Covert (vague symptoms) Under-active thyroid is a syndrome caused by a decrease in thyroid function. But unlike normal under activity of the thyroid gland, the diagnosis is very difficult because not only that the results of laboratory tests will be within normal limits, many of the symptoms are not always obvious to the connection between them.
What is Covert Underactive Thyroid Gland (Hypothyroidism)?
Covert Hypothyroidism is a relatively new syndrome that was first described in 1976 by Dr. Broda Barnes and in 1990 by Dennis Wilson.
They observed that stress causes symptoms of sub – covert activity of the thyroid gland. These symptoms appear in people who have undergone considerable physical or mental damages, but complaints of discomfort remain long after the cause of the stress was over. Another phenomenon described by Dr. Burns and Dr. Lillian, related to this syndrome was abnormally low body temperature.
We now know the various biological processes efficiency and the speed of most enzymatic activities in the human body have a direct connection on body temperature. Normal body temperatures (about 98.6°F or 37.0°C) maintain the proper spatial molecular structure of enzymes and proteins.
Proper structure of the enzymes also allows optimal activity of various biological processes in the cell. When the body temperature drops, the enzymes become narrowed and closer, and when the temperature raises enzymes are more spacious. Molecular changes in peripheral form of the enzymes may cause slowness in various biological activities within the cell.
This explains why the situation in which the body temperature is above or below normal, we hear various complaints arising from dysfunction of these enzymes in various parts of the body.
Sometimes in extreme situations, we witness body temperature of 105.8°F (41°C). This can cause permanent damage and even death at extreme cases.
A similar situation occurs when body temperature drops below 86.0ºF (30ºC). This condition is considered an emergency situation because it endangers the patient’s life, and actions to raise the temperature normal values must be taken immediately.
Less known condition that falls into the category of an emergency is when the body’s temperature drops approximately 33.8ºF (1°C), a situation that sometimes accurse with patients in the hospital wards. Doctors are not aware of this, because this situation may not constitute an emergency.
The best way to measure body temperature, is an oral temperature measurement by a mercury thermometer in the afternoon. If the average temperature during several days goes under 98.24ºF (36.8ºC), then the patient’s complaints are probably strongly related to sub-covert activities of the thyroid.
Hypothyroidism and the Thyroid Gland Functions
One of the principal functions of the thyroid gland is to regulate body temperature, to allow enzymes to function properly. First, the command goes from the Hypothalamus that is located in the base of the brain. The Hypothalamus secretes the hormone TRH that gets to the pituitary gland, which is located at the base of the skull and responses in the secretion of TSH hormone into the bloodstream.
When the thyroid TSH reaches the base of the neck, it stimulates the gland to secrete the hormone T4.
The T4 is an inactive hormone, but when it gets into the bloodstream, it reaches all the cells in the body and makes the hormone T3.
T3 is an active hormone that binds its receptors in the cell nucleus and causes a chain of complex chemical reactions that raise the temperature of the cell to 98.6°F (37.0°C), allowing normal activity of the enzymes.
This condition can develop into several scenarios:
- T4 hormone can become 3RT;
- The 5′-Deiodinase enzyme, which should make the hormone T3 to T4 is not active;
- 3RT hormone is absorbed by the 5′-deiodinase takes an active space in the enzymes activity and doesn’t allow conversion of the T4 hormone into T3 active hormone.
- The level of activity of the 5′-deiodinase enzyme is affected by many factors such as stress, illness, prolonged fasting, a high level of cortisol in the blood or selenium deficiency. Some drugs can also cause the inactivity of 5′-deiodinase enzyme and block the process of turning the T4 hormone into the active T3 hormone.
Please note that the only active hormone is the T3 hormone. Other hormones are not active at all or have very weak activity. The central building block of this whole process is the 5′-deiodinase enzyme that is influenced by many factors and eventually the 5′-deiodinase enzyme has the ability of determine the amount of T3 hormone produced. This can result in a reduced form of the T3 hormone and lead to a decrease in Body temperature.
Diagnostic of sub-covert activity of the thyroid gland (vague hypothyroidism symptoms)
The simplest way to discover covert under-active thyroid it to do three to four measurements each day of body temperature during 3 to 4 days. Standardization average temperature during the day tested should be in the range of 98.24ºF to 98.96ºF (36.8ºC to 37.2ºC) in the afternoon (between 10:00 am to 16:00 pm). Early morning and late evening and at night, the body temperature generally drops. In women, the body temperature rises two days before ovulation. Various complaints occur when the body temperature drops in the day time below 98.24ºF (36.8°C) and mostly at body temperature of 97.52ºF to 97.7ºF (36.4°C to 36.5°C) or less. Diagnosis of sub-covert activity of the thyroid gland by an abnormally low body temperature and proper treatment on the disease will cause the temperature to return to normal values and the disappearance of symptoms.
