A patient’s family history may reveal that many people in his family have been diagnosed with “thyroid problems”. Thyroid system problems, in general, tend to run in families. And Wilson’s Temperature Syndrome, in specific, also appears to have a hereditary component.
It is interesting to me, considering Wilson’s Temperature Syndrome is basically a starvation coping mechanism gone amuck that it seems to be more prevalent in patients who ancestors survived famine. Noting, that T4 to T3 conversion impairment is brought on by periods of starvation or fasting, I began questioning my patients carefully regarding their ancestry.
I was able to see a very definite pattern, namely, that there are some people who have a greater tendency towards developing Wilson’s Temperature Syndrome than others. These people tend to have a slightly different pattern of presentation than do people who have a greater resistance towards developing Wilson’s Temperature Syndrome. Interestingly, the patients who seem to be the most predisposed towards developing Wilson’s Temperature Syndrome (earlier in life with less provocation) seem to predominantly belong to certain nationalities such as, Scotch, Irish, Welsh, American Indian and Russian (as well as from other countries which have been plagued with famine). The greatest tendency of all is exhibited among those patients who are part Irish and part American Indian. But, people of any nationality can develop Wilson’s Temperature Syndrome. Patients who have a greater tendency towards developing Wilson’s Temperature Syndrome frequently have a light complexion with freckles, light-colored eyes, and red hair (or red highlights such as auburn colored hair). Irish and Scot people frequently have these characteristics of course, but there are people from other countries who also seem to have a tendency towards red hair, light-colored skin, and light-colored eyes who seem to be prone to Wilson’s Temperature Syndrome (e.g. northern Italy). So there does seem to be connection to nationalities who have survived famine. There also may be an independent correlation with the genetic makeup that is consistent with people having light colored skin, freckles, red highlights or red hair, and light-colored eyes. Some days it seems as if half the people in the waiting room have red hair when I know that half the population does not.
It is not too difficult to understand how Wilson’s Temperature Syndrome would be more prevalent among people whose ancestors survived famine, considering that people can compensate for starvation conditions by, among other things, decreasing the conversion of T4 to T3 in their bodies, which results in a conservational slowing down of the metabolism. As discussed previously, this impaired conversion is designed to return to normal once the starvation conditions have passed, so that the person might be able to return to a more productive and enjoyable life. It stands to reason that there may be some people who are able to compensate better than others, and one will not be among the survivors of a famine unless he is amongst the most adaptive to the conditions. The people who cannot slow down their T4 to T3 conversion (in response to starvation conditions) would be more likely to die. And those whose bodies can more readily adapt by slowing down T4 to T3 conversion are more likely to survive, and are more likely to pass this trait on to their offspring.
As it turns out, the more readily the T4 to T3 conversion can slow down, the more readily it can stay down causing people whose ancestors survived famine to be more likely to develop Wilson’s Temperature Syndrome.
2 Classic Presentations
The presentations of those who are more predisposed to Wilson’s Temperature Syndrome and those who aren’t are typically different.
Patients who are more predisposed to developing Wilson’s Temperature Syndrome tend to have more subtle courses. The symptoms tend to show up earlier in life, and with comparatively mild provocations. Sometimes they have Wilson’s Temperature Syndrome even from birth (birth can be quite traumatic). Their symptoms are often less dramatic in onset. And although they will often worsen with stresses, they tend not to be as dramatically precipitated by stressful events as they are in patients who are less predisposed to Wilson’s Temperature Syndrome . Sometimes, patients with a predisposition for Wilson’s Temperature Syndrome might develop the condition at the age of 7 or 8 after they have their tonsils removed, when they start junior high school, after changing to a new school, after moving to a new town at age 5, and/or when there was any family discord in the patient’s home such as divorce (which is not mild, of course, but often occurs early in a person’s life). These patients frequently comment that they are not sure what it feels like to be normal, and they probably don’t. Their symptoms sometimes increase in number gradually over the years, rather than all at the same time.
On the other hand, patients who are less predisposed often have a much more dramatic onset of their symptoms. They usually occur later in life, at least in the late teens or early 20’s, frequently in the 30’s and 40’s, and sometimes in the 50’s or 60’s or older. They may go for 35 years without having any sort of problems whatsoever, then suddenly develop 25 or 30 symptoms coming on together at the same time after a major stress (such as a car accident or divorce), with the symptoms persisting long after the stress has passed. There is frequently a remarkable difference in their quality of life.
Through working with the large number of patients that I have seen with this condition, these two patterns of presentation call to mind the following analogy. It is similar to what happens when one considers the difference between a large dam and a small dike. In the event of a flood, rain water would build up and rise up against the resistance provided by a small dike and soon overcome its resistance and flood. So the difference before and after would not be that significant since the dike would do little to slow down the pressure exerted by the floodwaters. However, the large dam providing much more resistance, would hold back a much larger volume of water. As the days would pass and the heavy rains would continue, the water would build up against the wall of the dam. Over a period of weeks, the floodwaters would possibly even get near to the top of the dam. All the while the land on the other side of the dam would remain relatively dry. However, if the pressure were to become too much for the dam and it were to break, then tons of concrete and millions and millions of gallons of water would suddenly come crashing down on the other side of the dam. This would cause a dramatic onset of circumstances from before to after.
This can explain why people with a stronger predisposition towards Wilson’s Temperature Syndrome seem to have a more subtle onset of their symptoms and complaints, while patients with a greater resistance seem to have a much more dramatic onset of their complaints later in life, usually developing a large number of symptoms at once after a significant physical, mental, or emotional stress.
As it turns out, patients who seem to have a greater predisposition towards developing Wilson’s Temperature Syndrome initially, also seem to be more prone towards relapsing again after successful treatment has been weaned, and after a subsequent stress. However, patients with lesser predisposition who stay well until later in life (35 or 40 years old) should be able to remain normal for a good number of years after treatment has been discontinued (unless they are pulverized by another subsequent stress). Of course, if the stress is severe enough (e.g., child abuse), even individuals with a great deal of resistance can develop Wilson’s Temperature Syndrome in their childhood.
If patients with a history of Wilson’s Temperature Syndrome do relapse, it is usually easier to correct a subsequent episode than previous ones if it is caught early enough. If a patient undergoes a significant stress, say, 7 to 8 months after treatment has been discontinued and begins to relapse, T3 therapy can be started to help prevent a full-blown relapse. Usually small doses for a couple of weeks (or until the stress has passed) are sufficient.
Some patients who are especially prone to Wilson’s Temperature Syndrome, and who have gained enough experience to predict the degree of stress that can precipitate a relapse, can benefit from an extremely low prophylactic dosage of liothyronine (T3). For example, let’s suppose you had a job such that once every 4 months it was necessary to make a large-scale presentation to your employers and to a group of hundreds of people. This might be quite a stressful situation. Now if this situation precipitates Wilson’s Temperature Syndrome symptoms, then you may be able to prevent the symptoms by taking an extremely low dose of the WT3 protocol the day before, the day of, and possibly for a couple of days after your presentation. There are patients who find they have much less physical and mental problems with this approach, and they are frequently able to avoid relapses. Some patients who are, for example, part Irish and part Indian, and who are found to have a significant predisposition towards developing Wilson’s Temperature Syndrome, may elect to be maintained on a small maintenance regimen of the WT3 protocol to help ward off a relapse. Usually, however, it is generally preferable to remain off medicine when possible.