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Paul Jaminet - Hypothyroidism is a circadian rhythm disorder

3 Answers

"The thyroid’s circadian pattern is diminished in autoimmune hypothyroidism. In a study of hypothyroid children, the night-time surge of TSH averaged 22%, compared to 124% in normal children."

It's more and more what I keep thinking... hypothyroidism comes from the brain. So the pituitary is not active enough at night. Now if you traced this further, they should have looked at the TRH. If it was also low, that would confirm that the hypothalamus is malfunctioning as well. Something happens that reprograms the thyroid to work at a lesser level and it comes straight from the brain. The thyroid could work just fine, in most people without autoimmune hypothyroidism it's not damaged. But for some reason, it's being told NOT to work at full capacity. This is why it's such a b**** to treat hypothyroidism, and maybe why people stay dependent on meds. The root cause is somewhere up there.

EDIT: It seems they looked at the TRH and it was mostly normal. So it seems that the pituitary does not respond to the TRH adequately at night. This is interesting.

answered Nov 8, 2013 by JuiceUser
edited Nov 8, 2013 by JuiceUser

If it's bs, what's your sugestion for treatment?

Hm? I didn't say anything was BS. I simply said that treating thyroid problems is difficult because in most cases you have to take the hormones for the rest of your life, in other words we don't have a cure. But that is greatly because they haven't looked deeply enough for a cure (read: it's not profitable for them). There are scattered studies like this out there that give the pieces but they need to be put together. The majority of cases of hypothyroidism are "primary hypothyroidism" which so far seems to involve some problem with the pituitary even though no doctor will acknowledge it because there is "enough TSH" (despite it being shown that the bio-activity of TSH can be reduced at will by the pituitary).

Sorry, for some reason I read bs instead of biatch ;)

"primary hypothyroidism" being a problem with the pituitary?

Yeah, that's how it looks to me. In secondary hypothyroidism the pituitary does not secrete enough TSH, in this case it is possible to suspect damage to the pituitary. Because of inadequate TSH the thyroid does not make enough hormones.

In primary hypothyroidism, there is a lot of TSH, but low hormones, so it is assumed that the pituitary is working fine and that the problem is with the thyroid. But as you can see here the pituitary can also secrete a less bioactive TSH. So even though the lab test will pick up the TSH, it may not be doing what a "real, healthy" TSH would be doing, so the thyroid is still understimulated like in secondary hypothyroidism. In those both cases the problem would then be the pituitary.

Something like this could be easily tested by synthesizing a bio-identical TSH and injecting it into euthyroid people, then hypothyroid people, and measuring the amount of hormone increase in each. That would prove whether the thyroid cannot respond (thyroid damage) or the TSH in hypothyroid people is inadequate (pituitary problem).

If I read into this correctly, this explanation would only make sense if TSH would be an indicator of thyroid activity. But it really isn't. Correct me if I interpreted your argument wrongly.

You're right. It isn't. But it is involved in stimulating the release of thyroid hormones from the thyroid. If the pituitary is sending out less-active TSH than it should then the thyroid would be understimulated.

My point is just that nobody ever demonstrated any kind of actual "damage" to the thyroid gland in primary hypothyroidism, which leads me to believe the gland is fine and that something changes in the pituitary.

In this study:
they used TSH-stim as a test of thyroid function (just like ACTH-stim for adrenals) to test whether the thyroids respond adequately to TSH (and most of them did). But it wasn't noted what the initial TSH of the people was or whether they were hypothyroid. This isn't used nowadays from what I can tell.

Coupled with the info that the pituitary can make TSH that is less biologicaly active and that the night time surge in TSH is deficient I am led to believe that the pituitary is the problem even in this case of hypothyroidism.

My interpretation of the data always was that the pituitary gland acts roughly in the opposite direction of the thyroid gland. Many of the pituitary hormones, but especially prolactin and the growth hormones, oppose the thyroid hormones in several ways, but mostly by impairing cellular energy metabolism and indirectly, water homeostasis. And Broda Barnes noticed that people on a high-protein diet needed considerably more thyroid than people on a low-protein diet (protein can act upregulating on prolactin, ACTH/Cortisol and the growth hormones). However, many of the pituitary hormones ,either directly or indirectly, supress TSH levels despite inadequate thyroid output and this may make the problem even worse. During circadian rhytm disorders and sleeping disorders, when people tend to stay awake sunset, the absence of light and the lack of protective sleep also increases the output of the pro-stress pituitary hormones (especially prolactin) and this in itself could cause a form of hypothyroidism. What still baffles me is that, during the night, TSH can be either highly supressed or highly stimulated. In the second part of the night (given there are no sleeping disorders involved), TSH levels usually rise quite a lot even though pituitary stress is high - the TSH surge usually does not increase thyroid output noticably. This makes me wonder if TSH itself has any adaptive or maladaptive effects on the body, independent of thyroid and pituitary function.

Although the FT3 seems to follow the night-time surge in TSH quite closely as I posted here:

My main question still is, in primary hypothyroidism (without autoimmune disease)... has anyone demonstrated actual damage or changes INSIDE the thyroid gland that would render it incapable of producing adequate hormones? Every textbook lists primary hypothyroidism as "failure of the thyroid gland" but I haven't seen evidence about that. I believe a TSH-stim comparison between euthyroid and hypothyroid individuals would prove the problem. If the thyroid glands responded with a similar increase in hormones in both groups, then we can stop saying the thyroid gland is failing in primary hypothyroidism, and look for the problem elsewhere.

If I remember correctly, there were some experiments on pituitary-deficient animals (the pituitary gland was either removed or genetically downregulated). The interesting thing is, they still produced adequate amounts of thyroid hormone, even without TSH.

This study seems to suggest the opposite:
Defining thyrotropin-dependent and -independent steps of thyroid hormone synthesis by using thyrotropin receptor-null mice

"Knockout mice DIED within 1 week of weaning unless fed a diet supplemented with thyroid powder."

Capitals mine. טּ_טּ

That's not even remotely the same thing I was talking about :)

I don't see how. The TSH receptor is activated by TSH, no? They disabled the receptor on these mice so TSH could not exert its effects on the thyroid. And the mice were hypothyroid.

Shouldn't a lack of TSH then have the same effect? Unless something else can activate the same receptor.

You see, that's exactly the point. From these experiments I mentioned, it seems that there is a secondary messenger for thyroid output besides TSH - just like there seems to be a secondary messenger for adrenal output besides ACTH.

Damn. Now it gets interesting. I really wonder what that is. I don't suppose I'll ever find out though.

I will tell you once I find out. But that may take a few years. :)

Great. :P

Hehe... Sorry, I don't have much information on this. The research was pretty much abandoned a few years ago and so far, nobody got funding for further studies.

Yeah I figured, don't worry.

Could be.  I avoided sunlight almost every day from age 30-40.  All other things being equal, it certainly didn't help.  

JuiceUser said:
It's more and more what I keep thinking... hypothyroidism comes from the brain.  

I agree.  Taking thyroid helped some but not that much.  I've experienced nothing but improvements in body temperature, mood and to a lesser extent sleep, since stopping the sunlight avoidance and reducing blue light at night.
answered Apr 3, 2015 by raintree

Interesting for sure. I never eat breakfast just because im never hungry. I tend to get hungry around 12 a clock. Maybe i should consider changing my eating habit since eating during daylight makes sense of course.

Have peat talked about this ?

answered Sep 22, 2013 by superhuman