A Vancouver internist, AI, and T3
Lois
what's happening according to a Vancouver internist.
First, he said that since the random cortisol test put my level at 293 at
about 3 pm (range up to about 600; I can't remember exactly), I don't have
adrenal insufficiency. I then told him I didn't think the test could mean
anything because I'm still working my way off the naturopathic supplement
for AI, but that I was satisfied to leave the subject for a few months and
if I still have symptoms then, to open the subject again. He was agreeable
to that.
About the symptoms. Susan told us in the hypoglycemia thread on Dec. 2 that
her hypoglycemia went away with a restricted carb diet, so I'm wondering if
my carboholic tendencies and not AI are to blame for this problem for me.
Jennifer told us on Nov. 23 that she experienced episodes of low bp and
dizziness on standing with being hypo, which went away with a dosage
increase, so that could be an explanation for my low bp. I've noticed just
in the past week that the lightheadness upon standing is considerably
reduced; this is at the same time that my daytime resting pulse rate has
gone up from the low 50s to the low 60s, and is a couple of weeks after a
dosage increase. I'm going with the theory that these 3 things are
connected. Also, 6 weeks ago my job changed from a sometimes stressful one
to an easier-paced one for a few months, and I can feel myself unwinding.
Last spring, I was doing 2 people's jobs for awhile for up to 11 hours a day
when everything that could go wrong did, and at the same time that I had an
arm injury, a wrist injury, a wrist brace and being hyper to deal with.
Wouldn't all that cause anyone's body to pump out more adrenaline and
possibly lead to problems?
Thanks, everyone who participated in my search for answers on this subject.
I hope the accumulated info has been useful to others as well.
Attention Vancouver, Canada people: I have found a doctor here who is
willing to prescribe T3 to hypo people who feel they need it. In fact, he
said he couldn't think of a reason not to. He thinks that only some hypo
people have a conversion problem, and that may be true. A doctor colleague
of his is hypo and apparently does well on T4 only. He also prescribes
desiccated thyroid (the equivalent of Armour in Canada) to those who prefer
it. If anyone wants this doctor's name, please contact me directly.
Here's a question for the big kids. He said that if someone is taking
synthetic T3, they don't need T4. Really? T4 converts to T3, but most people
here prefer both. ?? Wouldn't there be a problem of energy lows with no T4
backup because T3 is fast-acting?
Thanks again,
Lois
--
To contact me directly to get this doctor's name, change the "no_spam" in my
e-mail address to my name.
John Riggs
it run but if you stop it will run out faster and stop. Again, just like a
car, if you run out of gas you will end up putting a little in the
carburetor to prime it. You can fill the tank, but until you prime it, you
ain't goin' no where. Usually, if you treat with T3 you will be able to get
the process started so you can more efficiently convert T4. Some of us need
that prime to get the process going.
Sure, you can run on T3 only, but wouldn't it be nice to have a little
hormone in reserve?
Lois <no_...@infoserve.net> wrote in message
news:X1A24.478$JV.87...@news1.van.metronet.ca...
Nick
>
>Here's a question for the big kids. He said that if someone is taking
>synthetic T3, they don't need T4. Really? T4 converts to T3, but most people
>here prefer both. ?? Wouldn't there be a problem of energy lows with no T4
>backup because T3 is fast-acting?
I'm told that some T4 in the mix reduces the roller coast ride that straight T3
may give.
Nick
--
Warning, I am not a Doctor, If you are thinking of making any changes to your medication discuss it with your doctor first.
Check these sites for good information on thyroid problems
http://www.personal.u-net.com/~my4tune/appto_treatment.txt
http://www.personal.u-net.com/~my4tune/itg.htm
http://thyroid.about.com
Ted Huston
up with your own patenTED bad analogies... Take a break from reading
posts by Kevin and me. It will do your sanity good!
John Riggs wrote:
> Lois, just like a car, you can pour gasoline in the carburetor and make
> it run but if you stop it will run out faster and stop. Again, just like a
> car, if you run out of gas you will end up putting a little in the
> carburetor to prime it. You can fill the tank, but until you prime it, you
> ain't goin' no where. Usually, if you treat with T3 you will be able to get
> the process started so you can more efficiently convert T4. Some of us need
> that prime to get the process going.
> Sure, you can run on T3 only, but wouldn't it be nice to have a little
> hormone in reserve?
--
Ted Huston dr...@umich.edu
"I saw a woman wearing a sweatshirt with 'Guess' on it. I said, 'Thyroid
problem?' " -- Emo Philips
Ted Huston
> Here's a question for the big kids. He said that if someone is taking
> synthetic T3, they don't need T4. Really? T4 converts to T3, but most people
> here prefer both. ?? Wouldn't there be a problem of energy lows with no T4
> backup because T3 is fast-acting?
Is this a FAT joke? Huh? You wanna make something out of the fact that I
am BIGGER that the other kids here? HUH? HUH? HUH? >:)
Actually, all of the thyroid hormone action can be explained solely by
T3. So, you don't NEED T4 provided there is sufficient T3 around. BUT,
the advantage of T4 is that it is a store house to even the dips on the
rollercoaster of life (I know, an even worse patenTED analogy than John's,
tough luck). T4 has the ability to both go to T3 as needed, but also to
be shunted to non-productive ways when the body DOESN'T need more T3.
This allows you to be on ONE dose rather than figuring things out from
season to season or one activity period to the next (or, in my case,
being in kindergarten, RECESS period to NAP time). Some days you just
need MORE thyroid hormone than others, but to have to adjust yourself
on the fly, it gets messy. There are many pitfalls to trying to second
guess the causes of how you feel on any given day, and there are ample
opportunities to make mistakes. Why not mimic intact thyroid function
and shoot for a T4:T3 ratio of about 12:1? Or, go by the NEJM approach
to get the intact thyroid production of about 6ug of T3 per day plus the
rest of the way there with T4? The desiccated products, btw, are all
in the ballpark of T4:T3 of 4:1, way more T3 than intact thyroid function
secretions.....(a long story if anyone needs sleep inducements....).
John Riggs
has never been one of my strong points.
Ted Huston <dr...@umich.edu> wrote in message
news:384D8F2A...@umich.edu...
>John, John, John..... You have been around us too long! You are now
coming
>up with your own patenTED bad analogies... Take a break from reading
>posts by Kevin and me. It will do your sanity good!
>
>John Riggs wrote:
>> Lois, just like a car, you can pour gasoline in the carburetor and
make
>> it run but if you stop it will run out faster and stop. Again, just like
a
>> car, if you run out of gas you will end up putting a little in the
>> carburetor to prime it. You can fill the tank, but until you prime it,
you
>> ain't goin' no where. Usually, if you treat with T3 you will be able to
get
>> the process started so you can more efficiently convert T4. Some of us
need
>> that prime to get the process going.
>> Sure, you can run on T3 only, but wouldn't it be nice to have a little
>> hormone in reserve?
Lois
: > Here's a question for the big kids.
Encyclopedia Ted wrote:
: Is this a FAT joke? Huh? You wanna make something out of the fact that I
: am BIGGER that the other kids here? HUH? HUH? HUH? >:)
No, Big One. I mean, you are larger than life in this NG. That's all I
wanted to say, honest. My, what, er, interesting feet you have. Just don't
step on me as I skedaddle out of here, OK? Good Ted. Nice Ted.
And thanks to all the big kids for the analogies. They explain what I
thought, but I wasn't sure.
: Some days you just
: need MORE thyroid hormone than others
What days would those be? Is the amount of exercise a person gets in a day a
factor in how much hormone is needed? If I go from doing just bicycle
commuting to adding workout rides to riding all day, every day for a couple
of weeks on a cycling trip, should I anticipate needing more hormone and
possibly increase the dose while on the trip or while increasing the workout
levels?
Thanks again from the shadows,
Lois
Ted Huston
> : Lois wrote:
> : > Here's a question for the big kids.
