Re: High SHBG on T3

[Guest guest]

Yes he is well knowen but did not say anything about the other T's that get

converted from T4 or how the brain makes it's own hormone for the brain from T4.

Just go to Dr. M's forum and read up on Thyroid.

http://www.definitivemind.com/forums/index.php

=========================================

Originally Posted by wolverine

Dr. no, do T4 and T3 cross the blood brain barrier only as free T4 and free

T3? Or do all forms of T4 and T3 get across? Some forms easier than others?

Since T4 and T3, in whatever form, are all measurements of serum concentrations,

can Total T4, Free T4, Total T3, and/or Free T3 (or some combination) be used to

infer CSF concentrations?

I believe that this becomes an issue when desiccated thyroid is used as sole

replacement therapy. Often this results in normal (or high normal) Free T4, Free

T3, and Total T3, but markedly sub-normal Total T4. In this scenario, if CNS

hypothyroidism were suspected (and I'm not sure what symptoms would

differentiate CNS from peripheral hypothyroidism), would it be desirable, e.g.,

to achieve a normal Total T4 by decreasing the dose of desiccated thyroid and

adding pure T4?

Thanks.

T3 and T4 are bound to three proteins in the blood:

Thyroid Binding Globulin (also called Thyroxine-Binding Globulin, TBG)

Transthyretin

Albumin

The distribution of thyroid hormones and binding proteins are approximately:

T4: 68% to TBG, 11 % to Transthyretin, 20 % to Albumin

T3: 80 % to TBG, 9 % to Transthyretin, 11 % to Albumin

T4 has a stronger bond to TBG.

T3 has a stronger bond to Transthyretin

Both T3 and T4 have a much weaker bond (approximately 100 to 1000 x less) to

Albumin.

The thyroid hormones dynamically change between the free state and the bound

state. Since the bond to Albumin is weaker, much of what is bound to Albumin may

be free at any given moment, but won't be registered as Free T3 or Free T4. Some

portion of T3 and T4 is also free at any given moment but may not be registered

as Free T3 or Free T4.

Free T3 and Free T4 give you only a snapshot - one moment in time - of the

state. But this state varies from moment to moment.

This is why it is useful to take Total T3 and Total T4 into account to help

determine total thyroid function.

This is analogous to Testosterone. Some use " bioavailable " testosterone as a

measure of testosterone signaling activity. This would represent testosterone

that is free and testosterone that is loosely bound to albumin. However, even

tightly bound testosterone to sex-hormone binding globulin (SHBG) has signaling

functions via induced conformational changes in the SHBG molecule then binding

of testosterone-bound SHBG to SHBG receptors.

---

Thyroid hormone does not directly diffuse into cells.

Thyroid hormone is transported across cell membranes by various transporter

molecules. In the brain and in the blood brain barrier (BBB), two known

transporter molecules are Thyroid Hormone Transporter Molecule MCT8 and Organic

Anion Transporting Polypeptide OATP1C1. MCT8 is also produced in heart, kidney,

liver, and skeletal muscle.

There are two blood brain barriers: The Blood Brain Barrier Endothelial cells

that line the blood vessels of the brain and are connected to astrocytes of the

brain, and the Blood Cerebral Spinal Fluid Barrier Choroid Plexus Epithelial

Cells that connect the blood to the Cerebopinal Fluid. The Choroid Plexus

filters blood in order to produce Cerebrospinal Fluid.

From blood, T3 and T4 enter the brain via two paths:

1. T3 and T4 are transported into a BBB Endothelium Cell (via OATP). T3 and T4

are then transferred into an attached Astrocyte. In the Astrocyte, Deiodinase D2

coverts T4 to T3. T3 then exits the Astrocyte via MCT8. T3 then enters neurons

via MCT8 transporters.

2. T3 and T4 are transported into Blood Cerebral Spinal Fluid Barrier Choroid

Plexus Epithelial Cells (via MCT8). They they exit the choroid plexus (via OATP)

and enter the Cerebrospinal Fluid (CSF). From the CSF, T3 and T4 are taken up by

Tanycytes or Astrocytes. These cells have D2 Diodinase, which convert T4 to T3.

Upon exiting these cells, T3 enters neurons.

Notably, neurons have Diodinase D3 enzyme which converts T4 to reverse T3 and T3

to T2.

The presence of thyroid hormone can reduce production of OATP as part of a

negative feedback loop control.

---

Within brain cells, there are variations nuclear membrane thyroid transporters.

Usually, 90 % of the intracellular T3 is located in the cytosol and 10 % is in

the nucleus. In the pituitary gland's cells, however, 50 % of T3 is in the

nucleus.

---

Adding to the complexity of how thyroid hormone works, there is an Intracellular

T3 Binding Protein (CTPB) which is produced in high amounts in the brain and

heart, though is also widespread in production in the body.

---

Serum measurements of thyroid hormone can't be used to infer CSF concentrations.

Only a spinal tap will be able to tell what the CSF concentrations are.

---

Brain thyroid hormone levels and T3 to T4 ratios are going to be determined at

several levels.

For example, the number and types and location of thyroid transporters

determines what amount of thyroid hormone gets through.

Variations in the genes for the thyroid transporter molecules will determine how

effective they are and how selective they are for T3 or T4 transport - creating

a difference between Blood and Brain concentrations of Thyroid hormones.

Variations in Astrocyte and Tanycyte Diodinase D2 production will determine T3

to T4 conversions in the brain, which may be different from the blood.

etc.

---

From my point of view, given the differences that can arise in blood versus

brain levels of thyroid hormone and thyroid hormone conversion, it is important

to consider in some patients to not only optimize T3 but to also optimize T4

levels.

This is important, for example, in mood disorders. Here, the difference between

T3 and T4 treatment becomes apparent.

In major depressive disorder, historically, T3 is a more effective treatment

than T4 in reducing depressive symptoms. Spectulating: perhaps T4 to T3

conversion in the brain's astrocytes and tanycytes is impaired by lack of D2

Diodinase production, among other possible problems in brain thyroid hormone

metabolism.

In bipolar disorder, historically, T4 is much more effective than T3 in

stabilizing mood. T4 may be used medicinally to reach " hyperthyroid " levels -

based on TSH measurements - in psychiatry to stabilize mood in bipolar disorder.

Speculating: perhaps, in bipolar disorder, there is a gene mutation in one of

the thyroid transport molecules which selectively impairs T3 transport.

If a person is having problems with a T3 treatment or Armour Thyroid Treatment

(which is primarily a T3 treatment), then perhaps adding a T4 treatment would be

useful. Some patients benefit from combinations of thyroid treatments (e.g. T3 +

T4, Armour Thyroid + Levothyroxine) better than single treatments alone.

__________________

-

Romeo B. no, MD, physician, psychiatrist

Any information provided on www.definitivemind.com is for informational purposes

only, is not medical advice, does not create a doctor/patient relationship or

liability, is not exhaustive, does not cover all conditions or their treatment,

and will change as knowledge progresses. Always seek the advice of your

physician or other qualified health provider before undertaking any diet,

exercise, supplement, medical, or other health program.

--------------------------------------------------------------------------------

Last edited by Drno; 08-16-2009 at 09:07 PM.

============================================

Originally Posted by Jean

I've got primary hypothyroidism since 20 year's. This first 12 year's of

levothyrox is feel good. After this time levothyrox don't work very well,

because my adrenal shut down.

I don't known why my adrenal shut down but I've a suspicion about pathogens

(lyme disease, candidiasis...)

Today, I take armour + Levothyrox + HC and some pregnenolone. But, I've

difficulty to lose weight and a lack of energy depiste a good diet and exercise

program.

But I have a suspicion about the best thyroid treatment. In fact, if I take only

armour I feel bad if I take 2 grains, I lose muscle size and no fat, and more

tired depiste hydrocortisone therapy

If I take a mix of one grain of armour with 150 mcg of T4 (levothyrox) my blood

level is high normal range but I don't lose weight depiste normal temperature

Free T3 ---- 3, 98 pg/nl (N : 2,3 to 4,2)

Free T4 -----24,14 ng/l (N: 8,90 to 17,6)

TSH 0,010

RT3 ------- 0, 25 ng/ml (N: 0,09 to 0,35)

In fact, thera a war between doctor that explain armour work best because it's

natural and some doctor that explain that armour is to bad because is increase

to much free T3

There are some study that explain that levothyrox is toxic for the liver

(decrease glutathion level)

Thank you for your advises

Endocr J. 1999 Aug;46(4):579-83. LinksLevothyroxine-induced liver dysfunction in

a primary hypothyroid patient.

