Do You Have Symptoms 
of Hypothyroidism or
 Thyroid Hormone Resistance?

Dr. John C. Lowe

Below are the 69 most commonly reported symptoms of hypothyroid patients. The symptoms are also common to patients who have thyroid hormone resistance.

Conventional endocrinologists have long held a peculiar belief: that patients' symptoms are of no value in deciding whether a patient has hypothyroidism, or in finding a patient's effective dose of thyroid hormone. The endocrinologists' reason is that the symptoms aren't specific to hypothyroidism. By this they mean that other disorders can also cause the symptoms. Their solution is to use laboratory thyroid test results in diagnosing and treating patients.

It's true that other disorders can cause some of the same symptoms. But it doesn't logically follow that symptoms are of no value in diagnosing or treating hypothyroidism. Any doctor competent at deductive differential diagnosis can usually distinguish the symptoms of hypothyroidism from those of other disorders. If the doctor can't, the patient should be permitted to do a trial of thyroid hormone therapy. A trial is warranted because it's harmless when done with reasonable precautions, and the trial may confirm the diagnosis by relieving the symptoms.

With few exceptions, lab thyroid test results are meaningless without the doctor considering the patient's symptoms. When it comes to adjusting a patient's thyroid hormone dosages, using changes in her symptoms is far superior to using thyroid test results. This is clear from the studies of Johansen,[1] Fraser,[2] and our research group.[3][4][5][6][7][8][9][10] And the recently published study by Teitelbaum[11] confirms our study results.

Fraser[2] and our group have concluded that lab thyroid test results are of no value whatever in finding a patient's effective dose. In fact, using thyroid test results to decide on a patient's dose almost guarantees that the patient's treatment won't be effective.

If you have some of the symptoms below, you should ask yourself four questions:

1. Do I have a wholesome diet?	5. Do I abstain from taking metabolism-slowing drugs each day (such as beta-blockers, muscle relaxants, and narcotics)?
2. Do I take nutritional supplements?
3. Do I exercise to tolerance?
4. Do I get physical treatment as needed?

Answering no to any of these questions raises the possibility that your symptoms are caused by the issue addressed in the question.  For example, if you don't take nutritional supplements, nutritional deficiencies may the cause of your symptoms. In that case, taking nutritional supplements would relieve the symptoms. You should  consider the use of thyroid hormone only when you can honestly answer yes to all the questions.

If you answered yes to the five questions, we suggest you find an alternative doctor who is cooperative and collaborative. The doctor should be competent at differentiating medical disorders that might be causing your symptoms. For example, low adrenal function is a common cause of some of the symptoms, as our friend Dr. Barry Durrant-Peatfield makes clear in his new book The Great Thyroid Scandal and How to Survive It. As we said above, a doctor competent at diagnosis can help you determine the cause–whether it's hypothyroidism or some other disorder. It's likely, however, that the cause will be hypothyroidism or thyroid hormone resistance. Other than the lifestyle factors we mention in the five questions above, hypothyroidism or thyroid hormone resistance are the two most common causes of the symptoms.

