copyright, dr. tedde rinker 2/23/2010 wilson’s temperature syndrome and lyme disease dr. tedde...

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.


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


Most Important Tools for WTSMost Important Tools for WTS

Scored symptom listScored symptom listTemperature ChartTemperature ChartLab TestingLab Testing


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


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


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.


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.


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.


TSH

T4

Conventional Medical View is that you only need this limited amount of information to diagnose and treat.


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


StressHypothalamus Hypothalamus

PituitaryPituitary

Adrenal Medulla

Thyroid

Adrenal Cortex

Cell

TRH

TSH

CRH

Cortisol

Adrenaline

T4

T3

ACTH

Stress-induced Thyroid Dysfunction

inhibit

inhibit

inhibit


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


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


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)


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.


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!”


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.


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.


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)


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.


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


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

copyright, dr. tedde rinker 2/23/2010 wilson’s temperature syndrome and lyme disease dr. tedde...

Documents

constipation slide

bed slide

low thyroid symptoms

temperature dependent

temperature sensitive

thyroid function thyroid

thyroid dysfunction

thyroid hormones