Fibromyalgia, Hypothyroidism, Thyroid Hormone Resistance

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The Metabolic Treatment
of Fibromyalgia

by Dr. John C. Lowe
Readers' Comments

Nutrition
[Q&As are placed in reverse chronological order. In other words,
the latest Q&As come first. Earlier ones are further down the page.]

Latest Updates to drlowe.com

April 22, 2007

Question:
I was taking vitamins, but I didn’t see that they were helping me, so I stopped. I just don’t see why you push nutritional supplements so much on your website and in your books. Do you make money off them?

Dr. Lowe: First let me say that unlike many doctors, I have no vested financial interest whatever in any nutritional product. Nor do I resort to the ploy that I donate royalties from supplements to charity. I don’t sell them or profit from them financially in any way.

That issue aside, I’d like to address an issue that could make all the difference in you being relatively healthy and youthful throughout your life. Many patients have told me they felt much better after they started taking nutritional supplements. I even know of a few people whose fibromyalgia and other hypothyroid-like symptoms ceased after they started taking supplements.

Conversely, many people who begin taking supplement for the first time see no dramatic benefits over night. That seems true for you. That being the case, rather than you abandoning supplements, I encourage you to consider the subtle benefits of taking them.

Take, for example, the reduction of free radicals in your body. These are atoms or molecules that have unpaired electrons in their outer shells. These unpaired electrons make the atoms or molecules extremely reactive. They are so reactive that they set off rapid chain reactions. These destabilize other molecules and produce many more free radicals. Antioxidants available in supplements deactivate free radicals.

Anti-aging experts have long argued that free radicals are the main agents of aging. Reduce your body’s free radical content, they argue, and you’ll age more slowly and maintain a more youthful appearance, even into old age.

I had the opportunity to witness a case in point when I was in chiropractic college. Once a month, I attended a meeting of a health organization in Los Angeles. Another often attendee was the beautiful silent-movie actress Gloria Swanson. She was an avid health enthusiast. So was her last husband, William Duffy. He wrote the famous book Sugar Blues, a vade mecum of John Lennon and other anti-sugar advocates. One author wrote, "Gloria was insane about the use of sugar. I mean she would go ballistic if someone used it around her. She claimed that America lost the Vietnam War because of sugar."

Gloria was seventy-five-years-old then, but she was youthful and beautiful enough to hold the attention of most of the men at the meetings—despite the presence of much younger attractive women. Had any of us guys had the chance to leave the meeting with one of the women, it would’ve been Gloria.

Nutrients such as vitamin C reduce free radicals in our bodies. But while they are doing this, no flashing neon gauge pops into the forefront of our minds with a needle telling us how low our free radicals have dropped. We have no immediately perceptual gauge that lets us how much we’ve benefited. But despite that, benefited we indeed have.

What I recommend is that you study credible nutritional literature and come to understand the subtle ways that various supplements can help you over the long haul. You can get high-quality supplements for a modest price, and ingest them quickly each day. The price and time are well worth many the subtle benefits you’re likely to get from them over the years. For example, you may avoid dying of heart disease, and you may stave off cancer. And, at seventy or eighty years old, you may well turn young men’s heads the way Gloria Swanson did mine.

March 22, 2006

Question:
I read in the book by you and Dr. Honeyman-Lowe that taking vitamin C keeps people from having colds and the flu. Since I read that two years ago, I’ve been taking 250 mg two times a day, and in that time, I’ve had two colds and the flu once. Why isn’t vitamin C working for me?

Dr. Lowe: I don’t believe you’re taking enough vitamin C, but even if you were taking more, you’d most likely still have colds and the flu on occasion. However, you’d probably have them less often, and when you did, they would likely be less severe.

An effect of vitamin C on disease in general is illustrated by a study published thirty-five years ago.[1] The study included 221 dentists and their wives. The researchers determined how much vitamin C each of the 442 people consumed each day. They also had them fill out the Cornell Medical Index Health Questionnaire. From the Questionnaire, the researchers calculated how many indications of disease each person had. Then the researchers divided the people into two groups: those who consumed less than 180 mg of vitamin C each day, and those who consumed more. Finally, the researchers separated the people into three age groups.

As the graph below shows, older people had more indications of disease. In each age group, however, people who consumed more vitamin C had fewer indications of disease. The researchers weren’t specifically studying the effects of vitamin C on colds and the flu, but what they found is relevant to your  
question: Those who took more vitamin C weren’t free from all indications of disease; instead, they had fewer indications. 

