Month 1 labs are in...

[medicmommy]

Hi all,
So..Here's the labs after 1 month of treating Hashi's hypothyroid with supplements that have dessicated thyroid in it (130 mg -per Dr equivalent to between 1-2 grains of armour) and changing my diet to gluten-free...
          Now                                               Was
TSH   1.58 (range 0.40-4.50)                    2.20 (w/reflex to FT4) -no other levels last time
T4                    7.9   (4.5-12.0)                
FT4                 1.3   (0.8- 1.8)
FT3                  2.7   (2.3-4.2)
T3 reverse        34   (11-32)                    
thy antibodies  584  (<20)                          750
thy peroxidase antibodies   161 (<35)         157
vitamin D 25      46     ((30-100)                  45

Parathyroid
PTH                  19    (10-65)
Calcium            9.3    (8.6-10.2)
ionized calcium  5.0    (4.8-5.6)        

So, I don't know what has made the difference (or its just coincidence), but in the last month the following symptoms have resolved: Palpitations, joint swelling, muscle and joint pain, insomnia, craving for seafood and avocados (no, I'm NOT pregnant), hot flashes, freezing constantly, and a little brain fog (probably because I'm sleeping better...) Currently I'm on Thyroid Plus (130 mg); 2 grams of calcium citrate/day; a multivitamin; 15 mg K2; 25 mg pregninolone; and 7000 units of vitamin D3/day. I'm still fatigued, but not as much..Thoughts? ~MM

[medicmommy]

Okay, okay...I hear all of you, and I won't do anything stupid. Everything I've read supports exactly what you've said and I do believe (and hear) you...this is so incredibly frustrating. I've finally discovered what's going on, and I'm beginning to feel a teeny bit better with just the supplements and diet change, but I know it needs just a bit more to achieve wellness...I've prayed for wisdom, -I got you all...But if I pray for strength, -I'm afraid I'll choke my Drs to death! Hmmm...maybe I should bring cookies to my next Dr appt...or a baseball bat. ;) ~MM

[goolarra]

I agree with Stella and Barb...you'd be doing much better trying a more conventional combination of T3 and T4.  ERFA (any dessicated) has a high T3 content compared to what our thyroids would be putting out if working properly.  The ratio of T4 to T3 is between 4 and 5 to 1.  Our thyroids put out about 20 to 1.  So, you will be getting your extra T3, but you will also have the balance of the T4.

There's a reason that T3 is seldom used by itself.  It's very potent (about four times more potent than T4), and it's very difficult to control.  Taken alone, it has to be taken in very small doses multiple times a day to avoid the hyper/crash cycle that Barb refers to.  I think a lot of doctors are reluctant to use T3 for this reason.

medicmommy, I think you might be going where angels fear to tread here.  Find a doctor who can write you a script and try a more conventional, less dangerous approach to this.  I hate to be a mother hen (can't help myself), but your idea of taking 25 mcg "to start" is frightening.  

[Barb135]

A dose of 25 mcg (1/4 of 100) is WAY too much to start with -- if you have anything left but powder by the time you get it split into 1/4's, as the pills are very tiny.  You could send yourself to "hyper land" very quickly........ I was started on 10 mcg, and it was too much.  I realize that we are all different, but I believe you would be headed for trouble if you start with a single dose of 25 mcg.  Cytomel/T3 goes into your system very quickly and is gone within a few hours; therefore, one dose of 25 mcg could send you hyper for a short time, then you'd crash.

There are websites from which you can buy cytomel without a script, but again, I'd be very afraid of the quality.  Anything sold OTC is not regulated by FDA and I would consider it questionable.  The amounts of actual medication may not be what they say they are, so you could very likely be left with nothing more than you have right now.

You will need a script for any thyroid medication that is of high enough quality to provide a therapeutic dose - that goes for both, the US and Canada.

