Stiff Person Syndrome and IH

Are SPS and IH related and if so, would treatment for IH relieve some SPS symptoms?

Graphic from “global genes.org”

Celine

Celine Dion announced in 2022, that she had been diagnosed with “Stiff Person Syndrome” (SPS) and her affliction led me to a search of the www, regarding that rare condition.

It was obvious that the stress of such a devastating illness, added to the chronic stress of her profession and lifestyle, would in all likelihood have caused deep Intracellular Hypothyroidism (IH), thus adding hypothyroid symptoms to those of SPS.

On the other hand, I wondered whether IH, developing from her pre-existing chronic stress, might have been the underlying cause of the stiff person syndrome which threatened to ruin her life.

My web search failed to disclose sufficient supportive information, my efforts to contact her online representative were unsuccessful and although I felt inspired to write a post for my (then) website, “Hormone Therapy Explained”, I realised that it would merely be a statement of an unsupported opinion, with no solid scientific evidence and as such, would be ignored by any medical professionals, including Ms. Dion’s physician.
So I “shelved” it.

The idea has been “in the back of my mind” since then, and now, following my winter holidays (10 days in sunny Puerto Vallarta), my enthusiasm for controversial ideas and ”off-the-wall” proposals has returned.

So, let’s think about SPS!

This Post

This dissertation combines quotations from various websites with my own opinions on the subject, to articulate a suite of questions, which perhaps, some enterprising scientist may be motivated to investigate:

The Questions

(1) Are Stiff Person Syndrome and Intracellular Hypothyroidism (IH) related? if so,
(2) Would treating coexisting IH relieve the symptoms of SPS?
(3) Might IH be a prerequisite for SPS: if so, would therapy for IH cure SPS?
(4) Are other hormonal deficiencies related to SPS? If so,
(5) Which hormones are involved?
(6) Would hormonal supplementation be beneficial to individuals with SPS?

The National Organization for Rare Diseases

NORD, the National Organization for Rare Diseases, has provided, perhaps, the best dissertation on stiff person syndrome, describing it as an autoimmune disorder. [1]

NORD reminds us that autoimmune diseases are often associated with other autoimmune diseases, and that SPS occurs in company with Hashimoto’s Thyroiditis, Vitiligo, Pernicious Anemia, Celiac disease and other autoimmune states.
(Interestingly, in support of its designation as “autoimmune”, SPS sometimes accompanies Type I Diabetes, which is an autoimmune condition, but it isn’t associated with Type ll Diabetes, which is not).

NORD says (gently paraphrased): “The Stiff Person Syndrome, a fluctuating condition of variable muscular rigidity, has been described in the medical literature under many different, confusing names. It was originally called “stiff man” syndrome, but that designation was changed to “stiff person”, because the disorder can affect individuals of any age, race, ethnicity and gender. Also notably, as with many autoimmune disorders, the majority of individuals who develop the condition are female”.

Allopathic Physicians “Take”, on SPS

Clinicians describe SPS as a spectrum of diseases ranging from the involvement of just one area of the body, to a widespread, rapidly progressive form that also includes involvement of the brain, brain stem and spinal cord. It is frequently misdiagnosed as a variant of Parkinson’s Disease, Multiple Sclerosis or other neurological conditions which present with muscular hypertonia.

My “take” on SPS

Hormonal balance affects all normal metabolic functions and ergo, should be assessed wherever an individual presents with a noncommunicable disease. No illness should be diagnosed and treated without an assessment of hormonal balance.

In view of the known relationship of stiff person syndrome with hypothyroidism and especially in view of its neuromuscular manifestations, thyroid hormone metabolism, the cytokines (especially IL-6), vitamin balances, gut microbiota, homocysteine and all neuro-active hormones should be meticulously evaluated.

Once specimens have been obtained for baseline testing, supplementation of DHEA, Pregnenolone, Vitamins B9, C and D can be prescribed empirically, since doing so will do no harm and since evidence of support from a medical practitioner will provide the patient a slight reduction of stress, while awaiting the test results.

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Artificial Sweeteners

A report, from F. Perry Wilson, MD, MSCE, Feb. 28, 2023, and my comments.

“Sweetie” and “Sugar”: just friends!

By Dr. Gervais Harry

Our approach to the problem of foodstuff over-consumption is counterproductive: we have assumed that dietary sugars are responsible for obesity and thereby, should be blamed for the entire cascade of illnesses and disabilities which obesity produces.

Nothing could be further from the truth: the entire subject needs to be reviewed: we can, and we must, apply some logic to this vexing question.

By way of an “opening salvo”, here is a minimally-altered report by F. Perry Wilson, MD, MSCE, Feb. 28, 2023. Note that this is not my usual “blog” format, in which my comments are my own words. The reasons for my doing it this way are as follows:
– The “body” of Dr. Wilson’s report is already succinct: my paraphrasing of the entire paper would detract from his message, while gaining little in terms of brevity.
– His diagrams and their explanation are instructive and important.
– His words, framing a statement by one whose kudos clearly exceeds my own, are more likely to be taken seriously and it is important that this message reaches as many people as possible.

Layout of this post:

The first section (A) is my paraphrase of Dr. Wilson’s opening segment.
The 2nd section (B) is a direct quote, from the body of Dr. Wilson’s report.
The 3rd section (C) is my “take” on overeating, obesity and the disease cascade which results from over-consumption of foodstuffs and a “BOTTOM LINE” (C), in which I propose a solution to the entire “sweetener” conundrum.

