MEDICINE

I had a visit from a woman who is a scientist Phd in biology and chemistry, also an NP whose area of focus is Thyroid. We didn’t get to the walk that we had intended, but picked up on the pathways of Free T3 thyroid hormone, Reserve T3, and Free T4.  I told her that we are looking, in oncology, for answers to intense fatigue and psychological stress and how we may support looking under all stones so that we may appropriately address a piece of the puzzle in our search for answers to fatigue when a person is undergoing INTENSE stresses to the body — and compromised reserve in the pituitary gland.

She was very interested in the low level of TSH (0.1 – 0.5) we look for in someone at risk for relapse. TSH stimulates tumor growth factor in persons with cancer of the thyroid.  I learned from her that, the hunt for cause of symptoms of hypotyroidism, aka, in cases of fatigue, through diagnostic evaluation of TSH is an often misleaded approach to the not uncommon ‘euthyroid sick syndrome’.

She noted prehistoric stress could have contributed to seedling of Reserve T3 in our biological heredity but that there have not been enough studies, actually not any statistics, of response to current day environmental stressors; intrinsic and extrinsic.  I told her how important it is through the course of treatment to be able to maintain activity, movement of some form to assist in the metabolization and excretion of the massive chemical invasion – an INTENSE stress to the body.

At what point during or after treatment might it not be safe to have Thyroid hormone levels suppressed?  In our dialogue we came to the juncture that managing thyroid hormone in cancer treatment and survivorship, at net point of maintaining the need for rest and the tolerance for activity (plethora of evidence-based research exercise promotes positive outcomes), may be a function of Reserve T3 – versus TSH (mainstream guideline). It may be that the etiology of fatigue (at least in part), during and following cancer treatment, is overlooked: TSH level comes back within range, and the ‘sick’ part of Euthyroid Sick Syndrome – (A low Reserve T3 – how it relates to ‘severe stressors’ both as intrinsic psychological and spiritual response of threat to mortality, and extrinsic stress from cancer treatments) — is a stone left unturned.