Hypothyroidism Type Two and Thyroflex by Jeffrey Dach MD drdach

Jeffrey Dach, M.D. NewsLetter

Hypothyroidism Part Two

The Thyroflex and Reflex Time


Dear Friend or Colleague

Even though the death of Ann Nicole Smith was blamed on an apparent overdose in the Seminole Hard Rock Casino located 5 minutes away from my office, a low thyroid condition called Hashimoto�s thyroiditis was found at autopsy. (1) It seems that everyone is low thyroid nowadays. Anna Nicole Smith was also said to be taking human growth hormone (HGH), which is typical for an Anti-Aging program. Of course, this wasn't mentioned in the autopsy report. Although the use of HGH for Anti-Aging is firmly opposed by mainstream medicine, it seems to have caught the attention of seniors groups and is catching on despite the wet blanket provided by the The Institute of Medicine and JAMA .

Thyroid Hormone, The Missing Piece of the Puzzle

My thesis is that instead of human growth hormone (HGH), it is thyroid hormone that is the missing piece of the puzzle, and I spent a week learning about this puzzle at the Cenegenics Clinic in Las Vegas with Alan Mintz MD about two years ago. You may have seen Dr. Alan Mintz recently when he appeared on CBS Television 60 Minutes to describe his clinic program and talk about the Age Management Medicine Protocols offered there (2). I highly recommend the Cenegenics as a world class medical clinic with the best doctors and support staff. In this same CBS 60 minutes report, it was disclosed publicly that about 800 of the Cenegenics patients are on human growth hormone, also called HGH, based on this (protocol) for the indication of Adult Growth Hormone Deficiency.

Natural Thyroid as Anti-Aging Medicine

The usual Anti-Aging program includes various hormone treatments such as HGH (human growth hormone), testosterone, DHEA, estrogen and progesterone. However, natural thyroid hormone treatment by itself can be Anti-Aging since it changes the body composition, and skin and hair quality giving a more youthful appearance. Yet, most if not all of the larger Anti-Aging clinics tend to be conservative when it comes to thyroid treatment. They usually will not give thyroid. And if they do give thyroid, it is usually Synthroid rather than natural dessicated thyroid hormone such as (Nature-Throid from Western Research). Synthroid is the synthetic thyroid pill which contains only T4, while the natural thyroid pill contains both T3 and T4 accounting for its better results. Mainstream medical practice relies on the TSH test to determine when to treat with thyroid hormone (lab range 0.5 � 5.5) , so most people with low thyroid are missed by the system and are not given thyroid hormone.

Mark Starr and Type Two Hypothyroidism

A few months after I had the pleasure of meeting with Alan Mintz, M.D. at the Cenegenics clinic, I attended a medical meeting of the ICIM (Integrative and Complementary Medicine in Grand Rapids MI). At this meeting, I spoke with Mark Starr, MD who gave the lecture on hypothyroidism where he discussed his approach to diagnosing and treating the low thyroid condition which he called Type Two Hypothyroidism. (3)

Mark Starr's lecture and his book on the same topic were a real eye opener for me because he claimed that while 30% of the population are low thyroid, they are ignored and go untreated by mainstream medicine. These unfortunate souls drag themselves from doctor to doctor with labels such as chronic fibromyalgia, and chronic fatigue, and suffer from hair loss, constipation, depression and a host of other symptoms described by Dr. Jacob Teitelbaum. (4) Dr. Starr explained why the thyroid blood tests ( namely the TSH ) is unreliable, and Dr. Starr instead relies on old fashioned clinical judgment to decide when to treat with thyroid hormone and how much to give. (5) (6) (7)

Enter The Thyroflex Machine

One of the tried and true clinical parameters of thyroid function is the delayed Achilles reflex time which the old time docs routinely used for practical management of low thyroid before the blood tests were devised. (8) (9)

I was therefore really excited to meet Drs. Konrad Kail and Daryl Turner at their booth at the American Academy of Anti-Aging Medicine Meeting two years ago. The two of them developed the Thyroflex instrument which is a reflex hammer connected to a laptop computer which measures reflex time in milliseconds. They do not use the Achilles Tendon reflex, though. They instead decided to use the Brachio-Radialis muscle of the forearm which is more convenient while seated in a comfortable chair. The delayed reflex time is the finding which indicates low thyroid. (10)

