18 Mistakes Patients Make (or their Doctors make for them!)
And these mistakes ended up with either continued problems, or issues which eventually got worse as time went by.
Below are the most common mistakes patients, or their doctors, make when a switch has been made to desiccated natural thyroid (NDT)…or when you are working to improve your hypothyroid state. It’s all based on our experiences.
Can you find yourself below? Share these with your doctor!
- STICKING WITH TOO LOW A DOSE. For a myriad of reasons, this happens often and will make you feel even more hypo due to feedback loop suppression. Have one of these been true of you?
a) being held on a starting dose longer than two weeks (such as one grain, 1 1/2 grains or less)
b) being bound by the directives of a TSH-obsessed doctor. The TSH lab test only keeps you sick.
c) failing to get a raise of desiccated thyroid until the “next labwork”, which can be weeks and months away
d) following an inaccurate Synthroid-to-Armour type conversion equivalence chart.
e) being afraid to go higher!
- BEING ON AN OPTIMAL DOSE and FEELING GREAT, BUT BEING LOWERED DUE TO THE TSH LAB RANGE Similar to #2 above, this is the person who made his/her way up to an optimal dose which was working well, but having the dose lowered by a doctor who saw your suppressed TSH (i.e. below the range). This is doctor who thinks that ink spots on a piece of paper tell the truth more than your symptoms! When on an optimal dose of desiccated thyroid (or being very near), you WILL have a suppressed TSH without being hyper. (If you do feel hyper, see #3 below)
- THINKING NATURAL DESICCATED THYROID DOESN’T WORK BECAUSE YOU FEEL WORSE! In reality, what natural desiccated thyroid does is “reveal” two certain problems: adrenal insufficiency or low iron (both common in patients who’ve remained undiagnosed for years or were poorly treated on T4-only medications). You might find yourself with a high FT3 lab result with continuing hypothyroid symptoms (T3 pools rather than gets to your cells). Or experiencing anxiety, shakiness, fast heart rate, or other problems while on NDT.
- FAILING TO MULTI-DOSE Occasionally, some patients take their natural thyroid all at once in the morning and say they do fine. But, most individuals report better results by dosing at least twice a day. For example, a person on 3 1/2 grains might take 2 grains in the morning, and 1 1/2 grains by early or mid-afternoon. Multi-dosing better imitates what your own thyroid would be doing, and gives you the direct T3 throughout the day when you most need it.
- SWALLOWING NATURAL THYROID WITH ESTROGEN, CALCIUM or IRON. Estrogen, calcium and iron bind some of the thyroid hormones and makes them unusable, we’ve learned the hard way! So, it’s wise to avoid swallowing these at the same time you swallow your natural thyroid.
- TAKING DESICCATED THYROID BEFORE DOING LABWORK Bad idea! T3 starts moving up after you take desiccated thyroid, giving a false high serum result. And your doctor freaks out when he sees the lab result, and directs you to lower your thyroid. Patients have learned to take their normal desiccated thyroid the day before, then do labs the next morning.
- STAYING ON A STARTING DOSE TOO LONG (same as #1 above). The key to understanding this mistake is with the word “starting dose”, which for many, is one grain. Starting doses help your body adjust to the direct T3. But if a necessary starting dose is held too long (from two weeks to several weeks) there’s a normal suppression of the feedback loop between the hypothalamus, pituitary and thyroid gland, i.e less messenger hormones are released, making you even more hypothyroid than you began (plus you may experience the results of extra adrenaline).
- THINKING DESICCATED THYROID IS NOT WORKING WHEN A PROBLEM ARISES (OUTSIDE OF ONE’S ADRENALS OR IRON). Desiccated thyroid contains direct T3, and the T3 can initially aggravate certain conditions. When this happens, doctors have had patients stop the increase of their desiccated thyroid, or decreased it to give the reaction time to go away. An example is Mitral Valve Prolapse–one patient noted that with each raise, she had palps. But they went away within the first 5 days after each raise. One gal got itchy when she got on desiccated thyroid, and was so determined to blame Armour that she got off, got back on Synthroid, and is STILL itchy.
- “GUESSING” YOU HAVE AN ADRENAL PROBLEM and ACTING ON THAT GUESS…and/or prescribing HC when you may not need it, and/or starting on too low a dose if you do need HC: Symptoms of high cortisol can be very similar to symptoms of low, patients have learned the hard way. So it’s important to find out the right way with a 24 hour adrenal saliva test, which you can order on your own, if needed, and then share the results with your doctor. See #10 below on how to read those results.
