Partial interview with Dr. Shames

[Guest guest]

Got ahold of this from the immunesupport.com newsletter I

get..thought it was pretty interesting and informative.

Dr. Shames: I see both kinds of situations (they're talking about CFS

and FM) regularly in my San , CA office. There appears to be a

wide overlap; one thing is quite common between them. Both of these

medical conditions are intimately involved with thyroid and adrenal

dysfunction.

I treat them by first isolating for a thyroid problem, and treating

that first. Then, once thyroid is as stable as we can get it, I check

for and treat adrenal imbalance.

Many people are frustrated in dealing with the hormonal balance

difficulty because they don't isolate and treat the thyroid issue

first. Thyroid is somewhat prominent and preemptory, it is primary

among the endocrine glands, since it is the gas pedal for everything

else.

If you try to treat the adrenal imbalance first, in my experience,

you can make the system further imbalanced, more difficult to

diagnose properly, and success becomes more elusive.

There is one situation, however, where thyroid and adrenal

rebalancing need to take place concurrently. This occurs when the

adrenal balance is severe and co-exists in tandem with a thyroid

imbalance. In these situations, the procedure is to correct the

thyroid a little, then correct for adrenal a little, then go back and

correct a bit more for thyroid, then a bit more with adrenal

corrections. The reason for this dual upward titration is that

treating either one of these insufficiencies can " unmask " and

exacerbate the insufficiency symptom of the other.

Most of the time, however, this is not the case. Even if low thyroid

and low adrenal coexist, frequently correction of the thyroid alone

will then throttle the rest of the body, including the adrenal gland,

back into some semblance of normal function. Thus, many CFIDS and FM

sufferers get a jump-start on their recovery process via careful and

rigorous thyroid treatment first.

To accurately diagnose a thyroid problem is crucial. We cannot simply

rely on TSH and or Free T4 blood tests, even though this is the

industry standard. Instead, we need to do a more complete panel of

blood tests, which would include Total T3, Free T3, and thyroid

antibodies. In addition to blood tests, we must also include the

equally important basal body temperature evaluation, and family

history. For more details, I recommend that anyone with CFS or FM

look at this issue very carefully. The details of diagnosis and

treatment are clearly defined in our book THYROID POWER: 10 STEPS TO

TOTAL HEALTH (Harper, 2001).

What is often missed, especially in CFS or FM patients, is the

critical four columns of a " temple of diagnosis " (see visual of this

on our website www.ThyroidPower.com in cartoons for step 3) that

includes using signs and symptoms, family history, associated

conditions AS WELL AS blood testing.

ImmuneSupport: Do you use any alternative therapy methods for

improving thyroid function in patients?

Dr. Shames: Absolutely - this is a critical part of how I work. I

have been involved in holistic medical care for almost 30 years (and

I'm not that old!). I often use relaxation therapies and hypnotic

techniques, and teach them to my patients. I also send them to

receive a great variety of therapies, depending largely upon a number

of factors, such as what they believe has been helpful, their ability

to pay, etc. I recommend massage, energy healing or touch therapies,

nutritional therapies, biofeedback, visualization and imagery, yoga,

chi gung, and lots of fun and healthy exercise when they feel better!

These are selected individually depending on who practices in the

various areas.

In fact, I provide thyroid coaching for people over the phone, and

have the opportunity to " meet " people from all over the US and

beyond. I help them to gather the proper materials and family

history, seek the best possible testing (some is home-based, such as

saliva testing), then learn to advocate better for better health care

from their providers. I also do my best to help people from various

locations to connect with practitioners in their area who are more

open and " thyroid-friendly " .

Karilee, who is a holistic nurse, and I have been teaching seminars

to health practitioners on Thyroid Power, so we are continuing to

develop our practitioner database for various alternative and

complementary therapies, as well as for physicians.