Lab tests can confirm the existence of the condition. However, most of these tests seem the norm, because the range of values of the results of all lab tests of thyroid hormones is very broad.
This is why many doctors do not find a connection between patient complaints and health checks.
Signs and Symptoms of the Condition
One of the problems is that it is sometimes difficult to understand how one disease can cause so many complaints? This is a disease that causes multi-system enzyme interference within the cell and therefore not expressed in laboratory tests.
The second question raised is how can there be so many signs and symptoms that respond so well to T3 hormone treatment or when enhancing the activity of the enzyme 5′-deiodinase? The answer is simple: T3 raises the temperature of the cells in the body, improves the conditions within the cell and enables enzymatic processes operate as usual. In addition, we treat the initial reason that caused the appearance of signs and symptoms in the first place.
Please note that most of patient’s complaints do not endanger their lives. But these are very good reasons to contact your doctor. Hormone therapy involves providing a biological hormone, that the body produces not enough of, and it is important to maintain the proper level within the cell. A similar situation also occurs in other diseases caused by deficiency of other biological hormones, such as diabetes when the patient needs insulin, or women in menopause need different sex hormones.
The following Common complaints and Symptoms are usually accompanied by a body temperature of 97.7ºF (36.5°C) or lower:
1. Heartburn (acid re-flux) – a fairly common occurrence due to increased secretion of gastric juice and return (reflux) of acid gastric juice into the esophagus. This causes a sensation of burning chest pain as a result of local inflammation in the esophagus. Accepted treatment reduces the excretion of gastric juice and soothes the gastrointestinal motility but damages the absorption of important nutrients such as iron, vitamin B12 and others. T3 treatment rapidly improves the reflux symptoms.
2. Allergies and an Itchy skin rash – there are different types of allergic reactions such as runny nose, skin rashes, hay fever etc.. When allergy appears along with other symptoms and signs of sub-activity of the Thyroid gland after mental stress, physical or mental, and low body temperature than normal, the diagnosis is uncertain. This disease is caused by the accumulation of water in the body and is due to changes in the physiology of histamine (a substance that the body secretes as an allergic reaction to foreign substances the enter the body through food or the skin and gets fluids into the tissues).
3. Anxiety and panic attack – These symptoms are often accompanied by palpitations, sweating and chest pain, shortness of breath and even fainting due to low blood pressure. These seizures occur after any slight emotional stimuli during flight, a closed space like elevator or in a crowd. Usually the response to a particular situation is quite excessive and is caused by increased secretion of adrenaline in moderately stressful situations. In most cases there is a story of physical or psychological stress in the past.
4. Asthma – a drop in temperature of the body changes the activity and the breakdown of histamine, a substance that the cells secrete in response to the presence of an allergenic substance, which in turn can cause asthma attacks.
5. Bad Breath – This is caused by the produce multiplicity of bacteria in the mouth and digestive system. Decrease in enzyme activity as a result of low-temperature allows these bacteria proliferation.
6. Hemorrhages in the skin – dark spots (bruises) appear as response to the rupture of small blood vessels in the skin. As a result of the cells cleaning the area, the color changes and patches are brighter.
7. Increase in cholesterol – high cholesterol level in the blood is associated with decreased function of the thyroid gland but it can also be associated with the functioning of other glands in the body that uses cholesterol as a raw material to create their hormones. Therefore an increase of cholesterol in the blood begins just before menopause age for women and about the same age for men, and together with it there is a decrease in testosterone, and progesterone Estradiol.
8. Cold hands and feet and Raynaud’s disease – People with Sub-covert activity of the thyroid gland often complain about these symptoms as a result of contraction of the small parifiral arteries. They feel cold hands or feet when you touch them. Sometimes after exposure to cold the contraction of these vessels is extreme, skin color in the edges of the toes changes to white or blue.
9. Constipation and Sensitive Bowels – Constipation is a very common complaint syndrome. This is because a decrease in temperature causes a slowdown in activity of the enzymes and food dyspepsia. So these people also complain about the appearance of gas, abdominal pain, periods of diarrhea and constipation.
10. Lack of coordination – people complain that objects fall out of their hands, lose their balance for a moment while walking.
11. Depression – these patients are treated by antidepressants but the situation is not improving satisfactorily after drug treatment. Sometimes, bouts of depression appear before the menstrual cycle without or with abdominal pain. Because of the stress that accompanies the birth, women can get depressed shortly after birth lasts three months and sometimes depression that lasts beyond that time. Sometimes depression is due to a lack of other hormones.