>
> Encyclopedia Ted wrote:
> : Is this a FAT joke? Huh? You wanna make something out of the fact that I
> : am BIGGER that the other kids here? HUH? HUH? HUH? >:)
>
> No, Big One. I mean, you are larger than life in this NG. That's all I
> wanted to say, honest. My, what, er, interesting feet you have. Just don't
> step on me as I skedaddle out of here, OK? Good Ted. Nice Ted.
Ah, my Halloween post comes back to haunt me.... "'Attack of the 50 Foot
Woman' - starring Lois this year...please don't step on me {squishing sounds}"
Not to imply that you have more than the standard issue unit of 2 feet, what
would you do with those extra feet if you had them?? And what do you do with
the other 48 legs they're attached to? WHEEEEEEEeeeeee... :o)
> : Some days you just
> : need MORE thyroid hormone than others
>
> What days would those be? Is the amount of exercise a person gets in a day a
> factor in how much hormone is needed? If I go from doing just bicycle
> commuting to adding workout rides to riding all day, every day for a couple
> of weeks on a cycling trip, should I anticipate needing more hormone and
> possibly increase the dose while on the trip or while increasing the workout
> levels?
As you know, I am not one to advocate changing dosages on a daily basis the
way Nick does. There are too many chances for misinterpreting the needs.
As you are on a desiccated product, you WILL have some T4 along for the
rides. Don't obsess, don't micromanage....
> Thanks again from the shadows,
> Lois
"Back from the shadows again
Out where the Indian's your friend
Where the vegetables are green
And you can pee in the stream
(And that's important...)
Back from the shadows again...."
- - Firesign Theater, 'I Think We're All Bozos on this Bus'
Aron Apeldoorn
Monica
Nick wrote in message ...
>On Sun, 05 Dec 1999 20:37:11 GMT, "Lois" <no_...@infoserve.net> wrote:
>
>>
>>Here's a question for the big kids. He said that if someone is taking
>>synthetic T3, they don't need T4. Really? T4 converts to T3, but most
people
>>here prefer both. ?? Wouldn't there be a problem of energy lows with no T4
>>backup because T3 is fast-acting?
>
>
Lois
: > : Some days you just
: > : need MORE thyroid hormone than others
Lois wrote:
: > What days would those be? Is the amount of exercise a person gets in a
day a
: > factor in how much hormone is needed? If I go from doing just bicycle
: > commuting to adding workout rides to riding all day, every day for a
couple
: > of weeks on a cycling trip, should I anticipate needing more hormone and
: > possibly increase the dose while on the trip or while increasing the
workout
: > levels?
Ted wrote:
: As you know, I am not one to advocate changing dosages on a daily basis
the
: way Nick does. There are too many chances for misinterpreting the needs.
: As you are on a desiccated product, you WILL have some T4 along for the
: rides. Don't obsess, don't micromanage...
OK, but doing a self-supported cycling tour means your body has to put out a
*lot* more than usual. I eat a lot more when I'm cycling all day; I don't
call that obsessing or micromanaging, but necessary fun. If I don't eat and
eat, my legs won't pedal. Doesn't it follow that if I'm riding distances and
hills every day for 2 weeks, my body would need a lot more hormone, too?
This is not just hypothetical for me because depending on my health and the
group situation, I may be going on such a trip in February. I also think
it's possible that part of why my condition went downhill last summer was
due to my sudden increase in cycling uphills without a dosage increase.
Thanks again,
Lois
--------------------- PLAY TIME ---------------------
Lois wrote:
: > My, what, er, interesting feet you have. Just don't
: > step on me as I skedaddle out of here, OK? Good Ted. Nice Ted.
Ted wrote:
: Ah, my Halloween post comes back to haunt me.... "'Attack of the 50 Foot
: Woman' - starring Lois this year...please don't step on me {squishing
sounds}"
: Not to imply that you have more than the standard issue unit of 2 feet,
what
: would you do with those extra feet if you had them?
Open mouth, insert foot.
When Ted was 3 years old, he put his shoes on by himself for the first time.
His mother noticed that the left shoe was on the right foot. She said, "Son,
your shoes are on the wrong feet." He looked up at her with a not-yet-hypo
raised eyebrow and said, "Don't kid me, Mom. I KNOW they're my feet."
--------------
Ted's friend Mahatma Ghandi walked barefoot everywhere, to the point that
his feet became quite thick and hard. He was also quite a spiritual person.
Even when he was not on a hunger strike, he did not eat much and became
quite thin and frail. Furthermore, due to his diet, he wound up with very
bad breath. Therefore, he came to be known as a...
"Super calloused fragile mystic plagued with halitosis."
Nick
>What about a time released t3?
>Monica
I heard of someone who went from T4 to Armour to sustained release T3.
She described the T4 as a foggy day, the Armour as wonderfully clear after that,
and then when she was on just sustained T3 she realised the world was still a
bit misty on the Armour.
It can suit some people, I've never tried it.
At some stage I may try replacing some of my Armour dose with an amount of T3
equivalent to the T3 in the Armour to see what happens. My gut feeling is that I
am not converting appreciably and that I need the large dose of Armour because I
need that much T3. This is why I get a roller coaster if I don't spread te
Armour.
My Doc has said if I want to experiment like that he will support me.
Ted Huston
> OK, but doing a self-supported cycling tour means your body has to put out a
> *lot* more than usual. I eat a lot more when I'm cycling all day; I don't
> call that obsessing or micromanaging, but necessary fun. If I don't eat and
> eat, my legs won't pedal. Doesn't it follow that if I'm riding distances and
> hills every day for 2 weeks, my body would need a lot more hormone, too?
> This is not just hypothetical for me because depending on my health and the
> group situation, I may be going on such a trip in February. I also think
> it's possible that part of why my condition went downhill last summer was
> due to my sudden increase in cycling uphills without a dosage increase.
Until you have done it, I wouldn't hazard a guess. My gut feeling is that
the difference is minimal as long as you do have T4 available. One possible
suggestion: Do some serious exercising the day before/day of the testing
to simulate the worst case NEED for more hormone.... Or talk to the
wild ones that do fudge their dosing every day (just don't tell me about
it, cuz I'll have to restate my reservations about doing it).
> --------------------- PLAY TIME ---------------------
Lois wrote:
> When Ted was 3 years old, he put his shoes on by himself for the first time.
> His mother noticed that the left shoe was on the right foot. She said, "Son,
> your shoes are on the wrong feet." He looked up at her with a not-yet-hypo
> raised eyebrow and said, "Don't kid me, Mom. I KNOW they're my feet."
Ted, the teacher, was giving a lesson on the circulation of the blood. Trying
to make the matter clearer, he said, "Now, kids, if I stood on my head the
blood, as you know, would run into it, and I should turn red in the face."
"Yes," the kids said.
"Then why is it that while I am standing upright in the ordinary position the
blood doesn't run into my feet?"
A little fellow shouted, "Cause yer feet ain't empty."
Lois
your gut feeling. Anyway, I don't know how the difference in the amount of
hormone needed could be minimal at a time when I'll be suddenly putting out
huge amounts of energy day after day; the increase in the amount of food I
eat while on cycling tours certainly isn't minimal. Your suggestion to go on
an exercise binge the day before a blood test is an interesting one, but I
won't be able to use it because a) I'm currently working towards the right
levels, and a change is what I expect with each blood test anyway, and b) I
can't simulate the worst case need in only one day when I'm talking about a
2-week cycling trip.
Or talk to the
: wild ones that do fudge their dosing every day (just don't tell me about
: it,
Could you please turn your head while I ask....Hey, wild ones, do you want
to go up against Ted on this one? Come on, it's fun. I'm interested in your
thoughts too, and Ted produces more jokes when there's a difference of
opinion to play with.
Thanks while cheering for both sides,
Lois
________________
Ted wrote:
: Until you have done it, I wouldn't hazard a guess. My gut feeling is that
: the difference is minimal as long as you do have T4 available. One
possible
: suggestion: Do some serious exercising the day before/day of the testing
: to simulate the worst case NEED for more hormone.... Or talk to the
: wild ones that do fudge their dosing every day (just don't tell me about
: it, cuz I'll have to restate my reservations about doing it).
