free t3 tags

The Bri­tish Medi­cal Jour­nal (BMJ) recently came out with yet another thy­roid article, benignly tit­led Diag­no­sis and treat­ment of pri­mary hypothy­roi­dism and autho­red by the Bri­tish Thy­roid Asso­cia­tion (BTA),  that at first blush, looks so caring.

Namely, they express deep con­cern that that since hypothy­roid symp­toms can mimic other con­di­tions, patients may be get­ting an inco­rrect diag­no­sis which could expose some patients to the harm­ful effects of excess thy­roid hor­mo­nes, while other serious con­di­tions may go undiagnosed.

And they add: In other patients, ade­quate repla­ce­ment with levothy­ro­xine does not resolve symp­toms, which are attri­bu­ted to hypothy­roi­dism rather than other con­di­tions that may coe­xist, such as depression.

The article con­ti­nues with:  Nor­ma­li­sa­tion of thy­roid sti­mu­la­ting hor­mone means a return to nor­mal health in most patients with pri­mary hypothy­roi­dism.

In other words, what you have above are the Three Stoo­ges of the sta­ted beliefs of the Bri­tish Thy­roid Association.

Stooge stated-belief #1: “Inco­rrect diag­no­sis allow other con­di­tions go undiag­no­sed” What is infe­rred is that there are a host of diag­no­ses of hypothy­roi­dism that are inco­rrect. Why? Because a wise phy­si­cian dared to lis­ten to clear symp­toms of hypothy­roi­dism or use the free T3, in spite of a so-called “nor­mal” TSH – a lab test which mea­su­res a pitui­tary hor­mone, not the cells abi­lity to receive enough thy­roid hormones.

Stooge stated-belief #2: “If ade­quate doses of levothy­ro­xine do not resolve symp­toms, those symp­toms are due to something else.” That is akin to saying if eating 100 calo­ries a day results in mal­nu­tri­tion and star­va­tion, your mal­nu­tri­tion and star­va­tion is due to something else. And one par­ti­cu­lar symp­tom they are refe­rring to is depres­sion–a clas­sic symp­tom of undiag­no­sed and under­trea­ted hypothy­roi­dism in MILLIONS of indi­vi­duals around the world.  And isn’t it just odd how that depres­sion resol­ves itself when the patient is put on Armour and allo­wed to dose by the eli­mi­na­tion of symptoms.

Stooge stated-belief #3: “A nor­mal TSH lab result equals nor­mal health in those trea­ted for hypothy­roi­dism”. Gee, funny how millions of thy­roid patients around the world have had a so-called “nor­mal” TSH lab result along with a diverse blend of con­ti­nuing and CLEAR hypothy­roid symp­toms.  Addi­tio­nally, we have a large and gro­wing body of patients who, when they switched to Armour desic­ca­ted thy­roid or other fine desic­ca­ted thy­roid presc­rip­tion meds,  had those symp­toms resol­ved when they were dosed accor­ding to the free T3, impro­ved blood pres­sure, strong heart beat, lowe­red cho­les­te­rol, and com­plete eli­mi­na­tion of symp­toms. Patients have lear­ned what works!

When you unders­tand the Bri­tish Thy­roid Association’s hell-bent and rigid stands against Armour desic­ca­ted thy­roid, their pro­mo­tion of one of the worst labs ever crea­ted to diag­nose and dose by, their love affair with the most ina­de­quate thy­roid medi­ca­tion ever thrust onto the mar­ket by money-grubbing phar­ma­ceu­ti­cals (levothy­ro­xine), and their com­plete fai­lure to lis­ten to patients and recog­nize con­ti­nuing symp­toms of hypothy­roi­dism while on synthe­tic T4, you come to rea­lize how mea­ning­ful any article on hypothy­roi­dism will be by the Bri­tish Thy­roid Association.

P.S.  Do ya won­der if the Bri­tish Broad­cas­ting Cor­po­ra­tion (BBC) has the smarts to report the other side of the story??

