Frequently Asked Questions
You will find listed below some of the most frequently asked questions that we receive at The Woodlands Institute for Health & Wellness — from hormone therapy and HRT to questions about quality doctors in The Woodlands and Houston. If you have a question that is not answered, please contact us and it would be our privilege to serve you!
We do not accept assignment from insurance companies.
First, in keeping with a free enterprise philosophy, our policy regarding insurance has always been that we choose to work directly with and for our patients, rather than indirectly through an insurance company. Therefore, we have never joined any HMOs, PPOs or other types of managed care. Furthermore, our doctors have opted out of the Medicare Program, thus they are only able to see Medicare eligible patients who first elect to pay in full for all services rendered and subsequently sign a Medicare “Waiver” in which they agree not to seek reimbursement from Medicare for medical care received at our office.
HMOs, PPOs, managed care entities, and even indemnity insurance plans are not in the business of helping individuals obtain and maintain health and wellness. Rather, insurance companies are in the business of selling medical insurance plans for profit. While we have no problem with an insurance company’s right to make a profit, we do believe that for our practice to sign on with them, giving them permission to reduce reimbursement levels or, even worse, deny you, their client, the right to seek medical treatment or advice without first seeking their approval, is fundamentally wrong and deleterious to your health and the health of all individuals.
We believe that each individual is the best person to decide whether or not he or she needs medical care, not a clerk working for an insurance company, someone who has neither seen nor evaluated the individual regarding his or her health questions.
Second, because we seek to prevent disease and promote wellness, many of our medical services are not covered by most insurance companies.
Finally, though we don’t accept assignment, if you have indemnity insurance coverage, then we will provide you with an insurance-ready receipt after receiving your payment that you can use to submit a claim to your insurance company, with any reimbursement from them being paid directly to you. Many plans will partially cover services such as labs and some medications. In addition, many plans will apply the evaluation costs and other services towards your deductible.
Yes, despite our best efforts, occasionally we will see a patient who is not a good match for our treatment regimen. This has to do primarily with attitude. When individuals do not believe they can get better, it can become a self-fulfilling prophecy. Secondarily, we make every attempt to educate patients prior to their first visit regarding the scope and cost of our treatment regimen. Unfortunately, some individuals are unable to follow through with the financial commitment required over the long term to purchase hormone prescriptions and/or vitamins, and discontinue this treatment regimen. Finally, some individuals get conflicting advice and opinions from other medical professionals, family, or friends which leads them to discontinue treatment. Few medical doctors, and even fewer lay individuals, understand the intricate connection between nutrition, the immune system and hormonal balance. As long as there remains ignorance and confusion about these areas, there will continue to be some individuals who we are unable to help.
Once an appointment has been reserved there are several steps that need to be completed to ensure that the doctor has all of the information needed to provide the best care possible. Due to the length of each new patient appointment we do ask for a deposit to schedule, if the appointment is canceled with at least 48 hour notice we refund the deposit. The deposit amount will vary depending on program scheduled. For example, for the most extensive program the deposit is $250.
Our initial paperwork will come via email as a link to complete through Echosign for your security. One part will be requesting your medical history, the length of this one will depend on the program selected. The other will contain forms that must be signed such as an acknowledgement that we are not contracted with insurance companies, Dr. McManus is opted out of Medicare, program specific financial agreement listing the specifics of the program selected, and program specific consent forms. We strive to be as detailed as possible and we are available to answer any questions that may arise during this process. Once we receive all requested forms back the new patient coordinator will take that information and input all the data into the patient record to allow time for the doctor to review the chart prior to the patient getting to the office for their appointment.
All patients are treated individually and for this reason we do not handle any checkouts until after the doctor has seen the patient. During the 90 minute appointment with the doctor she will develop a treatment plan specific to each patient’s needs and will make recommendations for supplementation and prescribe medications as needed. Nutrition is an integral component of each patient’s treatment. Specific guidelines are provided for each program during the initial appointment or scheduled for a later time directly with the nutritionist. For example, patients are given detailed instructions to follow on the weight loss program that is medically supervised, this is the only calorie restrictive diet through TWIHW.
The final step for a new patient appointment is the checkout, the billing admin will review the supplements recommended and confirm the ones that each patient would like to purchase, if any. We then schedule any other appointments needed and collect payment. Follow up appointments are needed as indicated by your medical provider to stay an active patient and will be scheduled with Dr McManus, Dyvette, or Sandra depending on time frame indicated by the medical provider. The providers work as a team to allow for more flexibility for the patient’s schedule.