: Lois wrote:
: > OK, but doing a self-supported cycling tour means your body has to put
out a
: > *lot* more than usual. I eat a lot more when I'm cycling all day; I
don't
: > call that obsessing or micromanaging, but necessary fun. If I don't eat
and
: > eat, my legs won't pedal. Doesn't it follow that if I'm riding distances
and
: > hills every day for 2 weeks, my body would need a lot more hormone, too?
--------------------- MORE PLAY TIME ---------------------
Ted wrote:
: Ted, the teacher, was giving a lesson on the circulation of the blood.
Trying
: to make the matter clearer, he said, "Now, kids, if I stood on my head the
: blood, as you know, would run into it, and I should turn red in the face."
:
: "Yes," the kids said.
:
: "Then why is it that while I am standing upright in the ordinary position
the
: blood doesn't run into my feet?"
:
: A little fellow shouted, "Cause yer feet ain't empty."
Speaking of using your head....
Police in Radnor, Pennsylvania, interrogated a suspect by placing a
metal colander on his head and connecting it with wires to a photocopy
machine. The message "He's lying" was placed in the copier, and police
pressed the copy button each time they thought the suspect wasn't telling
the truth. Believing the "lie detector" was working, the suspect confessed.
A man in Virginia went into a drug store, pulled a gun, announced a
robbery, and pulled a Hefty-bag face mask over his head--and realized that
he'd forgotten to cut eye holes in the mask.
A man in Johannesburg, South Africa, shot his 49-year-old friend in
the face, seriously wounding him, while the two practiced shooting beer cans
off each other's head.
A company trying to continue its five-year perfect safety record
showed its workers a film aimed at encouraging the use of safety goggles on
the job. According to Industrial Machinery News, the film's depiction of
gory industrial accidents was so graphic that twenty-five workers suffered
minor injuries in their rush to leave the screening room. Thirteen others
fainted, and one man required seven stitches after he cut his head falling
off a chair while watching the film.
Nick
>
>Could you please turn your head while I ask....Hey, wild ones, do you want
>to go up against Ted on this one? Come on, it's fun. I'm interested in your
>thoughts too, and Ted produces more jokes when there's a difference of
>opinion to play with.
He is probably talking about me :-)
I am on a stupidly high dose of Armour and should be hyper by all normal rules.
I don't know why I need such a high dose, I imagine that I either have tissue
resistance or am not converting at all and am only using the T3 in the Armour.
Bear this in mind when comparing yourself with me.
What I am doing is with the full agreement and approval of my doctor and I
understand that he is doing something similar himself.
I take 4 grains of Armour on waking and another 2 at 10.30 to 11.00 provided I
feel ready for it. Symptoms that will prevent me taking more are shaking hands
of 'feeling' my heart beating. These are the ways hyper presents itself for me.
I then take more during the day if I feel myself slump and this does depend on
physical activity. My normal maximum is another 2 grains, typically 1 at 3.00 at
another at 5.00 to 6.00. If I have to function late into the evening on a long
drive or working then another at 9.00 but this is VERY rare, 2 or 3 times a year
typically.
The amount I need does depend on both physical and mental activity. On a lazy
day I can get away with the 6 grains and on a busy active day I need the 8.
The symptoms that I feel if I slump are brain fog and sometimes crashing
fatigue. These will pass within half an hour of taking another grain.
The more I think about it the more I think I am not converting and that these
peaks and dips are because I am only using the T3 component of the Armour.
Next time I go to Dr D-P for a check up I will probably ask to try cutting the
Armour to 2 grains a day and taking T3 for the booster doses. He has already
said he will support me if I want to try this.
All the usual warnings about don't try this without your Doctors approval etc
apply.
R. Scott
>I take 4 grains of Armour on waking and another 2 at 10.30 to 11.00 provided I
>feel ready for it. Symptoms that will prevent me taking more are shaking hands
>of 'feeling' my heart beating. These are the ways hyper presents itself for me.
>I then take more during the day if I feel myself slump and this does depend on
>physical activity. My normal maximum is another 2 grains, typically 1 at 3.00 at
>another at 5.00 to 6.00. If I have to function late into the evening on a long
>drive or working then another at 9.00 but this is VERY rare, 2 or 3 times a year
>typically.
Do you ever have labs done? It would be interesting to see the
numbers.
RS
Lois
: I am on a stupidly high dose of Armour and should be hyper by all normal
rules.
:
: I don't know why I need such a high dose, I imagine that I either have
tissue
: resistance or am not converting at all and am only using the T3 in the
Armour.
: Bear this in mind when comparing yourself with me.
This is interesting timing. I went to an alternative health centre this
afternoon, mostly to deal with an old arm injury, but also to see if the
treatment there could help my thyroid. When I asked the doctor (whose
philosophy is to combine the best of both Eastern and Western medicine) how
acupuncture could help a malfunctioning thyroid that needs more hormone, he
said it can rebalance the yang energy, or something like that, and that hypo
people have an imbalance of this sort. Laugh if you want, but when I went
for one acupuncture treatment somewhere else last summer for my arm and got
a full body treatment, I suddenly needed much less sleep. I wonder if your
tissue resistance or conversion problem could really be a yang problem.
This doctor wants to treat one thing at a time and we're starting with the
arm injury, so I'll let you know how it goes when we get to the thyroid.
: The amount I need does depend on both physical and mental activity. On a
lazy
: day I can get away with the 6 grains and on a busy active day I need the
8.
:
: The symptoms that I feel if I slump are brain fog and sometimes crashing
: fatigue. These will pass within half an hour of taking another grain.
:
: The more I think about it the more I think I am not converting and that
these
: peaks and dips are because I am only using the T3 component of the Armour.
I haven't been on it long enough to know if I'm converting, but the one time
I tried splitting my dose, a few days ago, my mind felt noticeably clearer
for the next couple of hours at least.
Everyone reacts differently, of course, but (ET, you might want to look away
now) based on what you (Nick) wrote, I'd like to talk to my doctor about
taking more if I get that crashing fatigue. I always carry extra food with
me when I'm cycling and I try to eat before I'm hungry and crash, so it
makes sense to me to be prepared the same way with my happy pills.
: Next time I go to Dr D-P for a check up I will probably ask to try cutting
the
: Armour to 2 grains a day and taking T3 for the booster doses. He has
already
: said he will support me if I want to try this.
Will you let us know how it goes? I'm interested in hearing about it, and
I'll bet Ted is, too. ;-) You might want to try acupuncture first,
though....
Thanks,
Lois
PS to Ted: I haven't disregarded any of your advice, but when I go on a
group cycling-camping trip, I *need* my body to be capable of putting out
what some people consider insane amounts of energy. If I can't keep
pedalling, my trip will be ruined, so I have to look at all options.
Nick
>
> Do you ever have labs done? It would be interesting to see the
>numbers.
No
My Doc is happy to treat by symptoms using temperatures, pulse rate, and 'feel
good factor' as parts of the puzzle.
I am private without insurance so would have to pay for the tests myself and
there just seems no point. My NHS Doc did not believe I had a problem in the
first place, if the TSH is below 5.5 the NHS around here does not believe you
can have a thyroid problem.
The numbers would be interesting but I'm not interested enough to pay for them!
I know how I feel now and my activity/ability levels compared with 18 months
ago.
John Riggs
on both T3 and T4 synthetics. Of course you'd miss out on the rest of the
piggy bits but I don't know how much of that we actually use. Just a
thought.
Nick <maa...@dial.pipex.com> wrote in message
news:qsv25s0irruptj930...@4ax.com...
>On Fri, 10 Dec 1999 03:41:16 GMT, "Lois" <no_...@infoserve.net> wrote:
>
>>
>>Could you please turn your head while I ask....Hey, wild ones, do you want
>>to go up against Ted on this one? Come on, it's fun. I'm interested in
your
>>thoughts too, and Ted produces more jokes when there's a difference of
>>opinion to play with.
>
>
>He is probably talking about me :-)
>
>I am on a stupidly high dose of Armour and should be hyper by all normal
rules.
