Type 2 Hypothyroidism -
You have been diagnosed with Type 2 Hypothyroidism as accurately described in chapter 5 of The Calcium Lie. This is based on laboratory evidence including normal thyroid hormone levels (ruling out Type 1 Hypothyroidism), abnormal calcium/potassium ratio greater than 4.2 based on a reliable determination of intracellular mineral levels (hair tissue mineral analysis or “HTMA”, TEI laboratory), and clinical documentation of low metabolic rate (low basal body temperature).
This medical diagnosis is new to the field of medicine and most physicians are currently not aware of it, unless they have read The Calcium Lie (chapter 5) or have been trained in measuring metabolic rates and have previous experience with HTMA through TEI laboratory.
Even for these practitioners, the application of the data and treatments described in The Calcium Lie for reversal of this illness may be new.
Due to the thyroid hormone resistance, your metabolic rate, as measured by your basal body temperature (low, being less than 97.8 degrees, most reliably taken as your wake up temperature, orally, with an accurate digital thermometer, three days average, first half of menstrual cycle where indicated) should be found to be low. This lowered metabolic rate has been conclusively been shown to be associated with hypothyroidism, with or without symptoms. This was how all forms of hypothyroidism were diagnosed before reliable blood tests became available in the early 1970’s.
The treatment of this abnormality in the case of Type 2 Hypothyroidism should be completely reversible with dietary changes, supplements, and in most cases medication, Spironolactone to help stop the potassium loss and correct the deficiency, and extra thyroid hormone to treat the symptoms of hypothyroidism until its reversal is apparent. (Again, the use of medication is temporary, extremely helpful, and important to the resolution of this disorder). Variations of this treatment may be needed in some patients based on specific clinical findings, e.g. resting tachycardia (fast baseline heart rate) before therapy is even instituted, which is treated with additional medication where indicated.
Medical follow up is very important, required for treatment, and is your responsibility. The basal body temperatures and pulse are needed every month for about three days to adjust the medication dosing needed to reverse the symptoms of slowed metabolic rate. The measurement of heart rate as well as the basal body temperature is critical to the safe treatment of this disorder. The resting heart rate measurement allows us to safely increase the dose of thyroid medication until the metabolic rate is corrected or in some cases until the heart rate increase tells us that we cannot increase the medication dose any further safely or even more importantly in most cases when this occurs, the dose of extra thyroid hormone must be decreased.
Correction of metabolic rate is the goal of this therapy. Equally important, measuring the heart rate monthly allows us to see when the hormone levels have become too high or extra thyroid hormone is no longer required or less is needed. This is also the goal of this therapy over time, and should become apparent after several months of successful treatment with medication and specific dietary changes.
Specifically, as a patient, you should be aware that a dose decrease is required if the resting heart rate becomes greater than 90. This has to be communicated with our office. It is important to note, a dosage of thyroid hormone that was previously OK, should become too much over time as your thyroid hormone resistance decreases with successful therapy, or as your sensitivity to the hormone increases. This again is the goal of treatment, is expected, and important to recognize and communicate with our office. It is a good thing. It indicates that your Type 2 Hypothyroidism is being successfully reversed, metabolic rate has improved, and decrease in therapy is required to prevent over treatment or complications.
Decreasing the dose of medication taken at this point will not affect your successful continued treatment or cause a return of symptoms of hypothyroidism. This is because your metabolism has been corrected or is correcting and thyroid hormone resistance is being successfully reduced or reversed. This will be reflected by an improvement in your calcium/potassium ratio on HTMA also. It is important to remeasure this ratio at periodic intervals (every 6 to 12 months) to reassess your dietary recommendations and adjust supplements and medications as indicated (which again should become less over time).
We are pleased to offer this cutting edge therapy to you, but feel it is important that you assume responsibility for your successful and safe treatment. We cannot do it for you. If you see another physician who is unaware of the diagnosis of Type 2 Hypothyroidism, please be patient and understanding. They are trained as I was to treat you based on your TSH levels. These are not reliable in Type 2 Hypothyroidism, but will become so again as the thyroid hormone resistance is reversed. The key word is resistance. Please refer the physician or health care practitioner to The Calcium Lie (chapter 5) or to me. You don’t have to be the expert.
We hope this is helpful and clarifies any confusion regarding the treatment of Type 2 Hypothyroidism. Please feel free to call my office with any questions.
Robert Thompson, M.D.
Co-author, The Calcium Lie