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Doctrine 612

CBD oil?

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7 hours ago, waveslider said:

I think it’s between you and the Lord if it is breaking the word of wisdom. I’m going through throat cancer right now and in my state we do have legalized cannabis. I have done a lot of research, fasting, prayer and pondering on the subject. In the end I decided to use it. I researched my best access to medical advice available to me and got dosages for both THC and CBD specific to my type of cancer. I got my medical cannabis card so I would be legal and changed my diet. I also spoke to my bishop about it and he never even blinked like anything was wrong. He wants me to keep my temple recommend and everything, no worries, but this is just my experience and it doesn’t mean everyone would be obeying the WOW if they did it too.

That said, it has been a hard time finding the right CBD oil, because it is so unregulated that much of what is available is truly snake oil. Much of it is processed in unhealthy ways and some of it doesn’t even have any CBD in it at all. There are, however, a few brands that are very good. The brand I went with was, “Medterra.” It is sold online by a hemp farm in Kentucky and they legally send it to all 50 states in the U.S.. It is all organically grown without GMOs. It’s 3rd party tested by a non biased lab to make sure it matches its labeling, and is extracted using CO2 instead of alcohol or other even more harmful solvents and has 0 percent THC in it. (I would never use the alcohol kind because it can react bad to your body, like cause heartburn and things that the CO2 kind won’t cause. The other solvents are even worse) I got the tincture that has 3,000 mgs of CBD in it, per 30mls. It comes with a dropper that has graduated lines so you can figure out exactly how many mgs you are taking. 

As far as the THC and other turpines and flavonoids I had to shop around for a good dispensary. Luckily I found the best one, because all the others were so thinned out that I would have had to spend nearly $10,000 dollars to get enough medicine to carry me through all of my chemo and radiation treatments, since most of them seem to be more geared towards vaping and smoking instead. I needed tincture and the good dispensary that I found had tincture that had enough THC mgs in it to make it far more affordable. All in all CBD included, I was able to get enough medication to more than carry me through all of my treatments for around $1,200. (This is the reason that in the states that fully legalize it for recreation too, that the number of people using medical cannabis diminishes.... because it’s far cheaper to not process it into good medicine than if you just sell it to recreational users, so good medical cannabis becomes too scarce to even find)

I’m currently recuperating from all of my chemo and radiation but my tumor is almost all gone now and is still shrinking. Both of my oncologists were stunned how quickly my tumor shrank. They even had to remap the tumor half way through the treatments because they only needed to target the smaller area where my tumor remained for the radiation. I wasn’t even able to take the medical cannabis and CBD for the last 2 weeks of treatment because I got hospitalized during that time and they wouldn’t let me use anything but their meds while in there. During this time the shrinkage slowed in its progress, but I was allowed to resume after. My most disbelieving oncologist didn’t believe it would work, but I’m quite certain he might be wondering just a little bit if it did, unless he just chalks it up to the placebo effect. I’m not out of the woods yet. I’ve still got a stomach tube to feed myself and stay hydrated because it’s really hard to swallow. I can barely swallow Sacrament when it’s brought over every Sunday, but hopefully in the next couple of months I’ll be doing fine.

A quick google search does show in many published, peer reviewed papers that not only does THC kill cancer cells, but also that CBD stops metastasis and the spread of cancer cells, for any doubters in its medicinal use. The Israelis have studied it far more than a decade. For more information on it’s medicinal properties and successes, as well as some failures, go to, “the sacred plant.com,” and see one of their docuseries, as well as (was mentioned in an earlier comment) Netflix’s, “Weed The People.” For anyone facing life or death and is looking for proper dosages, go to, “auntzeldas.org/consultation and pay the $300 to skype Dr Mc Ilroy. You also get free, unlimited follow up e-mails, that he is usually prompt to respond from.... at least in my personal experience. Also he checked for compatibility with all my regular meds as well, including my chemo because some types of chemo will have a really bad reaction to cannabis. As a rule of thumb, anything that can’t be taken if you eat grapefruit will also have a bad reaction to cannabis.