Ohmori M, Harada K, Tsuruoka S, Sugimoto K, Kobayashi E, Fujimura A.

Department of Clinical Pharmacology, Jichi Medical School, Tochigi, Japan.

Here we report a case of levothyroxine-induced liver dysfunction. T4

(levothyroxine) has been more commonly used for the treatment of hypothyroidism

than T3 active hormone (triiodothyronine), because with the former drug a

stabler plasma concentration is obtained after oral administration. Although

there are few reports on levothyroxine-induced liver dysfunction, we treated a

primary hypothyroid patient with high serum aminotransferase after

administration of levothyroxine. Liver dysfunction was improved after cessation

of the drug administration. Antibody to T4 was found in the serum of the patient

after this event. From clinical course and laboratory data of the patient, the

episode of liver damage was considered to be induced by levothyroxine. We then

administrated triiodothyronine, and it did not induce liver dysfunction.

Changing levothyroxine to triiodothyronine resulted in a successful clinical

course in this case, as re-administration of the

doubtful drug is strictly limited.

Intern Med. 2007;46(14):1105-8. Epub 2007 Jul 17. Links

Liver injury induced by levothyroxine in a patient with primary hypothyroidism.

Kawakami T, Tanaka A, Negoro S, Morisawa Y, Mikami M, Hojo M, Yamamoto T, Uegaki

S, Aiso M, Kawasaki T, Ishii T, Kuyama Y, Fukusato T, Takikawa H.

Department of Medicine, Teikyo University School of Medicine, Tokyo.

We report a patient with primary hypothyroidism, who developed hepatocellular

injury due to levothyroxine, synthetic thyroxine. A 63-year-old male was

admitted to our hospital due to elevation of liver enzymes. The patient was

diagnosed as having hypothyroidism and had been treated with levothyroxine for

almost two months until admission. Drug-induced liver injury induced due to

levothyroxine was suspected and liver enzymes were rapidly decreased after

discontinuation of levothyroxine and dried thyroid powder, also containing

thyroxine. Synthetic triiodothyronine, the deiodinated form of levothyroxine was

administered instead, and was well tolerated by the patient. The drug-induced

lymphocyte stimulation test (DLST) using levothyroxine was negative. Since

triiodothyronine which structurally resembles levothyroxine did not cause liver

injury, and DLST using levothyroxine was negative, it is unlikely that

levothyroxine itself was targeted by the immune

system. Rather, we assume that the complex of levothyroxine as the hapten and

liver-related macromolecules in the body as the carrier might have acquired

antigenicity in this patient and subsequently resulted in liver injury

Interesting case, but this is a rare case of someone developing an immune

reaction to T4 (Levothyroxine).

Levothyroxine (T4) is identical to what the thyroid gland makes. Synthetic or

naturally made, it is the same substance. To myself, Levothyroxine is a

bioidentical hormone treatment because it is identical to what the body makes.

Armour thyroid is 20% T3 (triiodothyronine) and 80% T4 (levothyroxine). Thus if

one is taking Armour Thyroid, then one is also taking Levothyroxine.

The problem of Armour Thyroid alone treatment is that it has a higher T3

component than what the human thyroid gland produces. Thus, some people may be

more sensitive to the higher T3 component and won't do well. On the other hand,

many people do better on Armour Thyroid because they need the higher T3

component than what could be obtained with Levothyroxine treatment alone. And

some people do better on a combination of Armour Thyroid and Levothyroxine. This

combination reduces the T3 component of treatment. Finally, some people do best

on T3 treatment alone - neither Levothyroxine or Armour Thyroid.

The ultimate question is: What mix of T4 and T3 would serve the patient best?

That will depend on that individual.

This is difficult to measure since the brain and body are two separate

compartments. The brain can have a different conversion rate of T4 to T3 than

the body. Thus, the body may have enough thyroid but the brain can be

hypothyroid, causing significant problems in function. Measuring brain levels of

thyroid hormone is not usually done. It can only be obtained by getting a lumbar

puncture from a neurologist then measurement of CSF thyroid levels would be

done. This has its own risks.

__________________

-

Romeo B. no, MD, physician, psychiatrist

Any information provided on www.definitivemind.com is for informational purposes

only, is not medical advice, does not create a doctor/patient relationship or

liability, is not exhaustive, does not cover all conditions or their treatment,

and will change as knowledge progresses. Always seek the advice of your

physician or other qualified health provider before undertaking any diet,

exercise, supplement, medical, or other health program.

Co-Moderator

Phil

> > > >

> > > > >

> > > > >

> > > > > i understand this. But other

> > > scenario(indirectly).

> > > > >

> > > > > I have long undiagnosed hashimoto(6

> years), but

> > > always normal TSH,

> > > > > FT4(sometimes high), despite i had

> hypothyroid

> > > symptoms. When i started

> > > > to

> > > > > check(myself) FT3 1 year ago, its was

> always

> > > high, but its was due to low

> > > > > cortisol and pooling.

> > > > >

> > > > > over the time of hormone fluctuation

> and

> > > inflammation my adrenals became

> > > > > exhausted(saliva confirm it) and my

> body started

> > > to create RT3 to protect

> > > > > myself? Can't be?

> > > > >

> > > > > Nigel, how much thyroid do you take now

> and how

> > > much was the biggest

> > > > dose?

> > > > >

> > > > > Antanas

> > > > >

> > > >

> > > > [Non-text portions of this message have been

> removed]

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > > --

> > > Mike

> >

> > >

> > >

> > > [Non-text portions of this message have been

> removed]

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

rt3 is always around if the source of the stress or what causing it has not

been properly identified..

>

> >

> >

> > i understand this. But other scenario(indirectly).

> >

> > I have long undiagnosed hashimoto(6 years), but always normal TSH,

> > FT4(sometimes high), despite i had hypothyroid symptoms. When i started to

> > check(myself) FT3 1 year ago, its was always high, but its was due to low

> > cortisol and pooling.

> >

> > over the time of hormone fluctuation and inflammation my adrenals became

> > exhausted(saliva confirm it) and my body started to create RT3 to protect

> > myself? Can't be?

> >

> > Nigel, how much thyroid do you take now and how much was the biggest dose?

> >

> > Antanas

> >

>

>

>

[Guest guest]

Well, according to him you don't need to worry about T4 because T3 does

cross the blood brain barrier and the brain would then convert the T3 to T2,

T1, etc...

Again, I'm not agreeing or disagreeing with him but just providing some

information I recently came across.

Mike

On Thu, Feb 17, 2011 at 9:58 AM, philip georgian <pmgamer18@...>wrote:

>

>

> Yes he is well knowen but did not say anything about the other T's that get

> converted from T4 or how the brain makes it's own hormone for the brain from

> T4. Just go to Dr. M's forum and read up on Thyroid.

> http://www.definitivemind.com/forums/index.php

> =========================================

> Originally Posted by wolverine

> Dr. no, do T4 and T3 cross the blood brain barrier only as free T4 and

> free T3? Or do all forms of T4 and T3 get across? Some forms easier than

> others?

>

> Since T4 and T3, in whatever form, are all measurements of serum

> concentrations, can Total T4, Free T4, Total T3, and/or Free T3 (or some

> combination) be used to infer CSF concentrations?

>

> I believe that this becomes an issue when desiccated thyroid is used as

> sole replacement therapy. Often this results in normal (or high normal) Free

> T4, Free T3, and Total T3, but markedly sub-normal Total T4. In this

> scenario, if CNS hypothyroidism were suspected (and I'm not sure what

> symptoms would differentiate CNS from peripheral hypothyroidism), would it

> be desirable, e.g., to achieve a normal Total T4 by decreasing the dose of

> desiccated thyroid and adding pure T4?

> Thanks.

>

> T3 and T4 are bound to three proteins in the blood:

> Thyroid Binding Globulin (also called Thyroxine-Binding Globulin, TBG)

> Transthyretin

> Albumin

>

> The distribution of thyroid hormones and binding proteins are

> approximately:

> T4: 68% to TBG, 11 % to Transthyretin, 20 % to Albumin

> T3: 80 % to TBG, 9 % to Transthyretin, 11 % to Albumin

>

> T4 has a stronger bond to TBG.

