Radio Interview: Dr Lowe - Dr Leisa Wheeler

[Guest guest]

Every one of you should read this Interview between Dr Lowe and Dr Wheeler (on Australia Radio recently). I believe Dr Wheeler is a member of this forum. Make yourself a cuppa - put your feet up, make yourself comfortable and set time aside to read it all. I am sure it will explain a lot to you and hopefully, answer some of your questions.

Luv - Seila

Embracing Health with

Leisa Wheeler N.D. and Dr. Lowe

Leisa N.D.: Hello everyone, you're listening to Leisa Wheeler from Embracing Heath.

As many of you know, I work as the consulting naturopath for Hippocrates

Health Centre of Australia. It's a raw, living foods detoxification retreat.

I have for many years had a special interest in disorders of the endocrine

system most especially; thyroid and adrenal problems, as I suffered from

trouble in those areas myself.

In doing a lot of study and research into finding out what it takes to get well

from these conditions, my journey led me to the work of Dr. Lowe, one

of the world's foremost experts on fibromyalgia. He is also the author of the

impeccably researched clinical resource "The Metabolic Treatment of

Fibromyalgia".

He also co-authored "Your Guide to Metabolic Health" and is the Director of

Research of the Fibromyalgia Research Foundation. He has also authored

or co-authored more than 150 papers for scientific and professional

journals. I'm very pleased to have Dr. Lowe join us today to talk about his

research and his successful treatment programs for fibromyalgia.

Welcome Dr. Lowe.

Dr. Lowe: Thank you very much Dr. Wheeler. May I ask you; is it appropriate to refer to naturopathic physicians as doctor in Australia?

Leisa N.D.: No actually, no, we're just known as naturopaths and Dr. is reserved for medical practitioners only.

Dr. Lowe: It varies in the United States as you may know.

Leisa N.D.: Yes.

Dr. Lowe: In one stat e I am a chiropractic physician, in another state I'm a

chiropractor. It varies so I just never know.

Leisa N.D.: Ok, we might just start by explaining to our listeners a bit of an overview of what fibromyalgia is and what symptoms someone might be suffering from if they've been diagnosed with fibromyalgia or a similar condition.

Dr. Lowe: The two distinguishing features, if you eliminate all the others that are associated with what we call fibromyalgia, is widespread chronic pain and

for a quantitative number, the duration of the chronic pain is usually given

as a duration of at least three months, and of abnormal tenderness.

There always is given a series of associated symptoms that include virtually

always chronic fatigue, stiffness especially early in the mornings that lasts

more than 15 minutes and for some people it lasts up to a couple of hours,

depression, non-restorative sleep, poor memory and concentration, a

sensation of swelling, cold intolerance, abnormal sensations such as

numbness and tingling. Anxiety, headaches, in women menstrual abnormalities, usually profuse bleeding during the menstrual period, dry skin and mucus membranes, irritable bowel syndrome usually involving constipation. There may be other symptoms too, but those are the ones the patients most prominently report.

Leisa N.D.: Yes, there's quite a number of symptoms isn't there? It's quite a big list and I guess a lot of those symptoms are becoming more and more common in today's society whether they're diagnosed as fibromyalgia or not. How did your interest in fibromyalgia come about and what did your early research uncover?

Dr. Lowe: I began working with fibromyalgia patients when I realized there was asmall percentage of my patients…I specialized in myofascial trigger point therapy as a neuromuscular skeletal practitioner and that therapy is

extraordinarily effective. A lot of physical therapists, massage therapists

and in the United States a lot of naturopathic physicians also do myofascial

therapy and it's extraordinarily effective.

There was a subset of patients for whom it didn't work very well; in fact, it

made a lot of them even worse. I became obsessed with what was wrong

with these patients and as I pointed out in the largest magazine here in the

Untied States `Fibromyalgia Aware' -- the issue hasn't come out yet - but

that started me on an odyssey that hasn't ended until this day.

What happened initially is that in 1987, I was treating a patient who had

these symptoms that we would describe today as fibromyalgia and back

then the condition was called fibrositis. I sent her to a medical internist I

worked with who diagnosed her with having hypothyroidism.

I had treated her maybe 20 times with myofascial therapy, muscle and

connective tissue therapy and this gave her brief palliative relief, but after

she began taking thyroid hormone she responded to a couple of treatments

and that was it, I released her. I was so fascinated with her case that I

wrote a case report on it for a journal, which began my publishing in the

field and it started in 1987-1988.

As I began trying to figure out what was going on with these patients, I

communicated with other researchers and other specialists in myofascial

therapy, such as Dr. Janet Travell, some people might remember her as

President Kennedy's White House physician. She had gotten him out of low back pain when he was a senator so that he could run for President. When he became President he made her the first female White House physician. She was very elderly and she was well aware that chronic myofascial pain can be underlayed by hypothyroidism.

It was essentially reading her work that got me doggedly pursuing a

possible relationship between too little thyroid hormone regulation, and

what we called fibrositis and fibromyalgia as of 1990. That's how it started.

Leisa N.D.: There are not many doctors that have put the association together I see. I know in your book I had to laugh where you say "this is an approach to diagnosis in which the doctor uses his or her intelligence in a process ofrational judgment; this approach is largely absent from modern mainstream medicine". I see that quite a bit where the symptoms are ignored in favor of the blood tests. I have to agree, there's often an alarming lack of common sense in the medical professional.

