Functional Hypothyroidism Case study #1: Weight Gain, Elevated Blood Pressure, Finger Numbness, Indigestion, and Snoring (Trouble Sleeping)
Dr. Sheehan saw a patient recently, let’s call him Ron. He had numbness and tingling in his hands and arms, which are common of Lyme’s symptoms. Ron had liver weakness upon Nutrition Response Testing, and Functional Medicine blood tests revealed mild Hashimoto’s thyroiditis, which is an autoimmune disorder that attacks the thyroid. Liver dysfunction is a very common contributing factor to thyroid issues because the liver is one of the primary organs responsible for converting thyroid hormone to its active form. And because autoimmune issues begin in the gut, Dr. Sheehan put him on a Paleo Reset to help heal his gut and handle his food sensitivities. In one week, Ron’s hand numbness disappeared, and he lost weight. He also stated that he really felt a difference when taking the liver and gallbladder support supplements. If Ron had strictly pursued Lyme disease treatment, it’s likely he would have ended up on antibiotics, which although not inherently incorrect, would have done nothing to address his underlying immune system, liver, and thyroid issues.
Case study #2: Ringing in the ears, Weight Gain, High Cholesterol and Triglycerides
Another patient came to see Dr. Sheehan complaining of chronic ringing in the ears that came on after an infection (a common Lyme’s symptom). He was overweight, so at first, Dr. Sheehan put him on a Nutrition Response Testing program and a low-carb diet to help him lose weight and strengthen his immune system. Even though he lost 30 pounds, the ringing in his ears persisted. He brought in labs that his doctor ran, showing normal blood sugar, but elevated cholesterol and triglycerides. Considering that he had lost 30 lbs., but his cholesterol and triglycerides were still high, Dr. Sheehan ordered comprehensive blood lab tests for him (his doctor did not order any further labs to try to determine why his symptoms were not abating, and why his cholesterol and triglycerides did not decrease). Blood testing revealed Hashimoto’s thyroiditis and iron overload syndrome, which was starting to cause liver damage as shown by elevated liver enzymes. Dr. Sheehan recommended the Paleo reset diet and proper supplementation, as well as a regimen of giving blood to bring down the iron levels and reverse the liver damage.
What’s important to note is that both these patients had certain Lyme Disease symptoms, which were actually symptoms of other disorders. Neither had Lyme disease, but both had an underlying immune system disorder, which, if left unchecked, could potentially develop into a more severe autoimmune disease such as Rheumatoid Arthritis, Lupus, Alzheimer’s, etc.
Diagnosed or subclinical thyroid issues can both resemble and complicate any case of persistent Lyme Disease. Subclinical hypothyroidism is especially problematic because of how difficult it is to identify. The definition of subclinical hypothyroidism is thyroid-stimulating hormone being above the upper limit of normal while free thyroxine levels remain normal.1
What are normal TSH levels? This is subject to debate.2 Medically speaking, the conventional laboratory ranges for TSH are what they are because thyroid replacement drug treatment would not be effective.3 Functionally, however, identifying hypothyroidism sooner has advantages, especially because even with the subclinical disease, people are often suffering from symptoms.
Thyroid symptoms include depression, constipation, fatigue, goiter (swelling of the thyroid gland), weight gain, hair loss, intolerance to cold, memory problems, “brain fog”, and joint pain. Many of these symptoms overlap with Lyme Disease symptoms, which is why it is so important to rule out a thyroid problem in cases of Lyme Disease.
With this in mind, here are the functional vs. conventional laboratory ranges for TSH:
|Name of Test||Standard Laboratory Range||Functional Range||Subclinical Hypothyroidism|
|TSH||0.45-4.5 uIU/mL||0.5-2.0 uIU/mL||2.0-4.5 uIU/mL|
Any natural or functional approach to thyroid health must ask the question: why is the thyroid malfunctioning? In many cases, the thyroid is really the victim of stress response or immune system malfunction. Drug therapy, while necessary in some situations, does not correct the cause, but merely handles the effect. Without correcting the cause—an imbalanced stress response, impaired sugar metabolism, dysregulated immune system activity, or other cause (yes there are several more)—the individual will not get well and may need drugs for life.
Nutrition Response Testing and Functional Medicine are excellent for identifying the root cause of why the thyroid is malfunctioning. Usual suspects include food sensitivities (especially wheat, dairy, and sugar), heavy metal and chemical toxicity, disturbances in the bio-energetic field (sounds weird-o but it’s not really), chronic infections (Lyme being only one possibility). Other organs and organ systems must often be supported as well, such as the adrenals, heart, liver, gall bladder, and stomach. Iodine is sometimes needed but more often will make thyroid issues worse.
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- Wartofsky L, Dickey RA. The evidence for a narrower thyrotropin reference range is compelling. J Clin Endocrinol Metab. 2005;90(9):5483- 5488
- Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin Proc. 2009;84(1):65-71.
- Laurberg P, Andersen S, Carlé A, Karmisholt J, Knudsen N, Pedersen IB. The TSH upper reference limit: where are we at? Nat Rev Endocrinol. 2011;7(4):232-9.