We start by recommending that you speak with one of the wellness consultants. They have been trained to review your symptoms and make a program recommendation that could help you achieve your wellness goals.
Another great way to learn about the various programs is to attend one of our monthly Lunch and Learn events. The event is free and open to the public, attendees are provided with as much information as possible to allow prospective patients to learn about the various programs and costs involved. Due to the amount of information provided the majority of potential patients call back after reviewing the program details and costs provided when ready to reserve their appointment. However, following the event the wellness consultants are happy to answer any questions you have one on one.
Sure aging is natural, if you live long enough! Death is natural too, so are wrinkles! But, who doesn’t fight the inevitable? Aging is caused by the slow and steady decline of our bodies’ natural hormones. Our hormones were at their peak when we were young healthy adults. The thyroid hormones, sex hormones and adrenal hormones all decline with age. This decline is associated with the onset of degenerative problems, such as, heart disease, hypertension, strokes, adult onset diabetes, arthritis, Alzheimer’s, and cancer. Numerous symptoms occur with hormonal decline as we age including: loss of energy, weight gain, decreased mental sharpness, depression, anxiety, irritability, joint and muscle pains, headaches, sluggish bowel function, hair loss, cold sensitivities, numbness and tingling in the extremities, insomnia, restless sleep, tiredness after sleep, afternoon fatigue, loss of stamina and endurance, decreased libido, loss of sexual potency, irregular menstrual cycles, fibrocystic breast disease, uterine fibroids, weight gain, and loss of resistance to infections.
These symptoms are so very common that they are considered normal by individuals and physicians alike. But they are not normal, rather they are a sign of a decline in bio-identical hormones that accompany aging. These symptoms are an indication that our bodies are transitioning from health and wellness to sickness and tiredness.
Since aging is caused by a decline in our natural hormones, it can be easily corrected by bio-identical hormone replacement. Think of hormonal decline as a drought. If your grass and plants are withering during the summer months due to a heat wave and lack of rain, then you can accept this as natural and normal, or you can water your yard to ensure that your grass and plants live. So too, when your hormones decline, as they inevitably will, you can replenish them with the same natural, bioidentical hormones, restoring your health, or you can suffer the drought of hormones with all the associated problems. It is your choice.
The average woman who lived 100 years ago did not survive very well. Her life expectancy was approximately 40 years.
Hormones are bioidentical chemical messengers made by the hormone producing glands in the body, known as the endocrine glands. The term hormone is derived from the Greek root hormaein which means to arouse to action or to excite. Hormones are secreted through glandular tissue into the blood stream which carries them to different areas of the body where they exert their effect.
The endocrine system allows the body to respond to both internal and external conditions in order to maintain the body’s internal equilibrium and balance. Ultimately the brain controls the hormonal production by sending messengers, called neurotransmitters, to the endocrine glands signaling them to action. The hormones are produced in minute amounts and are measured in picograms, parts per billion, yet they are very powerful. The influence of the various hormones on the functions of our body is profound. They regulate our growth, sex characteristics, reproductive capabilities and the energy production or metabolism which enables the cells of our body to perform their functions.
You have probably heard of the several of the glands that produce hormones, such as the thyroid gland, the ovaries, the testes and the adrenal glands. The hormones produced by these glands work together synergistically, enhancing one another’s function when they are properly balanced.
