SMOKINCHOICES (and other musings)

May 23, 2013

Bones – Hormones, Dr Roach

Elevated hormone level isn’t always treated

To Your
Good Health
Keith Roach

Q#1: I am a 64-year-old woman in fairly good health and take no medications.

In the past four months, I have had blood work done three times to check my thyroid and had slightly elevated thyroid-stimulating hormone scores (between 5 and 7). My doctor then tested me for antibodies, which came up negative.

I was told that, because I don’t have antibodies, I shouldn’t be treated. When I asked about the elevated scores, I was told, “We do not treat ‘old-age’ hypothyroidism.”

If my levels are elevated, what does the presence of antibodies mean? Do I have hypothyroidism?

A: I don’t know whether you have hypothyroidism.

But the issue, as far as I can see, isn’t so much the antibodies but the level of your actual thyroid hormone — free T4.

The thyroid-stimulating hormone is made by the pituitary gland in the brain, and its job is to stimulate the thyroid gland in the neck to make more thyroid hormone.

If the thyroid gland is not producing quite enough hormone, usually because of autoimmune disease, the brain senses this and increases TSH. Sometimes the thyroid gland is able to make enough hormone to be in the normal range. We call this “subclinical hypothyroidism,” or “compensated primary hypothyroidism.”

Most physicians don’t treat this condition if there are no other symptoms of hypothyroidism, such as fatigue, cold intolerance or muscle weakness.

But, in this situation, having thyroid antibodies or autoimmune disease makes the development of symptomatic hypothyroidism much more likely.

If you have no symptoms, no antibodies and normal free T4 levels, then I don’t think you need treatment. You should have periodic tests of both TSH and free T4.

Q#2: I am an 83-year-old woman who has osteoporosis. I took Fosamax and Actonel for seven years, but I don’t like the side effects. I have never had a broken bone. I have read about strontium. Is it safe to take?

A: A study of strontium ranelate published in 2004 showed improvement in bone density and noted a big reduction in bone fractures, so I understand why you would be interested in taking it.

There are a few issues. Strontium ranelate is not approved for use in the United States or Canada.

Strontium products sold as health supplements haven’t been evaluated in the same way as the prescription-grade strontium ranelate.

Second, because of the X-ray absorbing effect of strontium, the results of the bone-density test needs to be interpreted cautiously.

Finally, no drug is free of side effects. The major side effect in the strontium study I mentioned was diarrhea.

Dr. Roach answers letters only in his North America Syndicate column but provides an order form of available health newsletters. Write him at P.O. Box 536475, Orlando, FL 32853-6475; or ToYourGoodHealth  @med.cornell.edu  .

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(My Comment:

Q #1:  With regard to this lady, as it is shown,  patient doesn’t reveal enough by way of symptoms or background for any definitive reply.    One wonders however, if she  has no problematic  symptoms, why have three blood draws been done over four months.   Seems either she or her physician must have felt there was a thyroid potential issue, for insurance companies bearing rather close scrutiny now, it is unlikely to find coverage over a mere whim.  They can be highly resistant to unnecessary expenses or superfluous testing.   

Without a clue to her health picture, one must view this generically which Dr Roach has done by means of his  willingness to explain.   I enter in – –  not in disagreement, but because this was a sore spot of my own history.   

I had thyroid troubles from the time I was 18 and it never was treated properly.  My goiter was embarrassing to me.   It was surgically removed along with a lobe of the gland when I was 22.  No treatment was given or necessary they said.   Within a few years, the goiter grew back.   I was never really overweight (at 122 pounds on my 5′ 5 1/2″ frame), but I thought I was too round so I had to work on keeping my figure   I did have a few text-book issues, however. 

So I am quite aware of how it feels to have issues which the doctor  is indicating aren’t really there because there is nothing wrong which are shown by these tests. I was always within normal range, on the low side for close to 50 years.  Being left to cope on my own was difficult as I was not informed enough to change things on my own.   I had longed for a houseful of children.  I was almost 31 by the time our son came along  [with help from the doctor’s expert chicanery].  True he was perfect and the joy of my life, but all that I had saved up was maybe too much to throw onto just one kid.. . .just saying’ .  . . I appeared healthy,  capable and happy.  As an  adaptable person of moderate intelligence, a truly fine life has been enjoyed.  But I can assure any who doubt the depth of this thyroid problem we have in this nation, it is tragic for many and there has been a great deal of pain foisted onto millions  who turn to doctors for help and wind up struggling on their own, NEEDLESSLY. 

