Passwater Interview with Stephen Langer, M.D.


© Whole Foods Magazin August 2007

Solving the Riddle of Illness

An interview with Dr. Stephen E. Langer

By Richard A. Passwater, Ph.D. 

Quietly, over more than three decades, Dr. Stephen Langer has been helping countless people discover the cause of their puzzling symptoms and lead the path for their recovery. The cause had indeed been a “riddle” to them and Dr. Langer has been the answer. I first met Dr. Langer in the early 1980’s when he was the medical columnist for a national newspaper and host of his national radio program. I have been privileged to write blurbs for his book jacket for various editions of his seminal book, “Solved: The Riddle of Illness.” As science uncovers more to the riddle, Dr. Langer keeps improving on the solution with his updated editions.

      Hypothyroidism (low thyroid function) can masquerader as several other illnesses. In      fact, it is often called "The Great Masquerader." It is one of the most prevalent and    least diagnosed disorders by physicians, yet it can be the underlying cause of or   contribute to any of 64 ailments, from obesity and chronic fatigue to fibromyalgia and     cancer.

His earlier editions were published in 1984, 1995 and 2000. In his fourth edition, Dr. Langer explains how to determine if you suffer from low thyroid function; how to differentiate between low thyroid function and hypoglycemia; how to use simple, inexpensive treatments; and much more. He also revels how to cope with stress that lowers thyroid function, depletes energy, and contributes to weight gain.  The new edition also includes new chapters on environmental toxins, pregnancy, obesity, and how your thyroid influences other glands.

Stephen E. Langer, M.D., is a renowned thyroid expert who practices Preventive Medicine, orthomolecular and Clinical Nutrition in Berkeley, California.  Dr. Langer received his doctorate of Medicine from the State University of New York Downstate Medical Center College of Medicine (Buffalo) in 1967. He has written over two hundred articles for major health and medical publications.


Passwater: Dr. Langer, before we get into questions about your and James F. Scheer’s new fourth edition of the best-seller about the thyroid gland, Solved: The Riddle of Illness, I wonder if you will set the stage by explaining the thyroid gland. What it is and what does it do for us?

Langer: An excellent idea! The thyroid is a tiny, coral-colored, bowtie-shaped gland that semi-circles the windpipe under the Adam’s apple. Your five quarts of blood circulate through the thyroid gland every hour to absorb thyroid hormones and to deliver them to your trillions of cells where they control the speed of the metabolism of oxygen and food to create energy. Patients with hypothyroidism (i.e., low thyroid function) don’t secrete or absorb enough thyroid hormone in their cells, so they suffer some or many of its 64 symptoms. The result of this is like wet wood in a fireplace. There’s a lot of smoke but little fire. Your heartbeat slows and has little thrust, blood pressure drops, circulation becomes sluggish (contributing to your feeling cold, especially in the extremities—your hands and feet) your energy is low, your digestion slows down, constipation is common—so are headaches—wounds heal slowly, thinking and memory are undependable, menstrual and menopausal problems often occur, the sex drive weakens, hair becomes lifeless and brittle and, among other things, your skin becomes rough.

Passwater: After three successful editions of Solved: The Riddle of Illness, why did you decide to write a fourth edition?

Langer: There were so many new thyroid gland studies that Jim Scheer and I felt we owed readers an enlarged, updated book. Then, too, statistics on obesity and overweight have shot up to 66% of the population, so we wanted to alert readers to the virtual epidemic of undiagnosed hypothyroidism that makes for below-par metabolism, one of the reasons people accumulate fat. Sadly, under-diagnosis of hypothyroidism is due mainly to the fact that today’s doctors rely almost solely on amount of thyroid stimulating hormone (TSH) in the bloodstream. Most labs consider 50 mcg per liter the end of the normal range. However, hypothyroidism is five times greater at the 65-mcg level. It is incumbent for physicians to complete a battery of tests: total and free T3, T4, TSH, antithyroid antibodies, anti-TPO, and antithyroidglobulin. And, of course, physicians should analyze the patient’s symptoms: mainly cold extremities, low energy, constipation, menstrual problems, and depression, among many others.