By the way I take 2 large doses of CBD a day, and it has made me super drowsy every day, but I have 2 huge, full bottles of super strong opiate based pain pills that I didn’t take against my oncologist’s orders and my pain is easily bearable. That oncologist told me that I needed to take the pain meds so that my body could get used to it until I could take a full prescribed dose or I’d be really sorry when the pain started to get bad. It never got bad, and talk about drowsy.... when I first got them I took one and I was far to loopy to even feel comfortable. As far as my THC dose it is also a lot. It is 70 mgs per day, 63 mgs just before bed and 7 mgs upon waking in the morning. If I don’t sleep right away, I’ll be hallucinating and never be able to fall asleep. I know because someone called me once just before I fell asleep and I stayed up talking too long, and before I knew it I felt horrible. It wasn’t enjoyable at all! For some reason if I was already sleeping and had to wake up to go to the bathroom or something, I was able to go right back to sleep, because I remained really drowsy while I got up. I just had to go slow so I wouldn’t accidentally fall over from being dizzy. I too had to start with smaller doses of both CBD and THC until my body got used to it as well. These herbs are very potent and shouldn’t be taken willy nilly, if you ask me, but if you do want to try CBD on your own, I would start out with small amounts until it starts to work.

Hopefully this is helpful to someone in need. I wasn’t going to post but when I read this I could see that many of you aren’t very informed about it yet.

Thank you! I watched Weed The People as well, recommend it to those that think it's all a crock! I'm so glad it's working for you. I take it for the prevention of Alzheimer's and for keeping at bay, hypothyroidism. 

Last night I took the oil without the correct dosage, my usual 6 to 7 drops under the tongue. And I had trouble with paranoia and feeling like a rotten person. That's what THC does to me, so I would never use it recreationally. When I put the drops under my tongue I must have done it in a hurried way and huge drops came out, mostly likely doubled my usual amount. But I know it wouldn't have harmed me, just wasn't fun for a person that sometimes has low self esteem.

But again, so happy for you. Wish the CBD oil etc. wasn't such a tricky medicine and hopefully soon people get the right stuff more easily. 

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1 hour ago, cherryTreez said:

We used it on our dog. She had horrible arthritis and my husband couldn't say goodbye to her yet. She was on multiple pain killers and anti inflammatories. We started using the oil from a holistic pet store. It was amazing how much better she was. It gave her a good six months.  It was pretty amazing to see it work with her.   

What was the brand?  Our dog has greatly deteriorated in the last six months and unfortunately none of us have the capability at the moment to give her the attention she needs to limit it as much as possible.

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40 minutes ago, Calm said:

What was the brand?  Our dog has greatly deteriorated in the last six months and unfortunately none of us have the capability at the moment to give her the attention she needs to limit it as much as possible.

I don't have it anymore to look at the brand. She died 18 months ago sorry. I went to the pet store and they helped me.  It was $55 for the bottle. She weighed 60 lbs and it lasted 3 months or more.

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4 hours ago, Meerkat said:

I don’t know why the medical industry has not researched this and come out with a prescribable product.  It probably has something to do with the cost of research and approval and competition from cannibas shops.  It may also have something to do with the ease in which a person can make their own.  It may also compete favorably with more profitable (and less effective) pharmaceuticals.  I don’t see any of those options as fair, or my problem. I can listen to my own body, and decide the best course for me to take.  I will probably go to a pot shop to get my next CBD cream.  It may have some THC in it.  

In the US it is because most drug testing is done on the federal level through the FDA and marijuana is a touchy political issue which restricts federal funding and, of course, it is still federally illegal. It requires a long process to get permits to study it. In other nations studies for the use of treatment of chronic pain have had mixed results and it is still being studied.

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1 hour ago, Tacenda said:

Thank you! I watched Weed The People as well, recommend it to those that think it's all a crock! I'm so glad it's working for you. I take it for the prevention of Alzheimer's and for keeping at bay, hypothyroidism. 

I am curious. Do you mean to arrest the decay of the thyroid gland from Hashimotos or Graves? That is all I can think it might do. It can not replace hormones. Are you on hormone replacement pills as well?

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13 minutes ago, The Nehor said:

I am curious. Do you mean to arrest the decay of the thyroid gland from Hashimotos or Graves? That is all I can think it might do. It can not replace hormones. Are you on hormone replacement pills as well?

