5 Tips to Reclaim Your Thyroid Mojo

Today I'm reminding you of and then manhandling 5 mojo-zappers. Five things that I often find are depleting the energy of vast numbers of patients in my integrative medicine practice. Five things I want on your radar. Five things I want you to remove from your less-than-metabolized life. Immediately.

1.     Dial in your free T3. I find this tracks with mojo more than any other indicator of your thyroid function. I like to see my patients in the top half of the normal range.

2.     Correct your low Vitamin D. Even with all the press this cute little hormone gets, 90% of my patients are low. Yet Vitamin D has over 1000 jobs in your cells. My fave? It drives thyroid hormone into your cell nucleus, where it can work its wonders. Get some. Keep your level above 52. For optimal metabolism, I like 70-90.

3.     Beware: Endocrine disruptors. These buggers are killing you softly. They’re in your jeans (2/3 of jeans are manufactured in China). They’re in your mattress. They’re in your canned food. They’re in your car upholstery. Reduce your exposure starting today. Get your organic mattress (although you may need a doctor’s prescription – how ridiculous is that?). Get organic jeans against your skin (they are far foxier than they used to be). Eat fresh, organic, seasonal food rather than the canned crap. Be mindful about your plastics and cleaning products.

4.     Check your cortisol. Adrenal dysregulation – that is, a cortisol that is either higher or lower than normal – can influence your thyroid functioning. Both high and low cortisol affects how much T3 you make.

5.     Meditate. It elongates your telomeres, the sweet little shoelace caps on your chromosomes, longer and slows down biological aging. Even beginners get a boost in telomere length, says Nobel prizewinner Elizabeth Blackburn!

Now tell us in the comments what else gets your thyroid mojo revved up. And lengthen those telomeres!

 xoxox Dr. Sara

US Aircraft Carrier Detects Radiation Offshore Japan

Japanese officials insist there is no public health risk from the failing nuclear reactors in Fukushima. My read of the news: I have no idea if that is true, and suspect the opposite.

The BBC is reporting this morning that one of the US aircraft carriers detected radioactive fallout 100 miles offshore from the reactors. I do not know the amount they measured.

Why, if there is no public health risk, would the Japanese extend the evacuation zone yesterday from 10 km to 20 km? My inner skeptic is getting activated.

Drudge is reporting that 17 US Navy are suffering from radiation exposure.

Here is a report of possible days before the radiation comes to the West Coast (11 days to Los Angeles,7 to Anchorage). Totally depends on the winds and could be variable.

Consider preventive measures, such as taking iodine, with your physician. Orally-taken, non-radioactive iodine, available from Amazon and often your local health food store, may prevent binding of radioactive iodine in your thyroid. It's not for everyone, but get the details and discuss with your doctor. More info on that right here.

Help, Kelp?! What to Do with Japan's Radiation (Possibly Heading Our Way)

While I'm sure you've heard of the nasty earthquake in Japan - not sure you've heard that Japanese nuclear reactors spewed significant amounts of radiation that may be heading our way here in America. 

Learn about this now: IODINE. Talk to your doctor about protecting your thyroid with supplemental iodine, my friends. Taking supplemental non-radioactive iodine prevents your body from taking up radiactive iodine. You know I'm not a fear monger, so let's roll up our sleeves and talk prevention, and the role of this preventive micronutrient.

First, a prayer for the Japanese and their arduous, terrifying few days. May all beings experience peace. As the jet streams send OVER THE NEXT WEEK the radiation to Canada and the Western US, may all do what they can to learn how to manage it as safely as possible.

Second, there is not time for a slowly-formulated, methodically-researched, evidence-based plan (the type of plan I favor). It's pull yourself up by your bootstraps with what we know, and what we've learned from previous accidents. Let's turn instead to expert opinion on WTF we're to do about the sitch.

I've read estimates that potentially significant radiation is to hit us here in the Bay Area, according to Dr. David Brownstein (but he has not yet provided sources). We really don't know. I don't know his sources and cannot find confirmation. Let's hope they're an overestimate!

Risks of radiation are listed right here.

If you are flush with iodine, it is far more difficult for radioactive fallout to bind inside of us.