*Want to be infor­med of these blog posts? Curious what’s on Janie’s mind? Just use the Noti­fi­ca­tion fea­ture on the bot­tom  of the links to your left.

Want to be noti­fied of my blog posts? Curious what’s on my mind? Use Noti­fi­xious to be infor­med. Look on the bot­tom left of the links where you can sign up. )

Today I baked a cho­co­late cake for my son’s birth­day. It was exce­llent. Why? Because it was the result of seve­ral impor­tant ingre­dients. Lea­ving any of them out would have resul­ted in a cake less than great.

And your health and feel-goods as a thyroid/adrenal patient, inc­lu­ding your abi­lity to suc­cess­fully get off HC,  is like my son’s cake: a com­bi­na­tion of ingre­dients that you have to get right. Below are ten “ingre­dients” to inves­ti­gate and find out which may not be right in you for good health and feel-goods.

1) The right amount of cor­ti­sol: Too little cor­ti­sol or too much cor­ti­sol has its con­se­quen­ces. Too little results in thy­roid hor­mone still poo­ling, con­ti­nued hypo symp­toms, plus hyper in some. Too much can mean easy brui­sing, rising blood pres­sure, fluid reten­tion, a round face, etc.  And both can inc­rease anxiety, fee­ling poorly, etc.  Watch for symp­toms and com­pare your daily ave­ra­ged tem­pe­ra­tu­res. Also, have you chec­ked your aldos­te­rone?

2) The right amount of desic­ca­ted thy­roid: I have a friend who was stuck on 3 grains Armour out of habit. But she con­ti­nued to have hypothy­roid symp­toms out of habit. I finally con­vin­ced her to talk to her doc­tor. Labs sho­wed her free T3 was just a few points over mid-range, and having a free T3 towards the top seems to work bet­ter for most. So she did raise, and it finally did the trick.

3) Opti­mal B12 levels: Since hypothy­roid patients can have digestive/absorption issues, B12 levels can be lower than opti­mal. Symp­toms inc­lude fati­gue, weak­ness, fee­ling faint, breath­less, brui­sing, heart palps or others. Don’t take a chance. Get a B12 test. You want the result to be at the top of the range.

4) Plenty of Ferri­tin (sto­rage iron): Low ferri­tin means you have no iron in sto­rage to draw upon. And it also means you are pro­bably ane­mic.  Addi­tio­nally, low ferri­tin adver­sely affects the con­ver­sion of T4 to T3. Symp­toms inc­lude fati­gue, depres­sion, weak­ness, achi­ness, breath­less­ness or others.  Have a ferri­tin test.  Opti­mal is 70 – 90.

5) Good diges­tion: Hypothy­roid patients can have low hydroch­lo­ric (HCL) sto­mach acid levels. That not only con­tri­bu­tes to acid reflux because of the over­growth of bad bac­te­ria, it means you don’t absorb nutrients well (inc­lu­ding low B12 men­tio­ned above). As a result, it’s cru­cial to give that acid back to your­self.  A tables­poon of Apple Cider Vine­gar mixed in water and taken twice day helps many. Or try taking Betaine, which is HCL in pill form, or any other qua­lity HCL or diges­tive product.

6) Recog­ni­tion and treat­ment of Glu­ten into­le­rance: Some thy­roid patients lack a par­ti­cu­lar diges­tive enzyme, intes­ti­nal glu­ta­mi­nase, that helps digest glu­ten in various food pro­ducts. As a result, they don’t absorb nutrients well. Symp­toms inc­lude bloa­ting & gas, aches, stiff­ness, fati­gue, bur­ning or numb­ness in arms or legs, rashs or hives, wor­se­ned aller­gies & others. Your chance of have a glu­ten pro­blem is higher if you have Hashi­mo­tos disease. If you sus­pect a pos­si­ble pro­blem, eli­mi­nate all glu­ten from your diet. Also con­si­der having your doc­tor run a Celiac anti­bo­dies blood test.

