feel like giving up

[Guest guest]

Sounds like you are undertreated all the way. 1.5 grains Nature throid is not

much thyroid even with the extra T3. If your T3 was already high on your last

test it doesn;t make sense to increase just the T3, but I agree you need more

than 2 grains Naturethroid. Have you taken your temps recently? This is a good

way to tell if it is thyroid or adrenal causing you to feel bad. You can read

about this at www.drrind.com he even has a great temperature graph you can print

out & use.

*Artistic Grooming * Hurricane, WV

Fat cat? Diabetes? Listowner for overweight or hypothyroid cats

http://groups.yahoo.com/group/hypokitties/

[Guest guest]

My doctor said if I

> don't feel well up the T3 I take 5mcg of cytomel and

> 1.5 grain of naturethroid. I upped the dose of

> nautrethroid to 2 grain ,

___________________

Your total thyroid dose is proably still too low for you to feel

good. 5 mcg of cytomel is equal to 20mcg of T4. Add this to the 2

grains you are taking and you are at about 2-1/2 grains. This is

still not high enough for the majority of people to feel good.

Studies done with heatlhy people found that they were not able to

make any changes to people's metabolic rate and thyroid status

untill the dose got up to 3 to 5 grains. Another study done with T4

only meds found that they were not able to change their thyroid

status untill the dose got up to 250 -350mcg. This is equivelent to

almost 3-1/2 to almost 5 grains.

Lower doses of thyroid hormone (less than about 3 grains) can

actually make you more hypothryoid. They seem to interfere with

pituitary function and can slow your own thyroid down.

The heatlhy human thyroid makes between 3 and 5 grains a day. In

theory, if you take 2 grains, the pituitary adjusts TSH to tell your

thyroid to make another 1 to 3 grains to get your daily total up to

3 to 5 grains or whatever you need. But, it has been found that

doses lower than 3 grains minimum can actually slow the pituitary

down too much and then your thyroid does not get the message to make

enough more hormone to get your total up to where it needs to be.

So, from your story, you are likely not going to feel goo untill you

get your dose up more. Some people need much more than 5 grains to

feel well. In the past, thyroid doses were adjusted by how the

patient felt. They were slowly raised up over a few months or more

untill the patient was free of symptoms and felt well. This is what

you need to do. Typical thyroid teplacement doses before the big

fixation on test numbers were between 2 to 5 grains. For over 75

years thyroid doses were 2 to 3 times higher than they are today and

patients were in good health at these higher doses.

http://thyroid.about.com/library/derry/bl11.htm

http://thyroid.about.com/library/derry/bl3a.htm

Your depression is the result of inadequate thyroid replacement. It

will go away if you get your dose up high enough for your needs.

People's needs for thyroid hormone vary greatly and about 20% fall

outside of the so called " normal " ranges on tests.

The reason that your test results came back high in the past is

probably due to low adrenal function or anemia or another deficiency

that prevented your body from being able to use thyroid. When these

things happen, thyroid hormone builds up in the blood and can't get

into tissues. The result is that you will get false high results on

tests.

Anyway, keep pressuring your doctor for dose raises untill you feel

good. If he won't allow you to adjust your dose to where you need

it, find another doctor who will.

Tish

____________________

Author: Dr PBS Fowler

Date Published: 23-May-2001

Publication: Lancet 2001; 357: 619-24. Volume 357,

Number 9273 23 June 2001

Title: Letter in response to Colin Dayan's article '

Interpretation of thyroid function tests'.

Before the days of hormone assays, hypothyroid patients

received about double the average dose of thyroxine

given today, but did not develop osteoporosis or atrial

fibrillation. Doses should be judged clinically rather

than be governed by misinterpreted hormone results.

P B S Fowler

1 Dayan CM. Interpretation of thyroid function tests.

Lancet 2001; 357: 619-24.