By extension from the researchers' finding, taking enough vitamin C doesn't mean you'll never have colds or the flu; but you’re likely to have milder episodes

less often. This is especially true if in your health regimen you maintain multiple preventive practices. These should include regular exercise, a wholesome diet including black and green tea, and a wide array of nutritional supplements. Among those supplements, of course, should be megadoses of vitamin C. 

Reference

1. Cheraskin E. and Ringsdorf, W.M. Jr.: Predictive medicine: IX. Diet. J. Amer. Geriat. Soc., 19:962-968, 1971.

November 2, 2002

Question:
I’m being treated—not too successfully—with 0.1 mg of Synthroid (T4) for my hypothyroidism. A couple of months ago, after reading the nutrition section of your website, I began taking nutritional supplements. My hope was that the supplements would make the Synthroid work better. After a couple of weeks, my skin turned a yellow color. My doctor thinks the cause is the carotenes I’m taking as a supplement. He told me the amount I’m taking is small, but he thinks I have a low requirement for carotenes. He said because of that, even the small amount I’m taking has turned my skin yellow. He advised me to stop taking the carotenes. But I’ve read so much about their health benefits that I’m reluctant to stop taking them. Do you know how I can clear up the yellow color without stopping them?

Dr. Lowe: You may be right that your thyroid hormone therapy probably isn't effective. If so, then the cause of your yellow skin probably isn’t a low requirement for carotenes. Instead, it's more likely that your intestinal cells aren’t converting carotenes, especially beta-carotene, to vitamin A quickly enough.

Sluggish conversion of carotenes to vitamin A, with yellowing of the skin, is common in a certain class of hypothyroid patients—those who are untreated or under-treated with thyroid hormone. Too little thyroid hormone regulation of intestinal cells slows their metabolism; as a result, the cells convert carotenes to vitamin A much too slowly. The unconverted carotenes enter the blood, raising its level and turning the skin yellow. Because of the slow conversion, even small amounts of carotenes from eating vegetables and fruits turns some patients’ skin yellow.

Most doctors will want to make sure that a patient’s yellow skin isn’t jaundice. Jaundice is a yellowish staining caused by bile pigments, often caused by liver disease. We can usually distinguish jaundice from carotene-induced yellowness by closely examining the patient. Bile pigments cause yellowing of the skin, the membrane that lines the mouth, and the sclera (the dense, white, fibrous membrane that, along with the cornea, forms the outside covering of the eyeball). In contrast, excess carotene turns the skin yellow, but not the inside of the mouth or the sclera. Hence, when the skin is yellow, but the mouth and sclera aren’t, the cause is more likely excess carotene.

Your doctor may not remember this method of distinguishing jaundice from carotene-induced yellowness. If not, by reminding him, you may avoid needless lab testing he might otherwise order. But, of course, the conscientious doctor will clear up any lingering doubts by ordering appropriate lab tests.

I’ve seen many patients with hypothyroidism and thyroid hormone resistance who eliminated their yellow skin. The patient usually did this not by restricting her intake of carotenes, but by using a high enough dose of an effective thyroid hormone preparation. The typical patient I’ve seen with yellow skin was using T4 alone. She eliminated her yellow skin through two steps: First, she switched to a thyroid hormone product containing both T4 and T3, or one containing T3 alone. Second, she disregarded her TSH level and raised her thyroid hormone dose high enough to rid herself of the yellow skin color. Usually, a dose high enough to clear up the yellow color suppresses the patient’s TSH level. At the same time, however, that dose also safely eliminates other hypothyroid symptoms that plagued her while she was using T4 alone.

October 24, 2002

Question:
I read all over the place that it’s important to our health to take omega-3 fatty acids as a nutritional supplement. But I’m confused about this. A popular biochemist on the Internet says that omega-3 fatty acids are bad for the thyroid gland. He says they cause our hypothyroidism to get worse. Do you tell your hypothyroid patients not to take omega-3 fatty acids?

Dr. Lowe: You’re not the first person to quote the biochemist and ask whether we discourage hypothyroid patients from taking omega-3 fatty acids. Jackie Yellin and I have searched for the statement by the biochemist you and others refer to, but we haven’t found it. If you’re quoting him correctly, I don’t understand his grounds for the statement. We've found no evidence that omega-3 fatty acids impair the thyroid gland. We have, however, found some evidence suggesting just the opposite—that the fatty acids protect the gland.

