Hypothyroidism means that the thyroid is underactive, and hyper­thyroidism means that it is overactive. An enlarged thyroid gland is often called a goiter. Sometimes an inflammation of the thyroid gland (Hashimoto’s disease) will cause significant enlargement of the gland.

Since hyperthyroidism is not as prevalent and its symptoms are fairly easy to spot—bulging eyes, racing heart, profuse sweating, nervousness, and jittery feelings most of the time—I will focus on helping you to recog­nize if you might be suffering from the great metabolic shutdown associ­ated with hypothyroidism.

If you go to your doctor to have your thyroid tested, he or she will draw your blood and send it to the lab to obtain a thyroid panel. While the advances made in diagnosing diseases in the laboratory have been remark­able over the last decade, as can be seen in the tests for illnesses such as rheumatoid arthritis and breast cancer, lab tests for hypothyroid problems are still largely inaccurate, according to Dr. Charles Mary III of the Mary Clinic in Louisiana. Dr. Mary’s position was backed up by the majority of doctors attending the recent Consensus Development Conference.

One of the breakthroughs in the last several decades has been the Thy­roid Stimulating Hormone (TSH) test. When doctors first discovered how to measure this hormone, they decided that TSH was the gold standard of diagnosing thyroid dysfunction. TSH is a hormone produced by the pitu­itary gland in response to fluctuations of thyroid hormone. If the brain sees low levels of thyroid hormones in the body, or if a person’s metabolism is poor, the brain will begin to pump out higher levels of TSH. So, according to this lab test, elevated TSH would be indicative of hypothyroid function.

According to Mario McNally, MD, an endocrinologist, and James Carter, MD, DrPH, the emeritus head of the Nutrition Section at Tulane University School of Public Health and Tropical Medicine, the problem is that a person can be very ill with hypothyroidism yet still have a normal TSH test—that is, it is still possible for someone to have hypothyroidism when his or her levels of TSH are low. When the lab work shows that TSH is in the low or normal range in these cases, the problem is that the body is not adequately converting the hormone T4 to T3. Remember, T3 is a crucial hormone in getting oxygen into the cells and in enabling efficient metabolic function.

Factors that inhibit the body’s conversion of T4 to T3 are low levels of iodine, selenium, zinc, copper, vitamin B12, vitamin B6, vitamin A, and vitamin E; high levels of fluoride; high or low levels of serum ferritin; and a diet that is too low in calories. Other factors that interfere with the con­version of T4 to T3 are beta-blockers, birth-control pills, high levels of estrogen, lithium, lead, mercury, stress, cigarette smoking, pesticides, aging, diabetes, surgery, adrenal insufficiency, and human growth hor­mone deficiency.

According to Dr. Mary, one of the main hormones that impairs the effi­ciency of the conversion of T4 to T3 is estrogen. He suggests that the wide­spread use of birth-control pills and hormone replacement therapy (HRT) drugs such as Premarin may be contributing to our epidemic of obesity by making it harder for the body to convert T4 to T3. As evidence, he points out that all farmers know that you can easily fatten up cows, pigs, chick­ens, and other animals by giving them estrogen. Dr. Mary has found that 90 percent of the patients he diagnoses with hypothyroidism are women.

According to the Consensus Report of the International College of Inte­grative Medicine, there are two main approaches to accurately diagnosing a patient with hypothyroidism. The first approach is the comprehensive thyroid panel, which includes testing for ultrasensitive TSH (levels lower than 3.04, which is the usual accepted low end of normal in the regular TSH test), and levels of T4, free T4, T3, free T3, and reverse T3. This test has the advantage of allowing your doctor to look at the interrelationships between the different levels of hormones. It’s not just one factor that deter­mines healthy thyroid function but the synergistic relationship between several hormones.

According the to Consensus Report, the second and most effective approach to making an accurate diagnosis of thyroid problems is to con­sider the lab work as a backup but to base the main part of the diagnosis on taking a patient’s history, doing a thorough physical exam, recording basal axillary temperatures, and checking the Achilles reflex. All of these taken together constitute a more complete (holistic) approach to the diagnosis and treatment of hypothyroidism.

When we are evaluating a new client who seems highly symptomatic, my doctors always check for thyroid problems because trying to boost a person’s metabolism when he or she is suffering from severe thyroid prob­lems is like asking someone to run a race with a bowling ball tied to his or her foot. Hypothyroidism is too complex for you to self-diagnose from a post on a website. But the following hypothyroid questionnaire created by Dr. Mary can guide you as to whether you should consult with an endocri­nologist. You may have hypothyroidism if you check off about eight of these symptoms. However, as Dr. Mary points out, a person might only present with one symptom such as depression or low body temperature upon awakening in the morning.

