Foundational Thyroid Support—The First Approach  Contributed by Dr. Chris D. Meletis NDwww.DrMeletis.com  This last month, I lectured at an Advanced Hormone Module to 400 medical providers in Chicago, I have been immersed in the latest medical literature relative to thyroid

Foundational Thyroid Support—The First Approach 

Contributed by Dr. Chris D. Meletis NDwww.DrMeletis.com 

This last month, I lectured at an Advanced Hormone Module to 400 medical providers in Chicago, I have been immersed in the latest medical literature relative to thyroid health.  The clinical evidence is clear that prior to offering thyroid replacement, identifying underlying triggers for thyroid dysfunction is a must.  The First Approach ideally incorporates ensuring that the adrenal function is sufficient as defined by adequate cortisol levels such as an optimal 4x cortisol level, along with DHEA sulfate and pregnenolone levels. Relative to specific nutritional supplements ensuring that there are sufficient ferritin levels of at least 70 to 100 is a must, along with adequate serum selenium of at least 90 mcg/L.  In addition making sure that zinc status is optimal is foundational, as low zinc can also lower both T4/T3 levels.  Iodine is certainly a must as well, with a minimum of 150 mcg daily, with at least 1000 mcg per day a common initial therapeutic dosing.  It has also been noted that 40% of hypothyroid patients are B12 deficient, with my favorite form of B12 being methylcobalamin.

Bottomline: 

Always asking the clinical question of why a tissue or gland has become insufficient is foundation. Optimizing nutritional status is always the first step, while making sure that an acute or chronic adrenal stress response has not down-regulated the TSH and Free T4 and Free T3 is an absolute consideration. As we all know, thyroid hormone levels are dynamic as reflected in the 2007 survey published in the Archives of Internal Medicine, values spontaneously returned to normal in more than 50% of patients with abnormal TSH levels when the test was repeated at a later date. 

References: 

Ferritin 

Duntas LH, et al., Exp Clin Endocrinol Diabetes. 1999;107(6):356-60. 

Zimmermann MB, et al., Thyroid. 2002 Oct;12(10):867-78. 

Cinemre H, et al., J Clin Endocrinol Metab. 2009 Jan;94(1):151-6 

Pak J. Biol Sci. 2007 Jan 15;10(2):255-6 

Selenium 

Tong YJ, et al.  Zhonghua Yi Xue ZaZhi 2003;83:2036-2039 

 

Zinc 

Kralik A, et al., Horm Metab Res. 1996 May;28(5):223-6. 

Nishiyama S, et al., J Am Coll Nutr. 1994 Feb;13(1):62-7. 

Taneja SK, et al., Indian J Exp Biol. 2008 Mar;46(3):171-9. 

 

B12 

Morel S,  et al., Ann Endocrinol (Paris). 2009 Mar;70(1):55-8.  

J Pak Med Assoc. 2008 May;58(5):258-61.