Everybody who suspects low-thyroid function should take the Barnes Basal Temperature Test. (The late Broda Barnes, M.D., Ph.D., a friend and colleague, was one of the world’s leading thyroidologists.) Here’s how: before going to bed tonight, shake down a thermometer and leave it on the bedside table. Upon awakening the first thing in the morning after a good night’s sleep—no later—tuck the thermometer snugly under your arm for 10 minutes as you lie there. If your thyroid function is normal, your temperature should be in the range of 97.8 to 98.2 °F. If it’s lower, you’re probably hypothyroid, and this could be the cause of any symptoms you may have. Take the test on two consecutive days and average the findings. Women get the most accurate reading when not menstruating (temperature fluctuates at that time) or on the second or third day of menstruation. Bring the results to a preventive medicine, holistic or complementary doctor. Orthodox doctors don’t usually accept it. If after the physician’s testing and consideration of your symptoms you’re deemed hypothyroid, a prescribed supplemental thyroid hormone can usually normalize you.

Passwater: Good fill in. What new chapters did you write in Solved: The Riddle of Illness?

Langer: The first is on the possible need for hypothyroids to take thyroid supplementation for enhancing fertility and pregnancy; the second is on how to thrive in a polluted world; a third is on coping with hyperthyroidism (i.e., an overactive thyroid gland); and, the fourth is on reversing depression. Many conventional fertility programs fail to work because the thyroid gland is under-functioning, a fact not always considered by doctors and psychiatrists. Fluoride and smog and noxious chemicals in the air or spilled into water supplies can reduce the secretion of thyroid hormones or even turn it off. Among the hundreds of encouraging letters received from readers of earlier editions of Solved: The Riddle of Illness, we received several requests to cover the subject of hyperthyroidism, too-high thyroid functioning. A world authority on depression, Mark Gold, M.D., found that thyroid insufficiency is at the root of much depression and fatigue. Dr. Gold discovered that depression is often the first sign of low-level thyroid failure, not always detectable by the usual thyroid function tests. Significantly, he found that 90% of depressed patients who were clinically hypothyroid showed normal thyroid tests and improved when supplemented with thyroid hormone.

Passwater: That’s fascinating. Can you give me more information on how hypothyroidism relates to depression?

Langer: Hypothyroidism can cause oxygen deprivation in the brain in many ways. The heart pumping action is weaker, thus slowing the delivery of nutrients as well as oxygen. It also slows the rate of oxidation (burning) of food (glucose) to nourish brain cells and depresses the production of blood cells. Further, low thyroid function also contributes to atherosclerosis (i.e., narrowing of the arteries) decreasing the amount of blood that flows to the brain. In his book, The New Psychiatry, Nathan Masor, M.D., points out that narrowing vital brain arterioles by even one-sixteenth of their caliber can limit inflow of oxygen to such an extent that emotional disturbances such as depression result. The ability to think and remember also is reduced. Usually, thyroid hormone, supplemented with vitamin B-complex, corrects these conditions.

Passwater: Exactly how does hypothyoidism cause weight gain and the inability to lose weight?

Langer: Hypothyroidism doesn’t make you fat. Through our extensive records, Dr. Barnes and I found that at least 40% of hypothyroids are actually underweight. However, if you’re overweight or obese and also hypothyroid, you will probably need to take thyroid hormone to facilitate any diet you are on. A sluggish thyroid metabolizes food more slowly than normal. It also burns fat more slowly.

Passwater: How does low thyroid function contribute to female and male sexual disorders?

Langer: Characteristic fatigue drags people down to the survival level. They want the bed only for rest, sleep and revival. Icy cold hands and feet kill a partner’s desire for sex. Hypothyroidism often reduces a woman’s sensation of pleasure in sex and sometimes affects men with impotency that Viagra and the other drugs can’t correct. I’ve had several male patients regain their mojo through 50 cents worth of natural thyroid hormone per day.

Passwater: Is it true that hypothyroidism often causes menstrual and menopausal problems?

Langer: Definitely! Among my patients, I have seen supplemented thyroid hormone eliminate or at least lessen menstrual difficulties: severe pain, irregularity, too copious flow, too little flow, and premature and delayed menses. Dr. Broda Barnes managed almost 2,000 such cases with added thyroid hormone. His and my treatment was used successfully as early as 1899. Unfortunately, with new discoveries older medicines that were eminently successful are often shelved by orthodox medicine. Fortunately, doctors practicing complementary or preventive medicine use thyroid hormone successfully. Relative to menopause, many gynecologists understand that replacement with thyroid hormone often alleviates menopausal symptoms of hot flashes, fatigue, depression, and, among other things, sleeplessness. In fact, the president of the American Association of Clinical Endocrinologists says, “As women approach menopause, many symptoms may quickly be attributed to this milestone in a woman’s life without complete discussion of other easily corrected disorders, such as thyroid disease, that often mimic or accompany menopause.”

