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Wilson's Syndrome: The Thyroid's Role in Depression, Anxiety, and Other Symptoms

(Taken from: "A Brief Overview of the Thyroid System" by Dr. Denis Wilson)

You or someone you love may have a number of disturbing and baffling symptoms. Why baffling?

Baffling, because you may have been to the doctor only to be told that there's nothing wrong with you and that there's nothing that can be done to help you. Your reaction may be similar to that of many people in the same situation, depending on how badly you feel. If you don't feel too badly you may wonder about your sanity. The doctor may imply, and you may wonder, if everyone with your age and circumstances feels the way that you do. On the other hand, if you feel very badly and especially if you feel a lot worse than you used to, you may become angry because you know there's something wrong.

Problems with the thyroid hormone system can cause a large number of varied complaints. Because the thyroid hormone system regulates the metabolism, or the sum of all the body's chemical reactions, it can have very far-reaching effects. If the thyroid system malfunctions the entire metabolism can slow down causing a many classic symptoms such as migraines, depression, easy weight gain, fatigue, irritability, anxiety, panic attacks, dry skin, dry hair, hair loss, fluid retention, brittle nails, and many others. But why do doctors sometimes have such trouble recognizing and treating these problems?

Briefly, there's a gland in the head called the pituitary gland. There's a gland in the neck called the thyroid gland. The pituitary gland acts as a thermostat. When the metabolism slows down too much and the body doesn't stay warm enough, the pituitary gland secretes a hormone (Thyroid Stimulating Hormone or TSH) that stimulates the thyroid gland. The thyroid gland is supposed to respond by making more thyroid hormone, which is supposed to result in the speeding up of the metabolism. And when the metabolism speeds up to normal all should be well.

That sounds simple enough, doesn't it? However, there are two areas that confuse and mislead many physicians. The first is that many doctors don't know how the thyroid hormone produced in the thyroid gland speeds up the metabolism. The second is that most doctors don't know a good way of determining how well that stimulation is working. You can ask your doctor how the thyroid hormone produced in the thyroid gland speeds up the metabolism. S/he may respond by saying something about the thyroid hormone fitting in receptors in the cells of the body. But actually, the thyroid hormone produced in the thyroid gland (T4) is not primarily responsible for speeding up the metabolism. It is simply the raw material that the tissues of the body use to make the active hormone (T3). By far, most of the active thyroid hormone is produced OUTSIDE the thyroid gland, in the tissues of the body. That's very important.

You can ask your doctor if s/he knows a good way of determining how well the thyroid system is stimulating the metabolism. S/he may respond by saying something about thyroid blood tests. However, many patients have normal thyroid blood tests and yet still have low body temperatures and classic thyroid symptoms that respond quickly and completely to proper T3 therapy and often remain improved even after the treatment has been discontinued.

How can that be? Why WOULDN'T that be? Remember when I explained that the purpose of the thyroid system was to stimulate the metabolism to make sure it runs fast enough to keep the body warm enough? Wouldn't it make sense that measuring how warm the body is would be a good way of determining how well that was working? Looking at blood tests to see if the body's cells are being sufficiently stimulated is a little like looking at your car's gas gauge instead of the speedometer to see how fast you're going. Sure, you need gas to go but you never know how fast you're going until you look at the speedometer. A thermometer is like a speedometer. It tells you just how fast your body is going. A blood test is like the gas gauge; it shows whether or not you have plenty of raw material.

You say, "But that's obvious!" And I agree. Then where's the confusion? It's here. Have you ever heard someone working on a problem say something like, "I tried such-and-such and it didn't work so I tried so-and-so and it worked so that must have been the problem"? Or how about something like, "I tried such-and-such and so-and-so and it didn't make any difference so maybe that's the way it's supposed to be"? This thyroid mystery is really no more complicated than that. Doctors have been overlooking Wilson's Syndrome because they haven't had a good way to treat it.

On the other hand, doctors haven't overlooked hypothyroidism because they HAVE had a good way of treating IT. In hypothyroidism, the thyroid gland doesn't produce enough raw material (T4) to run the thyroid system and the body slows down, developing classic symptoms. That's like a car starting to run out of gas. And just as running out of gas shows up on the gas gauge, hypothyroidism shows up on blood tests. When a car runs completely out of gas, it stops; and when people run completely out of thyroid, they stop as well. Hypothyroidism can be fatal. Working on this problem, doctors tried giving sick people with low blood tests some T4 and they got better! So they concluded, "That must have been what was wrong with them."

However, Wilson's Thyroid Syndrome is not immediately fatal and giving patients with Wilson's Thyroid Syndrome (who are complaining of symptoms identical to hypothyroidism) T4 doesn't help very much. So doctors concluded, "I tried this, and I tried that, and neither seemed to help and the patients haven't died so maybe they're fine." But just as there are many cars that don't run properly even though they have plenty of gas, there are many people who don't run properly even though they have plenty of the raw material thyroid (T4). If a car has a full tank of gas but can't go over 30 miles per hour, there's a problem. Likewise, if a person has normal blood tests but has a low body temperature and classic symptoms of low thyroid function, there's a problem.

How'd you like to hear a fairly absurd story?

Once upon a time, there was a country that didn't have any cars. One day, cars were introduced into the country. Of course, the people didn't know very much about cars. Before long cars were seen parked in odd places like on the side of the road or in the middle of intersections. It turned out that the cars wouldn't go very far until they stopped.