They found excellent correlation between reflex time and thyroid function as measured by basal metabolic rate in patients before and after treatment with natural thyroid. Their study found a predictive Value of a Positive Test = 0.95 and a Predictive Value of a Negative Test= 0.017, which I thought was quite good. (11) (12)

Our Thyroflex Experience

We are proud to be the only medical clinic in Florida to offer this noninvasive Thyroflex test which really represents the best modern medicine has to offer while at the same time bringing back the original truths of clinical practice. After using the Thyroflex machine for about one year, we have found it to be especially useful in those cases in which the TSH is paradoxically low even though the patient is low thyroid. Note: a low TSH indicates high thyroid function, while a high TSH indicates low thyroid function. Many people are confused by this.

This paradoxically low TSH is called hypothalamic dysfunction. Since the TSH is below 3, no mainstream doctor is willing to give thyroid hormone treatment to these unfortunate souls. With the confidence of a delayed reflex time from the Thyroflex test, we feel comfortable giving these people the badly needed thyroid, and the results have been astounding.

Our approach to diagnosis of low thyroid uses a lengthy questionnaire which goes over 70 symptoms of low thyroid, a complete thyroid blood panel including TSH, free T3 and free T4, a physical examination which includes measurement of reflex time with the Thyroflex. Also included is a basal body temperature chart filled out by the patient at home.

A Trial of Low Dose Thyroid is Very Safe

Once it has been determined that thyroid hormone is likely to be beneficial, a trial of low dose Nature-Throid from Western Research is given with a small tablet every other day, while a log book is kept by the patient describing any changes in energy or other symptoms. Any symptoms of thyroid excess such as palpitations, feeling of warmth, anxiety or insomnia are noted. After 10-14 days the log book is reviewed to determine if the thyroid was of benefit. In addition, Iodine supplementation with Iodoral is given which was described in a previous NewsLetter. We have found that monitoring symptoms with a log book and small incremental doses in thyroid hormone makes the program very safe.

And this is the final piece of the Anti-Aging Medicine Puzzle which fits together and completes the picture.

For more information, visit my thyroid page.

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Common Symptoms of Low thyroid:

____Weight gain
____Puffy face
____Loss or thinning of eyebrows
____Cold intolerance
____Low sex drive
____Abdominal bloating
____Cold hands or feet
____Dry or thinning hair
____Joint or muscle pain
____Thickening of the skin
____Thin, brittle fingernails

Longer List of Commonly Reported Symptoms of Hypothyroidism

1. Dry skin
2. Thick, scaling skin
3. Coarse skin
4. Fineness of hair
5. Dry, coarse, brittle hair
6. Sparse eyebrows, especially outer ends
7. Hair loss
8. Brittle nails
9. Dry ridges down nails
10. Cold skin
11. Swelling of face (edema)
12. Swelling around the eyes (edema)
13. Swelling of eyelids (edema)
14. Nonpitting edema of ankles
15. Fluid accumulation in abdomen (ascites)
16. Thick tongue
17. Swelling of ankles 18. Paleness of skin 19. Paleness of lips
20. Bluish or purplish coloration of skin, nail beds, lips
21. Weight gain unexplainably
22. Hoarseness
23. Low basal & activity level temperature
24. Protrusion of one or both eyeballs (exophthalmos)
25. Slow speech
26. Slow pulse rate despite low physical fitness
27. Slow thinking
28. Sluggish movement 29. Slow relaxation phase of the knee or ankle reflex
30. Listless, dull look to eyes
31. Wasting of tongue
32. Nervousness
33. Rapid heart rate with weak force of contraction
34. Slow heart rate despite low aerobic fitness
35. Pounding heart beat
36. Cardiac enlargement on x-ray
37. Indistinct or faint heart tones
38. Low QRS voltage on ECG
39. Long-normal intervals on ECG
40. Fluid around heart (pericardial effusion)
41. Changes at the back of the eye (at fundus oculi)

References on Symptoms of Hypothyroidism:
(13) (14) (15)

(16) Lowe, J.C., Reichman, A., & Yellin, J.: The process of change with T3 therapy for euthyroid fibromyalgia: a double-blind placebo-controlled crossover study. Clin. Bull. Myofascial Ther., 2(2/3):91-124, 1997.

