Symptoms of Low Thyroid Activity
o Muscle Aches
o Fatigue
o Cold Intolerance
o Constipation
o Dry Skin and Hair
o Depression
o Difficulty Losing WeightReasons Blood Tests May Not Show Hypothyroidism
o TSH may be normal with low thyroid activity:
o If reason for low thyroid activity is in the hypothalamus, not the thyroid
o If problem is peripheral conversion of T4 to T3
 Selenium deficiency
 Soy and some xenobiotics
o If there is peripheral competition for the receptor, such as in PCB and other environmental chemical exposure

Temperature Testing for the Thyroid
o Morning Basal Temperatures below 97.6 may indicate low thyroid activity
o Measurement should be made in the first part of the menstrual cycle in menstruating women
Signs of Excessive Thyroid Activity
o Palpitations, rapid pulse
o Insomnia
o Irritability
o Anxiety
o Tremor
o Diarrhea

Hypothalamic Pituitary Adrenal Axis
o Set Point is determined by stressors in early life
o Studies are contradictory but ACTH response to stress is exaggerated in fibromyalgia, while adrenal response to ACTH is blunted
Symptoms of Adrenal Insufficiency
o Fatigue
o Hypoglycemia
o sugar craving
o shakiness relieved by eating
o Low blood pressure, esp. dizziness with standing
o Recurrent infections
Treating the Adrenals
o Nutritional – pantethine, magnesium
o Glandular extracts
o Cortef
o Safest may be herbal:
o Siberian ginseng
o Licorice if blood pressure is low – but monitor BP, potassium

Growth Hormone
o Secreted in Stage 3 + 4 Sleep
o Depleted in Fibromyalgia
o Symptoms of growth hormone deficiency:
o reduced exercise capacity
o poor general health
o muscle weakness
o cold intolerance

Elevators of Growth Hormone
o Exercise
o 10 minutes above lactate threshold intensity
o Adequate hydration
o Deep Sleep
o Low GI diet
o L-glutamine 2 grams, GABA 5 grams

Sex Hormones
o Sex steroids will be modulated by stress and HPA axis
o Low Androgens associated with Fibromyalgia:
o DHEA-S – optimal is 120-180 for women, 300-500 for men
o Testosterone – consider treating in the lower 20% of the normal range

Menopause
o For some women, pain increases at menopause, and HRT may decrease this effect
o Consider HRT if symptoms worsen in premenstrual period, if there has been TL or hysterectomy