I had one patient come in myself with a very large goiter, so she had a huge

swelling out of one side of her neck. It was very obvious and she had many

hypothyroid symptoms, yet her doctor had told her that her thyroid tests had

come back fine, that there was nothing physically wrong with her and

referred her to a psychiatrist!

This sort of thing happens all the time and I'm sure you've got hundreds of

similar incidents where the connection hasn't been made between the

symptoms of the patient and the condition.

Dr. Lowe: Definitely. A very unfortunate thing happened about 40 years ago, that is the TSH test that most doctors concentrate on and find very convenient, because it's supposedly simple to interpret where you can eliminate the possibility that a patient has hypothyroidism with it, supposedly.

What happened was some researchers around 1971 in earnest found that -- they were looking for how to help hyperthyroid patients -- in many patients that test was what they considered abnormally low.

When they compared the people in general and then they compared with

patients using thyroid hormone the level was much lower. They assumed

that since the level of TSH was higher in people who didn't have

hypothyroidism that patients with hypothyroidism suppressing their TSH

levels were taking too much.

The doctors sent out word the world over to cut their thyroid patient's

dosages in half. That began the appearance of chronic fatigue syndrome,

fibromyalgia and so on and so forth, a-typical depression and a variety of

gynecological problems.

Unfortunately, it became very profitable for corporations who manufactured

that test to sell it to laboratories and have doctors order it, it became

immensely profitable and the profit levels were in the billions. Now what we

have is a money flow that reinforces the belief that that test is valid for

deciding who does and doesn't have enough thyroid hormone regulation.

Leisa N.D.: Yes, that's very interesting, because I've suffered from this myself. Having had adrenal and thyroid problems, and knowing the limitations of the TSH test, which if the listeners aren't aware it's (thyroid stimulating hormone), but exactly what you've said there is what happened to myself. I had an accident several years ago where I broke my leg very badly and

had an operation to put titanium pins and screws in my femur. After the

operation I didn't recover well at all. What happened is through the stress

and trauma my adrenals and thyroid had basically shutdown or I'd become

resistant to thyroid hormone.

After a while I did receive the right treatment and I was on thyroid

medication, but after a while I still had plenty of symptoms. I went to one of

Australia's leading thyroid experts here, and when he did my blood test my

TSH was completely suppressed. He decided my thyroid medication was

too high, so he halved my dose.

Over the next few months I got sicker and sicker, I almost completely lost

my health and I nearly lost my job, because I couldn't cope with going to

work. I was so depressed I wanted to crawl into a corner and stay there,

and the doctor refused to increase my dose, because my blood test now

came back as perfect, even though I was an absolute mess.

I can sympathize with other patients who've been through that, because it is

a disaster when the blood tests come back fine yet you're really ill.

Dr. Lowe: The very troubling thing to me is that when those researchers back in the `70s decided that people were over-stimulated…they found a few

abnormalities that people had a 7 beat higher heart rate nocturnally when

they were sleeping, a little salt in their urine and a slightly elevated liver

enzyme. They thought those were evidence of tissue over-stimulation that

would eventually harm those patients.

I think they were in earnest expressing concern about the welfare of

patients, but through the years studies have been showing that those are

just natural physiological variations and they're completely harmless.

Those researchers, nor the ones who followed them during the next 25

years or so, ever bothered to compare TSH levels with patients' metabolic

rates, which is the ultimate way to determine whether or not a person is

having thyroid hormone stimulation – that's the basal body temperature, the

basal metabolic rate…there are things we can look for on an EKG like low

voltage and certain deflections.

They never bothered to correlate the levels of the TSH with tissue

measures of thyroid hormone regulation. Finally, when studies were done,

lo and behold they don't correlate. This year we should publish the largest

study that's ever been done comparing all of those factors.

We have somewhere near 200 patients in this study, and what we have

found is, that if a doctor makes a clinical decision about a patient's thyroid

hormone dosage based on the TSH level, about 75% of the time that doctor

will make exactly the wrong decision for that patient; worsening the

patient's condition.

Leisa N.D.: Isn't it interesting, because we see so many doctors that rely just on that test and that's end of story. If someone has a perfect TSH then there's

nothing wrong with their thyroid and their symptoms are possibly, all in their

head.

Dr. Lowe: Right and they've created a worldwide public health crisis through it. It's marketing over the health and well-being of humanity by corporations, but corporations have high-profile endocrinologists who are on the take from

the corporations. I say that fully prepared to step forward and defend it

legally. The U.S. is highly litigious.

Leisa N.D.: Yes and Australia is following closely behind believe me. I can imagine you've encountered much resistance from the medical profession with your views, especially the endocrinologists.

Dr. Lowe: Yes, it's interesting that changes are beginning to occur, but it's definitely not occurring quickly enough. A number of years ago I talked with a

mathematical logician at the University of Warwick in England; a man

whose books have guided me in my ability to analyze research data.

He pointed out that he's very conservative, changes occur, truth prevails

eventually, but when it comes to people's health and well-being, being

patient and conservative and letting truth gradually prevail really bothers

me.

I see too many people whose lives have been ruined, literally thousands of

them, all because of this collusion between the endocrinology specialty and

corporations that profit from that TSH test and restricting patients to

thyroxine is much too slow.

Leisa N.D.: Yes, it's incredibly frustrating when we know that there are answers there to help people, but there are so few practitioners that know about it and it's resisted by the medical profession on the whole.

