FT3 and Cholesterol

[artms]

I have been reading that there is a correlation between LDL, Cholesterol and FT3 in particular. Yhat raising the FT3 level will improve LDL and cholesterol. With LDL it has to do with reducing receptor sites. Has anyone here seen an improvement in their lipid panels as the FT3 got in the upper normal range?

[artms]

Certainly it's always good to look at the specifics in any study in terms of it's objectives and funding as well as the respect it may garner  in the medical community. Some things ring true and seem to be born out in the experiences of so many and some seem to exist too much in the fringes. I do believe the statistical analysis in reliable studies are very helpful in determining a course of action.

[flyingfool]

Well I'd rather feel well then listen to Dr's who keep people sick because they have only believed in TSH or reference ranges.

Story after story after story are all over telling us how the medical industry and many Drs if not most tend to treat their patients this way.  Often times people have lost YEARS of their lives feeling like crap because the ego of the Dr tells the patient that they are well, or prescribe anti-depressants, anti-psychotic, anti-anxiety drugs and many other unneeded drugs to cover symptoms because the Dr's are simply unwilling to believe that TSH is the end all, be all or that simply being within the bottom of a reference range is sufficient.

That is fact.

[moonlight0]

Scientific studies are not scientific facts, yet...Besides, some pharmacological companies are very aggressive and fund scientific studies that are specifically designed to "prove" and encourage people to take more drugs ! Would you believe them ?

[gimel]

I've started a new thread on which we can discuss these things.

[moonlight0]

I am Thyroid doctor and a thyroid patients as well

[flyingfool]

There were dozens of links. Which one was the Australian one?

Or maybe better yet is there a summary of the main links.

I'd love to go into my next Dr visit loaded for bear with connections of statins to diabetes and also the cholesterol to hypo links.  Maybe I could convince the Dr to switch from statin to thyroid meds and I'd be much healthier and reduce chances for diabetes.

[artms]

Barb I think you're absolutely correct. All of it is important.
Another thing that I think is really important is supplements, selenium in particular. As we age, we have so many changes going on. We can't skate by anymore. We have to address diet,exercise,lifestyle ,and be vigilant about all our issues. I think there's this domino effect when everything is addressed separately with all the treatments and side effects and treatments for side effects and OMG let me off this merry go round if possible.
We have to be sensible and methodical and be informed.I think it becomes a challenge to get all our ducks in a row and kudos to anyone who can. It takes so much time and energy but if we're dragging ourselves around or can't even get off the couch,forget it. We should have the medication at the dose  we need in order to move and correct the other issues. Being hypo is the worst and it doesn't have to be.

[Barb135]

I can point ya'll back to some of my first comments here; suppressed TSH, with not quite mid range FT3 and FT4, but have been able to rebuild bone lost to osteopenia, using a regimen of calcium, magnesium and vitamin D.

When I started on this journey, my TSH was 55+, FT4 below range and pcp refused to test FT3....

First test after starting on synthroid, my TSH was in the basement and has not come up since, no matter how much they reduced my med.

Once I started seeing my endo and he checks FT3, I was able to correlate TSH with FT3 for quite some time.

My cholesterol has coincided with FT3 levels until recently... Aug 2011, my cholesterol levels were perfect and FT3 levels were higher than they'd ever been... Nov 2011, cholesterol levels were high again, with FT3 levels near the same as Aug.. Feb 2012 cholesterol levels were back within normal ranges, with FT3 still the same, as Aug and Nov...... what changed?  Exercise - walking 3-5 miles/day....

While we know that low thyroid levels affect cholesterol, maybe once FT's get to a certain point, other factors, such as diet and/or exercise, kick in.  Seems to have, for me.