>
>I don't know why I need such a high dose, I imagine that I either have
tissue
>resistance or am not converting at all and am only using the T3 in the
Armour.
>Bear this in mind when comparing yourself with me.
>
>What I am doing is with the full agreement and approval of my doctor and I
>understand that he is doing something similar himself.
>
>I take 4 grains of Armour on waking and another 2 at 10.30 to 11.00
provided I
>feel ready for it. Symptoms that will prevent me taking more are shaking
hands
>of 'feeling' my heart beating. These are the ways hyper presents itself for
me.
>
>I then take more during the day if I feel myself slump and this does depend
on
>physical activity. My normal maximum is another 2 grains, typically 1 at
3.00 at
>another at 5.00 to 6.00. If I have to function late into the evening on a
long
>drive or working then another at 9.00 but this is VERY rare, 2 or 3 times a
year
>typically.
>
>The amount I need does depend on both physical and mental activity. On a
lazy
>day I can get away with the 6 grains and on a busy active day I need the 8.
>
>The symptoms that I feel if I slump are brain fog and sometimes crashing
>fatigue. These will pass within half an hour of taking another grain.
>
>The more I think about it the more I think I am not converting and that
these
>peaks and dips are because I am only using the T3 component of the Armour.
>
>
>Next time I go to Dr D-P for a check up I will probably ask to try cutting
the
>Armour to 2 grains a day and taking T3 for the booster doses. He has
already
>said he will support me if I want to try this.
>
>All the usual warnings about don't try this without your Doctors approval
etc
>apply.
>
John Riggs
extra pill too but if it is to soon or too much you can have hyper problems
real darned quick and THAT needs attention immediately. Your trip could be
ruined if you aren't careful.
Lois <no_...@infoserve.net> wrote in message
news:0ok44.104$0c5.2...@news1.van.metronet.ca...
>Nick wrote (some snipped):
>
>: I am on a stupidly high dose of Armour and should be hyper by all normal
>rules.
>:
>: I don't know why I need such a high dose, I imagine that I either have
>tissue
>: resistance or am not converting at all and am only using the T3 in the
>Armour.
>: Bear this in mind when comparing yourself with me.
>
>This is interesting timing. I went to an alternative health centre this
>afternoon, mostly to deal with an old arm injury, but also to see if the
>treatment there could help my thyroid. When I asked the doctor (whose
>philosophy is to combine the best of both Eastern and Western medicine) how
>acupuncture could help a malfunctioning thyroid that needs more hormone, he
>said it can rebalance the yang energy, or something like that, and that
hypo
>people have an imbalance of this sort. Laugh if you want, but when I went
>for one acupuncture treatment somewhere else last summer for my arm and
got
>a full body treatment, I suddenly needed much less sleep. I wonder if your
>tissue resistance or conversion problem could really be a yang problem.
>
>This doctor wants to treat one thing at a time and we're starting with the
>arm injury, so I'll let you know how it goes when we get to the thyroid.
>
>: The amount I need does depend on both physical and mental activity. On a
>lazy
>: day I can get away with the 6 grains and on a busy active day I need the
>8.
>:
>: The symptoms that I feel if I slump are brain fog and sometimes crashing
>: fatigue. These will pass within half an hour of taking another grain.
>:
>: The more I think about it the more I think I am not converting and that
>these
>: peaks and dips are because I am only using the T3 component of the
Armour.
>
>I haven't been on it long enough to know if I'm converting, but the one
time
>I tried splitting my dose, a few days ago, my mind felt noticeably clearer
>for the next couple of hours at least.
>
>Everyone reacts differently, of course, but (ET, you might want to look
away
>now) based on what you (Nick) wrote, I'd like to talk to my doctor about
>taking more if I get that crashing fatigue. I always carry extra food with
>me when I'm cycling and I try to eat before I'm hungry and crash, so it
>makes sense to me to be prepared the same way with my happy pills.
>
>: Next time I go to Dr D-P for a check up I will probably ask to try
cutting
>the
>: Armour to 2 grains a day and taking T3 for the booster doses. He has
>already
>: said he will support me if I want to try this.
>
Lois
: Well, Nick, I wonder if you would be better off doing like those of us
: on both T3 and T4 synthetics. Of course you'd miss out on the rest of the
: piggy bits but I don't know how much of that we actually use. Just a
: thought.
Here are more thoughts:
Other than dosage questions, why are over 90% of the problems with meds that
we read about here to do with synthetics and not natural thyroid?
Could it be that the piggy bits in desiccated thyroid (e.g. Armour) other
than T4 and T3 actually serve a purpose that hasn't been discovered yet?
As I suggested in another post, perhaps Nick's conversion problem is
something that is correctable. Rather than continuing to drive a car with
lowered gas mileage due to mechanical problems, why not get the mechanical
problems fixed and improve the gas mileage that way instead of continuing to
pump extra fuel into the car? (Hey, you started the car analogies.)
Lois
Lois
: Just remember to watch it carefully. Occasionally I have to take an
: extra pill too but if it is to soon or too much you can have hyper
problems
: real darned quick and THAT needs attention immediately. Your trip could be
: ruined if you aren't careful.
Thanks, John. I was thinking more in terms of an extra 1/2 pill, but what
hyper problems are you talking about that need attention immediately, other
than hunger? I did a 2-day mountain biking trip last spring when I was hyper
(just before I realized it), and the only problem I remember was not having
packed enough food to satisfy my ravenous appetite. Fortunately, we crossed
paths with civilization at around noon, and I was able to get more to eat.
What should I watch out for?
Nick
wrote:
> Well, Nick, I wonder if you would be better off doing like those of us
>on both T3 and T4 synthetics. Of course you'd miss out on the rest of the
>piggy bits but I don't know how much of that we actually use. Just a
>thought.
I'd rather go for Armour plus T3 synthetic if I'm going to do anything
different.
Nick
>What should I watch out for?
>
Heart rate, particularly with excercise
John Riggs
excessive heart rate.
You might try to take a pill and dissolve it in water ( say about 16
ounces ). Now, just a thought, but if you do that you should be able to
drink a portion of that water and take an eansy, tiny bit at a time to help
without too much time or hassle ( just remember to keep THAT bottle separate
from your regular water ).
If you are taking T4 your body should already be making what you need by
conversion ( unless THAT is your problem ).
Just a couple of thoughts to help keep you around. Not too many people
will go head to head with Ted. Personally, I rather agree with him too much
to be able to even consider how to approach being on a decidedly different
side of a problem.
Lois <no_...@infoserve.net> wrote in message
news:vJw44.110$0c5.2...@news1.van.metronet.ca...
John Riggs
instances and so it is more feasible and cost efficient to continue the
current method of operation or medication ( which ever the case may be ).
Lois <no_...@infoserve.net> wrote in message
news:VKw44.111$0c5.2...@news1.van.metronet.ca...
>John Riggs wrote ...
>: Well, Nick, I wonder if you would be better off doing like those of
us
>: on both T3 and T4 synthetics. Of course you'd miss out on the rest of the
>: piggy bits but I don't know how much of that we actually use. Just a
>: thought.
>
Jennifer Harmon
<no_...@infoserve.net> wrote:
> Other than dosage questions, why are over 90% of the problems with meds that
> we read about here to do with synthetics and not natural thyroid?
Perhaps because over 90% of the people taking thyroid replacement are
taking synthetics? I don't actually know this to be the case, I'm just
speculating.
Jennifer Harmon
Warning: I'm merely a self-educated patient, not a doctor. I'm not
qualified to give medical advice.
John Riggs
away from help you are screwed. I tend to think THAT can be a bit life
threatening. I would rather you thought of how to keep from having that
happen.
I've noticed the hyper ( heart racing and sensation of pressure in my
chest ) when I get too much so at my age I don't want to push the issue even
though my plumbing is still quite desirable ( a leave over from my lifting
and aerobics days ).
Lois <no_...@infoserve.net> wrote in message
John Riggs
><snippety-snip>
>Other than dosage questions, why are over 90% of the problems with meds
that
>we read about here to do with synthetics and not natural thyroid?
