Women's International Pharmacy E-Newsletter March 2012

HYPOTHYROIDISM: Is 98.6° Really Normal?

During the 1860s, an extensive study of over 25,000 patients revealed that the average temperature in the “normal” range was 98.6ºF. Based on that study, we have accepted 98.6º as our “normal” temperature, with variations being cause for concern of illness or infection. However, in the Townsend Letter for Doctors, Dr. Alan Gaby cites a more recent study, which determined that the average body temperature was 98.2ºF — somewhat lower than what we typically consider “normal.”

Some medical professionals believe that an increased prevalence of mild to moderate hypothyroidism may be contributing to the lowering of our “normal” body temperature. In other words, “normal” does not necessarily mean optimal. In fact, using thousands of patients as a basis for study, Dr. Broda Barnes (author of the book Hypothyroidism: The Unsuspected Illness) promoted a simple body temperature test as the most reliable indicator of a potential thyroid problem.

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Living Well With Graves' Disease and Hyperthyroidism By Mary J. Shomon
Reviewed by Carol Petersen, RPH, CNP - Women's International Pharmacy

Living Well With Graves' Disease adn Hyperthyroidism - Mary J. ShomonMary Shomon, a patient advocate on a mission to educate people about thyroid issues, has an enormously popular website (www.thyroid.about.com) and several books under her belt.  Mary’s expertise comes from having thyroid issues of her own, and doing the research herself to help her recover her health.  She found, as many others do, that the current medical guidelines for treating thyroid disease leave many people unsatisfied, in significant discomfort, and still looking for answers.

In this book, Ms. Shomon covers the condition of having too much thyroid hormone.  However, she points out that the problem is typically not simply malfunctioning thyroid glands.  Autoimmunity—when the body’s immune system is directed at its own organs and tissues—is more likely the underlying cause.

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Is Levothyroxine (T4) the Only Answer?
Written by Carol Petersen, RPH, CNP - Women's International Pharmacy

Some of the best selling drugs in the United States are Synthroid®, Levothroid®, Levoxyl® and generic levothyroxine, or T4, as this thyroid hormone is sometimes called. This is an indication, at least in part, of a significant prevalence of hypothyroidism or low thyroid function. However, many people—including some practitioners—are now questioning the effectiveness of this hormone in treating hypothyroidism.

Practitioners typically order a thyroid stimulating hormone or TSH test when presented with a patient who is displaying signs of low thyroid activity (see Hypothyroidism: Is 98.6° Really Normal?). TSH, which is produced by the pituitary gland, has for the last 25 years been considered the foremost indicator of thyroid activity. If a patient’s TSH number is high, it is assumed that the pituitary is working overtime to try to stimulate the thyroid to produce more hormones. So the practitioner prescribes the thyroid hormone T4 and the TSH number comes down. It’s that simple: when a hormone cannot be produced, a replacement dose fixes the problem.

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Stress and the Thyroid Merry-Go-Round
Written by Kathy Lynch, PharmD - Women's International Pharmacy

    Pharmacist Corner

As difficult as it may be to decipher the symptoms of improper thyroid function, stress may also be part of the problem. Acute stress results in high cortisol levels, which interferes with the conversion of T4 to active T3. Stress does this, in part, by inhibiting the absorption of selenium and other nutrients like vitamins A, B6 and B12, which are vital to proper T4 conversion. Ironically, low cortisol levels (which result from chronic stress) also impair thyroid function by interfering with T3’s ability to enter the cells. Without making sure the adrenals are functioning properly, a vicious cycle continues, even with traditional thyroid supplementation. Oral hydrocortisone is available as Cortef® and in compounded preparations.




Staff at Women's International Pharmacy






In This Issue
Book Review: Living Well With Graves' Disease
Is Levothyroxine (T4) the Only Answer?
Stress and the Thyroid Merry-Go-Round

Upcoming Events

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National Primary Care Nurse Practitioners
July 12-14, 2012
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AZ Nurse Practitioners Symposium (AzNP)

July 27-29, 2012
Flagstaff, AZ


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Aug 15-18, 2012
Bellevue, WA

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