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Discussion Thread: DIY Thyroid, Part 3: Thyroid Hormone Replacement

Member Forum >> Iodine and Thyroid Health >> Discussion Thread: DIY Thyroid, Part 3: Thyroid Hormone Replacement


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Posted: 9/30/2017 7:13:18 PM

This is a forum copy of the third of three transcripts for an Undoctored Blog video series. Only the first part is presently in the Inner Circle video library (since there is equivalent member-only content there).
DIY Thyroid {Part 1} [in UIC Video library] [on Undoctored Blog] [Forum thread]
DIY Thyroid, Part 2: Lab Interpretation (blog only) [Forum thread]
DIY Thyroid, Part 3: Thyroid Hormone Replacement (blog only)

For why this is here, see this revised Reply in an earlier transcript thread.


This is DIY Thyroid Part 3.

I’ve talked previously how to obtain the lab tests on your own, because many doctors don’t want to do it, don’t understand it, don’t want to be bothered learning about it. So you can get those tests done your own quite easily.

Once you get the tests, Part 2 of this series talks about how to interpret those tests, including posting your numbers (anonymously of course) on the Undoctored websites for discussion, including the Facebook page. You’ll be surprised at the level of help, interest, and sophistication you’ll encounter in everyday people, who share an interest in thyroid health.

This third part now is how to correct your hypothyroidism, if your TSH and other values suggest you have low thyroid status, how to do that. These are the kinds of conversations I’m introducing in my new book Undoctored — Why Health Care Has Failed You And How You Can Become Smarter Than Your Doctor.

So you got your thyroid panel, all the numbers from your labs. You think you have hypothyroidism, meaning low thyroid hormone status, suggested by an inability lose weight (no matter what you do, including doing the diet just right), feeling inappropriately cold (particularly in your hands and feet), low energy that you can’t explain by other reasons (like lack of sleep, or excessive stress), leg edema, and constipation that doesn’t make any sense (that you’re doing everything right, and still have constipation). There are other signs and symptoms, but that those are the most common by far.

So you get an oral temperature, don’t forget about that one, and your temperature is say is 96.1°F, or 95.9 on average. Recall that we’re aiming for 97.3°F (36.3°C), that reflects a normal thyroid status. The lower the temperature is away from 97.3, and the more consistently, the more likely that you have hypothyroidism.

So your panel comes back let’s say with a TSH of 3.5 and the laboratory says: Reference Range (that is presumed normal) is 0.5 to 4.5. Your doctor says “you’re fine”, even though you’ve gained 18 pounds, you’re cold all the time, and you’re depressed sometimes. So maybe you have to take this on yourself.

Or maybe you have a low free T3: in the lower half of the Reference Range, or even below the Reference Range altogether. Or perhaps you have a high reverse T3: above the Reference Range or the upper half of the Reference Range. These are different forms of hypothyroidism. Those are the most common forms. There are other forms. So what do you do?

Well first of all, you should have addressed iodine. It takes about two months for iodine to be fully restored. So you start the TSH, say at 4.0, and free T4 / free T3 maybe just normal or T4 can be a little bit lowish with iodine deficiency.

First step is to take iodine for a couple of months. Track your temperatures. Then repeat a thyroid panel. That’s the best way to do it. Let’s say the numbers are no better. It means you didn’t have iodine deficiency — still worth taking iodine to prevent iodine deficiency, and get the other non-thyroid benefits of iodine, like protection from breast diseases. But iodine deficiency was not the cause of your thyroid disruption.

If your thyroid comes into normal range, and you’re normal temperature, well good. You’re done. Just take the iodine. Track thyroid maybe once in a great while.

But if iodine proves not to be the solution, this is when we commit to thyroid hormones. There are too many factors in life, including prior grain consumption, that cause damage to the thyroid gland. The thyroid gland is very poor at recovering ability to manufacture thyroid hormones. So your solution is to take thyroid hormones that your thyroid gland cannot manufacture any longer.