>
>than T4 and T3 actually serve a purpose that hasn't been discovered yet?
You know, THAT is a question I was hoping I could get answered as I have
a gut instinct type feeling that hter is more than just the T3/T4 components
AND they just don't want us to know ( that's for you conspiracy folks ). I
wish I had the answer. I suspect our Shell Answer Man has an answer but is
afraid it's going to be a long, dry post if he replies.
Lois
: You could cause yourself a nice heart attack beyond the nervousness
and
: excessive heart rate.
:
: You might try to take a pill and dissolve it in water ( say about 16
: ounces ). Now, just a thought, but if you do that you should be able to
: drink a portion of that water and take an eansy, tiny bit at a time to
help
: without too much time or hassle ( just remember to keep THAT bottle
separate
: from your regular water ).
Thanks for the idea. Or, I might carry 1/4 pills with me. Maybe I won't need
them at all, but maybe I will.
: If you are taking T4 your body should already be making what you need
by
: conversion ( unless THAT is your problem ).
I've never been on T4 only, so I don't know about that, but I do know how
demanding cycling-camping trips are on the body. And because we're
self-sufficient as a group, we need to carry such things as a first aid kit,
spare tire tubes, a tool kit, etc., so it makes sense to me to carry a
thyroid first aid kit, too, if I learn beforehand how to use it.
: Just a couple of thoughts to help keep you around. Not too many people
: will go head to head with Ted. Personally, I rather agree with him too
much
: to be able to even consider how to approach being on a decidedly different
: side of a problem.
It's the weekend, so we can talk about Ted behind his back. ;-) This isn't
the usual kind of question that ET can answer with his scientific know-how,
and he isn't sure, altho I consider his guess to be an informed and valued
one. You know why I go head to head with him whenever I can? First, we have
fun. Second, he has said that he doesn't like to be a discussion stopper. He
doesn't consider his opinions to be the last word, so why should we? With
our current discussion, we have Nick's first-hand experience and knowledge
to add to it, and that carries a lot of weight, too. Third, when there is
more than one opinion to be discussed, more information comes out. You like
to play and learn, too, and I hope you will join me more often on this side
of the line in the sandbox.
Your fellow Ted Fan Club member,
Lois
Usuff Omar
mental fatigue to hypothyroidism. I always wondered if my thyroid was under
active but my doctor said many years ago my T4 was in the normal range (albeit
very low normal) so I must be all right despite my foggy mindedness, thin hair,
poor memory etc. I accepted his verdict (I didn't know about TSH back then).
I recently got my TSH measured at 4.72. The first GP I saw, Olga, insisted I was
fine as this was just within the top limit for normal. Olga treated me
contemptuously and I shall always remember her as Olga the ogre for her lack of
humanity. But this time I was armed with this NG's info, lots of information from
the web and, importantly, Ridha Arem's book. I saw a second doctor who, God bless
her, put me on 50mcg synthetic T4 (Oroxine). That was just 9 days ago.
My question is - how long should I wait to go on T3?? I've been on T4 for 9 days
now and, as expected, my fatigue hasn't lifted. I don't think it will until I go
on T3. Arem's approach is to establish the correct T4 dosage based on a TSH of
under 2 and, if hypothyroidic symptoms persist, trade off some T4 with T3. But
it'll take ages to find my correct T4 dosage and I want to improve as soon as I
can. I can't wait for my Cytomel! (Tertroxin actually, as I'm in Australia).
What shall I do? Should I start taking a few mcg of T3 every day immediately and
gradually build up to 10 or 15 mcg? Will this affect my TSH level and make it
difficult to find my optimal T4 dosage? I want to climb out of my hole I'm in as
fast as I can... Any thoughts appreciated.
Usuff.
AH
fact it can take a year for you to feel better and you don't necessarily
need t3. 9 days is a ridiculously short amount of time for you to assess
'my meds aren't working', and your doctor will most likely not be receptive
until you give it a good try on the t4. Take it first am without food for 1
hour afterwards. Most people convert enough t3 so as not to require it.
Good luck!
--
Alyson
Usuff Omar <geni...@mail.smartchat.net.au> wrote in message
news:38533E97...@mail.smartchat.net.au...
John Riggs
TSH is doing. The suggestion by the NEJM is 10mcg of T3 ( daily ) and enough
T4 to bring the TSH into range ( personally, I feel best when it is below
1.0 ). The sugestion of staying on the T4 for now is you need to establish
some sort of range ( dose wise ) as T3 is about 4 times as potent as T4. I
was at 150mcg T4 a day and added T3, a dose reduction is usually in order to
accomodate the addition.
Kevin G. Rhoads
that
>we read about here to do with synthetics and not natural thyroid?
>
>Could it be that the piggy bits in desiccated thyroid (e.g. Armour) other
>than T4 and T3 actually serve a purpose that hasn't been discovered yet?
1) The other stuff could be useful. I tend to suspect it is.
2) However, given the predilection of most MDs to shove synth-T4 first,
then add synth-T3 if needed (some MDs) and to avoid that natural stuff
like the plague -- I suspect that the high proportion of synth-med problems
are due to the high proportion of people on synth-meds.
3) You know your body the best, but you canNOT be objective about it.
(That's why doctors don't treat themselves or immediate family.)
4) The person who doctors themself has a fool for a patient -- it IS
sometimes necessary to be foolish in that way, but . . . it is still
foolish even when it is necessary.
Nick has arranged to minimize the downsides of 3) and 4) by doing
his dose adjusting with the full knowledge and consent of his doctor --
a rather rare situation. The closer you are to that, the less likely you
will have a bad outcome.
At the other extreme is the person who attempts an emergency
self-appendectomy with only a Bowie knife, a mirror and
a bottle of whiskey . . . Sounds like a recipe for disaster to me,
but it is where you can get if you take the self-doctoring
to extremes.
Keep it all in balance. Remember the lesson of the
thermonuclear flyswatter --
d*mn effective at wiping out flies, but . . . also everything else
nearby.
--
Kevin G. Rhoads, Ph.D. (The Cheshire Cat for official Internet mascot.)
kgrhoads@NO_SPAM.alum.mit.edu
Lois
: >Other than dosage questions, why are over 90% of the problems with meds
that
: >we read about here to do with synthetics and not natural thyroid?
: >
: >Could it be that the piggy bits in desiccated thyroid (e.g. Armour) other
: >than T4 and T3 actually serve a purpose that hasn't been discovered yet?
Kevin wrote:
: 1) The other stuff could be useful. I tend to suspect it is.
Doesn't the argument for synthetic hormones vs. natural remind you of the
push to use infant milk formula rather than breast milk for babies? It's now
accepted in the developed world that the natural product is far superior,
but I read a few years ago that infant formula companies were pushing their
product in developing countries, trying to convince parents there that a
formula was better than what mothers' bodies produce. Since being hypo is
less common than having babies, I don't know if natural will ever be
generally recognized as better for thyroid hormone replacement.
: 2) However, given the predilection of most MDs to shove synth-T4 first,
: then add synth-T3 if needed (some MDs) and to avoid that natural stuff
: like the plague -- I suspect that the high proportion of synth-med
problems
: are due to the high proportion of people on synth-meds.
That sounds like a reasonable argument, but it still could be that there
simply are more problems with synthetics. I haven't been keeping track of
problems with desiccated thyroid, but I can remember only 2 complaints about
it in the past year or so, but numerous ones about synthetic drugs. There
are a couple of websites where patients who might still be on desiccated
thyroid are advocated to switch to the synthetic hormones. That sounds like
brainwashing to me, and it scares me. Does anyone here have any natural vs.
synthetic stories to share?
: 3) You know your body the best, but you canNOT be objective about it.
: (That's why doctors don't treat themselves or immediate family.)
We can't be objective, but when you listen to a doctor spout the rubbish
about desiccated thyroid not being as good because it isn't standardized, or
say that only T4 is necessary, or that the patient is fine because the TSH
is "in range" even though the symptoms are still there, do you consider such
a doctor objective? They are simply parroting what they've read, which isn't
based on reality.
