Fibromyalgia; Part I

An article written by a medical professional I read stated that everyone with Fibromyalgia has low thyroid function to some degree.  That’s a bold statement and yet I agree.  The question that remains is whether the problem is the thyroid or it’s related mechanisms, or something else affecting the thyroid or thyroid hormones.  Ultimately it may not matter, as treating with hormone replacement helps low thyroid function (LTF) regardless of the cause.

First, what does low thyroid mean?  Many think low thyroid means your blood work for thyroid appears abnormal.  When your doctor checks your thyroid function they usually look at three markers, TSH, T4, and T3.  There are other tests that can be done, reverse T3, anti-thyroid antibodies, as well as other types of tests that can be used to rule out other abnormalities if your doctor finds reason to believe something else is wrong.

There are serious medical conditions that can affect the different mechanisms and structures involved in the production of thyroid hormone.  These need to be ruled out by a qualified medical professional.  This information is NOT intended to be a substitute for such health care.  If, however, everything is ruled out and the blood work shows you have, or even if it doesn’t show you have low thyroid function, you may benefit from thyroid treatment.

TSH refers to Thyroid Stimulating Hormone, which is produced in your brain in the anterior pituitary.  TSH tells your thyroid to produce T4 which in turn breaks down into T3.  T3 is the active hormone used by the different systems of the body for metabolism regulation as well as many other functions.  (this is a simple version)

In most cases, Doctor’s including Endocrinologists prescribe T4 (Synthroid, Levothyroxine) for hypothyroidism.  The theory is that your body will break down the T4 into the needed T3 making you will feel better.  Many times, however, even though a patient’s blood work may look better, they continue to feel terrible.  Inevitably they are then prescribed even more T4, and the process continues.  More about this will be said in the section on reverse T3.

Symptoms of Low Thyroid

Depression Insomnia Constipation Neuropathy			no sex drive fatigue dry skin Fibromyalgia
Anxiety weight gain cold hands / feet			brittle nails hair loss
high cholesterol
restless legs
muscle / joint pains low body temperature (below 98.6)
mood swings (sometimes misdiagnosed as Bipolar)
lack of concentration and focus (sometimes misdiagnosed as ADHD)

That’s an incomplete list of symptoms one can experience with LTF.

What if you have hypothyroid symptoms but your blood work is normal?  Often times people will have hypothyroid symptoms yet their blood work remains normal.  In fact blood work for TSH levels only started to be used in the early 1970’s.  Before then doctors looked at clinical symptoms such as those above.  The main medication for treating LTF for years was Armour’s Thyroid, which is typically desiccated porcine thyroid which naturally contains both T4 and T3 in a ratio similar to what humans produce.  It has been around since the late 19^th century actually.  If you went to a doctor in 1910 then, feeling lethargic, gassy, constipated, and depressed your doctor may have prescribed Armour’s thyroid. 

Today no doctor would treat you unless your blood work, specifically your TSH, is abnormal.  Yet many people continue to have hypothyroid symptoms even though their blood work continues to fall in normal range.

What are other reasons for treating with Armour’s Thyroid?  If a patient who has been diagnosed with LTF continues to feel poorly despite being given a T4 preparation, most likely it’s because they don’t break down T4 properly or they tend to produce too much reverse T3 instead of the active T3.  Reverse T3 is something we all produce.  Most likely reverse T3 is an old evolutionary mechanism that we still carry that slowed our metabolism during times of hunger or injury until either food was found or we healed.  Once some people start producing reverse T3 they may have a problem turning the mechanism off.  Another theory that may explain the overproduction of reverse T3 is a lack of enzyme to break T4 down into healthy or active T3.  Reverse T3 as the name suggests doesn’t work like active T3, and if you have a tendency to producing too much of this, all the T4 in the world won’t make you feel better. 

The reasons why someone may produce too much reverse T3 are irrelevant.  The only option to taking only T4 is adding T3 to it in a ratio of 4:1, 3:1, 2:1, or even 1:2 of T4:T3.  This can be given as regular prescriptions of Synthroid / Levothyroxine and Cytomel.  Another option is to have them compounded.  And lastly another option is Armour’s Thyroid, Natur-Throid, or a synthetic T4:T3 formula.  I personally take only T3 every day, and every other day add T4 because I don’t feel well taking T4 on a daily basis.

