copyright, dr. tedde rinker 2/23/2010 wilson’s temperature syndrome and lyme disease dr. tedde...
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Copyright, Dr. Tedde Rinker 2/23/2010Copyright, Dr. Tedde Rinker 2/23/2010
Wilson’s Temperature SyndromeWilson’s Temperature Syndrome and and
Lyme diseaseLyme disease
Dr. Tedde RinkerDr. Tedde Rinker
Stress Medicine ConsultingStress Medicine Consultingwww.stress-medicine.cwww.stress-medicine.comom
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Wilson Temperature SyndromeWilson Temperature Syndrome
Denis Wilson, MD, a GP in rural FloridaDenis Wilson, MD, a GP in rural Florida Developed protocol over several yearsDeveloped protocol over several years
Of clinical observations and treatmentOf clinical observations and treatment Found lab tests often didn’t match patient’s Found lab tests often didn’t match patient’s
symptoms.symptoms. Discovered a method to restore “normal” Discovered a method to restore “normal”
temperatures, eliminate low thyroid temperatures, eliminate low thyroid symptoms, and eventually stop taking thyroid symptoms, and eventually stop taking thyroid hormones.hormones.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Symptoms of low thyroidSymptoms of low thyroid
Low body temperatureLow body temperature Dry brittle hair, nailsDry brittle hair, nails Feels cold, cold hands Feels cold, cold hands
and feetand feet Dry, itchy skinDry, itchy skin FatigueFatigue
Poor sleep qualityPoor sleep quality Hair lossHair loss
Puffy eyes, eyebrow hair Puffy eyes, eyebrow hair loss lateral 1/3loss lateral 1/3
Aching muscles and Aching muscles and joints, weaknessjoints, weakness
Depressed, low Depressed, low motivationmotivation
Concentration and Concentration and memory problemsmemory problems
Weight gain, constipationWeight gain, constipation
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Most Important Tools for WTSMost Important Tools for WTS
Scored symptom listScored symptom listTemperature ChartTemperature ChartLab TestingLab Testing
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Scored Symptom ListScored Symptom List
60 symptoms listed, score 1-1060 symptoms listed, score 1-10 Score of 600= perfect healthScore of 600= perfect health Score <350 = likely thyroid problemScore <350 = likely thyroid problem Score >350 but <500 =likely hormonalScore >350 but <500 =likely hormonal
Score 10 for “not a symptom”Score 10 for “not a symptom” Score 1 for serious, worst symptomScore 1 for serious, worst symptom
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Temperature ChartTemperature Chart
Prior to treatment take temperature 3 Prior to treatment take temperature 3 times a day for 5-10 daystimes a day for 5-10 days
Use reliable, accurate thermometerUse reliable, accurate thermometer Start 2 or more hours after wakingStart 2 or more hours after waking Last temp of day should be more than 3 Last temp of day should be more than 3
hours before bedhours before bed
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Laboratory TestingLaboratory Testing
Should test both Adrenal and Thyroid functionShould test both Adrenal and Thyroid function Thyroid Labs: Free T3, Free T4, Reverse T3, Thyroid Labs: Free T3, Free T4, Reverse T3,
TSH, TPO antibodies, and Thyroglobulin TSH, TPO antibodies, and Thyroglobulin antibodies (For hyperthyroid, should also get antibodies (For hyperthyroid, should also get TSH receptor antibodies)TSH receptor antibodies)
Adrenal Testing: 4-point saliva cortisol testing in Adrenal Testing: 4-point saliva cortisol testing in am, noon, mid afternoon and bedtime.am, noon, mid afternoon and bedtime.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Why do we want optimal Why do we want optimal daytime temperatures?daytime temperatures?
Enzyme activity throughout the body is Enzyme activity throughout the body is temperature sensitive.temperature sensitive.
Metabolic rate of all organ systems are Metabolic rate of all organ systems are enzyme and temperature dependent.enzyme and temperature dependent.