7) Con­tro­lled EBV: At least 90% of adults have the Eps­tein Barr Virus (EBV) sit­ting dor­mant in their bodies. EBV is what cau­ses mono­nuc­leo­sis, but you don’t have to have had mono to carry the virus.  Because hypothy­roi­dism lowers your immune sys­tem, it’s not uncom­mon for thy­roid patients to have acti­va­ted EBV. I did, and my symp­toms inc­lu­ded extreme easy fati­gue, rin­ging in my ears, achi­ness and some swe­lling of my lymph glands. Some may have a sore throat return and other symp­toms.  Ask your doc­tor to test EBV. You’ll then need to ask about treat­ment options, which inc­lude bee­fing up your immune system.

8 ) Sex hor­mone balance: When your thy­roid or adre­nals get out of balance, your sex hor­mo­nes can follow suit, from estro­gen domi­nance to low tes­tos­te­rone.  When estro­gen domi­nance occurs, you can feel depres­sion, fati­gue, and sore breasts.  Low tes­tos­te­rone can equal lower energy and mood. Ask your doc­tor to test all your sex hormones.

9) Taking plenty of sup­ple­ments: There are a variety of good sup­ple­ments ever­yone with thy­roid or adre­nal issues should take for good health. They inc­lude high potency B-vitamins, Vit. C (1000 – 3000 mg. or to tole­rance), Sele­nium (around 200 mcg), mine­rals inc­lu­ding mag­ne­sium, pro­bio­tics, Vita­min D (1000 iu), iodine, and others.  In addi­tion to these, I also take CoQ10 (for heart and blood pres­sure health), and my favo­rite: a green pow­der which I stir in my orange juice.

10) Exer­cise: If you are a couch potato, you’re going to feel like one. Ins­tead, do what it takes to get moving, which pro­mo­tes all sorts of good health. If you have adre­nal fati­gue, keep it very light and easy.  If you just have hypothy­roi­dism, get out and walk.

P.S. My cho­co­late cake: I think cake mixes are just as good as home­made. I use Devils Food Cake. But the icing is ALWAYS home­made: cream one stick but­ter, add about 4 cups pow­de­red sugar, 1/2 cup cocoa, then cream or half-n-half.  Shake some sea salt in. Add two tsp. vani­lla.  Beat, beat.  Taste. Modify as nee­ded. YUM.

In honor of 2009,  a year we hope to see bold chan­ges in the medi­cal sys­tem, Stop the Thy­roid Mad­ness pre­sents the Fif­teen Most Anno­ying Phra­ses From the Mouths of Doc­tors. (Note that the word “Armour” has been used for sim­pli­city sake; any prescription-grade desic­ca­ted thy­roid pro­duct can be inser­ted there.)

Here’s rai­sing our New Year’s stem­med glas­ses to change!

15) I’ll see you in eight weeks.
14) Here’s a script for [insert any non-thyroid medi­ca­tion to ban­daid con­ti­nuing hypo symp­tom]
13) The free T3 lab test is not neces­sary.
12) Your symp­toms do not warrant a thy­roid medi­ca­tion.
11) You’re tired because you are [insert any label like “a mother” “meno­pau­sal”, etc]
10) That has nothing to do with your thy­roid.
9) I can find nothing wrong with you.
8 ) You need to eat less and exer­cise more.
7) Your TSH is too low.
6) The TSH test is [insert any posi­tive desc­rip­tion, like “a relia­ble mar­ker” or “sen­si­tive mea­sure”]
5) I do not believe in Armour.
4) Armour is [insert any nega­tive adjective/description like “uns­ta­ble” or “hard to regu­late”]
3) You’re depres­sed.
2) You are hyper.

.…and tah-dah, the #1 most anno­ying phrase that comes out of the mouth of a doctor:

1) You are normal.