__________________________

From " Thyroid Guardian of Health " by G. Young

It is an important guidline in that if individuals are placed on and

excessive dose of thyroid hormone, the temperature should become

elevated within two weeks time. However, if the thyroid feedback

mechanisms are working properly it is impossible to make and

individual hyperthyroid untill they are given more thyroid that the

gland produces--about 4-1/2 grains for a small individual and about

5 grains for the usual adult. Their basal temperature should rise up

over 98.2 deg F if they are truely hyperthyroid, and thus have too

much thyroid hormone. The pulse is important as well; a slow pulse

is typical of pure low thyroid condition. With low adrenal function,

the pulse speeds up and the rapid pulse may indicate inadequate

adrenal support. The blood pressure is also an important guid line.

A blood pressure with a systolic below one hundred indicates

inadequate adrenal support......

Some authorities believe that if autoantibodies are present, it

renders other thyroid testing invalid.

Clinical symptoms remain the best indicator of adequate dosage.

__________________________________

Barry Durrant Peatfield " The Great Thyroid Scandal " Page 101

We saw earlier that the thyroid hormones have to be processed in the

body to work;

the chief one, thyroxine (T4) has to be converted into the active

thyroid hormone triiodothyronine

(T3), under the action of the two 5'-diodinase enzymes. With a low

adrenal reserve this reaction doesn't proceed as it should, and the

body may become

toxic with unused and unusable T4. The problem doesn't end there:

the T3 has to be

taken up by the receptors within the cell wall, to be passed into

the cell. This uptake

is degraded in adrenal insufficiency; the receptors become dormant

or may disappear

or may become resistant. In this situation, even if T3 is available,

the system can

become toxic if it cannot be used properly. You can see how

desperately important

the adrenals are; and equally how important it is to provide adrenal

support, in the

form of cortisone supplementation when low adrenal reserve is

present. I must tell

you now that the failure of thyroid supplementation to restore

normal health may

well be largely down to the adrenal problem.

__________________________

http://www.bites-medical.org/hypo/hist.html

Desiccated thyroid in pill form continued to be the main treatment

for hypothyroidism until the 1960s. Its use diminished after

Synthroid, the first synthetic medication, arrived on the market in

1958. There were no problems with desiccated thyroid even at high

doses, and it was known as one of the safest drugs available.

Synthetic T4, on the other hand, has had a long history of

manufacturing and reliability problems.

**************

http://www.drlowe.com/QandA/askdrlowe/armourthyroid.htm

That optimal dosage range is highly individual, but historically,

the typical patient's therapeutic window has been somewhere between

120 to 240 mg (2 to 4 grains). There's no way to accurately predict

what your therapeutic window is.

****************

Dr. Derry, " Breast Cancer and Iodine " :

Before the 1973-1974 change in laboratory diagnosis, the objective

of treatment in all cases was raise the thyroid dose up untill the

patient was in a state of well-being.

Before the 1973-74 change, the normal dose of thyroid was three

times the level seen now (2 -3 grains now) and there were no cases

of fractures or osteoporosis ever reported in the previous 80 years.

_________________________________

Dr. Barry Peatfield from his book " The Great

Thyroid Scandal " Page 87-88:

The disgraceful fact is that all these measurements (except the

last) may not be worth the paper they are written on; or may be so

flawed that treatment based on them is bound to be wrong. So what

goes wrong? And why are doctors not aware that they may be so badly

off the beam? And why do so many have minds so closed?

The reasons blood tests may be so flawed we need now to examine.

First and foremost these are measures only of the levels of thyroid

hormone in the blood. What we need to know is the level of thyroid

in the tissues, and, of course, this the blood test cannot tell us.

