The Great Thyroid Debate

A number of M.E. sufferers (and the doctors who treat them) see an underactive thyroid (hypothyroidism) as an important element in their condition. However the medical world is deeply divided on the level below which an underactive thyroid can have a ?clinical? effect - and how to test for thyroid activity. Michelle Berriedale-Johnson and Foods Matter readers investigate.


The facts (very simplistic)
The thyroid is one of the family of glands (called the endocrine system) that controls hormone production.
In descending order (from the top of the head) they are the pineal gland, the hypothalamus, the pituitary (all within the brain), the thyroid (in the neck), the adrenals and pancreas (just below the stomach) and the ovaries and testes.

The main function of the thyroid gland in this system is to regulate the release of energy within the cells - so too much of the hormone will cause an excess of energy while too little will cause a dearth.

Thyroid hormones
There are, in fact, four thyroid hormones. The first is T4 (thyroxine) which everyone has heard of. However, T4 is really only a way of storing potential energy until it is needed.
To produce energy it needs to be converted, with the help of enzymes, into T3, the hormone which actually gets into the cells and produces energy.
If the thyroid cannot produce sufficient T3 to supply the body with energy then no function, physical or mental, will be able to operate at full efficiency. A situation in which many M.E. sufferers find themselves.
The thyroid may be unable to function properly for many (and much disputed) reasons including genetic failure, autoimmune disease, trauma, glandular fever, micro-malnutrition and the impact of environmental toxins such as fluoride.

Before the development of the TSH blood test diagnoses were based on family history, observations of symptoms (always tricky as similar symptoms can be caused by a range of conditions) and the measurement of body temperature - the basal blood test.

The main blood test is that of thyroid stimulating hormone (TSH) - the hormone released by the pituitary which instructs the thyroid to make more T4 to be converted into energy giving T3.
Normal levels are deemed to run from 0.15 micro units per millilitre up to a maximum of 6 micro units per millilitre. The more production-stimulating TSH is found in the blood, the less well the thyroid is deemed to be functioning. But at what point between 0.15 and 6 micro units an individual’s thyroid is failing to respond is hotly debated.

It is also possible to measure the amount of T4 (thyroxine) and T3 in the blood.

Conventional endocrinologists maintain that these measurements taken together are sufficiently sensitive to detect an underactive thyroid.

However, a minority of specialists in both the UK and US maintain that measuring the amount of TSH, T4 or T3 circulating in the blood does not tell you anything. What you need to know is how much is getting into and being utilised in the cells.
They recommend different tests (only available in private laboratories) which test urine or saliva, from which they can deduce the amount of T3 and T4 which has actually been used over a 24-hour period. This may produce very different results from standard blood tests.

Dr Durrant Peatfield
One of the leading proponents of this view is Dr Barry Durrant Peatfield; the second edition of his original book, The Great Thyroid Scandal is now available - see Your Thyroid and How To keep It Healthy.
Dr Durrant Peatfield has little time for the blood tests, which he sees as being not just useless but actively harmful in that they fail to recognise, and therefore enable to be treated, quite serious hypo-

Dr Peatfield also questions the validity of treatment that consists purely in supplementing the amount of T4 with extra thyroxine. For all kinds of reason (explained in detail in the book) he suggests that supplemented T4 may not be converted or properly utilised by the thyroid so be of little use.

Dr Peatfield’s treatment
His treatment suggestions include the avoidance of environmental toxins (which may have harmed the thyroid in the first place), nutritional and adrenal support and a carefully adjusted diet.
His other treatment of choice - and one which brought him into direct conflict with the medical establishment - is natural dessicated pig’s thyroid. No longer available in the UK (but still in the US) this was the main treatment available from the discovery of thyroid failure in the late 19th century until the development of synthetic thyroxine in the 1980s - and Dr Peatfield maintains that it is better tolerated, better absorbed and more effective than the synthetic thyroxine.

If you have any doubt about the health and function of your thyroid it is worth going to your GP. As you will see from our reader’s contributions, some do treat hypothyroidism successfully. However, if you do not get much satisfaction then you may wish to do some investigation of your own.

Whether or not you fully accept all Dr Durrant Peatfield's theses, his book is an excellent and accessible introduction to the subject for lay people.
There are also a plethora of websites offering support for both sides. Sue Boniface suggests the ones that she has found most helpful on the next page.
Sarah Early suggests, ardent supporters of Dr Durrant Peatfield.
The more conventional view is represented by www.british-
‘a non-profit making learned society of professional clinical specialist doctors and scientists in the United Kingdom who manage patients with thyroid disease and/or are researching into the thyroid and its diseases in humans’.

