Balancing the system is tricky. I don't know if it's even possible as long as infections and trauma are present; however, if you leave your hormones to their own devices amidst such crises, you're likely to really fall apart, or at least feel as though you are. Restoring some measure of balance to a flailing system will enable you to function and fight Lyme disease better.
This usually starts with the adrenal glands. No, I don't mean the thyroid, I mean the ADRENALS. Many physicians and patients start on the wrong end of things by first giving the body thyroid hormone, but this isn't usually how it should be done.
Why? In Lyme disease and chronic illness, the thyroid often malfunctions as a result of the adrenal glands, which are pooped from having to deal with so many bugs, toxins and stress. Treating the thyroid first puts greater stress on the adrenal glands, which then exacerbates the whole endocrine problem. Not treating the thyroid, however, can also stress the adrenals, but if you sense you have adrenal fatigue, it's best to deal with this problem first.
How do you know if you have adrenal fatigue? While some symptoms of hypothyroidism (most chronic Lyme sufferers) and adrenal insufficiency overlap--for instance, fatigue, depression, digestive disorders, pain and cognitive problems are common in both-- if your problem is predominantly with the thyroid, weight gain will be more of an issue (as, when accompanied by adrenal insufficiency, people who are hypothyroid tend to lose weight, as a result of malabsorption). Also, following exercise, the person with adrenal fatigue will be exhausted afterwards, whereas the hypothyroid sufferer may actually feel a bit better. Consulting a complete list of symptoms and performing a few reliable tests will help you to ascertain a diagnosis.
To determine adrenal function, saliva tests, along with a clinical diagnosis, have thus far proven to be most reliable. Forget blood and urine and ACTH-stim tests. Most physicians don't even believe in adrenal insufficiency unless you have a case of Addison's (adrenal failure) because the latter tests are almost always wrong by displaying "normal" results in people whose adrenals are really in trouble. I won't go into other reasons why you shouldn't even bother with such nonsense tests here, but suffice it to say, if you want to know the true state of your adrenals, order a saliva cortisol test from CanaryClub.org, and then learn to interpret the results by visiting the Yahoo! group Adrenal Fatigue, or by ordering G. Poesnecker's book, "Mastering Your Life."
Blood tests for the thyroid can be a tad more reliable than those used for the adrenals, but this depends upon who you are. If your body has trouble uptaking thyroid hormone into its cells; if it cannot convert T4 (inactive thyroid hormone) into T3 (active thyroid hormone), or you have adrenal fatigue, which adversely affects thyroid conversion, tissue uptake and thyroid response, then blood test results will tell you nothing. You may get any kind of results under the sun, which may or may not match the true condition of your thyroid and whether your body is actually using the hormone.
Even if you do a complete blood panel, the results will only reflect the amount of thyroid hormone that is circulating in your blood; they will not reveal how much that your body is actually using. In the case of adrenal insufficiency, the scenario is even worse. You may have high levels of thyroid hormone in your blood, but it's not because your body is producing enough of the stuff; it's because your body lacks the cortisol to help uptake the thyroid hormone into the cells, or cellular receptors are reticent to accept the hormone for other reasons.
Like the adrenal glands, the best way to test for thyroid function is with a do-it-yourself, at home test. This one is even simpler.
Despite what Pharmafia-motivated physicians might tell you, taking your body's basal temperature is actually the best way to determine whether you are hypothyroid. This is done by placing a thermometer under your armpit first thing in the morning, for ten minutes, before you roll out of bed. Do this consecutively for about a week to obtain an average reading. If your temperature is 97.6 F or 36.5 C or less, you may be hypothyroid. This test, along with a clincial diagnosis of symptoms and perhaps a complete blood panel to confirm the diagnosis, is most appropriate. Sometimes, the blood tests help to ascertain a result but should not be used as a stand-alone to diagnose thyroid problems.
So once you have your test results and find a knowledgeable professional to help you interpret them, you can begin treatment.