Dr. Lowe: I don't know about Australia. I have some colleagues in Australia who do research along the lines that I do. Dr. Lee in Queensland is one.

There are others that I communicate with that are very fine physicians who

know the truth and keep quiet about helping patients by violating the

dictates of the endocrinology specialty, which is go by the TSH only and

prescribe only thyroxine.

I've spoken at conferences in the United States with doctors who are aware

that this is horrific and has caused a worldwide public health crisis. There

may be anywhere from 500 to 700 of these mostly M.D.s and over here

D.O.s with these degrees, but naturopathic physicians over here in

probably about 20 states prescribing.

They're general practitioners in Australia and the U.K., but the audience is

full of these doctors. We now have systems where we can go online, type

in a patient's mailing zip code and find a doctor who most likely is going to

give the patient quality care. We see changes coming about, but they're

coming around very slowly.

Leisa N.D.: Why do you think the endocrinologists are so resistant to the idea of other hormone replacement other than thyroxine?

Dr. Lowe: I think they have a very nice money flow going. I'm probably going to come off as a conspiratorial nutcase to some people listening to your radio show.

Leisa N.D.: You'll fit in well with us; that's fine.

Dr. Lowe: I feel comfortable with that then. Consider this, one of the largest studies ever done of the effectiveness of T4-replacement involved giving the patient thyroxine and adjusting the dosage to keep the TSH within the reference range that dosage is inadequate for most patients.

A large study done in the U.K. showed 50% of patients on T4-replacement

were still sick with hypothyroid symptoms. They were matched with people

not on T4-replacement, they had higher incidence of five potentially fatal

diseases associated with hypothyroidism and they used more drugs to

control their symptoms. That study showed that T4-replacement in 50% of

the cases is ineffective.

Consider this in view of that study finding. The patients go to their doctors

fairly often and the doctors always order TSH and a T3 and T4 level, which

the same corporations own that own the TSH tests and sell them to

laboratories, so there's a money-making kit there.

High cholesterol, just for example, used to be diagnostic of hypothyroidism.

In my 23 years of working this field never have I seen a single patient with

high cholesterol and LDL, which is supposedly bad cholesterol, not a single

patient for whom those blood levels didn't fall down into what used to be

called the normal range, the reference range, suddenly when we treated

the patients effectively with thyroid hormone.

The number one selling drugs in the United States now and possibly the

world is the statin drugs that lower cholesterol down into the reference

range. Some of the same corporations that own Synthroid the brand of T4

used in Australia, own the TSH, the T3 and T4 tests, also own statin drugs.

The patent is also off thyroid medications.

If people were treated with thyroid medication those companies would lose

billions in revenue, but the statin drugs are patented. It's almost as though

those boardroom executives sit and calculate how to keep people's

cholesterol levels high enough so they'll have to be put on statin

medications to lower their cholesterol and that brings in billions of dollars in

revenue. It may sound conspiratorial, but I think it's the truth.

Leisa N.D.: Absolutely and I see it all the time in the clinic as well. You see the high cholesterol and you see the hypothyroid symptoms. This is older medicine isn't it? It's like the Broda with the basal metabolic temperature test. These were markers of a hypothyroid problem and nowadays, because we have more scientific tests, we ignore those simple things that were often much more accurate.

Dr. Lowe: Right.

Leisa N.D.: You said the use of T4 is one of the worst disasters in modern medicine and I suppose alongside of that the statins also come in as one of the worst disasters, but they're all inter-related.

Dr. Lowe: They are and I'm convinced that practically every patient who has elevated cholesterol and LDL could get them down into the reference range by first starting with diet, an acceptable level of physical fitness, nutritional

supplements and if need be thyroid hormone.

Leisa N.D.: If T4 is not effective in most patients then what type of thyroid hormone do you use in your protocol for helping people get well?

Dr. Lowe: If the patient is hypothyroid and we have a confirmed thyroid hormone deficiency or a good reason to think that the patient is hypothyroid we use a T4-T3 product. There are a lot on the market, but most people have heard of Armour Thyroid. It's the oldest one on the market, the most stable and the least expensive.

Leisa N.D.: In Australia it's called natural thyroid replacement.

Dr. Lowe: Natural thyroid replacement. It's all just thyroid except for Thyrolar, which is synthetic and some patients like taking an animal product and Thyrolar is already there. If the patient appears to be thyroid hormone resistant with those patients I always use a plain T3. The reason for that, is that in every study that's ever been done, only dosages of T3 that are larger than what the body normally produces are necessary to override the resistance and get the patient well.

Leisa N.D.: Can you tell us a little bit more about thyroid hormone resistance? As I understand it there are a couple of different indications in fibromyalgia or

hypometabolism. One may be a classic hypothyroid where the thyroid is

not producing enough hormone, but the other one is thyroid hormone

resistance where the thyroid is producing enough hormone, but the cells

are not taking it up properly. Can you explain a little more about that?

Dr. Lowe: Yes. There are laboratory methods for diagnosing thyroid hormone

resistance. One is a very painful procedure where you do a punch biopsy

of the skin and not many patients go for that.

You can take the fibroblasts out of the skin that normally produce the waterbinding mucopolysaccharides that give connective tissue turgor. Thyroid

hormone usually inhibits the production of those water-binding molecules

and keeps them in a normal quantity being synthesized and released into

the ground substance and the connective tissues.

