Dear Dr. Dean, 

Recently, I've been suffering from fatigue, hair loss, numbness in my fingers and toes, tightness in my neck (trapezius).

I took natural thyroid for many years, but have found it difficult to buy it in Portugal where I now live, and am now only able to obtain Synthroid.

Attached is my recent blood work. What do you think?

REBECA, Lisbon


Dear Rebeca,

The fatigue and hair loss are consistent with inadequately treated hypothyroidism. The numbness in your fingers and toes might be caused by diabetic nephropathy. Unfortunately, the blood work that you sent was only a complete blood count, with differential. This was perfectly normal, indicating that you are not anemic. However, there was no indication that any thyroid function studies were done, nor blood sugar, hemoglobin A1c, or insulin levels, which would enable us to evaluate your thyroid function or whether you may be diabetic.

Nevertheless, considering your history of hypothyroidism, and knowing how most physicians treat hypothyroid patients with doses of Synthroid based primarily on levels of thyroid stimulating hormone (TSH), I will bet that you are being undertreated.

Conventional physicians endeavor to keep the levels of TSH in the “normal” range. However, most hypothyroid patients do much better with TSH pushed into the subnormal range (i.e., with higher levels of replacement therapy). Furthermore, most physicians accept the dogma that Synthroid (thyroxine—T4) is the drug of choice—overlooking the requirement for the body to de-iodinate T4 into the active form of thyroid hormone, T3 (tri-iodothyronine) as in Armour thyroid or Westhroid. Armour is porcine thyroid, containing T3, T4, and T2 in their natural balance. Unfortunately, a high percentage of hypothyroid patients do not adequately convert T4 to T3, and although their blood levels may indicate normal thyroid hormone levels, they remain functionally hypothyroid. I think most thyroid function studies are a waste of blood.

I recommend that you switch to Armour Thyroid, and increase the dose slightly from what you are currently taking, and monitor your heart rate, energy levels, and other hypothyroid symptoms. I like my patients to maintain a heart rate in the 65–75 beats per minute range (or whatever is “normal” for them). If the heart rate increases, or you begin to feel anxious or “wired,” reduce the dose.

One hundred micrograms of Synthroid is equivalent to 60 mg (or 1 grain) of Armour Thyroid. If you are unable to obtain Armour or other forms of natural thyroid in Portugal, you may contact International Anti-Aging Systems in the UK ( Also, I suggest you consider adding Iodine in the form of Lugol’s solution to your regimen. It’s like the “frosting on the thyroid cake.” I recommend 4–8 drops per day of Lugol’s Iodine.

Hypothyroidism may also be a cause of diabetes—which may explain your numbness. Please ask your physician to check your fasting and post-prandial blood sugars and insulin, and hemoglobin A1c.

I suggest you also consider a thyroid complex designed by Dr. Jonathan Wright, a cinnamon and berberine ­complex, and mulberry fruit and leaf extract (500 mg three times daily).

I hope these suggestions will be helpful.

Ward Dean, M.D.