hi guys welcome back to the channel I'm here again with Dr Kishan hello and
this week we are gonna be talking about thyroid it's quite a hot topic isn't it
we've got so many friends on the GP's even they've come to me several times
and say I just don't think that we're able to manage thyroid that easily
in the community if you have an established clinically defined deficit
in your thyroid function and that might be through autoimmune condition or it
might be after a surgical procedure you will get some form of thyroid
replacement the usual replacement is in America it's called synthroid here it's
called thyroxine T 4 and T 4 is then supposed to convert into T 3 in the body
we rely on T 3 for so many different functions in fact every cell throughout
the body is supposed to have some effect from T 3 but t 3 itself can be low and
that may not be picked up in the standard testing that's done for thyroid
so I have some thyroid testing done because I put on a lot of weight and I
just couldn't lose the weight let's flash up a picture of me fat there we
are yeah and I was really tired couldn't get
up bed in the morning it was really difficult had some thyroid testing it
was so - Sarah didn't have a usual thyroid deficit that should
be defined as being hypothyroid however she had a functional thyroid deficit
which means that her numbers just didn't cross into that that arbitrary line
which says that she's got a thyroid disorder she had all the symptoms of
someone with with that issue and also she had low t3 so the treatment she is
having is essentially to restore that particular hormone and a small amount of
the t4 as well so my GP before actually prescribed me to you for t4 is like it's
almost like a storage thyroid hormone it needs to be there in the body but
it's also supposed to convert into t3 which is metabolically active and the
issue is that the vast majority of patients or the vast majority of the
population doesn't convert t4 which is lever thyroxine or thyroxine into t3 and
that's the problem because it's t3 that we need but also my TSH was yes
so that's quite interesting yeah you're a mystery well people keep telling you
yeah I know why don't you maybe explain to the guys
at home about general supplementation or medication that people can take if they
are hypothyroid this is all subject to testing and once we've got the numbers
and we can sort of have a have a really good assessment of where you are we can
then make a much more directive treatment plan for you so for sometimes
it might be that you just need nutritional supplementation with buy it
with the minerals iodine and selenium zinc all of which I'm taking about yeah
fantastic and also then sometimes we might need to
actually supplement you with the thyroid hormones in England we generally
supplement patients with t4 but the vast majority of patients that we see don't
convert t4 to the metabolically active t3 and that's the main issue that we
have they'll be on t4 for many years but not seeing any benefit they still feel
lethargic their hair can become thin it can have difficulty losing weight and
there's even some reported depression and under a whole host of other symptoms
and associated with a functional thyroid deficit what we tend to do is we'll tend
to look at your numbers and then provide you with a almost a custom-made thyroid
replacement so that might be an animal source or it might be a synthetic
compounded version and I find that by doing that what that approach that sort
of precision medicine approach and we get much more predictable result
actually let's talk about that so I was taking her fur and wor thyromine as well
for sign however for some patients who have got thyroid auto anti-bodies you were
doing something different so I prefer to use synthetic t4 and t3 in a unique sort
of combination and I'll put it through a slow-release format or a liquid and I'll
just dose patients accordingly to their needs the other thing I find is there's
quite a few of my patients who really don't like the idea of having things
derived from animals so poor sign the other the other gradually extractors from its
bovine source as well so I think for those patients you know we've got we've
got different options as well and of course some people say that you
shouldn't treat the thyroid until you've treated the adrenals you know so this is
the thing you know in in hormonal practice where everyone does things a
little bit differently and we're not endocrinologist with interpretive
hormonal doctors we want to look at stepwise health and the adrenal the
adrenal gland is really really like a central player in hormonal health so if
that's not working well and if there's a dysregulation there then that has a
definite impact on thyroid health as well so I actually kind of agree I think
we'd have to address the adrenal gland and to find out more about what happened
to my adrenals join us again we'll see you later