Book Review: Your Thyroid and How to Keep it Healthy
The Great Thyroid Scandal and How to Survive it by Dr Barry Durrant-Peatfield MB BS LRCP MRCS, Hammersmith Press Revised 2006
This book is written by the UK physician, Dr Barry Durrant-Peatfield who trained in conventional medicine, but was subsequently persuaded by various eminent naturopaths of the veracity of their approach to endocrine problems. He has devoted most of the latter part of his career to the treatment of thyroid disorders and has received much opprobrium from the establishment for his pains.
The explanations of the physiology of the body given in this book are clear and intended for the interested layman. And the general tone of the book is sympathetic to a vastly overlooked problem which causes a great deal of physical suffering along with mental and emotional anguish as not only is the cause often left neglected and untreated, but sufferers are frequently blamed for their 'psychosomatic' illness.
He estimates that about one-third of the population have some degree of thyroid disorder of which hypothyroidism - or underactivity of the thyroid gland - is the most common.
The author expresses dismay that a condition that has been recognised for over a century and for which there is a simple and effective treatment should go so widely unrecognised and untreated by the vast majority of doctors and even specialist endocrinologists!
As he says, thyroid disorders are a serious business and can actually kill the sufferer unless properly diagnosed and treated.
He feels it is ironic that you are less likely to have the condition diagnosed and treated now than at any time in the last century and he attributes this oversight either to wilful omission or lack of knowledge of treatment. And, although thyroid disorders are sometimes tested for and treated, they are usually associated with adrenal gland disorders that are rarely diagnosed or treated by allopathic doctors.
A history of thyroid disorders
In 1877 the UK physician, Dr William Ord, when conducting post-mortems on patients he had failed to cure noticed that their thyroid glands were shrivelled, fibrous, scarred and withered.
These patients had died from a condition which began with general fatigue, weight gain, and intractable coldness, and had progressed to hair loss, bloating, extreme constipation, depression, loss of cognitive function and muscle and joint stiffness. Every system had slowed and some slipped into madness and others into comas whilst taking a year or so to die.
He coined the term myxoedema, oedema because the victims were bloated and puffy and the prefix myx- because the swelling was caused by mucin (mucous). Various therapies were tried and feeding ground-up animal thyroid glands to these patients helped them to improve. This original treatment was tried in 1892 and later dried, desiccated animal thyroid gland tablets were formulated which proved relatively successful in treating hypothyroidism until they fell from favour in 1985.
In 1914 the Belgian physician, Dr Eugene Hertoghe, took up the cause and later on in the 1930s the American physician, Dr Broda Barnes, made the study and treatment of thyroid conditions his life's work and established the Barnes Foundation in Connecticut, USA.
How the thyroid gland works
Dr Durrant-Peatfield explains clearly how the thyroid gland works to regulate all the processes of energy release within the individual cells of the body and how its hormones also act as growth hormones early in life. The chief role of the hormones produced by the thyroid gland is in facilitating the processes of energy production in the mitochondria or 'powerhouses' of the cells.
There are four thyroid hormones, all of which contain iodine. Most of the physiological work is done by tri-iodothyronine which contains 3 iodine molecules for which reason it is also known as T3. However, approximately 80% of the thyroid gland output is in the form of thyroxine or T4, with 16% tri-iodothyronine or T3 and only 4% attributable to the remaining two hormones - T2 and T1.
Thyroxine or T4 has low biological activity and is transported around the body by a carrier protein molecule. The T3 produced by the thyroid gland is utilised immediately and then the reserves of T4 are activated by one of two enzymes called 5-deiodinase which remove one of the 4 iodine molecules to produce the active T3 form in the tissues.
However, this process can become faulty and the wrong iodine molecule can be removed creating reverse T3 (rT3) which is not able to dock on to the cell receptors and is therefore not biologically active. Approximately 5% of thyroid output is estimated to be in the form of reverse T3 and many of the problems of functional hypothyroidism may relate to the synthesis of increased amounts of reverse T3.
The levels of T3 are known to be responsive to the diet and during periods of fasting T3 goes down and rT3 goes up, and levels of T3 are also altered by cirrhosis, insulin dependent diabetes and surgery. This may explain why many people have functional hypothyroidism in spite of receiving 'normal' thyroid blood test results.
There are two problems with thyroid gland function. One is that it can become overactive and this is referred to as hyperthyroidism and the other and more common problem is that it can become underactive and this is known as hypothyroidism. Both of these thyroid problems may be secondary to issues with regulation of the controlling glands including the pituitary in the brain. These problems are addressed in turn below.