: 4) The person who doctors themself has a fool for a patient -- it IS
: sometimes necessary to be foolish in that way, but . . . it is still
: foolish even when it is necessary.
I wonder about this. I've made mistakes by self-medicating and I'm being
careful not to go there again, but what would you say to those who are very
informed about their hypo condition, perhaps more than their doctors, and
can't find a doctor to prescribe T3 or Armour, but can buy it on the Web?
This is not my situation, but if it were, I would be tempted to, as you say,
be foolish.
: Nick has arranged to minimize the downsides of 3) and 4) by doing
: his dose adjusting with the full knowledge and consent of his doctor --
: a rather rare situation. The closer you are to that, the less likely you
: will have a bad outcome.
:
: At the other extreme is the person who attempts an emergency
: self-appendectomy with only a Bowie knife, a mirror and
: a bottle of whiskey . . . Sounds like a recipe for disaster to me,
: but it is where you can get if you take the self-doctoring
: to extremes.
I should add that when I asked the question about taking additional hormone
on strenuous days when I felt my energy crashing, my intention was to get
all the information I could on the subject here and then discuss it with my
doctor, who is quite open-minded. However, some of my cycling trips are in
the mountains, where we might be a day or 2 from civilization, and I've
sometimes wondered what we would do if someone developed acute appendicitis.
Thanks for the tip. ;-)
Lois
suze1...@yahoo.com
> Doesn't the argument for synthetic hormones vs. natural remind you of the
> push to use infant milk formula rather than breast milk for babies? It's now
> accepted in the developed world that the natural product is far superior,
> but I read a few years ago that infant formula companies were pushing their
> product in developing countries, trying to convince parents there that a
> formula was better than what mothers' bodies produce. Since being hypo is
> less common than having babies, I don't know if natural will ever be
> generally recognized as better for thyroid hormone replacement.
This is not an exact analogy as pig thyroid is not the same as human
thyroid - infants are not fed pig milk and it is known that cow's milk is
very different than human milk. I had more severe up and down symptoms
on Armour than I ever had on synthetic T4 or T3 even though these still
fail to make me feel well. I hoped Armour would be the magical key to
wellness but so far there is none since my thyroid was messed up.
=
> : 4) The person who doctors themself has a fool for a patient -- it IS
> : sometimes necessary to be foolish in that way, but . . . it is still
> : foolish even when it is necessary.
>
> I wonder about this. I've made mistakes by self-medicating and I'm being
> careful not to go there again, but what would you say to those who are very
> informed about their hypo condition, perhaps more than their doctors, and
> can't find a doctor to prescribe T3 or Armour, but can buy it on the Web?
> This is not my situation, but if it were, I would be tempted to, as you say,
> be foolish.
>
Obeying the dr. at times can harm you even more than doctoring yourself.
The reason is they rigidly go by the book or other patients' experiences,
and believe a dose must be stuck to for 3 mos. to prove its effect,
whereas you live with your symptoms every day and know how different doses
feel and can tell if you are in distress from feeling either hypo or
hyper.
In efforts to lower my TSH, I was overdosed more than once and was in
danger. To continue on the excessive dose for 3 months as they wanted was
impossible. Even with the best endocrinologist in the city now, the
president of the department at the main hospital, he is only guessing and
I am his guinea pig. His latest guess (add .5 - T3 at the end of the day
to prevent fatigue) is no different than my guesses for years (take less
when heartbeat is racing, divide the doses, etc.) His guess made me hyper
too, and from fatigue I went to insomnia and constant tremors. There is no
final solution yet for me. I often wonder what percentage of thyroid
replacement patients ever find a dose that works for them most of the
time.
Ted Huston
> I haven't found any good information about calcitonin. Anyone?
Fortunately (?) calcitonin is also produced by the parathyroids.....
Other than that.... It is released when calcium levels are too high, to serve
as a check on parathyroid hormone and vitamin D. Obviously it is used in
treatment of osteoporosis, so it seems to me to be worthy of keeping going
rather than dismissing, too.
Jennifer Harmon
well. I hope mine are working overtime to make up for the dead thyroid.
I wonder how the calcitonin situation bears on the conflicting studies
that seem to show (or not) bone loss associated with thyroid replacement.
Jennifer Harmon
--
Rochelle Mehr
Usuff,
I know how hard it is to wait but Alyson and John are right to advise
you to do so. Adding T3 will definitely affect your TSH level and
make it difficult to find your optimal T4 dosage. And it is possible
that you will not need T3 ; T4/T3 therapy is much more difficult to
manage than T4-only therapy so you wouldn't want to start taking it
unless you are sure that you are not responding adequately to T4
alone. It may not "take ages" to find your correct T4 dosage since
your baseline TSH of 4.72 is not that high. Give it the 6-8 weeks
necessary to stabilize the levels and then get lab tests (including
Free T4 and Free T3). Remember not to take the T4 in the morning
until after the blood is drawn for the test. Then, if your TSH is
between 0.5 and 2.0, try to wait at least the three to four months
that Dr. Arem recommends before considering adding T3 (and lowering
the T4).
Rochelle
Rochelle Mehr
"Rochelle Mehr" <rochel...@gte.net> wrote in message
news:97n64.2261$9K2....@dfiatx1-snr1.gtei.net...
It may not "take ages" to find your correct T4 dosage since
> your baseline TSH of 4.72 is not that high.
I don't want to suggest that your TSH will definitely stabilize
between 0.5 and 2.0 in just 6-8 weeks. It could take longer, you
might need an adjustment in the dose.
Rochelle
John Riggs
an idea of what they propose as far as dosing. If you can get a copy of the
article for your doc it will help your case tremendously.
Usuff Omar <geni...@mail.smartchat.net.au> wrote in message
news:385B03DC...@mail.smartchat.net.au...
>Rochelle,
>
>Thanks for the advice, especially on not taking meds on the day of a
>blood test. Yes, it is hard to wait for T3. After two weeks on 50mcg
>oroxine (the synthetic T4 prescribed here in Australia) I'm finding it has
>only a marginal effect on my mood and energy level. I sort of expected
>this as I took thyroxine for several months in 1979 for my falling hair
>but found it made no difference, so I stopped taking it. But, twenty
>years on, with the info from this NG and Arem's book I realised what went
>wrong so I resumed taking T4 two weeks ago. This time round I noticed my
>cardiovascular functioning improved because of it (I can tell because I
>jog on the treadmill at my gym).
>
>I'm a little impatient to start taking T3 because my life is on hold
>(stopped working). Its like you were locked away in a prison and can only
>sit in your cell and do nothing all day. In my biological prison I sit and
>wonder about T3 alot of the time. In the 6 weeks I've read posts on this
>NG I haven't come across one that sings the praises of T4 alone, but lots
>for T3/T4. And, if my reading of the February 1999 NEJM study is correct,
>the majority of any random sample of 33 hypothyroids do better on T4/T3,
>which seems to imply any hypothyroid will probably do better on T4/T3. I
>also find it interesting that in the books I've read on the thyroid
>(except Arem's), the case studies go into detail about symptoms and the
>diagnosis of hypothyroidism but are silent on how the patient progresses
>after taking T4 alone. Hmmm. If the T4 I'm already taking has such a
>quick and noticeable effect on my cardiovascular system it makes it more
>difficult to believe "everything takes time".
>
>I'm not proposing to immediately take the full dosage of T3 of around
>10mcg a day but to start with a severe under dosage of one or two mcg and
>to monitor the effects on my mood and brain function, then to gradually
>increase the dosage every 6-8 weeks based on TSH, FT4 and FT3 blood
>results. That's the plan with T4, so why not T3 as well? This way some
>of the effects of T3 may kick in early and I can be on parole from jail.
>In any event its all academic as I can't get a hold of T3 as my GP won't
>agree and I haven't found an online source that will deliver without a
>prescription. Anyone want to send me some (half jokingly)?
