I have tried to make this as simple as possible so that you can understand the importance of the Hormones:

The thyroid gland is part of the ENDOCRINE SYSTEM. The main part of the endocrine system comprises:

Pituitary; Thyroid; Adrenals; Pancreas; Gonads

The Pituitary produces thyroid-stimulating hormone (TSH), which regulates the thyroid. If the thyroid isn't producing enough hormone, then the TSH pushes the thyroid into making more. If the thyroid is making too much hormone, then the TSH will fall telling the thyroid not to make so much.

The thyroid gland makes, among others, two hormones - T4 (thyroxine) and T3 (tri-iodothyronine). It produces more T4 than T3. There is 50 times more T4 than T3 in the bloodstream. Most of these hormones are then carried around the bloodstream bound to two proteins. Some float around on their own. The hormones arrive at their destination and are then released from the protein. The T4 hormone is then converted to T3. This means that all the T4 (now converted to T3) and the T3 produced by the thyroid is ready for use by the body. Only T3 is active on the cells, making this the most important hormone used by the body.

Stress can cause the body to convert T4 not into T3 but into Reverse T3. This hormone is inactive and will not be uptaken by the cells. Sometimes instead of reverting back to T3 when the stress is over, some people can get stuck in this mode due to ongoing stress. This could be another reason why the T4 and TSH levels are normal. Some private doctors are looking into doing Reverse T3 testing to see if this is the patient’s problem.

For information on what tests are available, see Private Tests.

When Things Go Wrong - Hypothyroidism

Dr Durrant-Peatfield tells us that Hypothyroidism is the result of:

1. Failure of production
2. Failure of processing and tissue uptake.

1. Pituitary or hypothalamic failure, causing secondary thyroid (also adrenal) insufficiency.
2. Genetic dysfunction. The Thyroid may be dysfunctional at birth, or is programmed to fail at some time in adult life. (a predisposition).
3. Environmental challenges or deficiencies. Chemicals or even perhaps dental amalgam, which can interfere with thyroid production.
4. Major surgery, especially gall bladder, and very commonly hysterectomy.
5. Tonsillectomy in the young adult often damages the thyroid blood supply.
6. Major physical or emotional trauma.
7. Previous thyroid surgery or radioactive iodine ablation.
8. Autoimmune conditions; usually referred to as Hashimotos disease. Autoimmune attack may first stimulate the thyroid, and then destroy it.
9. Glandular Fever. Very common and insufficiently recognised.
10. Traumatic or multiple pregnancies. Big cause of massive weight gain.

1. Inability to absorb synthetic thyroxine adequately.
2. Conversion failure (from T4 to T3).
3. Adrenal insufficiency caused by:
   1. a long period of untreated thyroid deficiency
   2. pre-existing other major illness (e.g. Lupus)
   3. previous massive use of cortisone.
   4. Receptor resistance due to Adrenal insufficiency or a long period of hypothyroidism, which desensitizes the receptor.

1. Failure of absorption of thyroxine.
2. Failure to convert T4 to T3, because of partial failure of the 5 Deiiodose enzyme.
3. Adrenal insufficiency, which affects the failure to convert T4 to T3 because of partial failure of the Deiiodose enzyme, and more especially receptor uptake.

1. natural thyroid** as recommended by Broda Barnes, Stephen Langer etc.
2. T3 supplementation to bypass the conversion block and/or
3. adrenal support, using ultra-low physiological amounts of a cortisone. **

He tells us "Thyroxine is synthetic; and is only one of the 5 hormones the thyroid produces. It's not the way nature does it, which is why it often fails, especially in the long term or more ill patient."

With regard to the blood tests, he tells us that the TSH may be normal or low, rather than high if the hypothyroidism is secondary to primary pituitary or hypothalamic insufficiency, and that the T4 may be normal or even high, if tissue uptake is dysfunctional. If the T4 is not being used by the tissues, it builds in the bloodstream even with poor thyroid output.

HRT complicates the problem. Modern synthetic HRT may actually work against you, which is why he recommends natural progesterone - essential for full uptake and natural oestrogen if demonstrably deficient. Premarin, though natural, is a particularly bad example of interfering with thyroid availability.