> T3 has a stronger bond to Transthyretin

> Both T3 and T4 have a much weaker bond (approximately 100 to 1000 x less)

> to Albumin.

>

> The thyroid hormones dynamically change between the free state and the

> bound state. Since the bond to Albumin is weaker, much of what is bound to

> Albumin may be free at any given moment, but won't be registered as Free T3

> or Free T4. Some portion of T3 and T4 is also free at any given moment but

> may not be registered as Free T3 or Free T4.

>

> Free T3 and Free T4 give you only a snapshot - one moment in time - of the

> state. But this state varies from moment to moment.

>

> This is why it is useful to take Total T3 and Total T4 into account to help

> determine total thyroid function.

>

> This is analogous to Testosterone. Some use " bioavailable " testosterone as

> a measure of testosterone signaling activity. This would represent

> testosterone that is free and testosterone that is loosely bound to albumin.

> However, even tightly bound testosterone to sex-hormone binding globulin

> (SHBG) has signaling functions via induced conformational changes in the

> SHBG molecule then binding of testosterone-bound SHBG to SHBG receptors.

>

> ---

>

> Thyroid hormone does not directly diffuse into cells.

>

> Thyroid hormone is transported across cell membranes by various transporter

> molecules. In the brain and in the blood brain barrier (BBB), two known

> transporter molecules are Thyroid Hormone Transporter Molecule MCT8 and

> Organic Anion Transporting Polypeptide OATP1C1. MCT8 is also produced in

> heart, kidney, liver, and skeletal muscle.

>

> There are two blood brain barriers: The Blood Brain Barrier Endothelial

> cells that line the blood vessels of the brain and are connected to

> astrocytes of the brain, and the Blood Cerebral Spinal Fluid Barrier Choroid

> Plexus Epithelial Cells that connect the blood to the Cerebopinal Fluid. The

> Choroid Plexus filters blood in order to produce Cerebrospinal Fluid.

>

> From blood, T3 and T4 enter the brain via two paths:

>

> 1. T3 and T4 are transported into a BBB Endothelium Cell (via OATP). T3 and

> T4 are then transferred into an attached Astrocyte. In the Astrocyte,

> Deiodinase D2 coverts T4 to T3. T3 then exits the Astrocyte via MCT8. T3

> then enters neurons via MCT8 transporters.

>

> 2. T3 and T4 are transported into Blood Cerebral Spinal Fluid Barrier

> Choroid Plexus Epithelial Cells (via MCT8). They they exit the choroid

> plexus (via OATP) and enter the Cerebrospinal Fluid (CSF). From the CSF, T3

> and T4 are taken up by Tanycytes or Astrocytes. These cells have D2

> Diodinase, which convert T4 to T3. Upon exiting these cells, T3 enters

> neurons.

>

> Notably, neurons have Diodinase D3 enzyme which converts T4 to reverse T3

> and T3 to T2.

>

> The presence of thyroid hormone can reduce production of OATP as part of a

> negative feedback loop control.

>

> ---

>

> Within brain cells, there are variations nuclear membrane thyroid

> transporters. Usually, 90 % of the intracellular T3 is located in the

> cytosol and 10 % is in the nucleus. In the pituitary gland's cells, however,

> 50 % of T3 is in the nucleus.

>

> ---

>

> Adding to the complexity of how thyroid hormone works, there is an

> Intracellular T3 Binding Protein (CTPB) which is produced in high amounts in

> the brain and heart, though is also widespread in production in the body.

>

> ---

>

> Serum measurements of thyroid hormone can't be used to infer CSF

> concentrations. Only a spinal tap will be able to tell what the CSF

> concentrations are.

>

> ---

>

> Brain thyroid hormone levels and T3 to T4 ratios are going to be determined

> at several levels.

>

> For example, the number and types and location of thyroid transporters

> determines what amount of thyroid hormone gets through.

>

> Variations in the genes for the thyroid transporter molecules will

> determine how effective they are and how selective they are for T3 or T4

> transport - creating a difference between Blood and Brain concentrations of

> Thyroid hormones.

>

> Variations in Astrocyte and Tanycyte Diodinase D2 production will determine

> T3 to T4 conversions in the brain, which may be different from the blood.

>

> etc.

>

> ---

>

> From my point of view, given the differences that can arise in blood versus

> brain levels of thyroid hormone and thyroid hormone conversion, it is

> important to consider in some patients to not only optimize T3 but to also

> optimize T4 levels.

>

> This is important, for example, in mood disorders. Here, the difference

> between T3 and T4 treatment becomes apparent.

>

> In major depressive disorder, historically, T3 is a more effective

> treatment than T4 in reducing depressive symptoms. Spectulating: perhaps T4

> to T3 conversion in the brain's astrocytes and tanycytes is impaired by lack

> of D2 Diodinase production, among other possible problems in brain thyroid

> hormone metabolism.

>

> In bipolar disorder, historically, T4 is much more effective than T3 in

> stabilizing mood. T4 may be used medicinally to reach " hyperthyroid " levels

> - based on TSH measurements - in psychiatry to stabilize mood in bipolar

> disorder. Speculating: perhaps, in bipolar disorder, there is a gene

> mutation in one of the thyroid transport molecules which selectively impairs

> T3 transport.

>

> If a person is having problems with a T3 treatment or Armour Thyroid

> Treatment (which is primarily a T3 treatment), then perhaps adding a T4

> treatment would be useful. Some patients benefit from combinations of

> thyroid treatments (e.g. T3 + T4, Armour Thyroid + Levothyroxine) better

> than single treatments alone.

> __________________

> -

>

> Romeo B. no, MD, physician, psychiatrist

>

> Any information provided on www.definitivemind.com is for informational

> purposes only, is not medical advice, does not create a doctor/patient

> relationship or liability, is not exhaustive, does not cover all conditions

> or their treatment, and will change as knowledge progresses. Always seek the

> advice of your physician or other qualified health provider before

> undertaking any diet, exercise, supplement, medical, or other health

> program.

>

> ----------------------------------------------------------

> Last edited by Drno; 08-16-2009 at 09:07 PM.

>

> ============================================

> Originally Posted by Jean

> I've got primary hypothyroidism since 20 year's. This first 12 year's of

> levothyrox is feel good. After this time levothyrox don't work very well,

> because my adrenal shut down.

>

> I don't known why my adrenal shut down but I've a suspicion about pathogens

> (lyme disease, candidiasis...)

>

> Today, I take armour + Levothyrox + HC and some pregnenolone. But, I've

> difficulty to lose weight and a lack of energy depiste a good diet and

> exercise program.

>

> But I have a suspicion about the best thyroid treatment. In fact, if I take

> only armour I feel bad if I take 2 grains, I lose muscle size and no fat,

> and more tired depiste hydrocortisone therapy

>

> If I take a mix of one grain of armour with 150 mcg of T4 (levothyrox) my

> blood level is high normal range but I don't lose weight depiste normal

> temperature

>

> Free T3 ---- 3, 98 pg/nl (N : 2,3 to 4,2)

> Free T4 -----24,14 ng/l (N: 8,90 to 17,6)

> TSH 0,010

> RT3 ------- 0, 25 ng/ml (N: 0,09 to 0,35)

>

> In fact, thera a war between doctor that explain armour work best because

> it's natural and some doctor that explain that armour is to bad because is

> increase to much free T3

>

> There are some study that explain that levothyrox is toxic for the liver

> (decrease glutathion level)

>

> Thank you for your advises

>

> Endocr J. 1999 Aug;46(4):579-83. LinksLevothyroxine-induced liver

> dysfunction in a primary hypothyroid patient.

> Ohmori M, Harada K, Tsuruoka S, Sugimoto K, Kobayashi E, Fujimura A.

> Department of Clinical Pharmacology, Jichi Medical School, Tochigi, Japan.

> Here we report a case of levothyroxine-induced liver dysfunction. T4

> (levothyroxine) has been more commonly used for the treatment of

> hypothyroidism than T3 active hormone (triiodothyronine), because with the

> former drug a stabler plasma concentration is obtained after oral

> administration. Although there are few reports on levothyroxine-induced

> liver dysfunction, we treated a primary hypothyroid patient with high serum

> aminotransferase after administration of levothyroxine. Liver dysfunction

> was improved after cessation of the drug administration. Antibody to T4 was

> found in the serum of the patient after this event. From clinical course and

> laboratory data of the patient, the episode of liver damage was considered

> to be induced by levothyroxine. We then administrated triiodothyronine, and

> it did not induce liver dysfunction. Changing levothyroxine to

> triiodothyronine resulted in a successful clinical course in this case, as

> re-administration of the

> doubtful drug is strictly limited.

