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	<title>Comments on: I am experimenting with adding T4 to my Armour</title>
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	<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/</link>
	<description>Thyroid Treatment Scandal and Hypothyroid Mistreatment</description>
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		<title>By: Pamela</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-31841</link>
		<dc:creator>Pamela</dc:creator>
		<pubDate>Wed, 21 Jan 2009 19:14:17 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-31841</guid>
		<description>I just have to add my name to this growing list of unhappy thyroid patients. Why are so many endocrinologists unwilling to accept the fact that the current mode of treatment is inadequate? Why is it so hard to get a free t3 test? I had always had some mild hypo symptoms but then was told that everything was normal because my TSH was 1.8. But due to a goiter, they recommended surgery. After surgery, I sank into a deep hole. I was completely incapacitated with all the hypo symptoms I had before surgery except now they were extreme symptoms. My TSH was 8.5 with a t4 of .8 and i was put on 80mcg Synthroid. When I reported that after 4 weeks I was still feeling horrible. I was told to see a psychiatrist. That doc refused to do a free t3. Thanks to this site, I immediately shopped around for a new doc and found one to prescribe Armour. I felt better the next day. I still have problems with weight gain, but my mental state is much closer to normal now. I think I may have an adrenal problem though and am going for new blood tests after being on Armour for 5 weeks. I know that if I didn&#039;t find this site, I would still be free falling on Synthroid and still unable to work. I was even reluctant to leave the house! After 6 weeks on 80Synt. my TSH was 2.5 (t4??). 2 weeks later I was prescribed more Synthroid. But by that point I had already switched to another doctor that gave me Armour. That first doc dismissed all of my symptoms. How is any endocrinologist supposed to evaluate a person&#039;s mental or physical state in a 15 min. office visit. If I say &quot;I don&#039;t feel normal&quot;, &quot;I&#039;m avoiding people because I know i&#039;m not normal&quot; shouldn&#039;t the doctor at least look into it? I&#039;m sure my chart says &quot;crazy&quot; on it, but at least now I can laugh about it because I don&#039;t have to see that doctor again. I can credit my health to this site and the information on how to get better, unfortunately, my doc with all that training did nothing but make me feel worse.</description>
		<content:encoded><![CDATA[<p>I just have to add my name to this growing list of unhappy thyroid patients. Why are so many endocrinologists unwilling to accept the fact that the current mode of treatment is inadequate? Why is it so hard to get a free t3 test? I had always had some mild hypo symptoms but then was told that everything was normal because my TSH was 1.8. But due to a goiter, they recommended surgery. After surgery, I sank into a deep hole. I was completely incapacitated with all the hypo symptoms I had before surgery except now they were extreme symptoms. My TSH was 8.5 with a t4 of .8 and i was put on 80mcg Synthroid. When I reported that after 4 weeks I was still feeling horrible. I was told to see a psychiatrist. That doc refused to do a free t3. Thanks to this site, I immediately shopped around for a new doc and found one to prescribe Armour. I felt better the next day. I still have problems with weight gain, but my mental state is much closer to normal now. I think I may have an adrenal problem though and am going for new blood tests after being on Armour for 5 weeks. I know that if I didn’t find this site, I would still be free falling on Synthroid and still unable to work. I was even reluctant to leave the house! After 6 weeks on 80Synt. my TSH was 2.5 (t4??). 2 weeks later I was prescribed more Synthroid. But by that point I had already switched to another doctor that gave me Armour. That first doc dismissed all of my symptoms. How is any endocrinologist supposed to evaluate a person’s mental or physical state in a 15 min. office visit. If I say “I don’t feel normal”, “I’m avoiding people because I know i’m not normal” shouldn’t the doctor at least look into it? I’m sure my chart says “crazy” on it, but at least now I can laugh about it because I don’t have to see that doctor again. I can credit my health to this site and the information on how to get better, unfortunately, my doc with all that training did nothing but make me feel worse.</p>
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		<title>By: Carla</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-240</link>
		<dc:creator>Carla</dc:creator>
		<pubDate>Sun, 26 Nov 2006 03:59:04 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-240</guid>
		<description>I too am at my wits end! I could explain my history but all you have to do is review the others to know mine. 

At age 44, I am in menopause, high cholesterol, 50 lbs overweight, no libido, cannot focus, pain all the time, exercised so much by running/jogging started to bleed from the intestines....I knew this was madness when it took me several days to recover from a colonoscopy that went wrong a few months ago. I was called to do yet more tests-I went to my dr who in the past appeared to be listening. She said the TSH was normal and states something about calories in and calories out- even people in the concentration camps lost weight-not sure what that was supposed to mean but I knew in her eyes she was not listening at that time nor was she ever. 

