What doctors do not tell you about thyroid/adrenal disease and depression
I will use the thyroid test to explain this point but the principles apply to every lab test:
Most labs define the thyroid stimulating hormone (TSH) as “normal” if its value is between 0.4 and 4.0. Yes, the lower and upper limit of the normal range can vary from lab to lab. Therefore, if a patient has a TSH of 4.3 and shows symptoms, he or she may not get a prescription if the upper limit of “normal” is defined as 4.5. One of my doctors admitted that the sole factor in determining whether or not a patient gets treatment is the threshold TSH level of 4.00 regardless of how he or she feels. Even a miniscule lab error and/or fluctuation can and does cause an improper "no treatment" decision. Suppose a patient’s TSH is 4.01, he/she will be considered “abnormal” and receive treatment. However, a TSH of 3.99 will be considered “normal” and the patient will not get a prescription. This type of logic sure seems “abnormal” to most patients yet a doctor told me that this is exactly the standard porcedure. Moreover, taking into account a 10% error range, the lab value of 3.99 could be truly be as high as 4.39. Finally, lab values can fluctuate a bit from day to day or even hour to hour. A patient’s TSH (free from lab error) may be 3.8 on Monday morning and 4.2 on Thursday afternoon. In conclusion, taking into account the natural fluctuation and the lab error, a lab TSH that is slightly below 4.0 may actually be closer to 5.0. Mary Shoman said it best: “We’re patients, not lab values.”
It is possible that you are merely “borderline” hypothyroid or hyperthyroid when you take into account lab error and daily fluctuation. Maybe you have been tested several times and your average TSH reading is between 3.25 and 3.75 and has never been as high as 4.0. Chances are, you do not feel your best and yes, the thyroid/endocrine system really is the cause or one of the causes.
The following websites explain this point very clearly and allowed me to recognize my adrenal disease without a medical doctor:
If you cannot find a doctor who is willing to provide treatment for “borderline” cases or if you are simply dissatisfied with mainstream medicine and your current treatment plan, here is a link for thyroid “top docs” who are much more likely to help you.
Certain lab values, such as calcium and magnesium correlate with each other. I will use a hair test example to illustrate this point but the principle applies to blood tests as well. Tissue calcium may be considered “normal” between the values of 20 and 60 with an ideal value of 40. Tissue magnesium could be considered “normal” if the value is between 4 and 8 with an ideal value of 6.0. Therefore, the ideal Ca/Mg ratio is (40/6) or 6.67. Suppose a patient has a Ca value of 20.0 and Mg value of 8.0. Both would be considered “normal” in mainstream medicine so no treatment is provided. However, the Ca/Mg ratio is a mere 2.50, which is just 37.5% of the ideal value. Tissue mineral analysis recognizes this as a problem. A patient is considered to be trending diabetic if the Ca/Mg ratio is below 3.00. Such a patient will make no changes in his or her diet but will gain weight rapidly, continue to have a very low energy level and will be told that there is nothing wrong. Then, he or she will likely be diagnosed with Type II diabetes a year or two later and the treatments will be only somewhat effective because the underlying cause has not been addressed. Relating back to thyroid disease and Dr. Rind’s scale, hypothyroidism is diagnosed by a low T4 along with an elevated TSH while the reverse is true in hyperthyroidism. Suppose that both the T4 and the TSH are low or at the low end of the normal range as is often the case with adrenal disease. Typically, no diagnosis is made especially if both values are within the normal range. When I was on thyroid medication, my TSH level fell well below normal but the low TSH was not accompanied by an elevated T4 level. In fact, my T4 was usually below the optimal level listed on Dr. Rind’s website. In addition, my blood cortisol level (stress hormone) was out of balance. All of these factors should have raised a major “red flag” suggestive of adrenal disease but the doctor did not do anything about it except increase my thyroid meds, which only made things worse.
