Hypothyroidism or Low Metabolism
R. M. Alford, M.D.
Copyright 1998






Hypothyroidism or Low Metabolism

The etiology of hypothyroidism is the failure to produce sufficient triiodothyronine (T3) to meet the optimal metabolic demands for normal body function. Such failure is secondary to one of two problems:

  1. The inability of the thyroid gland to produce sufficient thyroxine (T4) the primary precursor of T3
  2. The production of an excess amount of reverse T3 (rT3), which interferes with the production of T3
Triiodothyronine, the active form of thyroid hormone, is produced by the de-iodinization of thyroxine, the reservoir phase of thyroid, of a particular iodine radical. When the isomer of the de-iodinization enzyme is present, a different iodine radical is removed producing reverse T3, a totally inactive isomer of T3. When there is an excess amount of rT3 being produced relative to the available common precursor, insufficient T3 is produced for an optimal metabolic rate with resultant hypothyroidism. This hypothyroidism can only be treated successfully with the removal of a particular iodine radical.

The diagnosis of hypothyroidism needs to be made clinically - a very easy diagnosis using the many easily recognizable symptoms and clinical findings. The presently used tests are useful only in the diagnosis of T4 deficiency. With the use of the panel of the total T4 and the T3 resin uptake tests, a close approximation can be made of the T3 and rT3 levels.

The approximate median of the two tests is essentially the euthyroid T4 level. Thus, if the total T4 is below 8 mcg/dl (N=5-12 mcg/dl) and the T3 uptake test is below 30% (N=25-35%), the patient is not producing sufficient T4 for an optimal metabolic rate and needs supplemental T4. If the total T4 is between 8 and about 12 mcg/dl and the T3 uptake test is below 30%, the patient is producing a relative amount of rT3, the thyroid gland is unable to produce sufficient T4 to compensate sufficiently to allow for enough T3 production for an optimal metabolic rate. These patients do best on a combination of T4 and T3, or liotrix (Thyrolar). If the total T4 is above 12 mcg/dl and the T3 uptake test is below 30%, the patient is producing a considerable amount of rT3 and T4, but the gland will never be able to produce enough T4 to compensate. These patients need only T3 supplementation. If the total T4 is under 8 mcg/dl and the T3 uptake is above 30%, that patient is not only producing insufficient T4, but also some rT3 and needs the combination supplementation.

What are the most common symptoms of hypothyroidism? Usually the hypothyroid patient is characterized as being slow, dull, obese with dry skin, requiring a lot of sleep. The patient may also be of the opposite extreme. Coldness is the most prominent and absolute symptom, a result of the decreased metabolic rate. If a patient's hands are cold or cool in an inappropriate setting, that patient is hypothyroid. Hypothyroid patients may be overweight or underweight; have dry or oily skin with acne in the latter instance; have dry or oily hair that may be fine or coarse; have reduced intelligence or be very intelligent; have insomnia or hypersomnia; have constipation or spastic gut; bradycardia or tachycardia; absence of sweating or hyperhidrosis; and any of the following diseases.

Probably the most serious societal problem seen today resulting from hypothyroidism is the increasing immaturity and insecurity in our youth. The immaturity results from the relative failure of normal physical and chemical development. The insecurity develops as a result of this rendering of such individuals incapable of competing successfully with the more mature. As a result, they seek other means of compensation. The gun users in the recent shooting episodes are extreme examples of the problem. The increase in juvenile crime, early sexual activity with early pregnancy, poor school attendance and dropping out, cheating, etc. are some of the manifestations. They are continually looking for self-satisfaction that can never be attained. Going on to adults, promiscuity, cheating spouses, divorce, self-indulgence with decreasing altruism, constantly changing jobs, etc. are some examples. The individual with more normal thyroid function has a considerable sense of well being, self-confidence and self-assurance, and does not need to continually look for greener pastures.