Symptoms of estrogen dominanace:
- PMS (premenstrual mood swings, breast tenderness, fluid retention, headaches, cravings, cramping)
- Ovarian cysts
- Fibrocystic breast diease
- Uterine fibroids
- Weight gain
- Heavy periods
- Decreased libido
Estrogen dominance refers to a time during a woman’s menstrual life when the primary influencing hormones are the estrogen hormones. This condition is caused by progesterone deficiency and is the cause of female hormone imbalance. A woman’s ovaries generally function best between a few years after puberty until around age 30. As a woman ages so do her ovaries. By the time a woman reaches 35 years of age she is over halfway through her menstrual life and her ovarian function begins to falter. The progesterone hormone production falls most dramatically over the last half of her menstrual life, between the ages of 35 and 50. This decline in progesterone occurs for two reasons. Firstly, the ovaries are aging and functioning less effectively than they did earlier in life. Secondly, as a woman ages she begins to have menstrual cycles during which her ovaries do not ovulate, that is, they do not give off an egg. This is called an anovulatory cycle. When a woman does not ovulate during a menstrual cycle, her ovaries will produce no progesterone. These are the causes of what is termed “progesterone deficiency”. In these cases the hormones that have the greatest influence in a woman’s body are the estrogen hormones. When this occurs a woman will experience estrogen dominance, meaning her female hormones are imbalanced in favor of the estrogen hormones. Many women have experienced estrogen dominance since puberty. In most women this condition develops as they move through their menstrual lives. The estrogen hormones and progesterone decline as a woman ages. But progesterone declines much more rapidly than do the estrogen hormones. As a woman approaches and enters the change of life, menopause, she may begin to experience the symptoms of declining estrogen hormones manifested by hot flashes and vaginal dryness. By this time progesterone is no longer being produced by the ovaries. Even as she has symptoms of declining estrogen a woman still has estrogen dominance because there is no progesterone to balance the lower levels of estrogen. When a woman enters menopause her ovaries no longer function. Yet she still makes estrogen hormones, primarily estrone, in her fat cells at approximately 50% of what she made premenstrually. The estrogen hormones affect every cell in a woman’s body. Depending on the degree of the progesterone deficiency, estrogen dominance may manifest itself with one. See the section, What are the Symptoms of Estrogen Dominance? In menstruating females Progesterone can be used on days 15 through 28 of the menstrual cycle. The dose of Progesterone will vary depending a woman’s age, size, symptoms and weight. Very few physicians, including Ob-Gyn doctors, have been trained or have the experience to properly dose the biologically identical human hormones correctly. Most physicians, who prescribe these hormones, use much too high of a dose. This can cause adverse symptoms and make you think that you cannot take these bio-identical hormones. It is important to seek the care of a physician who is experienced and who has been successful in evaluating and treating female hormonal imbalances with bio-identical hormones. After a hysterectomy, if the ovaries are removed, the Ob-Gyn will prescribe counterfeit estrogen hormones or horse estrogen, such as Premarin, Ogen or Cenestin. This maintains the condition of estrogen dominance and progesterone deficiency which caused her problems in the first place. The symptoms of estrogen dominance will persist and worsen on the counterfeit estrogen hormones. After a hysterectomy, in which the ovaries were removed, a woman still needs progesterone. Many Ob-Gyn doctors tell women that they do not need progesterone after a hysterectomy because they no longer have a uterus. This would be true if it was only the uterus that had receptors for progesterone. But every cell in the body has receptors for progesterone, most importantly the brain cells. Progesterone balances estrogen and opposes the stimulating effect of estrogen on the cells of the body. Progesterone is also the hormone which stimulates new bone formation and is needed to prevent further bone loss. Menopausal women should take both Bi-Est, a combination of the bio-identical human estrogens, estriol and estradiol, and Progesterone. Additionally, Testosterone may be helpful in restoring a normal sex drive.
Many young girls and older women are prescribed birth control pills to control their menstrual irregularities. Premenstrual fluid retention and weight gain, and other menstrual irregularities are caused by female hormonal imbalance. Birth control pills are counterfeit hormones which turn off the production of a woman’s bio-identical hormones by the ovaries. Counterfeit hormones are made by drug companies and do not occur naturally. Counterfeit hormones are not biologically identical to naturally occurring human hormones. They do produce effects similar to the bio-identical hormones in a woman’s body but are also associated with numerous side effects, many of which are serious.
Birth control pills create a state of estrogen dominance and progesterone deficiency. Common side effects of birth control pills are headaches, including migraines, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, strokes and blood clots to the lungs. Birth control pills prevent the production of women’s bio-identical female hormones and pheromones making them less attractive to men. There is no reason for any woman to poison her body every day with the counterfeit hormones in birth control pills in order to control premenstrual symptoms and menstrual irregularities when BellaFem™ Progesterone is available. Menstrual cycles can be easily regulated using BellaFem™ Progesterone on days 15 through 28 of the menstrual cycle.
