Saturday, November 10, 2007

Hypothyroidism – A Major Risk Factor For Atherosclerosis

Conventional medicine is missing the primary causes of heart disease. For example:

60% of all heart attacks occur in people with normal cholesterol levels.

The majority of people with high cholesterol never suffer heart attacks.

What is the rest of the story? Could it be related to low thyroid function?

Broda Barnes initial research
Dr. Barnes noted that before the era of antibiotics, coronary artery disease was almost unknown. A certain percentage of the population was susceptible to tuberculosis and infections in general, and they would typically die young from infectious disease, primarily tuberculosis. Then came antibiotics and an entirely new population of people appeared: people who were susceptible to both infection and to coronary artery disease; except now they were enabled to live long enough to die from the slower of the two diseases: coronary artery disease.
Dr. Barnes noticed that the death rate from coronary artery disease in 1970 was ten times that of 1930. Statistically, the death rate would be expected to be double, not ten times the 1930 rate. The only way he could explain this to himself was that the people who were saved from tuberculosis were almost all dying of coronary artery disease.
Why would this be happening? What common denominator would there be to people susceptible to both severe infections and heart disease? Dr. Barnes knew from with his extensive experience treating thousands of people with thyroid replacement therapy that the incidence of both infection and coronary artery disease is dramatically reduced by thyroid replacement. Dr. Barnes realization that thyroid deficiency is the common denominator in both susceptibility to infection and coronary artery disease.
What about treatment? Does treatment with Armour Thyroid help?
Broda Barnes carefully compared the rate at which heart disease was seen among his patients with the prevailing rates of heart disease Among 1,569 patients that he followed for 8,824 patient-years, only 4 new cases of CHD were observed (Barnes noted they were only taking 2 grains a day and wondered if the dose was too low). This is a staggering 94% reduction in the expected incidence of the disease.

Dr. Barnes observed a 94% reduction in Heart Disease with Armour

Atherosclerosis – coronary artery disease and its associated complications are the most serious side effects of an underactive thyroid. Unfortunately, Broda Barnes work was largely ignored. Some tried using Armour but often ignored the need to start at low doses and in the physicians hast in starting at too high a dose caused problems. Barnes had recommended starting with ¼ grain tabs after a heart attack.

Since Broda Barnes’ research, heart disease remains the number one killer in this country and there are no signs of that changing anytime soon. If you asked most people on the street which they fear more, cancer or heart disease, they'd probably say cancer. But for every person you know who has died of cancer, you can probably think of another 20 who are on cholesterol or blood pressure medication, have had bypass surgery or angioplasty, or have died from cardiovascular problems.

Neutralizing Cholesterol with Thyroid Supplementation
In Russia, experiments with rabbits showed that while feeding cholesterol alone increased heart disease in rabbits, adding thyroid neutralized this effect. Sadly, the medical community latched onto the cholesterol theory and ignored the important role that hypothyroidism plays in producing heart disease.

Additional Research includes:
1. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study Ann Intern Med. 2003 Nov 18;139(10):866 Data on thyroid status, aortic atherosclerosis, and history of myocardial infarction were obtained at baseline in a random sample of 1,149 women (mean age, 69 years) participating in the Rotterdam Study (Rotterdam, The Netherlands):
Subclinical hypothyroidism was present in 10.8% of participants. The risk of heart attack was 2.3 times those without hypothyroidism. Additional adjustment for body mass index, total and high-density lipoprotein cholesterol level, blood pressure, and smoking status, as well as exclusion of women who took beta-blockers, did not affect these estimates. Associations were slightly stronger in women who had subclinical hypothyroidism and antibodies to thyroid peroxidase with an odds ratio for myocardial infarction of 3.1.
The results of this epidemiological study suggest that subclinical hypothyroidism is a strong risk factor for atherosclerosis and myocardial infarction in elderly women. Moreover, although hypothyroidism is known to increase serum cholesterol levels, the association between thyroid function and cardiovascular disease found in this study was independent of cholesterol levels.
2. Ann Intern Med 1999; 131(5):348-51 showed a connection between low thyroid and increased homocysteine which is strongly associated with heart disease (more below).
3. Archives of Internal Medicine, November 29, 2005 showed that low thyroid function was associated with heart disease risk. Rodondi N et al. Subclinical Hypothyroidism and the Risk of Heart Failure, Other Cardiovascular Events, and Death. Arch Intern Med. 2005;165:2460-2466.
4. Arch Intern Med. 2005;165:2467-2472 demonstrated hypothyroidism was associated with an increased risk of congestive heart failure (hazard ratio of 2.3) Walsh JP et al. Subclinical Thyroid Dysfunction as a Risk Factor for Cardiovascular Disease.
5. 1971, Dr. James C. Wren reported an extensive five year study with 347 patients with cardiovascular disease. All were treated with thyroid and saw a 44% lower death rate in his thyroid treatment group than expected.