Hyperthyroidism or an overactive thyroid gland
This is most frequently caused by the autoimmune disease, Hashimoto's thyroiditis, in which antibodies to the thyroid tissue are generated. This can cause overproduction of thyroid hormones initially, but over time the gland can burn itself out eventually failing and becoming underproductive. Sometimes this is caused by trauma or stress.
Often the thyroid gland becomes enlarged with hyperthyroidism and this is known as Grave's disease as it was first described in 1840 by Robert Graves.
The affected individual:
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Becomes nervous and anxious
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Loses weight in spite of having a good appetite
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Has frequent bowel movements
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Becomes breathless
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Is hyperactive - but also tired
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Feels hot much of the time
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Has palpitations
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Has tremors and
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May develop bulging eyes along with other clinical signs.
Allopathic treatment of an overactive thyroid gland often results in hypothyroidism (underactive thyroid gland) so the author counsels caution and favours more conservative treatment. Allopathic approaches include the use of radioactive iodine and/or surgical removal of part of the gland which results in the need for irreversible replacement therapy as the patient is frequently intentionally rendered hypothyroid by this treatment. As he points out, this is definitely not the same as having a responsive, fully functioning thyroid gland.
Hypothyroidism or an underactive thyroid gland
This is thought to be vastly underdiagnosed by a number of experts in the field. In fact, Dr Hertoghe in the 1990s even suggested that 80% of the population were hypothyroid to some greater or lesser degree!
In spite of the prevalence of this condition, most doctors still prefer to diagnose depression, chronic fatigue syndrome/myalgic encephalitis (CFS/ME), old age or hypochondria rather than hypothyroidism.
There are many reasons why the proper diagnosis is often missed including:
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The fact that levels of circulating hormones may only fall by a few percent
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There may be a failure to convert the largely inactive form of thyroxine (T4) into the active form tri-iodothyronine (T3)
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The thyroid hormone receptors may be blocked and so the hormone fails to dock on the tissues and
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There may also be some adrenal gland insufficiency as the whole endocrine system tends to fail together and this affects adversely thyroid production, conversion and uptake.
Although thyroid gland disorders can be secondary to pituitary gland dysfunction, primary failure of the thyroid gland is the most common cause of hypothyroidism. These primary causes include:
1. Genetic If not properly diagnosed in children, an underactive thyroid gland can have lifelong and devastating effects on the development of the brain and body of the child. This may have a genetic cause in that the gland may never develop properly or may fail during puberty or periods of stress.
2. Environmental This includes deficiencies - mostly of minerals - and exposure to toxins and particularly heavy metals. A common deficiency is that of iodine which is lacking in some inland soils, but other mineral deficiencies include selenium, calcium, magnesium and zinc.
There are a number of environmental toxins which may have an adverse effect upon thyroid gland function including the halogens (chlorine, fluorine, etc), heavy metals (including mercury from dental amalgam), excess dietary iron, dioxins, and PCBs. Some foodstuffs such as tea, coffee, the brassica family (cabbage, cauliflower, etc), soy and its products and tobacco are also known to have a detrimental effect on the thyroid gland. To this list I would also add electromagnetic and ionising radiation in all their various forms.
3. Autoimmune diseases such as Hashimoto's disease discussed above.
4. Glandular fever otherwise known as infectious mononucleosis ('mono') caused by the Epstein Barr virus, cytomegalovirus, or the coxsackie virus.
5. Major trauma This includes emotional or physical trauma.
6. Thyroid trauma This includes accidents involving whiplash where 30% of subjects are known to subsequently develop hypothyroidism.
7. Surgery Any surgery is a major trauma to the body, but gallbladder removal, uterine surgery [including hysterectomy, sterilisation or a dilation and curettage (D & C)] or tonsillectomy seem to particularly predispose to subsequent thyroid problems.
8. Pregnancy and childbirth Hypothyroidism is fairly frequently precipitated by childbirth. This is because the mother may have been using the baby's thyroid and adrenal glands during the later part of the pregnancy. Then when the baby is born the mother loses the extra support - crashing into what may be labelled post-natal depression. Also, the mother's nutrient reserve may have been greatly depleted by the pregnancy and birthing process.