Estrogen dominance refers to a time during a woman’s menstrual life when the primary influencing hormones are the estrogen hormones. This condition is caused by progesterone deficiency and is the cause of female hormone imbalance. The estrogen hormones affect every cell in a woman’s body. Depending on the degree of the progesterone deficiency, estrogen dominance may manifest itself with one, some or all of the following symptoms:
- Premenstrual breast tenderness
- Premenstrual mood swings, irritability, depression
- Premenstrual fluid retention and weight gain
- Premenstrual headaches, including migraines
- Heavier periods often associated with clotting
- Irregular menstrual cycles
- Menstrual cramping
- Fibrocystic breast disease
- Uterine fibroids
- Loss of sexual desire
- Anxiety and panic attacks
- Insomnia and restless sleep
- Bone loss, osteopenia and osteoporosis
- Adrenal gland fatigue
- Autoimmune disorders
- Triggering of allergies associated with more frequent respiratory illnesses
- Urinary frequency
- Easy loss of urine when coughing, laughing or sneezing
- Frequent headaches, including migraines, throughout the month
- Dry eyes
- Increase in body fat
- Sagging skin and wrinkles
- Decreased mental sharpness
- Gall bladder disease
- Polycystic ovaries
- Elevated cholesterol
- Elevated blood pressure
- Breast cancer
- Cancer of the uterus
Many of these symptoms and conditions commonly occur in women of all ages. However, while they may be common, they are not normal. These symptoms are an indication of declining ovarian function, which leads to an inevitable deterioration in health as women age. In order for women to obtain and maintain health and wellness as they age, it is essential that they preserve female hormonal balance as soon as the symptoms occur. Wondering if you may be suffering from estrogen dominance and progesterone deficiency? Complete our confidential, online test for estrogen dominance to determine if it’s likely that this is the culprit. We encourage you to contact us for an appointment to discuss your symptoms and how to begin the road to better health.
Progesterone is the hormone secreted by the ovaries after a woman produces an egg during the middle of her menstrual cycle. Progesterone is the dominant female hormone for the last half of the menstrual cycle.
Female hormonal balance between the estrogen hormones and progesterone is essential in order for women to obtain and maintain health and wellness. The three human estrogen hormones have numerous effects on the body which require the balance of progesterone to prevent the hyper effects of estrogen dominance which can lead to a host of health problems. (See What are the Benefits of Progesterone?) Good health occurs when the hormones in the body are produced in adequate amounts and are in balance. Think of this as hormonal harmony, as if the hormones are a symphony orchestra. If one section of the orchestra, say the brass section, is too loud, then this will drown out the other sections of the orchestra and ruin the symphony.
- stimulate growth of the lining of the womb or uterus,
- cause breast tissue to develop and grow,
- promote fat storage and weight gain,
- promote fluid retention,
- cause thickening of the blood,
- decrease bone loss, but do not stimulate new bone growth
- increase emotional sensitivity,
- activate progesterone receptors,
- inhibit the sex drive, and
stimulate the production of thyroid binding globulin by the liver, inhibiting the action of the thyroid hormones.
- causes feminization
Progesterone has the following effects which counterbalance the estrogen hormones:
- matures the uterine lining preventing excess buildup of tissue,
- inhibits breast tissue overgrowth, preventing fibrocystic breast disease,
- has a diuretic effect which mobilizes fluid, decreasing swelling,
- enhances the action of thyroid hormones, increasing metabolism,
- stimulates the production of new bone, protecting against osteoporosis,
- increases the sex drive,
- protects against breast cancer and uterine cancer,
- thins the blood, preventing blood clots,
- supports the function of the adrenal glands,
- elevates mood, and
- promotes pregnancy.
When our bodies no longer produce our hormones in adequate amounts to maintain good health, we should restore our faltering hormone levels with the same biologically identical hormones that our bodies currently make. The term bioidentical does not refer to the source from which they are derived. Because the supplemented bioidentical hormone molecules are exactly the same as those which we produce, then they are identical in action. The cells of the human body benefit from the supplemented bio-identical hormones in identically the same way they benefit from the hormones which the human body produces.
The cells of our body have receptors for each of our bio-identical hormones. When we supplement with bioidentical hormone supplementation, then we are replenishing the body with the same identical hormone molecules that our body has always made. Because these hormones are bioidentical they bind quickly to the receptors and cause the appropriate effect. Our body has enzymes which breakdown the bioidentical hormones quickly and metabolize them so that they can be excreted from our system.