Who are the thought leaders I turn to in times like these?

1. Dr. David Brownstein
2. CDC

I don't totally trust the CDC because they are a government agency and often respond too slowly to be helpful. However, here is the CDC's recommendations on iodine to prevent damage from radioactive iodine fallout.

• Adults and breastfeeding women should take 130mg of potassium iodide (available at health food stores)
• kids 3-18 should take 65mg of potassium iodide
• kids 1 month to 3 years should take 32 mg

The World Health Organization states that the radiation released is not significant, yet 9 people have tested positive in Japan as of 10:30pm PST on March 12, 2011 for severe radiation exposure. Let's hope we've seen the worst of it.

Yesterday I was on the phone with my grandfather to wish him a happy 92nd birthday, and he warned me (before it hit the news) in his entirely cogent, commanding, MIT-graduate voice that there was tremendous danger with the Japanese nuclear reactors exploding or otherwise releasing nuclear fallout into the atmosphere. Thanks, Gramps, for the heads up.

Dr. David Brownstein does not recommend starting the iodine now, he suggests we start 1-2 days before the the expected fallout. The oral potassium iodide lasts for 24-72 hours, so duration depends on how long we remain exposed. Follow the news, as he suggests, and plan accordingly. Keep checking back here to see what's next.

Non-radioactive iodine, such as the potassium iodide recommended by the CDC is relatively safe. Excess doses can cause palpitations and uncomfortable sensation of the heart beating but is usually tolerated well. Most of us are iodine deficient unless you mindfully take a supplement. You can also call my office at 510-893-3907 and check your urine iodine level if you have the luxury of time before the nuclear fallout arrives. Iodine is found naturally in sea vegetables, but you probably cannot get enough through food sources to prevent damage.

Thanks to Helayne Waldman for connecting me with Dr. David.

Share any concerns or questions you have here in the comments section, and please spread the word to your loved ones on the West Coast.

Days of Awe: Your Optimal Health

It's officially the Jewish High Holidays. In fact, today is Day 5.  

For me, there is nothing quite as fruitful and nourishing as the deep scouring on the agenda during the Days of Awe for Jews, from Rosh Hashanah to Yom Kippur. It just thrills me, and it's NOT just for Jews. Here's why.

A little background: after being raised Catholic (including parochial school for most of my lower school years with Mass twice/week), I converted to Judaism at age 33.  Along the way, I've studied Yoga, Mindfulness, Buddhism, Non-dualism, 12-Step and many other traditions. I'm a yoga teacher. My spiritual practice is rather similar to those of my neighbors here in Berkeley -- I take what really works for me and opens my channel grace.

Teshuvah is our main job during the 10 Days of Awe from Rosh Hashanah until Yom Kippur. My fave translation of this Hebrew term? Returning to your True Self. Reflecting on ways in which we've missed the mark of serving our Highest Self, our Highest Purpose, our alignment or congruence with the quiet voice internally that knows the next right action.

This is not about religion; I'm actually interested today in taking this concept and applying it to your health. Teshuvah your health, my friends. I’m talking about deeply relevant issues such as your daily energy, your alignment daily with your higher purpose, how you nourish yourself with food as medicine. Can you inventory the ways over the past year that you've perhaps missed the mark and hurt your body, metabolism, spirit, emotional balance?

Another way to look at this (and break out of the Judeo-Christian form) is to ask: what if I were in charge of the Buddha's physical health? Or HHH The Dalai Lama? Meryl Streep? Any enlightened being would do. Say you're to provide the dosage of thyroid medication each morning - what would that look like? What would I prepare for him or her for dinner today? If I were in charge of the best exercise and stress management for optimal aging, what would I schedule today for the Enlightened One?

Me? If I were HHH's thyroid boss, I would never miss a dose (BTW, I missed my Armour thyroid pill yesterday - can you tell?). I'd have HHH meditate while the Armour took it's sweet time to absorb fully for 60 minutes before any food or drink. Meanwhile, I'd cook HHH a lovely organic meal that didn't harm the planet or animals. Brown rice, kale from my garden and soaked nuts for breakfast? And I'd mindfully prepare the oolong tea or yerba mate as a sadhana (spirital practice or ritual).