Japanese researchers found that among hypothyroid patients, those with higher levels of fatty acids in their blood had less severe hypothyroid symptoms. The also found that patients with lower fatty acid levels had more severe hypothyroid symptoms.[1]

Based on this finding, the researchers suspected that fatty acids somehow enable the thyroid gland to function better despite being impaired. To test their idea, they gave rats a chemical that made them hypothyroid. The chemical damaged the rats’ thyroid gland follicles where enzymes assemble thyroid hormones. The chemical also reduced the rats’ blood levels of thyroid hormone.

The researchers had some rats that were exposed to the thyroid-impairing chemical also ingest an omega-3 fatty acid. The fatty acid, derived from fish oil, was a purified eicosapentaenoic acid or EPA. Rats who ingested the fatty acid faired far better than the rats that didn’t. In rats who ingested the fatty acid, the thyroid-impairing chemical caused less damage to thyroid gland follicles. The rats’ thyroid hormone blood levels also remained higher.

The results of this study contradict what you and others say the biochemist claims. Perhaps future studies will contradict the results of this study and show that omega-3 fatty acids harm the gland. Or studies may show that the fatty acids really don't affect the gland at all. For the present, though, I can find no evidence that the fatty acids harm the gland, and only a little evidence (as from the Japanese study) that they protect the gland. The weight of the available evidence—meager as it is—compels us to encourage patients to take omega-3 fatty acids. On another page of drlowe.com, I explain some benefits of these fatty acids and why we recommend their use.

[1] Makino, M., et al.: Effect of eicosapentaenoic acid ethyl ester on hypothyroid function. J. Endocrinol., 171(2):259-265, 2001.

February 6, 2002

Question:
I just read a short article by chiropractic nutritionist Dr. G. Douglas Andersen. He described a study in which fibromyalgia patients improved by making diet changes. In the article, Dr. Andersen wrote, "But we are far from a cure." This doesn't jib with what I read on your website site. Can you please comment.

Dr. Lowe: (I read the article by Dr. Andersen, who regularly writes a very helpful column in Dynamic Chiropractic updating chiropractic doctors on developments in the field of nutrition. In response to his article, I wrote the following comments to him.)

Dear Dr. Andersen: I appreciate your describing in your article the diet modification that produced positive changes in patients’ fibromyalgia status. We have long observed that fibromyalgia patients improve and maintain their improvement only if they make similar diet changes. However, changes in diet alone have enabled precious few patients fully and lastingly to recover from fibromyalgia symptoms. Diet modification is only one component of the approach we call "metabolic rehabilitation." With all the components operating on patients’ behalf, the majority fully and lastingly recover from fibromyalgia. By "recover," I mean patients no longer meet the criteria for fibromyalgia, are symptom free, and fully functional—even at 1-to-5-year follow-up.

Many people have never heard of the body of scientific studies that are the foundation of metabolic rehab for fibromyalgia. The reasons for the obscurity are complex. For the most part, though, they involve knowledge-suppressing politics within the fibromyalgia field. A tragic result of the political dynamics is tight control over which studies receive widespread attention by being published in major medical journals. As a result of the control, when most writers outside the fibromyalgia research field, such as yourself, have occasion to write about fibromyalgia, they make statements such as this one by you: "But we are far from a cure; anyone who comes up with the nutritional or pharmacological magic bullet will be able to buy an island and fly there in his or her private jet."

The fact is, whether we call it cure or not, the vast majority of fibromyalgia patients no longer have to remain ill. A first step for them is to wrestle free from the knowledge-suppressing clique of rheumatology fibromyalgia researchers who refuse to consider scientific studies that challenge their prevailing—and false—beliefs about fibromyalgia. Next, since there isn't, and never will be, a magic bullet therapy for fibromyalgia, patients must find a clinician to guide them who is experienced in the complexities of metabolic rehab. This approach is a complex process involving diet changes similar to those you described in your article—but much more. With individualized regimens of rehab, with all the metabolism-improving components operating for the patient’s benefit, within  two to six months, most patients achieve a metabolic status that frees them from fibromyalgia symptoms and signs. These are not mere anecdotal claims, but conclusions based on analyses of the available scientific evidence. I extend an invitation to you to consider that evidence, much of which is available on drlowe.com.