SIGNS AND SYMPTOMS OF HYPOTHYROIDISM

_____ Loss of Appetite

_____ Weakness

_____ Dry Skin

_____ Edema (Swelling) of Eyelids

_____ Cold Skin

_____ Edema of Face

_____ Heart Enlargement

_____ Impaired Memory

_____ Gain in Weight

_____ Pallor of Lips

_____ Deafness

_____ Nervousness

_____ Labored or Difficult Breathing

_____ Palpitations

_____ Pain Over Heart

_____ Painful Menstruation

_____ Emotional Instability

_____ Fineness of Hair

_____ Depression

_____ Muscle Pain

_____ Heat Intolerance

_____ Slowing of Mental Activity

_____ Burning or Tingling Sensation

_____ Cyanosis (Bluish Discoloration of Skin)

_____ Lethargy

_____ Coarse Skin

_____ Slow Speech

_____ Sensation of Cold

_____ Thick Tongue

_____ Coarseness of Hair

_____ Pallor of Skin

_____ Constipation

_____ Loss of Hair

_____ Swelling of Feet

_____ Excessive Menstruation

_____ Hoarseness

_____ Decreased Sweating

_____ Poor Heart Sounds

_____ Changes in Back of Eye

_____ Loss of Weight

_____ Choking Sensation

_____ Brittle Nails

_____ Muscle Weaknes

_____ Joint Pain

_____ Slow Movements

_____ Difficulty in Swallowing

_____ Poor Vision

_____ Total Answers

It used to be that patients with hypothyroidism were given desiccated (dehydrated) pig’s liver, but this medication was replaced by newer syn­thetic products. One of the most widely used is a drug called Synthroid. Although patients on Synthroid often improve with a lowering of their TSH, they often reach a plateau where they still have many of the signs and symptoms of hypothyroidism. Dr. Mary explains that synthetic thy­roid medications supply the body with T4 only. “If you can’t convert T4 to T3, you are going to have inadequate levels of T3 in the body, even though you have normal levels of T4.The way to overcome this is to just give them the combination therapy, with both T4 and T3.” For this reason, Dr. Mary and many of the endocrinologists with whom I consult have been going back to an older and highly respected thyroid medication called Armour Thyroid. This medication is made from desiccated pig’s liver and contains both T3 and T4. According to the Consensus Report, doctors agreed that “patients will continue to improve when switched to desiccated thyroid.”

In Dr. Murray’s Total Body Tune-up, he writes, “When we’re not exercis­ing, it’s the body’s cue to more or less hibernate. The thyroid gland is the major organ of metabolism and if you’re not exercising your metabolism slows and, as a result, the thyroid gland starts functioning at a lower level as well.”

While most of the endocrinologists with whom I consulted for this website told me that there was no natural cure for hypothyroidism, they were all in agreement that a good program of exercise could help prevent thy­roid problems and would certainly help to strengthen the effects of any thyroid medication. The reasons are twofold.

First, hypothyroidism develops when several of the body’s hormones are out of balance, especially estrogen, which inhibits the ability to convert T4 to T3. I have seen literally hundreds of men and women with thyroid problems improve dramatically when they began following my Fat-Burning tips because research shows that appropriate exercise helps to balance out the body hormonally. Douglas Daniels is an excellent example. He came into the program with undiagnosed hypothyroidism but began to experience significant results and a much better quality of life after two weeks of exercise, at which point he started taking thyroid medication.

Second, we are looking at a “What came first, the chicken or the egg?” situation when we look at the metabolic condition of someone with hypothyroidism. A person who has developed an inefficient metabolism because he never exercises is setting himself up for hormonal imbalances. One of the main characteristics of someone with a sluggish metabolism is a lower than normal body temperature. According to the Consensus Report, enzymes are very temperature sensitive, as are other bodily functions. If a person is not metabolically fit—running the engine on cool, if you will­ he or she will not have a proper hormonal balance. The less efficient thy­roid function becomes, the less efficient metabolism becomes, creating a downward spiral.

However, as Dr. Mary points out, once you develop hypothyroidism, it is very simple and inexpensive to take Armour Thyroid. Problems such as obesity, joint pain, depression, and chronic exhaustion make exercising harder. Finding relief from these problems can help a person to find the energy to stay on a good exercise program.

