Re: Letter to my Dr - the next stage

[Guest guest]

From: pauline <paulinedrichards@...>thyroid treatment Sent: Friday, 8 July 2011, 19:34Subject: Letter to my Dr - the next stage

Ok have just returned from Drs after they called me in following blood test results. I took a copy of the letter I posted on the Forum last week, amended after your suggestion. The Dr was amazing! was this the same doc? you had problems with? Said to hold back on B12 jabs – self administered and supplements for 4/6 weeks until next tests are done. He has requested Elecrolytes, Liver Function, Bone Calcium, TFT2, FBC, Intrinsic factor, B12, Folate, FT2, FT3, anti parietal cell? STOMACH CELLS where the HCL (needed to separate B12 from animal protein) and Intrinsic factor (needed for B12 absorption)is manufactured. (Couldn't read that bit!!) He said that he was in favour of patients taking responsibility for their health by joining support groups and using the internet. BUT said DONT scare yourself!!!!He acknowledged that there was a link between B12D and Hypothyroidism .Levothyroxine

has been reduced for 150 mcgs to 125 per dayAlso said that Cholesterol was 5.6 and gave me a sheet on diet. this will fall WHEN YU GET YOUR THYROID HORMONE SUPPORT doses and associated requirements sorted.As I live on a vlcd looked at all foods on the `avoid eating list' – don't eat them and still put on weight. This was the only frustrating part of the `chat'. I sooooo want to lose weight. Be patient. It does happen...it will happen. I know its frustrating and makes life tough but your geting somewhere now. Sally xx

[Guest guest]

Thank you Sally for your response. It was the Practice Nurse who initally was

intransigent at the first meeting - at the second she was listening, thank

goodness.

Any idea anyone why I should become hyper and have dose dropped after being on

150mcg for YEARS!!!!!!

Am 60 now and have felt dreadful for the last couple of months.....maybe hyper

explains it.

Does ANYONE out there have any idea how I can shift the weight?????? PLEASE

xxxxxxx

Letter to my Dr - the next stage

>

>

>  

> Ok have just returned from Drs after they called me in following blood test

results.

[Guest guest]

ine,

Some of the symptoms of hyper are: heat intolerance, tremor in hands, weight

loss, palpitations, sweating, hot, unable to sleep - how many of these do you

have? There is a list of them in the files.

Or has the doc just freaked because your tsh is low and the free t4 is slightly

over the range. I know which one my money is on. If the doc would read the

pulse article by Prof Toft, he would get the idea that it's perfectly ok

to have low tsh and high Free t4.

If you do have this and don't feel good, then you could either have too much

unconverted T4 and therefor too much reverse t3, and not enough free t3. Or

you could have plenty of free t3 and blocked recptors.

Strikes me that by reducing the meds, without actually doing anything to make

you better he's clutching at straws....

x

>

Am 60 now and have felt dreadful for the last couple of months.....maybe hyper

explains it.

> Does ANYONE out there have any idea how I can shift the weight?????? PLEASE

xxxxxxx

>

>

[Guest guest]

WHY THYROID HORMONE REPLACEMENT MAY NOT BE WORKING FOR YOU

There are MANY

reasons and many medical conditions associated with thyroid disease that stop

thyroid hormone from getting into the cells, where it does its work. I mention

these over and over and over again - ad nauseum - people must be bored with the

same old, same old but as each new member joins us, they need to know.

The

main condition responsible for stopping thyroid hormone from working, is, quite

simply, a patients thyroxine dose is too low because the doctor or consultant

refuses to increase it, because the serum thyroid function test results appear

OK. Sometimes, the thyroxine dose is too high, yet patients still don't feel

well. They continue to suffer. Some reasons for this:

They may be suffering

with low adrenal reserve. The production of T4, its conversion to T3, and the

receptor uptake requires a normal amount of adrenal hormones, notably, of

course, cortisone. (Excess cortisone can shut production down, however.) This

is what happens if the adrenals are not responding properly, and provision of

cortisone usually switches it on again. But sometimes it

doesn’t. If the illness has been going on for a long time, the

enzyme seems to fail. This conversion failure (inexplicably denied by

many endocrinologists) means the thyroxine builds up, unconverted. So it

doesn’t work, and T4 toxicosis results. This makes the patient feel quite

unwell, toxic, often with palpitations and chest pain. If provision of adrenal

support doesn’t remedy the situation, the final solution is the use of

the active thyroid hormone, already converted, T3 - either synthetic or

natural.