My morning now doesn't resemble this idealized version even remotely. Armour in, guzzle oolong tea, breakfast for the fam - check, lunches for the kids - check, nag kids to hurry up and brush their teeth - checkety check check. Race out door, hustling kids, pulse and blood pressure rising in response to my kids' slower and movements, their "Buddha nature." Oy. There's so much that's wrong with this picture.

For the Days of Awe, here's your homework: what is YOUR PART in the harm you've done to your body? Not the part contributed by your partner or boss or kids or parents but your part? What can you do differently with nourishing food, mindfully eaten, with movement, with your connection to Higher Self, with supplements, with assessing why your energy is lousy? How about sleep - if it sucks, are you on it, seeking help and have an attitude that invites change? Are you devoting your full energy to your healing and optimal health?

If you're interested in more resources and guiding questions, here's a favorite.

Shanah Tovah (Happy New Year in the Jewish Calendar). Time for a fresh start to your most vibrant year ever, but we all know measurement begets change. Start measuring, my friends.

Toxins Muckin' with My Thyroid

A kind gesture from my dentist today - she graciously offers plastic bottles of water in her waiting room - turns out to be a disaster for your thyroid. My daughter eagerly grabbed a bottle and started drinking. I love my dentist, but those bottle contain bis-phenol A (BPA) and they slow down our thyroid receptors. My TSH may not reveal the injury, but my weight does, as does my sluggish morning energy.

You’ve heard the dire news on environmental pollution. I used to pitch it into the file of “things I can’t worry about right now,” but then I realized that I too was affected. Turns out my lazy thyroid was rooted in mercury toxicity and too much BPA. What I thought 5 years ago was a healthy lunch once/week of brown rice/tuna sushi rolls from Whole Foods was slowly poisoning my system as mercury mounted and shut down my thyroid hormone production. My hair fell out, I gained weight despite an aggressive exercise campaign and I was tired most of the time.

Second-hand smoke has also been shown to impair your thyroid, particularly in younger kids and infants.

If your bod can’t keep up with the steady diet of toxins that we encounter, your liver metabolism takes a hit. Leptin rises. You become cranky, irritable and tired. You develop dark circles under your eyes. The main organ tasked with detoxification is your liver, and toxic backlog is a common diagnosis in my integrative medical practice. This is well-summarized by integrative nutritionist Byron Richards:

“It is like pouring sand into the gas tank of a car, It does not matter whether the car is old or new, when the engine gets clogged, it will not run correctly. The liver must be clear all such chemicals.”

There is a definite correlation between the severity of hypothyroid symptoms and toxic exposure. Being overweight is especially complex, because toxins are stored in fat. Toxic folks have tremendous difficulty losing weight, and here’s the worst part: when you manage to lose a few pounds of fat, you get re-exposed to the toxins stored in the fat you’re burning. So unfair!

What’s a thyroidista to do?

1.    Reduce exposure – you know that it’s best to drink from glass or stainless steel containers. Use them exclusively. Read Time Magazine’s recent review of what toxins do to your endocrine system and how to limit your risk. Recent data also shows that probiotics limit your absorption of BPA. Cracks in your metal dental fillings are another source of mercury – if you have metal amalgams, consider replacement with your dentist. http://tinyurl.com/GCtoxins

2.    Cleanse your liver – I recommend to my patients a 30-day cleanse every 6 months. Check out our website for more information. http://gottfriedcenter.com/

3.    See if you have mercury toxicity – there are many tests available commercially. I recommend a provoked test with a chelator such as DMPS. Testing is available for $79-100. Contact my staff for more info and to order your test at 510.893.3907.

For more info, check out the NRDC's excellent article on BPA-free water containers.

 Reposted from DearThyroid.org

Lakshmi: Inner Divinity

It's Goddess Monday for this gynecologist, and today I'm working with Lakshmi, one of the forms of the mother goddess in Hindu mythology. She is the goddess of fortune and wealth and is often called, "Sri," which translates from Sanskrit as elegance, sacredness, radiant power and prosperity. I think of her as manifesting soul prosperity, and helping me to align with my inner divine contentment regardless of my externals.

