Re: basic thyroid hormone questions - maybe for ?

[Guest guest]

JUST to emphasise this titration method is likely to be the equivalent of taking

25 mcg of T3 and then NOTHING for the rest of the day.

For you even the 25 mcg may not be enough to create a wave that does anything.

So, I'd re-focus on 3 doses of T3 and begin by bringing the 3 doses up to 20 or

25 micrograms each to begin with. Then focus on the first T3 dose and raise it

until you begin to get symptomatic improvements.

I need to go and read the data you've posted.

>

>

[Guest guest]

What - stopping the dose one day - what does that mean??????

Yes your temps are awful.

Don't know what you mean by stopping the dose one day.

>

[Guest guest]

IRON 20.0 umol/L 10.6 - 28.3

T.I.B.C 62 umol/L 41 - 77

TRANSFERRIN SATURATION 32 % 20 - 55

FERRITIN 31 ug/L 30 - 400

Tranferrin Saturation % needs to be in the 35-45% region to be confident that

there is sufficient cellular iron levels. It provides an indication of how much

free iron is being carried by transferrin.

Ferritin is TOO LOW and yes you do need to be on iron meds. A lot of them. This

can interfere with thyroid hormone within the cells - BIG TIME.

You need to be on ferrous gluconate or ferrous fumerate in high amounts to

correct this.

This could easily be your issue and it may take months to resolve.

This presents an issue because the T3 dosing schedule you are on is also

rubbish.

ENDOCRINOLOGY

THYROID PROFILE 2

TOTAL THYROXINE(T4) 118 nmol/L 59 - 154

THYROID STIMULATING HORMONE 2.00 mIU/L 0.27 - 4.2

FREE THYROXINE 20.0 pmol/l 12.0 - 22.0

FREE T3 5.0 pmol/L 3.1 - 6.8

How can free thyroxine be 20 if you aren't taking any and you are on 87mcg T3.

The T3 isn't actually being absorbed or the T3 you are taking is fake. The TSH

and FT4 would suggest that the T3 you are taking is actually not even reaching

any of your tissues in a way that it can actually affect anything.

TSH should be zero or as close as and FT4/total T4 should be nearly zero or

extremely low.

Do you have a digestive absorption issue or some other health issue that could

affect absorption of T3?????????

Do you trust your T3 supplier????? Suggest switching supplier if you can't

explain this.

I can understand the symptoms not responding but the pituitary almost always

responds - yours hasn't.

IS THIS WHEN ON 87 mch T3 or before the T3???

If the T3 is genuine and the results are on T3 then I'd say you were beginning

to look like a classic truly thyroid RESISTANT patient OR it really is due to

low IRON

If RESISTANCE

In this case you may want to contact Lowe in the USA directly as I believe

he still does some consultancy.

If this is true then 12.5 mcg T3 doses in 'p**** in the w**d'. You'd be better

off with two LARGE T3 doses per day to begin. Then focus on making the first one

even bigger until you get a result.

You need to be working with someone who is used to dealing with true cellular

resistance.

If IRON

Get decent supplementation levels in place ASAP. This can take 9 months to

resolve. In this case driving up the T3 too soon would be BAD. I'd still go to 2

or 3 bigger doses and hold it for a while until the entire iron panel looked

better.

THIS SHOULD HAVE BEEN TREATED!!!!!

>

> H

[Guest guest]

WERE the full thyroid profile results before or after being on T3??????????????

NOT SURE FROM YOUR POST.

IF BEFORE THEN SCRAP THE DEFINITE CONCLUSION OF RESISTANCE OR DODGY MEDS.

IF AFTER THEN KEEP IT.

[Guest guest]

Hi ,

Sorry that was in reply to something suggested about reducing my dose. It

is now irrelevant as I have read your other posts, which I will respond to now.

Mark

>

> Don't know what you mean by stopping the dose one day.

>

>

[Guest guest]

Hi ,

They were from BEFORE starting T3 but while on about 30mcg of HC.

Mark

>

> WERE the full thyroid profile results before or after being on

T3??????????????

[Guest guest]

if copper is low, could that affect whether Mark can get the ferritin higher?

(my copper was low and my feritin was low too)

chris

>

> IRON 20.0 umol/L 10.6 - 28.3

> T.I.B.C 62 umol/L 41 - 77

> TRANSFERRIN SATURATION 32 % 20 - 55

> FERRITIN 31 ug/L 30 - 400

>

[Guest guest]

Hi Mark,

So please confirm whether the thyroid panel was on T3 and what T3 dose.

You're on iron now - which is good - expect it to take 6 months or more to get

sorted. Low iron could be the problem or simply a result of low thyroid levels -

what is the chicken and what is the egg?

The tiny response to T3 is encouraging at least.

