In a message dated 1/23/04 12:06:21 PM Eastern Standard Time, 
[log in to unmask] writes:

> From:   J Hayes <[log in to unmask]>
> Subject: <No subject given>
> 
> I would like to thank Nancy and Greg for info on amio darone.I didn't give
> all the details in my message, because its a long history. 

I posted a long explanation of M.E.  from Dr. Barry Durrant-Peatfield 
earlier.  (i believe we're supposed to give a disclaimer that we don't profit from 
this book.)  He wrote another paper for the Internet called 
MANAGEMENT OF THYROID DEFICIENCY
by Dr Barry J Durrant-Peatfield
M.B., B.S., LR.C.P., M.RCS.

Below this point, I put an ** by my comments, all others are excerpts from Dr 
D-P.  Some things from there also relevant to your condition -

Hypothyroidism is due either to:
A.      Deficiency of thyroid hormone production;
B.      Failure of thyroid hormone to reach the tissues.

Both may operate together in varying degrees.

**Below, gives glandular fever as one of the reasons behind A above.  Maybe 
the illness you mentioned.  One thing low thyroid will do is cause poor 
circulation, even heart palpitations and other problems.  The worst thing for your 
heart is to be low thyroid.  And you were probably inadequately treated.  So, 
your heart problem may have simply been one of the many thyroid symptoms.

>It was ten years ago,
>when I would experience a pain in my throat, and the irregular heartbeat,
>difficulty breathing, even my eyesight would fade for seconds, then I would
>collapse.

**Adrenals and thyroid work together.  It wouldn't surprise me to find that 
was a factor, in this case.  Low adrenals make you feel faint when standing.  I 
know low thyroid can cause difficulty in breathing and so can low adrenals.

Deficiency of hormone production is due to:
1.       Environmental toxins/deficiencies
2.       Genetic thyroid failure
3.       Thyroid failure secondary to pituitary insufficiency
4.       Thyroid surgery
5.       Treatment of previous over-activity
6.       Major surgery
7.       Tonsillectomy
8.       Major trauma
9.       Glandular fever

Failure of hormone to reach the tissues results from:
1.       Receptor resistance, or failure
2.       Dysfunction of T4-T3 conversion
3.       Adrenal insufficiency


** Below he  mentions amiodarones, which Nancy told you about, as an 
environmental toxin.  Which means if nothing else, your dose would have had to be 
increased to compensate and that's only if you could convert T4 to T3.  Doc Don 
has called our area as still being the goiter belt, I see PCBs are listed and 
our fishing licenses come with a pamphlet that tells us not to eat certain fish 
from certain areas because they contain these.  Then there was one woman in 
Detroit whose PCBs were extremely high, she never ate fish, and they never found 
the source.  Plastics aren't thought of as a toxin, but we use it a lot for 
food, and even if we didn't know it was a toxin, we knew it was estrogenic.  We 
also know of a book that says avoiding plastic is a cure for all cancers.  

Dealing in turn with the therapeutic management of these problems, we may 
turn first to (A)Thyroid hormone production failure. This will be due to:
1.       Environmental toxins and deficiency
          a)Toxins

-A number of chemical agents tend to interfere with the manufacture of 
thyroid hormone. -Notables among these are:

-Poly chlorinated Biphenyls (Paints and wood preservatives)
-Resorcinol (Millet)
-Phthylate Esters (Plastics)
-Thiouracil (Cabbages, Turnips, Cassava.)
-Anthracin
-Bromoform
-Cyanides (Barbiturates)
-Fluorides
-Thiocyanates (Smoking)
-Caffeine
-Aspirin
-Lithium
-Amiodarones

The elimination of these from the diet may be desirable, if not always 
practical.


**Iodine deficiency in an island country, I was surprised the first time I 
heard that, everywhere is so close to the ocean and I would think would have 
seafood.  

b)Nutritional Deficiencies
(i)      Iodine. Endemically absent in certain inland areas e.g. (Peak 
District, UK)
(ii)Minerals, in particular:
          Selenium
          Iron
          Magnesium
          Zinc

(iii) Vitamins.

          Vit A - Conversion of Carotene to Vit A is inhibited by low thyroid 
states, and may cause yellow pigmentation. It controls uptake of Iodine into 
the thyroid gland. Deficiency also reduces TSH

          Vit B Riboflavin, Niacin, Pyridoxine play a role in thyroid hormone 
manufacture.

          VitC & VitE - Deficiency has been shown to cause hyperplasia at 
cellular level in the thyroid. Clearly, part of the management of hypothyroidism 
requires some dietary advice; the provision of iron and vitamins and other 
minerals is simple and obvious.

**I've wondered about iron.  Some consider it toxic and unnecessary.  (Ray 
Peat, biochemist for one.) Mine tends to run a little low, but kind of wonder if 
I should take it regardless.

7.       Tonsillectomy.
Quite why in adults, tonsillectomy may result in slow running down of thyroid 
function is not clear, but may be the result of interruption of the blood 
supply. The present writer has noted a number of cases of young adults 
misdiagnosed as M.E sufferers in this situation. Replacement therapy provides a most 
satisfactory return to normal.

**I find this interesting since my son needed thyroid meds only after 
tonsillectomy at age 10. 

Vague fears that thyroid is like "speed"; that any deliberate or accidental 
overrunning of the metabolism will result in early "burn out"; have been 
expressed. All that can be said is that is simply not true.