The nearest we can go is the Basal Temperature Test, or the Basal

Metabolic Rate. The first we have discussed; the second is now of

historical value. The patient is connected up to an oxygen uptake,

carbon dioxide excretion, measuring device, and the rate of usage

determines the metabolic rate. This is also subject to various

errors. The amount of thyroid hormones being carried by the

bloodstream varies in a highly dynamic way, and may be up at one

point and down the next. The blood test is simply a two-dimensional

snapshot of the situation at that moment. The slowed circulation may

cause haemo-concentration from fluid loss, so that the thyroid

levels are higher than they should be. (A simple way to explain this

is to think of a spoonful of sugar in your cup of tea. If it is only

half a cup of tea but you still put in your teaspoon of sugar, then

although the amount of sugar is the same, the tea will be twice as

sweet.)

But the blood levels depend mostly on what's happening to the

thyroid hormones. If the cellular receptors are sluggish, or

resistant, or there is extra tissue fluid, together with

mucopolysaccharides, the thyroid won't enter the cells as it should;

so that part of the hormone is unused and left behind, giving a

falsely higher reading to the blood test. It is simply building up

unused hormone. This may apply to both T3 and T4. Further

complications exist if the T4 + T3 conversion is not working

properly, with a 5'-diodinase enzyme deficiency. There will be too

much T4, and too little T3. If there is a conversion block, and a T3

receptor uptake deficiency, both T3 and T4 may be normal or even

raised. The patient will be diagnosed as normal or even over-active;

in spite of all other evidence to the contrary. It grieves me to

report that I have intervened several times to prevent patients,

diagnosed as hyperthyroid, having an under-active thyroid removed

when the only evidence was the high T4 level (due to receptor

resistance) and the patient was clinically obviously hypothyroid.

The patients thanked me, but not the consultants.

Adrenal insufficiency adds another dimension for error to the T4 and

T3 tests. Adrenal insufficiency, of which more anon, will adversely

affect thyroid production, conversion, tissue uptake and thyroid

response. It may make a complete nonsense of the blood tests.

The most commonly used test of all is the TSH. I have sadly come

across very few doctors who can accept the fact that a normal, or

low TSH may still occur with a low thyroid. The doctrine is high TSH

= low thyroid. Normal TSH = normal thyroid. But the pituitary may

not be working properly (secondary or tertiary hypothyroidism). It

may not be responding to the Thyrotrophin Release Hormone(TRH)

produced by the hypothalamus, which itself may not be producing

enough TRH for reasons we saw earlier. The pituitary may be damaged

by the low thyroid state anyway, and be sluggish in its TSH output.

______________________________

MINI REVIEW

Intrinsic imperfections of endocrine replacement therapy

J A Romijn, J WA Smit and S W J Lamberts

Department of Endocrinology, Leiden University Medical Center,

Leiden and Department of Internal Medicine, Erasmus Medical Center,

Rotterdam University, Rotterdam, The Netherlands

(Correspondence should be addressed to J A Romijn; Email:

j.a.romijn@...)

However, many patients

treated for endocrine insufficiencies still suffer from more or less

vague complaints and a decreased

quality of life. It is likely that these complaints are, at least in

part, caused by intrinsic imperfections

of hormone replacement strategies in mimicking normal hormone

secretion.

......effects of

hormones in general, and thus of hormone replacement strategies in

particular, are difficult to

quantify at the tissue level. Therefore, in clinical practice we

rely mostly on plasma variables –

`plasma endocrinology' – which are a poor reflection of hormone

action at the tissue level.

Complaints of thyroid patients....They range from

musculoskeletal complaints, to vague feelings of being

unwell, and to depression. Two approaches have been

used to decrease the complaints experienced by these

patients: an increase in the dose of L-thyroxine, and

combination treatment of thyroxine with tri-iodothyronine.

In some of the patients, a decrease in complaints

can be achieved by increasing the dose of thyroxine

above that required to restore TSH concentrations to

normal (1). For this reason, such patients are often

allowed to take a dose of thyroxine that would be

judged as overtreatment with respect to TSH concentrations.

