Re: getting put off T3 - any answers

July 25, 2011

don't know if this helps (i dno't think it does but posting it in case)

http://www.ncbi.nlm.nih.gov/pubmed/18171701

CONTEXT: Low-T(3) syndrome is a predictor of poor outcome in patients with

cardiac dysfunction. The study aimed to assess the short-term effects of

synthetic L-T(3) replacement therapy in patients with low-T(3) syndrome and

ischemic or nonischemic dilated cardiomyopathy (DC

CONCLUSIONS: In DC patients, short-term synthetic L-T(3) replacement therapy

significantly improved neuroendocrine profile and ventricular performance. These

data encourage further controlled trials with more patients and longer periods

of synthetic L-T(3) administration.

do you have low cortisol levels?

ray peat says that high pulse can be due to too much adreanline from low thyroid

http://www.thyroid-info.com/articles/ray-peat.htm

Dr. Ray Peat: In hypothyroidism, thyrotropin-release hormone (TRH) is usually

increased, increasing release of TSH. TRH itself can cause tachycardia,

" palpitations, " high blood pressure, stasis of the intestine, increase of

pressure in the eye, and hyperventilation with alkalosis. It can increase the

release of norepinephrine, but in itself it acts very much like adrenalin. TRH

stimulates prolactin release, and this can interfere with progesterone

synthesis, which in itself affects heart function.

I consider even the lowest TSH within the " normal range " to be consistent with

hypothyroidism; in good health, very little TSH is needed. When the thyroid

function is low, the body often compensates by over-producing adrenalin. The

daily production of adrenalin is sometimes 30 or 40 times higher than normal in

hypothyroidism. The adrenalin tends to sustain blood sugar in spite of the

metabolic inefficiency of hypothyroidism, and it can help to maintain core body

temperature by causing vasoconstriction in the skin, but it also disturbs the

sleep and accelerates the heart. During the night, cycles of rising adrenalin

can cause nightmares, wakefulness, worry, and a pounding heart. Occasionally, a

person who has chronically had a heart rate of 150 beats per minute or higher,

will have a much lower heart rate after using a thyroid supplement for a few

days. If your temperature or heart rate is lower after breakfast than before,

it's likely that they were raised as a result of the nocturnal increase of

adrenalin and cortisol caused by hypothyroidism.

>

> One of my symptoms is resting pusle 90-101, I have atrial fibrillation and

tachycardia and with so high pulse it doesnt take a lot to set it off, I know

I have low FT3 and thinking of trying to get t3/t4 combo treatment, but I

keep reading T3 makes heart work harder and pulse raise, and its putting me off.

I really dont want mine to do that because its enough risk already, my GP

probably wont let me have it on that basis anyway, so need to have answers ready

for her before asking in case.

>

July 25, 2011

if you go to this page: http://nahypothyroidism.org/deiodinases/

and then do a ctrl-f and type in 'heart' to find any articles with heart in, you

may find some relevant journal aritcles in the references section - just read

through them and see if any are relevant

chris

>

> One of my symptoms is resting pusle 90-101, I have atrial fibrillation and

tachycardia and with so high pulse it doesnt take a lot to set it off,

July 25, 2011

Hi there,

The first thing to ask - is there any reason that your GP, endo or cardiologist

has for your heart rate?

I'll assume the answer is no and carry on but if there is then please let us

know.

Heart rate is often high when the thyroid hormone isn't working correctly. The

most common reasons for this are:

a) low iron levels, low B12 or folate

low adrenal levels i.e. cortisol

If these levels are not addressed then the thyroid hormone does not get into the

cells correctly and the heart gets under strain.

Another possibility is the thyroid medication not being appropriate. For some

people T4 just doesn't do the trick. If the cells require more T3 then provided

this can actually reduce the heart rate rather than raise it. Don't forget the

heart is a muscle and muscle has cells. If the cells of the heart aren't

adequately resourced then they can be under strain.

