Dr. Jeffrey Dach, Jeffery Dach MD
Thyroid Nation
Achilles Reflex
A few months after 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 Michigan. At this meeting, I spoke with Mark Starr, M.D. who presented his approach to diagnosis and treatment of the low thyroid condition, which he calls Type Two Hypothyroidism.(14)
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 is 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. (15) Dr. Starr explained why thyroid blood tests such as the TSH are unreliable. Dr. Starr instead relies on old fashioned clinical judgment to decide when to treat with thyroid hormone and how much thyroid medication to give. (16)(17)(18)
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 doctors used routinely for practical management of low thyroid before the blood tests were devised. Checking the Achilles reflex is still accepted and used by mainstre
am medicine today as an indicator of thyroid function. (19)(20)(21)(22)(23)(24).
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 in 2005. (25)(26)(27)(28) Drs. Kail and Turner developed the Thyroflex instrument, a reflex hammer connected to a laptop computer which measures reflex time in milliseconds. (27)
They do not routinely use the Achilles Tendon reflex though. Instead, they decided to use the Brachio-Radialis muscle of the forearm, a more convenient way to illicit the reflex while the patient is seated in a comfortable chair. A delayed reflex time is the finding which indicates low thyroid.
They found an 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. (29)(30)
Our Thyroflex Experience
We are proud to be the first 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 validating the original knowledge of early thyroid 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, and Jacob Teitelbaum MD sees this frequently in his chronic fatigue patients.(31) Since in these cases the TSH is usually below 3, no mainstream doctor would be willing to give thyroid hormone treatment to these unfortunate souls. With the confidence of a delayed reflex time on a Thyroflex test, we can 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 (listed below), a complete thyroid blood panel including TSH, free T3 and free T4, and 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 RLC labs (Western Research) is given with a small half grain tablet every other day, while a logbook 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 in the logbook. After 8 days, the logbook is reviewed to determine if the thyroid was of benefit. In addition, Iodine supplementation with Iodoral is routinely given as described in a previous article on Iodine and Breast Cancer Prevention. (45)
We have found that monitoring symptoms by recording any changes in a logbook, as well as small half grain gradual increments in thyroid dosage makes this program very safe. In the event the patient experiences palpitations, they are instructed to hold any further thyroid medication and inform the physician.
About the Author
Jeffrey Dach, MD is Board Certified in Diagnostic and Interventional Radiology. He retired from the practice of radiology in 2004 after 25 years of experience as a hospital-based physician with Radiology Associates of Hollywood. Dr. Dach is the founder and Medical Director of a clinic in Davie, Florida specializing in bioidentical hormones, natural thyroid and natural medicine called TrueMedMD. Attending Radiologist specializing in Interventional Radiology with Radiology Associates of Hollywood, a private group practice consisting of 33 radiologists servicing Memorial Regional Hospital, Memorial Pembroke, Memorial West Hospital, Hallandale Outpatient Imaging, South Broward Outpatient Imaging, MRI of South Broward. Read more about Dr. Dach’s experience and biography, here. Click here to make an appointment. For Dr. Dach’s Pure Encapsulations store, click here. You can also purchase his Nature’s Sunshine Supplements.