Bioidentical hormones are derived from diosgenin, a plant molecule found in soybeans and wild yams. Diosgenin is extracted from these plants and converted into progesterone in the laboratory. Progesterone can then be converted into the three human estrogen hormones, estrone, estradiol, and estriol, and also converted into human estosterone, cortisol, dihydroepiandrosterone (DHEA), and pregnenolone.
Counterfeit hormones produced by drug companies have different molecular structures than the bio-identical hormones. They bind to the receptors in our cells in such a way that they are not easily broken down and removed by a woman’s body. It may take several months for the counterfeit hormones to be cleared from the body. This can cause an exaggerated hormonal effect, which can lead to a host of side effects.
Counterfeit hormones, including birth control pills, are produced by pharmaceutical companies and do not occur naturally in the human body. The counterfeit hormones are synthetically produced by making chemical changes to the bio-identical human hormones. The drug company counterfeit hormones are not biologically identical to naturally occurring human hormones. The counterfeit hormones include those hormones commonly used by mainstream medicine for hormone replacement therapy and for birth control. They do produce some effects similar to the bioidentical hormones in a woman’s body but are also associated with numerous side effects, many of which are serious. The counterfeit hormones create a state of estrogen dominance and progesterone deficiency. Common side effects of the counterfeit hormones are headaches, including migraines, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, heart disease, strokes and blood clots to the lungs. The numerous and severe side effects of counterfeit hormones are listed in the Physician’s Desk Reference. The counterfeit hormones also prevent the production of women’s own natural female hormones and pheromones making them less attractive to men. There is no reason for any woman to poison her body every day with counterfeit hormones when safe and effective BellaFem Bioidentical hormones are available.
The use of natural, bioidentical human hormones is not taught in medical schools. You are probably wondering, “Why not?” It is because medical schools have adopted the belief, propagated by the drug companies, that the medical problems of aging can be treated with drugs or surgery. Medical schools do not teach future physicians how to help people get well and stay well. Rather, they teach budding physicians how to intervene when people get sick. The mainstream medical establishment does not view illness as caused by a decline or imbalance of our own naturally occurring hormones. Illness is seen as an opportunity to prescribe drugs. If you do not think that this is the case, then take a look in your medicine cabinet.
Many health food stores carry wild yam creams which contain diosgenin. Diosgenin is termed a phytohormone, which means plant hormone. Often these products are claimed to contain progesterone or progesterone building phytohormones. Diosgenin is not progesterone and cannot be converted by our bodies into progesterone or any other hormone. While some women may experience a partial improvement of their symptoms using wild yam creams, you should not be misled into thinking that this is the same as bio-identical hormone supplementation or replacement.
Many different brands of over the counter progesterone cream products are available. The Federal Drug Administration (FDA) limits the maximum amount of progesterone that can be present per ounce of these creams. The FDA only allows these products to be sold as skin care products. In many of these products the amount of progesterone present is not even listed. The purity of the progesterone in these over the counter creams varies greatly from company to company. Contrary to what some authors have written, progesterone is poorly absorbed through the skin. This is why I recommend slow release BellaFem Progesterone which is released over a twelve hour period in the small intestine.
The causes of low testosterone are many and varied. Primarily, testosterone declines as men age. Another prevalent reason for the decline in testosterone in males of all ages is the exposure in our environment to petrochemicals. Xenoestrogens are byproducts of the petrochemicals in our environment. Petrochemicals enter our bodies through a variety of mechanisms, including the air we breathe, the water we drink, the foods we eat and the products with which our bodies come into contact, such as lotions and creams. Very simply, when petrochemicals enter the body, they are often converted to Xenoestrogens. Xenoestrogens then disrupt the synthesis and metabolism of the body’s hormones. As a result, males produce less and less natural testosterone. In fact, an article published in Baillieres Clinical Obstetrical Gynecology in 1997 entitled Declining Sperm Quality: A Review of Facts and Hypotheses, stated that there has been a 50% decrease in male sperm count since 1960. Environmental physicians attribute this decline to the growing exposure to petrochemical products and the resulting xenoestrogens. Other causes of low levels of testosterone in males include primary testicular dysfunction, also known as Klinefelter Syndrome, pituitary dysfunction and hypothalamic dysfunction.