References on reflex time for determination of thyroid function:

(17) (18) (19) (20) (21) (22) (23) (24)

Jeffrey Dach MD Web Site

The following is a testimonial from a patient after treatment for low thyroid:

"I highly recommend Dr. Dach to anyone that is frustrated with thyroid issues. For years I bounced from doctor to doctor - each giving me prescriptions for levoxyl and cytomel. Even when my TSH test results wouldn't budge below 5, they wouldn't prescribe higher doses because I was "within range" and "too high a dose will cause osteoporosis later". Who cares when I can't get out of bed now?!

Dr. Dach was recommended by a friend and he's been a lifesaver. He spent over an hour with me on my first appointment (I have Hashimoto's) and switched me to a bio-identical (Nature-Thyroid) in addition to testing my vitamin D levels (I was severely deficient). Not only does he listen, he opened my eyes to a lot of issues that all of my other doctors never even mentioned.

I've been going to him for about a year now and the change has been nothing short of amazing - I can get out of bed and be a functional human whose hair isn't falling out! He is kind and caring and highly informative.

I highly recommend Dr. Dach to anyone frustrated with their current treatment! He will make you feel well!"

signed LowThyroid

Jeffrey Dach, M.D. TrueMedMD

Catalog of NewsLetters

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(1) My Vitamins Are Killing Me by Jeffrey Dach MD !!!

(2) Stroke Prevention and Vitamin C by Jeffrey Dach MD

(3) Testosterone Risks and Benefits by Jeffrey Dach MD

(4) Medical School Days and SSRI Research by Jeffrey Dach MD

(5) Iodine and Breast Cancer Prevention by Jeffrey Dach MD

(6) Hypothyroidism Part One by Jeffrey Dach MD


Catalog of Articles Published on Hank Barnes World,
You Bet Your Life, by Jeffrey Dach MD


(1) Lipitor and "The Dracula of Modern Technology" by Jeffrey Dach MD

(2) Osteoporosis, Bisphosphonate Drugs and Toulouse Lautrec by Jeffrey Dach MD

(3) Prozac, Paxil and SSRI Drugs - Part One by Jeffrey Dach MD

(4) Prozac, Paxil and SSRI Drugs - Part Two by Jeffrey Dach MD

(5) Max Essex and Virological Failure in the NEJM by Jeffrey Dach MD

(6) The Origins of HIV by Jeffrey Dach MD

A Medical Article that I Published in 1980:

(7) Dach J, Patel N, Patel S, Petasnick J. Peritoneal mesothelioma: CT, sonography, and gallium-67 scan. AJR Am J Roentgenol. 1980 Sep;135(3):614

Jeffrey Dach, M.D.
Member of the Board of the American Academy of Anti-Aging Medicine
Board Certified by the American Board of Radiology

4700 Sheridan, Suite T
Hollywood Fl 33021
office phone 954-983-1443


Don't forget to visit my web site for more information, and we you might like to attend one of our free seminars on Wednesday Nights. Please call for reservations for the seminar, though.

Do you have a testimonial, or a question for the newsletter? Send it in via email reply.

Sincerely Yours
Jeffrey Dach, M.D.
4700 Sheridan Suite T.
Hollywood, Fl 33021


Useful Links:

Thyroid page on the Jeffrey Dach MD Web Site

Stop the Thyroid Madness.com
Blog, website and forum dedicated to Natural Thyroid

The Broda O. Barnes, M.D. Research Foundation, Inc.

Mark Starr MD

Richard L. Shames, M.D.

Mary Shomon, M.D. CFS Site

Mary Shomon, M.D. Thyroid Site

William McK. Jefferies, M.D. (Retired)


Dr. Dach is Board Certified by the American Board of Radiology and a member of the Board of the American Academy of Anti-Aging Medicine. He has 25 years experience in the Memorial Hospital System as an interventional radiologist. His current practice focuses on Bio-identical hormone supplementation for men and women, menopause, andropause, HGH, testosterone, natural thyroid and the use of natural substances rather than drugs in the appropriate setting.

Conflict of Interest Disclaimer: We receive no money from the pharmaceutical industry or from the NIH. We do not sell any products to the public at large. We do however, make available selected nutritional supplements to our office clients at a small markup to cover our costs.

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