Most people find that they can maintain diet and lifestyle changes when they make them gradually. Regular mild-to-moderate exercise has more benefit than the intense push that results in injury and down time for healing. I advise my patients to begin exercise with “baby steps” to avoid injury to deconditioned tissues. Also, if you’re struggling with an impaired metabolism, your healing time may be increased if you do get injured.

After all of the holiday meals and goodies many of us need to clean up our diets. I recommend a wholesome diet as part of metabolic rehab, and that looks very different to different people. Some of my patients are strict vegans: Others eat meat regularly. A reasonable start for most people is to eliminate the refined sugars and grains and focus on plenty of fresh veggies and fruits. Whether you choose vegetable or animal sources, an adequate protein intake is also a necessity. If at all possible, be sure to use organic sources for your food. Clean water is also a part of wholesome diet. Reverse osmosis-filtered water will help eliminate chemicals and heavy metals that can have harmful effects on our bodies, including thyroid hormone production and utilization.

Many of my patients say that they’ve diligently worked with diet and exercise to improve their health and that their exercise tolerance is still poor and that they haven’t dropped an ounce. If this is your experience, you may indeed be struggling with impaired metabolism resulting from poor thyroid hormone regulation of your tissues. Testing with indirect calorimetry to measure resting metabolic rate (RMR) most often reveals a slow metabolic rate in people who experience this frustration.

As I’ve used metabolic rehabilitation for the past decade to successfully treat people with thyroid disease and fibromyalgia, the public health questions surrounding these problems have long been an interest of mine. Research has shown that, for most people, fibromyalgia is linked to slow metabolism from thyroid problems. The thyroid problems can be related to poor production of thyroid hormone, problems with transport of thyroid hormone to the tissues, or poor utilization of thyroid hormone at the receptors on the cellular level. Why don’t more health care providers and patients know about this link between fibromyalgia and thyroid problems?

Why do so many people have thyroid problems? Why do people become resistant to a hormone that they should make and that is essential for optimal functioning of nearly every tissue in the body? Thyroid disease, whether it is a production or utilization problem, seems to be a quiet public health epidemic. Why is so little attention paid to such treatable problems? Is it because most of the thyroid disease and fibromyalgia patients are women? How many of our health care dollars go toward the ineffective treatment of a multitude of symptoms when treating the cause of the symptoms would be much more efficient?

I recently joined the American Public Health Association (APHA) as a contributing member. The APHA is a multidisciplinary organization dedicated to improving public health through education and advocacy. I’m hoping that through my participation in the APHA I can increase awareness of these problems. And, just as importantly, I want to increase the awareness that effective treatment is available for most people so they no longer have to suffer needlessly.

I've been deeply concerned about the welfare of Planet Earth since my teenage years (such a long time ago!!) and am distressed by the damaging effects of the loads of petrochemicals that have been dumped into our air, water, soil, and food. There’s a lengthy list of such chemicals that have the potential to harm our health in various ways. Chapter 12, page 262 of Your Guide to Metabolic Health has a list of chemicals that are known to lower thyroid hormone levels.

Neuroendocrine disruption (NED) is a general term for the effects of chemicals such as polychlorinated biphenyls (PCB's), DDT, and dioxins on our brains, endocrine glands (such as the thyroid), and hormone receptors. These chemicals did not exist in nature before humans manufactured them and then allowed them to filter into the air, water, soil, and food. While some of them such as PCB’s and DDT have been banned, they linger in the environment from previous use.

The thyroid system, whether we’re considering central regulating mechanisms in the brain, thyroid hormone production by the gland, transport of thyroid hormone in the blood, or utilization at the receptor level, seems to be particularly affected by NED. When I did a literature search for neuroendocrine disruption (NED), most of the research articles I found discussed the damaging effects of PCB’s on the thyroid hormone system. Since adequate thyroid hormone is so important for the optimal functioning of nearly all of the tissues in the body, a multitude of symptoms can result when there’s a breakdown in that system.

The Agency for Toxic Substances and Disease Registry (ATSDR) issued a report in 2000 that points out that we all have some level of PCB's in our bodies. There are numerous studies showing that breast milk in women across the USA has significant levels of PCB's. If you’re breast-feeding, please don’t let this information deter you - the benefits of breast-feeding far outweigh the fears of even PCB exposure. This is just an example of how pervasive these petrochemical toxins are in the environment.

An adequate amount of thyroid hormone is critical to the normal structure and chemistry of our brains. Impaired cognitive function, depression and anxiety can be linked to poor thyroid regulation of brain tissue. The production of neurotransmitters like serotonin and dopamine are affected by thyroid regulation. How many people do you know who are taking antidepressants? Particularly disturbing were the multitude of articles discussing the damaging effects of PCB’s on the brains of developing fetuses and infants through the first two years of life. How much of the ADD, ADHD, and autism that are so common in children today can be linked to poor thyroid regulation of the brain? How many children are medicated for behaviors that may be related to NED?

While I sincerely hope that we clean up the planet quickly, we're most likely going to be at the effect of these chemicals for the rest of my lifetime and yours. Some people seem to have the physical constitution to buffer against these contaminants and don’t seem to have any significant health impact. Others have subtle but significant problems that defy usual diagnostics. They modify their lifestyles and diets to try to be well in spite of their "mysterious illness". Some people have devastating health problems because of NED and are sidelined from full participation in their lives. How much human potential is undeveloped because of impaired thyroid regulation due to NED?

The ray of sunshine in this dismal prediction is that you can still be well, regardless of the level of impact you may currently experience. If NED has disrupted your thyroid production or utilization, metabolic rehabilitation effectively addresses the cause of the symptoms. One of the most frustrating problems for my patients has been the lack of information about thyroid disease and effective treatment by their primary care physicians and endocrinologists. My goal in participating with the APHA is to increase awareness of these problems and their solutions.

If you or someone you know has a personal story about health problems related to exposure to petrochemical toxins I’d be grateful if you’d share it with me. Please feel free to email your story to me at MetabolicHealth@aol.com.

I don’t want it to sound as if I think that any and all health problems are only related to poor thyroid regulation due to NED. There are certainly many, many health problems that are not related to poor thyroid hormone regulation and I would not want anyone to limit his or her search for diagnosis and treatment to this alone.

Another tool you can use to help in your recovery is "Your Guide to Metabolic Health", the book I coauthored. It is the by-the-numbers guide to metabolic rehab. Many people have used the information in this book and, with just a few troubleshooting consultations with me, have gotten well. Some people have asked their local library to order the book so others may use it as well.

My emphasis at the Center for Metabolic Health remains on high-precision metabolic rehabilitation, metabolic evaluations, and telephone consultations. The full range of clinical services is offered on Tuesday, Wednesday, and Thursday and I'm available for telephone consultations on Monday and Friday as well. The telephone is answered Monday through Friday from 9:00 am to 4:00 pm. Please call the clinic at 303-413-9100 for information and to schedule appointments. My assistant will be glad to answer your questions.