Self medicating is never advisable. Have you discussed this with your NaturoPath?  I know there are some medications that a naturopath can't prescribe; I'm not sure if thyroid med is one of them or not, maybe that's why he's stuck on the Thyroid Plus......

Stella is right - you will need a balance of T4/T3, but the first thing you are going to have to do is find a good doctor that will work with you.  I'd much rather see you put your energy into that, than trying to self medicate.

[stella5349]

and stick with the D dosage too.

[stella5349]

I really don't think Cytomel is your only need.

We all have a RT3 involved and if the combo of T4-T3 is not properly induced the RT3 can spill off quickly causing more problems.

Go with ERFA.

[medicmommy]

Hmmm...I was hoping to get T-3 without a script (endo isn't cooperating and my Naturopath has more faith in the supplement's thyroid content than I do)...And I thought I'd try a trial of 25 mcg to start (cutting the 100s into quarters.) I don't plan on doing this without regular monitoring -and I'm not interested in experiencing anything like the thyroid storm I had in the past!...Taking a T-4/3 med does make sense for the Hashi's, but if the T-3 is what is deficient (maybe because of past liver damage and the T-4 can't convert to T-3 as well?), shouldn't I target that for supplementation? It would be easier if I could get a "Hashi's smart" endo, but until then, I am determined to do what it takes to stabilize the problem. Sigh. ~MM

[goolarra]

I agree that 100 mcg is a HUGE dose of T3.  In fact, 35 mcg is a fairly good size dose as well.

T3 is very tricky to use.  You can get yourself into hot water pretty quickly with it.  I'd strongly warn you against trying to dose it on your own, especially in the dosages available.  Even 1/4 (if you can beak it that much without turning it to powder...the pills are usually very small)  of 35 mcg could be too much for you.  Also, T3-only is rarely used, except on a temporary basis.  T3/T4 combos (either synthetic or dessicated) are much better choices in most cases.  Those dosages are probably aimed at body builders who are more interested in their ripples than their health.

Good luck whatever you decide, but DO be careful as well.  

[Barb135]

There are some on this forum who purchase Canadian ERFA thyroid med (I believe Stella does), and  yes, at this point, Customs lets it in, though I don't understand why you would want to buy cytomel from Canada, when you can get it here at a reasonable price. It requires a script in either country.

Please understand that 100 mcg cytomel is a HUGE dose and your levels do not warrant anything near that.  Depending on the dosage your doctor gives you, it's usually best to split cytomel into multiple doses/day.

[medicmommy]

Wow! -and Thanks! I was going in circles trying to figure out the supplement's thyroid content and strength. Very good information, and it certainly answers why beef thyroid (or raw) isn't used...I'd been eyeballing (thinking about trying) a 2 year old script of levothyroxine (I really should toss it) that I stuck in my fridge's butter drawer after recovering from thyroiditis a couple years ago. I realized yesterday this wasn't a good option if I really need T-3, not T-4. (Not to mention it's old.) So, if I can get it to clear customs, I'm gong to order the Cytomel and get that going.

My Naturopath is of the same thought process about controlling the antibodies to get the thyroid to a "happy place". The NG diet is step 1...He's also upped the vitamin D to 7,000/day (I'm actually taking 10,000 now -the amount that brought my level up to begin with.)
I continue to have a niggling worry in the back of my mind that my liver has lasting damage from the hepatitis C that I went through treatment (interferon + viral suppressant) for 3 years ago (also when the thyroid storm/ thyroiditis happened). The liver enzyme levels are fine, no traces of the virus survive, but little things like the vitamin D not coming up, and the T-3 being off make me wonder...I guess it doesn't matter for now as the treatment is still the same...
I can hardly wait to get a good grip on all of this! I am determined to make this my "year of wellness"! It annoys me to no end that my "traditional medicine" doctors aren't a cooperating part of the solution, but ah well, I've been there before and I am not squeamish about taking matters into my own hands. HA! So my parting words to uncooperative, misdiagnosing doctors everywhere, "You can kiss my a$$! Not on the right side. Not on the left side. -But right in the middle!" :) ~MM

[goolarra]

Believe me, I understand your disgust with what I am calling the military/medical/industrial complex (sorry, Ike).  I haven't had much luck with doctors, either, except that I have found an endo that I love...he listens, he always considers my opinion, etc.  It's worth it to take the time and find someone you can work with.  Good doctors are out there.