A few years ago, I tried the hormones but I didn't like them. And it's been a couple or more years that I've been off of the thyroid meds. I attribute my CBD oil for helping me on that. I asked my doctor if I could quit the thyroid meds because I thought they were causing me to have panic attacks because I had read that they did that. He said to go off of them for three months and then check afterwards. After that period of time I got my lab work done and they showed that I didn't need the meds and that I was in a good range. I don't know why, maybe in the first place I really didn't need the thyroid meds or I had a very mild case, don't know for sure. But I really want to say the CBD oil did the trick. Here's some information that it helps the thyroid. https://420evaluationsonline.com/health-and-news/can-cannabinoids-normalize-thyroid-function

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1 hour ago, Tacenda said:

A few years ago, I tried the hormones but I didn't like them. And it's been a couple or more years that I've been off of the thyroid meds. I attribute my CBD oil for helping me on that. I asked my doctor if I could quit the thyroid meds because I thought they were causing me to have panic attacks because I had read that they did that. He said to go off of them for three months and then check afterwards. After that period of time I got my lab work done and they showed that I didn't need the meds and that I was in a good range. I don't know why, maybe in the first place I really didn't need the thyroid meds or I had a very mild case, don't know for sure. But I really want to say the CBD oil did the trick. Here's some information that it helps the thyroid. https://420evaluationsonline.com/health-and-news/can-cannabinoids-normalize-thyroid-function

Did you have symptoms of hypothyroidism or did it show in bloodwork before or both? I doubt it was CBD that changed it because the effect in the studies was marginal unless you had a very mild case.

There have been studies showing a small but statistically significant effect on autoimmune diseases that target the thyroid but the findings need controlled studies to measure the effect. Even if it is shown the influence so far at least appears to be minor so it is not a replacement treatment. I have also heard anecdotal reports of it being used to treat hyperthyroidism but I am dubious about that. It is more likely it mitigates the symptoms then deals with the hormone imbalance.

In case it needs saying: I am not a doctor.

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24 minutes ago, The Nehor said:

Did you have symptoms of hypothyroidism or did it show in bloodwork before or both? I doubt it was CBD that changed it because the effect in the studies was marginal unless you had a very mild case.

There have been studies showing a small but statistically significant effect on autoimmune diseases that target the thyroid but the findings need controlled studies to measure the effect. Even if it is shown the influence so far at least appears to be minor so it is not a replacement treatment. I have also heard anecdotal reports of it being used to treat hyperthyroidism but I am dubious about that. It is more likely it mitigates the symptoms then deals with the hormone imbalance.

In case it needs saying: I am not a doctor.

Yes, before they put me on levothyroxine my lab work most definitely showed that I had hypothyroidism. But like you said, maybe I had a mild case, nonetheless I'm glad to not have the side effects of that levo drug, so glad! Also, I'm taking a thyroid supplement too, so I'm sure it helps as well. But I am not recommending people go that route before checking with their doctor.

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3 hours ago, cherryTreez said:

I don't have it anymore to look at the brand. She died 18 months ago sorry. I went to the pet store and they helped me.  It was $55 for the bottle. She weighed 60 lbs and it lasted 3 months or more.

Thanks for the info.  Maybe my sister can find a holistic pet store in Colorado, we get pretty much just PetSmart in Utah Valley last I checked.  The pet store we bought her at might still be around, but it wasn't holistic by a long shot.

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39 minutes ago, Tacenda said:

Last night I took the oil without the correct dosage, my usual 6 to 7 drops under the tongue. And I had trouble with paranoia and feeling like a rotten person. That's what THC does to me, so I would never use it recreationally. When I put the drops under my tongue I must have done it in a hurried way and huge drops came out, mostly likely doubled my usual amount. But I know it wouldn't have harmed me, just wasn't fun for a person that sometimes has low self esteem.

THC is much stronger these days than the 60s.  I know some young people who smoked it regularly who developed paranoia and depression, and were told by their therapist it could be long lasting, maybe permanent.  Maybe liquid THC has a similar effect.  Please be careful.

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19 minutes ago, Tacenda said:

Yes, before they put me on levothyroxine my lab work most definitely showed that I had hypothyroidism. But like you said, maybe I had a mild case, nonetheless I'm glad to not have the side effects of that levo drug, so glad! Also, I'm taking a thyroid supplement too, so I'm sure it helps as well. But I am not recommending people go that route before checking with their doctor.

I am tempted to ask what your numbers were but I will stop. I have hypothyroidism and am hyperinterested in it so I am probably being a pest. Sorry for the interrogation.