There is a huge problem  with relegating millions of people to live in frustration, misery and pain all because their test results say their numbers show there is nothing wrong;  they are in normal range. So many with much worse problems than I had have been pressured into believing the worst in themselves.  This is not what medicine should be about.  

As to those tests,  acceptable ranges will vary depending on the particular discipline of the doctor reading them.  The ranges within the laboratories are generally pretty standardized, but the levels of interpretation  within the doctor’s specialties will vary.  As an example, Endocrinologists  may grade the high to be 3.5, whereas the standard may read 0 to 5.5.  Toward another branch –  –  Naturopaths, physicians may want to see 2.5 or less.  They are not wrong.  It’s the way they work, what they are seeing. 

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But to someone like me, from my perspective,  it is folly to base an individual’s needs on the general parameters for standards which apply to a wide spectrum of the population.  There are a great many variables which enter into any diagnosis, not the least of which is the doctor’s ability to even read all those numbers and interpret them, let alone understand how they work and interplay with one another.  It is really too bad that we don’t have Bio-markers for Health, because these bio-markers for disease don’t seem to be helping a lot of us.   As an aside,  in all my years, I have only had two docs discuss, handle and explain and mark-up my blood analysis reports because they wanted me to understand.  TWO!  (both alternative).

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#2:  Well, this one is a sticky wicket for me. I am 100% opposed to any calcium ingestion at all for our bodies.  Don’t take calcium, never have.  I believed Dr McDougall’s concept about massive animals of earth who grow huge bodies  and live on grasses and plant-food.   Though our systems are of course different – – we aren’t cows, but we too can grow our bones without calcium supplements of any kind.  Just the plants of the field.  For those who haven’t seen it, I did a post called “Battered Jan” in which I took a flying leap off an embankment down 3 0r4  feet to a hard  surface and it hurt like hell but I didn’t break anything but my composure. Guess the date on it is (10-12-11).   Had all the tests and x-rays, because my doc couldn’t believe an octogenarian could experience such a thing with out coming undone.  Chalk one up for McDougall. 

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Then there is David Wolfe and who doesn’t adore David?  Well I love his advice not to ingest calcium also, but his reason is different – – its messing up our cardio system big-time!.  Stuff is no different than ordinary chalk – who needs it?  It is leaving calcium deposits all over our body in the arteries, in, on and around the heart, in our eyes and it never gets to the joints which is where we thought we wanted it in the first place.  David is big on mineralization, but get it from the wholesome, organic plants.  Eat it, juice it, just don’t take calcium tablets. 

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When it comes to scientific explanations tho, its Loren Cordain, every time.  He’s my go-to man.  Every home should have his book – the Paleo Diet.   Not going to interpolate him tonite, done it to death.  He says it better anyway. (go to FIND IT).  So chalk another up for David and another for Cordain.   Play it cool.  Just eat right, wholesome raw and /or organic plants – your choice and pastured grass fed animals if that’s your choice and only wild-caught salmon from the great northwest (not China or in the polluted waters “over yon”) 

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Do not not have your bones tested for density.   Do not take once a month or once a year anything to improve your bones.  Just eat sensibly.  Please.  BIG PhRMA is rich enough. The lady of Q2 is just lucky or has a guardian angel sitting on her shoulder.  Because it’s only a matter of time for something to break.  As for Strontium,  If I were to take something, it would be as good as anything I guess.  Dr Nan Fuchs has been selling it for a LONG  time and seems to swear by it.  Says its been used for over 100 years.  The Mayo Clinic did testing on it  in ’59 and found it very effective.   

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 Strontium  ranelate is what the pharmaceuticals called their patented form of strontium, but it was no more effective than the non-patented product and they couldn’t make any money off it, so they abandoned it.  That’s why the interest died down.  They ‘chose’ not to sell it as it wasn’t worth their time.   I repeat, we don’t need calcium.  Don’t worry about it.  Get your minerals and plenty of fresh produce – – that’s what your body needs and wants.  Medicines only get in the way and fowl things up.  Americans are SOLD more calcium than any other country in the world.  We are ill advised and badly counseled.   We also have the worst bones of any nation in the world – bar none.  We are worse off than any 3rd world country and we are paying through the nose for all our bad advice and poor care.   Do yourself a favor and do the simple stuff.  Eat good food, Have fun.  Love a lot and laugh as often as possible.      As McDougall says, our Bones are Okay.    Love you guys,  Jan)  

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