Copyright, Dr. Tedde Rinker 2/23/2010 Wilson’s Temperature Syndrome and Lyme disease Dr. Tedde Rinker Stress Medicine Consulting

Copyright, Dr. Tedde Rinker 2/23/2010 Wilson Temperature Syndrome  Denis Wilson, MD, a GP in rural Florida  Developed protocol over several years  Of clinical observations and treatment  Found lab tests often didn’t match patient’s symptoms.  Discovered a method to restore “normal” temperatures, eliminate low thyroid symptoms, and eventually stop taking thyroid hormones.

Copyright, Dr. Tedde Rinker 2/23/2010 Symptoms of low thyroid  Low body temperature  Dry brittle hair, nails  Feels cold, cold hands and feet  Dry, itchy skin  Fatigue  Poor sleep quality  Hair loss  Puffy eyes, eyebrow hair loss lateral 1/3  Aching muscles and joints, weakness  Depressed, low motivation  Concentration and memory problems  Weight gain, constipation

Copyright, Dr. Tedde Rinker 2/23/2010

Copyright, Dr. Tedde Rinker 2/23/2010 Most Important Tools for WTS  Scored symptom list  Temperature Chart  Lab Testing

Copyright, Dr. Tedde Rinker 2/23/2010 Scored Symptom List  60 symptoms listed, score 1-10  Score of 600= perfect health  Score <350 = likely thyroid problem  Score >350 but 350 but <500 =likely hormonal  Score 10 for “not a symptom”  Score 1 for serious, worst symptom

Copyright, Dr. Tedde Rinker 2/23/2010 Temperature Chart  Prior to treatment take temperature 3 times a day for 5-10 days  Use reliable, accurate thermometer  Start 2 or more hours after waking  Last temp of day should be more than 3 hours before bed

Copyright, Dr. Tedde Rinker 2/23/2010 Laboratory Testing  Should test both Adrenal and Thyroid function  Thyroid Labs: Free T3, Free T4, Reverse T3, TSH, TPO antibodies, and Thyroglobulin antibodies (For hyperthyroid, should also get TSH receptor antibodies)  Adrenal Testing: 4-point saliva cortisol testing in am, noon, mid afternoon and bedtime.

Copyright, Dr. Tedde Rinker 2/23/2010 Why do we want optimal daytime temperatures?  Enzyme activity throughout the body is temperature sensitive.  Metabolic rate of all organ systems are enzyme and temperature dependent.  Detoxification pathways slow down with low body temperature.

Copyright, Dr. Tedde Rinker 2/23/2010 Optimal Daytime Temperatures  (F) % metabolic activity  (F) 55-75% metabolic activity, expect these temps at night.  < (F) 50% or lower metabolic activity.

Copyright, Dr. Tedde Rinker 2/23/2010 TSH T4 Conventional Medical View is that you only need this limited amount of information to diagnose and treat.

Copyright, Dr. Tedde Rinker 2/23/2010 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 TRAUMA TOXICITY INFECTION INLAMMATION STARVATION SUDDEN HORMONE CHANGE EVENTS TG-T4 T3 T4-TG REVERSE T3 5’ DEIODINASE SELENIUM 5 DEIODINASE TPO Ab TG Ab

Copyright, Dr. Tedde Rinker 2/23/2010 Stress Hypothalamus Pituitary Adrenal Medulla Thyroid Adrenal Cortex Cell TRH TSH CRH Cortisol Adrenaline T4 T3 ACTH Stress-induced Thyroid Dysfunction inhibit

Copyright, Dr. Tedde Rinker 2/23/2010 Pregnenolone Progesterone DHEA-S Testosterone Androstenedione Increased 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 Rinker 2/23/2010 Helpful Nutrients for Thyroid Function  Improve T4 production:  Tyrosine, Iodine, Zinc, Vitamin E, Vit A, B-2,B- 3, B-6 and Vitamin C  Improve conversion of T4- T3:  Zinc and Selenium  Adequate Progesterone  Adequate Melatonin  Improves T3 receptor site binding:  Vitamin A

Copyright, Dr. Tedde Rinker 2/23/2010 Conventional Medical Interventions  Thyroid: Synthriod™, Levoxyl™,  Thyroxine (T4)  Cytomel™ (short acting T3)  Armour thyroid (both T4 and T3)  Adrenals: Predisone, Cortef™ (hydrocortisone)

Copyright, Dr. Tedde Rinker 2/23/2010 Integrative Approach  Get a complete history  Take Temperatures (temp chart)  A complete thryoid/adrenal panel  Examine causative factors  Take steps to restore balance in the system.

Copyright, Dr. Tedde Rinker 2/23/2010 What should we do first?  Give Levoxyl, Synthroid (T4)?  Radiate the thyroid gland?  Give Armour thyroid?  Give T3 ?  Give Cortisol/cortisone?  Suppress cortisol production?  Send the patient to a psychiatrist?  Tell patient “There’s nothing wrong with you!”

Copyright, Dr. Tedde Rinker 2/23/2010 WTS Protocol  Uses 12-hour Sustained -release T3  Graduated dosing, increasing dose daily by 7.5 mcg every 12 hours (0.625 mcg/hr )  Until average temperature is at 98.6 or patient reaches 75 mcg every 12 hours (6.25 mcg/hr ), or patient has negative symptoms  Hold at max. tolerable dose for 3 weeks, then cycle down (more slowly) to no SRT3 for two days. If temperature drops, begin cycling up again, daily increasing dose.

Copyright, Dr. Tedde Rinker 2/23/2010 In the best circumstance  With each successive cycle:  It should take a lower dose to “capture” temperature at 98.6  Temperature should stay close to 98.6 as dosage is cycled down  Until, at zero medication, temperature maintains daytime average around 98.6 and symptoms have resolved.

Copyright, Dr. Tedde Rinker 2/23/2010

Copyright, Dr. Tedde Rinker 2/23/2010

Copyright, Dr. Tedde Rinker 2/23/2010 When Cycling up is “bad”  If patient starts to cycle up, and within days or the first week feels even worse than before she started, suspect:  Adrenal Fatigue (over stimulated or worse fatigue)  Metal Toxicity (overt symptoms of metal toxicity)  Chronic Infection (infectious symptoms become acute, or obvious for the first time)

Copyright, Dr. Tedde Rinker 2/23/2010

Copyright, Dr. Tedde Rinker 2/23/2010 When WTS protocol makes patient feel worse:  If the problem that precipitated the WTS is not resolved :  The body is not yet ready for a ramped up metabolism  The down-regulation was done for a reason. It’s important to remember that  This is also the time that the patient will need extra support, so they won’t give up. It doesn’t mean they can’t benefit from SRT3 treatment.

Copyright, Dr. Tedde Rinker 2/23/2010 When Lyme and WTS Present  Cautious ramping of thyroid (SRT3)  Adaptogens to support adrenals  Remove toxins carefully (slowly)  Support low stress lifestyle  Eliminate factors that increase RT3  Treat the infections

Copyright, Dr. Tedde Rinker 2/23/2010 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.) STARVATION SUDDEN HORMONE CHANGE child birth, menopause EVENTS TG-T4 FREE T3 T4-TG REVERSE T3 5’ DEIODINASE SELENIUM 5 DEIODINASE TPO Ab TG Ab

Copyright, Dr. Tedde Rinker 2/23/2010 Thank You! Questions? Dr. Tedde Rinker www.stress-medicine.com