1. Incomplete testing- Minerals are key building blocks for activation of hundreds of enzymes but are rarely tested properly. When Magnesium is tested, it is almost always the useless serum test rather than the RBC, which measures the content at the cellular level. When it comes to copper, a patient with a "normal" value could very well be toxic. Ceruloplasmin, which is a key liver protein that binds and transports copper, may not be tested at all. Copper is solidly normal but becomes toxic if too much is not bound to ceruloplasmin. Without the test, there is no way of knowing how much is bound (good copper) vs unbound (bad copper) This zinc/copper imbalance is so prevalent today, I feel I must address it in detail:
Q: If all my lab values are normal, why do I feel so bad?
A: The reference range does not reflect healthy lab values. Your numbers are not normal and do explain why you feel so bad.
The following are "normal" ranges for a test that I've had done a few times
Ceruloplasmin - 15-30 (copper binding protein synthesized in the liver for transport)
Let's say that a patient receives the following results from their doctor:
All 3 are well within the range and the patient will almost certainly be told that they are fine. If they insist that they feel terrible (which they certainly do), they'll be given SSRI anti-depressants, which have no impact at all on zinc/copper balance. When it doesn't work, you will be told to increase the dose and talk to a quack psychologist in which you will field questions such as whether or not you believe you have magic powers. I've been there.
The healthy range of copper is actually 80-100 and the zinc value should be no less than total copper. Ideally, the ratio should be 1.2
Also, copper must be bound to ceruloplasmin or else it becomes toxic. Unbound copper should be no higher than 15 units or 20%.
In order to determine unbound copper, multiply ceruloplasmin by 3 and subtract it from the total copper:
In this case, bound copper is 60 units (20*3) and unbound is 90 (150-60) or 60% while the zinc/copper ratio is very low at 0.5
I recently saw a post on Facebook from a woman with 42% unbound copper who claims to have tried 30 antidepressants without success and her marriage is on the rocks. 30 different drugs! Are you serious? They call me crazy and maybe I am but the true definition of insanity is to keep doing the same thing and expect different results.
The blood test may be normal or even close to ideal but a Tissue Mineral Analysis (hair test) may reveal numerous imbalances and deficiencies that cause symptoms of fatigue and depression. Analytical Research Labs tests 10 minerals that are associated with key hormones and compares 6 mineral ratios with the ideal value. This reveals important information about your metabolic rate, thyroid/adrenal function including a test for adrenal exhaustion, blood sugar and toxic metals. I am not aware of any blood test that is designed to test for adrenal exhaustion so if you suspect it, a hair analysis is clearly the best tool to diagnose and ultimately treat it. More information about hair testing can be found on the following website:
I cannot overemphasize the importance of hair testing since it is possible to have a blood test that shows ideal thyroid and adrenal function yet the hair test correctly reveals severe imbalances and trends toward chronic diseases, the effects of which can be life-threatening in the most extreme cases. If this seems far-fetched, do not take my word for it but check out the following link about ratios and their meaning and pay close attention to the sodium/potassium or “life and death” ratio: http://www.endomet.com/RatiosDoc.htm
In short, the hormones that are critical for energy may truly be circulating at normal levels in the blood but may not be reaching the tissue cells for a variety of reasons. Consequently, it is the hair test that correctly shows the dysfunctions that cause your symptoms and provides a plan to correct them at their source. Fortunately, my condition was diagnosed before I did develop any chronic diseases and no hair test ever showed that I was in mortal danger. What if I had gone undiagnosed for another few years?
Here are some more links about hair testing vs. blood testing as it relates to endocrine imbalances:
Many other excellent articles and newsletters can be found on ARL's home page: http://www.arltma.com/index.html
First of all, symptoms of depression are often a by-product of another condition, which is one of the reasons that prescriptions are often ineffective and unnecessary. In my case, it was somewhat related to adrenal burnout and thyroid imbalance. Fully 70% of patients who take an anti-depressant continue to have unresolved symptoms. The reason is that most doctors simply assume that the patient is depressed because of a low serotonin level and do not even test any neurotransmitters. In reality, serotonin is just one of many neurotransmitters that may be causing the symptoms. A patient with a normal serotonin level and a low dopamine or adrenaline level will certainly not benefit from a drug that regulates serotonin and will continue to have symptoms of depression until all of the neurotransmitters are balanced.