12. Dry eyes or blurred vision – This results from a decrease in the amount of tear fluid. Sometimes there is fluid retention in the body that changes the shape and appearance of the eyeball and causes blurred vision.
13. Dry hair or hair loss – common complaints in patients with hypothyroidism. Hair loss is mostly felt in the head, but hair loss is not limited to the head and might manifest in the eyelashes for example. Sometimes patients report softer than normal hair.
14. Dry Skin – This complaint is also typical to – thyroid gland. Forearms, elbows, back of the hands, fingers, legs and feet are the areas in which patients reported having dry skin.
15. Fatigue – a fairly common phenomenon, continuing all day and paradoxically these patients cannot sleep at night. Sometimes they get up exhausted but increasing fatigue during the day (especially in the afternoon), because the body energy varies with the temperature of the body. Sometimes they sleep about 10 to 12 hours and still wake up tired. Not like other patients suffering from influenza, for example, patients with sub – thyroid feel tired for a long time, even years.
16. Water retention – causes swelling fingers. Another area of water storage is ankles and hands, and sometimes edema can come up as far up as the knees. Sometimes when pressing the skin a small hole remains due to fluid distribution outwards to the pressure point. Edema around the eyes is a classic symptom to an underactive thyroid gland.
17. Blushing stains in the neck and upper chest – a classic sign to covert under activity of the thyroid gland.
18. A passion for food – excessive hunger – especially ice cream and pickles during pregnancy or before the menstrual cycle is typical to an under active thyroid gland (hypothyroidism). It is possible that this is caused by instability in blood sugar levels that drops down too low and causes carbohydrate cravings. Thus the patient brings it into the circle of weight gain.
19. Non- specific food intolerance – Sometimes patients notice a sudden lack of tolerance to food like wheat, milk or dairy products. The result might result in diarrhea, gas, or a feeling of heaviness in the stomach.
20. Migraine headaches – this phenomenon is caused by the accumulation of fluid in the brain. Following the drop in temperature, the arteries dilate and fluid out of the blood vessels and stored in different places in the body and brain tissue. Increased intracranial pressure and patients feel a migraine -related symptoms. Therefore, medications that cause contraction of blood vessels are helpful to alleviate symptoms. Migraine and headache can be related to the shortage of other hormones especially during menopause .
21. Intolerance to cold or heat – these patients feel unease when in a hot environment. They perspire easily and think their bodies are at a temperature above the norm, however, surprised when discovering body temperature is below normal.
22. Infertility – This condition has been associated with sub – activity of the thyroid gland, but after blood tests look normal, denied the connection between them. You can find out the condition of these patients by measuring body temperature. This situation is avoided by providing T3 hormone treatment.
23. Irregular menstrual cycle and stomachache – stomachache during the periods. This condition is usually accompanied by low temperatures and a strong bleed.
24. Moods – This causes people to change their behavior over short periods of hours or even minutes without any apparent reason. They are in a good mood and are easy to anger or depression or bad mood. They are described as “emotional rollercoasters”.
25. Itching or tingling sensation – a feeling that intensify after a shower, when the skin is dry, and is worse in the evening or in the morning when the temperature is low. Sometimes the itch is so strong that it causes wounds by scratching nails.
26. Dizziness – related to an imbalance in the body fluids, decrease in blood sugar or low blood pressure.
27. Low blood pressure – low blood pressure can worsen when the patient moves from a sitting or lying down position to standing up and is caused by a change in tone (contractility) of blood vessels due to low body temperature.
28. Decline in memory or concentration – many patients complain of mental fogginess and short term memory problems. Sometimes they might temporarily forget the names of familiar people . They find it difficult to prepare themselves for exams, and readers discover the pages over and over again and do not remember reading anything. Sometimes have difficulty performing tasks at work because they wander mentally. This effect can be related to the scarcity of other hormones.
29. Decrease in motivation – lack of desire to do different activities, even people who used to be very active. This phenomenon is repeats itself often and might worsen with time, until the patient sits idle for hours or even days at times.
30. Muscle pain or arthritis – these complaints related to water storage in the body causes an inflammatory response in the joints and muscles. This pain is at its worst after you wake up, and acts up again in the evening and before you go to sleep. Sometimes the phenomenon of muscle or joint pains lasting a long time is a result of a very light and moderate physical activity or exercise. When fluid retention is around the joints, bones or at the chest, the pain can be similar to a heart attack. After checking it with a Cardiologist ruled out a heart attack, you can think about that sub – covert action of the thyroid. Temperature measuring and other symptoms in the disease can confirm this diagnosis. This condition is often diagnosed as fibromyalgia that is considered to be related covert under active thyroid gland, because pain gets worse at night at low body temperature.
