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Getting to the bottom of thyroid issues

High weight, low energy

Q: Ever since being diagnosed with type 2 diabetes last year, I’ve been trying to manage my blood sugar naturally. I’m having a hard time losing weight, though, and just don’t have the energy for exercise. My doctor suspected my thyroid, but the tests were normal. What could explain my situation?

Dr. Wright: Low energy levels and difficult weight control are two of the most common complaints among people suffering from diabetes. Since these are also symptoms of weak thyroid function, doctors often run blood tests for thyroid hormones. Most frequently these tests come back within the normal range, and nothing further is done in this direction.

But some carefully done research indicates that these tests may not be telling you — or your doctor — the whole story. Actually, in diabetics, blood tests for thyroid hormones only indicate how much thyroid hormone there is in the blood. In diabetics, blood hormone levels, which are found outside of cells, may have nothing at all to do with levels of thyroid hormone inside of body cells, which is where thyroid hormones do most of their “work.”

There are two major thyroid hormones, usually called thyroxine or T4, which contains four iodide molecules, and tri-iodothyronine, or T3, which contains three. T4 is considerably less active than T3. So the more T3 there is in your body, the more energy you have and the better weight control you can achieve.

But the large majority of circulating thyroid hormone is T4. Your body cells use T4 to create T3 through a process called de-iodination, which just means subtraction of one iodide from T4 so that it becomes T3. According to the study I mentioned above, this process is much less efficient in diabetics than it is in normal, healthy individuals.

So how can you and your doctor determine if there’s not enough T3 in your body’s cells?

There’s no magical solution: The only way to know is to try T3 and observe what happens. You’ll definitely need a doctor’s help with this, though, since bio-identical T3 is available only by prescription. It’s also much easier to experience symptoms of overdose when you’re just using T3 than it is with whole thyroid extract.

In the majority of diabetics, prescription T3 improves energy levels and helps weight control, and does so more effectively than “whole” thyroid, (which is one of the few exceptions to the general natural medicine rule of using whole, natural thyroid extract with all the thyroid hormones in their natural proportions). But this is one of those very special circumstances where using the whole extract simply won’t help, since your body can’t use the T4 it contains.

Of course, as with any other treatment, it sometimes does nothing. But there’s no way to predict in advance. So you may want to talk to your doctor about trying this approach. There’s a good chance you’ll be glad you did.