> Intern Med. 2007;46(14):1105-8. Epub 2007 Jul 17. Links

> Liver injury induced by levothyroxine in a patient with primary

> hypothyroidism.

> Kawakami T, Tanaka A, Negoro S, Morisawa Y, Mikami M, Hojo M, Yamamoto T,

> Uegaki S, Aiso M, Kawasaki T, Ishii T, Kuyama Y, Fukusato T, Takikawa H.

> Department of Medicine, Teikyo University School of Medicine, Tokyo.

> We report a patient with primary hypothyroidism, who developed

> hepatocellular injury due to levothyroxine, synthetic thyroxine. A

> 63-year-old male was admitted to our hospital due to elevation of liver

> enzymes. The patient was diagnosed as having hypothyroidism and had been

> treated with levothyroxine for almost two months until admission.

> Drug-induced liver injury induced due to levothyroxine was suspected and

> liver enzymes were rapidly decreased after discontinuation of levothyroxine

> and dried thyroid powder, also containing thyroxine. Synthetic

> triiodothyronine, the deiodinated form of levothyroxine was administered

> instead, and was well tolerated by the patient. The drug-induced lymphocyte

> stimulation test (DLST) using levothyroxine was negative. Since

> triiodothyronine which structurally resembles levothyroxine did not cause

> liver injury, and DLST using levothyroxine was negative, it is unlikely that

> levothyroxine itself was targeted by the immune

> system. Rather, we assume that the complex of levothyroxine as the hapten

> and liver-related macromolecules in the body as the carrier might have

> acquired antigenicity in this patient and subsequently resulted in liver

> injury

>

> Interesting case, but this is a rare case of someone developing an immune

> reaction to T4 (Levothyroxine).

>

> Levothyroxine (T4) is identical to what the thyroid gland makes. Synthetic

> or naturally made, it is the same substance. To myself, Levothyroxine is a

> bioidentical hormone treatment because it is identical to what the body

> makes.

>

> Armour thyroid is 20% T3 (triiodothyronine) and 80% T4 (levothyroxine).

> Thus if one is taking Armour Thyroid, then one is also taking Levothyroxine.

>

> The problem of Armour Thyroid alone treatment is that it has a higher T3

> component than what the human thyroid gland produces. Thus, some people may

> be more sensitive to the higher T3 component and won't do well. On the other

> hand, many people do better on Armour Thyroid because they need the higher

> T3 component than what could be obtained with Levothyroxine treatment alone.

> And some people do better on a combination of Armour Thyroid and

> Levothyroxine. This combination reduces the T3 component of treatment.

> Finally, some people do best on T3 treatment alone - neither Levothyroxine

> or Armour Thyroid.

>

> The ultimate question is: What mix of T4 and T3 would serve the patient

> best? That will depend on that individual.

>

> This is difficult to measure since the brain and body are two separate

> compartments. The brain can have a different conversion rate of T4 to T3

> than the body. Thus, the body may have enough thyroid but the brain can be

> hypothyroid, causing significant problems in function. Measuring brain

> levels of thyroid hormone is not usually done. It can only be obtained by

> getting a lumbar puncture from a neurologist then measurement of CSF thyroid

> levels would be done. This has its own risks.

> __________________

> -

>

> Romeo B. no, MD, physician, psychiatrist

>

> Any information provided on www.definitivemind.com is for informational

> purposes only, is not medical advice, does not create a doctor/patient

> relationship or liability, is not exhaustive, does not cover all conditions

> or their treatment, and will change as knowledge progresses. Always seek the

> advice of your physician or other qualified health provider before

> undertaking any diet, exercise, supplement, medical, or other health

> program.

> Co-Moderator

> Phil

>

>

> > > > >

> > > > > >

> > > > > >

> > > > > > i understand this. But other

> > > > scenario(indirectly).

> > > > > >

> > > > > > I have long undiagnosed hashimoto(6

> > years), but

> > > > always normal TSH,

> > > > > > FT4(sometimes high), despite i had

> > hypothyroid

> > > > symptoms. When i started

> > > > > to

> > > > > > check(myself) FT3 1 year ago, its was

> > always

> > > > high, but its was due to low

> > > > > > cortisol and pooling.

> > > > > >

> > > > > > over the time of hormone fluctuation

> > and

> > > > inflammation my adrenals became

> > > > > > exhausted(saliva confirm it) and my

> > body started

> > > > to create RT3 to protect

> > > > > > myself? Can't be?

> > > > > >

> > > > > > Nigel, how much thyroid do you take now

> > and how

> > > > much was the biggest

> > > > > dose?

> > > > > >

> > > > > > Antanas

> > > > > >

> > > > >

> > > > > [Non-text portions of this message have been

> > removed]

> > > > >

> > > > >

> > > > >

> > > >

> > > >

> > > >

> > > > --

> > > > Mike

> > >

> > > >

> > > >

> > > > [Non-text portions of this message have been

> > removed]

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > >

[Guest guest]

So when you tried Erfa what exactly happened when you " crashed " ? Were your

temps still stable when you crashed taking a little NTH?

Since you obviously have iron in your body then I'd wonder if adrenals were

taxed when you added Erfa.

I don't know what it would be like if I were on T3 only as I'm not. I know I

actually feel better on natural thyroid with a little T3 added compared to

just T3, but that could be a lot due to getting iron up.

-Nigel

On 17 February 2011 00:32, antanas_aradas <antanas_aradas@...> wrote:

>

>

> originally (umol/l)

>

> Fe 20,5 9,5-29,9

> TBIC 53,5 44,8-80,6

> UBIC 33 19,0-66,2

> Saturation 38,3%

> Ferritin 117,2 30-400

>

> or converted to ug/dl

>

> Fe 114,53 53,07-167,04

> TBIC 298,88 250,28-450,28

> UIBC 184,36 106,15-369,83

> Saturation 38,32%

> Ferritin 117,2 30-400

>

> I have never heard that someone took 300 T3

> What would be happen,Nigel, if you would restore you Iron and

> still be on T3 only?

>

> Antanas

>

[Guest guest]

I felt stress out without any reason. It was classical adrenal fatigue symptoms,

which were stronger then before. Its passed 4-7 days after i stopped ERFA.

Interesting thing, after 2 days stopping erfa, i felt somehow better then before

ERFA. Maybe i need to start from very very low dose like 7.5mg, because my FT4

is always on the top, despite i am very hypoT

my thyroid labs before erfa, on 25 HC.

TSH 1,91 0.27-4.2

FT4 20,53 2-22

FT3 5,37 2.76-6.45

I didn't charting my 3x temp at that time, but its clear that my adrenals was't

happy at all.

Antanas

>

> >

> >

> > originally (umol/l)

> >

> > Fe 20,5 9,5-29,9

> > TBIC 53,5 44,8-80,6

> > UBIC 33 19,0-66,2

> > Saturation 38,3%

> > Ferritin 117,2 30-400

> >

> > or converted to ug/dl

> >

> > Fe 114,53 53,07-167,04

> > TBIC 298,88 250,28-450,28

> > UIBC 184,36 106,15-369,83

> > Saturation 38,32%

> > Ferritin 117,2 30-400

> >

> > I have never heard that someone took 300 T3

> > What would be happen,Nigel, if you would restore you Iron and

> > still be on T3 only?

> >

> > Antanas

> >

>

>

>

[Guest guest]

But do you believe that too much RT3 is blocking T3?

>

> rt3 is always around if the source of the stress or what causing it has not

been properly identified..

>

[Guest guest]

Looking at your thyroid labs before NTH meds tells me you don't need NTH meds

your thyroid looks fine. Only thing left to do is test your Total T4 and T3 is

this is good your good. It should be as follows.

================================================

Quote:

Originally Posted by MetalMX

What is the point in testing total T3, T4 vs the Free T3, T4. Pretty much all

endocrinologists i have seen have only tested TSH and Free T4 and one alternate

practioner added Reverse T3 and Free T3 which are very important.

I got these new bloods to do as follows:

8am:

TSH

Free T4

Free T3 - Which i added

Reverse T3 - Also added by me

Thyroid antibodies

IGF-1 / GH

Cortisol / ACTH

LH / FSH

Total Testosterone

Parathyroid Hormone / Vitamin D / Calcium

+ Iron Studies / Ferritin - Which i also added.

