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JANUARY 10, 2003     PAGE TWO      
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                                                                          Lora's Desk

Guest Column. . .


January is the American Association of Clinical Endocrinologists' Thyroid Awareness Month. We're very lucky to have Joan Hedman, an accomplished writer to use this forum to bring some of that very awareness to our low carb community via the Low Carb Luxury Online Magazine.



                                               Stalled? Stuck on a Plateau? Maybe not...
If you've been following the low carb way of life but aren't seeing the weight loss results you'd like to see, there may be an explanation beyond your diet. It could be your thyroid.


My Story
I'm 39 years old, a full-time mother of three and part-time freelance writer. I'm "pre-diabetic" (insulin resistant), and I have PCOS. I've been controlling both of those conditions through low-carbing with tremendous success for nearly four years now. But just a few months ago, I began a slow deterioration that I successfully ignored until a specific complaint sent me the gynecologist. The diagnosis brought into focus all the symptoms I had been brushing off: I am hypothyroid.


The Thyroid Gland
thyroid The thyroid is a butterfly-shaped gland that lies just above your collarbone, below the Adam's apple, in the front of your throat. It is part of the body's endocrine system, which produces and regulates the hormones that control all the chemical processes that take place in the body. The thyroid's job is to regulate metabolism. If you have too much thyroid hormone circulating in your system, you are hyperthyroid, with associated symptoms like palpitations, insomnia, and nervousness. Your metabolism is in overdrive.

If, on the other hand, your thyroid gland is not producing enough thyroid hormones, you are hypothyroid. Your metabolism can barely shift out of neutral. Some of the most common symptoms of hypothyroid are fatigue, weight gain or an inability to lose weight in spite of diet and exercise, dry skin, "brain fog", and low body temperature. In women, irregular menstrual cycles and prolonged and/or heavy bleeding can also be caused by hypothyroidism. In my case, I was physically and mentally exhausted, cold all the time, and experiencing abnormal menstrual bleeding. My skin was dry, my lips constantly chapped, and my hair was falling out. All these are classic symptoms of hypothyroidism.


Diagnosis and Treatment
Living Well with Hypothyroidism There are many underlying causes of thyroid dysfunction, including transient infections, autoimmune conditions in which the body attacks the thyroid (Hashimoto's Thyroiditis, Graves' Disease), thyroid nodules (benign tumors) or cancer, or problems in the pituitary or adrenal glands.

Initial diagnosis, however, is nearly always as simple as a blood test. The most common test determines your level of thyroid stimulating hormone (TSH). TSH is produced by the pituitary gland in response to the levels of thyroid hormones it detects in your blood. If you have too much TSH, you are hypothyroid: the pituitary is producing more TSH than is usual, in an effort to get your thyroid to make more thyroid hormones. This is contrary to what you might think at first, but remember that TSH is not itself a thyroid hormone, it's the thyroid hormone "requestor". The Goddess Diet

If TSH is elevated, doctors should also measure the amounts of actual thyroid hormones (T4 and T3) circulating in your blood stream, since it's possible that your thyroid is actually fine and there's something amiss in the pituitary gland. In the ideal situation, diagnosis will be made on the basis of your symptoms as well as your lab results. Some people feel fine with an elevated TSH, others are barely able to make it through the day.

Thyroid Power Treatment of hypothyroidism, regardless of underlying cause, is thyroid hormone replacement. Yes, that sounds a bit scary, but the reality is you take a pill or two first thing in the morning, or for some patients, twice a day, to replace the hormones that your thyroid gland is unable to produce. Initially patients are started at a low dose, and then they are re-evaluated after 6-8 weeks, including rechecking TSH and thyroid hormone levels. It takes that long for the body to adjust to the new levels of hormones, so testing before 6 weeks will not yield an accurate assessment. It may take several rounds of adjustments before the optimal levels are found.

Some patients feel almost immediate relief when treatment begins; for others, it's a slow process of regaining lost energy, finally being able to lose weight, and "becoming my old self" again. Another common symptom or side effect of hypothyroidism is depression, and this can sometimes be the worst after diagnosis when the initial treatments don't provide an instant fix. It' s important to stay focused and confident. There is no reason that you can't get your life back!


Hypothyroidism, Metabolism, and the Benefits of Low Carb Living
Benefits of Low Carb Living If you're following the low carb way of life, you're probably already familiar with the term insulin resistance. It describes a state in which our bodies respond to carbohydrate intake by producing too much insulin, which results in a host of unpleasant side effects such as food cravings caused by blood sugar crashes, and extra calories being stored as fat. Insulin resistance is an endocrine system disorder, just as hypothyroidism is. There's a growing body of evidence that shows if your endocrine (hormonal) system is out of whack in one area of your body, there's a good chance that things may go haywire in your other systems, too.

For hypothyroid sufferers, there are a couple of "broken" mechanisms that lead to weight problems. Mary J. Shomon, in her book, Living Well With Hypothyroidism, describes how the under-functioning metabolism fails to signal the brain when we are full, leading to weight gain. Shomon also discusses how our bodies establish a metabolic set point, the level at which we need to operate to maintain weight. In a healthy person, when weight gain is detected, the body will put up some resistance and increase the metabolic rate to shed the excess pounds. In hypothyroid sufferers, this metabolic resistance is weak or non-existent, making it very difficult to lose weight.

While the entrenched health establishment still can't come right out and advocate low carb diets, everyone agrees that high glycemic foods should be eliminated. All of the nutritional advice starts out with the recommendation to drop sugar, flour, and foods made with them. If you're already following a low carb way of life, you're ahead of the game. Controlling insulin resistance can go a long way towards relieving some of the symptoms of hypothyroidism, including fatigue, dizziness, and unrelenting hunger.


What About You?
The American Academy of Clinical Endocrinologists estimate that more than 13 million Americans have thyroid disease and remain undiagnosed. Thyroid disease can have a negative impact on quality of life, but the consequences of failure to treat over the long term are deadly serious. Left untreated, thyroid disease can lead to elevated cholesterol, heart disease, osteoporosis, infertility, and depression. Testing is simple and inexpensive, treatment is easy and can be life-changing. If any of the symptoms described above sound familiar to you, take a few minutes to read about hypothyroidism in more detail at the links below, and make an appointment to follow up with your doctor.

I've been on thyroid hormone therapy for a few weeks now. Within a few days, the abnormal bleeding stopped and my cycle returned to normal. My energy level is improved although I still become easily fatigued. I anticipate there will be a few rounds of adjustments to my medications, but I'm hopeful that in a few months I'll be my old self again. and it won't take me quite so long to write an article like this!

LINKS AND REFERENCES:

Association of American Clinical Endocrinologist, Thyroid Awareness Month press release:
http://www.aace.com/pub/tam2003/press.php

Endocrine Web's Thyroid main page, excellent advice for thyroid patients, including information on diagnosis, testing, and treatments:
http://www.endocrineweb.com/thyroid.html

Mary J. Shomon's Thyroid Info site, from which you can subscribe to her newsletter, Sticking Out Our Necks:  http://www.thyroid-info.com/

Also visit Mary's Thyroid site at About.com, which includes many articles and a lively and supportive forum:  http://thyroid.about.com/


Joan Hedman is the owner/editor of FarscapeWeekly and encourages you to watch the last 11 episodes of Farscape on the SCI FI Channel, Fridays at 8 PM and 12 Midnight Eastern time, beginning January 10th.




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