In a recent lecture by Dr. Paul Cheney, he states why he believes it is not a good idea to treat with thyroid hormone for ME/CFS. See from 22:00 to 25:50 in this video. In short, he believes that the brain responds to ME/CFS by intentionally down-regulating thyroid, forcing the body into a low metabolic rate. This is because the body 'knows' that it has lost the ability to deal with oxidative stress. Therefore, the body shifts into a low metabolic state in order to create less oxidation, a measure which Dr. Cheney describes as literally "life-saving." I believe he is referring to the tendency of oxidation to lead to cancer, but I could be wrong about this.
Dr. Cheney states that he can tell if someone truly needs thyroid supplementation by their blood TSH level. TSH is Thyroid Stimulating Hormone--the chemical signal that the brain (the pituitary to be exact) sends to the thyroid gland telling it to produce more thyroid hormone. Dr. Cheney says that people who are "true" hypothyroid cases actually have high TSH levels, suggesting that the brain recognizes the need for more thyroid hormone and is sending the signal stronger (but for whatever reason, the message isn't being received.)
In ME/CFS patients, on the other hand, TSH is usually low (mine is) suggesting that the patient's low thyroid function is 'intentional' on the part of the pituitary. *I did some liberal paraphrasing here, but I think it's an accurate summary of Dr. Cheney's views.
You can imagine my concern given than I have been taking thyroid supplementation on the recommendation of one of my ME/CFS doctors, since January, 2012. There's no question that it has made me feel better and has certainly improved by low body temperature issues (although it hasn't solved them completely). Now I don't know who to believe and I have a difficult decision to make. Coming down off of thyroid hormones will not be fun. I need to do a little more research and ask for more opinions, but I know which way I'm leaning.
*Thanks to the excellent blog CFS Patient Advocate, which is where I found the Cheney video linked above.
Thank you for that... very interesting. I haven't explored any of the thyroid thing, but that is a useful summary and food for thought.
ReplyDeleteI'm sure your M.E. doctor knows what he's doing :-) Maybe Dr. Cheney doesn't have all of the information with regard to thyroid problems, especially if he's going by the TSH. Here's a link which contains information about the doctor who created the TSH (among other tests including helping to discover the importance of T4 to T3 conversion) in which he said that he "hoped that doctors will still practice medicine and treat the patient not the TSH".
ReplyDeletehttp://tpauk.com/articles/3377-creator-of-tsh-and-t3-test-said-body-temperature-is-better/
Noreen.
Hey there - do you have an e-mail address? I can relate to you. I can be contacted at
ReplyDelete"ready for what 7 @ yahoo". (hopefully spammers won't catch onto that). Please contact me, I would love to compare notes.
I am behind on responding to comment, but I haven't forgotten about this. Will email you soon.
DeleteDo you ever have swollen lymph nodes?
ReplyDeleteI think Cheney is correct and you're more likely to do more harm than good.
ReplyDeleteAs I see it we should only treat two things in CFS:
1. Root cause (e.g. eliminating pathogens and toxin in the body).
2. Support body's activity with current 'scarce resources' (e.g. Methylation supports, anti-oxidant support, gut support).
Treating symptoms at its best is just hiding them temporarily, at its worse you could be undoing something that is helping you and sabotaging your recovery. We can't go by how we feel today, as the body often makes us feel worse in its resolution processes - all typical flu symptoms are the inflammatory response from the immune system doing its job. So we have to be very careful about judging progress by how we feel in the short term - better to find a biomarker that matters and shows progress in body rebuilding low resources, or the elimination of a pathogen or toxin load from the body.
An analogy: A couple of years ago I had a back injury which prevented me from walking properly and anything else. It would result in a lot of pain. I went to the doctors and he prescribed me some pain killers/ anti-inflammatories. I started on them and was able to walk around more. My back started getting worse though with less functionality and more pain off the meds. I stopped the meds and wasn't able to walk around so much (had to rest and lie down) and got some deep tissue massage to help fix some of the problem. My back quickly recovered. Pain and other symptoms are there to tell us something, and you never gain by treating them or hiding them.