We all have the innate capacity to connect to our Sri or inner Lakshmi -- it is our birthright.  According to UC Berkeley Sanskrit scholar Christopher Wallis, Lakshmi teaches us that the "inner state of feeling that you have enough creates the experience of prosperity in your outer life, not the other way around. No matter how much time, money and love you have, you will always feel as though it's not enough until you can evoke and honor the Sri within you."

Lakshmi is depicted with four arms: usually with two hands holding a lotus, one hand pouring forth gold coins, and the fourth poised in a gesture of blessing. The lotus is a symbol of purity and fertility as it grows with great beauty from mud.

What does Lakshmi represent hormonally to me? Intuition, which I believe is a form of inner divine guidance. Lakshmi is in a place of clear knowing that her intuition is sacred and pure, and that stems in part from her hormonal balance - internal manifestation of the right amount of cortisol, the right amount of thyroid hormone, estrogen and progesterone in balance - in sum, balanced and poised for action from a place of deep contentment.

For more reading, check out Dr. Jean Shinoda Bolen's famous book (mostly on Greek Goddess archetypes).

Goddesses in Every Woman: New Psychology of Women

How's That Thyroid?

I'm re-posting this great thyroid questionnaire, modified from the Hotze Health and Wellness Center. If the question addresses a concern that applies to you, record the number. When done, total the numbers.

1. Do you experience fatigue (4)?
2. Is your cholesterol elevated (4)?
3. Do you have difficulty losing weight (2)?
4. Do you have cold hands and feet (2)?
5. Are you sensitive to cold (2)?
6. Do you have difficulty thinking (2)?
7. Do you find it hard to concentrate (2)?
8. Do you have poor short-term memory (2)?
9. Are your moods depressed (2)?
10. Are you experiencing hair loss (2)?
11. Do you have fewer that one BM per day (2)?
12. Do you have dry skin (2)?
13. Do you have itchy skin in winter (1)?
14. Do you have fluid retention (2)?
15. Do you have recurrent headaches (1)?
16. Do you sleep restlessly (1)?
17. Do you experience afternoon fatigue (2)?
18. Are you tired when you awaken (2)?
19. Do you experience tingling in hands or feet (2)?
20. Have you had infertility or miscarriages (2)?
21. Do you have decreased sweating (2)?
22. Do you have muscle aches (2)?
23. Have you had recurrent infections (2)?
24. Do you have joint pain (2)?
25. Do you have thinning of your eyebrows or eyelashes (2)?

Score < 11? You are unlikely to have a thyroid problem.
Score 11-30? Low thyroid function is a possibility.
Score >30? Low thyroid function is probable.
Get tested if your score is > 11, including a free T3 and TSH.

Adrenals Burned Out?

Adrenal fatigue or dyregulation is the change in the ability of the adrenal glands to carry out their normal job. The main symptoms is fatigue, or in the case of hyperadrenalism, feeling tired but wired.

In response to chronic stress, many folks suffer from adrenal dysregulation, which can be either low production of adrenal hormones (hypoadrenalism) or high production, or a combo of the two. Many of my patients wake up in the morning with low cortisol, drink a cup of coffee to wake up, and then have high cortisol (coffee raises cortisol) and feel wired. Then they’re exhausted when the caffeine wears off by 2-4pm.

What causes adrenal fatigue? At Gottfried Center for Integrative Medicine, every case is individualized, but there are four common causes as identified by Dr. James Wilson:

• Disease that overwhelm the body such as auto-immune conditions or cancer;
• Physical stress such as poor nutrition, addiction (especially to sugar and/or flour), injury, exhaustion;
• Environmental stress, e.g., toxic chemicals in air, water, clothing or food;
• Emotional stress – usually arising from relationship, work or psychological sources.
  

Overlap with other hormone systems
Over 80% of people with adrenal dysregulation suffer from some type of decreased thyroid function. We often find that people who have both adrenal dysregulation and hypothyroidism do not get relief from thyroid replacement alone, and need adrenal support to get better. Dr. Marsha Nunley, MD, and Dr. Charlotte Massey, ND, L.Ac., are especially good at addressing both simultaneously. Dr. Nunley is available to coach patients who live outside of California, but you must visit her in Oakland to receive prescriptions.