We have also been moving more in the direction of home-based testing,

so those whose pocketbooks or physical situation (or beliefs) allow

them to work with these less medical, less standard, and less

approved methods. Some people are having tremendous success using

saliva and urine testing for thyroid and other concerns.

ImmuneSupport: How do you believe Omega-3 fatty acids and

multivitamin supplements support and promote optimal thyroid

function?

Dr. Shames: The thyroid is the gas pedal for your body's energy flow,

but you need fuel and spark for the gas pedal to accomplish anything.

Fuel would be optimal nutrients, and supplements add the spark.

There are certain steps in the production and utilization of thyroid

hormone that require specific nutrients in quantities that many

people do not have.

For instance, let's consider the conversion of inactive T4 in the

body. T4 is made by thyroid gland and transported in bloodstream or

taken by synthetic pills, but is inactive in the body. It has to be

converted to T3 . This conversion of T4 to T3 is dependent on a 5'

(prime) deiodinase enzyme. It turns out this enzyme is selenium

dependent, so without selenium, it is hard to get active thyroid

hormone.

Omega 3 fatty acids are helpful for inflammation (and thyroiditis has

inflammation in the production phase). The omegas help to reduce this

inflammation. Also the receptor site on the lipid protein layer of

the cell surface seems to be enhanced with the addition of omega

fatty acids to the diet.

A good multivitamin provides a variety of the other nutrients known

to be just as crucial as selenium, in other pathway bottlenecks.

Thyroid status is controlled at seven different hierarchical levels

in the body; this is more control than any other process, and taking

key vitamins and co-factors will help to ensure proper function at

each level.

ImmuneSupport: What traditional medicine approaches do you use to

treat patients with thyroid problems?

Dr. Shames: When practicing only using traditional medicine, I use

thyroid hormone pills, and I monitor the results with blood tests and

basal temperatures. This standard approach, when combined with the

alternatives mentioned above, is your best shot at full thyroid

recovery.

ImmuneSupport: Do you think there is frequent misdiagnosis in the CFS

patient population that could prevent thyroid problems among these

patients from being properly treated?

Dr. Shames: Absolutely!! Many of the thyroid symptoms are wrongly

considered to be part of the CFS problem. Also many of the symptoms

are similar. In fact, some people don't have a thyroid problem until

they have the immune system compromised from CFS, then the thyroid

can go downhill. The thyroid is easy to treat compared to many

aspects of CFS and FM, so it should be handled first.

ImmuneSupport: What issues are you addressing in your new book?

Dr. Shames: In our upcoming project, we are moving beyond strict

thyroid care into a more holistic approach to thyroid, adrenal, and

reproductive hormone balance.

After 30 years of practice, we have come up with a step by step

process to work with these issues, and to help people uncover the

roots of their health issues, one step at a time. We believe in slow,

careful, methodical care that allows us to unpeel the layers of your

condition, addressing them carefully and moving slowly enough that we

don't unmask other related conditions, thereby further muddying the

waters.

While we know that most people in our society are accustomed to fast

food and fast medicine, we believe these underlying difficult to

diagnose energy problems must be addressed carefully for optimal

results.

ImmuneSupport: What is your advice to patients struggling with

debilitating fatigue?

Dr. Shames: My heartfelt advice to people struggling with CFS or

fibromyalgia conditions is to do everything possible for diagnosis

and treatment of a possible co-existent thyroid insufficiency. This

will make the remedies and procedures for CFS and FM more effective,

and more long-lasting.

We're not saying that CFS or FM are really being misdiagnosed; there

are indeed some people who are truly thyro-compromised and diagnosed

with CFS; when they are treated for the underlying thyroid problem,

many of their symptoms, sometimes all of them, are better. For most

others, however, the thyroid problem co-exists with the CFS/FM

syndromes, and can help people to begin to feel better, so they then

are more able to address the other more complex concerns.

Our Bottom Line: Remember - YOU CAN STILL BE LOW THYROID, EVEN WITH

NORMAL TESTS. Treat the thyroid first!