Limits of Liability/Disclaimer of Warranty

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2 Limits of Liability/Disclaimer of Warranty The author, Brad Shook has made their best effort to produce a high quality and informative reference. The author makes no representation or warranties with respect to the accuracy, applicability, fitness or completeness of the contents of this program. They accept no liability of any kind for any losses or damages caused or alleged to be caused directly or indirectly, from using the information contained in this book. This book is not intended for use as a source of any legal or medical advice. The publisher wants to stress that the information contained herein may be subject to varying international, federal, state and/or local laws or regulations. The purchaser or reader of this publication assumes responsibility for the use of these materials and information. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen. Page 0 of 8

3 The Office of Dr. Brad Shook As a quick and easy way to give you a general idea of the potential problems that could be causing your thyroid symptoms, I have developed this patient based, thyroid markers interpretation form. All you need to do is get a copy of your thyroid related labs, transfer the values of your laboratory markers to this form. If your laboratory ranges are outside of the optimal ranges I use, or outside the lab high and low ranges, you will be able to read about some of the potential problems associated with each marker. This is not a comprehensive list of possible problems that can occur with your thyroid physiology, and only the most common physiological breakdowns that I see on a regular basis are mentioned. I would be very difficult to expand my explanation of possible laboratory findings beyond what I have done, simply because of the shear amount of time and information required to detail each marker and all of the possibilities. This form is in no way a substitute for medical care, and is not provided to you to treat, diagnose or cure any condition. In functional medicine, we seek to identify the drivers of disease processes, so that we can work to begin a program of supportive care, to help your body heal by addressing the root problem. We use more sensitive laboratory test ranges, called functional ranges. These values compare you to what is believed to be a healthy normal population of people, rather than just comparing you to the laboratory average range, which is based on an unhealthy population. We want to detect potential problems before they become a diagnosis, and work to be preventative, and restorative. Functional Medicine takes the opposite approach of traditional medical care, which is primarily based on symptomatic treatment once you are sick. If you have a symptom or problem, you can be treated under the traditional model, but that system of healthcare does not focus on a true preventative or restorative approach to most chronic health problems. All of your doctors care about you, and mean well, but they are tied to a system that approaches healthcare from a reactive, rather than proactive perspective. Before reading through, and trying to utilize these thyroid markers make sure you watch Dr. Shook s video on how your body makes and uses thyroid hormone. This video explains the process of thyroid hormone creation, and follows it as it passes through your body until it is finally used by the cell. There are 24 known physiological patterns of thyroid dysfunction that can cause hypothyroid symptoms, and thyroid replacement hormone is only a solution for 1 of those 24 patterns, primary hypothyroidism. Once you finish with Dr. Shook s first video on thyroid physiology, view his presentation on thyroid dysfunction, and then watch his presentation on autoimmunity if you have Hashimoto s, Graves disease or any other autoimmune condition. Understanding autoimmunity is critical if you have an autoimmune thyroid condition, because the autoimmune condition is usually the primary reason for your symptoms, not low thyroid hormone levels. If you are interested in working with Dr. Shook, you must watch all of these videos before an appointment can be scheduled. Your understanding of Dr. Shook s approach to supporting your health is the starting place for you to begin your journey to taking your health back. Your health has to be a top priority, and it is our goal to educate you so that you can become empowered, and be your own advocate. Page 1 of 8

4 *The following values follow adult reference ranges, and have been derived from numerous sources including clinical observation. Please be aware that lab ranges for most laboratory values are different depending on the lab you go to. That s right, lab values are different around the country, and are based on averages of people that visit that lab, not based on a standard value for everyone! If your lab says that for TSH to be lab high, the value must be over 5.5, then for you to be diagnosed as hypothyroid your TSH must be above 5.5. The lab high value in my area is 4.45, but you have to go by the values from your lab when diagnosing a condition. For this very reason, in Functional Medicine we use Functional Ranges, or optimal ranges that compare you to healthy people, and not just to the lab ranges which are considered to be associated with poor health. What are Functional Ranges? Page 2 of 8

5 Watch Dr. Shook s first video and follow along using this diagram. If you understand this diagram, you will know more than 99% of the healthcare providers that you will see. Knowledge is power, be your own advocate! Here is the link to the video. Page 3 of 8

