Hypothyroidism: The Silent Epidemic

Hypothyroidism can be loosely defined as a medical condition that results from the under-secretion of thyroid hormone. The difficulty with this traditional approach to diagnosis of hypothyroidism is that it relies on ‘normal values,’ or reference ranges that are defined by the population itself. It has been estimated that as many as 50 million Americans suffer from undiagnosed hypothyroidism.

Fact #1: Thyroid hormone is necessary to maintain basal metabolic rate, or the amount of fuel that is consumed to sustain health. When a person is generating too little thyroid hormone, or has an imbalance that involves thyroid metabolism, body temperature will fall. These persons may be told that they normally have low temperatures. The result is weight gain, depression, and elevations in cholesterol levels.

Fact #2: The traditional approach to the diagnosis of hypothyroidism involves measurement of a hormone released by the pituitary gland, thyroid stimulating hormone (TSH). If the central nervous system senses that there is inadequate thyroid hormone in the blood stream, TSH levels will increase. Increases in TSH generally lead to increases n the release of thyroid hormone from the thyroid gland. As levels of thyroid hormone reach adequate levels, TSH release decreases.

Problem #1: A lot can go wrong between the brain, pituitary gland, and the thyroid gland. Inadequate levels of thyroid hormone can persist, and the brain will reset to new and lower levels of this hormone. Factors that can cause this include: chronic stress, pregnancy, trauma, chronic disease states, autoimmune conditions, and fasting. As TSH levels drop back to normal, the diagnosis of hypothyroidism becomes more difficult, especially if all the practitioner relies upon is the TSH level. Unfortunately, this is the case more times than not.

Problem #2: Thyroid Hormone requires adequate levels of estradiol, estrone, progesterone, testosterone, cortisol, insulin, DHEA, and a host of other hormones, peptides, fatty acids, and humoral elements. If any one of these necessary pieces is missing, out of balance, or in excess, thyroid hormone may not work properly, leading to a state of ‘functional hypothyroidism.’

Problem #3: Thyroid Hormone replacement may be inadequate or improper for the patient. There are chemicals in some of the commercially available thyroid preparations that cause all kinds of problems. One such substance is ‘Acacia.’ Portions of this plant are used in some medications to provide form and shape to tablets. Lactose is also used in the most popular of the Thyroid Replacement Hormones. Not only is lactose an allergic trigger for people with lactose intolerance, but it may also block the absorption of the Thyroid replacement itself. Signs of lactose intolerance include nausea, cramps, bloating, gas, and diarrhea.

It is common to hear patients say that the thyroid medicine they are taking is making them sicker. Often the doctor doesn’t make the effort to figure out why this is the case.

Problem #4: Certain foods make thyroid conditions worse Patients with autoimmune disorders may be more sensitive to soy protein than other persons. Soy contains two chemicals that inhibit an important enzyme that is necessary for thyroid hormone replacement. If a person is already on the edge, taking soy protein can make the condition worse.


1. In order to sort through the diagnosis of thyroid related problems, it is important to determine not only the levels of thyroid hormones and TSH, but it is also important to determine the presence of antibodies to the binding protein and converting enzymes.

2. If you suspect that you have hypothyroidism, it is necessary to cease eating anything that contains soy, soy lecithin, peanuts, and pinto beans.

3. Replacement of thyroid hormone should be accomplished with products that do not contain lactose, Acacia, and artificial colorations.

4. Thyroid hormone must be taken on an empty stomach.

5. Determination of hormone imbalances that affect thyroid metabolism must be accomplished.

About David S Klein, MD 149 Articles
David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.