Metabolic Hypothyroidism Revisited

Posted on January 27th, 2017

Over the past many years, the medical establishment has recognized a state of hypothyroidism in patients caused by a reduced production of thyroid hormones.

The clinical symptoms in people and in animals are quite similar, however there seems to be a large increase in the number of human and animal patients that demonstrate all the clinical symptoms and signs of hypothyroidism, yet their measurable thyroid hormones are normal.

Why is this occurring?

This appears to be happening, because of other endocrine imbalances that will reduce the human or animal body from utilizing the thyroid hormones, even though the production of thyroid hormones, are normal.

The main endocrine imbalance that is causing this state of metabolic hypothyroidism in humans and in animals is due to the production of either deficient or defective cortisol, which is being produced by the middle layer adrenal cortex..

The cortisol imbalance works in a negative feedback mechanism with the hypothalamus and the pituitary glands.

Once the cortisol is produced at a normal level and provides its normal functions, it is broken down in the liver and excreted by the kidneys in a 24 hour period.

Once this occurs and the cortisol levels are reduced, the hypothalamus releases its Cortico Releasing Factor (CRF), which in turn causes the pituitary to release its hormone called ACTH {Adreno-Corticotropic Hormone}, which stimulates the middle layer adrenal cortex, to release more cortisol.

This entire mechanism is referred to, as a negative feedback mechanism.

However, if the middle layer adrenal cortex production of cortisol is deficient or defective, the negative feedback mechanism will be damaged and not function correctly..

NOTE: Deficiencies and defects can occur to the middle layer adrenal cortex due to genetics, stress, alcohol, drugs, chemotherapy, radiation, anesthesia, vaccination, medications, toxins, heavy metals, trauma, GMO, phytoestrogens. Xenoestrogens, etc.

This various damaging environmental inputs are occurring due our changing environment, which is creating many of our medical problems and diseases.

When the middle layer adrenal cortex is not able to respond with normal amounts of cortisol, the hypothalamus will release its CRF, which causes the pituitary to release it’s  ACTH.

The excess ACTH causes the inner layer adrenal cortex to respond, by producing excess amounts of adrenal estrogen.

This causes the mechanism, to become a positive feedback mechanism now involving the inner layer adrenal cortex and not the middle layer adrenal cortex, causing an excess production of adrenal estrogen.

In humans and animals, the excess adrenal estrogen invalidates the patient’s body from using normal thyroid hormones, and can cause a state of metabolic hypothyroidism, even when the thyroid gland is producing normal amounts of thyroid hormone.

In humans when this occurs, a Reverse T3 may be produced that will also make normal thyroid hormones unavailable for use in the patient’s body.

A similar mechanism in animals may occur also, even though Reverse T3is usually not measured.

When this occurs, even though normal thyroid hormone levels still exist, including free thyroid hormone levels, and since the thyroid hormones can no longer be used by the body, a state of metabolic hypothyroidism can exist.

It is imperative when measuring thyroid hormones, that the cortisol and total estrogen levels are also measured, in order to determine if a state of metabolic hypothyroidism does exists.

If the patient has been exposed to estrogen mimicking chemicals, the total estrogen may still be within the normal range, but various estrogen mimicking chemicals called xenoestrogens like DDT and various toxic plant chemicals, can also invalidate the use of thyroid hormones and create a state of metabolic hypothyroidism.

For more information on xenoestrogens, please Google xenoestrogens with my name.

To determine if xenoestrogens may be affecting the test results, it will be necessary to include in the blood sample with cortisol, total estrogen, T3, T4, these 3 immunoglobulins, IgG, IgM and IgA.

What is not fully understood yet, is that the endocrine system regulates the immune system and hopefully together will create a healthy normal state of endocrine immune imbalance.

For more information on endocrine immune surveillance, please Google endocrine immune surveillance, with my name

When a state of metabolic hypothyroidism exists, due to a cortisol imbalance and elevated estrogen, the immunoglobulin IgG, IgM and IgA will be deficient in animals.

In humans, the immunoglobulin levels may vary, but the IgA level will be the most significant indicator of an exposure to a xenoestrogen.

If a cortisol imbalance is present yet the total estrogen level is normal and a deficiency of immunoglobulins is present, this indicates that the patient has been exposed to estrogen mimicking chemicals (xenoestrogens).

In the field of veterinary medicine, Thyroxin (T4) measurements are the standard for determining whether a patient is hypothyroid or not.

Triiodothyronine (T3) analysis is normally not measured.