6 TSH TSH (Thyroid Stimulating Hormone or Thyrotropin): Stimulates the enzyme TPO to manufacture thyroid hormones through the recruitment of iodine and hydrogen peroxide. TSH is used to confirm or rule out suspected hypothyroidism. It is produced by the pituitary gland, and as its name implies, it stimulates thyroid hormone production. It is often used alone to infer whether or not thyroid hormone (T4) is low. When TSH goes high, T4 should be low if the feedback loop to your brain is working normally. As an individual marker, it is my opinion, and the opinion of other experts in the field of Functional Medicine that this is not adequate to best determine the mechanism behind hypothyroid symptoms. Clinical Adult Range: mlU/L Optima, or Functional Adult Range: mlU/L Common Causes of TSH Increase: Thyroid hypofunction Common Causes of TSH Decrease: Thyroid hyper-function, anterior hypofunction T3 T3 (Triiodothyronine): T3 is a thyroid hormone produced mainly from the peripheral conversion of thyroxine (T4). T3 contains three molecules of iodine, and is the primary thyroid hormone used by your body. Most of your T4 to T3 conversion occurs in the liver and GI tract. If your liver is not functioning properly you may have a difficult time converting T4 (which is mostly inactive in the body) to T3 (the active for of thyroid hormone). Without enough T3 hormone you will have hypothyroid symptoms. Optimal liver function and a healthy GI tract are critical for conversion of T4 to T3. Clinical Adult Range: ng/dl Optimal Adult Range: ng/dl Common Causes of T3 Increase: Hyperthyroidism Common Causes of T3 Decrease: Hypothyroidism T4 T4 (thyroxine): T4 is the major hormone secreted by the thyroid gland (93%). Thyroxine is a combination of 4 iodine molecules and the protein thyroglobulin. T4 is mostly inactive in the body. T4 is bound to the carrier protein Thyroid Binding Globulin (TBG) and transported throughout the body until it reaches its destination, where T4 is released by the protein (becoming free T4) to be used by the tissue. Clinical Adult Range: mcg/dl Optimal Adult Range: mcg/dl Page 4 of 8

7 Common Causes of T4 Increase: Hyperthyroidism Common Causes of T3 Decrease: Hypothyroidism, anterior pituitary hypofunction Free T3 Free T3 is non-protein bound Tri-Iodothyronine that is available for the cells of your body to use. A common clinical presentation is increased or decreased thyroid binding globulins (transport protein for thyroid hormones) from increased estrogens or testosterones that will lower or raise Free T3 levels. Clinical Adult Range: ng/dl Optimal Adult Range: ng/dl Common Causes of T3 Increase: Hyperthyroidism Common Causes of T3 Decrease: Hypothyroidism Free T4 Free T4 is non-protein bound thyroxine that is available for the cells of your body to use. A common clinical presentation is increased or decreased thyroid binding globulins (transport protein for thyroid hormones) from increased estrogens or testosterones that will lower or raise Free T4 levels. Clinical Adult Range: ng/dl Optimal Adult Range: ng/dl Common Causes of T4 Increase: Hyperthyroidism Common Causes of T4 Decrease: Hypothyroidism Reverse T3 Of the 93% of thyroid hormone made by your thyroid gland is T4. The majority of the T4 made in your body is converted to T3 in your liver. Of the T4 that is converted in you liver, 20% of it is converted into Reverse T3 (rt3). Reverse T3 is an inactive isomer of T3. Reverse T3 levels fluctuate for numerous reasons, but the most common I see clinically is elevation due to inflammation or high T4 levels that drive more T4 through the reverse T3 conversion pathway in the liver. Though Reverse T3 is inactive, if it is present in high levels it can compete for thyroid hormone receptor sites on the surface of every cell in your body. Adult Range: ng/dl Optimal Adult Range: ng/dl Page 5 of 8

8 T-3 UPTAKE T-3 Uptake T-3 uptake measures the unsaturated binding sites on the thyroid binding proteins (TBG), these are the transport proteins for thyroid hormones. If the T3 Uptake is low, it could indicate that you have an increased number of TBGs that are holding onto your thyroid hormones and not letting go of them for the body to use, lowering your ability to uptake the hormone. This pattern is frequently seen when using birth control or estrogen hormone replacement therapy. T3 Uptake is often high, when there is a decrease in TBGs, and that pattern is commonly seen with increased testosterone levels. Increased testosterone levels are frequently seen in women with PCOS, and that get accidental exposure to testosterone cream. **Testosterone creams have been shown to get passed onto children by fathers and grandfathers with very serious side-effects. Make sure that this is not happening to you or any children in your life. Clinical Adult Range: 22-36% Optimal Adult Range: 27-37% Common Causes of T-3 Uptake Increase: Thyroid hyperfunction Common Causes of T3 Decrease: Thyroid hypo-function Thyroid Peroxidase (TPO) Antibodies TPO Antibodies are used to determine if your immune system is attacking the enzyme TPO that is located inside the cells of your thyroid gland. If these are positive, you have an autoimmune process against your thyroid gland. If you are over 19 y.o. the normal range is If your levels are over 34 you have an autoimmune process against TPO. Thyroglobulin Antibodies (TgAb) Thyroglobulin Antibodies are used to determine if your immune system is attacking the thyroglobulin protein located in your thyroid gland. Reference range is <4.0 IU/mL for all ages. Thyroid-Stimulating (TSI) Antibodies TSI antibodies are antibodies against the TSH receptors on the cells (thyrocytes) of your thyroid. When these antibodies attacked the TSH receptor they stimulated the thyroid cells to produce massive quantities of thyroid hormone. This increase in thyroid hormone can create hyperthyroidism and lead to a life threatening increase in thyroid hormone that can result in stroke and heart-attack. This hyperthyroid states are often referred to as a thyroid storm. Any person with TSI antibodies, or that is diagnosed with Graves Disease must be medically managed by someone so that in the event you have an autoimmune flare, you can be immediately treated with medications to suppress the thyroid storm. Reference Range = < or = 1.3 TSI index. This range applies to all ages. Page 6 of 8

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