How may hypothyroidism be prevented? High levels of rT3 are documented with pregnancy, liver disease and chronic illness. If the hypothyroidism that results from the elevated rT3 during the first trimester, before the fetal thyroid begins to supplement the maternal deficiency, is corrected as outlined above, thyroid deficiency in the child can essentially be prevented. It is the need to supplement the maternal deficiency by the fetal thyroid that results in the thyroid deficiency in the offspring to a degree relative to the motherís.

Finally, why is such a high percentage, well over ninety percent, of our population relatively hypothyroid? The continental US is practically devoid of iodine, essential for the production of thyroid. When our ancestors started across the continent and left their source of iodine behind, they soon became relatively hypothyroid, the women suffering most because they had to share their meager supply with each succeeding child, and they usually had large families. With each pregnancy, mothers became more deficient and each succeeding child also became more deficient. The larger the families, the faster the incidence of hypothyroidism progressed. As a result, each generation has become more deficient. This explains why the inner city poor of all nationalities have the greater deficiency with their history of large families. The supplementation with iodine only slowed the progression of hypothyroidism. Hypothyroidism and the incidence of its progression can only be successfully treated with thyroid hormone.


Essential Hypertension *

Elevated Cholesterol *

Atherosclerosis *

Raynaudís Disease *

Scleroderma *

Diabetes and its Complications *

Hyperhidrosis *

Intelligence *

Summary *

Essential Hypertension

Hypertension is a result of the hypothermia of hypothyroidism.

It is well established that exercise is beneficial for the hypertensive, but to date no logical explanation has been ascribed. The beneficial component of exercise is the heat generated. This is nature's most potent vasodilator. If heat is beneficial to the hypertensive, there then has to be some degree of coldness or hypothermia, nature's most potent vasoconstrictor, causing the hypertension. Hypothermia is essentially always secondary to the decreased metabolic rate of hypothyroidism.

The core organs, including the brain, of the human organism are programmed to function optimally at a very narrow temperature range. When the temperature control center senses there is core hypothermia, it signals the shunting of the warmer arterial blood directly back to the core via peripheral glomus bodies. This shunting produces a relative falling in blood pressure. With the steady decline in the metabolic rate with aging, there is increasing shunting with a progressive fall in blood pressure. When the fall in blood pressure reaches the point that the renal perfusion pressure is compromised, angiotensin is released to relatively constrict arterioles to raise the renal perfusion pressure. Thus is the evolution of hypertension

The medications being used in the treatment of hypertension today are mainly aimed at reducing the vasoconstrictive effect of angiotensin, the protector of the renal perfusion pressure. This is especially true of the angiotensin converting enzyme inhibitors and to a lesser extent the calcium blockers. Over a period of time this will lead to increased renal damage.

The most effective way to reverse the entire process, as would be suggested by the above, is to raise the total body temperature and end the shunting. With early diagnosis and treatment of hypothyroidism, hypertension can be prevented and in the early phases effect a cure. Once atherosclerosis has begun, the rate of improvement is dependent on the particular stage to which it has progressed. When yet in the cholesterol phase, the cholesterol will gradually be reabsorbed as it is utilized. Once calcification has occurred, improvement is less assured.



Elevated Cholesterol

Cholesterol levels are directly related to the level of thyroid function. Cholesterol is produced by the liver and is the chief building block in the formation of cell walls. With normal thyroid function, there is a higher rate of cellular production with its increased utilization of cholesterol. Hypothyroidism may lead to impaired liver production of cholesterol translating into low to normal levels of cholesterol. A normal to low cholesterol level does not assure normal thyroid function without atherosclerosis.




Atherosclerosis occurs in the hypothyroid patient as a result of the angiotensin-produced arteriospasm with resultant intimal damage and cholesterol deposition at the damaged sites. Untreated, the cholesterol deposits are replaced with calcium. When treated appropriately and early enough with thyroid, over time the cholesterol will be reabsorbed.



Raynaudís Disease

Raynaudís Disease is the result of the hypothermia of hypothyroidism. Raynaudís has the same etiology as that seen in the hypertensive, but, because they on average are ectomorphic and have no subcutaneous fat for insulation, suffer at a much younger age from the ravages of the greater shunting of circulation away from the peripheral structures. The result is atrophy of the skin and ultimately gangrene of the digits. The use of calcium blockers as an attempt to open the constricted arteries cannot succeed and will ultimately increase the causative hypothermia.