So is their any need for me to add Total T3 and T4 to this, and why would this

be useful?

Many physicians gauge thyroid replacement treatment based on TSH. However, TSH

is not an accurate test when one has non-thyroid illness (such as mental

illness, diabetes, heart disease, adrenal problems, thyroid resistance, etc.)

affecting thyroid hormone function.

Free levels may also not give the full story - particularly Free T4, which tends

to be insensitive to thyroid hormone activity.

Total T4 gives one an indication of total thyroid hormone production since

almost all of thyroid hormone released by the thyroid glands is T4. Total T4,

like Total Testosteorne, is highly useful to determine how much thyroid hormone

to give. If one is using Levothyroxine for replacement or optimization of

thyroid hormone levels, then a Total T4 makes treatment very easy to determine.

I, for example, like seeing Total T4 between 8-12 (up to 14 if that person is a

female taking birth control pills).

Total T3 gives on an idea of conversion from T4 to T3. One can't get this from

Free T3 since this is only the small fraction that is not bound to a thyroid

binding protein. This would then give an indication of the presence of a

non-thyroid illness affecting thyroid function.

Free T3 gives information about how much thyroid hormone activity there is in

the body. It may, however, be different in the brain (since it is in a separate

compartment from the body). If one assumes they are similar, Free T3 can be a

useful level to manipulate to optimize thyroid hormone. Free T3 is most affected

when one gives Armour Thyroid or Cytomel (T3) since they have a greater

percentage of T3 than what the thyroid gland outputs. Realize that Free T3 is

also determined by the signals that determine how much thyroid binding proteins

to produce. Estrogen, for example, increases thyroid binding globulin

production, which can lower Free T3. Thus, Free T3 is determined by more than

one hormone.

Frequently, a person would have adequate T4 (8-12) but low Free T3 or low Total

T3. This person has non-thyroid illness affecting thyroid hormone signaling.

Reverse T3 may be high in this situation. It can give more information, but I

haven't found it as useful since I can tell it from Free T3 or Total T3 and the

history and physical exam. Thus I don't use Reverese T3 often. Once one has this

information, then the more important treatment is to find and treat the

non-thyroid illness rather than adding more thyroid hormone. I've often found

that I can add too much thyroid hormone, causing the person to become

hyperthyroid, once the non-thyroid illness is treated, forcing me to reduce the

dose. Thus, when total T4 is 8-12, I generally would hesitate and consider the

other options before considering adding more thyroid hormone to try and improve

a person's health. These days, what is the point of overshooting the mark and

having to backtrack on the dose

because it causes complications down the line when a person is suppose to be

consistently getting better? It is far easier and less complicated to set the

target dose, then track down and target the causes of non-thyroid illness. Once

that is done, then the foundation is set for further increasing thyroid hormone

without complications such as hyperthyroidism.

__________________

-

Romeo B. no, MD, physician, psychiatrist

Any information provided on www.definitivemind.com is for informational purposes

only, is not medical advice, does not create a doctor/patient relationship or

liability, is not exhaustive, does not cover all conditions or their treatment,

and will change as knowledge progresses. Always seek the advice of your

physician or other qualified health provider before undertaking any diet,

exercise, supplement, medical, or other health program.

--------------------------------------------------------------------------------

Last edited by Drno; 07-19-2009 at 10:19 PM.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Friday, February 18, 2011, 2:07 AM

>

>

> I felt stress out without any reason. It was classical

> adrenal fatigue symptoms, which were stronger then before.

> Its passed 4-7 days after i stopped ERFA. Interesting thing,

> after 2 days stopping erfa, i felt somehow better then

> before ERFA. Maybe i need to start from very very low dose

> like 7.5mg, because my FT4 is always on the top, despite i

> am very hypoT

>

> my thyroid labs before erfa, on 25 HC.

>

> TSH    1,91    0.27-4.2

> FT4    20,53    2-22

> FT3    5,37    2.76-6.45

>

> I didn't charting my 3x temp at that time, but its clear

> that my adrenals was't happy at all.

>

> Antanas

>

>

> >

> > >

> > >

> > > originally (umol/l)

> > >

> > > Fe 20,5 9,5-29,9

> > > TBIC 53,5 44,8-80,6

> > > UBIC 33 19,0-66,2

> > > Saturation 38,3%

> > > Ferritin 117,2 30-400

> > >

> > > or converted to ug/dl

> > >

> > > Fe 114,53 53,07-167,04

> > > TBIC 298,88 250,28-450,28

> > > UIBC 184,36 106,15-369,83

> > > Saturation 38,32%

> > > Ferritin 117,2 30-400

> > >

> > > I have never heard that someone took 300 T3

> > > What would be happen,Nigel, if you would restore

> you Iron and

> > > still be on T3 only?

> > >

> > > Antanas

> > >

> >

> >

> >

[Guest guest]

Read this link about RT3.

http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Friday, February 18, 2011, 2:09 AM

> But do you believe that too much RT3

> is blocking T3?

>

>

> >

> > rt3 is always around if the source of the stress or

> what causing it  has not been properly identified..

> >

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Philip,

blood tests are not reliable and even good blood chemistry doesn't mean no

illness! Blood is one time snapshot whats happen in your blood. Whats happen at

cellular level nobody knows. your basal and symptoms are main thing, maybe 24h

thyroid urine could be more sensitive when its mild hormone deficiency.

my TPO antibodies where 80 (range <35), its just question of time when my blood

will show that i finally need thyroid.

> > >

> > > >

> > > >

> > > > originally (umol/l)

> > > >

> > > > Fe 20,5 9,5-29,9

> > > > TBIC 53,5 44,8-80,6

> > > > UBIC 33 19,0-66,2

> > > > Saturation 38,3%

> > > > Ferritin 117,2 30-400

> > > >

> > > > or converted to ug/dl

> > > >

> > > > Fe 114,53 53,07-167,04

> > > > TBIC 298,88 250,28-450,28

> > > > UIBC 184,36 106,15-369,83

> > > > Saturation 38,32%

> > > > Ferritin 117,2 30-400

> > > >

> > > > I have never heard that someone took 300 T3

> > > > What would be happen,Nigel, if you would restore

> > you Iron and

> > > > still be on T3 only?

> > > >

> > > > Antanas

> > > >

> > >

> > >

> > >

[Guest guest]

OK with high Anti's your thyroid will look on labs low.  When Anti's are not

attacking your Thyroid it will look normal it's very hard to tell by labs you

need a dam good Dr. that goes by how you feel read this link.

http://www.thyroid-info.com/articles/woliner.htm

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Friday, February 18, 2011, 11:33 AM

> Philip,

>

> blood tests are not reliable and even good blood chemistry

> doesn't mean no illness! Blood is one time snapshot whats

> happen in your blood. Whats happen at cellular level nobody

> knows. your basal and symptoms are main thing, maybe 24h

> thyroid urine could be more sensitive when its mild hormone

> deficiency.

>

> my TPO antibodies where 80 (range <35), its just

> question of time when my blood will show that i finally need

> thyroid.

>

>

> > > >

> > > > >

> > > > >

> > > > > originally (umol/l)

> > > > >

> > > > > Fe 20,5 9,5-29,9

> > > > > TBIC 53,5 44,8-80,6

> > > > > UBIC 33 19,0-66,2

> > > > > Saturation 38,3%

> > > > > Ferritin 117,2 30-400

> > > > >

> > > > > or converted to ug/dl

> > > > >

> > > > > Fe 114,53 53,07-167,04

> > > > > TBIC 298,88 250,28-450,28

> > > > > UIBC 184,36 106,15-369,83

> > > > > Saturation 38,32%

> > > > > Ferritin 117,2 30-400

> > > > >

> > > > > I have never heard that someone took

> 300 T3

> > > > > What would be happen,Nigel, if you

> would restore

> > > you Iron and

> > > > > still be on T3 only?

> > > > >

> > > > > Antanas

> > > > >

> > > >

> > > >

> > > > [Non-text portions of this message have been

> removed]

> > > >

> > >

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

With that much T4 and T3 in your blood it would seem possible that you just

aren't responding to what you've got. A high reverse T3 level in relation to

how much T3 you have wouldn't be surprising.