A lot of mainstream doctors haven't a clue about T3 meds or RT3 or they don't "believe in" poor conversion and RT3 dominance.  It's very sad.  You might consider pre-interviewing some doctors to get a feel for their philosophy before making any appointments.

I don't know if bovine thyroid is less potent than porcine.  However, porcine thyroid is the closest to human thyroid.  I was on a thread a while back where a guy was trying to put words in my mouth and make me say a supplement was the same as dessicated porcine thyroid.  So, I did some research at that time, but without a company website name found it almost impossible to qualify my search.  From what I did read,I was left with the impression that the T3 and T4 is removed from bovine thyroid in supplements leaving nothing but the thyroid tissue itself.  If you get a definitive response from the company, I'd really be interested in their answer to T3 and T4 content.

I agree with Stella...talk to your doctor about real meds.  Don't go it alone.

Keep us updated on what you find out...

[stella5349]

You're responding - and - craving iodine MM too. That is a PLUS believe it or not and if your body is telling you to eat it.. then you need it!

[stella5349]

I was going to check into this product MM and seeing this post I started to,

Here is the ingredient levels of what I found on your supplement.

Supplement Facts Serving Size: Two (2) Capsules Servings per container: 60

Amount Per Serving: Vitamin B-1 (Thiamine HCI) ..............
30 mg Vitamin B-2 (Riboflavin) ....................
50 mg Niacin/Niacinamide(50/50)...............
50 mg Magnesium (Aspartate) ...................
200 mg Zinc (Picolinate) ...............................
10 mg Manganese (Citrate) .........................
10 mg Iodine (Organic) ............................. .
0.45 mg Thyroid............................................
130 mg A Proprietary blend of the following: Potassium (Aspartate), L-Tyrosine, L-Aspartic Acid............................ 750 mg

Other Ingredients: Rice powder, magnesium stearate, gelatin.

RECOMMENDATIONS: Any recommendations made are based upon the discretion of a physician.

WARNING: Thyroid supplementation should be monitored by a physician on an ongoing basis. If you are pregnant or breast feeding, consult your physician before using this product. May cause a reaction with other thyroid medications. If heart palpitations, excessive sweating, or hyperthyroidism occur, discontinue use. Do not exceed four (4) capsules in a 24 hour period.

Contains no preservatives.

** So here is my thoughts**

On actual thyroid in here this is a bovine RAW thyroid mix. It is ratioed  out as a .45mg - rougly under a 1 grain found in porcine. There are no ratios of T3 and T4 found and with bovine thyroid it doesn't measure as porcine doses with the 38 T3 found in that.

With it being labeled as "supplement" the regulation of how the bovine product is manufactured in the pill will be semi-inconsistant and with the mixture only as raw - the ratios can swing more without fault of the pills. This meaning you could find one batch you purchase seems to be better than others from time to time. With thyroid stability - consistancy is really important and you may not find one bottle to the next being able to support you the way you need for long term treatment.

Also looking at the bottle listing, I feel this is more an immune support formula than an actual thyroid booster of hormone itself.

I'd like to go back to the labs you had done. Clearly the FT3 is an issue. The other concern is definately the low Vit D with the higher values of the TPOab tests. So here are my thoughts.

You found improvement  with using this supplement - more on a immune booster than thyroid help, which is a positive impact on you. That can change things better for most illness with improving immune function. Along with going GF that too helped "clear out the garbage" - :)

To look at thyroid wellness is another issue. Your ratios are not where most find optimal health and my feeling is if the raw bovine is helping you getting on a consistant porcine - dessicated will really help you that is produced consistant.