What is not realized in the veterinary profession yet, is that thyroxin (T4) is the thyroid hormone, which is mainly a “storage” hormone and the triiodothyronine (T3) hormone is the active thyroid hormone.

To transfer T4 to T3, it requires a certain amount of normal, active cortisol.

When tested and the T4 is high and the T3 is low or low normal, it indicates a cortisol imbalance, causing this lack of transference of T4 to T3.

In many instances, this is the reason why giving a patient a T4 supplement does not help a state of hypothyroidism or a state of metabolic hypothyroidism, because no transference can occur from T4 to active T3, thyroid hormone.

In the field of veterinary medicine, a diagnosis of hyperthyroidism is often made when the T4 is elevated and the therapy is begun without checking the T3 first.

When this occurs and thyrotoxic drugs are administered, the results for the patient can be catastrophic.

NOTE: It is highly important to keep the serum sample in a refrigerated state, from the time the sample is taken until the sample is tested, otherwise the test results will all be elevated and incorrect. For samples that need to be mailed etc, the sample can be refrigerated or frozen until tested and in these instances, a temperature strip should accompany the sample and in the transference of the sample, it has warmed up to room temperature, the sample may not be worth testing and all values will be artificially elevated.

The following 3 cases will demonstrate Metabolic Hypothyroidism.

Case Studies

Case 1

This case involved a very obese, 4 year old, spayed female Rottweiler that should have weighed 65 pounds but weighed 105 pounds.

All kinds of reducing diets were prescribed and thyroid testing was done, and all thyroid levels (T3 and T4) were normal.

Even the Michigan State test was done and all the hormone values appeared to be normal, yet her weight prevailed.

When I had the opportunity to make suggestions for this patient, an Endocrine immune blood test was performed, with the following results;




Cortisol = 0.47 ug/dl

1 to 2.5 ug/dL

Total Estrogen = 25.22 pg/ml

20 to 25 pg/ml

T3 = 156 ng/dL

100 to 200 ng/dL

T4 = 4.0 ng/dL

2.0 to 4.5 ng/dL

IgA = 52 ng/dL

70 to 170 ng/dL

IgM = 79 ng/dL                                                                 

IgG  = 780 ng/dL


Once her IgA reached 58, after giving her 3 intramuscular injections at a 10 day interval of a long acting steroid, the patient was able to absorb oral hormone and in the beginning was placed on thyroid hormone for 2 reasons.

NOTE: In canines and felines, until the IgA reaches 58ng/dl, malabsorption of oral steroid replacement will occur, and that is why it may be necessary in this instance, to use injectable steroids to bypass the gut and achieve an IgA of 58 or higher.

The elevated total estrogen invalidates the use of thyroid hormones even if they measure within the normal range and that is what creates what creates, Metabolic Hypothyroidism.

The 2nd reason why thyroid hormone is given, even if the thyroid hormone appears normal, is because with an increase in liver and kidney metabolism, the physiological dose of synthetic cortisol that is used to fund the negative feedback to the hypothalamic-pituitary axis and help reduce the total estrogen, and will allow the liver and kidney to break down and excrete the replacement cortisol in 24 hours, otherwise signs of a steroid overdose may occur.

NOTE: If thyroid replacement hormone is not used, that physiological amount of replacement cortisol will be only partially broken down in 24 hours and after 3 to 4 days, that physiological amount of replacement cortisol will become a pharmacological dose and cause all the side effects to occur, due a steroid overdose.

With any hormone replacement program done in humans and animals, you need to know if that hormone replacement will be successfully broken down in 24 hours and if not, realize it may become an overdose, which may have happened to many woman that took estrogenic supplements, while never have been measured for total estrogen as opposed to only measuring their 3 ovarian estrogens, especially estradiol.

The fact that a postmenopausal woman has an estradiol below 40mg/ml does not mean she needs an estrogen replacement, unless her adrenal (total) estrogen has also been measured, and is found to be deficient.

NOTE: Both estradiol and adrenal estrogen should be first measured before any estrogen replacement is prescribed, for a postmenopausal woman.

I have always wondered why adrenal estrogen has never been included as an important form of estrogen, along with the 3 ovarian estrogens.

I recently read an article that discusses the history of estrogen.

Apparently in the mid 1940’s, a prominent human laboratory decided for the medical profession, that the human body only produces 3 estrogens , which are estradiol, estrone and estriole. There was no mention of adrenal estrogen.

After 2 months of replacement therapy, this patients lost 25 pounds of weight and continued to do so for the next 6 months, until she achieved her normal weight.