So, first steps are to get a full evaluation of serum iron, serum ferritin (and

ideally transferrin saturation %) to thoroughly check your iron levels out.

Insist on these tests and get the results and the lab ranges and post them back

here. Don't accept " your results are normal " from the GP - normal / just inside

the normal range is not good enough. Do the same for B12, folate and if you can

get the GP to do it vitamin D also.

If you can get your GP or endo to organise a 24 hour urinary cortisol test then

this would be good also.

Get all the results, reference ranges and units for each result - don't be

fobbed off - you are entitled to have a proper set of tests if your T4 isn't

working correctly.

The other thing you can do is to take your body temperature several times a day

for a few days. Do it when totally at rest and when you haven't eaten or drank

anything for 10 mins or so. Your normal temp should be over 97.8 Fahrenheit or

36.555 Centigrade. My guess is that yours may be a lot lower than this.

I wouldn't be overly concerned about T3 or T4/T3 because it actually may help

your heart rate. Before any other thyroid meds are considered though a proper

evaluation of nutrients and cortisol ought to be done. It could easily be one of

these things that are hampering the thyroid hormone and causing heart rate

issues (or just the T4 that is not doing its job correctly).

Take care,

>

> One of my symptoms is resting pusle 90-101, I have atrial fibrillation and

tachycardia

July 25, 2011

Carole,

On the references side - there isn't a lot.

There is considerable myth and rumour that suggests that taking T3 can cause

problems. However, no proper studies have been done on those patients that use

T3 correctly. Any idiot can take any thyroid hormone and use it incorrectly.

The information that I already have is this (I hope it helps):

There is no published research that links the correct use of T3 containing

medications, or of T3 on its own, to heart attacks or other heart related

issues. In fact, in 2003 a group of respected endocrinologists published a

paper, which included the comment '... the possible long-term risks of elevated

or fluctuating T3 levels have not been evaluated.'[1]

If someone has a pre-existing heart condition, then they may be advised not to

use T3, because of the increased risk of any adverse effects due to a dosage

change that is incorrect.

There is research that clearly shows that untreated hypothyroidism causes

elevated cholesterol, homocysteine levels and heart attacks.[1, 3] Untreated, or

incorrectly treated hypothyroidism, is also associated with strokes and

peripheral vascular disease. Any thyroid hormone medication, if taken in too

high a dosage, will lead to tissue level over-stimulation and may result in a

variety of heart related symptoms or events.

1. Kaplan, M.M., Sarne, D.H., Schneider, A.B.: Editorial: In search of the

impossible dream? Thyroid hormone replacement therapy that treats all symptoms

in all hypothyroid patients. J. Clin. Endocrinol. Metab., Vol. 88, No.

(10):4540-4542, 2003.

2. Dullaart, R.P., vanDoormaal, J.J., Hoogenberg, K., Sluiter, W.J.:

Triiodothyronine rapidly lowers plasma lipoprotein (a) in hypothyroid subjects.

Neth. J. Med., 46:179-184, 1995.

3. LeMar, H.J. Jr., West, S.G., Garrett, C.R., Hofeldt, F.D.: Covert

hypothyroidism presenting as a cardiovascular event. Am. J. Med., (5):549-552,

1991.

Take care,

>

> One of my symptoms is resting pusle 90-101, I have atrial fibrillation and

tachycardia

July 25, 2011

there seems to be a few articles relating to t3 and atrial fibriliation - not

sure if you'll find exactly what you want though.

think you'll need to get a coffee and do some googling? can you ask your doctor

to try you on a small safe dose and monitor you?

http://www.ncbi.nlm.nih.gov/pubmed/8633935 Triiodothyronine therapy lowers the

incidence of atrial fibrillation after cardiac operations.