What is the relationship between the thyroid and heart attacks? Why does low thyroid adversely effect thyroid function?
Research over the past forty years has clearly shown a direct relationship between heart attacks and sluggish thyroid function. A few key concepts emerge as we look at the effect of low thyroid function on the heart:

Mucin deposition from low thyroid activity causes atherosclerosis to develop
Studies have shown that low thyroid levels causes a glue-like substance called mucin (mucopolysaccharides) to accumulate causing a cascade of biochemical changes leading to a degeneration of the arteries. Other studies have shown that the removal of the thyroid gland soon leads to atherosclerosis.
Researchers have discovered that mucin can even develop in children who have insufficient thyroid function. They found out that as long as thyroid is administered, the tissue would be normal. But if thyroid therapy was stopped, mucin rose rapidly. If thyroid therapy was begun again, the mucin content returned to normal. Therefore, one of the many preventive measures that can be done to prevent the possibility of heart attacks is to ensure the proper amount of thyroid is in the body.

The Thyroid/Homocysteine Connection
Studies continue to establish stronger links between even moderately elevated blood levels of homocysteine and heart disease. In the 1992 Physicians' Health Study, men with very high homocysteine levels had a risk of heart attack three times that of men with normal homocysteine levels. In fact, an elevated homocysteine level was such a dominant factor that it indicated increased risk even in the men who had no other cardiovascular risk factors.
Because of the importance of homocysteine levels as a heart attack risk factor, efforts have thus far concentrated on lowering high levels through any means possible. And up until now, the only consistently successful approach has been to increase the intake of the B vitamins especially folate, B6 and B12. However, new research indicates that simply lowering homocysteine levels in this manner may be masking a more serious underlying problem, the one that's causing the elevated levels in the first place. This bigger problem is an underactive thyroid.
Researchers at the Cleveland Clinic Foundation in Ohio have released new findings showing that correcting an underactive thyroid gland normalizes elevated homocysteine levels in the blood. Even more amazing is that the researchers were able to normalize homocysteine levels without having to administer any of the B vitamins. In other words, correcting the thyroid problem in turn corrected the vitamin deficiency. (Ann Intern Med 99;131(5):348-51)

We can now look Dr. Barnes' observations and see how inflammation and free radical mediated heart disease would be mitigated by thyroid replacement. Excess hydroxyl radicals left over from lipid peroxidation cause tiny areas of inflammation, then necrosis (tissue death), in the walls of arteries. When the body tries to repair this necrosis it forms a scar tissue and incorporates into the scar tissue calcium and cholesterol. The body's natural defense this oxidation (which is similar to rusting) is to produce antioxidants, which neutralize hydroxyl free radicals before they can do damage. Thyroid hormones regulate the rate of metabolism and when sluggish metabolism is present the rate at which antioxidants are produced would be slowed. Therefore, there would be less antioxidants, more free radicals and oxidative damage and similar to rusting we would see the vessels damaged and atherosclerosis would proceed more rapidly.

The sequence appears to be that: Low thyroid function à decreased antioxidant production à vascular lesions à scar (plaque) formation àeventual artery blockage à heart attack or stroke ( "brain attack," as it is now called), or gangrene, or any set of symptoms caused, or contributed to, by decreased blood flow to organs.

Low Cardiac Output/Cardiac Muscle Fatigue
The above mentioned Arch Intern Med. 2005;165:2467-2472 study demonstrated hypothyroidism was associated with an increased risk of congestive heart failure. This is basically sluggish muscle function but in this case the muscle is the heart. If you have a weak pump you have a greater chance the flow will be low in plugged arteries and this increases the risk for a heart attack and stroke.

Causes of Hypothyroidism (why is this problem so common?)
Genetics would be one because typically we live with hypothyroidism long enough to have children.

Estrogen Dominance is caused by petrochemicals, fuel exhaust we breath, estrogenic hormones in meat and chickens, plastics, propylene glycol, sodium laurel sulphate in ointments, herbicides and pesticides. These potent estrogenic substances block the production of thyroid hormone and greatly magnify the incidence of estrogen dependent cancers. All males and females in developed nations have estrogen dominance.

Antibiotics, chlorine from our water purification systems, fluoride, and NSAID drugs used for arthritis all kill the healthy bacteria in the intestinal tract. This results in overgrowth in the intestines of candida, fungi, mycoplasma, and anaerobic bacteria (Yeast syndrome). These dangerous organisms release powerful neurotoxic substances into the blood stream that damage the hypothalamus often resulting in multiple endocrine disorders including under activity of the thyroid gland.

Mercury released from our dental amalgams is toxic to the thyroid gland.

