Monday, May 14, 2007

Contemplations on the Rise in Obesity in America

Much is said in the popular press about the rise in obesity in America, and how wide spread it is (so to speak. =D). Eric Berger has taken the stand that a little body fat is not as unhealthy as it is made out to be and per some studies, it might be healthier than a very low body fat level..

I think I know where at least some of the obesity is coming from and it is NOT any of the usual suspects (high calorie processed foods, sugary sodas, lack of exercise etc.). It is coming from doctors. Let me explain:

The standard treatment for hypothyroidism USED to be treatment with a Bovine or Porcine thyroid extract which had both T3 and T4 in them. Armour Thyroid was (and still is) a popular brand of such extracts. The doc would increase your dose until your symptoms went away and then he declared you cured. However a seachange in the way Hypothyroidism was treated occurred 20-30 years ago when synthetic T4 and cheap thyroid hormone tests became widely available. Synthetic T4 was more consistent in dosage, and did not run the risk of introducing beef or pork viruses into humans and did not run the risk of causing allergic reactions.
T4 is normally converted to T3 by the body, T3 is the actual functional hormone. Synthetic T3 came along later but was never as popular among doctors because T3 levels do not reduce the TSH (Thyroid Stimulating Hormone) levels whereas T4 does. T3 is also 3-4 times more potent than T4 so titrating the dosage is more difficult, a little bit goes a long way.

Nowadays, the standard treatment that doctors are taught in school is to give you enough Synthroid/Levoxyl/Levothroid (levothyroxine) to get your hormone levels into the "normal" range and declare you cured. Even if you still have cold hands and feet, gain weight, are depressed, have no energy, lose hair, have hyperlipidemia (High Cholesterol) etc. As far as the Doctor is concerned, as long as the lab report says the levels are "normal" the doctor will treat all your symptoms as separate problems with other causes instead of recognizing that you are still hypothyroid. A lot of these people end up on statin drugs and antidepressants and myriad other drugs, undergo gastric surgery etc. when what they really need is the doctor to treat their Hypothyroid condition.

The problem is than many people with hypothyroidism are still not asymptomatic when given enough synthetic T4 to put both the T4 and T3 levels as well as the TSH level into the "normal range". There are two possible reasons for that: One is that the T3 their body makes is either non- or only partially functional. Perhaps it has the wrong sugars attached to it so it folds the wrong way. The other is that the "Normal" range is excessively wide. Either or both could play a role.

This was the case for my wife who is hypothyroid. Just recently she was put on a combination of synthetic T4 and T3, suddenly she has more energy, is losing weight, can think straight again. She is (well almost) a whole different person. how many other HT patients are still symptomatic despite being on T4? I'd bet a lot of them, and that will skew the obesity epidemiology quite badly I'd suspect.

People with Hypothyroidism are also 10 times more likely to have coronary artery disease, so it is skewing the heart attack rates too.

So if you are taking synthetic T4 for hypothyroidism and your doctor claims you are "cured" based solely on test results while still exhibiting all the classical Hypothyroid symptoms, You might want to consider getting a new doctor.


Blogger The Dude said...

"So if you are taking synthetic T4 for hypothyroidism and your doctor claims you are "cured" based solely on test results while still exhibiting all the classical Hypothyroid symptoms, You might want to consider getting a new doctor."

Excellent advice Ror. My wife has had this very problem for the last few years and I do think she needs a doctor who is willing to look beyond the numbers. The situation gets VERY frustrating. I'm going to pass the link to your post on to her.

May 15, 2007 7:32 AM  
Blogger TxGoodie said...

Good post! Food for thought, for sure!

May 15, 2007 10:45 AM  
Blogger Ride said...

I need to get out my medical dictionary to understand a lot of what you've written. I still say that the term "medical practice" was coined for a reason! Interesting information, to be sure.

May 16, 2007 10:31 AM  
Blogger Rorschach said...

Ride, feel free to ask for clarification on anything you don't understand. I won't mind, and I promise not to snicker (too much) =D

May 16, 2007 10:52 AM  

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