The clue we have here is that adding a little Erfa induced LOW CORTISOL

symptoms, per your story. Have you ever tried more cortisol? Does that make

you feel better or even bring temps up a little? I don't think lots of

cortisol is good, but there are some people that just need a little more.

Have you checked estradiol? Too much can mess up thyroid hormones and block

their effects, according to what some have reported.

-Nigel

On 18 February 2011 01:07, antanas_aradas <antanas_aradas@...> wrote:

>

>

> I felt stress out without any reason. It was classical adrenal fatigue

> symptoms, which were stronger then before. Its passed 4-7 days after i

> stopped ERFA. Interesting thing, after 2 days stopping erfa, i felt somehow

> better then before ERFA. Maybe i need to start from very very low dose like

> 7.5mg, because my FT4 is always on the top, despite i am very hypoT

>

> my thyroid labs before erfa, on 25 HC.

>

> TSH 1,91 0.27-4.2

> FT4 20,53 2-22

> FT3 5,37 2.76-6.45

>

> I didn't charting my 3x temp at that time, but its clear that my adrenals

> was't happy at all.

>

> Antanas

>

[Guest guest]

I haven't tried more cortisol then 25 HC at that time.

I am on 30hc right know, but today i was on 40hc due to stress.

I am afraid of doing stress dose, but its seems really necessary to do.

Next Monday i am going to test

TSH, FT4, FT3

and

Total T

E2

SHBG

Should i ask to calculate free T, or i can do myself?

Antans

>

> >

> >

> > I felt stress out without any reason. It was classical adrenal fatigue

> > symptoms, which were stronger then before. Its passed 4-7 days after i

> > stopped ERFA. Interesting thing, after 2 days stopping erfa, i felt somehow

> > better then before ERFA. Maybe i need to start from very very low dose like

> > 7.5mg, because my FT4 is always on the top, despite i am very hypoT

> >

> > my thyroid labs before erfa, on 25 HC.

> >

> > TSH 1,91 0.27-4.2

> > FT4 20,53 2-22

> > FT3 5,37 2.76-6.45

> >

> > I didn't charting my 3x temp at that time, but its clear that my adrenals

> > was't happy at all.

> >

> > Antanas

> >

>

>

>

[Guest guest]

Hello,

I have got my latest lab results.

On 30 HC, 50T3, 1 tea spoon celtic sea salt.

TSH 0.021 0.4-4.0

FT4 7.52 9,0-19,0

FT3 7.62 2,63-5,70

Gliucose 5,32 4,2-6,1

Potassium 3,9 3.8-5.3 (LOW)

Sodium 141 134-148

E2 37 40,4-161,5, nmol/l

Total T 20.7 5,76-30,43, nmol/l

SHBG 45,4 10-57, nmol/l

My SHBG is a bit high, but in the range. E2 is low.

I suppose i don't have high E2 problem...?

3x day temperatures started to swing about 0,3 when i increase to 43 T3. More

tired, dizzy, hand and feet's sweating more.

Should i try to rise HC from 30 to 35? How much potassium should i take to

increase it?

>

> >

> >

> > I felt stress out without any reason. It was classical adrenal fatigue

> > symptoms, which were stronger then before. Its passed 4-7 days after i

> > stopped ERFA. Interesting thing, after 2 days stopping erfa, i felt somehow

> > better then before ERFA. Maybe i need to start from very very low dose like

> > 7.5mg, because my FT4 is always on the top, despite i am very hypoT

> >

> > my thyroid labs before erfa, on 25 HC.

> >

> > TSH 1,91 0.27-4.2

> > FT4 20,53 2-22

> > FT3 5,37 2.76-6.45

> >

> > I didn't charting my 3x temp at that time, but its clear that my adrenals

> > was't happy at all.

> >

> > Antanas

> >

>

>

>

[Guest guest]

To me your FT3 is very high over the top of the range meaning your hyper. Check

your BP and your heart rate. I don't know how to read your Estradiol most labs

are in pmol/l or pg/ml I think to convert nmol/l into pmol/l you x's it by 10 if

I am right your Estradiol is to high it should be 74 pmol/l. or 7.4 nmol/l but I

am not sure about this. I do know your Estraidol levels are very high.

Your SHBG is to high in the normal range but on the very high side and this is

from all the T3 meds your on.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Monday, February 21, 2011, 7:42 AM

>

>

>

>

> Hello,

>

> I have got my latest lab results.

>

> On 30 HC, 50T3, 1 tea spoon celtic sea salt.

>

> TSH    0.021    0.4-4.0

> FT4    7.52    9,0-19,0

> FT3    7.62    2,63-5,70

>

> Gliucose  5,32    4,2-6,1

> Potassium 3,9    3.8-5.3 (LOW)

> Sodium      141   

> 134-148

>

> E2     37    40,4-161,5,

> nmol/l

> Total T    20.7    

> 5,76-30,43, nmol/l

> SHBG     45,4    10-57,

> nmol/l

>

> My SHBG is a bit high, but in the range. E2 is low.

> I suppose i don't have high E2 problem...?

>

> 3x day temperatures started to swing about 0,3 when i

> increase to 43 T3. More tired, dizzy, hand and feet's

> sweating more.

>

> Should i try to rise HC from 30 to 35? How much potassium

> should i take to increase it?

>

>

> >

> > >

> > >

> > > I felt stress out without any reason. It was

> classical adrenal fatigue

> > > symptoms, which were stronger then before. Its

> passed 4-7 days after i

> > > stopped ERFA. Interesting thing, after 2 days

> stopping erfa, i felt somehow

> > > better then before ERFA. Maybe i need to start

> from very very low dose like

> > > 7.5mg, because my FT4 is always on the top,

> despite i am very hypoT

> > >

> > > my thyroid labs before erfa, on 25 HC.

> > >

> > > TSH 1,91 0.27-4.2

> > > FT4 20,53 2-22

> > > FT3 5,37 2.76-6.45

> > >

> > > I didn't charting my 3x temp at that time, but

> its clear that my adrenals

> > > was't happy at all.

> > >

> > > Antanas

> > >

> >

> >

> >

[Guest guest]

Too much T3 will worsen potassium depletion.

-Nigel

On 21 February 2011 06:42, antanas_aradas <antanas_aradas@...> wrote:

>

>

> Hello,

>

> I have got my latest lab results.

>

> On 30 HC, 50T3, 1 tea spoon celtic sea salt.

>

> TSH 0.021 0.4-4.0

> FT4 7.52 9,0-19,0

> FT3 7.62 2,63-5,70

>

> Gliucose 5,32 4,2-6,1

> Potassium 3,9 3.8-5.3 (LOW)

> Sodium 141 134-148

>

> E2 37 40,4-161,5, nmol/l

> Total T 20.7 5,76-30,43, nmol/l

> SHBG 45,4 10-57, nmol/l

>

> My SHBG is a bit high, but in the range. E2 is low.

> I suppose i don't have high E2 problem...?

>

> 3x day temperatures started to swing about 0,3 when i increase to 43 T3.

> More tired, dizzy, hand and feet's sweating more.

>

> Should i try to rise HC from 30 to 35? How much potassium should i take to

> increase it?

>

[Guest guest]

I made mistake pasting my E2 my results

Estradiol(E2) (pmol/l) 37 range 40,4-161,5

its pmol/l, not nmol/l

Anyway, to convert pmol/l to pg/ml

(http://www.unc.edu/~rowlett/units/scales/clinical_data.html)

pmol/l 37/3,671 = 10,07 pg/ml, Low?

My potassium was always high, due to low sodium, but after 2month on 1tbs celtic

sea salt, it went down, but sodium up finally. I always was low sodium diet due

my family history. Now i need just supplement a bit potassium.

Maybe my SHBG is high due T3, i never tested it before.

Philip, how can i be hyper if i feel terrible hypoT?

my temp low, pulse is normal. I know, that my FT3 is high due to pooling.

But who knows why? Iron is perfect, maybe adrenals, or maybe RT3..?

I am on 9 week. You need 12 weeks to clear RT3, at least other people experience

this.I will try till the end.

> > >

> > > >

> > > >

> > > > I felt stress out without any reason. It was

> > classical adrenal fatigue

> > > > symptoms, which were stronger then before. Its

> > passed 4-7 days after i

> > > > stopped ERFA. Interesting thing, after 2 days

> > stopping erfa, i felt somehow

> > > > better then before ERFA. Maybe i need to start

> > from very very low dose like

> > > > 7.5mg, because my FT4 is always on the top,

> > despite i am very hypoT

> > > >

> > > > my thyroid labs before erfa, on 25 HC.

