mild hypo 3

The word “myxoedema” was first used by Ord in 1878 to describe the mucin deposits in subcutaneous tissue.³ This was officially recognised by a committee appointed in 1883 by the Clinical Society of London as being caused by changes in or destruction of the thyroid gland. Semon had previously suspected that thyroid deficiency caused myxoedema. Thus severe changes in the thyroid and the resulting symptoms were identified, and by 1892 oral thyroid preparations, using animal thyroid were being prescribed or injected. However the concept of mild or minor hypothyroidism was not fully discussed or defined until 1915.
In 1917 McCarrison wrote: “the minor manifestations of thyroid defect are of very common occurrence”. He termed these “manifestations” as “minor thyroid insufficiency”. Significantly he referred to hypothyroidism as either the “complete syndrome of myxoedema” or “minor thyroid insufficiency”, suggesting that hypothyroidism fell into two clearly defined syndromes.
The concept of mild and severe versions of one condition is well represented in medicine. Functional changes often precede severe changes. Adrenal exhaustion or hypo-adrenalism can precede Addisons Disease, and functional hypoglycaemia can precede late onset diabetes.
In many early stage functional health disorders, the symptoms may be well established, but the laboratory evidence and blood changes are not always present. This is not surprising, as many ‘normal’ ranges for blood tests are designed to identify only major changes in the organs or systems under test.
Higgins in 1925 drew attention to skin changes, constipation, headaches and general nervousness as symptoms of incipient hypothyroidism, while in 1929 McLester discussed the general poor health and decreased metabolic rate that accompanied poor thyroid function.
In 1933 Mayo observed complications in the circulation, and the typical subnormal temperatures that occur when the metabolism is depressed. Breckenridge in 1932, Hinton in 1933 and Salzman in 1916 all reported that hypothyroidism was a cause of menorrhagia (heavy periods).
Raised cholesterol levels were noted in thyroid patients by many investigators. This was found so predictably that measuring the serum cholesterol was seen as a potentially useful method to assess thyroid function and to monitor changes in the symptoms following thyroid treatment.
In 1934 Hurxthal concluded that “the relationship between the blood cholesterol and the basal metabolism is usually reciprocal, when they undergo change as a result of variations in the activity of their thyroid gland”. Also, “the blood cholesterol provides another variable which may be used as a guide in the treatment of thyroid disease”.

Seward, in 1935, produced a study which was seen by his contemporaries as the definitive description of mild hypothyroidism. He wrote: “mild to severe grades of hypothyroidism are seen relatively frequently”. He found the most important and frequent single symptom to be fatigue.
Although underactivity of the thyroid is usually associated with weight gain, Seward accurately observed that young patients often lose weight. It was patients over 40 years who tended to gain weight.
Also in the 1930s Kimbal reported in the Kentucky Medical Journal 1933: “In the practice of medicine today, no more important condition is encountered or so often unrecognised as such as hypothyroidism”. He expressed concern that the milder degrees of hypothyroidism were being missed, as it was then thought that hypothyroidism could not exist without myxoedema. He questioned “just why this teaching should persist now, in the face of all the experimental evidence to the contrary”. “It was”, he said, “hard to understand”.
Six years after this report, Wharton wrote in the Canadian Medical Association Journal: “many patients who could be helped by thyroid treatment are not recognised as hypothyroid. Cretinism and myxoedema are the textbook examples of the hypofunctioning thyroid gland. Very little has been written about the milder degrees and the atypical forms of deficient thyroid activity. Hypothyroidism in a mild or masked form differs so greatly from myxoedema and cretinism that constant alertness for its many and varied manifestations is demanded”.
In his book ”Hypothyroidism – The Unsuspected Diagnosis”, Broada Barnes reported on a study in the Journal of the American Medical Association published in August 1942 in which 1000 young college students where checked for their basal temperature (underarm, resting morning temperature). These results were then compared with the standard metabolism test for thyroid function. The study showed that the subnormal body temperature measurement was a more reliable indicator of hypothyroidism.
Dr Barnes was a strong advocate of the basal temperature being an accurate reflection of the metabolism and the thyroid activity. He considered that any reservations over the value of basal temperature testing for diagnosing hypothyroidism was based on the medical dislike of self-testing and self-diagnosis by patients – coupled he thought with the absence of a test fee!
His special interest in thyroid problems spanned a career of over 40 years. During this time he designed many large scale thyroid testing programmes.
In 1941 he found “indication of low thyroid function in approximately 20 per cent amongst a large group of students”.
A colleague of Barnes, Dr Starr, believed that on the basis of his experience, both clinical and research, and the available thyroid function tests, that about 10 per cent of the total American population was hypothyroid.
Dr Nathan Masor in his book “The New Psychiatry”, published in 1959, expressed scepticism over the accuracy and value of the usual laboratory tests for thyroid function. He wrote, “this is strongly suspected in the conditions of metabolic insufficiency (hypothyroidism) wherein all tests prove normal but the individual may suffer from a fully developed fatigue and anxiety state”.
Dr Murray Israel founded the Vascular Research Foundation in New York and worked with thyroid patients for 40 years. In August 1971 in Prevention Magazine, he wrote “laboratory tests failed to uncover even a minute fraction of hypothyroids”. Standard tests had indicated that 85 per cent of his patients have normal thyroid function. Yet he observed that all of the patients showed marked benefits from thyroid supplementation. These improvements included increased and comfortable body temperature with increased energy and vitality.