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1 hour ago, The Nehor said:

I am tempted to ask what your numbers were but I will stop. I have hypothyroidism and am hyperinterested in it so I am probably being a pest. Sorry for the interrogation.

No problem Nehor! I can try to copy and paste my lab numbers but I only go to a general doctor so it's not really his specialty and he's never explained them to me other than they looked good. But I can send them to you in a PM and we can discuss from there or here, either way.

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Just now, Tacenda said:

No problem Nehor! I can try to copy and paste my lab numbers but I only go to a general doctor so it's not really his specialty and he's never explained them to me other than they looked good. But I can send them to you in a PM and we can discuss from there or here, either way.

No, no worries. I am curious but I do not want to ask for medical records. Glad it got corrected though. I wonder if it was just a temporary inflammation which can look like hypothyroidism but heals up on its own.

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Tacenda's bout with panic attacks lasted quite awhile iirc (we share similar symptoms in that area), so seems like a more chronic inflammation if not hypo if my memory is accurate.  My daughter has been both hypo and hyper and corrected back to normal for at least ten years before doing it again, it is connected to her diabetes so may be different.  I was told I would be taking the levo whatever the rest of my life, but I hope something else will work because I hate the ringing in my ears that it causes.  Have to have music or a Korean drama (English I listen to so it keeps me awake, Chinese is too high pitched) playing to go to sleep on most days.

I think .I am babbling...skipped a sleep and had about 3 hours yesterday iirc....it is all a blur really.  Need to sign off and give into the darkness.

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47 minutes ago, Calm said:

Tacenda's bout with panic attacks lasted quite awhile iirc (we share similar symptoms in that area), so seems like a more chronic inflammation if not hypo if my memory is accurate.  My daughter has been both hypo and hyper and corrected back to normal for at least ten years before doing it again, it is connected to her diabetes so may be different.  I was told I would be taking the levo whatever the rest of my life, but I hope something else will work because I hate the ringing in my ears that it causes.  Have to have music or a Korean drama (English I listen to so it keeps me awake, Chinese is too high pitched) playing to go to sleep on most days.

I think .I am babbling...skipped a sleep and had about 3 hours yesterday iirc....it is all a blur really.  Need to sign off and give into the darkness.

That is also odd though because it is usually hyperthyroidism that causes panic attacks and anxiety. Hypo usually causes depression and makes you lethargic. There are exceptions but they are rare. I have been taking levo for years now. Never had anything but increased energy. Hope it gets better.

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5 hours ago, The Nehor said:

That is also odd though because it is usually hyperthyroidism that causes panic attacks and anxiety. Hypo usually causes depression and makes you lethargic. There are exceptions but they are rare. I have been taking levo for years now. Never had anything but increased energy. Hope it gets better.

With myself, I had anxiety before my thyroid crossed into definite low.  It gets worse if I am not consistent with the hormone.  I was always very low normal and now think given my body can now actually sweat and build muscle from exercise which it couldn’t very well before, probably could have used more hormone my entire life.  The anxiety could have been caused by another issue that is then exacerbated by depression or other issue of low thyroid. 

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24 minutes ago, Calm said:

With myself, I had anxiety before my thyroid crossed into definite low.  It gets worse if I am not consistent with the hormone.  I was always very low normal and now think given my body can now actually sweat and build muscle from exercise which it couldn’t very well before, probably could have used more hormone my entire life.  The anxiety could have been caused by another issue that is then exacerbated by depression or other issue of low thyroid. 

So many are affected by thyroid issues! :(

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9 hours ago, Calm said:

Thanks for the info.  Maybe my sister can find a holistic pet store in Colorado, we get pretty much just PetSmart in Utah Valley last I checked.  The pet store we bought her at might still be around, but it wasn't holistic by a long shot.

This one is off Fort Union by Reams in Cottonwood heights area. I was told of one off of Wasatch as well.

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3 hours ago, Tacenda said:

So many are affected by thyroid issues! :(

Yep.  Synthroid or Lavoxyl every day for life.  

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15 hours ago, Calm said:

With myself, I had anxiety before my thyroid crossed into definite low.  It gets worse if I am not consistent with the hormone.  I was always very low normal and now think given my body can now actually sweat and build muscle from exercise which it couldn’t very well before, probably could have used more hormone my entire life.  The anxiety could have been caused by another issue that is then exacerbated by depression or other issue of low thyroid. 

