Another Indicator of Hypothyroidism

nobimbo · 09-11-2004, 12:00 PM

I thought this was interesting and wanted to share:

Taking your pulse

Your pulse rate is an important indicator of your metabolism and general health, including thyroid balance. If you have a slow pulse it can be a sign that you have a more sluggish metabolism, low thyroid, and that you may be experiencing other health problems. A faster pulse can indicate a more rapid rate of metabolism, overactive thyroid, and can also point to other health problems as well. Your pulse is a good indicator of how your thyroid system is working, and if thyroid supplementation is necessary, or if the dosage you are taking is working. The thyroid gland and hormones it releases into the body have a direct influence on your metabolism.

Scientists performed tests on elderly patients and a group of young students to better understand pulse rate and metabolism. The study found that students with a pulse rate of 85 beats per minute generally did better on tests and were more alert than other students with lower pulse rates. Scientists also monitored a group of elderly heart patients with pacemakers, where the heart rate could be adjusted to different levels. The scientists learned that when the pacemakers were set at 85 beats per minute, that the heart patients were more alert, felt better, and performed better on tests.

So 85 beats per minute is a good target level for daytime pulse, and a good indicator of overall health. Yet don't jump to conclusions based on pulse alone, and don't be too quick to react or change doses if your pulse is low. Healing takes time, and you are looking for overall trends over longer periods of time.

During routine physical exams, doctors and nurses will often comment to seemingly healthy youthful people, or sometimes even to older folks, telling them that their slow pulse rate is a very healthy condition and shows that the person must be an athlete or runner. It is surprising how many of us have heard this at some time in our lives. These doctors are wrong, this is not a healthful state or desirable for heart health, but is a very good indicator of suppressed thyroid function. A low thyroid condition is quite common to distance runners and extreme athletes, and is not healthy by any means. Studies of marathon runners and extreme athletes as a whole have repeatedly shown that thyroid problems exist, often difficult to treat, which is the cause for slower than normal pulse rate.

Now maybe you are beginning to see why monitoring and recording your pulse is an important part of monitoring overall health. Don't neglect to monitor and record your pulse in conjunction with taking your temperatures. As time goes on you will notice important changes and trends that will help you take charge of your health.

How To Take Your Pulse

Make sure that you have a watch or clock with a digital or second hand feature. Place it nearby with the dial within your view. Using your index finger and thumb, or middle finger and thumb, gently press your fingers to either side of your throat at the top of your neck. Keep your fingers several inches apart, to the sides of your windpipe. As you press back gently on either side you should be able to easily feel the pulses as your heart pumps blood through these major arteries. This is a good place to take a pulse, where it is easy to feel the heart beats. Don't push too hard or it can make you light headed, just be real gentle.

Count these pulses for exactly 15 seconds, then multiply by four, which gives you your heartbeats per minute. Write it down. Go ahead and count the pulses for a whole minute if you like. If done right, the 15 second method will be the same as counting them for a minute, yet much easier.

If you have trouble monitoring your pulse at your neck, or if it makes you light headed (don't push so hard!), then try the wrist method, which works just as well.

Use your thumb or several middle fingers to find your pulse at your opposite wrist. This works best when you hold your wrist limp, letting it relax and hang a little, either backwards or forward, then press the tips of your several middle fingers or thumb (whichever works for the way you are holding your wrist) near the bend in your wrist near the base of your thumb. As you explore the softer areas between the tendons (usually best to the side of your wrist at the base of your thumb) you will feel your pulse. If it is not found in the very bend of the wrist, then move an inch closer to your arm and away from the bend in your wrist. It won't be long until you become a pro at finding and taking your pulse.

If your average basal resting pulse is in the range between 65-75 beats per minute, this is considered normal. If your average daytime resting pulse is in the range of 75-85 beats per minute, this is considered normal.

If your basal pulse rate is consistently under 65 beats per minute and your daytime pulse rate is consistently under 75 beats per minute, this is considered low. Coupled with low body temperatures, this is a good indicator of a low thyroid condition.

If your basal and daytime pulse rates are consistently higher than the normal top basal limit of 75 beats per minute and top daytime limit of 85 beats per minute, this is considered high. There are numerous things that can cause a rapid pulse, but coupled with low body temperatures it may be a good indicator of an overactive thyroid condition.

http://www.thyroidrevolution.com/solutions/pulse.htm

VitaBella · 09-11-2004, 01:41 PM

This is so disturbing with me. I have low body temperature (usually around 97 degrees) and my pulse has ALWAYS been low.

I just took my pulse and it was 16 beats in 15 seconds = 64 beats per minute.