Just as I was finishing up the post below about a short sum­mary on the Endoc­ri­no­logy Today web­site, I saw a link at the bot­tom of the page that inte­res­ted me.  It took me to a blog post on the same site from Decem­ber 10^th tit­led “Why can’t it be my thyroid?”.

And a slew of thy­roid patients around the world, as well as a gro­wing body of doc­tors,  would com­ple­tely disa­gree with this post.

Namely, a DO explains the pro­blem of patients arri­ving in doc­tors offi­ces with “innu­me­ra­ble pos­si­ble symp­toms of hypothy­roi­dism” inc­lu­ding “fati­gue, cold into­le­rance, dec­rea­sed energy, weight gain, depres­sion, hair loss, low libido, mens­trual irre­gu­la­rity and others.”

Yet, he bemoans, these patients have a “nor­mal TSH” which is “well within the nor­mal labo­ra­tory refe­rence range.” He also refers to their nor­mal free T3 and free T4, and sta­tes there is no his­tory to sug­gest pitui­tary dys­func­tion or that the TSH is unreliable.”

He then pro­ceeds to pat him­self on the back because he 1) will treat some patients with a high-normal TSH and other cli­ni­cal fea­tu­res,  2) he will treat to a low-normal TSH of less than 2.0, but like the good-boy-doctor, “still within the nor­mal labo­ra­tory refe­rence range” and 3) he will not induce iatro­ge­nic hyperthy­roi­dism, even if symp­toms per­sist. (yikes)

“Iatro­ge­nic hyperthy­roi­dism”??  Since “iatro­ge­ne­sis” refers to harm­ful medi­cal pro­ce­du­res, he’s pro­bably refe­rring to a TSH below the range, which in his mind, equa­tes to hyperthyroidism.

***Then comes the obser­va­tion that has made many thy­roid patients shi­ver, since so many doc­tors have said it: because he feels that adding T3 to T4 has more nega­tive results than posi­tive, he explains to his patients “that there may be cau­ses of their symp­toms besi­des the thyroid.”

THUD.

So here is my 6-point res­ponse to any doc­tor who might share these beliefs:

1) There’s hardly a thy­roid patient around who hasn’t had a so-called “nor­mal” TSH in spite of clear and obvious hypothy­roi­dism.  The TSH lab test fre­quently lags behind what is rea­lity in the body, and has been doing so since it’s crea­tion in the early 1970’s (see Chap­ter 4 in the Stop the Thy­roid Mad­ness book for his­tory).

2) Having a “nor­mal” free T3 and free T4 means nothing. It’s “where” the result falls in that range that means something. i.e. patients all around the world are noti­cing that having a free T3 mid-range or lower in the pre­sence of hypothy­roid symp­toms is usually a BINGO lab result poin­ting to hypothyroidism.

3) Exactly because doc­tors tend to dis­miss clear hypothy­roid symp­toms as “something else” thanks to a lousy TSH refe­rence range, a bur­geo­ning num­ber of thy­roid patients are falling into adre­nal fati­gue with its low cor­ti­sol, which ser­ves to mess them up even more.

4) A huge body of thy­roid patients who are on desic­ca­ted thy­roid hor­mo­nes (aka Armour, Natu­reth­roid, etc), and who finally have a com­plete remo­val of symp­toms with a nor­mal tem­pe­ra­ture and hear­trate, also have a sup­pres­sed TSH lab result, and not one iota of “iatro­ge­nic hyperthyroidism.”

5) When it appears that adding T3 to T4 is having nega­tive effects, the pro­blem is most likely adre­nal fati­gue that needs correc­tion, and/or low ferri­tin, NOT deci­ding that the symp­toms must be from another cause or T3 doesn’t work.

6) “Fati­gue, cold into­le­rance, dec­rea­sed energy, weight gain, depres­sion, hair loss, low libido, mens­trual irre­gu­la­rity and others” may be sha­red in other con­di­tions, but you are most likely mis­sing CLEAR symp­toms of hypothy­roi­dism, both in the undiag­no­sed patient with a so-called nor­mal TSH, or with a patient trea­ted with the lousy thy­ro­xine, which lea­ves most ever­yone with con­ti­nuing hypothy­roid symp­toms.