Dr. Mary states that the number one reason that people develop hypothy­roidism is because something is blocking the natural function of the thy­roid. “If we cleared our systems of all of the garbage, if we had the ability to eat pure organic meat, pure unadulterated vegetables, to maintain an ideal body weight, to drink pure water, and breathe pure air—then we could eliminate some of the issues that are blocking proper thyroid func­tion.” While Dr. Mary feels that eating organic vegetables and hormone-free meat can sometimes seem like a monumental task, I have seen over and over again how easy it is to maintain a healthy eating plan once you have made it a part of your daily regimen. Eating nutritionally takes some thought and planning in the beginning, but it soon becomes habit. Fortu­nately, we live in an enlightened time when supermarkets and food chains are offering a wide selection of healthier and more natural food choices.

Ideally we should be able to get all of the vitamins and minerals from the foods we eat, but there are two factors working against that. The first is that we cook most of our foods, which destroys essential nutrients. The second and most important is that we are growing our food in soil that is often exhausted of certain vital minerals. According to Dr. Mary, “U.S. Geological Survey maps from 50 years ago will tell us that there’s no more magnesium in the soil now compared to what it was. There are entire communities filled with people that have heart problems because their soil has selenium deficiencies. Eighty percent of a community with heart disease? That’s bizarre. So, nutritional depletions in our foodstuffs are rampant and I think that’s why people need to supplement. And supplementation is not as easy as just popping into your local pharmacy and picking up Centrum.”

Well-known naturopath Dr. Michael Murray suggests a basic supple­mentation program for thyroid health. He writes: “I am a firm believer in building a strong foundation. In that goal, there are three key dietary sup­plements that I recommend to provide a strong foundation for a proper nutritional supplement plan:

A high-potency multiple vitamin and mineral formula (MultiStart).A ‘greens’ drink product (Enriching Greens).A pharmaceutical grade fish oil supplement (RxOmega-3 Factors).”

Dr. Murray recommends his specially designed vitamin/mineral supple­ment MultiStart because it contains optimal levels of zinc, copper, man­ganese, and the vitamins A, 132, 133, 136, C, and E (MultiStart is available in most health food stores or on the Internet). Deficiencies of any of these sub­stances “could cause or contribute to hypothyroidism.” I have found this to be a wonderful product, but any high-quality multivitamin/mineral that you can buy in a health food store will include these nutrients. Just remember to read labels carefully before you buy vitamins.

Again, these three steps will help prevent thyroid problems and will greatly help in minimizing the symptoms of mild cases of hypothyroidism. How­ever, low thyroid function is a serious problem. If you suspect that you are hypothyroid, make an appointment with an endocrinologist who will do more than just a basic lab test. A natural thyroid medication may be needed to help balance out your hormones and increase your metabolic efficiency.

Allie, a twenty-four-year-old actress, came into my program because she was overweight and was suffering from some quality-of-life issues. Her doctor had told her that she was borderline hypothyroid but had left her untreated. I could see that she had all of the classic symptoms of hypothy­roidism: she was overweight, felt tired all the time, and had trouble con­centrating and sleeping at night. When we ran a metabolic study on her, which has an error factor built into it of plus or minus 10 percent, we found out that she scored 20 percent below the lowest end of normal. Even allow­ing for the range of error, that’s at least 10 percent too low.

When I sent Allie to Dr. Mary for an evaluation, he felt that she should start on Armour Thyroid. By then Allie had been in the Fat-Burning tips for two weeks and was already starting to feel signifi­cantly better. Now she’s been on her thyroid medication for several months and she says, “It has made me feel like a different person.”

Allie is a classic example of someone who is hypothyroid but was con­sidered normal and left untreated. Because I encounter clients like Allie quite frequently, I have begun to agree with the doctors who say that low thyroid is an undiagnosed epidemic.

Human growth hormone (HGH) helps to regulate bone and organ growth in your youth. In adulthood, it is responsible for many other metabolic processes including protein synthesis, which means that there is a direct correlation between the level of HGH and the percentage of lean muscle. Many of the obese clients that I see in my program have significantly lower than normal levels of HGH. However, it is normal for this hormone to naturally decrease with age, so no one is going to have the same amount of HGH in middle or old age as he or she had in youth.

Is there anything that can be done about low HGH levels in middle age? A few years ago there was a lot of excitement about HGH injections. Headlines called injectable HGH the fountain of youth. However, interest has begun to wane as people have found out that it is not the simple panacea that it was promised to be.

In fact, every doctor who I asked about HGH injections felt that they are not the answer for several reasons. One is that this therapy is prohibi­tively expensive, costing $800 to $1,250 per month, and it may not be covered by health insurance. Also, it takes up to six months for these in­jections to begin to take effect. And, of course, there is the unpleasant prospect of giving yourself a daily injection.