I think you found your supplements you need on a regular basis with the zinc, magnesium, The B's, and possibly the amino acids too. However the lack of consistant thyroid and D's is keeping you off.  

I think going on direct supplements above, eliminating the bovine thyroid and getting a script of desiccated thyroid ( Canada ) around 2 grains total daily will be better. Also you need to raise that vit D level with the meds to about 80 on the lab and only taking a Vit D3 script or quality D-3 supplement will help you get things more on track to feel excellent.

The rule of thumb so many are finding about Hashimoto and low vit D is
raise the D and watch the antibodies fall"  When you destroy the function of Hashi's then you are able to correct thyroid function with meds to stabilze you.

You're close MM.... so close you should taste victory soon. Just look and talk to your doctor about real dessicated and preferrably not Armour thyroid either, and raise that D - level with what you are doing.

[medicmommy]

My endo (the one I'm ditching) called and said everything was "fine" and said the high reverse T-3 was caused by some sort of "stress". I asked about the antibodies and the upside-down levels of FT-4/FT-3 and got the verbal "shrug" and the reply that no medications were needed. (Again I got the feel they think I'm a nutball and they think the hypo symptoms are in  my head...Puh.)
So, if it comes to it, have you had any experience with ordering prescription from outside of the US? I was wondering if customs will let it through. I found a site in Canada that will sell Cytomel in 35mcg and 100 mcg (it is suggested to break them into quarters) strengths without a prescription...If I do this, I will monitor my own levels and seek higher medical if needed...I'm not being stupid about this, I'm just a bit fed up with Drs who will happily take your money but won't fix the problem...~MM

[medicmommy]

Thanks for the look-see and the info! -I did not know that about the T-3...

I wondered about the thyroid content of the supplement as well and I asked my Dr if it was dessicated thyroid, and he said it was...and the weight (130 mg) is equivalent to roughly 2 grains (1 grain = 60 mg). So until your post, I'd assumed all thyroid was created equal...But it is bovine origin..Is cow thyroid weaker than pig? -I'm assuming so and this is why pig is the standard instead...If this is the case, I'll use "bovine thyroid" in the future. I don't want everyone thinking this can replace their meds -but it does seem to be doing something for me...:)
I'm going to e-mail the company and see if I can't get the to "spill the beans" about the actual hormonal content as I'd really like to know! If/when I go onto prescribed thyroid meds, I want to know if this is safe to take with it (if I choose to keep taking the supplement). I do believe you about the FDA approval system and prescription content, as I am aware of how supplements are "qualified" as well as prescription meds...Thus, more investigation...thanks again and I'm going to look into the FT3 issue...~MM

[goolarra]

Your FT4 looks good; it's right at midrange. However, FT3 is very low.  It's in the bottom fifth of the range, and upper half to third of range is the rule of thumb for FT3.  Also, your RT3 is way too high (above range), so it looks like you have an RT3 dominance problem.  

Our bodies convert T4 into both T3 and RT3.  RT3 is a mirror image of T3, but is inert.  It can dock "upside down" at T3 receptors in cells blocking T3 from getting in where it's needed.  Taking some T3 might help.

Unfortunately, you don't have anything but TSH from before starting meds, so we can't see if a trend might be developing in your labs.

Your vitamin D level doesn't seem to be going anywhere fast...that could be part of the reason for your fatigue.

Correct me if I'm wrong, but I don't believe your supplement is "equivalent to between 1-2 grains of Armour".  Armour (or any of the prescription dessicated porcine thyroid meds) contain both T3 and T4.  I'm under the impression that nothing with a measurable T3 or T4 content can be sold in the U.S. without a prescription.  I believe your supplement contains bovine thyroid from which all hormones have been removed.  Since we use the term "dessicated" as a generic term for prescription dessicated porcine meds, it might be best to adopt another term for the supplement you are taking to avoid confusion.