I said ok-the weight is my fault, I am not doing enough. What about the other symptoms. She said that she suspects it is some type of long term virus and we have not isolated it yet. Long term virus?? I have been fighting this for 6 years. I find it hard to believe any virus lasts 6 years. 

Most of my life, I was always a health nut, knew about reading labels and understood them long before it was popular. I served in the military for 4 years and found it invigorating to be so active. I was also very active before and had always went to the gym. Was out of the military for 8 years prior to onset of symptoms and was very active. My dr has me feeling sloppy and lazy to tell me it is my fault. She also told me to stay under 1200 cals. I spent these past 4 days on low cal diet. I went into freak mode. I was just about out of my mind about midnight last night. I got up, ate some cereal and was able to eventually sleep-at least it stopped the dizziness. Today, I am eating very small meals 4 x. I feel much better. Some symptoms are still there. But the worst have subsided. I plan to try levoxyl and armor every other day to see how this goes. I appreciate this site as a sounding board but also very valuable information. I see a glimmer of hope.</description>
		<content:encoded><![CDATA[<p>I too am at my wits end! I could explain my history but all you have to do is review the others to know mine. </p>
<p>At age 44, I am in menopause, high cholesterol, 50 lbs overweight, no libido, cannot focus, pain all the time, exercised so much by running/jogging started to bleed from the intestines.…I knew this was madness when it took me several days to recover from a colonoscopy that went wrong a few months ago. I was called to do yet more tests-I went to my dr who in the past appeared to be listening. She said the TSH was normal and states something about calories in and calories out– even people in the concentration camps lost weight-not sure what that was supposed to mean but I knew in her eyes she was not listening at that time nor was she ever. </p>
<p>I said ok-the weight is my fault, I am not doing enough. What about the other symptoms. She said that she suspects it is some type of long term virus and we have not isolated it yet. Long term virus?? I have been fighting this for 6 years. I find it hard to believe any virus lasts 6 years. </p>
<p>Most of my life, I was always a health nut, knew about reading labels and understood them long before it was popular. I served in the military for 4 years and found it invigorating to be so active. I was also very active before and had always went to the gym. Was out of the military for 8 years prior to onset of symptoms and was very active. My dr has me feeling sloppy and lazy to tell me it is my fault. She also told me to stay under 1200 cals. I spent these past 4 days on low cal diet. I went into freak mode. I was just about out of my mind about midnight last night. I got up, ate some cereal and was able to eventually sleep-at least it stopped the dizziness. Today, I am eating very small meals 4 x. I feel much better. Some symptoms are still there. But the worst have subsided. I plan to try levoxyl and armor every other day to see how this goes. I appreciate this site as a sounding board but also very valuable information. I see a glimmer of hope.</p>
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		<title>By: Lou</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-197</link>
		<dc:creator>Lou</dc:creator>
		<pubDate>Tue, 07 Nov 2006 19:21:35 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-197</guid>
		<description>I am on Armour and have had troubble getting my meds increased so it is like being on a roller coaster.  I finally got a referral to an Endocrinologist, but she is afraid to throw me into hyper so she won&#039;t increase my meds either.  I have taken it upon myself to do so and I am finally feeling somewhat better after two months at 180mg.  She wanted to switch me to a synthetic and I refused.  Why is it so hard for them to understand lab results are different for everyone?  I may be in what she thinks is the norm, but my symtoms say otherwise.  Frustrated!</description>
		<content:encoded><![CDATA[<p>I am on Armour and have had troubble getting my meds increased so it is like being on a roller coaster.  I finally got a referral to an Endocrinologist, but she is afraid to throw me into hyper so she won’t increase my meds either.  I have taken it upon myself to do so and I am finally feeling somewhat better after two months at 180mg.  She wanted to switch me to a synthetic and I refused.  Why is it so hard for them to understand lab results are different for everyone?  I may be in what she thinks is the norm, but my symtoms say otherwise.  Frustrated!</p>
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		<title>By: Dixxie</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-196</link>
		<dc:creator>Dixxie</dc:creator>
		<pubDate>Tue, 07 Nov 2006 17:00:16 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-196</guid>
		<description>Hi all...First...thank you for all the great info I have discovered here. I have had a really bad summer trying to get my thyroid meds straight.  I even went to Colorado to see Dr.(s)Lowe for metabolic fibro...I also have cfs/epsBarr/had Hep C for 20 years...did two rounds of treatment and have been non detectable for five years. Problem...when I did my first round of treatment the doc I was seeing sent me to an endo as my thyroid went hyper during treatment...the radiation (which we now know should never had been done ) fried my thyroid and damaged the rest of my endocrine system. I am now thinking my parathyroid is involved...while in Colorado, in July, way up in the mountains, I was able to get optimal sunshine...When I returned home to VA it was too hot and muggy. My vit D levels were so low I was suicidal. I was put on high doses of vit D and am still taking it...what I have discovered since is my cortisol is low...ferritin...am going to have checked immediately...but the vit D has helped my conversion of t4 so much that I went insanely hyper so I am now back on T4 only for now.  