The second approach was evaluated by

Bunevicius et al. (2), who performed a randomised controlled

trial to compare the effects of thyroxine alone

with those of thyroxine plus tri-iodothyronine. Patients

with hypothyroidism benefitted when 12.5 mg triiodothyronine

was substituted for 50 mg thyroxine in

their treatment regimens. This resulted in improved

neuropsychological functioning. Pulse rates and

serum sex hormone-binding globulin concentrations

were greater after treatment with thyroxine plus

tri-iodothyronine, indicating a slightly greater effect

on the heart and liver. Serum thyroxine concentrations

were lower and tri-iodothyronine concentrations

were greater after treatment with thyroxine plus

tri-iodothyronine, but serum TSH concentrations, a

sensitive measure of thyroid hormone action, were

similar after the two treatments. It should be noted

that not all patients benefitted from this approach

because, even in the group with combination therapy,

patients continued to report complaints of depression.

Thyroxine:

The thyroid secretes tri-iodothyronine (T3) (,20%) in addition to

thyroxine (T4) (,80%). In the absence of

thyroid function, exogenous thyroxine is not able to normalise the

concentrations of T4 and T3 in all tissues in rodents, even in the

presence of normal TSH concentrations. Despite this knowledge,

currently available preparations of T3 have unfavourable

pharmacological profiles and adequate markers of biological effect

are lacking. Additional evidence is required before combination

therapy can be advised.

First, it is remarkable that the normal values

of TSH show a more than tenfold variation, between

0.4 and 4.5mU/l. Because, in clinical practice, the optimal

TSH concentration for individual patients within

this range is unknown, titration of the substitution

dose of thyroxine within this tenfold variation is

relatively crude. Secondly, the intrinsic assumption of

many doctors in this approach is that normal TSH

concentrations reflect adequate thyroid hormone

concentrations, not only at the tissue level of the

hypothalamus and the pituitary, but also in the other

tissues. However, it is likely that this assumption is

erroneous, because TSH is produced only by the

pituitary gland and therefore may not reflect thyroid

hormone status in tissues outside the hypothalamo–

pituitary axis. This notion is supported by data obtained

from animal experiments.

Thyroxine is considered to be an

inactive hormone, because a thyroxine-specific receptor

has not been identified. Rather, thyroxine serves as a

prohormone, because it is the precursor of tri-iodothyronine.

Some tissues, such as muscle, have a relatively low

deiodinase activity and are dependent, to a great

extent, on tri-iodothyronine derived from the thyroid

and the liver.

In rodents, it has been clearly demonstrated that

there is no single dose of thyroxine or tri-iodothyronine

that normalises thyroid hormone concentrations in all

tissues simultaneously in hypothyroid animals (3).

Therefore, it is highly likely that, in patients treated

with L-thyroxine, subtle derangements at the tissue

level are present with respect to thyroid hormone availability,

and probably also thyroid hormone action.

[Guest guest]

>>my temperature is 97.8° from morning to night. It was

98.6° when I took my last blood test, can stress and

or mercury filling removal change the thyroid

condition so fast. I feel that my thyroid crashed ..<<

I am not sure. Inga might chime in here if she is reading. But it does sound

like a thyroid crash. If you have Hashi's that is a very good possibility. I had

swings from very hypo to very hyper for a number of years before my thyroid gave

up the ghost and now I am at full replacement and then some.

*Artistic Grooming * Hurricane, WV

Fat cat? Diabetes? Listowner for overweight or hypothyroid cats

http://groups.yahoo.com/group/hypokitties/

[Guest guest]

>>my temperature is 97.8° from morning to night. It was

98.6° when I took my last blood test, can stress and

or mercury filling removal change the thyroid

condition so fast. I feel that my thyroid crashed ..<<

I am not sure. Inga might chime in here if she is reading. But it does sound

like a thyroid crash. If you have Hashi's that is a very good possibility. I had

swings from very hypo to very hyper for a number of years before my thyroid gave

up the ghost and now I am at full replacement and then some.

*Artistic Grooming * Hurricane, WV

Fat cat? Diabetes? Listowner for overweight or hypothyroid cats

http://groups.yahoo.com/group/hypokitties/