Symptoms of hypothyroidism
The symptoms of an underactive thyroid gland include:
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Unexplained weight gain
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Lowered body temperature
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A lack of energy
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Depression
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Fluid retention
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Chronic constipation
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Nervous disorders
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Loss of memory and thinking ability
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Intractable headaches
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Arthralgia ie: aches and pains in muscles and joints [includes rheumatoid arthritis, ostearthritis and systemic lupus erythematosus (SLE)]
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Skin problems such as boils, spots, rashes, dermatitis and eczema
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Dry, course hair
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Pale or yellow skin colouration possibly with blue lips
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Loss of axillary, pubic, or head hair, eyelashes and/or the outer third of the eyebrows
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A deepening and hoarseness of the voice
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A feeling of discomfort or a lump in the throat
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Poor resistance to infection
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Poor quality nails which split and flake
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Raynaud's phenomenon ie: excessive coldness of the hands and feet which may become white or blue in the cold
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Carpal tunnel syndrome
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Atherosclerosis, chest pains, and palpitations
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Breathlessness
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Heavy, painful or irregular menstruation in women
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Infertility or repeated miscarriages in women
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Loss of libido in both sexes
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Visual disturbances and hallucinations
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Early or late puberty.
There are over 40 different tests that can indicate the presence of a thyroid gland malfunction including measuring blood pressure and heart rate, assessing the Achilles reflex, the presence of a scalloped tongue, and the Barnes temperature test.
Ironically, prior to the advent of thyroid function blood tests, doctors used to look at the picture in the round and diagnose thyroid disorders based upon the balance of clinical signs and symptoms.
The author discusses in some detail why now, when there are so many different tests, the wrong tests are frequently ordered and the results are so often misinterpreted by physicians.
The effects of over- and under-function of the parathyroid glands which are embedded in the rear of the thyroid gland are also discussed.
Almost every aspect of reproductive and sexual function depends upon healthy thyroid function and the effect of thyroid gland disorders on other hormones including oestrogen, progesterone, and testosterone is outlined along with the role of menopause in women.
Treatment of hypothyroidism
Dr Durrant-Peatfield examines the role of good nutrition and rest in aiding recovery from thyroid gland disorders and also the importance of supporting the adrenal glands either concurrently or prior to treating the thyroid dysfunction.
Treatment can be achieved by a combination of the following:
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Providing the nutrients required by the thyroid gland using diet and supplements.
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Using natural extracts of animal thyroid and adrenal glands (known as glandulars).
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Using the pharmaceutical, Armor thyroid, which is an extract of bovine or porcine thyroid hormones which provides a natural mixture of T4 and T3.
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Using synthetic pharmaceutical thyroxine (T4) supplemented with synthetic tri-iodothyronine (T3).
Everyone is different and deserves to be assessed on an individual basis rather than in relation to societal norms. Also note that for those that are diagnosed with hypothyroidism and prescribed thyroxine, increased amounts may be required in the winter, and in response to illness, stress or pregnancy.
The book also offers a reference section for interested physicians.
The role of thyroid disorders in fatigue syndromes
Individual chapters address the related issues of diabetes mellitus, elevated blood cholesterol, depression, growth hormone issues - and chronic fatigue syndrome. The author considers that almost all fatiguing syndromes have some degree of hypometabolism due to a thyroid gland disorder at their root.
In the author's experience, half of all hypothyroid patients can recover completely within weeks or months if they have not been ill for very long and receive effective treatment. A quarter of patients with rest and support will improve significantly and lead relatively normal lives - but never regain full health. And the remaining quarter don't get better at all or may deteriorate and may need to significantly alter their lifestyle.
If you identify with any of the symptoms listed above, this book is definitely worth reading before you approach a physician so that you are fully informed and can press for appropriate testing and treatment or a referral.
Ideally, you would detoxify your body and thyroid gland of the toxins that are poisoning its function using good nutrition and supplements.
In the half of patients that Dr Durrant-Peatfield observes either fail to respond to treatment or only partially respond, a significant cause - dental amalgam fillings, root-canal treated teeth and cavitations - may still be present. Or these individuals may still be subject to other adverse environmental, occupational or dietary influences.
The first rule of naturopathy is to remove the cause, and until this is done these individuals may continue to struggle. However, restoration of thyroid function is a longer-term objective and in the short-term you may need some thyroid support.
For more information refer to my book Chronic Fatigue, ME and Fibromyalgia: The Natural Recovery Plan which deals in some depth with the causes of thyroid disorders and the problems inherent in diagnosis and outlines a plan for the longterm detoxification of the body.
Further resources
To buy the book Your Thyroid and How to Keep it Healthy click the relevant link to go to Amazon UK or US. Other similar books are listed under Fatigue Syndromes & Toxicity in Recommended Reading.
"I suffer from FMS, and this book has been a real life saver for me. I rather randomly stumbled across The Natural Recovery Plan website whilst researching first a fluoride, then heavy metal link. Influenced by the ‘You can’t cure it’ mentality, I first borrowed the book from the library, but I thought it made total sense and just had to buy it and give it a try. Thank goodness I did!"
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