You can subject patients' fibroblasts to T3 and measure the amount that's

necessary to inhibit production of those water-binding molecules and if it

takes an extraordinarily large amount that's one way of diagnosing cellular

resistance to thyroid hormone.

Usually what we do clinically is, our criteria are post-treatment criteria. If

we assume the patient has hypothyroidism, we treat the patient with a T4-

T3 product, get up to around four grains or 250 milligrams and we haven't

seen acceptable improvement in the patient, we make the assumption for

treatment purposes that person may be partially resistant.

Then we slip the patient over to T3, through a very careful protocol

monitoring for safety and for evidence of improvement carry the patient to

higher and higher dosages.

If the patient ends up on a dosage that will hospitalize most other patients

with heart problems, but that patient has no indication whatsoever of over

stimulation, has a very high blood level of T3, the person's hypothyroid-like

symptoms have gone away, and they're functional and symptom free, posttreatment, after the treatment, based on those criteria diagnose the patient as being thyroid hormone resistant.

Leisa N.D.: So it's an after-the-fact diagnosis according to how they've responded to different thyroid hormone treatment.

Dr. Lowe: Exactly.

Leisa N.D.: How do you go about diagnosing up front the hypothyroid symptoms? You were talking about the basal metabolic rate and the temperature, how else do you go about diagnosing these problems?

Dr. Lowe: What we do is we measure the metabolic rate with an instrument called an indirect calorimeter. Those instruments have been around for some 400 years they were developed into clinical diagnostic tools about 100 years

ago. What we do is we measure a person's oxygen consumption at rest and as close to a vegetative state as possible and that tells us how much oxygen

that person's body is taking in to have enough for cells to exchange oxygen

for electrons to remove the energy from the chemical bonds of food

breakdown products such as glucose and fatty acids. It's amazing how precise the intake of oxygen is regulated to provide just enough oxygen for what's called oxidative phosphorylation. I work with a lot of patient's long distance and they just don't have access to that procedure.

You mentioned Dr. Broda O. who had developed the basal body

temperature test in the 1940s. He correlated low basal temperatures with

low resting metabolic rates and he established the range of normal or the

reference range we call it now, which is 97.8 to 98.2. Most hypothyroid

patients will have a basal temperature somewhere around 97 or below, so

that's one measure.

I like physiological measures. The Achilles reflex is slow in about 80% of

hypothyroid patients. You probably know this, but the thyroid hormone

regulates the gene transcription for the enzyme that removes calcium ions

out of a contractive muscle enabling it to relax.

If the person doesn't have enough thyroid hormone and doesn't have

enough of that enzyme then when we hit the Achilles tendon the foot goes

down at a normal speed, but it relaxes visibly slowly. It's another

physiological measure of the effects of thyroid hormone in the body and it

can give us an idea of whether the patient has enough thyroid hormone

regulation or not.

Something I use very often is I just ask patients to get a resting EKG and if

the voltage is low, which is very easy to determine quickly looking at it,

unless the person has a severe infiltrating diseases, short of those it's too

little thyroid regulation that causes the voltage of the EKG to be too low and

that too is a useful physiological measure.

Of course, the patient may have many classic clinical symptoms of

hypothyroidism and some of those symptoms could be explained by a low

level of physical fitness, especially a pro-inflammatory diet, deficiencies of

B-complex vitamins that cause neuromuscular hyper excitability.

I know naturopathic physicians trained in this country spend a good hour

and a half to two hours with the patient initially, sorting out those sorts of

things, considering some relation to lifestyle and the physical exam and

over here they do lab work.

If the patient has classic signs and symptoms, a slow Achilles reflex, a low

voltage EKG, a low basal temperature, a low pulse rate, has elevated

cholesterol and is maybe borderline anemic, which can be due to the

reduced oxygen demand from too little thyroid hormone regulation. Then

you can get a very firm feeling about whether or not the patient is likely to

benefit from treatment for hypothyroidism.

I think in most cases a trial of thyroid hormone therapy is appropriate,

because it's innocuous to most people.

Leisa N.D.: Yes and we find here that there's a great resistance to trialing something like thyroid hormone. Like you said if it does to not being needed it is not going to cause harm whereas some of the other medications that may be like putting people on the anti-depressant medication or high dose antiinflammatories can cause harm.

Dr. Lowe: So true. That's so well illustrated by, a colleague of mine in Australia, because he was suppressing patient's TSH levels with T3 the medical board took away his privilege of prescribing thyroid hormones for two years I think.

Interestingly, he told me when we were speaking at a conference together

he said, I can't prescribe thyroid hormone. On the other hand and he

named a series of drugs and said some patients will drop dead on the spot

when they first swallow this medication, but I can't treat them with thyroid

hormone, which wouldn't hurt anybody except maybe a 98-year old person

who's been lying up in a nursing home for a year with no cardiovascular

conditioning whatsoever.

Leisa N.D.: It just seems insane doesn't it? Absolutely. We can't understand it. It seems like common sense, but often there isn't a lot of that in medical

profession, as you say it's not common sense, its money flow. We have a hard time with that.

Tell me, do you test at all, with the blood tests? The TSH, the T3 and T4,

are they all useless or do they give you any indication?

Dr. Lowe: If they're in an extreme I think they are useful. The range over here now for the TSH is somewhere between the upper limit, 2.5 and 3. If a patient

comes in and has a TSH level of say 35, obviously something isn't right

there and we need to check that out.