During my research I discovered that NO two t4 products are alike...and several of them... mainly generics...contain sodium lauryl sulphates which is a carciogenic as well as not metabolised in the liver.  I do not understand how the FDA can let a drug company use a known cancer causing agent be put into a medication at any cost.  

I have also found through saliva testing that I am estrogen dominant and I take a compounded progesterone everyday. I also have low cortisol levels which we are now watching.  I have been to 8 different endos and none of them have come up with the same answer..now I work with my pcp and we are trying to keep my free t3 and t4 levels in the high range...we don&#039;t pay much attention to the tsh. I did notice that the inactive ingrediants in synthroid are way different than any other t4 med...I apparently am allergic to one of them as my gums and liver became inflamed after three days...and it containes periodine???which could explain why I can only take 100mg of it vs 150 of levelthyroxine???  Any additional info is greatly appreciated.

Thanks for the wonderful info I have found here...I have been able to get rid of the pain meds, the anti-depressants, and all other RX&#039;s after learning what I have from this site...I am finally able to resume my gardening and excercising...have lost six dress sizes and actually have a sex life after 5 years of nothing...keep up the great work...Blessings  Dixie</description>
		<content:encoded><![CDATA[<p>Hi all…First…thank you for all the great info I have discovered here. I have had a really bad summer trying to get my thyroid meds straight.  I even went to Colorado to see Dr.(s)Lowe for metabolic fibro…I also have cfs/epsBarr/had Hep C for 20 years…did two rounds of treatment and have been non detectable for five years. Problem…when I did my first round of treatment the doc I was seeing sent me to an endo as my thyroid went hyper during treatment…the radiation (which we now know should never had been done ) fried my thyroid and damaged the rest of my endocrine system. I am now thinking my parathyroid is involved…while in Colorado, in July, way up in the mountains, I was able to get optimal sunshine…When I returned home to VA it was too hot and muggy. My vit D levels were so low I was suicidal. I was put on high doses of vit D and am still taking it…what I have discovered since is my cortisol is low…ferritin…am going to have checked immediately…but the vit D has helped my conversion of t4 so much that I went insanely hyper so I am now back on T4 only for now.  </p>
<p>During my research I discovered that NO two t4 products are alike…and several of them… mainly generics…contain sodium lauryl sulphates which is a carciogenic as well as not metabolised in the liver.  I do not understand how the FDA can let a drug company use a known cancer causing agent be put into a medication at any cost.  </p>
<p>I have also found through saliva testing that I am estrogen dominant and I take a compounded progesterone everyday. I also have low cortisol levels which we are now watching.  I have been to 8 different endos and none of them have come up with the same answer..now I work with my pcp and we are trying to keep my free t3 and t4 levels in the high range…we don’t pay much attention to the tsh. I did notice that the inactive ingrediants in synthroid are way different than any other t4 med…I apparently am allergic to one of them as my gums and liver became inflamed after three days…and it containes periodine???which could explain why I can only take 100mg of it vs 150 of levelthyroxine???  Any additional info is greatly appreciated.</p>
<p>Thanks for the wonderful info I have found here…I have been able to get rid of the pain meds, the anti-depressants, and all other RX’s after learning what I have from this site…I am finally able to resume my gardening and excercising…have lost six dress sizes and actually have a sex life after 5 years of nothing…keep up the great work…Blessings  Dixie</p>
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		<title>By: Jennifer from Missouri</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-180</link>
		<dc:creator>Jennifer from Missouri</dc:creator>
		<pubDate>Wed, 25 Oct 2006 01:01:19 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-180</guid>
		<description>I just read all your comments and it&#039;s good to know, finally, that there are others that have had the same experiences that I&#039;ve had (ie. bad doctors, bad suggestions, bad advice, etc).  All the comments are so helpful and I finally realize that I am not alone and that there are resources out there where people can help me get through this (and shake my doctor&#039;s mis-diagnoses). 

To Janie and her peri-meno phase:  I recently read this on wikipedia under melatonin.  I&#039;ve been taking melatonin for months now and it has really helped me to feel rested and wake up not feeling as tired.  In addition, I read this  (hope this helps)...