Cortisol = 2.3 ug/dL

1 to 2.5 ug/dL

Total Estrogen = 34.89 pg/ml

20 to 25 pg/ml

T3 = 181 ng/dL

100 to 200 ng/dL

T4 = 4.39 ng/dL

2.0 to 4.5 ng/dL

IgA = 74 ng/dL

70 to 170 ng/dL

IgM = 168 ng/dL

100 to 200 ng/dL

IgG = 1780 ng/dL

1000 to 2000 ng/dL

The lesson to be learned here is that even with normal thyroid hormone levels, there is no guarantee that those hormones can be used by the body and this is why a comparative endocrine immune blood test must include total estrogen.

Also an IgA level is definitely important to do, because with most oral supplements, if the IgA is below 58, the patient may not be able to absorb oral medication.

NOTE: A number of years ago, I created a thyroid panel including total T3, T4, free T3, T4 and thyroid binding globulin.

My results with these tests did not indicate the fact that the patient could not use their thyroid hormones until I included total estrogen which then said, “Yes, you can have a thyroid imbalance even with normal thyroid levels”.

This same malady occurs in humans and has been proven that elevated total estrogen in a human, may cause a ReverseT3 that will cause an invalidation for the use of  thyroid hormones by the patient.

In humans, an axillary temperatures can be taken before getting out of bed in the morning, which will often indicate a low basal metabolic temperature.

Other clinical symptoms in humans that might indicate a state of metabolic hypothyroidism state can be over-weight, hair loss, easily chilled and very susceptible to colds, flu and other viruses, yet their thyroid hormones are normal.

Any human patient with elevated total estrogen needs to have their health care professional also do a Reverse T3, because if this level is also elevated, taking a T4 supplement will only be turned into more Reverse T3, which will further invalidate the patient’s ability to utilize their thyroid hormones and that is why some thyroid patients on thyroid hormone supplements, receive no benefits from taking the T4 supplement.

As far as I know, a Reverse T3 is not a standard test done for dogs and cats yet.

Case 2

This patient was a 6 years old, 120 pound, male, neutered Golden retriever that was grossly obese with spinal arthritis.

Multiple diet changes were made to no avail.

NOTE: For your own information please, realize that dry food, (kibble and biscuits) has 2 1/2 to 3 times the calories of canned food!




Cortisol = 3.2 ug/dL

1 to 2.5 ug/dl

Total Estrogen = 25.17 pg/ml

20 to 25 pg/ml

T3 = 134 ng/dL

100 to 200 ng/dL

T4 = 3.0 ng/dL

2.0 to 4.5 ng/dL

IgA = 58 ng/dL

70 to 170 ng/dL

IgM = 84 ng/dL

100 to 200 ng/dL

IgG = 910 ng/dL

1000 to 2000 ng/dL

Please remember that his elevated cortisol is either bound or defective and if the cortisol was active, his estrogen level would be below 25pg/ml.

This is not Cushing’s syndrome. This is Atypical Cortisol Estrogen Imbalance Syndrome (ACEIS)

NOTE: I have named this syndrome ACEIS which does describe the medical condition, however the public refers to this syndrome as Plechner’s Syndrome, ONLY because it is easier to remember than ACEIS. This was definitely NOT my choice. ACEIS accurately describes this syndrome and should be used only

Hormonal therapy was initiated, in order to replace his bound or defective cortisol with an active synthetic cortisol and thyroid supplements were given.

After 6 weeks the patients weight had decrease markedly, which also helped his spinal arthritis.




Cortisol = 0.3 ug/dl

1 to 2.5 ug/dl

Total Estrogen = 25.01 pg/ml

20 to 25 pg/ml

T3 = 167 ng/dl

100 to 200 ng/dl

T4 = 4.21 ng/dl

2.0 to 4.5 ng/dl

IgA = 110 ng/dl

70 to 170 ng/dl

IgM = 168 ng/dl

100 to 200 ng/dl

IgG = 1590 ng/dl

1000 to 2000 ng/dl

Case 3

This case involved a 3 year old, spayed, female miniature poodle that was very obese, even only being fed small amounts of beef and vegetables with no carbohydrates.

Her Michigan State thyroid panel did not indicate she was hypothyroid.

She had developed 2 sizable lipomas that had been identified by their veterinarian, through needle biopsies.

NOTE: Lipoma development is very common when an elevated total estrogen occurs, causing an invalidation of use for the thyroid hormones, and even with its removal of the lipomas, often the lipoma will reoccur because the endocrine immune imbalance had not been identified or corrected.