Then, we have

systemic candidiasis. This is where candida albicans, a yeast, which causes

skin infections almost anywhere in the body, invades the lining of the lower

part of the small intestine and the large intestine. Here, the candida

sets up residence in the warmth and the dark, and demands to be fed. Loving

sugars and starches, candida can make you suffer terrible sweet cravings.

Candida can produce toxins which can cause very many symptoms of exhaustion,

headache, general illness, and which interfere with the uptake of thyroid and

adrenal treatment. Sometimes the levels - which we usually test for - can

be very high, and make successful treatment difficult to achieve until

adequately treated.

Then there is

receptor resistance which could be a culprit. Being hypothyroid for some

considerable time may mean the biochemical mechanisms which permit the binding

of T3 to the receptors, is downgraded - so the T3 won’t go in. With

slow build up of T3, with full adrenal support and adequate vitamins and

minerals, the receptors do come on line again. But this can be quite a

slow process, and care has to be taken to build the dose up gradually.

And then there are

Food allergies. The most common food allergy is allergy to gluten, the protein

fraction of wheat. The antibody generated by the body, by a process of molecular

mimicry, cross reacts with the thyroperoxidase enzyme, (which makes thyroxine)

and shuts it down. So allergy to bread can make you hypothyroid. There

may be other food allergies with this kind of effect, but information on these

is scanty. Certainly allergic response to certain foods can affect

adrenal function and imperil thyroid production and uptake.

Then we have hormone

imbalances. The whole of the endocrine system is linked; each part of it needs

the other parts to be operating normally to work properly. An example of

this we have seen already, with cortisone. But another example is the

operation of sex hormones. The imbalance that occurs at the menopause

with progesterone running down, and a relative dominance of oestrogen is a

further case in point – oestrogen dominance downgrades production,

transportation and uptake of thyroid hormones. This is why hypothyroidism

may first appear at the menopause; the symptoms ascribed to this alone, which

is then treated – often with extra oestrogen, making the whole thing

worse. Deficiency in progesterone most especially needs to be dealt with,

since it reverses oestrogen dominance, improves many menopausal symptoms like

sweats and mood swings, and reverses osteoporosis. Happily natural

progesterone cream is easily obtained: when used it has the added benefit of

helping to stabilise adrenal function.

Then, we must never

forget the possibility of mercury poisoning (through amalgam fillings) - low

levels of ferritin, vitamin B12, vitamin D3, magnesium, folate, copper and zinc

- all of which, if low, stop the thyroid hormone from being utilised by the

cells - these have to be treated.

As Dr Peatfield says

" When you have been quite unwell for a long time, all these problems have

to be dealt with; and since each may affect the other, it all has to be done

rather carefully.

Contrary

to cherished beliefs by much of the medical establishment, the correction of a

thyroid deficiency state has a number of complexities and variables, which make

the treatment usually quite specific for each person. The balancing of

these variables is as much up to you as to me – which is why a check of

morning, day and evening temperatures and pulse rates, together with symptoms,

good and bad, can be so helpful.

Many

of you have been ill for a long time, either because you have not been

diagnosed, or the treatment leaves you still quite unwell. Those of you

who have relatively mild hypothyroidism, and have been diagnosed relatively

quickly, may well respond to synthetic thyroxine, the standard treatment.

I am therefore unlikely to see you; since if the thyroxine proves satisfactory

in use, it is merely a question of dosage.

For

many of you, the outstanding problem is not that the diagnosis has not been made

– although, extraordinarily, this is disgracefully common – but

that is has, and the thyroxine treatment doesn’t work. The dose has

been altered up and down, and clinical improvement is variable and

doesn’t last, in spite of blood tests, which say you are perfectly all

right (and therefore you are actually depressed and need this fine

antidepressant).

The

above problems must be eliminated if thyroid hormone isn't working for you.

Luv - Sheila

Thank you Sally for your response. It was the

Practice Nurse who initally was intransigent at the first meeting - at the

second she was listening, thank goodness.