In our medical practice, the diagnosis of hypotestosteronemia is made primarily by taking a thorough clinical history from the patient. Blood tests, including free testosterone levels and less often, luteinizing hormone (LH) and follicular stimulating hormone (FSH) are also helpful in the detection of low testosterone.
In keeping with my philosophy regarding the use of natural products whenever possible to obtain and maintain health and wellness, we treat this condition using natural testosterone in the form of injections of Testosterone Cypionate. Patients are given a physiologic replacement dose. This dose can be adjusted to allow our patients to receive the optimal benefits of testosterone without the side effects of other forms of testosterone. Patients take an herbal supplement, Saw Palmetto, in conjunction with testosterone. Saw Palmetto decreases the conversion of testosterone to DHT, which can cause benign prostatic hyperplasia. We conducted our own in-house study regarding testosterone supplementation in male allergy patients. The results of the study indicated that the vast majority of patients experienced significant improvement of many symptoms, including fatigue, mental sharpness, memory, abstract thinking, mathematical ability, goal setting, initiative, assertiveness, decisiveness, sense of well being, self confidence, depressed moods, anxiety, irritability, muscle strength and romantic inclinations.
The thyroid gland governs the body’s metabolism and growth through the production of thyroid hormones. These hormones determine our body’s metabolic rate, the rate at which our body’s cells produce and utilize energy. If your thyroid gland were to be removed, and you were not given any supplemental thyroid, then you might live one year. You would slowly unwind like a doll on Christmas morning until your body would cease functioning. The thyroid hormones are essential for life.
The thyroid gland produces two hormones: tri-iodothyronine (T3), the active, primary intracellular hormone and thyroxine (T4), the inactive, primary extra cellular hormone. Thyroxine (T4) is produced by the thyroid gland in twenty (20) times the concentration as T3. T4 must be absorbed into the cells where it must be converted to T3 in order for the cells to function at a healthy metabolic rate. If T4 is not properly assimilated into the cells or converted to T3 within the cells, then hypothyroidism results. It is not the level of thyroid hormone in the blood that is important, but rather, how much T3 is present within the cells. This is why blood tests are inconclusive and oftentimes do not correlate with a patient’s clinical symptoms. The thyroid hormone, T3, enables the cells to produce and use energy, which is ultimately converted to heat, giving the body its temperature.
As we age the thyroid gland, like all the endocrine glands, produces lower levels of thyroid hormones. Because the “normal laboratory range” of thyroid hormones is based upon a population normal, 90%-95% of all individuals will have thyroid levels that fall within the “normal range”. But many people whose thyroid hormone levels fall within the so called “normal” range do not feel normal or healthy. Young healthy individuals have thyroid hormone levels which are high in the “normal range”. Older, less healthy individuals have thyroid hormone levels which are in the lower end of the “normal range”. Over your lifetime your thyroid hormone levels call fall by 50%, with you experiencing a 50% decline in your energy level, yet your thyroid hormone level will remain in the laboratory “normal range”, the low end of the “normal range”, yet still in the “normal range”. Despite the fact that you may have a host of symptoms of hypothyroidism, due to your decline in thyroid hormone production with age, your doctor will tell you that you are in the “normal range”. But you are not feeling normal because your thyroid hormones have declined as you have aged. You do not want your thyroid hormones to be in the “low normal range”, rather you want to keep your thyroid hormone levels in the “optimum range” so that you have good energy and feel healthy.
Hypothyroidism is a commonly overlooked and undiagnosed medical problem that severely impairs an individual’s quality of life. Hypo means low, so hypothyroidism relates to a medical condition manifested by low thyroid gland function or by low thyroid hormone action in the cells. If left untreated, it can lead to a host of medical illnesses. Thyroid deficiency frequently causes chronic fatigue, recurrent headaches, including migraines, recurrent and chronic infections, skin disorders, obesity, menstrual irregularities and infertility, emotional disorders, hypertension, coronary artery disease, cancer and the complications of diabetes.