>
>Thanks Alyson and John for your replies, and Rochelle for appreciating how
>hard it is to wait. I'm torn between your sensible advice to wait (who
>knows, maybe I'll do just fine on T4??, I'm new at all this) and my
>eagerness to start functioning again. Under the circumstances I have no
>alternative but to wait it out, unless a good samaritan wants to share
>their cytomel with me.
>
>Usuff.
Usuff Omar
Rochelle Mehr
Usuff,
I haven't read any post on this newsgroup either from anyone who
"sings the praises of T4 alone" and T4 alone certainly did not work
for me. (I'm still not feeling well, just increased my dose of T4 two
weeks ago, but there is some slight improvement. I am also taking 10
mcg. Cytomel.)
If you go to http://thyroid.about.com and then go to the bulletin
boards (thyroid forum) and post your question about whether anyone
there feels well on T4 alone (or look it up in the archives), you'll
see from the responses that some people do.
I think that you may see a cardiovascular response to the T4 before
you see a response by some other systems of the body. Different
systems seem to respond at different times. For example, the effects
on skin and hair may take months to abate. The central nervous
system? I don't know. This is just speculation but perhaps it might
take a few weeks or a couple of months; antidepressants can take that
long to work and thyroid hormone and antidepressants both act on the
beta-adrenergic receptor, if I remember correctly.
I wish I had something more comforting to say than "wait." I know how
hard it is to feel that your life is on hold; I feel the same way
right now. But by starting the T4 you are making progress. Even if
you eventually end up adding the T3, you are on your way to
establishing your T4 dose now and that is important as it will guide
you later in determining how much T4 you'll need with the T3.
Rochelle
Nick
wrote:
>
>I'm not proposing to immediately take the full dosage of T3 of around
>10mcg a day but to start with a severe under dosage of one or two mcg and
>to monitor the effects on my mood and brain function, then to gradually
>increase the dosage every 6-8 weeks based on TSH, FT4 and FT3 blood
>results. That's the plan with T4, so why not T3 as well?
The philosophy of 6 week dose changes on T4 is that it takes that long for the
levels to stabilise in the blood stream.
T3 has a much shorter life in the body and would probably stabilise in levels in
1 week, certainly 2.
There is a complication if you are on less than a full replacement dose in that
the addition of T3 will lower TSH which in turn reduces your own thyroids
hormone production and hence this changes the T4 levels that then take longer to
stabilise.
Lois
:
: The philosophy of 6 week dose changes on T4 is that it takes that long for
the
: levels to stabilise in the blood stream.
:
: T3 has a much shorter life in the body and would probably stabilise in
levels in
: 1 week, certainly 2.
:
: There is a complication if you are on less than a full replacement dose in
that
: the addition of T3 will lower TSH which in turn reduces your own thyroids
: hormone production and hence this changes the T4 levels that then take
longer to
: stabilise.
Oh, no. Can't you change that, Nick? You're messing up my plans. :-(
My situation is that I started on a too-low dose of desiccated thyroid at
the end of Oct. and have been gradually increasing the dose with my
internist. I'm on 30 mg/day and am hoping to increase it again after my next
appt on Wed., which will be 3 wks after the previous increase. The internist
thinks it isn't necessary to wait 6 wks to increase the dosage and I like
that way of thinking. I'm also working with a time line--I have a cycling
vacation coming up in Feb., and I'm the group leader. With a current free T4
of 11.9 in a range of 11-22 (this dr. prefers to measure fT4 instead of the
TSH), I have a ways to go, and how am I going to get there if we don't
increase the dose every 2-3 wks? But by doing this, am I messing up the T4
level? I realize the original question was about adding T3 to synthetic T4,
so perhaps my concern doesn't relate to your explanation, but I'm confused.
In my situation, do the advantages of increasing the dose every 3 wks
outweigh the disadvantages, or vice versa?
Thanks,
Lois
Nick
>
>In my situation, do the advantages of increasing the dose every 3 wks
>outweigh the disadvantages, or vice versa?
I'd go with it if your doctor is willing but get him to keep an eye on the free
T3 as well due to the mix you are taking.
I was talking about full stability of blood numbers and you don't need to get
full stability to know that you are under dosed.
My Doc sent me up a grain at a time at weekly intervals telling me to monitor
temperatures and pulse rate shooting for a maximum resting rate of 80 (from a
starting rate of 60).
I took a rest at 3 grains for longer than a week as my body needed time to get
used to this and started the increase again when the brain fog came back.
The thing with the T4/T3 mix is that if you feel you are over (my hyper
sensations are shaking hands and 'feeling' my heart beating in my chest) then
these wear off after a couple of hours from a slight overdose of the sort you
will get if you ramp up too quickly. This is because the T3 component tips you
over the edge first and that wears off quickly.
If your Doc supports it go with the increase but watch that resting pulse.
Good luck
Lois
: I'd go with it if your doctor is willing but get him to keep an eye on the
free
: T3 as well due to the mix you are taking.
I probably don't need to worry about the T3 yet as I'm not near where I want
to be, but when I get closer to the target, I'll check it. (Because I'm "in
range," I don't think it's covered by my medical insurance, but it isn't
really expensive.)
: My Doc sent me up a grain at a time at weekly intervals telling me to
monitor
: temperatures and pulse rate shooting for a maximum resting rate of 80
(from a
: starting rate of 60).
My resting pulse rate can be as low as 48 (76 is hyper for me), so I might
ask my dr. to increase at shorter intervals now.
: I took a rest at 3 grains for longer than a week as my body needed time to
get
: used to this and started the increase again when the brain fog came back.
I was slowly feeling better until this past week, I felt a drop in my
limited energy. I was wondering if it was because I'd been eating leftover
tofu lasagne all week (I usually limit my soy intake to about twice a week),
but you're saying that once your body got used to a dosage, your symptoms
came back. Hmmm. Did this keep happening until you were at the right dosage
for you? Did you wait until the symptoms came back before increasing the
dosage again? Were the one-week intervals when the dosage was too low for
the symptoms to disappear?
: The thing with the T4/T3 mix is that if you feel you are over (my hyper
: sensations are shaking hands and 'feeling' my heart beating in my chest)
then
: these wear off after a couple of hours from a slight overdose of the sort
you
: will get if you ramp up too quickly. This is because the T3 component tips
you
: over the edge first and that wears off quickly.
There's a difference between being hyper with high T3/T4 and low TSH levels,
and being temporarily hyper from a slight overdose, I think. I'm nowhere
near the former, so I doubt the latter could happen anytime soon, but I'll
watch for it.
: If your Doc supports it go with the increase but watch that resting pulse.
Thanks a lot, Nick,
Lois
Nick
>
>I was slowly feeling better until this past week, I felt a drop in my
>limited energy. I was wondering if it was because I'd been eating leftover
>tofu lasagne all week (I usually limit my soy intake to about twice a week),
>but you're saying that once your body got used to a dosage, your symptoms
>came back.
Yes, this 'compensation' is a common effect as your own thyroid reduces output
as a result of the changed TSH from the applied hormone.
> Hmmm. Did this keep happening until you were at the right dosage
>for you?
Many times
>Did you wait until the symptoms came back before increasing the
>dosage again?
Not really on the initial increases but I did on the later ones.
>Were the one-week intervals when the dosage was too low for
>the symptoms to disappear?
You would probably see it in a week.
Nick
>There's a difference between being hyper with high T3/T4 and low TSH levels,
>and being temporarily hyper from a slight overdose, I think. I'm nowhere
>near the former, so I doubt the latter could happen anytime soon, but I'll
>watch for it.
Do that, if it happens back off for a few days and then try again at the dose
that caused the hyper. You will probably find that you can tolerate it then.
Lois
: >I was slowly feeling better until this past week, I felt a drop in my
your symptoms
: >came back.
Nick wrote:
: Yes, this 'compensation' is a common effect as your own thyroid reduces
output
: as a result of the changed TSH from the applied hormone.
Lois wrote:
: > Hmmm. Did this keep happening until you were at the right dosage
: >for you?
Nick wrote:
: Many times.
This is interesting. I wasn't expecting this, and it sounds strange to me.