Any idea anyone why I should become hyper and have dose dropped after being on

150mcg for YEARS!!!!!!

Am 60 now and have felt dreadful for the last couple of months.....maybe hyper

explains it.

Does ANYONE out there have any idea how I can shift the weight?????? PLEASE

xxxxxxx

Letter to my Dr - the next stage

>

>

> Â

> Ok have just returned from Drs after they called me in following blood

test results.

[Guest guest]

Sheila once again thank you for your patience and attention to so many of us

here. You are a Blessingxxxx

>

> WHY THYROID HORMONE REPLACEMENT MAY NOT BE WORKING FOR YOU

[Guest guest]

Hi - thanks for that xx TSH was 0.02 ( 0.4-5) and FT4 was 24.9 (12-23) I do have both heat and cold intolerance - live in layers!!....a recent hand tremor which makes me feel really embarrased! But no other symptoms on the hyper list. My basal temp is 34/35 degrees and never goes above 36. Which I just dont undertsand if I am now hyper. BUT the worst thing is the weight. Have been on a vlcd now for 2 months and only shifted a few pounds. I could cope with everything else - just want to drop some pounds - well have more energy as well!!!!

[Guest guest]

forgetting your blood tests DO YOU FEEL HYPER? if not then you are not hyper. The blood tests should appear to the uninitiated that you are hyper when taking supplements, its how you feel that is important. Its likely as you get older if you had any thyroid function that this is being further depleted as you get older. Sally xx

Thank you Sally for your response. It was the Practice Nurse who initally was intransigent at the first meeting - at the second she was listening, thank goodness.Any idea anyone why I should become hyper and have dose dropped after being on 150mcg for YEARS!!!!!!Am 60 now and have felt dreadful for the last couple of months.....maybe hyper explains it.Does ANYONE out there have any idea how I can shift the weight?????? PLEASE xxxxxxxLetter to my Dr - the next stage> > > Â > Ok have just returned from Drs after they called me in following blood test results.

[Guest guest]

i'm wondering if not being able to shift any weight is to do with both your low

body temperature and your very low calorie diet ...enzyme reaction needs a min

body temperature of (i think)98.2; very low carbohydrate intake apparently

stops the use of t3 ...

" Low-Carbohydrate Diet and Thyroid Hormones:

According to Dr. Kurt (one of the proponents of paleo diet) in an

interview, people who take low carbohydrate diet to the extreme can undergo a

so-called “starvation response.†During this response, these people react to

low carbohydrate as if they are starving. One of the effects of this starvation

response is the peripheral conversion of thyroid hormones. The thyroid hormone

conversion is reduced and the cells purposely use less energy. Moreover, Dr.

emphasized that if you have a low metabolism or low carb diet, this will

never show as a classical hypothyroidism pattern based on thyroid hormones. "

trish

>

> Hi - thanks for that xx TSH was 0.02 ( 0.4-5) and FT4 was 24.9 (12-23)

I do have both heat and cold intolerance - live in layers!!....a recent hand

tremor which makes me feel really embarrased! But no other symptoms on the hyper

list. My basal temp is 34/35 degrees and never goes above 36. Which I just dont

undertsand if I am now hyper. BUT the worst thing is the weight. Have been on a

vlcd now for 2 months and only shifted a few pounds. I could cope with

everything else - just want to drop some pounds - well have more energy as

well!!!!

>

[Guest guest]

Are you taking any T3 supplement? Perhaps you dont convert T4 to T3 since your T4 levels are high? That is perhaps why your temperature remains low? Sally xx

TSH was 0.02 ( 0.4-5) and FT4 was 24.9 (12-23) I do have both heat and cold intolerance - live in layers!!....a recent hand tremor which makes me feel really embarrased! But no other symptoms on the hyper list. My basal temp is 34/35 degrees and never goes above 36. Which I just dont undertsand if I am now hyper. BUT the worst thing is the weight. Have been on a vlcd now for 2 months and only shifted a few pounds. I could cope with everything else - just want to drop some pounds - well have more energy as well!!!!

[Guest guest]

Hi Sally maybe thats what i have to do....any idea how i go about it?????

