INTRODUCTION

INTRODUCTION

At first sight there could hardly be a more simple disorder to diagnose and treat than hypothyroidism. We have hormone blood tests and thyroid hormone replacement therapy. So what remains?
Doctors rely on an increase in blood levels of pituitary TSH beyond the reference standards for the diagnosis of hypothyroidism. TSH levels increase when the blood thyroid hormone levels fall (T4 and / or T3) due to a deficiency of the thyroid gland. What is particularly disturbing is the fact that hypothyroidism may be evident despite a normal TSH.

Doctors are often in the presence of patients presenting symptoms apparently related to hypothyroidism. In many of these patients, TSH levels and those of T4 and T3 may be within normal, driving their doctors to rule out any thyroid disease, and this often for years, before their TSH levels will raise enough to reveal their hypothyroid condition. Symptomatic treatments will be prescribed to each disorder taken apart. This includes tens of thousands of patients.

Moreover, despite a seemingly adequate therapy, relying on a normal TSH (back in the reference standards, I should say), a high percentage of patients continue to have symptoms.
Undiagnosed or poorly balanced with thyroid hormone replacement, hypothyroidism can have severe consequences on the quality of life, even devastating.

Where is the problem? The problem lies in the range of reference values for TSH. According to the AACE (American Association of Endocrinologists Clinicians) and more recent studies, the so-called "standard" has too wide limits, leaving if their doctors do not refer to it, tens of thousands of patients suffering from hypothyroidism which should benefit from a treatment but not receiving it.

Hypothyroidism is a condition characterized by a decrease thyroid hormones production. Because Hashimoto's thyroiditis (an autoimmune disease) is the most common cause of hypothyroidism, I will devote much of this study to this disease, without neglecting, however, the other aspects and causes of hypothyroidism.
But first of all, a complete understanding of thyroid function and basics of thyroid physiology is necessary. The metabolism of thyroid hormones has unknown aspects, whose importance is yet major for the comprehension of hypothyroidism treatment. I have devoted a chapter to auto-immune diseases because antibodies underline the disorder, like a "red thread" running through this presentation.
Later in this study, I will focus on the connections between hypothyroidism, fibromyalgia and chronic fatigue syndrome, between thyroid and menopause, between leptin, overweight and thyroid, between thyroid and adrenal glands, between thyroid, gluten and gut. These issues are usually overlooked, yet these pathologies, associated in varying degrees, frequently occur in daily medical practice. They are poisoning the existence of millions individuals. Their special interactions, if carefully taken in full consideration, should influence considerably the management of these pathologies.
At last, I will expose the treatment regarding to the physiological aspects of hypothyroidism and to the associated pathologies. I will show why the therapeutic consensus is not effective and is obsolete in the vast majority of cases. New options exist to achieve optimal health and resolution of symptoms.
 

norkurld@zahav.net.il
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