The Low Carb Luxury Newsletter: 
Volume III / Number 19: October 11, 2002: Page 3
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 Advice Lady         
A well-known low-carber in the community answers your questions about everything from nutrition to family issues, stress, and heck — even your love life. She's been the "go to gal" for awhile now when people need a little advice. And who is she? Well, we're not telling. She remains anonymous so that she can better give very frank advice. She doesn't pull any punches. You can remain anonymous too if you want — Just think "Dear Abby" — you know, signing off like "Harried in the Workplace" or "Desperate for Carbs in Detroit". Send in your question to The Advice Lady at

Thyroid Glands After my last column, we received quite a lot of email about the ease with which problems with thyroid can be overlooked or dismissed. I had failed to pick up on that comment in this woman's letter, and I stand corrected. Here are a few of the many letters we received, and we think it will be helpful to not only "Desperate in Calgary", but to many others out there.

In case you may have missed it, here's a link to it.

Dear Advice Lady,
I could be reading my story, although I didn't have quite as much weight to lose, but my battle has been similar.

Here is what you assumed ... that the Canadian Dr. diagnosed her correctly! Bad mistake. Canadian Dr's are woefully inadequately trained in diagnosing thyroid problems! As an example, my TSH level of 7 and a 3cm Goiter, basal temps of 96 and weight-loss problems still only had him say "live with it ... we will monitor it, it does not seem to be a problem".

The American Endocrinology assoc. and the British Medical Journal both agree that a TSH level above 4.5 is not normal and that ideally it should be less than 3 and agree that with carefully monitored treatment, there are simply NO SIDE-EFFECTS to taking thyroid medication.

I happen to have lived in the same city as "Desperate in Calgary, Alberta, Canada" for 15 years ... my advise to her would be to get a 2nd and a 3rd opinion!!! Here's an article you can't miss:

Thyroid disorders may run in your family, and you might not even know it. It is a good idea to ask if someone in your family has a thyroid disorder, according to Paul S. Jellinger, MD, FACE, president of the American Association of Clinical Endocrinologists. If thyroid disorders are in your family, you have a higher chance of having thyroid disease than other people without a family history.

When the thyroid produces fewer hormones than the body needs, the result is hypothyroidism, the most common thyroid dysfunction. An overactive thyroid gland that secretes excessive hormones produces hyperthyroidism. Properly treated, thyroid patients can lead normal, active lives says Dr. Jellinger. See

Thyroid disease affects an estimated 13 million people of all ages and sexes, yet more than half remain undiagnosed says Dr. Jellinger.

Your thyroid is a small, butterfly-shaped gland located in your neck just below your Adam's apple that makes hormones called T4 and T3. It influences the function of many of your body's most important organs, including your heart, brain, liver, kidneys and skin. Ensuring that your thyroid is healthy and functioning properly and asking about your family history is important to your body's well-being.

Thyroid hormone is controlled by another endocrine gland called the pituitary and part of the brain called the hypothalamus says Dr. Jellinger. They work together to make sure the right amount of thyroid hormone is released, developing a balanced metabolism of your body. The pituitary gland maintains this delicate balance by secreting Thyroid Stimulating Hormone (TSH). When thyroid hormone is low, more TSH is secreted from the pituitary and when too much thyroid hormone is produced, the pituitary reduces TSH production.

Take the "Neck Check"(TM) to help determine whether you have an enlarged thyroid gland called a goiter, which may require further examination or testing by an endocrinologist with a highly sensitive TSH test. A simple blood test can be used to check thyroid hormones and TSH in the blood to determine thyroid dysfunction. The thyroid gland may develop nodules or lumps. Whenever a goiter or nodules are found, it is important to check for cancer, although most nodules are benign.

Neck Check™ All you will need is: A glass of water and a hand-held mirror

Hold the mirror in your hand, focusing on the area of your neck just below the Adam's apple and immediately above the collarbone. Your thyroid gland is located in this area. While focusing on this area in the mirror, tip your head back. Take a drink of water and swallow. As you swallow, look at your neck. Check for any bulges or a protrusion in this area when you swallow. Reminder: Don't confuse the Adam's apple with the thyroid gland. The thyroid gland is located further down on your neck, closer to the collarbone. You may want to repeat this process several times. If you do see any bulges or protrusions, see your physician immediately. You may have an enlarged thyroid or a nodule and should be checked to determine whether cancer is present or if treatment for thyroid disease is needed.

This test found my Goiter - NOT my Dr!

Jennifer Eloff

And from Nancy Charter:

Please tell "Desperate in Calgary" that if her temp is as low as she says it is, she definintely needs to be on thyroid medication. Basal temperature is the method that used to be used for detecting hypothyroid in the "olden" days and was a very accurate diagnostic tool. Ever since the advent of the TSH blood test which most doctors use, experts in thyroid metabolism estimate that 40% of people with low thyroid are being missed. She needs a one-hour thyroid releasing hormone test (TRH). Most doctors won't give this test as it's time consuming. I had to seek out a doctor who was more cooperative and more educated on thyroid disease, and I found that I did, indeed, have low thyroid.....which my sister had been telling me for years. My former doctor simply did a TSH test and always said "your tests are normal." She needs to get help for this as the ramifications of long-term hypothyroidism are very serious.

And from Penny Burke:

While reading "desperate's" letter, I immediately thought of a thyroid syndrome my doctor told me about called "Wilson's Syndrome" It is characterized by:

"A normal serum thyroid-stimulating hormone in combination with oral temperatures averaging consistently below 98.2°F with the symptoms described above confirms the diagnosis of Wilson's syndrome."

The symptoms described "above" include: "The symptoms of Wilson's syndrome are the same as those associated with low thyroid function, including chilliness; fatigue; easy weight gain; fluid retention; dry eyes; dry skin; dry hair or hair loss; weak, brittle unhealthy nails; constipation and concentration impairment. Other possible associated symptoms include insomnia, headaches, irritability, anxiety and panic attacks, depression, premenstrual syndrome, irregular periods, low sexual desire and low self-esteem."

Apparently, Wilson's Syndrome is fairly unknown and not widely accepted in the mainstream medical community. The problem underlying the syndrome is that although serum levels of T3 and T4 are normal, conversion of T4 to T3 is impaired in the liver and individual cells. So even though the serum levels are fine, the body still has a thyroid deficiency of sorts. Treatments vary but often include T3 (not T4!) supplementation (by prescription).

There are many sites on the web that address the syndrome, including:

Thanks, everyone, for the wonderful information! It truly does take a team.

                                                                             The Advice Lady

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