**I think this was written even before some of the doctors attacking Derry 
said thyroid was like speed.  So, it must not be something they came up with 
just to persecute Derry.  

b. Basal Pulse. This may be taken at the same time as temperature; overdose 
will result in a rise of the resting pulse. 80 bpm will usually signify 
overdose.

**I get irritated whenever I see a magic number for pulse rate, especially 
80.  I used to jog in high school and I would read that those in excellent shape 
had a pulse around 60.  So, I would take my resting pulse and it would go to 
60 and keep on going and it was a bit closer to 90, than 60.  Actually it was 
somewhat above 90.  Furthermore on 100 mcg of Synthroid, my wife's pulse rate 
was 100+.  Did that mean she was overdosed?  Well. she was put on Armour, went 
up to 18 grains (1,080 mg, and incredible amount), and her pulse rate dropped 
to 70.  And her BP dropped to normal.  So, I don't think they should keep 
using that number.  Anyway, Ray Peat says the average pulse rate in a healthy 
race is 85.  That's average and some will be higher or lower than others, so 
Atkins, Langer and Durrant-Peatfield ought to stop focusing on that number.

4.       Receptor resistance or deficiency:
Resistance to the passage of T3 via the receptors has been seen in a number 
of cases. Why this occurs is not clear, but long periods of thyroid dysfunction 
are associated. The replacement dose of the chosen thyroid hormone has to be 
much larger than usual, which may cause some heart searching. Deficiency 
results from a protracted low thyroid state; prolonged low levels de-sensitizes the 
receptors. This will improve with time, and treatment of any Adrenal 
insufficiency present.

**May be one of the reasons my wife could take 18 grains of Armour and still 
seem to need more.  

**And here we start getting into some specific things you mentioned, episodes 
of collapse, bad response to illness, multiple allergies (or chemical 
sensitivities), and fainting -

5. Adrenal Insufficiency
This might be more properly described as low adrenal reserve. Since 
hypothyroidism adversely affects every cell, every tissue, and every gland in the body 
it is clear that the endocrine system as a whole will be also similarly 
affected. The adrenals will be subject firstly to lowered efficiency resulting from 
a lowered vitality primary to hypothyroidism, and secondarily, to reduced ACTH 
stimulation from the pituitary. As a result, in general, patients with a 
protracted and/or severe hypothyroid state will have some degree of adrenal 
insufficiency. A significant level of this will be suspected in these situations:

a.       Longstanding and severe hypothyroidism.
b.     Episodes of extreme exhaustion, or collapse.
c.      Bad response to minor illness.
d.     Multiple allergies.
e.      Digestive problems – alternate diarrhea and constipation
f.       Flatulence
g.     Weight loss
h.     Increasing arthralgia (fibromyalgia) and morning stiffness.
i.       Pallor, yellow pigmentation (due to poorly metabolized carotene)
j.       Fainting, dizziness

These patients often present with dark rings under their eyes, looking quite 
ill. Blood pressure is low, with a positive Raglan's sign. (Pressure fails to 
rise on standing). These symptoms and signs, it will be appreciated, are those 
of the early phases of Addison's Disease.

**Sometimes if the adrenals are treated, the thyroid doesn't need treatment -

It is essential to manage this insufficiency where present, or where 
suspected. Remarkably, patients with symptoms, signs and blood pathology of low 
thyroid, may improve completely on management and correction of the adrenal problems 
alone; as conversion and receptor efficiency improves, the thyroid hormone 
circulating - partly unused - is brought into play.

**Replacement doses don't have the related side effects of corticosteroids -
Adrenal insufficiency is dealt with by the provision of the two hormones most 
likely to be lacking; Cortisonehydrocortisone, and DHEA. (as pointed out 
above, low DHEA may be used to infer low cortisone output). The treatment 
therefore, is the exhibition of, ideally, Hydrocortisone. This should be given in 
divided doses initially of 5mg qds; after a week, 10 mg qds may be used. This 
remains a physiological dose, not challenging or suppressing the adrenal function, 
but supplementing it. In these doses all of the usual anxieties associated 
with 
cortisone do not apply, since restoration of normality is being aimed at.

>  after
> all these years of avoiding antibiotics, I had to take three courses to try
> to clear the ear infection, but, to date,, has not succeeded.

**I use hydrogen peroxide in my ears.  Mercola (www.mercola.com) says that 
through the ears is one way we catch illnesses and this will stop a cold before 
we get one.  When I'm sick and have sinus troubles, I do feel better if I put 
hydrogen peroxide in my ears, it may help them drain plus it may kill some of 
the bacteria trying to crawl around in there.  If I think about it, it doesn't 
make much sense to me to take pennicillin or ceclor (which my children got 
monthly for a long time) orally when the problem is in the ears.  A topical 
treatment seems to be more logical.  

**Of course, I do know people who get yeast infections whenever they take 
antibiotics.  

**If one needs T3 and only gets T4, I've heard a person describe this as 
"toxic" and I kind of agree.  Not all people who are hypothyroid improve on 
thyroxine alone, if they are on too low a dose the literature says it can exacerbate 
symptoms, which means make them worse, and that's where many doctors leave 
most people.  And if they need T3, I believe it will make the person worse than 
not taking thyroxine at all.   Some need dessicated thyroid, others pure T3 
and some need adrenal support like Cortef.  It's not uncommon for those with low 
adrenals to not do well on thyroid meds and to be especially sensitve to even 
small increases in dosage.  

Skipper




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