My wife began to have anxiety issues after the birth of our third son - post partum depression, milk drying up, and failing thyroid. It took awhile to get her thyroid right. For a time a "natural:" thyroid helped more. Anyway, she seems to get anxiety if her thyroid is too high or too low. The SSRIs gave her some unbearable side effects. More recently, well-butrin and a combination of fast acting and generic synthetic thyroids have given her the best results. She recently was too anxious though and her blood pressure was quite high until she cut her fast acting thyroid in half. It seems to me that sometimes her own thyroid works better than at other times, requiring her to adjust her medication, and making it difficult to ever get "the right combination." I would definitely recommend that people with these issues be very careful with caffeine intake as that will tend to pump up adrenaline, and I believe can cause anxiety issues for her as well.

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1 minute ago, RevTestament said:

My wife began to have anxiety issues after the birth of our third son - post partum depression, milk drying up, and failing thyroid. It took awhile to get her thyroid right. For a time a "natural:" thyroid helped more. Anyway, she seems to get anxiety if her thyroid is too high or too low. The SSRIs gave her some unbearable side effects. More recently, well-butrin and a combination of fast acting and generic synthetic thyroids have given her the best results. She recently was too anxious though and her blood pressure was quite high until she cut her fast acting thyroid in half. It seems to me that sometimes her own thyroid works better than at other times, requiring her to adjust her medication, and making it difficult to ever get "the right combination." I would definitely recommend that people with these issues be very careful with caffeine intake as that will tend to pump up adrenaline, and I believe can cause anxiety issues for her as well.

That sounds awful. Thyroid issues in some cases come in fits and starts. If it is really rough on her quality of life for an extended period she may want to look into having the thyroid removed. This fixes the dosing problems as the body produces a consistent amount (none) and you can use drugs to get a stable amount. Not saying she should do it but it is an option.

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4 minutes ago, The Nehor said:

That sounds awful. Thyroid issues in some cases come in fits and starts. If it is really rough on her quality of life for an extended period she may want to look into having the thyroid removed. This fixes the dosing problems as the body produces a consistent amount (none) and you can use drugs to get a stable amount. Not saying she should do it but it is an option.

She has discussed that actually. I have always hoped that she could turn her Hashimoto's around with diet, but being that both her parents had to take thyroid, that is probably wishful thinking. She has rarely felt "good" or like she did when we married. She gets tired, feels forgetful, complains of brain fog, gets depressed, gets bouts of anxiety, etc. It's a complicated medical picture with symptoms which come and go, and can have many causes. Unfortunately, she doesn't seem to be like her father who didn't seem to have many symptoms, and was surprised when he was tested, and told "how are you walking around? you don't have any thyroid..." However, he died of diabetes related causes(as well as his sister), and to date she has managed to avoid diabetes, so at least she has not had to deal with that bug, and its complications. I have always tried to stress a more natural diet, low in processed foods and sugar and simple carbs, and I have been doing the family shopping for the last 4 years or so. Every once in awhile I will buy a pie, and I do buy cookies, but I think all in all we have a fairly low intake of sugar by modern standards. I also don't fix anything with pasta unless she wants spaghetti.  We also don't drink a lot of juices. Fruit is eaten whole which slows the sugar intake. I guess what I am saying is that I don't see her reversing her Hashimoto's with diet. However, she is entering menopause now, so I am hopeful that will moderate the thyroid swings. All in all I would say she is generally happier than say ten years ago, but she will probably always need a supplemental source of iodine because she is a seafood hater...  I think the major cause of her issues is that for whatever reason her body has auto-immune issues - that is at the heart of Hashimoto's, gluten sensitivity, leaky gut syndrome and other things which I believe probably affect her. The best way to address that is diet. I don't want to tell her that removing her thyroid will fix all her symptoms, because I am dubious of that.