Fluoride in our water directly interferes with thyroid function.
Selenium deficiency is related to lack of trace minerals in our soil. The proper conversion of precursors into thyroid hormone depends on a selenium containing enzyme which is lacking.

Lack of iodine in our soil and diet leads to decreased thyroid hormone production.

Diagnostic x-rays injure the thyroid gland (dental, neck, spine).

Perchlorates widely found in drinking water inhibit the production of thyroid hormone by blocking the reuptake of iodine

In the light of these common issues it is remarkable that anyone has normal thyroid function!

Diagnosing Hypothyroidism
Dr. Barnes felt that 40% of Americans suffer from inadequate thyroid. Nobody disputes that hypothyroidism is common and commonly untreated. Even groups that use blood tests alone such as the American Association of Clinical Endocrinologists state 20% of Americans are Hypothyroid. Dr. Arnold Jackson reported in the Journal of the American Medical Association that “Hypothyroidism is the most frequent chronic affliction and at the same time the most often overlooked condition…”

I wonder if things are not worse now with the increase in pollution. Since almost ½ of humanity is low on this key hormone, we would expect the addition of Armour Thyroid to the appropriate individuals to save million.

Signs and Symptoms of Hypothyroid
How do you know if you have low thyroid? Primarily it is by the pattern of having typical symptoms and signs of low thyroid (hypo – Latin for low ..thyroid) such as: weakness, dry skin, coarse skin, lethargy, slow speech, swelling of the eyelids, sensation of cold, decreased sweating, cold skin, thick tongue, edema of the face, coarseness of hair, heart enlargement, pallor of skin, impaired memory, constipation, weight gain, loss of hair, pallor of lips, labored or difficult breathing, swelling of the feet, hoarseness, loss of appetite, nervousness, excessive and/or painful menstruation, deafness, palpitations, poor heart sounds, pain over the heart, poor vision, changes in the back of the eye, loss of weight, emotional instability, choking sensation, fineness of hair, cyanosis (bluish skin), difficulty in swallowing, brittle nails, depression, muscle weakness, muscle pain, joint pain, burning or tingling sensations, heat intolerance, slowing of mental activity, slow movements.
One may also see high cholesterol, hardening of the arteries, heart attacks, digestive problems, emotional disturbances, allergies, asthma, recurring infections, anemia, all types of skin problems like eczema and psoriasis.
Sadly, hypothyroidism often goes undiagnosed because blood thyroid values are usually within the broad reference ranges. What blood tests cannot tell us are changes within the range which take us out of our individual range or problems related to the utilization or regulation of thyroid hormone.
Dr. Barnes recommended a simple test, called the basal body temperature test, which anyone can easily perform at home. The temperature test should be done upon awakening in the morning, but before leaving your bed.
If you are male or a non-menstruating female, take a digital thermometer or an oral mercury thermometer (which has been shaken down and placed at the bedside the previous evening) and place it in your armpit for 10 minutes immediately upon awakening while lying quietly in bed. Repeat the test three days in a row. Normal temperature is 97.8 degrees to 98.2 degrees. If your temperature is low, your thyroid gland is probably under active. The temperature should not be checked during menses.

It was the opinion of Dr. Barnes and all of us at the Hotze Health & Wellness Center using the natural thyroid supplement; Armour Thyroid is the best kind because it contains all the essential thyroid components that are not found in other thyroid drugs such as Synthroid®.
Natural Thyroid Supplementation
Add Iodine (Iodoral) and Selenium
Never drink tap water – avoid fluoride and chlorine (see Oct NWC Newsletter on Chlorine)
Eat Organic
Avoid Pesticides, Herbicides & Plastics
Optimize Vitamin D


in addition to the above steps to optimize thyroid function:

- Eat less refined carbs - cookies, white bread, and even fruit juice.
- Eat 9+ servings of vegetables and fruit and supplement with fruit/vegetable capsules which has been clinically shown to lower cardiac score, lower blood pressure, improve vascular compliance, lower triglycerides, lower homocysteine, improve blood sugar control and raise anti-oxidant levels, see the Vanderbilt Study)
- Multivitamin with B-vitamins and Selenium (i.e. Power Pak) 1-2 /d
- Vitamin C, L-Lysine and L-Proline (Dr. Hotze Cardio Powder)
- Exercise (Interval training and not just “cardio”)
- Eliminate all trans fats and partially hydrogenated fats - eliminate corn oil and margarine. Use olive & coconut oil and butter instead.
- Add Fish Oil
- Suspect hypothyroidism and get it treated with Natural Thyroid. Test your basal body temperature first thing in the morning to see if your thyroid function is lower than normal ( 97.8 - 98.2 degrees is normal)

To your health!

Donald P Ellsworth, M.D.
Feel free to pass this information on to others