Testing
We recommend saliva or blood testing to check your adrenal function. For your adrenal home test, order a diurnal cortisol test. Alternatively, ask your doctor to order a morning cortisol level in your blood. For your thyroid, we recommend TSH, free T3 and free T4 tests.

Thyroid Treatment in Infertility Lowers Miscarriage Rates

In women with infertility who have thyroid autoimmunity (TIA), they fare better when treated with levothyroxine as compared to placebo. Women are 5-10 times more likely to make antibodies against the thyroid than men.

Here are the results of a large group of pregnant women, 12% of whom were TIA-positive. Half of the TAI-positive group was treated with levothyroxine during gestation, whereas the other half was left untreated. The endpoints of the study were to assess the outcome of pregnancy and changes in thyroid function by comparing the group of TAI-positive women without treatment with those who were treated and with healthy pregnant controls. Drastic reductions in the rates of miscarriage (75%) and premature delivery (69%) were reported among TAI-positive women who had received levothyroxine since early gestation and throughout pregnancy. Thyroid function test results were normal for women with TAI who received levothyroxine, whereas 19% of women in the control group became subclinically hypothyroid at the time of parturition. Published by Negro et al, 2006.

Higher TSH Associated with Weight Gain

Here is a good review of a study showing that higher thyroid stimulating hormone (TSH, the most sensitive indicator of thyroid function) is associated with weight gain, and the increase is linear. Optimum TSH is < 2.5.

News Author: Laurie Barclay, MD
CME Author: Hien T. Nghiem, MD

March 25, 2008 — Modest increases of thyroid-stimulating hormone (TSH) within the reference range may be associated with weight gain, according to the results of a large, community-based study reported in the March 24 issue of the Archives of Internal Medicine.

"Overt hypothyroidism and hyperthyroidism may be associated with weight gain and loss," write Caroline S. Fox, MD, MPH, from the National Heart, Lung, and Blood Institute's Framingham Heart Study in Framingham, Massachusetts, and colleagues. "We assessed whether variations in thyroid function within the reference (physiologic) range are associated with body weight."

This study included 2407 participants in the Framingham Offspring Study who attended 2 consecutive routine examinations, were not receiving thyroid hormone therapy, and had baseline serum thyrotropin (TSH) concentrations of 0.5 to 5.0 mIU/L and follow-up concentrations of 0.5 to 10.0 mIU/L. During 3.5 years of follow-up, the relationship of baseline TSH concentrations with body weight and body weight change was determined.

From the lowest to highest TSH concentration quartiles at baseline, adjusted mean weight increased progressively from 64.5 to 70.2 kg in women (P < .001 for trend) and from 82.8 (lowest quartile) to 85.6 kg (highest quartile) in men (P = .007 for trend). Mean body weight increased by 1.5 ± 5.6 kg in women and 1.0 ± 5.0 kg in men during 3.5 years of follow-up.

Although baseline TSH concentrations were not associated with weight change during follow-up, an increase in TSH concentration at follow-up was positively associated with weight gain in women
(0.5 - 2.3 kg across increasing quartiles of TSH concentration change; P < .001 for trend) and men (0.4 - 1.3 kg across quartiles of TSH concentration change; P = .007 for trend).

"Thyroid function (as assessed by serum TSH concentration) within the reference range is associated with body weight in both sexes," the study authors write. "Our findings raise the possibility that modest increases in serum TSH concentrations within the reference range may be associated with weight gain."

Limitations of the study include observational design precluding determination of causality; lack of measurement of free thyroxine levels; sample nearly entirely white, with possible lack of generalizability to other ethnic groups; and inability to account for other covariates known to be associated with body weight and weight change, including diet and physical activity.

"The identification of change in thyroid function as a risk factor for weight gain might help guide research into the identification, prevention, and treatment of individuals at risk for the development of excess adiposity," the study authors write. "Confirmation of our findings in other samples is warranted, and in particular more longitudinal studies are warranted."