> > > >

> > > > TSH 1,91 0.27-4.2

> > > > FT4 20,53 2-22

> > > > FT3 5,37 2.76-6.45

> > > >

> > > > I didn't charting my 3x temp at that time, but

> > its clear that my adrenals

> > > > was't happy at all.

> > > >

> > > > Antanas

> > > >

> > >

> > >

> > >

[Guest guest]

OK wow you are low on Estradiol levels with a high SHBG like this I question the

lab for error.

The thing about RT3 is we need some RT3 and it's half life is short very short.

People are reading about RT3 on the web and going NUTS over what they read. If

your labs are high for RT3 how do you know it's bad. If you think thyroid meds

are pooling on you and your on HC meds can't be.

I can't tell you how to fix your Thyroid but here is what I did. They quit

making Armour so I flat out stopped using it. At the time I was on HGH and it

was making me go hyper so I did good for a time but the HGH was to much for me I

could not take the sides so when I stopped it my Thyroid went down.

I went on Synthroid starting at what was = to 3 grains of Armour 150 mcgs of T4.

I felt better on this but needed some T3 so we added in 5 mcg 2x's/day in time

we were able to go up to 3x's/day.

Yes I have a high RT3 but it's not making me sick but if you read the web I

should be sick as a dog that is why I say it's all Bull Shi*. I get people

coming to me all messed up trying to lower there RT3 because they read on the

web or posted there labs and someone not a Dr. told them they need to get there

RT3 down.

I have people posting to me at my Thyroid forum in PM messages that they ended

up in the ER doing so dam much T3 only meds. The will not post in the open

because they don't want the people that told them to lower there RT3 to see they

are having problems.

The more they post on the open about the problems they are having the more Bull

they are told to do that is making them sicker.

I don't think people with labs of high RT3 can get a Dr. to give them such high

dose's of T3 only meds.

One needs to find out why RT3 is high and fix the why.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Monday, February 21, 2011, 12:55 PM

>

>

> I made mistake pasting my E2 my results

>

> Estradiol(E2) (pmol/l) 37 range 40,4-161,5

> its pmol/l, not nmol/l

>

> Anyway, to convert pmol/l to pg/ml

(http://www.unc.edu/~rowlett/units/scales/clinical_data.html)

>

> pmol/l 37/3,671 = 10,07 pg/ml, Low?

>

> My potassium was always high, due to low sodium, but after

> 2month on 1tbs celtic sea salt, it went down, but sodium up

> finally. I always was low sodium diet due my family history.

> Now i need just supplement a bit potassium.

>

> Maybe my SHBG is high due T3, i never tested it before.

>

> Philip, how can i be hyper if i feel terrible hypoT?

> my temp low, pulse is normal. I know, that my FT3 is high

> due to pooling.

>

> But who knows why? Iron is perfect, maybe adrenals, or

> maybe RT3..?

> I am on 9 week. You need 12 weeks to clear RT3, at least

> other people experience this.I will try till the end.

>

>

>

> > > >

> > > > >

> > > > >

> > > > > I felt stress out without any reason.

> It was

> > > classical adrenal fatigue

> > > > > symptoms, which were stronger then

> before. Its

> > > passed 4-7 days after i

> > > > > stopped ERFA. Interesting thing, after

> 2 days

> > > stopping erfa, i felt somehow

> > > > > better then before ERFA. Maybe i need

> to start

> > > from very very low dose like

> > > > > 7.5mg, because my FT4 is always on the

> top,

> > > despite i am very hypoT

> > > > >

> > > > > my thyroid labs before erfa, on 25 HC.

> > > > >

> > > > > TSH 1,91 0.27-4.2

> > > > > FT4 20,53 2-22

> > > > > FT3 5,37 2.76-6.45

> > > > >

> > > > > I didn't charting my 3x temp at that

> time, but

> > > its clear that my adrenals

> > > > > was't happy at all.

> > > > >

> > > > > Antanas

> > > > >

> > > >

> > > >

> > > > [Non-text portions of this message have been

> removed]

> > > >

> > >

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

I understand your position. I don't have mine still. I will tell you later from

my personal experience. My plan - one day to switch to NTH, i don't want to stay

on T3, even i will feel perfect. NTH or T4/T3 sounds more natural, but i can't

tolerate T4 at all.

50 T3 = 2grains is not much, its physiological dose.

> > > > >

> > > > > >

> > > > > >

> > > > > > I felt stress out without any reason.

> > It was

> > > > classical adrenal fatigue

> > > > > > symptoms, which were stronger then

> > before. Its

> > > > passed 4-7 days after i

> > > > > > stopped ERFA. Interesting thing, after

> > 2 days

> > > > stopping erfa, i felt somehow

> > > > > > better then before ERFA. Maybe i need

> > to start

> > > > from very very low dose like

> > > > > > 7.5mg, because my FT4 is always on the

> > top,

> > > > despite i am very hypoT

> > > > > >

> > > > > > my thyroid labs before erfa, on 25 HC.

> > > > > >

> > > > > > TSH 1,91 0.27-4.2

> > > > > > FT4 20,53 2-22

> > > > > > FT3 5,37 2.76-6.45

> > > > > >

> > > > > > I didn't charting my 3x temp at that

> > time, but

> > > > its clear that my adrenals

> > > > > > was't happy at all.

> > > > > >

> > > > > > Antanas

> > > > > >

> > > > >

> > > > >

> > > > > [Non-text portions of this message have been

> > removed]

> > > > >

> > > >

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > >

[Guest guest]

I am sorry but 2 grains of Armour is = to 18 mcgs of T3 where did you read this.

Your taking what would = 5.5 grains of Armour.

http://www.stopthethyroidmadness.com/armour-vs-other-brands/

My wife can't take much T4 or T3 so she takes generic Synthyroid she started out

at the lowest dose and cut the pill half. Over time she got up to 75 mcgs of T4

and dose 1/4 of a 5 mcg. pill of T3 every other day. Try doing this with T4

start low see how you do. Sounds to me like your cells are now working from

being low so long. In time they sould pick up again.

====================================================

One grain is 60 mg and contains 38 mcg. of T4 and 9 mcg. of T3, plus unmeasured

amounts of T2, T1 and calcitonin.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Tuesday, February 22, 2011, 1:46 AM

> I understand your position. I don't

> have mine still. I will tell you later from my personal

> experience. My plan - one day to switch to NTH, i don't want

> to stay on T3, even i will feel perfect. NTH or T4/T3 sounds

> more natural, but i can't tolerate T4 at all.

>

> 50 T3 = 2grains is not much, its physiological dose.

>

>

> > > > > >

> > > > > > >

> > > > > > >

> > > > > > > I felt stress out without any

> reason.

> > > It was

> > > > > classical adrenal fatigue

> > > > > > > symptoms, which were stronger

> then

> > > before. Its

> > > > > passed 4-7 days after i

> > > > > > > stopped ERFA. Interesting

> thing, after

> > > 2 days

> > > > > stopping erfa, i felt somehow

> > > > > > > better then before ERFA.

> Maybe i need

> > > to start

> > > > > from very very low dose like

> > > > > > > 7.5mg, because my FT4 is

> always on the

> > > top,

> > > > > despite i am very hypoT

> > > > > > >

> > > > > > > my thyroid labs before erfa,

> on 25 HC.

> > > > > > >

> > > > > > > TSH 1,91 0.27-4.2

> > > > > > > FT4 20,53 2-22

> > > > > > > FT3 5,37 2.76-6.45

> > > > > > >

> > > > > > > I didn't charting my 3x temp

> at that

> > > time, but

> > > > > its clear that my adrenals

> > > > > > > was't happy at all.

> > > > > > >

> > > > > > > Antanas

> > > > > > >

> > > > > >

> > > > > >

> > > > > > [Non-text portions of this message

> have been

> > > removed]

> > > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > ------------------------------------

> > > > >

> > > > >

[Guest guest]

Phil,you are wrong about converting T3 to T4 or T4/T3

http://www.frx.com/pi/armourthyroid_pi.pdf

1 grain = 38 mcg T4, 9 mcg T3

armour thyroid provide dosage calculator

http://www.armourthyroid.com/hcp_treatment.aspx#dose calculator

2 grains armour = 200 mcg T4 = 50 mcg T3

I take 2 grains, not 5,5 grains.