My TSH is still just "borderline," though. I am having it tested again next week to see if the results have changed. My doctor seems willing to medicate around the 3.0 range and after SEVERAL tests at that level, my last test (first visit to this doctor) came back around 2.7. UGH!

I feel strongly that I need to be medicated for hypothyroid. I guess I'll just have to wait and see what happens...

But I did want to say that I've often been told that having a low resting pulse was healthy! In fact, I posted on here asking about that before.

nobimbo · 09-11-2004, 06:01 PM

Jen, have you had the TPO antibodies test? If you have antibodies present, it can throw off all the other thyroid tests. Many, many Hashi's patients have symptoms but test within the normal lab ranges. I suggest you find a doc who does not use the TSH alone for diagnosis, as it is very unreliable for those with Hashi's. Since you have PCOS, you are at a higher risk for Hashi's, and it sounds like you certainly have the symptoms. Read this great article called Understanding Thyroid Lab Tests by a doc over the at about-thyroid.com site:

http://thyroid.about.com/gi/dynamic/...%2Fwoliner.htm

Finding a good thyroid doc isn't easy, and you can't always trust the ones listed on the "Top Thyroid Doc's" list. I learned that the hard way yesterday when I finally had my appointment with a supposed top doc. In my case, the doc was too quick to prescribe a med (he ONLY prescribes Cytomel for all of his patients), and I had to push to get him to run thyroid tests for me (I have tested normal the two times I had the full thyroid panel this past year, but I had antibodies present on my TPO test last fall). I am going to take advantage of the lab requisite he gave me and have the tests run (I really want to see what my TPO is now), but I will not return to that doc and am back to square one. While I appreciate the fact that he thinks outside of the box, I don't respect his "one-size-fits-all" method of treatment. Frankly, it scared me!

I know it shouldn't be this hard, Jen, but it is. Hang in there.

Linda

VitaBella · 09-12-2004, 11:14 AM

Hi Linda.

Yes, when I went to my new endo at the end of May, he listened to all my symptoms and said that it sounded like Hashi's - so he ran a TPO.

He didn't give me a copy of the labs (actually, I didn't go in to go over the labs with him. We just talked on the phone) but he said my antibodies were lower than the lab range, so the test was negative.

I think the lab range was under 60 and I was around 30.

BUT I read your journal at FAAS about how your endo said that any antibodies indicate a thyroid problem...so maybe a few years (or more) from now, a real problem will show up.

My endo is one of those "top docs" as well. Your experience didn't sound that great, though! I don't understand how a doctor that treats endocrine disorders, which are tricky and very individual anyway, could even think about only prescribing ONE med for all his patients. Although I would love to have someone who treated on symptoms and not on blood test results.

My symptoms aren't awful - mostly dry skin and exhaustion. I know I'm a grad student and I'm busy, but geez...I could lay down and go to sleep at any point in the day. I do have low body temperature and low heart rate, but those obviously aren't troublesome. And I'm cold more often than other people, but that doesn't bother me much either.

Anyway, I see my GP and this endo again in the next two weeks. He volunteered to run more tests and I'm going to just break down and beg for meds...I really think it would make a difference and if it doesn't, I'm wrong and I just stop taking them. He admitted that with a low dose, you can't really hurt your body by starting the meds. So I feel like it can't hurt to try, you know?

Are you going to look for another endo? I thought my problems would be over when I started Gluc, but I think there is more to the puzzle than just the IR. *sigh*

VitaBella · 09-12-2004, 11:26 AM

I just got finished reading that explanation link you posted - I don't think my antibodies are "off the chart" because they were under the range for a positive response. But at least I understand why thyroid tests aren't always accurate...

I wish there were doctors like that out there! Unfortunately, I tend to find doctors who just go by lab results. Maybe someday I'll find someone else, but this thyroid stuff is such a pain...

nobimbo · 09-12-2004, 12:45 PM

Hi Jen,

I think the conflicting and misinformation out there for thyroid disorders is appalling. I am as confused as you are!

I came across something that I think is saying that my TPO ab test that I had last fall might not be indicative of Hashi's. The way the lab report listed the results was strange and didn't fit the usual ranges that are used. The lab range listed was >60, and my level was 58. Anyway, according to this, there are problems with the sensitivity of some of the methods used for TPO tests and the significance of low levels of the antibodies is questionable (and the kind I had sounds like one of those).