[artms]

You know this has been a long slog and a real wake up call for me. In the beginning you all were so helpful to me.I understood very little of my condition but had a gut feeling there was a disconnect between what I was experiencing and  what the Dr was telling me. When it all goes like clockwork no big deal but when things go wonky and don't add up it's time to get to work and figure it out. Thanks to forums and research availability we can gather info and put it all together. I wanted to find studies supporting the importance of FT3 and FT4 within the mainstream. It started with me trying to fight on a level plane with the Endo I saw until I realized it was a futile attempt. At that point I decided to look at my set of issues,see if there was a logical connection between them all and if I decided to 'go rogue' I could have some level of confidence that I would be doing the right thing and not further harming myself. I hope you guys have a chance to look at this stuff...see if you need more T3 LOL

[LazyMoose]

I was going to go to all those links,(lot of reading) but my T3 is starting wear off!

[LazyMoose]

I checked out PrivateMD, they have more online test purchases than any other like them that I've seen so far. Cheaper too.

[gimel]

Wow, that is a great link.  Thanks again.  I already gave it to another member, with credits to you.  LOL

[artms]

Here's another link I bookmarked

Hypothyroid symptoms but normal tsh levels how to treat symptoms of low thyroid by optimizing free t3 levels


http://www.worldlinkmedical.com/blog/hypothyroid-symptoms-but-normal-tsh-levels-how-to-treat-symptoms-of-low-thyroid-by-optimizing-free-t3-levels/

Info on this Dr Rouzier in terms of credentials
http://www.preventivemedicineps.com/Information/neal-rouzier-md.html

[gimel]

Good info and comment.  Thanks.

And I agree with the importance of the Australian study.  

[artms]

Flyingfool I encourage you and everyone else to not just read the excerpts but go to the links as well for full article. I think the links are all ok if not let me know. I didn't realize what a big deal the Australian study was till I saw all the other references.Running on Empty is really good and you can read most of it at googlebooks.
As far as labs go, I encourage anyone frustrated with a Dr who won't do their FT3 or FT4 to please go online and get your own labs done .I use PrivateMD and it cost me $66 for TSH and Frees. Google for their coupon code and enter it. After you get a lab they'll send you a code every week. You don't have to share the darkness with your doctor. Find out for yourself what's under the hood.

[artms]

So I think that these studies within the mainstream medical research are positive for us  regarding bone loss as well as lipids and cardiovascular problems.They seem to indicate to me at least that if you are overtly hypothyroid or even subclinically hypothyroid it causes cardiovascular problems.If you are hyperthyroid it's also detrimenta; The grey area is subclinical.Many Drs won't treat subclinical hypothyroid patients and don't check lipids. If they do treat them they may keep them in upper level TSH with low frees.On the flip side patients with high cholesterol may not be checked for thyroid even though they exhibit all the symptoms. If they were checked,even if they were subclinical. and were treated by getting their Frees into upper normal, it could go a ways to correcting their lipid levels. And obtw they can safely,according to the one study, get into subclinical hyperthyroid without too much cardio risk or, for women, decreasing bone density. But...we're talking exogenous subclinical hyperthyroid with in range FT3/FT4 and no hyper symptoms.
That's my take away from all this.

[flyingfool]

I have a dog in this hunt as well.

My father in law has been taking statins for years.  Now he has to test his blood and is controlling blood sugar with diet.

My father also taking statins and he also is borderline to diabetes.

I am on a statin for Cholesterol.  I hate that I'm on it.

I came to this site to educate myself for my wife's Hypothyroidism.  Come to find out that I have several symptoms as well.

Dr's only tested TSH which were fine in the 1.1 to 1.5 range for the last few tests.  After BEGGING and pleading I got my last Dr to finally test FT4 and it is very near the bottom of the range. But with the "perfect" TSH and the FT4 in the "normal range" I was unable to obtain even a starter dose of T4.

Along with that last blood test my cholesterol was down a LOT.  to total 106.

I swim 3 days a week and my diet is OK, not great but OK.  I was swimming right after getting the initial high cholesterol test back.  After rigorous exercise it did little to nothing for the cholesterol.  That is why they put me on Crestor.  And it has dropped the cholesterol and triglyceride levels. But at 106 there is too much of a good thing.

Also I am just about convinced that if I got my thyroid level up a bit,  That I'd be able to eliminate the Statin.  Since the last blood test I've started splitting my Crestor pills in half (5 mg per day instead of 10).  I'm about due for new test so I'll be interested to see how this cut back responds in blood labs.