Cortisol = 0.71 ug/dL

1 to 2.5 ug/dL

Total Estrogen = 35.27 pg/ml

20 to 25 pg/ml

T3 = 147 ng/dL

100 to 200 ng/dL

T4 = 3.9 ng/dL

2.0 to 4.5 ng/dL

IgA = 56 ng/dL

70 to 170 ng/dL

IgM = 78 ng/dL

100 to 200 ng/dL

IgG = 820 ng/dL

1000 to 2000 ng/dL

Appropriate hormone supplementation was implemented, and not only did the patient’s weight dramatically drop, but so did her lipomas.

NOTE: One physical feature you can look for that may indicate this imbalance, is by checking the color of the skin on the abdomen and in the arm pit regions.

Often this skin will start to hyper pigment and will begin to turn gray and may progress into black.

This may indicate some form of hypothyroidism.

In other patients with this malady, their white skin, beneath their total hair coat, will begin to darken.

This is due to an elevated total estrogen and either deficient production of thyroid hormone or an inability of the patient, to use their thyroid hormones.

If this is the case, you might ask your veterinarian to do the endocrine immune blood test as a preventative test in order to identify if an endocrine immune imbalance is  present or not, and if so, your veterinarian will be able to help reduce the chances for other catastrophic diseases to occur.

NOTE: My clinical studies over the past 50 years have identified endocrine immune imbalances with elevated adrenal estrogen in over 90,000 cases that had allergies, autoimmunity and cancer. All these patients were tested after they had had their ovaries and testicles removed, which was further indications that the majority f the estrogen that was measured, was produced by the inner layer adrenal cortex.




Cortisol = 1.4 ug/dl

1 to 2.5 ug/dl

Total Estrogen = 34.99 pg/ml

20 to 25 pg/ml

T3 = 190 ng/dl

100 to 200 ng/dl

T4 = 436 ng/dl

2.0 to 4.5 ng/dl

IgA = 120 ng/dl

70 to 170 ng/dl

IgM = 168 ng/dl

100 to 200 ng/dl

IgG = 1890 ng/dl

1000 to 2000 ng/dl

Please finally realize that it takes a very little increase in adrenal estrogen to cause major, health problems.

This is why it is so very important to avoid estrogen mimicking chemicals, plastics, house hold products and carefully check the food you eat, feed your family and feed your pet, because many foods contain high levels of Phytoestrogens (plant estrogens) that can also cause major problems, especially if you or your pet are already estrogen dominate.

For further information on phytoestrogens, please Google Phytoestrogens with my name.

Many pet food manufacturers are adding ingredients that you as the pet owner believe are healthy, however realize that sweet potatoes, carrots and apples are high in phytoestrogens and if you, your family or your pet are estrogen dominant, PLEASE BEWARE!

One final note that can definitely cause a metabolic hypothyroidism, may develop from the use of a human male taking a testosterone supplement.

This has become a very popular topic for many human males and there are now a number of online, manufactured testosterone products, that are readily available.

What is not yet realized, is that a testosterone product may be turned into a form of estrogen called estradiol. If this occurs, it may cause the male not only to develop metabolic hypothyroidism, but may also cause many other catastrophic diseases occur, especially if the male is estrogen dominant.

The fatty tissue in the body, contains high levels of an enzymes referred to as aromatase.

Aromatase has the ability to transform testosterone into estradiol, which can cause a gain in weight. There have been a number of reports indicating that upon taking a testosterone supplement, the patient’s weight increased. Unfortunately as this happens, more fat is created and aromatase levels may also be increased. It definitely could turn into a vicious cycle.

From a standpoint of safety, in order to determine if a testosterone supplement is healthy for you to take, an determine if the testosterone is being transferred into estradiol, it might be wise to have the patient’s physician  check the testosterone and estradiol levels, even before having the patient take a testosterone supplement.

After 2 to 3 weeks, those levels should be checked once again. If the tests indicate that the patient’s testosterone levels have increased and their estradiol levels have remained within the normal limits, than taking a testosterone supplement might be worth trying.

However, if the patient’s testosterone levels remain the same or become lower and their estradiol levels increase beyond normal limits, this may be a sign that taking the testosterone supplement should be avoided, and NOT continue to take the supplement.

These are just some of my thoughts I wanted to share with you.

The intention of this article is only to provide the information that might make you think about metabolic hypothyroidism and the possibilities that you or a member of your family or your pet, may be suffering from this syndrome.


Dr. Al Plechner

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