One man found out from a tourist what was going on. The cars were running out of gas! He became a mechanic and was able to help anyone with that problem. People would push their cars in and he'd fill their tanks with gas and off they'd go. He even taught his clients to predict when they might need to bring their cars in based on the readings of a gauge on their dashboards. Some of his clients brought in cars that wouldn't go as fast as they used to. The gauges said there was enough gas, and the mechanic even tried putting some more gas in anyway, but it didn't help. So what did he think? "Well all cars are different, maybe these cars aren't as fast as other cars." "Maybe these folks are just imagining things, maybe their cars are going as well as ever but they just think they're running slower." "If they are running slower, maybe that's normal for cars as they get older and there's nothing that can be done about it." Or how about, "Well they have plenty of gas, and the cars are moving, so they're fine" (remember up until this point the mechanic knew of only two kinds of cars, those that move and those that don't because they're out of gas). These are all fairly reasonable thoughts considering the mechanic's experience.

One day, his tourist friend returns and shows him how to adjust the carburetors on some of these cars. Only when he sees the cars speed away does he realize the cars did indeed have an easily corrected problem! The medical profession has been overlooking Wilson's Syndrome, and doctors have been wondering if sufferers' problems have been imagined or normal because they didn't have a good way of treating it. Doctors aren't
going to realize that Wilson's Thyroid Syndrome is a very common and very treatable condition until they try the T3 therapy as described in the Doctor's Manual in a few patients and see some of them reincarnated. The fact that this story sounds so absurd only shows that we know a lot more about cars than we do about the thyroid system. 

Let's go over the most common thyroid problems and their treatments.

Hyperthyroidism: the thyroid gland produces too much thyroid hormone.
Grave's disease: can be thought of as severe hyperthyroidism.
Hypothyroidism: the thyroid gland produces too little thyroid hormone.
Hashimoto's Thyroditis: white blood cells infiltrating into the thyroid gland tissue, sometimes progresses to hypothyroidism.
Wilson's Thyroid Syndrome: the thyroid gland produces plenty of T4, but the body temperature is still low and patients still complain of low thyroid symptoms that respond well to T3 therapy.

The treatment of Hyperthyroidism and/or Grave's disease often render patients permanently hypothyroid. There are several kinds of hypothyroidism (Primary, Secondary, Tertiary, as well as those due to treatment of hyperthyroidism, and those due to Hashimoto's or other forms of thyroditis).

But they are all treated the same way: giving patients enough T4 to make their blood tests normal.

Treatment of hypothyroidism (due to any cause) may not be successful in eliminating the patients' hypothyroid symptoms because the patients may ALSO be suffering from Wilson's Thyroid Syndrome.

A car can run out of gas, but it can also have a maladjusted carburetor. Likewise, people can have Wilson's Thyroid Syndrome in addition to hypothyroidism, but most patients with WTS are not hypothyroid.

The standard treatment for Wilson's Thyroid Syndrome applies to people who are not hypothyroid, but Chapter 12 of the Doctor's Manual explains how to treat hypothyroid patients with Wilson's Thyroid Syndrome.

Wilson's Thyroid Syndrome is probably more common than all other thyroid system disorders combined!

Measuring Your Temperatures

If you have the symptoms of Wilson's Thyroid Syndrome or low thyroid function, particularly if they seem to have been brought on or worsened by stress, I urge you to see how fast your metabolism is running my measuring your temperature! Even if you "know" your temperatures are normal, I urge you to check them again.

I recommend that you use a mercury thermometer. Digital thermometers can easily become inaccurate due to being dropped and/or having low batteries. If you do not have a mercury thermometer, I recommend that you make a note on a sheet of paper right now, while you're thinking about it, and stick it into a crack of the steering wheel of your car. That way you'll be able to easily remember to get one the next time you're out.

Remember to shake the mercury in the thermometer down below 97 degrees (36.1 C) each time before you take your temperature. Grab the top of the thermometer and flick your wrist while holding tightly! (It's easy to fling them across the room and they can break). I suggest you measure your temperature 3 times a day, 3 hours apart, starting 3 hours after you wake up, for 3 days. For example, if you wake up at 7am, you can take your temperature at 10am, 1pm, and 4pm. Add your 3 daily temperatures together and divide the sum by 3 to get each day's average. If you are female, it's best not to take your temperature during the 3 days prior to your period since it's higher then. The temperature should be taken under the tongue for around 7 minutes. Do not drink anything hot or cold for at least 15 minutes before taking your temperatures. If your temperatures run, on average, less than 98.6 F (37 C), that could easily explain symptoms of low thyroid system function. Temperatures of less than 98 F (36.7 C) are particularly consistent with Wilson's Thyroid Syndrome.

What if your temperatures aren't low?

If your story is very consistent with Wilson's Syndrome, as described in the book Wilson's Thyroid Syndrome - A Reversible Thyroid Problem, then it is quite possible that your thermometer is wrong. You might try making sure the mercury is shaken down below about 96 (35.6 C) or 97 (36.1 C) before measuring your temperature. Or, you might try using another thermometer because sometimes your thermometer may read normal, but another one may indicate your temperature's low.

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Copyright Dr. Denis Wilson 2001, Reprinted with permission.

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