- THINKING BEING IN A NORMAL RANGE MEANS YOU ARE DOING GREAT: To the contrary, patients figured out that it’s where you fall in the erroneous range, not the fact that you fall in it. Learn how to read lab results.
- STAYING ON YOUR T4 AS YOU RAISE NDT: Most patients report that they do perfectly fine on desiccated thyroid alone, especially when they have taken the time to raise and find their optimal dose. But a mistake can be made if you keep up with the T4 you were once on–it will start converting to excess RT3 due to an excess. which in turn will start to make you more hypo. NDT is 80% T4 anyway!
- GOING UP WITH DOSAGES WAY TOO FAST. This was observed a few years ago: a doctor put his patient on desiccated thyroid. One grain, then 2 grains, 3 grains, 4 grains, 5 grains, then 6 grains. But the problem was that he did this within 4-5 weeks! OUCH. He started to find himself majorly overdosed with symptoms to match (high heart rate, sweating). He had to stop for a few weeks… then resume again at one grain and do it the right way–approx. 1/2 grain raise every two weeks, slowing down in the 2-3 grain area (and for some, slowing down on even lower amounts).
- BELIEVING THAT DESICCATED THYROID IS “HARD TO REGULATE”. Totally and completely false. Patients have found nothing hard about desiccated thyroid. You simply raise it high enough to rid yourself of symptoms, which in turn gives you a free T3 towards the top of the range and a suppressed TSH. Believing that desiccated thyroid is hard to regulate is akin to believing that tricycles are hard to ride.
- THINKING THAT SYNTHETIC T4 ALONG WITH SYNTHETIC T3 IS JUST AS ADEQUATE AS NATURAL DESICCATED THYROID Adding synthetic T3 to your Synthroid or other T4 brands is definitely a step up from being on T4 alone! We applaud that addition. But….to say it’s equal to being on desiccated thyroid t’ain’t so. Too many patients who have been on the synthetic combo, and switched to desiccated thyroid, report that the results were even better. That’s impressive. Besides, with desiccated thyroid, you are getting exactly what your own thyroid gives you–T4, T3, T2, T1 and calcitonin. Makes a difference.
- AVOIDING NDT BECAUSE YOU HAVE HASHIMOTO’S Sadly, some doctors will state that those with Hashimoto’s should avoid NDT because it can increase the attack. It’s true that at first, antibodies raise, say patients. But the higher they raise, the lower antibodies become, as reported by many, probably due to a better immune system due to the T3! A large body of Hashi’s patients need to avoid gluten to get those antibodies down. Others use 200 – 400 mcg selenium to lower antibodies, while more difficult cases may need Low Dose Naltrexone. Many even report that their iodine use lowered their antibodies.Overall, Hashi’s patients have soared with NDT if they do it right,
- THINKING YOU SHOULD TRY WHATEVER SOMEONE ELSE REPORTS IS WORKING The hardest part about patient groups is the wrong influence by one patient on another…and you don’t really know the full story about that individual! For example, a patient may say that whatever she tried, NDT did NOT work and they are doing quite well again on T4 or another kind of combination. But what you may not know is that they never optimized their iron and/or cortisol levels to do well on NDT, for example, even if they state they did. Or, they might have an unusual cellular problem that you don’t have. NDT has worked for all-too-many as long as cortisol and low iron are optimized.
- THINKING THAT IF YOU HAVE HIGH RT3 (or poor ratio), YOU NEED TO BE ON T3-ONLY. Since RT3 come from T4, patients were switching to T3-only to lower high levels. Soon though, patients discovered they could lower RT3 simply from lowering NDT. Some added T3 to the lowered amount of NDT, as well. We learned that you do NOT necessarily have to be on T3-only, which can be a rougher treatment. It’s individual.
- THINKING YOUR DOCTOR KNOWS MORE THAN YOU DO. Granted, we have great respect for education, and we appreciate the knowledge that a medical school trained doctor brings to our health quest. It’s important! BUT… that education does NOT take away from our OWN knowledge and our OWN intuitive sense about our bodies… about what works, about what doesn’t work… no matter what that doctor says. This website, and even more the STTM book, represents just that! So, patients have discovered that the doctor-patient relationship is best as a TEAM, with respect going BOTH directions. Doctors are not “gods”. They can and DO make mistakes in judgment. TEAMWORK counts. Find a good doc!!
Want to order your own labwork?? STTM has created the right ones just for you to discuss with your doctor. Go here: https://sttm.mymedlab.com/
- Need help interpreting your lab results? Go here: www.stopthethyroidmadness.com/lab-values/
- Take the STTM book right in the office with you for emphasis when teaching your doctor!!