On the other hand, Volpé , a good endocrinologist in Canada who

died a few years ago unfortunately, pointed out in many publications for his

own colleagues in the general medical profession, a patient can have

autoimmune thyroiditis with antibodies destroying the thyroid gland for

several years before the TSH will ever rise out of the reference range or

before the thyroid hormones will decrease.

Then we have the work of Dr. Bo Wikland in Stockholm, Sweden, a

colleague of mine, doing fine needle aspirations and finding that many

patients have very active autoimmune thyroiditis with lymphocytes and

antibodies destroying the thyroid gland and those people don't even have

elevated antibodies in the blood.

Their TSH and hormone levels may be perfectly normal and that's on a

fairly high percentage of patients. So it makes the diagnosis very difficult. I

always order antithyroid antibodies with a new patient who comes in as a

primary patient of mine as well as a TSH, T3 and T4. I never order them again, which probably frustrates laboratories that make the most money off them over here.

I just want to know initially are these way out of range. If they are in range

that doesn't mean that patient doesn't have hypothyroidism and doesn't

have autoimmune thyroid disease destroying the thyroid gland as Dr.

Wikland's work shows.

Leisa N.D.: For myself, being a naturopath in Australia, we can't order blood tests. We could order them, but the patient then pays for them, whereas if a doctor orders blood tests they go through our Medicare system where the government covers that. It's very difficult to gain the cooperation of physicians in testing things like thyroid antibodies, especially if the TSH, T3 and T4 have come back as normal.

In many cases, I don't think I've have one actually that didn't come up with

high antibodies when I've pushed for the test, because I expected there

was something going on in the autoimmune area. If the immune system is

attacking the thyroid gland or thyroid hormone do people with high antibody

counts still benefit from the T3 and T4 approach or just the T3 approach?

Dr. Lowe: The majority of them are simply hypothyroid and they do benefit from a T4 and T3 combination. I should say parenthetically however and some of my colleagues here would disagree with me, but I would debate them on it. Any patient who gets well on a T4-T3 product can get well on T3 alone.

The only reason you would recommend T4-T3 for hypothyroid patients is

for political purposes.

For example, last year my dear friend, a major physician who's a

researcher on my research team, Garrison, died from a pulmonary

embolism at a young age of 52. He had hundreds of patients under his

care on T3. Those patients will disperse now to other physicians who out of

intimidation by the endocrinology specialty, will try to get them to go on T4

alone or may put them on T4-T3 products.

Most of them are frightened of T3 alone thinking that the patient will drop

dead from a heart attack if she swallows T3.

Leisa N.D.: Yes, I've had patients tell me their doctors say that. I can't give you T3, because you'll have a heart attack. Where did that come from?

Dr. Lowe: I think it filtered down from some endocrinologists did studies, I think this is, where this nonsense began. They did studies of elderly, sedentary patients and found that the ones who had suppressed TSH levels had a higher incidence of atrial fibrillation, where the heart's electrical activity is going wild and circular.

Since T3 is highly effective and does suppress the TSH I think, very quickly,

that observation from those studies, which should always be explained

along with the fact that these were elderly, sedentary people that there may

be, if the heart is deconditioned, if a person is not doing cardio protective

nutrition, diet, or exercise the heart is more vulnerable to stimulation. You

can have atrial fibrillation with coffee; you don't have to take T3.

In the U.S. these statements get distilled down, whereas for example, in

women who've had Graves disease or hyperthyroidism, once they've

become post-menopausal there is a higher incidence of reduced bone

mineral density.

That finding, which should be stated with qualification becomes, if you take

a type of thyroid hormone that suppresses your TSH your bones are going

to crumble under you and you'll fall to the floor.

It's like gossip in small towns where I grew up in south Alabama and

Mississippi. Gossip gets distilled down to absurdly false statements that

may have started out as very highly qualified findings in a particular

situation.

I think that is what's happened. I have to say bluntly; there are a lot of

irresponsible endocrinologists who, the bone mineral density thing is a

settled issue. Suppressing TSH does not cause reduced bone mineral

density. We know that from studying thousands of thyroid cancer patients

who all take TSH suppressant dosages of thyroid hormone.

Still endocrinologists are saying studies don't show that there is reduced

bone mineral density, but you'd better be careful. You'd better not

suppress your TSH! As though it's still true. They contradict themselves.

Leisa N.D.: Very interesting. Let's talk about your treatment program. I know we've mentioned the word hypothyroidism and thyroid resistance, which as you explained in your book, is the underlying cause of fibromyalgia. They're not separate conditions. Is that correct?

Dr. Lowe: Our precise scientific statement is that inadequate thyroid hormone

regulation is the main underlying mechanism of most patients fibromyalgia.

There are a few other causes and that's why we say the main underlying

mechanism of most patients fibromyalgia. The inadequate thyroid hormone

regulation comes from either hypothyroidism or thyroid hormone resistance.

You're correct; that is what we've said. We like to emphasize the qualifiers,

because of what we were just talking about. The tendency of the media

and people who take the statements and stretch them into something they

can criticize.

Leisa N.D.: Of course. With your treatment protocols you term it a rehabilitation program and use the collaboration between the patient and practitioner to obtain the best results. How do you find that differs from a normal doctor/patient relationship?