Detoxification pathways slow down with Detoxification pathways slow down with low body temperature.low body temperature.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Optimal Daytime TemperaturesOptimal Daytime Temperatures
98.2-98.6 (F) 90- 100% metabolic activity98.2-98.6 (F) 90- 100% metabolic activity 97.5-98.1 (F) 55-75% metabolic activity, 97.5-98.1 (F) 55-75% metabolic activity,
expect these temps at night.expect these temps at night. < < 95.6- 97.4 (F) 50% or lower metabolic 95.6- 97.4 (F) 50% or lower metabolic
activity.activity.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
TSH
T4
Conventional Medical View is that you only need this limited amount of information to diagnose and treat.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
F F F F F F R R R R F R F F R R
F F F
FT3
T4
RT3 (not active)
STRESSTRAUMATOXICITYINFECTIONINLAMMATIONSTARVATIONSUDDEN HORMONE CHANGE
EVENTS
TG-T4
T3 T4-TG
REVERSE T35’ DEIODINASESELENIUM
5 DEIODINASE
TPO Ab
TG Ab
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
StressHypothalamus Hypothalamus
PituitaryPituitary
Adrenal Medulla
Thyroid
Adrenal Cortex
Cell
TRH
TSH
CRH
Cortisol
Adrenaline
T4
T3
ACTH
Stress-induced Thyroid Dysfunction
inhibit
inhibit
inhibit
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
PregnenoloneProgesterone
DHEA-S
Testosterone
AndrostenedioneIncreased levels followed by depletion as stress or low thyroid continues to lead to Adrenal Fatigue.
Adrenal Fatigue Due to Low Thyroid Function
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Helpful Nutrients for Thyroid Helpful Nutrients for Thyroid FunctionFunction
Improve T4 production:Improve T4 production: Tyrosine, Iodine, Zinc, Vitamin E, Vit A, B-2,B-Tyrosine, Iodine, Zinc, Vitamin E, Vit A, B-2,B-
3, B-6 and Vitamin C3, B-6 and Vitamin C Improve conversion of T4- T3:Improve conversion of T4- T3:
Zinc and Selenium Zinc and Selenium Adequate ProgesteroneAdequate Progesterone Adequate MelatoninAdequate Melatonin
Improves T3 receptor site binding:Improves T3 receptor site binding: Vitamin AVitamin A
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Conventional Medical InterventionsConventional Medical Interventions
Thyroid: Synthriod™, Levoxyl™, Thyroid: Synthriod™, Levoxyl™, Thyroxine (T4)Thyroxine (T4) Cytomel™ (short acting T3)Cytomel™ (short acting T3) Armour thyroid (both T4 and T3)Armour thyroid (both T4 and T3)
Adrenals: Predisone, Cortef™ (hydrocortisone)Adrenals: Predisone, Cortef™ (hydrocortisone)
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Integrative ApproachIntegrative Approach
Get a complete historyGet a complete history Take Temperatures (temp chart)Take Temperatures (temp chart) A complete thryoid/adrenal panelA complete thryoid/adrenal panel Examine causative factorsExamine causative factors Take steps to restore balance in the Take steps to restore balance in the
system. system.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
What should we do first?What should we do first?
Give Levoxyl, Synthroid (T4)?Give Levoxyl, Synthroid (T4)? Radiate the thyroid gland?Radiate the thyroid gland? Give Armour thyroid?Give Armour thyroid? Give T3 ?Give T3 ? Give Cortisol/cortisone?Give Cortisol/cortisone? Suppress cortisol production?Suppress cortisol production? Send the patient to a psychiatrist?Send the patient to a psychiatrist? Tell patient “There’s nothing wrong with Tell patient “There’s nothing wrong with
you!”you!”