(A)

The artificial sweetener, ERYTHRITOL, tradename “zerose”, is a sugar substitute derived from corn. It is also found in many fruits, including peaches, pears and watermelons (our bodies make some, too). It is used in many food products, including chocolate, chewing gum, beverages, baked goods and other items.

A recent article warns us of the dangers of erythritol, noting a survey in the USA, which showed the following consumption of erythritol among the population surveyed (Fig1).

Figure 1: Who uses the artificial sweetener, erythritol?

Figure 1Erythritol consumption, from “Sugar substitute linked to heart disease”, by F Perry Wilson, MD, MS CE

“Sugar Substitute Linked to Heart Disease”, was written by F. Perry Wilson, MD, MSCE and published on 2/20/23. I have paraphrased it and removed two statistical diagrams, to make this note shorter and more easily understood, for my readers.

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Reverse T3: BAD advice, from the Mayo Clinic

Regarding Mayo Clinic lab’s monograph on rT3: it’s such a pity that the Mayo Clinic doesn’t understand how thyroid hormone functions and how stress can screw up the works!

Caveat Emptor

I offer, below, the copied and pasted advice from the Mayo Clinic Lab: I have not changed the wording and have not changed the date, but I have rearranged the solid block of type, originally without paragraphs, into a more easily understood “English-Language Style” format.

Also, I have “bolded” the two statements which led me to exclaim, Caveat Emptor!

If you wish to see the monograph “in the flesh”, please click on the following link (be prepared to dig a bit):

DownloadTestCatalog (mayocliniclabs.com)

Page 3 of the monograph, regarding reverse T3

Test Definition: RT3 T3 (Triiodothyronine), Reverse, Serum
Document generated January 31, 2025 at 11:51 AM CT Page 2 of 3

Specimen Type Temperature Time Special Container Serum Ambient 28 days Refrigerated (preferred) 28 days Frozen 28 days

Clinical & Interpretive Clinical Information Reverse Triiodothyronine (rT3) differs from Triiodothyronine (T3) in the positions of the iodine atoms attached to the aromatic rings.

The majority of rT3 found in the circulation is formed by peripheral deiodination (removal of an iodine atom) of T4 (thyroxine).

rT3 is believed to be metabolically inactive.

The rT3 level tends to follow the T4 level: low in hypothyroidism and high in hyperthyroidism.

Additionally, increased levels of rT3 have been observed in starvation, anorexia nervosa, severe trauma and hemorrhagic shock, hepatic dysfunction, postoperative states, severe infection, and in burn patients (ie, sick euthyroid syndrome).

This appears to be the result of a switchover in deiodination functions with the conversion of T4 to rT3 being favored over the production of T3.

Reference Values 10-24 ng/dL Interpretation In hospitalized or sick patients with low triiodothyronine (T3) values, elevated reverse triiodothyronine (rT3) values are consistent with sick euthyroid syndrome.

Also, the finding on an elevated rT3 level in a critically ill patient helps exclude a diagnosis of hypothyroidism.

The rT3 is high in patients on medications such as propylthiouracil, ipodate, propranolol, amiodarone, dexamethasone, and the anesthetic agent halothane. Dilantin decreases rT3 due to the displacement from thyroxine-binding globulin, which causes increased rT3 clearance.

To convert from ng/dL to nmol/L, multiply the ng/dL result by 0.01536.

Cautions

Generally, reverse triiodothyronine tests are not necessary since triiodothyronine should not be ordered in hospitalized or sick patients.

Clinical Reference 1. Bowerbank SL, Carlin MG, Dean JR. A direct comparison of liquid chromatography-mass spectrometry with clinical routine testing immunoassay methods for the detection and quantification of thyroid hormones in blood serum. Anal Bioanal Chem. 2019;411(13):2839-2853 2. Moore WT, Eastman RC: Diagnostic Endocrinology. Mosby; 1990:182-183

CAVEAT ! …… Nota Bene

PLEASE! Do not interpret this post as an endorsement of the Mayo Clinic’s “take” on reverse T3: be aware that my reason for highlighting it here is precisely the opposite –

I am appalled at the ignorance and misinterpretation which the clinic’s “piece” on reverse T3 exhibits.

PLEASE read my previous posts, as below!

I invite you to compare this statement from the Mayo Clinic, with my previous posts, “T3/rT3 Ratio in diagnosing and treating hypothyroidism” and
”Reverse T3: Researchers Unaware of 29.7 Million articles !”

The Bottom Line:

This is evidence that “Mainstream Medicine” actually has the information necessary to diagnose and treat Intracellular Hypothyroidism (or the Low T3 Syndrome, or Euthyroid Sick Syndrome, or Subclinical Hypothyroidism– call it what you will) and

It is evidence on the other hand, that mainstream medicine pays no attention to the facts of the matter.

I’ll leave it to you, to answer the question as to why questionable advice, such as is given in this laboratory monograph, still shows up in such a prominent website.

Oh, by the way – the advertised “normal” level of reverse T3 (less than 25 ng/DL) is a scam – if rT3 is greater than 13 ng/DL, the patient most likely has the low T3 syndrome: please see my explanation in “T3/RTC ratio in diagnosing and treating hypothyroidism”, via the link in the previous paragraph.

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