Passwater: What is Hashimoto’s thyroiditis and why is it important?

Langer: It is an apparently hereditary, inflammatory, autoimmune illness in which antibodies attack the thyroid gland, as if it were a threatening invader such as bacteria, viruses or fungi (yeast). Statistically, two out of 100 people develop it; 95% of them are women. Symptoms are deep fatigue, often written off as chronic fatigue syndrome, depression, memory loss and difficulty in concentrating, acute nervousness, allergies, irregular heartbeat, muscle and joint pain, sleep disturbances, reduced sex drive, menstrual problems, digestive disorders, headache and difficulty in swallowing. Frequently, such patients test normal for circulating thyroid hormones. However, even slightly elevated antithyroid antibodies are the telltale sign. I start treatment on such patients with a quarter grain of natural, desiccated, Armour thyroid, increasing that dosage by a quarter grain every several weeks. Along with this, I upgrade the patient’s diet with liberal amounts of vitamins, minerals and essential fatty acids—mainly gamma-linolenic acid (GLA) eicosapentaenoic acid (EPA) vitamin B-complex and vitamin C. Within 90 days, the major symptoms usually are under control, and the patient loses weight and becomes charged with energy.

Passwater: Which foods, drugs and environmental conditions reduce thyroid function?

Langer: Perfectly good foods otherwise, the following tend to limit the secretion of thyroid hormone: cabbage, cauliflower, kale, kohlrabi, mustard greens, rutabaga, turnips, and millet, soy, and walnuts and should be eaten only in moderation by hypothyroids. Among drugs that contribute to low thyroid function are some cough medicines, amiodarine HCI (Cordarone) and lithium used as an antidepressant or for treating bipolar disorders, as well as aspirin and other salicylates—pain-killing drugs—and rubbing liniments containing wintergreen oil. Major environmental thyroid gland suppressants are cigarette smoke, smog, and fluoride in city water supplies, toothpastes, mouthwashes and in dozens of processed foods and beverages produced in cities with fluoridated water. Lead and mercury in the air and water and, the latter, in fillings of teeth are notorious for this. Perchlorate, a byproduct of making synthetic fertilizers and solid propellants for rockets, missiles and fireworks is found in the waters of most states and is notorious for blocking the thyroid gland from absorbing iodine, its principle food. A new chapter, “How to Thrive in a Polluted World,” names even more enemies of the thyroid gland and your health and helps you to cope with them.

Passwater: Recently, I noted that hypothyroidism may be a contributor to the so-called “incurable” disorder, fibromyalgia.

Langer: Yes. As a matter of fact, Dr. John C, Lowe, the research director of the Fibromyalgia Research Foundation, in Boulder, CO, has studied this matter for more than 15 years and has found that almost 65% of patients with this excruciating disorder can experience less pain or complete healing from fibromyalgia with thyroid hormone supplementation. Dr. Lowe has told me that his doctors have had such a positive experience treating fibromyalgia with natural thyroid hormone that they consider this condition to be another symptom of hypothyroidism, rather than a disease entity. This chapter gives hope to patients who think that fibromyalgia is untreatable. Is Dr. Lowe sure that fibromyalgia is another of hypothyroidism’s 64 symptoms? Here’s what he told me: “I’m so certain of this that I would put my neck on the chopping block.” This chapter explains in detail how and why thyroid hormone can cope with the symptoms of fibromyalgia.

Passwater: What course would you recommend for someone who suspects he or she is hypothyroid?

Langer: Pursue the matter beyond mere suspicion. Get the facts. Does this person manifest any of the symptoms mentioned above? (Unfortunately, there are many more than can be listed here.) If so, I would advise the person to take the Barnes Basal Temperature Test. If the resting temperature is below 97.8, I suggest seeing an alternative, preventive, holistic or complementary medical doctor and have thorough testing, as mentioned above. If the patient is hypothyroid, I recommend treatment with natural, desiccated thyroid. This has brought renewed energy, new hope and zest for living to most of my patients!

Passwater: Thank you, Dr. Langer, for updating your classic book that has benefited so many people and for sharing your information with our readers. WF

© 2007 Whole Foods Magazine and Richard A. Passwater, Ph.D.

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