In a newsletter I received from the Fibromyalgia and Fatigue Centers, they state that there is mounting evidence that hypothyroidism is present in the majority of, and possibly all, Fibromylagia & CFS patients. The problem is that standard blood testing that consists of TSH, T4 and T3 does not detect it and patients are told repeatedly that their thyroid levels are fine. I know from personal experience that this is true! I was suffering with severe symptoms of hypothyroidism and the doctors and specialists I saw in my area kept telling me my thyroid was okay. It wasn’t until I went to the F & F Centers (www.fibroandfatigue.com) that my suspicions were confirmed
TSH is secreted by the pituitary in the brain, which tells the thyroid to secrete T4. T4 is not the active thyroid hormone. T4 has to then be converted in the body to T3, which is the active thyroid hormone. When T4 and T3 levels drop, the TSH should increase indicating hypothyroidism. This is the standard way to diagnose hypothyroidism. There are many things that result in hypothyroidism but are not diagnosed using the standard TSH, T4, and T3 tests. THIS METHOD MISSES THYROID PROBLEMS IN FM & CFS PATIENTS 90% OF THE TIME!
The F & F Centers have found that there is clearly pituitary dysfunction in these diseases from a variety of causes including viruses, bacteria, stress, yeast, inflammation, toxins, pesticides, plastics and mitochondria dysfunction. This results in low normal TSH levels along with low normal T4 and T3 levels. Very few doctors understand the significance of this and will state the thyroid is fine when in reality, it is not.
They have also found that most CFIDS and FM patients do not adequately convert T4 to the active T3, resulting in low levels of active thyroid hormone and suffer from low thyroid despite having a normal TSH. Also, there is another problem in that T4 cannot be converted to T3 but it can also be converted to revert T3 which is inactive and blocks the thyroid receptor. This is a major problem, but very few physicians consider this.
Low thyroid not only results in undesirable symptoms, but it also increases the risk of heart disease and cancer. There are only a few labs that can accurately measure reverse T3 (The F & F Centers use Quest Laboratories). There is also a thyroid resistance syndrome found in these patients meaning that there may be thyroid in the blood but there is no thyroid effect. This has been discounted in the past but more and more evidence is surfacing proving that this is indeed a significant problem with these conditions.
The combination of factors present in CFS, FM, including pituitary dysfunction, high reverse T3, and thyroid resistance, results in most, if not all, patients having inadequate thyroid effect. T4 preparations such as Synthroid and Levoxyl rarely work and Armour thyroid is somewhat better, but not adequate for most patients. The treating physician must know when to use a T4/T3 combination or straight T3. Compounded timed release T3 is usually the best treatment. To achieve significant improvement the treating physician must be very knowledgeable about T3. F & F Center doctors are trained on how to use thyroid and remarkable results can be achieved.