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11 minutes ago, RevTestament said:

She has discussed that actually. I have always hoped that she could turn her Hashimoto's around with diet, but being that both her parents had to take thyroid, that is probably wishful thinking. She has rarely felt "good" or like she did when we married. She gets tired, feels forgetful, complains of brain fog, gets depressed, gets bouts of anxiety, etc. It's a complicated medical picture with symptoms which come and go, and can have many causes. Unfortunately, she doesn't seem to be like her father who didn't seem to have many symptoms, and was surprised when he was tested, and told "how are you walking around? you don't have any thyroid..." However, he died of diabetes related causes(as well as his sister), and to date she has managed to avoid diabetes, so at least she has not had to deal with that bug, and its complications. I have always tried to stress a more natural diet, low in processed foods and sugar and simple carbs, and I have been doing the family shopping for the last 4 years or so. Every once in awhile I will buy a pie, and I do buy cookies, but I think all in all we have a fairly low intake of sugar by modern standards. I also don't fix anything with pasta unless she wants spaghetti.  We also don't drink a lot of juices. Fruit is eaten whole which slows the sugar intake. I guess what I am saying is that I don't see her reversing her Hashimoto's with diet. However, she is entering menopause now, so I am hopeful that will moderate the thyroid swings. All in all I would say she is generally happier than say ten years ago, but she will probably always need a supplemental source of iodine because she is a seafood hater...  I think the major cause of her issues is that for whatever reason her body has auto-immune issues - that is at the heart of Hashimoto's, gluten sensitivity, leaky gut syndrome and other things which I believe probably affect her. The best way to address that is diet. I don't want to tell her that removing her thyroid will fix all her symptoms, because I am dubious of that.

Sounds like there is a lot going on. There is no guarantee it will mitigate these symptoms but it will stabilize thyroid levels which might help. I would wait until menopause is over though.

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2 hours ago, RevTestament said:

She has discussed that actually. I have always hoped that she could turn her Hashimoto's around with diet, but being that both her parents had to take thyroid, that is probably wishful thinking. She has rarely felt "good" or like she did when we married. She gets tired, feels forgetful, complains of brain fog, gets depressed, gets bouts of anxiety, etc. It's a complicated medical picture with symptoms which come and go, and can have many causes. Unfortunately, she doesn't seem to be like her father who didn't seem to have many symptoms, and was surprised when he was tested, and told "how are you walking around? you don't have any thyroid..." However, he died of diabetes related causes(as well as his sister), and to date she has managed to avoid diabetes, so at least she has not had to deal with that bug, and its complications. I have always tried to stress a more natural diet, low in processed foods and sugar and simple carbs, and I have been doing the family shopping for the last 4 years or so. Every once in awhile I will buy a pie, and I do buy cookies, but I think all in all we have a fairly low intake of sugar by modern standards. I also don't fix anything with pasta unless she wants spaghetti.  We also don't drink a lot of juices. Fruit is eaten whole which slows the sugar intake. I guess what I am saying is that I don't see her reversing her Hashimoto's with diet. However, she is entering menopause now, so I am hopeful that will moderate the thyroid swings. All in all I would say she is generally happier than say ten years ago, but she will probably always need a supplemental source of iodine because she is a seafood hater...  I think the major cause of her issues is that for whatever reason her body has auto-immune issues - that is at the heart of Hashimoto's, gluten sensitivity, leaky gut syndrome and other things which I believe probably affect her. The best way to address that is diet. I don't want to tell her that removing her thyroid will fix all her symptoms, because I am dubious of that.

My sister in law had her thyroid taken out, sounds like she had the same problems as your wife's. But I remember her telling me once that she'd die if somehow she wasn't able to take her meds, that sounded a bit scary!

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9 minutes ago, Tacenda said:

My sister in law had her thyroid taken out, sounds like she had the same problems as your wife's. But I remember her telling me once that she'd die if somehow she wasn't able to take her meds, that sounded a bit scary!

Hashimoto's is basically an auto-immune disorder. The only ways I know to address it are to decrease the body's auto-immune response or if it get's bad, to remove the thyroid. My wife's condition has essentially stabilized - the amount of thyroid she has to supplement, hasn't really gone up much, and at times has gone down. But, yes, if she had it removed and had no supplements, I believe she would die. The only way to address it then would be to "make your own supplement" by eating animal thyroid glands - so it is not like someone would be totally out of options.

I am very intrigued by your comment that you believe CBD helped your thyroid, but right now I think my wife will shy away from CBD, and I have to admit that I am somewhat dubious of the claim. However, the body is a complex factory of chemical reactions, and I do not pretend to even begin to understand the modes of action of CBD. Perhaps it can help the brain in a way which helps certain thyroid dysfunction. 

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