By default, the best solution is always a combination T4+T3 preparation. These are often called desiccated thyroid, bovine thyroid, porcine thyroid. They come in names like Armour® Thyroid, Nature-Throid®, Thyrolar® and several other preparations. Most doctors will not prescribe those. The first step is to find someone, a health care practitioner, who will prescribe the natural or desiccated forms of thyroid. Why? Because they include the T3 thyroid hormone, and 80% of people feel better, warmer, happier, lose weight more readily, and all the other phenomena of hypothyroidism reverse much more readily.

Now 20% of people don’t need that T3, or the other hormones in the desiccated or natural preparation. They can do fine on levothyroxine, that is the T4-only. That is the solution that your doctor typically prefers, because for many years the levothyroxine was branded as Synthroid®. The sales reps would make often false claims about its potency and purity etc. over the natural preparations. Now that it’s gone generic, a lot of that marketing push has fallen apart, but a lot of the doctors still follow that old marketing, those marketing ploys of only prescribing levothyroxine. But 20% of you can do just fine on levothyroxine.

Some people don’t like the T3 component of the Armour® Thyroid, Nature-Throid®, etc. They get kind of jittery, like an anxiety effect, and can’t sleep at night, and their heart is racing. If you get those effects, you’re probably among the people who just need levothyroxine. And that’s OK. It just means that you preserve the capacity to convert T4 to T3.

But 80% of us, including myself by the way, do better with the T4+T3 natural and desiccated thyroid preparations, because something has impaired our conversion of T4 to T3. T3 only comes from T4 being converted to T3 or by taking T3 separately. So most of you do better on the combination T4+T3 preparations. If you’re already on levothyroxine, you want to find a practitioner who will entertain the possibility of converting you over to one of those natural desiccated preparations, to add the T3. That’s first choice.

Second choice would be to add T3. You can take a separate T3. Just as T4 is levothyroxine, T3 is triiodothyronine. You can take that too — not the best — there’s a theoretical benefit to taking the other thyroid hormones and other components that are present in the natural desiccated preparations, like the thyroid hormones T2 and T1 (all those numbers: T4, T3, T2, T1, simply refer to the number of iodine molecules within each thyroid hormone molecule). There may be benefits those other thyroid hormones, but it’s very poorly charted out.

If you take levothyroxine, find a doctor who will (1) assess your T3 (or you assess it yourself) and (2) then talk about correcting your T3 should it be low, or if your reverse T3 is high.

That’s pretty much it: how to correct thyroid. Then you want to monitor your levels. A reasonable period of time is no sooner than 4 weeks after any kind of introduction of a dose, or dose change, to recheck your thyroid panel. It takes that long for the T4 component to exert its full effect. T3 is quick, but T4 is slower; so no sooner than 3 or 4 weeks at the earliest, to reassess.

We aim for ideal values like we talked about in the second video: an ideal TSH, an ideal free T3, free T4, etc. If you identify a need for thyroid hormone, and your doctor refuses; first step, find a health care practitioner who’s willing to prescribe, because it is a prescription agent. We can question whether the wisdom of whether it should be a prescription agent, but it is a prescription agent, whether we like it or not.

There are ways to get it on your own if you have to. I have ordered my thyroid without a prescription. I didn’t write my own. I just ordered it from the UK (from England), for a while; no problems. It cost a little bit more, maybe, but there’s no doctor’s visit involved, no hassles. So that’s how I’ve done it. Some people cross the border to Canada, and found ways to do that, or have a friend who gets it for them. There are ways to do this. I’m not going to go to a lot of detail here, because we get ourselves in some legal trouble, and I don’t want to bring legal trouble on the people who manage to bring it into the US or North America for us. Recognize there are ways that you can find, by talking to people, googling, etc., ways to obtain thyroid hormone if you must, but they’re second best. Your first choice is to find a health care practitioner who supports you, who advocates for you, who collaborates with you. But if you must go out in your own, you can do that too.

DIY Thyroid (Part 1)
DIY Thyroid, Part 2: Lab Interpretation