Scleroderma has the same etiology as Raynaud's except for the added manifestation of subcutaneous fibrosis. The deficient production of T3 reduces the production of cortisol by the adrenals with the resultant inability to block the autoimmune reaction that results in the fibrosis.




Diabetes and its Complications

Diabetes occurs only in the presence of hypothyroidism. Hypothyroidism being present at birth, diabetes may occur at anytime thereafter. With an impaired immune system being a part of hypothyroidism, those most impaired are the most vulnerable to the virus that attacks the insulin producing cells. If instead diabetes is secondary to an autoimmune reaction that destroys the islet cells, in such patients the T3 deficiency does not allow the adrenals to produced the necessary cortisol to block the autoimmune reaction. With the appropriate supplemental use of thyroid during pregnancy, new cases of diabetes could conceivably become a thing of the past.

Additionally, raising of the metabolic rate in the diabetic will achieves the same beneficial effect of consuming sugar just as is seen with exercising. It has also been reported that patients taking thyroid run higher than "normal" blood sugars. Maybe it is time to look at what a truly normal blood sugar is in a truly euthyroid state. It may be that those patients having low blood sugars are hypothyroid.


As for the vascular complications of diabetes, they are essentially the same as that seen in Raynaudís (discussed above), except here the changes are seen body-wide instead of primarily in the extremities (diabetic are more commonly overweight). Again, raising of the core temperature will open the peripheral vasculature and resolve the problem up to the point of already present permanent changes.




Hyperhidrosis is unexplained sweating without exertion or in other than hot weather. It also presents as wet hands and feet and axillary wetness. Foul body odor may also be associated. Supplementation with thyroid with its raising of the total body temperature cures the problem. The absence of sweating with exercise or in hot weather is an indication of hypothyroidism. Normal sweating occurs with the hyperthermia of exercise or hot weather as a mechanism for cooling.




It has long been known that a child born without a thyroid gland will have no intelligence unless supplemented early with thyroid. A cretin, a child with limited thyroid function, will only have an intelligence level relative to the degree of thyroid deficiency unless supplemented early.

It would then seem logical that thyroid deficiency would lead to a universal relative deficiency of intelligence. This is not the case. A very high percentage of very intelligent individuals today have relative degrees of hypothyroidism. After years of observation, it would appear that those intelligent individuals with the more normal thyroid function are smarter. That is, they have more common sense, probably related to more normal brain perfusion and production of serotonin. The euthyroid brain is like a perfectly operating computer, able to function faster and solve more complicated problems with greater storage capability. It is reported that the brain begins losing brain cells steadily from the time of birth. Better perfusion and oxygenation should slow the process. The higher blood sugar levels found in patients taking thyroid would seem to indicate that the core organs, especially the brain function better with higher glucose levels.


It is well established that cancer evolves from an abnormal gene most likely found in patients with an impaired immune system. It is also well established that hypothyroid patients have impaired immune systems, the degree relative to the degree of thyroid deficiency. It would then be a logical assumption that individuals with optimal thyroid function would have a much greater ability to delay the expression and emergence of that cancer-producing gene. If this would be true for cancer genes, why would it not be true for other genetic abnormalities such as cystic fibrosis? In short, the best of genes are only as good as the individuals' metabolism and chemistry will allow.


Not too long ago a group of practicing homosexual males was studied. A part of the study was to challenge them with the administration of estrogen. The results showed that about 50% of them responded as a female would with the production of prolactin. More recently, it has been observed that a predominant majority of homosexual males have been the last child in their family, a time when mother has become most hypothyroid. It has also been observed over the years that homosexual males die at a younger than average age of arteriosclerotic heart diseases and cancer. Some thirty years ago, a study of a group of overt hypothyroid males disclosed that as a group, they had difficulty producing testosterone. The last study gives strong testimony that homosexuality has a strong relationship to hypothyroidism, and the first study that homosexuality is of an organic etiology. It would also seem logical that the other 50% in the first study are also hypothryoid with levels of immaturity and insecurity, along with reduced testosterone production, such that they are incapable of relating appropriately to the opposite sex. They find it much easier to relate to the more effeminate, homosexual males. As you may assume from the above, homosexuality is a preventable disease.