I have been wary all along about Statins.  And I'd be happy to trade in my Statin for a Thyroid med.  Because having low cholesterol has no outward symptoms.  But I'd sure love to get rid of the Hypo symptoms (pretty mild but real and chronic as I type this out with frozen hands and a sweater on inside a 68 degree room) that I have.

I'd love to print this whole thread out for reference with my new Dr.

I'd like to know the connection between the widespread prescription of Statins to the nearly epidemic rate of Diabetes.  Connection????

What about obesity and diabetes which seem to correlate well together.  Well how about the thought that some of these people who are obese are Hypo which may cause the weight gain. Then they may also be on a Statin as well.  Could this combination be significantly contributing to the diabetes rate in the USA?????

I'd think there is enough of a question to ask and do some research.  I'd particularly like to see the correlation with FT3 and FT4 levels as percentages of the "normal" range as well as TSH.

Wouldn't it be interesting if a large percentage of obese people have otherwise normal TSH but their FT3 and FT4 are low in the "normal rage" and they also have high cholesterol and are issued statins as a result.  Then later they get diabetes.  They blame the over weight condition but maybe it was the high cholesterol medicine which was only prescribed because they missed the need to add thyroid.  I've been thinking about that connection for well over a year now.  But I don't have a billion dollars to invest in research to look into it.  And te Drug companies make more money selling Statins, and insulin than generic thryoid.  So they have no interest in doing the research.

[artms]

Running on Empty
Gimel Subclinical hyperthyroid for this study is  .04-.4 with normal FT3 and FT4, no symptoms. Note that the etiology of subclinical status is more important as a risk. These findings were beneficial to those with "exogenous" subclinical hyperthyroid resulting from thyroid medication as opposed to "endogenous" or those whose condition would naturally progress to hyperthyroid.I understand your concerns about the TSH and am impressed that within the endocrinology community these findings do seem to validate what we already know. Here's some more info for you thyrogeeks out there.Sorry if it's long.Some may be repetitious. And BTW more heads are better than one so I offer this to you, have at it and thanks for your input. I've learned a great deal and am happier for it.Thanks guys!
---------------------------------------------------------------------------------------------------------Note that low is .04-.4 mU/l
"We aimed to examine the safety of having a TSH which was either suppressed (≤0.03 mU/l), low (0.04–0.4 mU/l), ‘normal’ (0.4–4.0 mU/l) or raised (>4.0 mU/l) in a population-based cohort of patients all of whom were treated with thyroxine."
"People on long-term thyroxine with a high or suppressed TSH are at increased risk of cardiovascular disease, dysrhythmias and fractures. People with a low but not suppressed TSH did not have an increased risk of these outcomes in this study. It may be safe for patients treated with thyroxine to have a low but not suppressed serum TSH concentration."
Read the full abstract here:
http://www.endocrine-abstracts.org/e...a0021oc5.6.htm
5 March 2010 - 18 March 2010
Society for Endocrinology
British Endocrine Societies

http://www.australianprescriber.com/magazine/22/6/132/4
Risk of osteoporosis
There has been some concern that thyroxine given in doses that suppress serum TSH to undetectable concentrations might promote osteoporosis. Meta-analyses of various controlled studies in which thyroxine therapy has been (in some patients) excessive are difficult to interpret because of the heterogeneity of patients studied.12,13 One meta-analysis suggests that postmenopausal women with serum TSH concentration suppressed to below the reference range have a higher annual bone loss than healthy individuals not given thyroxine12; another suggests that thyroxine therapy, even when adjusted to give a TSH value within the range, is associated with bone loss in premenopausal women.13 However, a study of 1180 women (largely postmenopausal) on thyroxine for over 1 year found no increased rate of fracture when serum TSH concentration was suppressed to below 0.05 mU/L compared with those with a serum TSH concentration in the range
0.05-4 mU/L.14
It is likely that patients most at risk of developing osteoporosis from thyroxine therapy are those whose hypothyroidism has resulted from treatment of hyperthyroidism that might already have reduced bone mass. This view is supported by the results of a case-control study involving 148 women that examined the effect of previous thyroid history and thyroxine therapy on bone mineral density: thyroxine therapy alone did not represent a significant risk factor for loss of bone mineral density, but there was an increased risk of bone lost in postmenopausal (but not premenopausal) women with a previous history of thyrotoxicosis treated with radioiodine.15 The risk of osteoporosis from thyroid replacement therapy has probably been overestimated.