Normal reference values for TPOAb assays are highly variable and often arbitrarily established, so that a large majority of patients with AITD test positive, and most subjects without clinical evidence of AITD test negative. The lower normal limit appears to relate to technical factors. Specifically, assays citing a low detection limit (<10 kIU/L) typically report undetectable TPOAb levels in meticulously selected normal subjects. Such methods suggest that the presence of TPOAb is a pathologic finding. In contrast, TPOAb assays reporting higher detection limits (>10kIU/L) typically cite a TPOAb â€œnormal reference rangeâ€. Since such methods appear to have no enhanced sensitivity for detecting AITD, these â€œnormal rangeâ€ values may represent non-specific assay â€œnoiseâ€ and may not be pathologically meaningful.

Then there's this:

The presence of autoantibodies doesn't mean one has AITD,when there are no symptoms of the associated disease and low antibody titeres, one has thyroid autoimmunity, not autoimmune thyroid disease.

"Symptoms of the associated disease"....hmmm, but symptoms can be indicative of so many other things (low ferritin, PCOS, perimenopause, adrenal gland exhaustion, etc.)...so if there are low levels of antibodies and confusing symptoms and regular levels of TSH, FT3, and FT4, what should be done? Taking thyroid meds makes the thyroid lazy and can be a hassle (don't take within 4 hours of calcium, iron, take an hour before eating or two hours after, etc.), so I am not about to start treatment for a thyroid disorder that I may not have. On top of this, my temps are going up (was 97.6 this morning on day 12 of my cycle, usually I am at 96.6 this time of my cycle)...so is that from my 200 mcg of selenium, the NPC I took the past two and a half months or the Vitex I started 3 weeks ago (which can balance out my estrogen/progesterone and raise temps), or the iron supplements I restarted a couple of weeks ago? Or is my thyroid kicking into hyper mode from antibodies attacks? Aaarrrggghhhh!!! LOL!

Linda

VitaBella · 09-12-2004, 01:42 PM

Lol, Linda poor Linda!

I have no idea because, like you said, increasing temps could be related to ALL of those scenarios.

So is that how it works? You have antibodies, they attack the thyroid...your thyroid kicks into hyper, burns out, and you end up hypo? You would think that if that was the case, you should notice the symptoms of hyper for a brief time and then the hypo symptoms.

But I don't think I've ever had hyper symptoms! Can you just BE hypo without going hyper first? If you can, that wouldn't be Hashi's right? (Or would it?)

Also, if the presence of antibodies in low numbers doesn't necessarily mean anything, my antibodies (around 30 - I actually think he said 33) would probably mean NOTHING. Even less than your 58! Lol.

So I know we have different needs as far as hormones because you're in peri-menopause and I'm not. But we both want to lose weight. Does the Vitex, NPC, or selenium seem to be helping with that? Is there any indication that selenium would help with thyroid function? (I'm not familiar with selenium...)

I don't want to TTC right now. And I feel that if I lost weight, TTC on my own would be so much easier. So if I'm having cycles of my own, do I NEED Vitex or NPC?

Are there even answers to these questions? Am I going crazy? Are you going crazy as well?

nobimbo · 09-12-2004, 05:13 PM

Quote:

But I don't think I've ever had hyper symptoms! Can you just BE hypo without going hyper first? If you can, that wouldn't be Hashi's right? (Or would it?)

Yes, you can have clinical or subclinical hypothyroidism without having Hashis. Hashis is the most common form of hypothyroidism, though. Symptoms of hyper can often present like hypo, and vice versa. For instance, high blood pressure can be a symptom of both hypothyroidism and hyperthyroidism. Many people experience unexplained weight loss with hyper, but not all. Same with hypo; being hypo does not necessarily mean gaining weight. People often are diagnosed with either hypo or hyper without having any symptoms, but have abnormal thyroid blood test readings.

Quote:

Also, if the presence of antibodies in low numbers doesn't necessarily mean anything, my antibodies (around 30 - I actually think he said 33) would probably mean NOTHING. Even less than your 58! Lol.

The thing is, Jen, it all depends on the lab range. Many of the lab ranges for TPO that I've seen posted are ">10". If that were the lab range for my test, then my 58 would definitely be an elevated number. Btw, one can have a variant type of thyroiditis that comes and then leaves, due to a virus. That's why I feel that it is important to have a second TPO test to confirm. The only definitive test for Hashis is a fine needle biopsy of the thyroid gland.

Quote:

Does the Vitex, NPC, or selenium seem to be helping with that? Is there any indication that selenium would help with thyroid function? (I'm not familiar with selenium...)