[Guest guest]

Hi Sally - am very hot with an embarrassing hand tremor ????? Thanks for your response xx

[Guest guest]

Trish - thanks

Lord knows what to do......eat put on weight.

Healthy but vlcd - stay the same.

Maybe I am stuck at being an elephant!!!!

Polly

[Guest guest]

Hi

>> Lord knows what to do......eat put on weight.

> Healthy but vlcd - stay the same.

> Maybe I am stuck at being an elephant!!!!

i think you need to focus on first things first - get the thyroid treatment

sorted, then weight loss will follow.

It doesn't look like things are working right. i'm not convinced a VLCD diet is

the way forward. also i'm surprised you're not losing weight on ketosis. it's

impossible not to lose weight if you're in ketosis, isn't it? ?? are you in

ketosis on your VLCD?

you may wish to read this page, it explains how we can be low on thyroid at a

tissue level. ps though the thing below talks about long term reduction in

metabolism, i'm not convinced it is long term (with proper treatment of course).

interesting how the average tsh in a chronically dieting patient is 0.7, that's

my tsh pretty much exactly, and i did one of those vlcd's years ago.

Chris

=

http://nahypothyroidism.org/deiodinases/

Dieting

Acute or chronic dieting can result in a significant decrease in intracellular

and circulating T3 levels by up to 50% (46,47,51,90), which significantly

reduces basal metabolic rate (number of calories burned per day) by 15-40%

(48,230,232). With chronic dieting, the thyroid levels and metabolism often do

not return to normal levels; the body stays in starvation mode for years with

significantly reduced metabolism despite the resumption of normal food intake,

making it very difficult to lose or maintain lost weight (48).

A study by Araujo RL et al. published in American Journal of Physiology,

Endocrinology and Metabolism found that 25 days of calorie restriction (dieting)

significantly reduced D1, resulting in reduced T4 to T3 conversion with a 50%

reduction in T3. This dramatic reduction in T3 was associated with an increase

in D2, so there was no increase in TSH but rather a decrease from an average of

1.20 ng/ml to 0.7 ng/ml, demonstrating the fact that the TSH is a poor marker

for tissue T3 levels, especially in a chronically dieting patient (47).

Fontana et al. found that T3 levels were significantly decreased by 25% in

chronically dieting individuals compared to non-dieting individuals with no

difference in TSH and T4 (thus undetected by TSH and T4 testing). This

clinically significant reduction in T3 levels, potentially causing inability to

lose weight or regaining of lost weight, fatigue, and depression, remained in

the normal range despite the significant decline, demonstrating the weakness and

unreliability of the common use of population references ranges that consider

95% of the population as " normal " (49).

A study by Leibel et al. published in the journal Metabolism found that

individuals who had lost weight in the past had a significantly lower metabolism

than those of same weight who had not gained or lost significant weight in the

past (48). The metabolism in the weight reduced patients was 25% less than an

equal weight person who did not lose or gain significant weight in the past and

equal to someone who weighed 60% less than they did. Additionally, the reduction

was shown to be present years later.

This 25% percent reduction in metabolism equates to an approximate deficit of

500-600 cal per day. Thus, if the previous overweight person is to maintain the

reduced weight he or she lost, he or she must either eat 600 cal per day less

compared to a person of same weight who has not had a weight problem or must jog

about 1 ½ hours per day to maintain the lost weight. This equates to

approximately a pound per week of weight gain, explaining why weight is so

quickly gained without continued very strict dieting. So many people who have

difficulty keeping weight off don't eat excessively but are continually told

they are eating too much or they need to exercise more by people who have never

had a weight problem. They are made to feel it is a character issue and that

nobody believes how how little food they actually consume. Unless the

physiologic thyroid dysfunction is corrected, any diet and exercise strategy is

doomed.

Croxson et al. in Journal of Endocrinology and Metabolism found that individuals

with a history of intense dieting had dramatic reductions in T4 to T3 conversion

with an intracellular deficiency of T3. The inadequacy and inaccuracy of

standard TSH and T4 testing was demonstrated, as such testing failed to detect

the dramatic reduction in tissue levels of T3 in all of the patients (50).

[Guest guest]

Lightbulb moment...!!

I've said for a long time that all my problems with thyroid and weight loss

started when I lost 3 stones with Slimming World. Before this I'd been on T4

only for 10 years and was fine - except that I'd managed to get 3 stone

overweight going through university.