31. Problems nails – nails break easily, show scratches or cracks, soft look, not developing properly or contaminated by fungi.
32. Change in skin color or hair – patients with underactive thyroid gland develop color fading in these areas or other areas where there are dark areas. Another phenomenon is the white hair at a young age.
33. Tendency to fall asleep after meals – some fatigue after a meal is a normal phenomenon, but especially so in patients with an underactive thyroid gland, even after a small meal.
34. Decreased sexual urge – sometimes these patients lose interest in sport like activities that once made them very happy.
35. Slow sexual development – Thyroid hormones are important for the development of the body and genitals, breast development and hair. Thyroid dysfunction can cause lack of menstrual cycle, lack of development and lack of high fertility and lack of genital hair for man or woman.
36. Acne and a tendency to infections – acne in adults is an important sign to Covert hypothyroidism. Acne is sometimes treated by antibiotics for a long time, because the immune system of these patients is weak and there is a tendency to develop infections around the spots.
37. Feelings of suffocation / lump in the throat – a feeling of discomfort in the throat, like a chock hold.
38. Sweat disorders – those patients who do not notice sweating in the summer. Others describe sweating all day or night. Sometimes these signs are accompanied by low blood pressure or low blood sugar and feeling of fainting, dizziness and palpitations.
39. Ringing in the ears – a disorder that lasts a long time and there was no apparent reason after extensive testing of the inner ear.
40. Weight gain regardless of the amount of food consumed – dysfunction of the thyroid gland can lead to weight gain due to a decrease in metabolism. One of the characteristics of the phenomenon is that the patients reported eating little but gain weight easily. Trying to lose weight, the patient begins to fast and this brings a reduction in the T# production, which in turn causes not only the lack of success in weight loss but also increase weight gain after stopping the diet. You must take into account that regarding the issue of excess weight, other hormonal systems are involved like sex hormones, pituitary and kidney and course of thyroid hormones. Psychological factors can also affect weight gain.
How to treat a covert underactive thyroid gland?
Alternative Treatment: This approach advocates a change in mental and physical behavior because they themselves have caused the development of the condition. For example, reducing stress is one way to improve the situation, but you should take into account that in the Western way of life, a certain level of stress is inevitable. In addition, many find it difficult to control their emotions and reactions because of the disease itself. So you should look for other solutions that can lead to reduction in stress levels like exercise, yoga, drinking tea with passion fruit drinks or other herbs, avoid smoking and eating too many carbohydrates.
Dietary Changes: contribute to improving the situation. Small meals during the day with a large component of proteins versus carbohydrates greatly improve the condition of the patient. For example proteins such as tuna fish, cheese, cottage, chicken or turkey and red meat in three daily portions of 5oz – 3oz (150g – 100g) provide about 1,200 to 1,500 calories. Extra vegetables and two to three fruits can add another 300 calories. Finally, 5oz – 3oz (100g – 150g) grams of complex carbohydrates (oats, bran, whole wheat, brown rice, or fungi) can complete the number of daily calories consumption. Such diets corrects the situation of decrease in blood sugar typical of the disease and prevents attacks of uncontrollable excessive hunger.
T3 hormone Treatment: the only treatment that brings the body temperature to normal values is T3 hormone treatment. The situation is similar with lack of other hormones in the body.
In such cases the taking of T3 hormone results in body temperature return to normal and the symptoms of the disease disappear.
Potential risks and side effects of T3 Hormone Treatment
There are several existing medical conditions which should not be accompanied with a T3 hormone because it can worsen the existing condition of the patient, especially in cases of very low levels or very high levels of the hormone cortisol in the blood, heart failure, anemia, cancer, atrial fibrillation, autoimmune diseases, active disease in the arteries of the heart or stroke in the past, high and unbalanced blood pressure and more.
During treatment, the patient should absolutely avoid caffeine, alcohol, blood pressure medications and stress. Sometimes during treatment the symptoms of the condition worsen. This phenomenon stems from the fact that the patient did not keep the instructions in a continuous and didn’t take the medication time. These side effects occur when the body heat is unstable, too high or too low. For these reasons, you should not stop treatment abruptly because the symptoms can worsen so it is advisable to consult the doctor that gave you the prescription.
Treatment is aimed at suppressing symptoms even after cessation of treatment with T3 hormone. During the treatment with T3, the symptoms usually disappear gradually, but only after the patient stopped the treatment with T3 it is possible to examine whether the treatment was successful, after the disappearance of symptoms. This means that the body resumed turning T4 into T3 regularly to the complete needs of the body and the body temperature remains normal 98.6°F (37.0°C). So before starting treatment your doctor must weigh the risks involved in providing you treatment with T3 hormone against the benefits that can be achieve with treatment.