If I were you I'd quit all forms of adrenal supplements because I don't believe

the adrenals are a root cause issue and if your're on them it is not clear if

they are helping or hindering. There are ways of using T3 as I have described to

correct cortisol if this is needed. You won't even know it is needed whilst you

are on adrenal meds.

Regardless of your answers to my most recent questions you still need to be

using 3 bigger T3 doses and then focus on raising the first one to see if you

can experience any real improvement.

This needs to be done slowly and carefully - with attention to BP, temp, heart

rate.

If you do down this route then you can email me with specific questions as you

go along.

Cheers,

>

> Hi ,

>

[Guest guest]

Hi ,

Posts coming in thick and fast - thanks!

What you say on dosing and the need to create waves makes so much sense! The

dosing schedule I gave to is only a recent example since I read that T3

needs to be split up during the day. However I see you are saying " almost " the

opposite - that they need to be relatively concentrated and focused in the

morning.

When I was on 75mcg I was taking it as 25, 25, 25. That did nothing. NOW! The

first day I started on 87.5mcg I dosed 25,32.5,25 and I have to say that on that

day, a few hours after the 32.5 dose, I THOUGHT I noticed an improvement in

energy.

So let me conclude that I think it is safe to assume that doses of 25mcg don't

do anything, but 32.5mcg might well be doing something, so for the next few days

I will cut my current dose (87.5mcg) down to 75mcg and dose as 32.5mcg early

morning (say 6-ish) then another 32.5mcg say at lunch. There's no point in an

extra 12.5mcg. I see what you're saying - focus on that first dose to find the

level needed and forget about anything smaller.

This idea of yours is great. I always wondered why people say split your dose up

when Lowe says he takes his 100mcg all in one go!

Cheers!

Mark

[Guest guest]

Hi ,

I think replies are being lost in the maze of posts. I am responding to your

queries one by one rather than in one big reply. My thyroid panel was BEFORE

starting T3.

Thanks for allowing me to email you, but I think I have the gist now (see my

other reply which should appear before this one if it is not lost in

cyberspace).

Mark

> >

> > Hi ,

> >

>

[Guest guest]

OK - Thank goodness - you've now turned form a nightmare case to a mildly

difficult case.

You need a new thyroid panel - just to be confident that the T3 is actually

absorbing and the pituitary can see it. This confirms what we think.

Chris's point is good about copper - get this checked also.

The iron will take bloody months to resolve and may then need a maintenance

dose. It could be low due to the low thyroid hormones though and so the

maintenance dose may not need to be that high if the thyroid hormones are

sorted.

Really don't think adrenal hormones are a smart idea - get in the way of sorting

this out.

THREE BIG T3 doses of 25 to begin with would be what people with your sort of

issue might be using: 7:00 am, 11:00 am and 5:00 am might be typical for people

like you.

With impaired cellular response to thyroid hormone the next step would be the

most important. Slowly and carefully people like you might increase the first T3

dose by 5 mcg every few days until symptoms and signs began to improve. When

improvement was detected then the interval between changes would increase to

perhaps a week to two weeks and the change might drop to 2.5 mcg when the first

dose appeared to result in something a little more acceptable. Attention would

then switch to the second T3 dose, only taking this once the first T3 dose had

definitely run out of gas i.e. adjust the time of the second dose and then begin

to increase it.

This is an iterative process. Use symptoms and signs and record them each day in

a log with T3 dosage recorded in detail with times and levels.

Is this OK ? Questions?

I think you'll sort this out - seen problems like this resolved on a large

number of occasions. Just use the T3 properly. Sort the iron out and get the

copper tested like suggested.

Also please do take a strong B complex (50 mg of each of the main Bs twice a day

with meals, vitamin C in 500 mg doses multiple times a day - say 4 or 5, a

multi-mineral to cover all the remaining bases).

If this begins to help then a twenty-four hour urinary cortisol is in order to

assess real adrenal status (but do suggest you get off the adrenal meds - you

probably don't need them).

Take care and thanks for being such an interesting problem!

>

[Guest guest]

This is a very real

issue . If all our blood tests show that our pituitary, hypothalamus, thyroid

glands are functioning fine and secreting the hormones at the levels they

should, yet we are suffering with peripheral thyroid hormone deficiencies etc.,

just what ARE the tests doctors can do to find this out. There must be

something that we can point them to, to help with this, otherwise, this is

going to continue to be missed, and denied even, that such a condition actually

exists.

Luv - Sheila

Not only do I totally believe this last statement based on what I know but

years ago I went through some of the same quests for information as you are

doing in the hope that I could just 'find the answer' and 'unravel the

solution' - you won't be able to do this. All the good stuff happens within the

cells and we can't measure any of the really interesting things. We can

identify based on medical research all the various things that can go wrong but

this only gives background info - it doesn't help resolve anything.