Hypothyroidism usually manifests itself gradually over a period of years with the progressive and insidious development of one or several of the following symptoms:
- Weight Gain
- Cold Extremities and cold intolerance
- Decreased mental sharpness (brain fog)
- Slow speech
- Depression or mood swings
- Dry skin
- Hair loss
- Sluggish bowel function
- Fluid retention
- Muscle pain (fibromyalgia)
- Joint pain
- Tiredness after a full night’s sleep
- Tingling and/or numbness in extremities
- Irregular menstrual cycles
- Recurrent yeast vaginitis
- Allergic disorders
- Recurrent infections
- Decreased sweating
The following are physical signs of hypothyroidism:
- The three P’s: pallor, pastiness, puffiness
- Enlarged tongue with teeth indentations
- Loss of hair on the lateral third of the eyebrows
- Decreased body hair
- Thinning hair
- Cold extremities & cold skin
- Dry skin
- Brittle fingernails with ridging
- Low blood pressure
- Slow pulse rate
- Low basal body temperature
- Enlarged thyroid gland
- Elevated cholesterol and triglycerides
The most common causes of hypothyroidism are:
some prescription drugs
Hormonal imbalance. Women have hypothyroidism at least four (4) times as frequently as do men. This is commonly due to female hormonal imbalance in midlife which leads to a condition known as estrogen dominance. As the ovaries age, women produce decreasing amounts of progesterone, the hormone of the last half of the menstrual cycle. Progesterone deficiency is the cause of estrogen dominance. Estrogen dominance causes the liver to produce increasing levels of a protein, which circulates in the blood, called thyroid binding globulin (TBG). Even when the thyroid gland is producing sufficient amounts of hormone, TBG will bind to the thyroid hormones, lowering the free, unbound thyroid hormone available for use. This in turn causes a decrease in the metabolic rate, lowering the body’s overall energy level. Birth controls pills, pregnancy and postmenopausal estrogen supplementation all lead to increased TBG. Commonly, women complain that their metabolism changed after one of their pregnancies or when they began birth control pills or supplemental counterfeit estrogen hormones. The male hormone, testosterone, does not increase TBG. In fact, testosterone stimulates the conversion of the inactive thyroid hormone, T4, to the active thyroid hormone, T3, within the cells. This is why men have fewer problems with low thyroid function than do women.
Autoimmune Thyroiditis, also known as Hashimoto’s Thyroiditis, is another cause of hypothyroidism. In this disease, the patient’s own immune system is dysregulated and produces antibodies to the individual’s thyroid gland and to the thyroid hormones circulating in the blood. This immune system disorder is frequently associated with allergic disorders. Low intracellular thyroid function and allergies travel together like thieves in the night. In my practice we have tested thousands of individuals since 1991 to determine the presence of thyroid antibodies. Approximately 31% of our female allergy patients and 18% of our male allergy patients have Autoimmune Thyroiditis. This is far greater than the 5% of individuals in the general population who have this disorder. Autoimmune Thyroiditis prevents thyroid hormone from being properly assimilated into the cells.
Nutritional deficiencies. Less commonly than the above, hypothyroidism may be caused by nutritional deficiencies. The thyroid gland requires iodine for the normal production of the thyroid hormones. In the past, hypothyroidism occurred commonly in the Midwest and in the Great Lakes regions of the United States and was characterized by an enlarged thyroid gland, known as a goiter. This condition was due to low iodine levels in the soil and in fresh water fish. With the advent of iodized salt the incidence of this problem has been dramatically reduced. Goiter areas still exist in many areas of the world. Clinical hypothyroidism may also be caused by a selenium deficiency. Selenium is a trace mineral that plays a critical role in the conversion of the inactive hormone, T4, to the active intracellular thyroid hormone, T3. The soil in the United States is deficient in Selenium. The thyroid gland may produce insufficient amounts of the thyroid hormone due to a variety of underlying genetic defects. These conditions are very uncommon.
Another rare cause of the hypothyroidism is pituitary gland dysfunction. The pituitary gland is located in the brain and regulates the thyroid gland by secreting thyroid stimulating hormone (TSH). When there is not a sufficient amount of thyroid hormone in the blood, the pituitary gland increases the production of TSH. If the pituitary gland is diseased and unable to secrete TSH, then the thyroid gland will not produce thyroid hormone.
Prescription drugs, such as Dilantin, Lithium, and Beta Blockers, used in the treatment of hypertension and heart disease, blunt the effect of the thyroid hormones in the cells of the body, leading to symptoms of hypothyroidism. As mentioned earlier, the counterfeit hormones and horse estrogens, such as Premarin, Ogen, and Cenestin, and birth control pills, which are also counterfeit hormones, raise the level of thyroid hormone binding globulin and prevent the proper uptake of thyroid hormones by the cells of the body.