Fibromyalgia; Part II

Since looking at Fibromyalgia, much of this discussion has been about LTF. Are there other causes of Fibromyalgia? The simple answer is yes, however, some of them may be indirectly related to your thyroid function. I will discuss a few here as well as provide other references.

First regardless of the cause, I want to say that it is important to take care of yourself. For me, that means going to the gym twice a week to do moderate resistance training. I eat healthy, and practice a Yoga type of stretching. I meditate daily (meditation being a great tool to learn to be more present, which among other things helps with stress).

1. Genetic. Treatment options include those mentioned above, and include any other self care techniques that you find beneficial.

2. Accident. After suffering from a car accident for example that causes whiplash, you may need therapy. Treatment options include body work therapy, such as Physical Therapy, CranioSacral Therapy, Myofascial Release, and Chiropractic. I’m leaning more toward what I call gentle Chiropractic these days, but regardless who you see, check with their referrals, and make sure you feel comfortable with them.
   
   Most people bounce back from accidents, but some see them as the beginning of their spiral downward with health problems. If your symptoms continue seek professional help for thyroid treatment, for the reasons previously discussed. Your low thyroid levels could very well be the cause of your Fibromyalgia.

3. Nutritional. There are so many books written regarding nutrition. Many of them contain valid information, though often you have to wade through a lot of fluff, or information that may not pertain to you.
   
   I suggest you seek the advice of a Registered Dietician. I do this because of their core understanding of nutrition, biochemistry, and ability to make suggestions for your specific health needs. Also I would like to make a few book suggestions; The Only Diet There Is, One Man’s Food is Another Man’s Poison, check out a book on vegetarianism, If this is Tuesday it Must be Chicken.
   
   And if you think eating right is difficult or pricy, remember this, beans and rice, are a staple diet for many in other developing countries. They are cheap, and can be the building blocks for a healthy complete diet.

4. Food Allergies. Food allergies usually come after your body has been compromised in some way; hormone imbalance, stress, chemicals, accident, genetics, psych/emotional issues, etc. Saying that, however, treating food allergies can play an important part in regaining your health. If you suspect food allergies, some supplements to look into are L-glutamine, 4-8grams/day, Vitamin C, 3000-5000mg/day, MSM ¼ tsp 2X day up to ½ tblsp 2X day. One of the best methods for determining food allergies is the elimination diet. Eating foods that your body is NOT allergic to, and addressing other issues that you may have will give your body the break it needs to begin to recover. The process may take time. We don’t get sick overnight, so have patience.

5. Detox System. Finally a word or two about your detox system. There are books that you can reference, that can provide you with more information than you really need. For our purpose let’s say that your body detoxes through your lungs, skin, liver, intestines, and kidneys.
   
   Eating well, drinking fresh clean water, and living a clean lifestyle will help your body to naturally detox. Structural body work techniques will facilitate this process by releasing restrictions that may impede blood and oxygen flow, and also open energy flows that can hold psychological and emotional stress. Sauna therapy and exercise will help mobilize fat cells and help your body to literally sweat out toxins. Specific supplements can help facilitate this process such as, Vitamin C, fish oils, B complex, l-glutathione, and milk thistle. Liver detox formulas can help the function and process of your liver. Besides herbal formulas that contain milk thistle, a simple remedy you can make at home requires ½ a lemon squeezed into ½ a glass of water, with 2 tblsps of olive oil. Drinking this every morning at least half an hour before eating for at least two weeks can facilitate normal liver / gallbladder function.
   
   I don’t normally make specific supplement recommendations, but I have heard good things about an internal cleansing program for parasites by UniKey Health. It comes recommended by Louise Gittleman.

There are a host of other resources on the subject of Thyroid function, as well as Fibromyalgia. My purpose here was not to try and provide all the answers, rather to provide you with a different perspective, and to get you to continue your own search.

PS.  I don't know very much about this treatment, but have heard about it over the years with interest, Low Dose Naltrexone Therapy.  Naltrexone is a medication used to help those addicted to opiates, but used in low doses taken at night it seems to reset immune receptors shared with those for opiates...my suggestion, look it up.