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Thyroflex Testing for Hyopthyroid

Years before blood tests – TSH, FT3 and FT4 – were developed to evaluate the function of your thyroid, doctors used the reflex response of the Achilles tendon to determine the thyroid status of a patient.

If a patient had symptoms such as dry skin, dry hair, cold, constipation, hair loss and inability to lose weight, it was suspected the person had a low-functioning thyroid.  The reflexes were tested and if found to be sluggish, the diagnosis of hypothyroidism was made. The reflex test, called the Woltman Sign, is most easily observed at the ankle tendon (Achilles) but can also be evaluated at other sites. 

NiTek International embraced the simplicity of the Woltman Sign and developed a device call a Thyroflex. The in-office evaluation uses the brachoradialis tendon, near the elbow, to check the rate and caliber of the reflex response.  The Thyroflex provides a pain-free, needle-free, cost effective measurement of thyroid function with an accuracy of 98.5 to 99% when compared to laboratory testing.

Why is the Brachioradials reflex used?
The brachioradials reflex is used because the tendon is easy to access and the procedure can be performed while sitting comfortably in a chair. In addition, the Achilles reflex may be an unreliable indicator in some patients, particularly in those with diabetes, some neurological diseases and in the elderly.

How does the test work?
A small strap is placed around your hand.  The exact reflex point on the brachioradialis tendon is located and marked with an X.  A metallic hammer that is connected to a computer is used to strike the reflex point.  The computer measures the time between the strike of the hammer and the upward fleck of the wrist. The longer the time lapse, the more you are in need of additional thyroid hormone.

Ideally, it should take 50 to 100 milliseconds for the wrist reflex to occur. If the response time is between 100 to 120 milliseconds, the thyroid function is marginal (satisfactory). If the reflex speed is greater than 120 milliseconds, it is a sign of low thyroid functioning, or hypothyroidism. If the reflex response is very fast, less than 50 milliseconds, it is an indication that your thyroid is overactive, or hyperthyroid.

The Thyroflex test takes approximately 4 minutes to administer and results are provided immediately. If you are taking thyroid medication, your doctor can make subtle adjustments in your dosage, even if your lab tests are in the normal range.  A Thyroflex assessment is actually a deeper determination of thyroid function:  It is the only test available that determines how well your thyroid hormones are functioning at the cellular level.

Resting Metabolic Rate:
The reports shows your current Resting Metabolic Rate (RMR). This represents how many calories you are currently burning per day. An optimal resting metabolic rate in women should burn 2,250 calories per day; 
for men, that increases to 2,750 calories per day.

Your healthcare practitioner will interpret the Thyroflex report during your office visit. You will be advised on taking thyroid supplements and nutritional changes to optimize the health of your thyroid gland. If you are currently on medication, your practitioner can adjust your dosage as needed. If your Thyroflex assessment and your thyroid laboratory tests are both completely normal, your practitioner my suggest a saliva test to assess the health of your adrenal glands and /or gonads (tests or ovaries)..

To watch a video from Dr. Miller on how the thyroflex works click below:

Thyroflex Questionaire:

The follwing is an excerpt from Chapter 17: Hypothyroidism:The Undiagnosed Epidemic from 13 Secrets to Optimal Aging: How Your Hormones Can Helo You Acheive a Better Quality of Life and Longevity, by Kelly Miller DC NMD FASA FBAARM CFMP.

Chapter 17: Hypothyroidism : The Undiagnosed Epidemic        

            By far, the most difficult hormones to accurately assess are the thyroid hormones. When I attended Logan University of Health Sciences in 1980 I was taught that an initial screening for the thyroid consisted of TSH, T4, and T3. This procedure has changed through the years for the worse, in my opinion. TSH has become the sole standard marker to screen for hypothyroidism. Today’s doctors have been brainwashed to believe this, most probably because the standard treatment now for hypothyroidism is with synthroid or levothyroxine to be determined by TSH only. If the TSH is above the reference range, one of the two drugs above is prescribed. As soon as the TSH comes back into range they are declared cured of the hypothyroidism as long as they continue with the medication. I wish this was the case but it is not. It would be so much simpler if it was true, but it is not.  The fact of the matter is that this methodology does not work for the majority of hypothyroid patients because the TSH does not demonstrate the hypothyroidism in most people. Furthermore, even when an individual is prescribed a medication, approximately half of these patients still exhibit multiple overt signs and symptoms of hypothyroidism but the doctor points to the TSH on the report and tells the patient there is nothing wrong with their thyroid. I have heard this story from one my patients hundreds of times. Unfortunately, this is the standard of care despite patients exhibiting numerous signs and symptoms of hypothyroidism. This protocol prevents millions of patients from being treated and millions others under-treated for hypothyroidism.

            Over fifty years of research in monitoring basal body temperatures by Dr. Broda Barnes demonstrates that there are many people with hyothyroidism that are being missed by TSH. The clinical experience and writings of Dr. David Brownstein also echo the opinions of Dr. Barnes of widespread hypothyroidism in the population based on signs, symptoms, and lowered basal body temperatures. My personal thirty-seven years of clinical experience of examining and treating patients with hypothyroid symptoms by monitoring their basal body temperature despite a normal reference range of TSH has convinced me of the efficacy. These patients often exhibited temperatures as low as 96 degrees vs. the expected 98.6 degrees. Their thermostats were way off. No wonder they felt tired, fatigued, and could not lose weight. I treated these patients for hypothyroidism and they made improvements in function even though their TSH was within reference range. My conclusions after many patients and many years in clinical practice is that using reference range of TSH, T4, and T3 as determining factors for hypothyroidism is practically worthless. Even patients who had reference ranges in the upper quartile of free T3 often had hypothyroid symptoms. This was all before I discovered the thyroflex.