Recent research has concluded that melatonin supplementation in perimenopausal women produces a highly significant improvement in thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing the depression associated with the menopause.[25]</description>
		<content:encoded><![CDATA[<p>I just read all your comments and it’s good to know, finally, that there are others that have had the same experiences that I’ve had (ie. bad doctors, bad suggestions, bad advice, etc).  All the comments are so helpful and I finally realize that I am not alone and that there are resources out there where people can help me get through this (and shake my doctor’s mis-diagnoses). </p>
<p>To Janie and her peri-meno phase:  I recently read this on wikipedia under melatonin.  I’ve been taking melatonin for months now and it has really helped me to feel rested and wake up not feeling as tired.  In addition, I read this  (hope this helps)…</p>
<p>Recent research has concluded that melatonin supplementation in perimenopausal women produces a highly significant improvement in thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing the depression associated with the menopause.[25]</p>
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		<title>By: becky burton</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-179</link>
		<dc:creator>becky burton</dc:creator>
		<pubDate>Tue, 24 Oct 2006 01:13:08 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-179</guid>
		<description>I too am on a combo of sythroid and WEsthroid.  I take one yellow synthroid and 3 grains of the westhroid which is like armor.  I was on more armor but I was itching so bad I couldn&#039;t handle it.  I am an avid exerciser. I go to the gym and do cardio 4-5 days a week.  I use to jog an hour a day.  I want to lose the weight and I am steady but it would be nice to lose the extra 5lb&#039;s.  Thank you for the oportunity to express myself. 
Becky from Washington</description>
		<content:encoded><![CDATA[<p>I too am on a combo of sythroid and WEsthroid.  I take one yellow synthroid and 3 grains of the westhroid which is like armor.  I was on more armor but I was itching so bad I couldn’t handle it.  I am an avid exerciser. I go to the gym and do cardio 4–5 days a week.  I use to jog an hour a day.  I want to lose the weight and I am steady but it would be nice to lose the extra 5lb’s.  Thank you for the oportunity to express myself.<br />
Becky from Washington</p>
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		<title>By: Janie</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-169</link>
		<dc:creator>Janie</dc:creator>
		<pubDate>Sat, 14 Oct 2006 12:22:40 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-169</guid>
		<description>Caligirl, as you continue working to find your optimal amounts, do remember that you want your free T3 to be towards the top of the range. If it&#039;s not there, upping your Armour, and slightly decreasing the Levoxyl, will help. Glad you are getting close! :)</description>
		<content:encoded><![CDATA[<p>Caligirl, as you continue working to find your optimal amounts, do remember that you want your free T3 to be towards the top of the range. If it’s not there, upping your Armour, and slightly decreasing the Levoxyl, will help. Glad you are getting close! <img src='http://www.stopthethyroidmadness.com/wp/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
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		<title>By: caligirl</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-167</link>
		<dc:creator>caligirl</dc:creator>
		<pubDate>Sat, 14 Oct 2006 06:24:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-167</guid>
		<description>Hi Janie,