I lost the weight in 1999/2000 and since then it has gone back on, and more

besides. I've been on various diets, worked out, and found I needed T3.

(NHS supply it)

Am now on NT, feel fine, plenty of energy, can do anything, stay awake, sleep

ok, but zero weight loss. In fact I have never lost any weight except maybe

a couple of pounds, since 2000.

OK, so now I have a reason.... half the battle, now I have to work out what to

do about it.......

> Croxson et al. in Journal of Endocrinology and Metabolism found that

individuals with a history of intense dieting had dramatic reductions in T4 to

T3 conversion with an intracellular deficiency of T3. The inadequacy and

inaccuracy of standard TSH and T4 testing was demonstrated, as such testing

failed to detect the dramatic reduction in tissue levels of T3 in all of the

patients (50).

>

[Guest guest]

hCG???...and it's not all in our head!

Luv - Sheila

Am now on NT, feel fine, plenty of energy, can do anything, stay awake, sleep

ok, but zero weight loss. In fact I have never lost any weight except maybe a

couple of pounds, since 2000.

OK, so now I have a reason.... half the battle, now I have to work out what to

do about it.......

[Guest guest]

Hi!

No, I don't think so, I believe the paper that found which says I got in

this mess through dieting,

I wouldn't be prepared to undertake another diet, especially a very low calorie

one.... I've always thiought at the back of my mind that my problems started

after the diet, and the paper seems to confirm this..... What I need to

work out is why the body stays in a reduced metabolism state for years after

dieting.......

Hmmmm

.

>

> hCG???...and it's not all in our head!

>

[Guest guest]

With all your symptoms of hypo and an over the range T4, your RT3 is likely to

be high. You are probably not converting to T3 properly.

If you got your RT3 tested, it would likely be high.

IMO, you definitely need less T4 and you may even need T3 only for a period of

time.

I agree that weight is the worst symptom of hypo, but a VLCD will only worsen

RT3 in a person whose thyroid is undertreated.

Lynn x

[Guest guest]

i tend to agree with you

could it be something else like leptin resistance, insulin resistance?

there's also set point theory, affecting the hypothalamus i think - see seth

roberts' shangrila diet (i think), and this was discussed in the diet program

'naturally slim' (which is expensive). not sure if the book, which i think it

was based on (the dallas doctors diet) mentions it.

I think some people such as Tom Venuto say that the metabolism slows down unless

you eat little and often? (that's a vastly simplified summary). not enough to

be stored as fat but enough to keep things going?

Chris

>

> I wouldn't be prepared to undertake another diet, especially a very low

calorie one.... I've always thiought at the back of my mind that my problems

started after the diet, and the paper seems to confirm this..... What I

need to work out is why the body stays in a reduced metabolism state for years

after dieting.......

[Guest guest]

ine,

I feel sure you sent me a message that I havent yet responded to. I am terribly sorry I seem to have lost it. I cant seem to use this forum terribly well. Please resend. Sally xx

Trish - thanks

Lord knows what to do......eat put on weight.

Healthy but vlcd - stay the same.

Maybe I am stuck at being an elephant!!!!

Polly

[Guest guest]

Hi Trish...Thank you for liking elephants xxxx HCG ....will try anything....but once again it is a vlcd. Other posts suggest that ,maybe its my vlcd way of life that has stopped me from losing weight. I did contact Lilian - and do have a Paypal account but need to have the paying details/costs sent before I can do anything.

[Guest guest]

In the same boat Galathea !!!!!

[Guest guest]

will explore that. Thank you

[Guest guest]

Thank you - I have been waiting for 20 years to get Thyroid sorted. ...and now I understand I am hyper !!!! Will print off this info for Dr. Cheers. Poll x

[Guest guest]

Doing more of the same thing won't necessarily get you a different result....but

i hope hcg works for you.

>

> Hi Trish...Thank you for liking elephants xxxx HCG ....will try

anything....but once again it is a vlcd. Other posts suggest that ,maybe its my

vlcd way of life that has stopped me from losing weight. I did contact Lilian -

and do have a Paypal account but need to have the paying details/costs sent

before I can do anything.

>