PH: What do you think are the best tests?
BDP: I have found urine and saliva tests that measure T3, T4, TSH, and the T3/T4 ratio to be more useful. Saliva is especially useful because it is a better reflection of what’s happening in the cell itself, rather than the blood. www.thyroiduk.org does a thyroid screen based on saliva, which includes testing for antithyroid antibodies. This can indicate if someone has an autoimmune thyroid problem.
PH: Can you tell me a bit more about autoimmune thyroiditis?
BDP: About 50% of people with thyroid problems have this disorder. Basically, this means their immune system over-stimulates and then attacks the thyroid tissue, leading to hypothyroidism. Ironically, a person with autoimmune thyroiditis may start out being ‘hyperthyroid’, the symptoms of which include wide-eyed staring, shakiness, tremors, feeling warm to the touch, frequent bowel movements, nervousness and irritability. If a person is anti-thyroid antibody positive, it’s very important to check for and eliminate allergies. There is a strong possibility they are gluten sensitive. I’ve found that simply eliminating wheat often stops the symptoms. In most cases, hyperthyroidism will self-correct in a year or two. That’s why I’m not in favour of immediate surgical removal of thyroid tissue or another procedure known as thyroid ablation, which involves swallowing radioactive iodine that ‘nukes’ the thyroid gland. Both procedures are very hit and miss. Too much thyroid tissue can be removed, or too little, requiring more intervention. I prefer the use of one of two drugs that shut down thyroid function – neomercazole or propylthiouracil. If a patient takes these for a year or two, the condition often corrects itself, avoiding the need for irreversible surgery or ablation.
PH: How do you treat an underactive thyroid?
BDP: I usually start with diet, supplements and lifestyle changes. All the usual suspects make thyroid function worse – sugar, refined foods, alcohol and smoking. There is some dispute about the effects of caffeine. In my opinion, if you’re not hooked, it may not be a problem. Fluoride in water is a problem, as fluoride competes with iodine, thus effectively contributing to an underactive thyroid. I think environmental pollutants and hormone-like chemicals in non-organic produce are also contributing to thyroid problems. Exercise promotes thyroid function, so much so that some people are pseudo-overactive because it’s the only way they feel slightly normal. As far as supplements go, I give 500-2000mg of tyrosine, as well as iodine (in kelp) 1-2 tablets a day, 200mcg of selenium, 15mg of zinc and 200mg of magnesium. These minerals help the manufacture and conversion of T4 to T3. Many people are iodine deficient, but you have to be a bit careful not to give too much. I also give glandular extract of bovine thyroid, and sometimes adrenal glandular extract. Very often, this combination of diet, supplements, glandulars and a few lifestyle changes solves the problem. However, if this strategy doesn’t relieve symptoms, I will recommend thyroid medication.
PH: In terms of diet, do you think that the soy and the Brassica family of vegetables should be considered anti-thyroid?
BDP: It certainly is true that the Brassica family (cabbage, Brussels sprouts, broccoli and kale) have small amounts of thiouracil, which inhibits the formation of thyroid hormone within the thyroid gland itself. Soy contains phytoestrogens, which while being beneficial for reducing breast cancer risk, do somewhat interfere with T4 reception in cell receptors. My advice is to have these foods in moderation. Of course, if you are hyperthyroid you might benefit from eating these foods.
PH: You mentioned earlier that you sometimes recommend thyroid medication. Which brand or brands do you prefer?
BDP: The vast majority of my patients, though not all, were happiest on Armour thyroid. This is a natural, desiccated thyroxine (T4) derived from pigs, which is very close to human T4. Armour thyroid contains all the hormones produced by the thyroid T4, T3, T2 (T2 helps improve energy), and T1. There have been a lot of anti-Armour thyroid reports, claiming synthetic T4 is better. That is certainly not my experience. But there’s big money in synthetic T4 medication, and the pharmaceutical PR machines make sure it stays that way. Many doctors are forever adjusting the dose of thyroid medication, not based on how the person feels, but on the often unreliable blood levels of T4. A classic scenario is that the T4 level goes up with synthetic T4, but the patient doesn’t get better because they have poor conversion of T4 to T3 – which is what you actually need. The dose is then lowered and the patient gets worse. This is just one example of why I think it’s really important to treat the person not the blood test. If a patient doesn’t find relief with Armour thyroid, I would recommend Thyrolar, a combination of 80 percent T4 and 20 percent T3, which is closer to nature. Dr Barry Durant-Peatfield's book, The Great Thyroid Scandal and How To Survive It (Barons Down Publishing) is available on Amazon.com.