68 Most Commonly Reported Symptoms of Hypothyroidism*
o Fatigue	o Swelling of eyelids	o Emotional instability
o Lethargy	o Dry skin	o Choking sensation
o Low endurance	o Dry mucous membranes	o Fineness of hair
o Slow speech	o Constipation	o Hair loss
o Slow thinking	o Weight gain unexplainably	o Blueness of skin
o Poor memory	o Paleness of lips	o Dry, thick, scaling skin
o Poor concentration	o Shortness of breath	o Dry, coarse, brittle hair
o Depression	o Swelling	o Paleness of skin
o Nervousness	o Hoarseness	o Puffy skin
o Anxiety	o Loss of appetite	o Puffy face or eyelids
o Worrying	o Prolonged menstrual bleeding	o Swelling of ankles
o Easy emotional upset	o Heavy menstrual bleeding	o Coarse skin
o Obsessive thinking	o Painful menstruation	o Brittle or thin nails
o Low motivation	o Low sex drive	o Dry ridges down nails
o Dizziness	o Impotence	o Difficulty in swallowing
o Sensation of cold	o Hearing loss	o Weakness
o Cold skin	o Rapid heart rate	o Vague body aches & pains
o Decreased sweating	o Pounding heart beat	o Muscle pain
o Heat intolerance	o Slow pulse rate	o Joint pain
o Non-restful sleep	o Pain at front of chest	o Numbness or tingling
o Insomnia	o Poor vision	o Protrusion of one or both eyeballs
o Thick tongue	o Weight loss	o Sparse eyebrows
o Swelling of face	o Wasting of tongue
* After L.J. DeGroot, P.R. Larsen, S. Refetoff, and J.B. Stanbury: The Thyroid and Its Diseases, 5th edition. New York, John Wiley & Sons, Inc. 1984, pp.577-578. * From Lowe, J.C.: The Metabolic Treatment of Fibromyalgia. McDowell Publishing Co., L.C., Boulder, 2000. * From Honeyman, G.S. and Lowe, J.C.: Your Guide to Metabolic Health. Boulder, McDowell Health-Science Books, 2003. References [1] Johansen, K., Hansen, J.M., and Skovsted, L.: Myxoedema and thyrotoxicosis: relations between clinical state and concentrations of thyroxine and triiodothyronine in blood. Acta Med. Scand., 204(5):361-364, 1978. [2] Fraser, W.D., Biggart, E.M., O’Reilly, D. St. J., Gray, H.W., and McKillop, J.H.: Are biochemical tests of thyroid function of any value in monitoring patients receiving thyroxine replacement? Br. Med. J., 293:808-810, 1986. [3] Lowe, J.C., Eichelberger, J., Manso, G., and Peterson, K.: Improvement in euthyroid fibromyalgia patients treated with T3. J. Myofascial Ther.,1 (2):16-29, 1994. [4] Lowe, J.C.: T3-induced recovery from fibromyalgia by a hypothyroid patient resistant to T4 and desiccated thyroid. J. Myofascial Ther., 1(4):26-31, 1995. [5] Lowe, J.C.: Results of an open trial of T3 therapy with 77 euthyroid female fibromyalgia patients. Clin. Bull. Myofascial Ther., 2 (1):35-37, 1997. [6] Lowe, J.C., Garrison, R., Reichman, A., Yellin, J., Thompson, M., and Kaufman, D.: Effectiveness and safety of T3 therapy for euthyroid fibromyalgia: a double-blind, placebo-controlled response-driven crossover study, Clin. Bull. Myofascial Ther., 2(2/3):31-57, 1997. [7] Lowe, J.C., Garrison, R., Reichman, A., Yellin, J.: Triiodothyronine (T3) treatment of euthyroid fibromyalgia: a small-n replication of a double-blind placebo-controlled crossover study. Clin. Bull. Myofascial Ther., 2(4):71-88, 1997. [8] Lowe, J.C., Reichman, A., Yellin, J.: The process of change with T3 therapy for euthyroid fibromyalgia: a double-blind placebo-controlled crossover study, Clin. Bull. Myofascial Ther., 2(2/3):91-124, 1997. [9] Honeyman, G.S.: Metabolic therapy for hypothyroid and euthyroid fibromyalgia: two case reports. Clin. Bull. Myofascial Ther., 2(4):19-49, 1997. [10] Lowe, J.C., Reichman, A., Yellin, J.: A case-control study of metabolic therapy for fibromyalgia: long-term follow-up comparison of treated and untreated patients (abstract). Clin. Bull. Myofascial Ther., 3(1):23-24, 1998. [11] Teitelbaum J, Bird B, Greenfield RM et al. Effective treatment of CFS and FMS: a randomized, double-blind placebo controlled study. J. Chron. Fatigue Synd., 8(2): 3-28, 2001. Do You Have Signs of Hypothyroidism or Thyroid Hormone Resistance? © Dr. John C. Lowe, PLLC 2006