The National Heart, Lung, and Blood Institute's Framingham Heart Study supported this study. Two of the study authors have been supported by the National Heart, Lung, and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases. The other study authors have disclosed no relevant financial relationships.

In an accompanying editorial, Roy E. Weiss, MD, PhD, and Rebecca L. Brown, MD, from the University of Chicago Medical Center in Chicago, Illinois, address potential mechanisms linking thyroid function and obesity.

"Assuming preservation of tissue responsiveness to thyroid hormone levels, the absence of reciprocal changes in T3 and T4 levels suggests a central modification of the HPT [hypothalamic-pituitary-thyroid] axis in obesity," Drs. Weiss and Brown write. "Elucidation of the mechanisms by which obesity alters the HPT axis may give clues to the other metabolic abnormalities seen in this condition. There is no evidence at this time to advocate lowering serum TSH concentrations to treat obesity."

Drs. Weiss and Brown have disclosed no relevant financial relationships.

Arch Intern Med. 2008;168:568-569, 587-592.

Clinical Context

In the United States, the prevalence of obesity is rising. Obesity is associated with the increased risk for diabetes, vascular disease, all-cause mortality, and cancer. Known predictors of obesity and weight gain include a low level of physical activity, increased energy intake, parity, smoking cessation, inflammation, depression, and genetic factors. It has been recognized that thyroid dysfunction is a cause of weight change. Studies have suggested that variation in thyroid function within the reference range may be related to weight change.

The aim of this study was to determine whether variations in thyroid function are associated with body weight.

Study Highlights

• From the Framingham Offspring Study, participants (n = 2407) who attended 2 consecutive routine examinations, were not receiving thyroid hormone therapy, and had baseline serum TSH concentrations of 0.5 to 5.0 mIU/L and follow-up concentrations of 0.5 to 10.0 mIU/L were included in this study.
• The prevalence of obesity at baseline was 14.3%, and the mean baseline serum TSH concentration was 1.91 mIU/L in women and 1.70 mIU/L in men.
• Baseline TSH concentrations were related to body weight and change in body weight during 3.5 years of follow-up.
• Results revealed that at baseline, adjusted mean weight increased progressively from 64.5 to 70.2 kg in the lowest to the highest TSH concentration quartiles in women (P < .001 for trend) and from 82.8 (lowest quartile) to 85.6 kg (highest quartile) in men (P = .007 for trend).
• Baseline TSH concentrations were not associated with weight change during follow-up.
• During 3.5 years of follow-up, mean (SD) body weight increased by 1.5 (5.6) kg in women and 1.0 (5.0) kg in men.
• Weight increased by 1.9 kg per every 1-unit increase in log TSH concentration (P < .001) in women and by 1.0 kg per every 1-unit increase in log TSH concentration (P = .007) in men.
• An increase in TSH concentration at follow-up was positively associated with weight gain in women (0.5 - 2.3 kg across increasing quartiles of TSH concentration change; P < .001 for trend) and men (0.4 - 1.3 kg across quartiles of TSH concentration change; P = .007 for trend).
• Limitations to this study included the observational design of the study; lack of measurement of free thyroxine levels; sample nearly entirely white, with possible lack of generalizability to other ethnic groups; and inability to account for other covariates that may affect body weight, such as diet and physical activity.

Pearls for Practice

• Risk factors leading to obesity include low level of physical activity, increased energy intake, parity, smoking cessation, inflammation, depression, and genetic factors.
• Thyroid function within the reference range is associated with body weight in both sexes, suggesting that modest increases in serum TSH concentrations within the reference range may be associated with weight gain.

Thyroid Function Linked with Alzheimer's

You don't want your thyroid function to be too high or too low if you're worried about developing Alzheimer's. I love it when we figure out that moderation is the best for our health.

This is the first part in a series I'm highlighting on hormones and the big "A."

This is from a Medscape article by Pauline Anderson & Hien T. Nghiem, MD:

The study, published in the July 28, 2008 issue of the Archives of Internal Medicine, did not find an association between extreme thyroid hormone levels and Alzheimer's disease in men.