            In November, 2016, one of my mentors, Dr. Paul Ling Tai, told me about an exciting FDA cleared device that detects intracellular T3 levels with a 98.5 % accuracy. My investigation of the device and its implementation in my practice has changed the way I analyze and treat the endocrine system forever.

            Before we discuss the thyroflex in more detail let us go over the increased risks for subclinical, also known as type II hypothyroidism, in the literature.  There are numerous studies demonstrating significant increased cardiovascular, diabetes, arthritis, inflammatory, and neurological risks for hypothyroid patients.

            Several investigations have shown an increase in dyslipidemia (elevated cholesterol and triglycerides), homocysteine, c-reactive protein, coronary disease, hypertension, and ischemic heart disease in people with subclinical hypothyroid.1-11 Several investigators have also found hypercoagulability (sticky platelets and red blood cells), endothelial dysfunction, and peripheral artery disease.12-16 One researcher found a correlation between hypothyroidism and cardiac output. 12

                Research from McCluskey showed that disruption of a substance called GLP-1 (glucagon like peptide-1) which signals the pancreas to produce insulin adversely affected cortisol levels and thyroid function in mice.18 Another researcher, Schultes, demonstrated that hypoglycemic episodes in humans caused a decrease in TSH, free T4, and free T3 lasting up to eighteen hours.19 This probably accounts for the reason all people trying to lose weight hit a plateau at 30-90 days. Another researcher showed that beta cell productivity and insulin resistance and triglyceride/HDL ratios all increased with hypothyroidism.20  Research also demonstrates that insulin sensitivity, insulin clearance, and glucose uptake and oxidation increased with normal thyroid function.21-22 Risk of blood sugar dysregulation seems to be reduced with normal thyroid function. 21-22

            Dessein showed that in rheumatoid arthritis patients, subclinical hypothyroid patients had dysfunction of glucose metabolism and insulin resistance.19 Innocencio showed that 52% of systemic sclerosis and 32% of rheumatoid arthritis patients also had antibodies for Hashimoto’s disease. The finding of undiagnosed Hashimoto’s disease in these two populations may contribute to low thyroid symptoms in people with other autoimmune disease.20-23

            Many musculoskeletal and neurological risks are associted with hypothyroidism. Caskir showed an increase in Dupuytren’s contracture, carpal tunnel syndrome, and decreased joint mobility in people who were subclinically hypothyroid. 26 A polymyositis-like syndrome has been demonstrated in hypothyroid patients.28 Tandeter showed an increased incidence of subclinical hypothyroidism in Parkinson’s patients.27 Davis showed increased hearing loss in hypothyroid patients.25 Other researchers have found abnormal EEG (brain) readings in subclinical hypothyroid patients.30 Several researchers have shown an association between anxiety and depression and hypothyroidism. 29,34 Research from Valpoto demonstrated in 628 women older than 65 years old there was a 1.97 (approximately 2x) relative cognitive loss risk in subclinical hypothyroid women. These multiple findings of abnormal brain functions related to subclinical hypothyroidism is disturbing news as Alzheimer’s disease is now the fastest growing cause of death in the US.

            There is research that demonstrates a three-fold increase in placenta previa and a two-fold increase in premature delivery in pregnant women with subclinical hypothyroidism.35 Undiagnosed hypothyroidism could very well be the leading cause of infertility in women.

            Had these researchers had the thyroflex at their disposal for analysis I suspect all these patients classified as having sub-clinical hypothyroidism through bloodwork would have been clearly confirmed as hypothyroid. The data base on thyroflex-tested patients is now over 100,000. The findings confirm approximately eighty per cent of those tested exhibit varying degrees of hypothyroidism. This is a percentage proposed by Dr. David Brownstein. We now have objective confirmation with the thyroflex on this clinical finding by Dr. Brownstein as determined by basal body temperature.

            The thyroflex measures the speed of the brachioradialis reflex in milliseconds. The observation of diminished or absent reflexes in the hypothyroid patient was made over 100 years ago. This is something most doctors were taught in school but forgotten by many. The original study validating the thyroflex was conducted on 563 patients who were evaluated by measuring thyroid symptoms, age, gender, height, weight, body mass index, calculated RMR (resting metabolic rate), measured RMR with the Douglas Breathing Apparatus (the gold standard),  brachioradialis reflex intervals, and serum measurements of TSH, T4,T3, total cholesterol, LDL, HDL, and triglycerides. Some patients had free T4, free T3, and TPO and thyroglobulin antibodies, ACTH, and prolactin measurements as well.

            Those patients testing hypothyroid and that were already on thyroid medication received a dosage increase of the same medication if tested abnormal on the thyroflex. People not on medication were given a choice of thyroid treatments including both prescriptive and non-prescriptive choices. All patients were re-evaluated at 30 day intervals and dosages were increased until the brachioradialis reflex interval was < 66 milliseconds.

            Subsequent data was gathered on additional patients until 2200 were in the data pool. After that the mathematicians went to work crunching the numbers with cross correlation between the basal body temperature, RMR, and reflex speed. A speed of 50-100 milliseconds was arrived at for optimum thyroid function. A speed of 100-120 milliseconds was considered satisfactory, but marginal.  The predictability of correlating thyroid function with brachioradialis reflex speed is 98.5 % accurate. This is far more accurate than bloodwork because it is demonstrating the level of bio-active T3 within the cell not in the serum.

            Having this information is invaluable in helping a patient achieve optimum thyroid function and better health. With optimum thyroid function, the sex hormones produced by the adrenals and gonads ae more likely to be higher. If the thyroid is functioning optimally, less dosing may be necessary for the sex hormones to achieve balance.

Call today at 813-985-5190 for your thyroid evaluation.