I hope, that my receptors come only after slow T3 increase in my system and HC.

Anyway, tomorrow i am going to decrease my T3 to 43,75 , because my 3x

temperatures started to swing more then 0.3, and i feel low cortisol symptoms.

Not so strong as it was with erfa, but its quite uncomfortable. Can't work even

part time right now

>

> I am sorry but 2 grains of Armour is = to 18 mcgs of T3 where did you read

this. Your taking what would = 5.5 grains of Armour.

> http://www.stopthethyroidmadness.com/armour-vs-other-brands/

>

> My wife can't take much T4 or T3 so she takes generic Synthyroid she started

out at the lowest dose and cut the pill half. Over time she got up to 75 mcgs

of T4 and dose 1/4 of a 5 mcg. pill of T3 every other day. Try doing this with

T4 start low see how you do. Sounds to me like your cells are now working from

being low so long. In time they sould pick up again.

> ====================================================

> One grain is 60 mg and contains 38 mcg. of T4 and 9 mcg. of T3, plus

unmeasured amounts of T2, T1 and calcitonin.

> Co-Moderator

> Phil

>

[Guest guest]

Wow I went and looked at diff. sites each one was diff. but most were like your

saying. But when my Dr. did the calc. he said 4 grains of Armour = 152 mcg. of

synthyroid. I wounder if some of them site,s are mixed up with the Armour

coming in mgs as to the mcgs in Synthyroid.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: High SHBG on T3

>

> Date: Tuesday, February 22, 2011, 1:49 PM

>

>

> Phil,you are wrong about converting T3 to T4 or T4/T3

>

> http://www.frx.com/pi/armourthyroid_pi.pdf

> 1 grain = 38 mcg T4, 9 mcg T3

>

> armour thyroid provide dosage calculator

> http://www.armourthyroid.com/hcp_treatment.aspx#dose

> calculator

>

> 2 grains armour = 200 mcg T4 = 50 mcg T3

>

> I take 2 grains, not 5,5 grains.

>

> I hope, that my receptors come only after slow T3 increase

> in my system and HC. Anyway, tomorrow i am going to decrease

> my T3 to 43,75 , because my 3x temperatures started to swing

> more then 0.3, and i feel low cortisol symptoms. Not so

> strong as it was with erfa, but its quite uncomfortable.

> Can't work even part time right now

>

>

>

> >

> > I am sorry but 2 grains of Armour is = to 18 mcgs of

> T3 where did you read this. Your taking what would = 5.5

> grains of Armour.

> > http://www.stopthethyroidmadness.com/armour-vs-other-brands/

> >

> > My wife can't take much T4 or T3 so she takes generic

> Synthyroid she started out at the lowest dose and cut the

> pill half.  Over time she got up to 75 mcgs of T4 and

> dose 1/4 of a 5 mcg. pill of T3 every other day.  Try

> doing this with T4 start low see how you do.  Sounds to

> me like your cells are now working from being low so

> long.  In time they sould pick up again.

> > ====================================================

> > One grain is 60 mg and contains 38 mcg. of T4 and 9

> mcg. of T3, plus unmeasured amounts of T2, T1 and

> calcitonin.

> > Co-Moderator

> > Phil

> >

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Phil, just realize someone called you wrong... Do you want me to pay a " visit "

to his home?

Re: High SHBG on T3

>

> Date: Tuesday, February 22, 2011, 1:49 PM

>

>

> Phil,you are wrong about converting T3 to T4 or T4/T3

>

> http://www.frx.com/pi/armourthyroid_pi.pdf

> 1 grain = 38 mcg T4, 9 mcg T3

>

> armour thyroid provide dosage calculator

> http://www.armourthyroid.com/hcp_treatment.aspx#dose

> calculator

>

> 2 grains armour = 200 mcg T4 = 50 mcg T3

>

> I take 2 grains, not 5,5 grains.

>

> I hope, that my receptors come only after slow T3 increase

> in my system and HC. Anyway, tomorrow i am going to decrease

> my T3 to 43,75 , because

[The entire original message is not included]

[Guest guest]

I've been under the impression that there is NO way to convert the metabolic

activity of natural thyroid to synthetics. Way too many variables!

I'll just state that regardless of your microgram dose of T3 you have the

clue of an elevated serum FT3 level. Now, taking T3 too close to blood draws

can do this also. However, you also have the higher in-range SHBG level to

think about.

-Nigel

On 22 February 2011 00:46, antanas_aradas <antanas_aradas@...> wrote:

>

>

> I understand your position. I don't have mine still. I will tell you later

> from my personal experience. My plan - one day to switch to NTH, i don't

> want to stay on T3, even i will feel perfect. NTH or T4/T3 sounds more

> natural, but i can't tolerate T4 at all.

>

> 50 T3 = 2grains is not much, its physiological dose.

>

>

>

> > > >

> > > > > From: antanas_aradas <antanas_aradas@>

> > > > > Subject: Re: High SHBG on T3

> > > > >

> > > > > Date: Monday, February 21, 2011, 7:42 AM

> > > > >

> > > > >

> > > > >

> > > > >

> > > > > Hello,

> > > > >

> > > > > I have got my latest lab results.

> > > > >

> > > > > On 30 HC, 50T3, 1 tea spoon celtic sea salt.

> > > > >

> > > > > TSH 0.021 0.4-4.0

> > > > > FT4 7.52 9,0-19,0

> > > > > FT3 7.62 2,63-5,70

> > > > >

> > > > > Gliucose 5,32 4,2-6,1

> > > > > Potassium 3,9 3.8-5.3 (LOW)

> > > > > Sodium 141

> > > > > 134-148

> > > > >

> > > > > E2 37 40,4-161,5,

> > > > > nmol/l

> > > > > Total T 20.7

> > > > > 5,76-30,43, nmol/l

> > > > > SHBG 45,4 10-57,

> > > > > nmol/l

> > > > >

> > > > > My SHBG is a bit high, but in the range. E2 is

> > > low.

> > > > > I suppose i don't have high E2 problem...?

> > > > >

> > > > > 3x day temperatures started to swing about 0,3

> > > when i

> > > > > increase to 43 T3. More tired, dizzy, hand and

> > > feet's

> > > > > sweating more.

> > > > >

> > > > > Should i try to rise HC from 30 to 35? How much

> > > potassium

> > > > > should i take to increase it?

>

[Guest guest]

No Ha Ha but I was not wrong the info I have is wrong us Eng. are never wrong.

Once I thought I was but I was mistaken.

Co-Moderator

Phil

>

> > From: antanas_aradas <antanas_aradas@...>

> > Subject: Re: High SHBG on T3

> >

> > Date: Tuesday, February 22, 2011, 1:49 PM

> >

> >

> > Phil,you are wrong about converting T3 to T4 or

> T4/T3

> >

> > http://www.frx.com/pi/armourthyroid_pi.pdf

> > 1 grain = 38 mcg T4, 9 mcg T3

> >

> > armour thyroid provide dosage calculator

> > http://www.armourthyroid.com/hcp_treatment.aspx#dose

> > calculator

> >

> > 2 grains armour = 200 mcg T4 = 50 mcg T3

> >

> > I take 2 grains, not 5,5 grains.

> >

> > I hope, that my receptors come only after slow T3

> increase

> > in my system and HC. Anyway, tomorrow i am going to

> decrease

> > my T3 to 43,75 , because

>

> [The entire original message is not included]

>

>

[Guest guest]

My last T3 12.25 mcg was at 10.30 pm, blood draw was taken at 7.35am.

Val recommended to take bed time dose, but probably its too close.

SHBG could be low due to low T. Mine its still not optimal, even i am not on

TRT.

Testosterone(TTE) (nmol/l) 20.7 5,76-30,43

SHBG can be high when you hyperthyroid. I am not hyperthyroid if you take my

symptoms, basal temp, basal pulse. My blood shows that i hyperT, buts its only

blood, not how i feel. Hormones are stupid, if they shifts according to blood,

not what happens at your cellular level.

Phil, sorry for " wrong "

Antanas

>

> I've been under the impression that there is NO way to convert the metabolic

> activity of natural thyroid to synthetics. Way too many variables!

>

> I'll just state that regardless of your microgram dose of T3 you have the

> clue of an elevated serum FT3 level. Now, taking T3 too close to blood draws

> can do this also. However, you also have the higher in-range SHBG level to

> think about.

>

> -Nigel

>