Treating adrenal insufficiency I have found to be quite tricky. While taking adrenal glandular formulas may help some, not everyone benefits from them. Sometimes, the body rejects those that contain active cortisol, by shutting down its own cortisol production when it senses the presence of bovine or sheep cortisol in the blood. Response to synthetic cortisone may be better but higher doses must be used to compensate for whatever the body decides to stop producing, and synthetic cortisol can cause immune suppression and side effects when dosed improperly (which is a common occurrence). Glandular formulas may do the same, but they tend to be gentler than powerful, synthetic hormones such as hydrocortisone and prednisolone.
Yet, for those with moderately severe or severe adrenal insufficiency, taking a product containing cortisone may be beneficial, provided that appropriate doses (which are usually lower than those typically prescribed) are given.
As a basis, and as I have described in my book, "The Lyme Disease Survival Guide: Physical, Lifestyle and Emotional Strategies for Healing," the adrenals need lots of vitamin C and pantothenic acid, as well as a good, food-based multi-vitamin. Siberian ginseng can be helpful as an adrenal tonic but by itself, will not cure moderate to severe adrenal fatigue (as most supplements). Yet it can be a helpful adjunct to an adrenal fatigue protocol, as can rhodiola, which balances the endocrine system. A good quality licorice, such as Dr. Baschetti's (which is sold by the Clymer Healing and Research Center) can boost the adrenals by causing the body to retain cortisol longer than it normally would, but will not aid in cortisol production. Traditional chinese medicine (TCM), involving the use of other herbs to treat adrenal and other endocrine problems may also be a good solution. Check out C. Willis' TCM adrenal fatigue protocol in the Files section of the Yahoo! group, Adrenal Fatigue.
Finally, avoiding stress, sugar and stimulants are essential for helping the adrenal glands to recover.
Now, on to the thyroid. Fortunately, treating this gland seems to be a bit easier than treating the adrenal glands, but it is not without its complications. As mentioned in my book, some Lyme disease sufferers have trouble converting inactive T4 hormone (which is what most synthetic thyroid hormone supplements are made of), into T3 (active thyroid), and therefore, either pure, bio-identical T3, or a combination product such as Armour (hormone that is made from porcine thyroid glands) must be taken, instead of the synthetic stuff that is so commonly prescribed.
Furthermore,the body, in addition to T4 and T3, also makes T2 and T1, which are slight variants of the other two hormones. These latter two comprise only a small portion of the body's thyroid hormone production, yet tests have shown that they may be more involved in the body's processes than previously thought. For instance, T2 has proven to be more effective in liver and lipid metabolism than T3, and is involved in increasing the metabolism of heart, muscle and brown adipose tissue. While Armour is said to contain only T4 and T3, because it comes from the tissue of a pig's thyroid, it may also include the lesser-known and oft-ignored T2, and T1, which could be of benefit. It most closely resembles, in any case, human thyroid. However, if your body produces excessive amounts of "reverse T3" (this can be ascertained by a blood test), you may want to consider pure, bio-identical T3, but bear in mind that some health care practitioners believe that pure T3 is harder on the heart and liver than Armour.
Some people opt to supplement their diet with iodine. While iodine is necessary for the thyroid, if you take too much, your thyroid may actually decrease the amount of hormone it makes in order to compensate for the excess. (Kind of like the adrenals when they sense the presence of supplemental cortisol in the blood). Hence, if you take a prescription thyroid hormone, it's probably a good idea not to supplement your diet with too much iodine, since the hormone should technically give your body close to what it needs. If you don't take hormone, then you will have to somehow ascertain how much iodine is beneficial for you, which is not necessarily the amount prescribed on the bottle. Pay attention to how you feel at different doses. If you decide to use iodine, choose a high-quality product such as Lugol's. Also, keep in mind that the basis of thyroid hormone is the amino acid L-tyrosine, so you may want to supplement this amino acid, along with iodine and plenty of minerals, which are all involved in thyroid hormone synthesis (especially selenium).
Just one final word about hypothyroidism. Flouride negatively affects thyroid function, so stay away from flouridated water, toothpaste and other sources. Believe it or not, tea is grown in flouride-rich soil, so consider the possibility that your tea (as well as coffee) may suppress your thyroid function. Stick with lemon water, unless you know how your tea is made.