I am finding that my best thyroid dosage is a combination of Levoxyl and Armour.  I am on 100 mcg. of levoxyl and 45 armour (15 3x per day)  I wasn&#039;t able to find &quot;stability&quot; on just armour and my free T4 was in the lower half of normal range.  Once I got my free T4 bumped up into the upper half of normal range (I am currently 1.57 on a scale of .78 - 2.19) I started to feel MUCH better.  It feels like the levoxyl gives me a solid platform to stand on and keeps me feeling much more stable with my energy and sense of general well being.  And then the Armour keeps me sharp and happy.  But I definitely felt more sluggish when my free T4 wasn&#039;t making it into the upper range.  The doctor also told me to take selenium to help with T4 conversion.  I don&#039;t think my current dosage is perfect just yet but I&#039;m getting really close.  I feel better than I have in years!</description>
		<content:encoded><![CDATA[<p>Hi Janie,</p>
<p>I am finding that my best thyroid dosage is a combination of Levoxyl and Armour.  I am on 100 mcg. of levoxyl and 45 armour (15 3x per day)  I wasn’t able to find “stability” on just armour and my free T4 was in the lower half of normal range.  Once I got my free T4 bumped up into the upper half of normal range (I am currently 1.57 on a scale of .78 — 2.19) I started to feel MUCH better.  It feels like the levoxyl gives me a solid platform to stand on and keeps me feeling much more stable with my energy and sense of general well being.  And then the Armour keeps me sharp and happy.  But I definitely felt more sluggish when my free T4 wasn’t making it into the upper range.  The doctor also told me to take selenium to help with T4 conversion.  I don’t think my current dosage is perfect just yet but I’m getting really close.  I feel better than I have in years!</p>
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		<title>By: Becky</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-151</link>
		<dc:creator>Becky</dc:creator>
		<pubDate>Thu, 28 Sep 2006 15:49:18 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-151</guid>
		<description>Janie, I&#039;m just cheering at your reply to Dr. Robert. Totally spot on! You are more of an advocate to us HypoT people than any single doctor ever has been, at least to me. Keep up your amazing work, spreading the word - you&#039;ve helped countless people come to WELLNESS.</description>
		<content:encoded><![CDATA[<p>Janie, I’m just cheering at your reply to Dr. Robert. Totally spot on! You are more of an advocate to us HypoT people than any single doctor ever has been, at least to me. Keep up your amazing work, spreading the word — you’ve helped countless people come to WELLNESS.</p>
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		<title>By: Janie</title>
		<link>http://www.stopthethyroidmadness.com/2006/07/14/adding-t4/comment-page-1/#comment-139</link>
		<dc:creator>Janie</dc:creator>
		<pubDate>Wed, 13 Sep 2006 00:34:04 +0000</pubDate>
		<guid isPermaLink="false">http://www.stopthethyroidmadness.com/blog/2006/07/14/adding-t4/#comment-139</guid>
		<description>Sorry, Robert, but your comment reveals you are very uninformed and failing to listen to patients. Synthroid does treat T4 because it&#039;s a T4-only medication. But treating the T4 alone doesn&#039;t result in adequate amounts of T3 from the conversion. We have learned from experience, Robert, that direct T3 is needed. And Armour is far more than simply &quot;treating the T3&quot;.  Armour is everything one&#039;s own thyroid puts together--T4, T3, T2, T1 and calcitonin. It gives back the whole spectrum which is lacking in a T4-only treatment. 

And if some of those &quot;thousands&quot; of your patients are on thyroxine alone, you haven&#039;t done your homework to find out how they&#039;re really doing. Because bar none, every single one of them is going to have some symptoms of an inferior &amp; inadequate treatment, including chronic low grade depression, or dry skin or hair, or less stamina than others, or weight gain, or difficulty losing weight, or high cholesterol...it&#039;s an endless list, which you can also see on the page SYMPTOMS of HYPO. Because everything listed are recorded  symptoms of patients while on thyroxine with a so-called normal TSH. 

And Robert, to say the best objective is for a doctor or practitioner to be &quot;in control&quot; is frightening. It&#039;s our bodies, not yours. We live in them, and we feel them. If a patient&#039;s wisdom and intelligence about his own body can&#039;t be part of the doctor-patient equation, it&#039;s tragic. It&#039;s akin to the thousands of thyroxine-treated patients who come into your office, feel like crap, and the doctor says &quot;Sorry, your labs are in range. You&#039;re normal&quot;.  i.e. toss the anti-depressant scrip at the patient and ignore obvious symptoms which reveal that the TSH range, and thyroxine alone, suck.</description>
		<content:encoded><![CDATA[<p>Sorry, Robert, but your comment reveals you are very uninformed and failing to listen to patients. Synthroid does treat T4 because it’s a T4-only medication. But treating the T4 alone doesn’t result in adequate amounts of T3 from the conversion. We have learned from experience, Robert, that direct T3 is needed. And Armour is far more than simply “treating the T3”.  Armour is everything one’s own thyroid puts together–T4, T3, T2, T1 and calcitonin. It gives back the whole spectrum which is lacking in a T4-only treatment. </p>
<p>And if some of those “thousands” of your patients are on thyroxine alone, you haven’t done your homework to find out how they’re really doing. Because bar none, every single one of them is going to have some symptoms of an inferior &amp; inadequate treatment, including chronic low grade depression, or dry skin or hair, or less stamina than others, or weight gain, or difficulty losing weight, or high cholesterol…it’s an endless list, which you can also see on the page SYMPTOMS of HYPO. Because everything listed are recorded  symptoms of patients while on thyroxine with a so-called normal TSH. </p>
<p>And Robert, to say the best objective is for a doctor or practitioner to be “in control” is frightening. It’s our bodies, not yours. We live in them, and we feel them. If a patient’s wisdom and intelligence about his own body can’t be part of the doctor-patient equation, it’s tragic. It’s akin to the thousands of thyroxine-treated patients who come into your office, feel like crap, and the doctor says “Sorry, your labs are in range. You’re normal”.  i.e. toss the anti-depressant scrip at the patient and ignore obvious symptoms which reveal that the TSH range, and thyroxine alone, suck.</p>
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