Dr. Lowe: We find that collaboration for us is absolutely essential. Most people are delighted, over here we have managed care and such that it's socialized medicine and it has some terrible limitations to it, because physicians may be restricted to seeing patients for only seven minutes and its difficult to establish rapport.

We operate on a different basis. We don't deal with insurance or third party

payment at all and that makes our services less available to people with

limited resources. On the other hand we pack as much as we can onto our

website www.drlowe.com with 400 pages published on it. It's nowhere near

as attractive as your beautiful website, but it is packed full of information.

For patients with limited resources we do everything we can to get

information to them they can use to get themselves well. Over here

patients can buy over the counter desiccated thyroid and treatment cells,

don't need a doctor's approval and we recommend it to many patients who

are hypothyroid.

For patients who do come in we use the same protocol that we use in our

clinical trials. We learn everything we can about the patient through as

many measurements as we can that are relevant to the person's metabolic

status.

We create an individualized treatment program in collaboration with the

patient, not trying to shove various – a lot of patients can't take a lot of

nutritional supplements in capsule form and we try to help them find

powders or liquids, whatever we have to do to work with that patient's

individual needs, we do it.

We carry the patient through the treatment regimen as we originally

formulate it and we re-measure at fairly frequent intervals. If we aren't

getting a satisfactory response in terms of those measurements and in the

patient's subjective changes that are taking place, improvements, then we

reformulate, modify the treatment regimen and try to tweak it so that it

better meets that patient's individual needs.

When you had your accident with your leg you may have gone through a

similar process of physical rehabilitation where you worked with a

physiotherapist or some other practitioners. Usually those physical rehab

programs are individualized to that particular patient. We try to do that in

helping people acquire what we call metabolic health.

Leisa N.D.: That makes a huge difference to people rather than seven minutes and a prescription, and back out the door, or a referral to a more specialized practitioner like an endocrinologist, which is what happens in Australia quite often. As a point, in Australia too, Armour thyroid is prescription only and even then a lot of doctors are very hesitant to prescribe it, because they will just prescribe Oroxine, the thyroxine product in Australia.

For myself, when I was on that half dose of medication and getting ill I

ordered Armour from the international pharmacy online and had it sent to

Australia. That's how I started to get better before I was under the care of

another doctor. Occasionally, we can get it in from overseas when we're

desperate for it.

You talk about metabolism slowing factors that people need to change to

get results. What are the most common factors that are slowing people's

metabolism that they can change?

Dr. Lowe: Too little thyroid hormone regulation from hypothyroidism or thyroid

hormone resistance those are important factors to rule out or rule in and

deal with. There are also other factors.

I have almost every patient do what I call a home glucose tolerance test. I

have the patient get a glucometer, the same thing that diabetics use to

regulate their blood sugar. I don't send patients to the lab anymore,

because I don't want them, swallowing 100 grams of pure glucose.

I don't feel like the blood sugar pattern changes that occur in response to

that are representative of what happens in that person when he or she eats

carbohydrates at home or in a restaurant.

I have the patient use a glucometer to do the test at home. We provide

written instructions about how to do that. It's fascinating to me. I came up

through the era when hypoglycemia was getting a lot of attention, low blood

sugar. For many years I thought that low blood sugar was a cause of

abnormally low metabolism in a lot of patients.

What I found, after several years of having patients do this glucose

tolerance test at home, the majority of them have glucose intolerance or a

high glucose curve. We know that can happen from down regulation of

insulin receptors due to hypothyroidism, thyroid hormone resistance or high

cortisol can down regulator receptors.

In either case, if plenty of blood sugar was in the blood and for whatever

reason it's not getting into the cells of the tissues of the body, particularly

the brain, then symptoms such as fatigue, poor memory, concentration and

even excess muscle tension, we require energy to relax, to separate the

contractoral filaments and completely relax muscles.

I learned that with women taking artificial progesterone compiled in birth

control pills. They cause insulin receptors to down regulate, which leads to

an energy deficiency in muscle, which can cause the muscles to go into a

mild state of rigor mortis and be excessively tense.

If that person begins using thyroid hormone, it will increase the production

of the enzymes that drive energy metabolism, but if the person can't get

enough sugar out of the blood into cells to provide the substrate to meet the

demand of the increased energy metabolism then it can cause an energy

crisis and the patient can feel horrible from that.

I look at factors like that. I always consider the possibility of not enough

cortisol and we find that's a very common cause of severe fatigue in

patients.

Leisa N.D.: Another piece of the puzzle that we talk about in hypometabolism does seem to be that adrenal fatigue where people may have been pushing their adrenals for many years and they slow down in function and can't produce enough cortisol. Do you find that many of your patients also need to support that adrenal function before they'll fully recover?

Dr. Lowe: A very high percentage, more than I ever would have imagined going back 10 years ago.

Leisa N.D.: Do you think that's because of the lifestyle we're living today? Does that play a factor?

Dr. Lowe: I sure do. My impression is you can take a young, healthy Australian or U.S. citizen, throw that guy over in Bush or Dick Cheney's direction in Afghanistan or Iraq and in short order with the intense repetitive stresses it appears that there's a down regulation of the enzymes that convert precursors into cortisol and the cells of the adrenal cortex.

When those enzymes are down regulated the gene transcription pool

decreases just, because the system is overworked and the person will end

up with too little cortisol and begin to develop cortisol deficiency symptoms.

