increase thyroid, change thyroid, or stay put?

Around the beginning of the year I was below range with my T3 and T4 even though I was supplementing with naturethroid, levothyroxine, and some bioidentical T3. I’ve gradually increased on the naturethroid and am finally in range.

I’m now taking 4 grains of naturethroid, 50 mcg of levothyroxine, and 20 mcg of bioidentical T3.

My levels are now
TSH .006 (.450-4.5)
T4 1.26 (.82-1.77)
T3 2.9 (2.0-4.4)

They stayed exactly the same even since my latest naturethroid increase.

I still feel like I might be hypothyroid.. I’m not sure but I suspect I still have symptoms… My body temp is low and my resting pulse is never above 60. And I’m tired, feel cold, can’t eat much, etc. But my doctor is already freaked out with how much thyroid replacement I’m taking and wants me to stay at my current dosages. I’m a little freaked out, too, it seems like an awful lot. I’m wondering if I should advocate for another increase tomorrow or leave well enough alone. I certainly feel better than I did at the beginning of the year.

It also occurred to me to try phasing out the T3 and increasing the naturethoid more… Maybe decreasing by 5mcg on the T3 while increasing quarter grains on the naturethroid, until I’m at 0 bioidentical T3 and 5 grains of naturethroid. I’m tempted to try something like this just because it seems haphazard to be on three different kinds of treatment, and the naturethroid seems best to me. But I don’t want to create more problems.

Thanks for any thoughts!

Thats a lot of thyroid hormone to still be having hypo symptoms. Youre definitely not converting, and though a RT3 test should be done, its easy to come to that conclusion when your supplementing that much direct T3 and still coming up short on T3 labs. Lowering T3 and increasing T4 and T3 in naturethroid isnt the answer. Something is holding back T3 conversion AND utilization of direct T3. It may be as simple as too much T4 to strart with, because with too much T4 your body will instantly stop the conversion AND utilization of any and all T3.

What does your liver values look like? If youre unsure, thats where to start. Your doctor is right 100% in not increasing until you find out whats going on. He/she may not even understand fully, and it may end up being your job to save your own hide by researching the HPA Axis and figuring out whats up.

When youre having issues with thyroid, always start with RT3 and the liver, proceed from there. You need a complete look at the body and see whats going on. Something as simple as inflammation(SED rate) among others(vitamin deficiency) can throw off how your body processes supplemental hormones. Youre getting into a dangerous sutuation, and you need answers before you proceed with fixing things. A lot more lab work that what yourr showing is needed. Good luck and God bless!

Same as others. Your on a lot.

Something is not right (well, ya, lyme).

Consider:

The liver is a major T4 to T3 conversion organ. Whats your liver alt/ast look like? Anyone killing bugs (abx or herbs, or anti candida if bad )inside you should have the liver health eznymes testd -its a standard in practice, yet so many Drs forget it.

Iron?

Adrenal test-saliva?

These need to be known with your T3 issue.

One of the Best sups for liver detox is d-limonine, seldom mentioned. Does more than the herbs for it. Sam-e is liver support to- but has brain chemistry effects also which some do well on, some not.

Ah Trader yeah that definitely scares me reading that!!

I appreciate it, though.

The appointment didn't clarify much for me. My doctor definitely thinks there's more going on that just a thyroid issue.. He thinks there's something causing the seeming miscommunication in my endocrine system (pituitary not asking for more thyroid hormone, even when I was below range). Based on my symptoms he thinks I'm still hypothyroid and wants me to try another naturethroid increase. He also suggested (on his own) that I could simultaneously try going down on the T3. Based on what everyone here is saying, I'm not sure about doing this.

Nature Throid has two versions - look on their web site, RCL labs?

Might try sublingual, but with the NT brand I read you must chew it up then leave in cheek (clean mouth/no food protiens).

Also: I use NP Acella thyroid (goggle it) (sublingual is easy too). Any place in US can order it. Is closer to the superior old Armour and NT (both had FDA forced filler changes in 2009). I used the old and post 2009, older versions were better feeling for many people, the reason I dont use either of these brands today.

marigold,

A 1/4 grain of Naturethroid contains 2.25mcg T3.

The thought that the body responds better to desiccated thyroid is why doctors would suggest a switch such as yours - it should be easier for the body to tolerate.

Optimizing thyroid levels can be an insanely long process. It took me 15 months and I still needed small dose adjustments (often increases) every 10-12 wks. I'd finally been stable for almost a year when Lyme hit. It's been insane since lol

I long ago read an analogy about what's necessary to optimize levels. I call it the sponge theory and it goes something like this...