“I’m sorry. It IS your thy­roid” is exactly what patients need to hear.

How many doc­tors can I stran­gle with my bare hands?? Grrrrrrrrrrr.

Today, I am once again appa­lled and sad­de­ned by the end­less body of thy­roid patients who con­ti­nue to plum­met into the abyss of adre­nal fati­gue, day after day after day. And it just never needs to hap­pen if doc­tors would simply pay atten­tion and be infor­med.

Belinda is the per­fect exam­ple. She didn’t par­ti­ci­pate in thy­roid patient groups any­more, living her life hap­pily, because she thought her post-RAI thy­roid treat­ment was under con­trol, being on 2 grains of Armour for a year. But sud­denly, she felt the need to return to her groups and seek feed­back. Because she has become more irri­ta­ble and moody, has a hard time falling asleep, and feels fre­quently anxie­tal. Labs are redone, and she finds her­self with a slightly over-range free T3 and a very sup­pres­sed TSH. Her doc­tor deci­des to lower her thy­roid meds, which in turn impro­ves her insom­nia and anxiety, but weight starts piling on. She’s con­fu­sed and won­ders how she can find her balance bet­ween being on too little with unwel­come weight gain and being on too much with uncom­for­ta­ble anxiety and insomnia.

What Belinda didn’t get, and what her doc­tor didn’t get, is that Belinda had now joi­ned the dubious cama­ra­de­rie of those with adre­nal fati­gue, a need­less con­di­tion of over-stressed and under-functioning adre­nals. As a result, T3 in Armour starts to pool in the blood, cau­sing anxiety, insom­nia, and all sorts of low cor­ti­sol symp­toms. Thy­roid patients just like Belinda have to first dis­co­ver what is going on, then face the com­pli­ca­ted balan­cing act of trea­ting adre­nal fati­gue AND hypothy­roi­dism. And it’s a path that never nee­ded to happen.

WHAT IS POTENTIALLY TAKING YOU DOWN THE DIRTY-YELLOW BRICK ROAD TO ADRENAL FATIGUE??

1) Being undiag­no­sed, or being dosed by, the faulty TSH lab test and its dubious “nor­mal” range, which will leave you with lin­ge­ring hypothy­roid symp­toms. (Belinda’s 2 grains tells me she was being dosed by the TSH)
2) Being trea­ted by T4-only medi­ca­tions like Synth­roid, Levoxyl, Eltro­xin, et al, which end up tea­sing your adre­nals to work har­der to take up the slack of an ina­de­quate treat­ment.
3) Lowe­ring your expec­ta­tions of what “nor­mal” is. No, it’s not nor­mal to have less sta­mina than others, to be on an anti-depressant to ban­daid your hypo depres­sion, to feel col­der than others, to require fre­quent naps, to feel the need to avoid peo­ple, to be bothe­red by lights or noi­ses, to be told by those you love that you are too defen­sive or over-reactive…and so on.

I hope anyone rea­ding this comes to an unders­tan­ding that you can­NOT enter your doctor’s office as if you are ente­ring the throne of a god. Your doc­tor, no mat­ter how edu­ca­ted or dedi­ca­ted, may not have a strong unders­tan­ding of the role of adre­nal func­tion in rela­tionship to bad treat­ment via T4-only meds or the TSH lab range. You may have to bring this know­ledge to your doc­tor, or find another one who is either lear­ned, or open-minded. Because your chan­ces of having adre­nal fati­gue are huge if you are on T4, if the TSH is worship­ped by your doc­tor whether on T4 or desic­ca­ted thy­roid, or if you keep wal­king into the doctor’s office and hang your own know­ledge on the hook outside his or her door.

(See Deborah’s story about cea­sing to smoke with adre­nal fatigue)