In addition to numerous mineral imbalances revealed on my hair test including trends toward chronic diseases and significant energy loss, my neurotransmitter adrenaline and GABA levels were less than 50% of the optimal values. These deficiencies caused further energy depletion, poor mental concentration and panic attacks so severe that, in a few instances, I felt as if I was about to die. My serotonin and dopamine levels were not much better, which caused a persistent low mood and lack of feelings of pleasure. In addition, my taurine level was way too high because I had to take a specific amount to compensate for deficiencies of GABA and glycine. Considering that I had numerous other imbalances in addition to a serotonin deficiency, it is quite obvious why selective serotonin reuptake inhibitors (prescriptions) did little good.
Even if low serotonin is your main problem, prescriptions still may not be your best solution because they often do not cross the blood brain barrier and thus may not increase your serotonin level or relieve your symptoms.
Neuroscience uses Targeted Amino Acid Therapy (TAAT) to balance all of your neurotransmitters and thus eliminate your symptoms. Individual amino acids listed below may be a viable option if you have a negative reaction to Neuroscience products or seek a less expensive alternative. However, keep in mind that neurotransmitter support will also impact your tissue mineral levels and ratios.
Serotonin- 5-HTP, Tryptophan, St. John’s Wort
Dopamine-Tyrosine, Phenylalanine, Mucuna Prureins (L-dopa), Sam-e*
Adrenaline and noradrenalin- Sam-e*, tyrosine
*-not recommended for bipolar patients.
Important: (Tyrosine, Sam-e and Phenylalanine may increase thyroid and adrenal glandular activity especially if taken with a catalyst listed below)
GABA-theanine, taurine. (500+ mg of GABA taken with taurine may be necessary in cases of extreme anxiety) (test regularly because too much GABA also causes anxiety)
-You will need sufficient Vitamin C (1000 mg), B6 (25 mg) and methyl donors along with the amino acids to achieve maximum benefit. For example, 5-HTP or tyrosine alone may not be effective but if taken with Vitamin C, B6 and methyl donors (SAM-e, DMG), the effect is much greater.
Here are some additional links about neurotransmitters:
6. Caution about Alternative Medicine:
Before starting a nutritional supplement program, I strongly suggest consulting a holistic doctor, “health coach,” or nutritional specialist. My current health care provider told me that my self-diagnosis of adrenal fatigue was “dead on” accurate but my personally prescribed treatment plan was dead wrong. Many supplements appear to have all of the necessary ingredients and seem to be a good choice. However, in many cases, the supplements are not designed in a manner such that the necessary minerals can be absorbed by the body. Suppose that you have a calcium deficiency and view 2 supplements. One contains 100% of your daily value and the other contains 50%. It seems obvious that you should choose the first supplement. However, it is not necessarily the better choice. Calcium from the source of calcium citrate is more expensive that calcium carbonate but calcium citrate is absorbed far more readily. If you are unsure of the sources of the nutrients listed on the bottle, a good rule of thumb is to be especially wary of inexpensive products. Also, as I will explain in the FAQ section, single mineral replacement is usually not the best way to increase a level that is low on your hair test. Furthermore, inexpensive vitamins may contain “binders” which include a fair amount of toxic metals such as lead and mercury. The wrong supplement for your condition is likely to do more harm than good. It is also possible that it will be very helpful for a period of time but eventually leave you worse than before. Fortunately, the proper specialist will direct you about what to take, what not to take and how much to take. All three of these considerations are vital to your health.
How do I get a Tissue Mineral Analysis and a Neurotransmitter test?
Both tests can easily be done at home and sent by mail.
I have been working with Specialized Nutritional Support for hair and neurotransmitter tests. Overall, I have been pleased with the staff.
Here are three other sources that are better known in alternative medicine but are more expensive:
http://www.forresthealth.com/Store/home.php?cat=536 (also sells neurotransmitter)
If you cannot find a doctor in your area and prefer face to face contact to a phone consult, you can visit Analyical Research Labs at http://www.arltma.com/ and make contact by phone. They should provide you with a listing of providers in your home state.
To find a doctor in your area that tests neurotransmitters, go to:
Click on “About Us” or “Patient Resources” then click “Find a Physician near You”