The above would also help to explain the 50% drop in male testosterone and sperm count levels over the last 40 years, resulting in a growing number of infertile and, as is confirmed by the considerable interest in the new impotence medications, impotent males.

No similar studies have been done relative to the female population, but such studies would probably show that the hypothyroid female produces less estrogen. This would fit with the growing incidence of homosexuality among the female population and with the growing incidence of female infertility.

As for children born of pregnancies appropriately supplemented with thyroid, the boys have been very masculine and the girls very feminine.

Mental Diseases

Just as intelligence is related to thyroid function, mental diseases are also related hypothyroidism and the failure of the brain to produce optimal levels of chemicals such as serotonin and acetylcholine. The lack of optimal brain perfusion and inability to readily clear metabolites adds to the problem. The fact that schizophrenia, depression and ADD respond to specific medications would indicated they are a result of a chemical imbalance, with hypothyroidism being the logical choice.


All individuals with normal thyroid function will be mesomorph or of a muscular habitus. This would indicate that both the ectomorph and the endomorph are hypothyroid. Muscle tissue is heavy compared to fat tissue. The latest tables released for optimal weights would seem to be slanted toward the ectomorph, certainly not for a muscular individual, whom should be the ideal for determining optimal weights. The enhanced muscularity does not just apply to the visible musculature, but also to the heart and muscles in the other organs. The optimal perfusion of all body parts will also ensure that muscles present will have optimal function and endurance.

The Skin

Studies have shown that the elastic fibers in the skin are the first component to be lost when the skinís vascular perfusion is diminished, with resultant wrinkling an evidence of relative aging. With hypothyroidism, there is early constriction of the skinís capillary bed.

The same loss of capillary perfusion is the leading cause of many skin problems, the most notable being acne. With the loss of normal perfusion, the oil glands in the skin do not function normally and become vulnerable to infection. Psoriasis is another.


Some thirty years ago the Hershey Sleep Center published a study on a group of overt hypothyroid patients and found that as a group, they had a problem attaining the deeper levels of sleep, that is Planes IV and V, the rejuvenating levels of sleep. They sleep fitfully, rouse easily, sleep shortened or extend periods and awaken tired in the morning. In practice, sleep abnormalities can be used as a factor in making the diagnosis of hypothyroidism, with thyroid, especially triiodothyronine, being very effective in the treatment of all types of sleep disorders, from insomnia to narcolepsy. The probable determining factor is the deficiency of serotonin, along with the lack of normal perfusion.

Weight Problems

Being too heavy as well as being too thin are both health problems. A true euthyroid is always a mesomorph. The ideal level of body fat is in a range of about 10-17%. Less than 10% body fat can be just as much a life threatening problem as obesity. The use of the appropriate thyroid will assist in weight loss for the obese along with dieting, but is not a panacea. It takes work and dedication, but with weight loss, such individuals will have an increased sense of well-being with an increased incentive to keep it off. Weight loss may seem slow in the early stages because of a concomitant weight gain in the form of increased muscle mass. They need to follow their measurements to show that there is a loss of fat. The ectomorph will have fewer problems. Thyroid seems to work in their case by assisting in better assimilation and utilization of food with a relief of the hyperkinesis seen in many of them. They also do better as they develop an insulating layer of fat.



The thyroid gland would seem to be the master gland that controls all functions in the human organism, including the function of all the other endocrine glands. With normal function from birth, it would seem that man could become eternal, but just as a very fine engine ultimately wears out, so will the human organism. In Genesis, it states that God destined us to live a maximum one hundred and twenty years, and I do not think we can ignore that fact. But, more optimal function can lead to a much more healthy, pleasurable and fulfilling existence than the vast majority of mankind suffers through today. God Bless You.

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