For example, an exaggerated stress startle reaction being bothered by

lights and noises that may be diagnosed as psychiatric disorder, fear of the

battlefield when in fact it's just a result of a low cortisol level from what's

colloquially called adrenal fatigue. I think the same thing can happen in a

corporate environment some of those environments can be brutal.

Leisa N.D.: I always found that, the corporate world is very brutal at times and that's why exited it. What about the role of other hormones like estrogen and

progesterone especially in menopausal women do they play a role in

fibromyalgia?

Dr. Lowe: There haven't been that many studies of women's gynecological status, sex hormone status in fibromyalgia. What we find is that many women and I can't back this up by studies from other fibromyalgia researchers just,

because not that many studies have been done, but a very important

consideration for a lot of women diagnosed as having fibromyalgia have

migraine headaches.

There was a brilliant doctor in England and you may remember her name. I

think it was Dalton. She had migraine headaches chronically except when

she was pregnant. After her second pregnancy with complete freedom

from migraine headaches, she started injecting herself with progesterone,

which relieved her migraine headaches.

We do see a high incidence of migraine headaches in fibromyalgia patients.

The relevance of that to thyroid hormone is when the woman is in her

follicular phase of the menstrual cycle, an ovum is secreting progesterone,

but mostly estrogen to build up the endometrium and have a proliferative

effect of breast tissue and other tissues in the body. There has to be

enough T3 available for that ovum to develop enough luteinizing hormone

receptors or LH receptors.

If the woman doesn't have enough T3 and doesn't develop enough LH

receptors at ovulation even though the pituitary secretes a large amount of

luteinizing hormones there may not be enough luteinizing hormone

receptors in the follicle that then should become the corpus luteum and

start secreting more progesterone.

Due to the deficiency of T3 there are too few luteinizing hormone receptors

for LH from the pituitary to stimulate the conversion of that ovum into a

corpus luteum. The woman ends up with too little progesterone and one

symptom of that is migraine headaches.

Also the woman can be colder than other women during the luteal phase,

because she's not secreting that progesterone and progesterone normally

stimulates the release of norepinephrine and noradrenalin that warms the

body. One step after another can cause the woman to have an awful time

of the menstrual period.

Leisa N.D.: During menopause do you often find that progesterone is a valuable addition to your protocol?

Dr. Lowe: Yes. We have to be careful about that and the main thing we watch for is adrenal cortical health. After a woman has run out of ova in the ovaries the main source of estrogen and progesterone is probably going to be the cortex of the adrenal glands even though a good bit of DHEA that gets

secreted is converted by fat cells into sex hormones.

The main thing we watch out for is if a woman comes in and she's postmenopausal and not having symptoms of estrogen and progesterone

deficiency, if she starts on effective doses of thyroid hormone it accelerates

the pathway in the liver that clears estrogen, progesterone and cortisol out

of the body at a faster rate.

We have to be very careful in making sure that we don't induce deficiency

of those hormones. If the woman begins developing deficiencies of them

we immediate address possible under-functioning of the adrenal cortex.

Leisa N.D.: I have another couple of things before we finish. One of the things I liked in your book was that you talk about food as being one of the essential factors that people need to address to get good results.

I lecture on the same thing, if people don't build a solid foundation of health

first by looking at the type of foods they're eating it's very difficult to get well

using other techniques like herbs or supplements or even thyroid hormone

if they're not eating well.

A lot of naturopath's are using a bottle of pills approach rather than

counseling patients in their lifestyle choices, which is quite a shame, and

you address that as well…

Dr. Lowe: We've run into a lot of patients who just don't care to adopt a wholesome diet. Their solution is a bottle of pills, which you mentioned. That's okay that I don't eat vegetables and fruit, I'll just take carotinoid complex to

make up for it. I've run into that a great deal and it's one of my most frustrating aspects of clinical care, getting people to change over to a wholesome diet. In the U.S. the typical American diet is meat and potatoes type, cafeteria diet is

now called a pro-inflammatory diet.

We know that it increases the production of inflammatory cytokines that

signal the brain that I'm not well. Fibers that feed back from the abdominal,

thoracic cavity go to the hypothalamus and can produce a shift in activity

that can actually be that prodronal period of illness of just not feeling well.

What I try to get patients to do is either what I call a caveperson diet or a

Mediterranean diet. In epidemiological studies, those people who study large populations of people say that the Mediterranean people, if anybody

is healthy and has more longevity, it's those people. They relate it to their

Mediterranean diet.

Like olive oil that's supposedly 75% oleic acid, you know more about the

nutritional aspect of that than I would.

Leisa N.D.: I think one of the important things is that people need to understand that the only diet that humans are not adapted to is a processed food diet. We do well on any number of whole foods as long as they're not processed and that's one of the important things that I talk to people about. If it's not found in nature then don't eat it.

Dr. Lowe: Right and we don't find dioxins, PCBs and organo-phosphates in nature, the pesticides and herbicides. We push the organic diet and I certainly

appreciate your philosophy on that. I've been sending more people to your

website for background information. www.leisawheeler.info

As we concentrate more on the hormone it certainly is a help with wonderful

sites like yours for patients to go as part of our educational packet to help

inform them of what they should be doing.

Leisa N.D.: One of the other important factors that I wanted to mention in recovery is the exercise to tolerance. I know there are many people listening who shake their heads at that one, because they're lucky to have enough

energy to walk from the bedroom to the kitchen let alone exercise, or

they're in so much pain they feel they can't exercise at all it's just something

they don't do.