Why does the thyroid gland reduce output to compensate if the body still
isn't getting enough thyroid hormone? If it keeps doing this, do you have to
go a little hyper briefly and then wait for the latest output reduction to
reach the right level of thyroid hormones, gland-produced and supplemental
in combination? You said it's a common effect--does that mean it happens to
some but not all of us?
Perhaps the thyroid gland is like the government. They provide welfare
relief for those who have run out of other income, but when people on
welfare manage to earn a little money, the government reduces its output to
'compensate,' even though that bit of money isn't enough to raise their
standard of living to an acceptable level and it isn't raised at all when
the govt reduces its output. Another hmmm.
Thanks again,
Lois
John Riggs
it thinks is a proper level. That would account for the phenomenon. I'm sure
Nick will correct me if I'm wrong.
Lois <no_...@infoserve.net> wrote in message
news:dxB74.74$iw5.7...@news1.van.metronet.ca...
Jennifer Harmon
A compensatory reduction in hormone production by the thyroid gland
doesn't make sense to me as an explanation for the adaptation to a dosage
increase. If TSH falls or T increases, there must be a net gain: Thyroid
levels are higher than they were before the dosage increase.
I suspect that the "feeling better, feeling worse" cycle is partly a
result of the fact that higher levels of thyroid hormones increase the
requirement for thyroid hormones. That is, the more you have, the more you
need. As dosage goes up, metabolic rate, activity level, and clearance of
T4 and T3 all increase. When you reach your optimum dosage the effect
should taper off.
Another factor that contributes to the FBFW cycle is that, in
hypothyroidism, the thyroid shifts production from T4 to T3, and various
peripheral adaptations occur that make the best possible use of the
thyroid's limited output. When replacement therapy is begun and TSH falls,
these adaptations are reversed. The loss of adaptation to hypothyroidism
might explain why people often feel worse when they start treatment,
especially treatment with T4 alone. TSH falls, but T3 may also fall, and
peripheral T4->T3 conversion isn't up to speed yet (that, too is reduced
in hypothyroidism, in order to allow the brain to have first crack at the
limited supplies of T4.)
Jennifer Harmon
Warning: I'm merely a self-educated patient, not a doctor. I'm not
qualified to give medical advice.
--
In article <dxB74.74$iw5.7...@news1.van.metronet.ca>, "Lois"
Rochelle Mehr
"Jennifer Harmon" <mjha...@yahoo.com> wrote in message
news:mjharmon-211...@p237.204.ic.net...
> I suspect that the "feeling better, feeling worse" cycle is partly a
> result of the fact that higher levels of thyroid hormones increase the
> requirement for thyroid hormones. That is, the more you have, the more
you
> need. As dosage goes up, metabolic rate, activity level, and clearance
of
> T4 and T3 all increase. When you reach your optimum dosage the effect
> should taper off.
Jennifer,
This is just what it says in Chapter 9 Part 3 of the De Groot Online
Thyroid Disease Manager. I think it just happened to me. All of a
sudden, after starting to feel like I was at the threshold of getting
better, I felt the symptomatically like I did last July before my
Synthroid was raised. My worst symptom is this feeling of being slowly
asphyxiated. So I just raised the Synthroid again. I hope that what I
am now on (100 mcg. Synthroid and 10 mcg. Cytomel) is my optimum dose.
Rochelle
Lois
my doctor today, I printed them and brought them to him to see what he
thought. He didn't know. Interestingly, though, I told him *before* I found
out my latest blood test result that I had been feeling better and then
feeling worse. And whaddaya know, the numbers side with me. In a range of
11-22, the free T4 (this doctor prefers it to the TSH) was 11.5 at the end
of Oct., 11.9 in early Dec. when I was feeling better, and has now gone back
to 11.5. He said that I wouldn't be able to feel the difference of .4, and
that the numbers aren't exact anyway (which I agree with), but I did notice
a difference. I am happy to have another dosage increase, and I will watch
to see if the FBFW syndrome appears again.
Do any of your explanations include a drop in fT4?
Thanks,
Lois
---------------
Jennifer wrote:
: A compensatory reduction in hormone production by the thyroid gland
: doesn't make sense to me as an explanation for the adaptation to a dosage
: increase. If TSH falls or T increases, there must be a net gain: Thyroid
: levels are higher than they were before the dosage increase.
:
: I suspect that the "feeling better, feeling worse" cycle is partly a
: result of the fact that higher levels of thyroid hormones increase the
: requirement for thyroid hormones. That is, the more you have, the more you
: need. As dosage goes up, metabolic rate, activity level, and clearance of
: T4 and T3 all increase. When you reach your optimum dosage the effect
: should taper off.
:
: Another factor that contributes to the FBFW cycle is that, in
: hypothyroidism, the thyroid shifts production from T4 to T3, and various
: peripheral adaptations occur that make the best possible use of the
: thyroid's limited output. When replacement therapy is begun and TSH falls,
: these adaptations are reversed. The loss of adaptation to hypothyroidism
: might explain why people often feel worse when they start treatment,
: especially treatment with T4 alone. TSH falls, but T3 may also fall, and
: peripheral T4->T3 conversion isn't up to speed yet (that, too is reduced
: in hypothyroidism, in order to allow the brain to have first crack at the
: limited supplies of T4.)
-------------------
John wrote:
: Lois, I believe it reduces to compensate on it's own perception of what
: it thinks is a proper level. That would account for the phenomenon. I'm
sure
: Nick will correct me if I'm wrong.
--------------------
Nick
>
>Do any of your explanations include a drop in fT4?
If your thyroid 'set point' (ie the level that the hypothalamus/pituitarary is
trying to stabilise things at) is wrong then each time you have a dose increase
your body reduces it's own production to stabilise it back to where you were
before.
The time this stops happening is when you get to full replacement dose, your TSH
will end up around zero but your FT4 will be correct.
Your TSH will be low because your body 'thinks' it is hyper do to it's own
version of 'correct' being hypo.
I hope I've made myself clear.
Rochelle Mehr
>
> A compensatory reduction in hormone production by the thyroid gland
> doesn't make sense to me as an explanation for the adaptation to a
dosage
> increase. If TSH falls or T increases, there must be a net gain:
Thyroid
> levels are higher than they were before the dosage increase.
>
> I suspect that the "feeling better, feeling worse" cycle is partly a
> result of the fact that higher levels of thyroid hormones increase the
> requirement for thyroid hormones. That is, the more you have, the more
you
> need. As dosage goes up, metabolic rate, activity level, and clearance
of
> T4 and T3 all increase. When you reach your optimum dosage the effect
> should taper off.
Jennifer, Nick, and Lois,
From what I (who am not a doctor) can understand of Chapter 9 Part 3 of
the De Groot Online Thyroid Disease Manager, if the patient's thyroxine
clearance increases as his/her metabolism increases and, therefore, "a
dose of levothyroxine that is adequate when the patient is metabolizing
thyroxine more slowly may be inadequate when the patient is euthyroid,"
this should be reflected in the thyroid tests: the TSH should go up, the
Free T4 should go down. This is why they recommend repeating the TSH
test (although they elsewhere advocate monitoring both the TSH and
estimates of free T4) "after the patient has been euthyroid for
approximately 6 months."
But if there is a compensatory reduction in thyroid hormone production
by the thyroid gland after a dose increase because the pituitary is
stimulating it less (in order to maintain the thyroid level at the same
level, as Nick says), then the TSH should, of course, be lower. The
Free T4? Would it be about the same until the thyroid gland is
completely suppressed and at that point start rising to a therapeutic
level?
Of course, one could also feel worse after initially feeling better
after a dose increase simply because the thyroid gland is failing more
due to the autoimmune process and this should be reflected in the tests
as a higher TSH and a lower Free T4.
And, of course, the preceeding discussion presupposes the reliability of
the thyroid tests, something I am not sure we should do.
Rochelle
Rochelle
Rochelle Mehr
> the thyroid tests, something I am not sure we should do.
>
>
>
> Rochelle
>
> Rochelle
>
Sorry about the repetition. I was not trying to allude to a "Seinfeld"
episode.