Between March 1977 and November 1979, Dr. Zaldy Tan and his colleagues measured thyrotropin levels of 1864 participants in the Framingham longitudinal, community-based, observational study who had been free of dementia for 3 years (this window of time minimized the risk of inadvertently including patients with early Alzheimer's disease in this study). They later divided these hormone levels into tertiles according to serum concentrations.

Thyroid Function Intricately Linked to Central Nervous System

At this baseline and then biennially, researchers used neurologic and neuropsychological examinations, plus interviews and various other expert sources, to establish dementia status of the study participants, whose mean initial age was 71 years.

During a mean follow-up of 12.7 years (range, 1 - 25 years), Alzheimer's disease developed in 209 participants (including 142 women [12.8%]). After adjusting for confounders such as age, educational level, smoking, body mass index, and various cardiovascular risks, the researchers observed that women with the lowest serum thyrotropin concentrations (<> 2.1 mIU/L) were more than twice as likely to have Alzheimer's disease vs women with mid-range levels of the hormone (hazard ratio, 2.39; 95% confidence interval [CI], 1.47 - 3.87; P < .001 for those in the lowest levels and hazard ratio 2.15; 95% CI, 1.31 - 3.52; P = .003 for those in the highest levels).

Short version: Keep your TSH between 1-2.1. In addition to thyroid dysfunction, multiple studies have shown that insulin resistance, high cortisol levels, and decreased estrogen and testosterone levels are associated with the development of dementia.

So prevent insulin resistance (no flour, no sugar, no stress & exercise), normalize your cortisol levels, and keep your estrogen and testosterone in the normal range....

Dr. Marsha Nunley, MD, Joins Gottfried Center

We are tremendously blessed to have Dr. Marsha Nunley, MD, integrative internist, join us this month. She began the first week in January to rave reviews and extraordinary service and care. Dr. Nunley is 50-something and has the energy, vitality and beauty of a 30-year-old. She is certified in the Wiley Protocol and Age Management; extremely facile with all areas of bioidentical hormone balancing for men and women especially thyroid, adrenal estrogen/progesterone/testosterone; transformative in her care of complex medical problems; board-certified in Internal Medicine, Palliative Care and Pain Managment, and quite simply, a lovely person and doctor. Dr. Nunley also completed Dr. Andrew Weil, MD's Integrative Medicine Fellowship at the University of Arizona when it first opened.

Dr. Nunley, MD, is full-time at our newly expanded Gottfried Center for Integrative Medicine, Monday-Thursday. She has special introductory rates for initial consultation in January and then her regular fees kick in February, 2009.

Thyroid: Is Yours Working Optimally?

Here is a great thyroid questionnaire, modified from the Hotze Health and Wellness Center. If the question addresses a concern that applies to you, record the number. When done, total the numbers.

1. Do you experience fatigue (4)?
2. Is your cholesterol elevated (4)?
3. Do you have difficulty losing weight (2)?
4. Do you have cold hands and feet (2)?
5. Are you sensitive to cold (2)?
6. Do you have difficulty thinking (2)?
7. Do you find it hard to concentrate (2)?
8. Do you have poor short-term memory (2)?
9. Are your moods depressed (2)?
10. Are you experiencing hair loss (2)?
11. Do you have fewer that one BM per day (2)?
12. Do you have dry skin (2)?
13. Do you have itchy skin in winter (1)?
14. Do you have fluid retention (2)?
15. Do you have recurrent headaches (1)?
16. Do you sleep restlessly (1)?
17. Do you experience afternoon fatigue (2)?
18. Are you tired when you awaken (2)?
19. Do you experience tingling in hands or feet (2)?
20. Have you had infertility or miscarriages (2)?
21. Do you have decreased sweating (2)?
22. Do you have muscle aches (2)?
23. Have you had recurrent infections (2)?
24. Do you have joint pain (2)?
25. Do you have thinning of your eyebrows or eyelashes (2)?

Score < 11? You are unlikely to have a thyroid problem.
Score 11-30? Low thyroid function is a possibility.
Score >30? Low thyroid function is probable. Get tested if your score is > 11, including a free T3 and TSH.