[Guest guest]

I had thyroxine and TSH tested after being on 12.5mcg of T3 for 1 week and my

TSH had come down:

THYROID STIMULATING HORMONE 0.97 mIU/L 0.27 - 4.2

FREE THYROXINE 17.1 pmol/l 12.0 - 22.0

so I think the pituitary is responding. I heed all of your other advice and am

already on half the dose of B's you suggest but will up it.

Mark

[Guest guest]

Hi Sheila or anybody who can remember -I did a post a while ago to find out the

highest dose of T3 anybody was taking -the largest was a member from Florida who

if I remember correctly was 300T3 which was a lot bigger than anyone else - her

doctor did a test which showed she was not hyper [how much enters the cells ] Do

we have that test in the UK? If not why not ?

[Guest guest]

There aren't any at the moment Sheila.

It needs researchers to make some massive breakthrough.

It can only be done currently by careful assessment of symptoms and signs and

having ruled out all other causes you are left with the only remaining

possibility - hypothyroidism at the tissue level.

As I refer to it 'impaired cellular response to thyroid hormone'

As Mark Starr calls it 'Type 2 Hypothyroidism'

As Lowe calls it 'Peripheral Tissue Resistance'

- it is all the same thing and at the present time it is virtually undetectable

by any laboratory test. The exception to this is if you know exactly what the

particular underlying cause is and then can persuade a research lab to test for

it - NOT MUCH OF A CHANCE OF THAT.

So, we wait for a breakthrough and we hope that the doctors and endos learn that

by being a lot smarter they can actually figure out that it is occurring and

then treat people.

Look, I'm not a doctor but I've now worked with loads of people and got them

from near invalidity in some cases to complete recovery - sometimes after having

been ill for 10-20 years. So, it can be done but it requires far more subtlety

and a lot of close 1-1 time. So, it may require specialist centres in the

interim until a breakthrough in research allows proper diagnosis and some tests

that can help the titration of thyroid meds (since TSH, FT3 and FT4 are near

useless in this case).

Happy days eh?

Cheers,

>

> This is a very real issue . If all our blood tests show that our

[Guest guest]

Let me be clear,

There is no one answer for everyone!!!!!!!!!

In general people do better on 3-5 divided doses of T3 - in order to keep the

peak levels down.

In your case you clearly can't do much with the smaller doses.

So, if I was someone like you then I'd simplify things and try larger doses.

Horses for courses - no one solution.

>

> Hi ,

>

>

[Guest guest]

Hi Mark,

Good.

The iron is clearly a problem.

In terms of the T3, someone like you with a clear almost non existent response

to T3 should have everything else evaluated first to exclude all possibilities

prior to dropping down from 3-5 doses and aiming for two or even one really much

bigger ones.

Anyone who is soldiering on with 12.5 mcg doses with no response should have

their head examined because these are tiny doses for most people.

I spoke to someone only last week who takes 80mcg in the morning and 60 around

tea time. A lot of folks I've talked to take totals of up to 200 mcg and I know

people exist on a lot more than this.

Many do fine on a lot less T3, including me.

Being safe, being thorough is critical before increasing as you may decide to

do.

It is essential to have the understanding of how T3 works and what the problems

can be though - in order to be able to work out what may be the issues.

This is why so many GPs and endos struggle to use it right. They have parked

their brains a long time ago and come to rely on laboratory testing to tell them

what to do.

Please post back when you start to improve, which I am reasonably confident you

will.

>

> Hi ,

>

[Guest guest]

I don't believe a lab test exists other than the BMR.

You can test this to a certain extent by doing biopsy but not through blood or

urine.

Anyway, entering the cells is no measure.

You need to know:

1. Do the nuclear thyroid receptors have enough T3? AND

2. Do the mitochondrial receptors have enough T3? AND

3. Has the resultant chemical processing resulted in correct regulation of cell

function?

Even after binding to the thyroid receptors in 1 and 2 problems can still occur.

So, this is extraordinarily hard to test for. The old fashioned BMR was ideal

because it showed out real basal metabolic rate - a real, unequivocal measure

of how our metabolisms were being regulated.

So, I don't know what tests the doc that you referred to did but they cannot be

anyway close to definitive. It really does not exist - honestly!!!!!

300 is at the high end of my experience with people also. But there has been at

least one case of someone needed 500 mcg - with no symptoms of excess.

>

> Hi Sheila or anybody who can remember -I did a post a while ago to find out

the

[Guest guest]

Mark,

As you get into this your questions will be less general. These will be better

handled by email so feel free to do so.

To repeat one more time - most people do well on 3-5 doses per day of T3. Very

few do great on doses as small as 12.5 but I'm sure a few do.