http://www.ncbi.nlm.nih.gov/pubmed/8...?dopt=Abstract
Our study suggests that slightly suppressive L-thyroxine administration in nontoxic goitre can activate bone turnover but constitutes neither an actual risk factor for bone loss nor, consequently, for osteoporotic fractures.

http://www.ncbi.nlm.nih.gov/pubmed/8...?dopt=Abstract
T4-suppressive therapy was associated with bone loss in postmenopausal women, which could be prevented by either calcium supplementation or intranasal calcitonin, although the latter did not provide additional benefit compared to calcium alone. However, careful titration of T4 dosage to maintain biochemical euthyroidism is a better way to avoid the adverse effect of T4 on bone.

http://hormones.gr/preview.php?c_id=171
In conclusion, the etiology of subclinical hyperthyroidism possibly affects BMD in postmenopausal women. Postmenopausal women with endogenous subclinical hyperthyroidism have significantly lower BMD, mainly at the distal and proximal cortical bone,versus healthy postmenopausal women. Therefore, endogenous subclinical hyperthyroidism (both of autoimmune and non autoimmune etiology) might be considered as an additional risk factor for oseoporosis in postmenopausal women. On the other hand, exogenous subclinical hyperthyroidism has no effect on BMD. Postmenopausal women with subclinical hyperthyroidism have a higher bone turnover rate in comparison with the control group, though they do not differ in biochemical parameters of calcium and phosphorous metabolism.
http://www.ccjm.org/content/77/11/803.full

http://hormones.gr/preview.php?c_id=144
The management of exogenous SubHyper relies on appropriate adjustment of T4 dosage taking into consideration a) individual requirements in T4, sex, age and the presence of cardiovascular disease or other co-morbidity, b) the recognition that small changes in serum FT4 have a logarithmic effect on TSH, c) the variability of FT4-TSH interactions between individuals, d) the instability of T4 preparations and its bioavailability, and e) the values of serum FT4 and FT3 that accompany a suppressed TSH. This last parameter is of importance since it is the free thyroid hormones values in the serum that generate and reflect the thyroid metabolic state of the organism rather than the degree of TSH suppression.

http://hormones.gr/preview.php?c_id=171
The etiology of subclinical hyperthyroidism influences B MD in postmenopausal women. Endogenous subclinical hyperthyroidism might be considered as an additional risk factor for osteoporosis in postmenopausal women, especially for cortical bone, whereas exogenous subclinical hyperthyroidism has no effect on BMD.
Therefore, it is likely that not only low TSH level but also the etiology of subclinical hyperthyroidism affect BMD.
exogenous subclinical hyperthyroidism has no effect on BMD.

http://www.ncbi.nlm.nih.gov/pubmed/17324919
Endogenous subclinical hyperthyroidism might be considered as an additional risk factor for osteoporosis in postmenopausal women, especially for cortical bone, whereas exogenous subclinical hyperthyroidism has no effect on BMD.

http://endocrinetoday.com/view.aspx?rid=62295
“Our findings confirm that it may be safe for patients with hypothyroidism to take marginally higher doses of thyroxine than our currently recommended,” Leese said in the release.
http://www.endocrine-abstracts.org/e...a0021oc5.6.htm
Society for Endocrinology BES 2010
Manchester, UK
15 March 2010 - 18 March 2010
Society for Endocrinology
British Endocrine Societies
http://www.imt.ie/news/uncategorized/2010/03/thyroxine-safe-with-low-tsh-levels.html
And finally on google books
Running on empty: hypothyroidism, introduction to an underactive thyroid gland
By Robyn Koumourou


This was an interesting back and forth with therapist about depression
http://www.dr-bob.org/tips/split/Thyroid-replacement.html

[gimel]

Just wanted to throw in my two cents worth.  