If you wish to contact Dr Durrant Peatfield direct, he now practises in Sussex as a complementary therapist in the field of nutrition.

If you wish to get a private thyroid test he recommneds IWDL
44 (0)20 8336 7750
or the Red Apple Clinic on 44 (0)1633 262772

From Chris Hillier:
Further to your request in the August edition of Foods Matter I also had a problem getting a thyroid problem diagnosed.

For about three years I had the following symptoms.
• Excessive catarrh resulting in snoring and sounding as though I had a permanent cold
• Overwhelming tiredness
• Lump in my throat
• Watery eyes
• Weight gain despite dieting
• Very puffy blown up face as if I was on steroids
• Difficulty in speaking - sounded as if tongue was swollen

I was referred to ear, nose and throat specialists both on the NHS and also privately at great expense, and was prescribed various nasal drops that achieved nothing. I was referred to a speech therapist who could find nothing wrong and also at my request to a neurologist as I felt the symptoms were similar to that of motorneurone disease, again to no avail.

All this time I was also consulting a Chinese herbalist, who having tried several alternatives, eventually asked me if I had had my thyroid checked. I went to my GP and asked for the TSH test. When the results came back the blood count was 114. The normal is below 5 and 30 is considered to be high! I am now taking 125 micrograms of thyroxin to counteract my underactive thyroid .
When I asked my GP why this was not picked up sooner I was told that sometimes it is missed or one doctor assumes that another has checked it!

From Sue Boniface

I read about other people's thyroid dilemmas with interest.
The big problem is that, before blood tests were developed, GPs listened to the symptoms and treated them but now they just do blood tests and go by them. The ‘normal’ range was devised 50 years ago, but people and lifestyles have changed since then. Also, averages do not take account of the fact that people are different. Anyhow, here's my story.

I had pre-existing health problems and earlier this year acquired some new ones. Having already given up on the GP, I looked at alternative therapies. I got nowhere with acupuncture so moved onto reflexology.

On examining my feet the reflexologist (Lesley Jepps said immediately that I had a thyroid problem. I denied this.
Yet every week when she touched that area of my foot I said ‘ouch’. She maintained that my pre-existing and recently acquired symptoms could be thyroid related.

I gave in, went to the GP and told him about the symptoms. He agreed - ‘thyroid’ - and did the TSH test, which came back
normal. So I was dismissed, as being depressed and anxious, given a mild anti-depressant and advised counselling.

Not happy, I internet searched and discovered that GPs are quick to dismiss patients as depressed - which is a thyroid symptom - and to offer no more than the one TSH test because of cost. But although the TSH test may be normal, until the other tests are done you do not have a complete picture of the workings of the
thyroid. So I paid for the T4, T3, thyroid antibodies and, again, the TSH tests to be done. These tests also came back normal.

Frustrated, because the reflexologist was still insisting my
thyroid foot was bad - I researched and discovered that different labs around the country use different ‘normal range values’. My T4 at another lab was under the normal range.

Even more frustrating - I discovered an associate living in another part of the country whose T4 was in the ‘normal’ range (two points above mine), but because she was on the low side her GP prescribed a trial dose of thyroxine to see if it would help.
I decided to leave the medical side and concentrate on the reflexology and some mineral supplements that the reflexologist suggested to boost my flagging thyroid. It seems that I am borderline, and if it hadn't been picked up now I would have deteriorated and then in a few years the test would probably have been accepted by my GP. I do seem to be improving and my thyroid foot is no longer the ‘ouch’ it was. I am also booked to see a kinesiologist. She can also test the thyroid strength and advise on supplements if still needed.

PS Re: soya
I have not done any research on this but I do know that the thyroid is affected by our hormones and soy is an oestrogen - so if too much is eaten this would upset the balance of the thyroid. I had been
prescribed progesterone to dampen down my oestrogen
levels and I believe it had depressed my thyroid too far.

Websites that have helped me: - this site advises on other tests that can be done and private doctors who think ‘outside the box’ - a good place to start.

Supplements that have helped me:
Vit C 500mg twice a day for both over and under
Vit E 250mg once a day - unless on anticoagulants
Vit B complex - 1 tab each morning for both under or over - must contain B-50 complex with 50mcg Vit B12, Biotin, 400 mcg folic acid, 50mg other B Vits.
Zinc, selenium and kelp but you really need advice as to whether they are suitable for your thyroid type.


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First Published in 2006

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