Only when the response has been poor, everything else has been excluded should

doses in the neighbourhood of 30 -100 mcg per day be investigated and then it is

common to drop down to only a couple of doses to day to minimise the total T3.

Increasing one dose first before the other is also common - to work out how much

T3 is required to begin to see improvements. Once this has been established it

is common to then titrate the size of the second dose and adjust its timing to

only take it when the first dose 'begins to run out'.

Cheers,

[Guest guest]

Hi Sheila , -the message referring to a test was63306 and your reply was

63327 .I'm not sure how good this test is but in many things we are well behind

the States .

[Guest guest]

Hi Sheila,

The test that Myhill has used, developed by McClaren-? is the

nearest to finding out the energy available from the mitochondria (as

ATP and ADP/ATP ratio), it's the best we've got so far beyond the BMR.

Bob

>

> This is a very real issue . If all our blood tests show that our

pituitary, hypothalamus, thyroid glands are functioning fine and

secreting the hormones at the levels they should, yet we are suffering

with peripheral thyroid hormone deficiencies etc., just what ARE the

tests doctors can do to find this out.

[Guest guest]

Hi , so long as one sticks to a particular subject heading

and doesn't go off posting about the same topic elsewhere under another

heading, other replies on the topic are easy to follow, e.g. to follow all the responses

in this particular topic, go here thyroid treatment/message/87119

where you can read the original message, and underneath, read also all other 39

responses.

Luv - Sheila

I've posted a bunch of other replies - good luck finding them - these threads

are hard to follow.

Please post your iron results - these can be significant regardless of who

tells you they aren't.

Check all the other replies and then provide the info in a single message if

you can.

[Guest guest]

Hi

What are

you thoughts about this - see message No. Message #63327

of 87329 - and read all the messages there (subject " T3 dose " ). The

test in question is SHBG.

http://www.diagnose-me.com/treat/T248809.html

Luv - Sheila

Hi Sheila or anybody who can remember -I did a

post a while ago to find out the highest dose of T3 anybody was taking -the

largest was a member from Florida who if I remember correctly was 300T3 which

was a lot bigger than anyone else - her doctor did a test which showed she was

not hyper [how much enters the cells ] Do we have that test in the UK? If not

why not ?

[Guest guest]

Do you know what the test is called Bob?

Luv - Sheila

Hi Sheila,

The test that Myhill has used, developed by McClaren-? is the

nearest to finding out the energy available from the mitochondria (as

ATP and ADP/ATP ratio), it's the best we've got so far beyond the BMR.

Bob

>

> This is a very real issue . If all our blood tests show that our

pituitary, hypothalamus, thyroid glands are functioning fine and

secreting the hormones at the levels they should, yet we are suffering

with peripheral thyroid hormone deficiencies etc., just what ARE the

tests doctors can do to find this out.

[Guest guest]

Hi Sheila,

No its rubbish - no correlation between high SHBG and T3 thyrotoxicity.

Been there and done that.

Yes, I've heard this view even from Colin Dayan. SHBG is produced by the liver

and if this is high then supposedly the liver thinks the thyroid hormone is too

high.

It isn't true. From practical experience I know it isn't true and I have heard

this from others also.

Apart from the fact that I know of at least two people who one would assume are

hyper based on this test and aren't there are other things against it. Partial

peripheral resistance may mean that different tissues have different levels of

resistance. What if the liver is less resistant than many other tissues - the

test then fails.

There have been no real scientific studies on people who take T3 only who have

the T3 perfectly titrated so that their BMR is ideal and they have no symptoms

of over-stimulation of thyroid hormone. These studies have never been done - so

how can the endocrinologists expect to pull a rabbit out of the hat and say if

SHBG is high then the patient must be hyper - total BS I'm afraid.

As soon as I went on thyroid hormone my SHBG was high. It was high for a few

years when I was on T3 also. I did have some issues that might be associated

with high SHBG at the time, which I'm not going to discuss here. I got these

sorted by taking a low dose of another drug to cut the SHBG in half. AT NO TIME

DID I HAVE ANY HYPER SYMPTOMS. I was not thyrotoxic and I was only taking

between 35 and 45 mcg of T3 then!!!!!

When my autoantibodies began to lower I realised that I no longer needed the

drug to reduce the SHBG and I haven't used it for 6 or 7 years and have no

issues no. I haven't had SHBG re-measured at all but it could still be high.

You could discount my data. But I don't. There is a total lack of decent

research using populations of perfectly titrated T3 patients. The data doesn't

exist.

I've seen this mentioned a ton of times and yet again the endos are trying to

find a laboratory test that they think can make their lives simple - and yet

again it just doesn't work.

Cheers,

>

> Hi

>

>

>

> What are you thoughts about this - see message No. Message #63327 of 87329 -

> an