How important is this point in people's recovery and what do you

recommend to people who've been so tired that they haven't exercised in

years?

Dr. Lowe: I always suggest that they start out with, if nothing else, picking up a tennis ball and lightly squeezing it. We know from imaging studies that if someone grabs the edge of the table and lightly squeezes it, the motor area in the opposite side of the brain lights up with increased blood flow and increased metabolism.

Even if it's a very gentle exercise, if it's going up on the toes and lifting the

heels off the floor, leaning against the wall once a day, it helps get

physiology moving in the right direction.

I caution patients not to exercise beyond their tolerance, because if they

have too little thyroid hormone regulation they'll have too many of a slow

down type receptor called `alpha II aginergic receptors'. If they stimulate

vigorously enough to release adrenalin and noradrenalin it will bind to those

inhibitory receptors, which will increase peripheral resistance to blood flow,

decrease the flow of blood tissues and slow down energy metabolism in

cells.

My caution is always, exercise below a level of intensity that will cause

adrenalin and noradrenalin to be secreted. Start out with something. If it's

nothing but before you get out of bed in the morning, lift your head up one

time, feel your abdominal muscles contract once and go ahead and roll out

of bed.

That's a start and it helps create a habit of resistance type and aerobic type

activities that eventually can develop into a momentum where the person

does have metabolic wherewithal to exercise vigorously, the habit pattern is

already there.

Leisa

N.D.: Vigorous exercise does enhance the treatment once people are able to do that?

Dr. Lowe: Women would come in and say when they finally reached an effective dose f thyroid hormone would come in and say for the first time in 10 years I did power house cleaning. I didn't understand power house cleaning at the ime, but they explained they cleaned the entire house in one day and I

haven't done that in 10 years.

It's important even in that point, because the patient's observed the

principle of exercise tolerance. If the people are deconditioned they can

still become so sore that it can create some disinclination to go with the

exercise again and I don't want them to get discouraged. Gradualness is a

good principle to live by.

Leisa N.D.: In summary, if someone has been diagnosed with fibromyalgia, chronic atigue or they suspect they have thyroid issues or hypometabolism what y they need to do, step-by-step to get better? What are the important

points?

Dr. Lowe: The most important thing to me Leisa, is they not listen to the old guard heumatologists who say we don't know what causes fibromyalgia, we don't know what it is and we can't help you. Take these drugs and you may feel better. Don't listen to them.

Go to naturopath's, to chiropractic doctors or alternative MDs, or go to

scientifically oriented alternative healthcare. The most important thing for

people to realize is we do know the major underlying cause of fibromyalgia.

If the patient will go to the right types of practitioners I think they will

eventually get the relief they're looking for.

The worse thing that you can do is to become hopeless. We've got

evidence that hopelessness causes the secretion of hormones that can

activate certain cells that can eventually lead to cancer. Hopelessness is a

pathogenic process of emotion and there's no reason to feel hopeless

nowadays.

There's reason to feel great hope. We'll get the work out. I just ask people

to hang on and stick with your natural medicine, alternative complementary

whatever you want to call them doctors and other healthcare practitioners.

Leisa N.D.: Yes, there is plenty of help out there it's just not always easy to find. There are plenty of doctors that read this information and look at this science and are keen to help patients. Unfortunately they often get targeted by the authorities, but they still get out there and help a lot of people.

What patients are likely to make a full recover?

Dr. Lowe: We did a study in 2000 and 2001 with 77 patients. This was very

informative to us, because we treated those patients with T3. They all met

the criteria for fibromyalgia and were all women. Seventy five percent of

the patients either significantly improved or completely recovered.

Among the 25% of patients who didn't improve were those who smoked

and had absolutely awful diets. There was one lady I remember who was

married to a truck driver, she traveled with him and they ate in truck stops.

She ate the greasy food with no fiber, smoked, got no exercise and she

slept in the back of the cab most of the time.

On the other hand the patients who responded very well and over the years

I've watched this with many patients, the patients who continue to exercise

despite their pain and fatigue, continued with nutritional supplements even

though they didn't get completely well and continued with a wholesome

diet.

Add in the right hormone and wham those patients recover faster than any

others do. I'd say get, everything going for you that you can, because when

you plug in those final last ingredients recovery will come fast for those

people in my experience.

Leisa N.D.: Thanks Dr. Lowe. I want to thank you again for joining us today. I'm sure our listeners have learned a great deal from today's discussion. It's been very generous of you to spend your time with me.

Dr. Lowe: I enjoyed it Leisa.

Leisa N.D.: I'd like to let everyone know about our websites to finish off. The best way to find me, Leisa Wheeler is at www.leisawheeler.info that's my blog and where I write every couple of days about health issues, links to great sites

and a lot of other great information. There's a lot on food as well, as Dr.

Lowe mentioned before. If you haven't signed up for my free monthly

newsletter yet you can sign up on that site as well.

You can find Dr. Lowe on www.drlowe.com and you can purchase his

excellent books the Metabolic Treatment of Fibromyalgia and Your Guide to

Metabolic Health from McDowell Publishing. Is that the best site to find

your books?

Dr. Lowe: Right. There is a link at the top of the website at www.drlowe.com that carries people to the website.

Leisa N.D.: As we said there is an enormous amount of information that Dr. Lowe has on these issues that we've been discussing today.

Thanks very much again for joining us.

Dr. Lowe: You're quite welcome.