Dr. Ridha Arem is Associate Professor of Medicine in the Division of Endocrinology and Metabolism at Baylor College of Medicine in Houston, Texas. He is also Chief of Endocrinology and Metabolism at Ben Taub General Hospital in Houston. Dr. Arem is a nationally recognized thyroid specialist and teaches medical students and physicians-in-training. He is the author of The Thyroid Solution, and also believes that some patients are hypothyroid, even though they have normal blood test results. He says “ What is normal for your TSH level, may differ dramatically from what is normal for mine” and he gives examples of this. He also believes that T4 is not enough to achieve complete remission. He maintains that the T4 does not provide the 100% correct amount of T3 needed for normal functioning. "In humans, 20% of T3 needed by the body is produced directly by the thyroid gland". He feels that in some cases, lack of T3 may be the cause of residual symptoms such as Depression, Mental alertness, Lack of libido and being overweight.

He noticed that when his patients originally changed from Armour Thyroid (the natural thyroid taken from pigs) to synthetic T4 they complained of hypothyroidal symptoms. This led him to devise a protocol that combines synthetic T4 and T3. He regards this treatment as a state of the art treatment for hypothyroidism, and a viable alternative to the most widely accepted current medical approach, which has been to prescribe T4, a portion of which converts to T3. He believes that adding T3 in the treatment of hypothyroidism is beneficial because the body and mind depend on this most potent form of thyroid hormone. A minute T3 deficit may impair the person’s functioning, although not in all cases. In humans, 20% of T3 needed by the body is produced directly by the thyroid gland. The correct replacement is usually judged by monitoring what the pituitary senses and releases (TSH).

He thinks that it is possible that, even though blood tests are normal and the conversion of T4 to T3 within organs is taken into account, some form of brain or body hypothyroidism, due to lack of T3 still exists. Having a normal TSH level does not necessarily mean that your brain and organs are receiving the exact amount. Many people continue to suffer from symptoms of low metabolism. They have difficulty in losing weight, have hair loss, dry skin, brittle nails, muscle cramps and a host of physical symptoms. This indicates that the body is not receiving exactly the right amount of T3 from the conversion of T4. He has determined that to achieve symptom relief the right amount of T3 in a general person is 10mcg. Patients should be treated with T4 first and once they have reached and maintained normal and stable blood levels of TSH he subtracts 37-38 mcg. of T4 and replaces it with 10 mcg T3 in divided doses, 5mcg in the morning with the T4 and 5 mcg at 2pm. He believes that this treatment combination allows both thyroid hormone and TSH levels to remain normal. Only occasionally, patients on high doses of T4 need a higher dose of T3 i.e. 5mcg three times per day.

If you are on thyroxine and are still having symptoms of hypothyroidism, it could be that you are not converting your T4 to T3 properly. Since the body only uses T3, this could cause problems for you. Try getting a T3 test done first to see if this is low. Some areas will not do this for you. If this is the case see Private Tests. On the Research Studies page, you will find the link to an abstract of some research on the Effects of Thyroxine as compared with Thyroxine plus Triiodothyronine in Patients with Hypothyroidism. If you want to try and convince your doctor to give you a trial of T4/T3 combination, show him this piece of research. It might help.

Dr. Peatfield insists, “Nothing short of 100% remission should be accepted”. This most certainly is not happening and it is what this group will fight for.

Some doctors, of whom Dr. Peatfield and Dr. Skinner are two, prefer to give their patients natural thyroid hormone – Armour Thyroid – which comes from the thyroid gland of pigs. This is closer to the hormone that we produce naturally and contains all five hormones. I do know of many, many people using this and who feel much better. Unfortunately, this is not licensed in this country and you may find great difficulty in obtaining this via your NHS doctor. If you can find a doctor to prescribe this for you, it is possible to obtain it. For further information, contact me.

Hashimoto's Disease

Hashimoto’s Disease is an autoimmune disease. It is the leading cause of hypothyroidism (1) and appears to be hereditary as often parents and one or more children will have it. Antibodies are produced by your own body and attack the thyroid gland. Eventually, this will destroy many of the thyroid cells so that they can’t produce thyroxine and this will then cause hypothyroidism. In Hashimoto's disease, there are usually high levels of TSH due to the loss of T4 synthesis because the antibodies are affecting the thyroid’s ability to generate thyroid hormones. Initially a lot of thyroglobulin will be released and then once it is released into the bloodstream it will be attacked and broken down into various fragments, some of which will become T4 eventually. This will cause the person to have short-lived high levels of T4, causing the person to become hyperthyroid. Because the T4 has not been released from the thyroid in it's usual way, it is not replaced. The person will then very quickly become hypothyroid. Initially, a goitre may be present, due to the inflammation, but sometimes the gland may shrink. If you suspect that you may have Hashimoto’s, ask your GP for an antibody test. Even if you have low antibodies, it does not mean that you do not have Hashimoto's. As this disease is insidious, it may take some time to even show antibodies, so don’t give up hope. Usually, once diagnosis is made, thyroid replacement is prescribed.