Holistic Approach to Diagnosing Hypothyroidism

dr_david_brownstein_130By David Brownstein, M.D.

 (This article was excerpted, in part, from Overcoming Thyroid Disorders, 2nd Edition)

The Holistic Approach to Diagnosing Hypothyroidism

The holistic approach to diagnosing hypothyroidism is very different from the standard conventional model of relying only on the blood tests.  I believe it is inappropriate to rely solely on laboratory tests to diagnose hypothyroidism, as this will miss many individuals suffering from this condition. 

A holistic approach includes looking at the following components:
1. Thyroid Blood tests
2. Medical history
3. Basal body temperatures
4. Physical exam

The holistic approach is best accomplished by a health care provider knowledgeable about how to integrate the four components mentioned above. It is important to look at the thyroid blood tests (TSH, T3, T4, reverse T3 as well as thyroid antibodies). 

Furthermore, a detailed history and physical exam can reveal underlying causes of thyroid disorders.  Finally it is important to look at basal body temperatures.  More about this process can be found in my book.

Basal Body Temperatures
One of the thyroid's main functions is to regulate the metabolism of every cell in the body.  When adequate amounts of thyroid hormone are produced, the metabolic machinery inside each of the billions of cells runs at a normal pace. 

One by-product of this metabolic machinery is heat. The production of heat helps keep the body warm on cold days. However, in a hypothyroid condition, the metabolism of the cells runs at a much slower pace. Hypothyroid individuals will often complain of feeling cold much of the time, including having cold hands and feet.  In fact, when the thyroid gland is removed from an otherwise normal animal, all metabolic activity in that animal is reduced.

Maintaining a steady body temperature is one of the most crucial functions of the thyroid gland.  Many of the enzymes, vitamins, minerals and chemical reactions that are utilized in the body are temperature sensitive. When the body temperature is maintained within a normal range, from 97.8 - 98.2 degrees Fahrenheit, the enzymes, vitamins, minerals and chemical reactions optimally function.  Small variations in temperature, either elevated or depressed, will significantly decrease the utilization of these items.

How can you accurately measure this metabolic activity?  This is a very difficult task. For over 50 years, physicians have been trying to develop a laboratory test that will actually measure the metabolism of the body. First, they relied on the Basal Metabolism Test, which proved inaccurate. Next, they relied on the protein-bound iodine test (i.e., PBI), which also failed. Finally, the thyroid hormone tests, T4 and TSH were touted as the ‘gold standard' for diagnosing/monitoring thyroid function. 

At some point in time, each of these tests was accepted by the medical establishment as the optimal test of thyroid function. Over time, as the tests have been found to be inaccurate, it was determined that each test was missing many people who were suffering from hypothyroidism. 

Now, the TSH test exists as the newest, best test.  In my opinion, since we cannot measure the amount of thyroid hormone inside each of the billions of cells in the body, each test can provide some information, but should not be used solely to confirm or deny a diagnosis of hypothyroidism.  To do so ensures missing many individuals who may be suffering from the ravages of hypothyroidism.

Basal Body Temperature Testing
One test that is underutilized is checking the basal temperature.  When the thyroid is producing adequate amounts of thyroid hormone and the cells are able to utilize the thyroid hormone, the cells of the body are producing enough heat to maintain a steady and normal body temperature (97.8-98.2 degrees Fahrenheit). 

The basal body temperature is best measured in the morning, upon awakening.  I recommend using axillary (under the arm pit) temperatures.  It is best to do the basal temperatures on consecutive days.  Menstruating women need to do their basal temperatures at the beginning of their menstrual cycle.

A Comprehensive Holistic Approach to Diagnosing Hypothyroidism
As previously stated, my clinical experience has shown that relying solely on the blood tests to diagnose hypothyroidism will miss many hypothyroid individuals.  A more complete evaluation of the thyroid gland can be accomplished by using the blood tests in combination with the physical exam signs, the medical history and the basal body temperatures. 

This is truly a comprehensive holistic way to diagnose an individual with a complicated illness such as hypothyroidism.  Relying solely on laboratory tests ignores the basic tenets of being a physician and treating the patient as an entire being. 

4. Barnes, Broda.  Hypothyroidism, The Unsuspected Illness.  Harper and Row.  1976.  p.  19

Dr. David Brownstein, M.D. 
David Brownstein, M.D. is a family physician who utilizes the best of conventional and alternative therapies. 
He is the Medical Director for the Center for Holistic Medicine in West Bloomfield, MI.

December 2010

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