The study mentioned by artms caught my attention as well, since my TSH has been about .05, very suppressed, for well over 25 years.  Yet I have never had any heart problems or bone issues.  Since I am unaware of any evidence of TSH causing any of these things directly, then what is supposed to be the real cause, for which TSH would only be an indicator?  


By inference, I suppose it would have to be Free T3 and Free T4.  Yet we all know very well the number of reports that we have on the Forum of members with suppressed TSH, yet their Free T3 and Free T4 are well within the reference ranges.  Also, we know conclusively just how poorly TSH correlates with Free T3 and Free T4 before taking thyroid meds, and even worse after medication.  

I also noted that patients with high levels of TSH also had similar, or higher hazard rates than the suppressed group.  So are we to conclude that both too little and too much TSH causes heart problems and bone problems?  Not likely.


So what is the underlying possible cause for the different hazard rates?  Was there any attempt in the full study to try to explain why this would occur?  I don't know.  There was no indication of that in the abstract.   One thing that did come to mind is that if patients have underlying conditions for heart problems, or bone loss, then higher levels of Free T3 and Free T4, as reflected somewhat by lowered TSH, may exacerbate the existing problems,   I have no conclusion, just thoughts; however, based on my understanding of the fallacy of relying on TSH to accurately reflect the levels of the actual thyroid hormones, especially after taking thyroid medication, at this time I see no reason to lose any sleep over this study, or change my opinion about what a suppressed TSH represents.

[artms]

So good to know about statins and diabetes .Great article. Wow! One thing my Dr suggested as an alternative is red yeast. Anyone use that?

[Red_Star]

hi Barb...happy to pass that info on. I only know three women taking a statin drug and one has type 2 diabetes and two are pre diabetic!  75% who have a heart attack have normal cholesterol levels. The lipid hypothesis has more holes in it than swiss cheese. :)

[Barb135]

My TSH went to the basement, as soon as I was started on thyroid med, but with FT's either low or below range.  Doctors kept wanting to cut my med to bring up my TSH, regardless of FT's, and of course, every time, they cut my med, I went right back to hypo he// and had to start over.  My endo is the only one who adjusts my med and I don't have to fight too hard with him, because he goes by how I feel more than the TSH, even if he does cringe at my < 0.01 TSH.

It's not the low TSH that causes heart trouble, bone loss, etc; it's high levels of FT3 that does it.  I've had both a heart workup and bone scans since I've been hypo with severely suppressed TSH.  Cardiologist says my heart is fine, even though I have a couple of leaky valves.  I've got my bp pretty much in control now and my resting heart rate is around 50 - 55, but my cardio says that's okay because I'm active; I do yoga, which actually centers on deep, rhythmic breathing.  My last bone scan showed that I had actually rebuilt bone, previously lost to osteopenia - yes, in spite of my suppressed TSH.  This involved implementing a regimen of calcium, magnesium and vitamin D.

My FT3 is not quite to the upper 1/3 of the range yet, but endo did give me a slight increase in T3, in order to try to bump it up; I'll retest late this month to see where I'm at.

I'm on synthetic med(s) - Tirosint @ 88 mcg with generic T3 @ 7.5 mcg; like some others who have been around for a while, I feel better than I have in a very long time.

[LazyMoose]

typing error - "Extremely suppressed with over the top free T3/T4, is a different story, then yes; thats hypo." -obviously I meant thats hypEr.

[artms]

Many feel well with the FT3 in upper range. To get there the TSH often drops. It would be interesting to see if there is  a typical range of drop. Would it fall within the subclinical range? It did for me. Then if the drop is a little too much could you adjust to the low subclinical and still feel ok. Of course this may be more of an issue for women but still. It seems a good starting point for all the maladies would be the thyroid levels and then work out from there.
What started all this for me was my dr dropping my dose at the mere hint of low tsh. OMG saw an endo and she wanted to get my tsh to 1 and my frees were in the basement at .30 Never knew till this happened that you have to do so much work on your own to figure it out.