Dr. Michael Murray warns about some of the negative side effects of injectable HGH:

My take on it is, like most hormones, it’s a double-edged sword and needs to be used very carefully if it is being used. I don’t know how wise it is to use it. I think there’s been a lot of publicity about its positive benefits. Not enough press has been given to the poten­tial harmful benefits of excess hormone, such as inducing diabetes and actually promoting the growth of cancer and possibly worsen­ing osteoarthritis. Those are some of the risks of excess growth hormone. I’m not too optimistic that HGH injections will be shown to be all that beneficial in the long term. Again, I think that taking into consideration diet and lifestyle and trying to maintain natural levels of HGH for as long as possible is the best way to go. I think there’s a reason why the body starts secreting less growth hormone. I think it’s a natural process, and any time we go against that process, whether it’s growth hormone or whether it’s estro­gen, we run the risk of doing more harm than good.

As the Consensus Report of the International College of Integrative Medicine states, “You can’t just focus on one hormone, and the patient has to be treated as a whole person. You have to look at the other aspects of the endocrine system. For example, people with thyroid disorders will not achieve optimal health until the thyroid disorder is corrected first. They may also need testosterone, progesterone, estrogen, etc. So you should check all of the hormone levels when approaching the patient.”

In recent years secretagogues, which act like HGH, have become popular. Like HGH injections, these products come with the promise that they will lower your lipids, increase your muscle mass and strength, and increase your bone mass. However, at a recent meeting of the Consensus Develop­ment Conference on Injectable Growth Hormone vs. Growth Hormone Secretagogues hosted by the Great Lakes College of Clinical Medicine, several physicians pointed out that they felt the jury was still out on their effectiveness. These products have been around for only three to five years, and there hasn’t been enough time or funding to research their effec­tiveness.

However, these physicians felt that one advantage that secretagogue supplements may have over injectable HGH is that the hormone isn’t injected directly into the bloodstream. It is theorized that secretagogues stimulate the pitituary gland to secrete more HGH, creating more of a bal­ance in the body and making it less likely that a person will end up with too much.

Since I have used a secretagogue with the goal of increasing my own levels of HGH, I tend to disagree that they should be dismissed out of hand. But I do agree that you should be very careful about what kind of secretagogue you take and how often you take it. I only take this supple­ment daily for a month or two a year because I want to avoid any possible negative side effects. Also, according to Dr. Carter, secretagogues might cause hypertension in certain people, so if you choose to take them, your doctor should monitor your blood pressure for the duration. Secretagogue supplements can be found in any good health food store. Ask your doctor to recommend a brand for you.

When I consulted with endocrinologist Dr. Mario McNally about what cri­teria he used to diagnose low levels of HGH, he gave me five different areas that signaled a deficiency. If you score low in several of these areas, it is likely that you may have low HGH and should consult with your doctor:

Body composition—the amount of lean muscle mass compared to fat massBone mineral densityExercise capacityLipid profileQuality-of-life factors

According to Dr. McNally, “The more issues you have in each of these areas, the more likely you are to have an HGH deficiency.” Below is Dr. McNally’s quality-of-life questionnaire. When I asked him how to score this test, he said that the patient who didn’t feel well and who answered yes to the majority of these questions should consider getting a full physi­cal workup by his or her doctor. If the physical and the lab tests show noth­ing wrong yet the patient still feels badly, has a low sex drive, and has low strength—what doctors call failure to thrive—then he or she should con­sider testing for levels of HGH.

However, from what I see at my program, especially regarding obese clients, these HGH statistics should be much higher. And keep in mind that all of us will likely experience a decline in HGH as we age. It’s part of the natural aging process.

For most of us, especially those with a significant HGH deficiency, we are really talking about a quality-of-life issue. The real issues are slowing the drop in HGH as you age and increasing levels if they are already low. The prescription is the Fat-Burning Tip.

In recent years a significant number of studies have shown that spe­cific types of exercises done at specific levels of intensity significantly increase the amount of HGH in the body. A recent report in the Exercise and Sport Sciences Reviews clearly shows that both aerobic exercise and resistance exercise increase HGH. An article in the Strength and Condi­tioning Journal stresses the effectiveness of interval training in stimulating the production of HGH. These are exactly the types of exercises I pre­scribe in my four-week program.

I have found that the most important thing to keep in mind is that you should never focus on just one particular hormone but always look at the whole picture. The body’s hormonal system is like a symphony. You can’t just look at estrogen or testosterone or T3 levels or HGH levels. All of these hormones are interconnected and the body needs all of them to be balanced.