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
WTS ProtocolWTS Protocol
Uses 12-hour Sustained -release T3Uses 12-hour Sustained -release T3 Graduated dosing, increasing dose daily by 7.5 Graduated dosing, increasing dose daily by 7.5
mcg every 12 hours (0.625 mcg every 12 hours (0.625 mcg/hrmcg/hr)) Until average temperature is at 98.6 or patient Until average temperature is at 98.6 or patient
reaches 75 mcg every 12 hours (6.25 reaches 75 mcg every 12 hours (6.25 mcg/hrmcg/hr), or ), or patient has negative symptomspatient has negative symptoms
Hold at max. tolerable dose for 3 weeks, then Hold at max. tolerable dose for 3 weeks, then cycle down (more slowly) to no SRT3 for two cycle down (more slowly) to no SRT3 for two days. If temperature drops, begin cycling up days. If temperature drops, begin cycling up again, daily increasing dose.again, daily increasing dose.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
In the best circumstanceIn the best circumstance
With each successive cycle:With each successive cycle: It should take a lower dose to “capture” It should take a lower dose to “capture”
temperature at 98.6temperature at 98.6 Temperature should stay close to 98.6 as Temperature should stay close to 98.6 as
dosage is cycled downdosage is cycled down Until, at zero medication, temperature Until, at zero medication, temperature
maintains daytime average around 98.6 and maintains daytime average around 98.6 and symptoms have resolved.symptoms have resolved.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
When Cycling up is “bad”When Cycling up is “bad”
If patient starts to cycle up, and within days or If patient starts to cycle up, and within days or the first week feels even worse than before she the first week feels even worse than before she started, suspect:started, suspect: Adrenal Fatigue Adrenal Fatigue (over stimulated or worse fatigue)(over stimulated or worse fatigue)
Metal Toxicity Metal Toxicity (overt symptoms of metal toxicity)(overt symptoms of metal toxicity)
Chronic Infection Chronic Infection (infectious symptoms become acute, or (infectious symptoms become acute, or obvious for the first time)obvious for the first time)
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
When WTS protocol makes When WTS protocol makes patient feel worse:patient feel worse:
If the problem that precipitated the WTS is not If the problem that precipitated the WTS is not resolvedresolved::
The body is not yet ready for a ramped up The body is not yet ready for a ramped up metabolismmetabolism
The down-regulation was done for a reason. It’s The down-regulation was done for a reason. It’s important to remember thatimportant to remember that
This is also the time that the patient will need This is also the time that the patient will need extra support, so they won’t give up. It doesn’t extra support, so they won’t give up. It doesn’t mean they can’t benefit from SRT3 treatment.mean they can’t benefit from SRT3 treatment.
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
When Lyme and WTS PresentWhen Lyme and WTS Present
Cautious ramping of thyroid (SRT3)Cautious ramping of thyroid (SRT3) Adaptogens to support adrenalsAdaptogens to support adrenals Remove toxins carefully (slowly)Remove toxins carefully (slowly) Support low stress lifestyleSupport low stress lifestyle Eliminate factors that increase RT3Eliminate factors that increase RT3 Treat the infectionsTreat the infections
Copyright, Dr. Tedde RinkerCopyright, Dr. Tedde Rinker2/23/20102/23/2010
F F F F F F R R R R F R F F R R
F F F
FT3
T4
RT3 (not active)
STRESS (overtaxed, untreated)TRAUMA (chronic illness, surgery, loss)TOXICITY (mercury, Lyme toxins)INFECTION (Lyme & co-infections)INFLAMMATION (Herx, immune resp.)STARVATIONSUDDEN HORMONE CHANGE
child birth, menopause
EVENTS
TG-T4
FREE T3 T4-TG
REVERSE T35’ DEIODINASESELENIUM
5 DEIODINASE
TPO Ab
TG Ab
Copyright, Dr. Tedde Rinker 2/23/2010Copyright, Dr. Tedde Rinker 2/23/2010
Thank You!Thank You!Questions?Questions?
Dr. Tedde RinkerDr. Tedde Rinker
650-964-6700650-964-6700
www.stress-medicine.comwww.stress-medicine.com
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