Selenium has been shown to actually lower TPO antibodies, and it helps with T4 to T3 conversion (difficulty converting is common with Hashis). About 9 months ago after I found that out, I began eating 1-2 brazil nuts a day, because 1 brazil nut has about 100 mcg of selenium, and 100-200 mcg is the recommended daily amount for supplementation. Then a few weeks ago I read that once the brazil nut comes out of the shell, it has a lot less selenium. So I decided to switch to selenium supplements. I take 2 a day (one with breakfast, one with dinner); they are 100 mcg each. Too much selenium (something like 800 mcg a day) can actually inhibit thyroid function, so you have to be careful.

I started using the NPC in early June because at my yearly gyn exam, my bloodwork showed that my estrogen was 222, but my progesterone was 0.9 (on day 27 of my cycle). I had done alot of reading about NPC in the last year, but my hormones were well-balanced last year at my yearly exam, so I didn't have the need for it. My hormones went whacko somewhat suddenly (I have been tracking my BBT's with fertility friend for the past year or so just for hormone awareness purposes, and because I have a large fibroid and heavy bleeding issues, and it helps me to be able to predict when AF is coming to be prepared; I often have to take off of work on my very heavy second day of AF). Anyway, I noticed my BBT's going whacko in the two weeks before my gyn visit, which is why I asked him to run a hormone panel for me. I had a procedure in March (uterine artery embolization, to try to cut off the blood supply to the fibroid and shrink it), and during the procedure the doc had to embolize my right ovarian artery, which may have something to do with my hormone changes. Then again, it could just be perimenopause. I also switched from regular Met to Met XR in April, maybe that had something to do with it.

I read that low progesterone can cause the thyroid to slow down, and too much estrogen can bind thyroid hormone. So that is another reason why I wanted to try to balance out my estrogen/progesterone ratio. I used the NPC for two and a half cycles, then decided to switch to Vitex instead (which works through the pituitary to increase progesterone). I just somehow feel that the Vitex is safer; the reason I didn't use it before the NPC is because I had read that it can cause heavier or irregular AF's at first, but so far it hasn't effected me that way.

Something else that I started taking a couple of months ago is black currant oil. This works like evening primose oil, except that EPO can stimulate estrogen, and I don't want more estrogen, lol. On the about-thyroid.com site, several people are using it to help with hormone balance. It is an essential fatty acid that contains GLA (source of omega 6 and 9), and is good to balance out the omega 3's I get in fish oil (which I've taken for almost a year now). GLA has been shown to help with neuropathy, and it has helped decrease the paresthesias in my feet (started getting that a couple of months ago; could be diabetic neuropathy, could be hypothyroidism, could be other things, who knows). It is also supposed to help with overall hormone balance, so I figured it was worth taking. Just a couple of days ago, though, I have switched to a combo omega supplement that contains fish oil and borage oil (borage oil works the same as black currant oil and EPO, it is a source of omegas) for simplicity (I take so many pills these days!).

As I've said, my temps over the last week are rising. They are a full degree higher than before, at this time of the month. I am not cold all the time like I had been, and my feet aren't cold. And this past week the scale has finally budged (4 pounds since Monday). So, maybe the supplements are slowly helping my body to heal, maybe my progesterone has increased (that can raise body temps) or maybe I am going into a hyper mode. I am so anxious to see the results of the tests I'm having done tomorrow (progesterone, estrogen, FSH, LH, fasting insulin (I've never had a fasting insulin test, which surprised the endo I saw on Fri., since I have diabetes and PCOS; my regular doc doesn't do those and doesn't think they are necessary), TPO AB (he's ordered a TSH and a total T4, which I could care less about; just had those done last month at my gp; I asked him to run a free T3 and free T4 but he wouldn't...I did have those run in June at the gyn's, though, and they were all good numbers).

Whew, I wrote a book, sorry! HTH,
Linda

nobimbo · 09-12-2004, 07:12 PM

Jen,

You might want to join the Ohio Thyroid Support board and get info there. Here is the link:

http://health.groups.yahoo.com/group...hyroid_Groups/

There is one doc listed for Columbus in the files there, here is the info:

Ernest Shearer, D.O.
4191 North High St.
Columbus, OH. 43214
614-262-1308

He is listed as a Broda Barnes doctor. Broda Barnes was a doctor who had hypothyroidism himself. He developed a protocol for diagnosing thyroid disease with basal body temperatures and treating with Armour Thyroid. I couldn't find one of those docs in my area, though.

Another link that may help is the "find a doc" link on the Armour Thyroid website. Just click on the link below and type in your zip code, and it will provide you with a list of docs who prescribe Armour. A doc willing to prescribe Armour may be more open-minded, since many mainstream docs won't.

http://www.armourthyroid.com/locate.html

Linda