A hypothyroid body is like a dried-up sponge. All the holes in the sponge represent the various areas of the body lacking thyroid hormone that is vital for proper function.

We can't dump water (thyroid hormone) on the dried up sponge (the hypothyroid body) because the sponge (body) just can't absorb all it needs in one shot.

Water would run off (hyper symptoms)...some would be absorbed (possible slight improvement in some bodily deficiencies). But, the sponge would still be too dry (the body wouldn't have enough hormone which means hypo symptoms).

We have to slowly add water (thyroid hormone) to the sponge (body) to maximize absorption and minimize run-off (symptoms).

Lyme is known to block thyroid hormone receptors - those are the areas around the holes in the sponges (the body's cells are being blocked from absorbing the thyroid hormone it needs for proper function).

For someone with a dried-up sponge (hypothyroid body) + Lyme, that could very well mean the need for more water (thyroid hormone) rather than usual.

It doesn't matter if you're body can't convert at this point....or if your T4 is being converted into inactive rT3.

All that matters is that your body get the right amount of thyroid hormone so your immune system (and the rest of your body) can function properly.

CD, I am going to highly disagree that "it doesnt matter that your body doesnt convert at this point". What happens when your body shuts down the conversion mechanism? What happens when that process has occurred and you increase T4? Im not going to spell it out, but that creates a dangerous situation, and anyone, doctor or not, who refuses the seriousness of such a situation needs to rethink what in fact is happening. Look at the system as a whole. Looks like marigold made the decision already so ill end with good luck, and God bless!

marigold

Here's some good info on thyroid:

www.westonaprice.org/modern-diseases/best-kept-secret/

You might feel more comfortable with your doctor's recommendations when you read this paragraph:

"A small number of large or overweight thyroid hormone-resistant patients, usually women, may need up to 6-9 grains of Armour Thyroid per day (or the equivalent of thyroxine, counting 0.1 mg of T4 as equivalent to 1 grain); or a combination of the two. These patients seem to represent some form of thyroid hormone resistance syndrome, as described by Refetoff.23"

This is not to imply that you are large or overweight but it appears you are thyroid-hormone resistant (ala Lyme blocking your thyroid hormone receptors) and thus your greater dose needs.

Dr. Burrascano addresses the blockage in his "Diagnostic Hints and Treatment Guidelines". You can find the specifics in the "Pituitary" section that starts on page 5 here:

www.ilads.org/lyme/B_guidelines_12_17_08.pdf

"Pituitary and other endocrine abnormalities are far more common than generally realized. Evaluate fully,
including growth hormone levels. Quite often, a full battery of provocative tests is in order to fully define the problem. When testing the thyroid, measure free T3 and free T4 levels and TSH, and nuclear scanning and testing for autoantibodies may be necessary.

Activation of the inflammatory cascade has been implicated in blockade of cellular hormone receptors.

One example of this is insulin resistance; clinical hypothyroidism can result from receptor blockade and thus hypothyroidism can exist despite normal serum hormone levels. These may partly account for the dyslipidemia and weight gain that is noted in 80% of chronic Lyme patients. In addition to measuring free T3 and T4 levels, check basal A.M. body temperatures. If hypothyroidism is found, you may need to treat with both T3 and T4 preparations until blood levels of both are normalized. To ensure sustained levels, when T3 is prescribed, have it compounded in a time-release form."

We can compensate for the absence of time-release thyroid meds by dosing more than once during the day.

Happy to help marigold. Elaine really helped clear the muddy thyroid waters for me. Doctors certainly didn't help.

Glad you liked the Dommisse article. It makes a lot of sense - doesn't it?

Umm...on a "good" day, my TSH is .006. It's more commonly <.005 Please be comforted in knowing that TSH has no physiological implications - it doesn't cause symptoms.

TSH is similar in concept to FSH (hormone test to check for menopause). Just as the FSH test tells a woman where she stands with ovulation capabilities, TSH tells a person what the pituitary is doing in regards to thyroid function. If a person is getting enough exogenous thyroid hormone, the body isn't "telling" the pituitary it needs more.

Dividing the dose of any T3-containing med makes a lot of sense based upon the short half-life of T3.

I take synthetics and dose my T3 at 8AM and 2PM.....always have since I first started the stuff in 2010.

Good luck!

If your thyroid were "dangerous", you'd have a high pulse and high blood pressure. It seems you do not have either. That can give you some peace as you move forward. Just a heads up, there is a T3-only protocol for those who have his Reverse T3. Since RT3 is caused by too much T4, and it blocks the uptake/conversion of Free T3, T4 is often more implicated in problems than T3. I am sensitive to t3 and I dose it about every 4-5 hours in the daytime so as not to have to much at once. Best wishes!!