http://www.ncbi.nlm.nih.gov/pubmed/16499161

Atrial fibrillation and thyroid gland

Abstract

Many diseases can lead to atrial fibrillation and one of these is thyroid

disfunction. The prevalence of atrial fibrillation does not differ between

subclinical and overt hyperthyroidism. **Hypothyroidism also can be associated

to atrial fibrillation. Low-T3 syndrome is considered a risk factor in cardiac

patients. **In 100 patients affected by atrial fibrillation we studied the

thyroid function and performed ultrasound examination of the thyroid gland. 30

patients had a low-T3 syndrome, 66 (38 > or =10 mm) patients had thyroid

nodules, while just 10 patients had an abnormal thyroid function. So, in

patients affected by atrial fibrillation, we suggest to study the levels of

thyroid hormones and, even if these are normal, to perform an ultrasound

examination of the gland.

> >

> > One of my symptoms is resting pusle 90-101, I have atrial fibrillation and

tachycardia and with so high pulse it doesnt take a lot to set it off,

>

July 25, 2011

How about these:

1.

Hertoghe

T, Lo Cascio A., Hertoghe J. Considerable improvement of hypothyroid symptoms

with two combined T3-T4 medication in patients still symptomatic with thyroxine

treatment alone. Anti-Aging Medicine (Ed. German Society of Anti-Aging

Medicine-Verlag 2003) 2004; 32-43

Arguments pro

treatment with either T4 alone, either T4 and T3

T3-T4 treatments work

as good as T4 alone, but not better

1. T, Lavis VR, Meininger JC, Kapadia AS, Stafford LF. Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone. Endocr Pract. 2005 Jul-Aug;11(4):223-332. Sawka AM, Gerstein HC, Marriott MJ, MacQueen GM, Joffe RT. Does a combination regimen of thyroxine (T4) and 3,5,3'-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double-blind, randomized, controlled trial. J Clin Endocrinol Metab. 2003 Oct;88(10):4551-5

Arguments pro

treatment with T4 and T3 combinations

T3-T4 (and T3)

treatments work better than T4

3. Saravanan P,

DJ, Greenwood R, s TJ, Dayan CM. Partial substitution of thyroxine (T4)

with tri-iodothyronine in patients on T4 replacement therapy: results of a

large community-based randomized controlled trial. Clin Endocrinol Metab. 2005

Feb;90(2):805-12

4. Kloppenburg M, Dijkmans BA, Rasker JJ. Effect of therapy for thyroid dysfunction on musculoskeletal symptoms. Clin Rheumatol. 1993 Sep;12(3):341-5

5.

Hertoghe

T, Lo Cascio A., Hertoghe J. Considerable improvement of hypothyroid symptoms

with two combined T3-T4 medication in patients still symptomatic with thyroxine

treatment alone. Anti-Aging Medicine, Ed. German Society of Anti-Aging

Medicine-Verlag 2003- 2004; 32-43

6.

Pareira VG, Haron ES, Lima-Neto N,

Medeiros-Neto GA. Management

of myxedema coma: report on three successfully treated cases with nasogastric

or intravenous administration of triiodothyronine. J Endocrinol Invest.

1982;5:331-4

7.

Chernow

B, Burman KD, DL, McGuire RA, O' JT, Wartofsky L, s LP. T3

may be a better agent than T4 in the critically ill hypothyroid patient: evaluation

of transport across the blood-brain barrier in a primate model. Crit Care Med.

1983 Feb;11(2):99-104

8.

Arlot

S, Debussche X, Lalau JD, Mesmacque A, Tolani M, Quichaud J, Fournier A.

Myxoedema coma: response of thyroid hormones with oral and intravenous

high-dose L-thyroxine treatment. Intensive Care Med. 1991;17(1):16-8

T3-T4 treatment:

adding T3 to T4 results in greater improvement of clinical symptoms and signs

in hypothyroid patients

9.

Benevicius R, Kazanavicius G, Zalinkovicius

R, Prange AJ. Effects of thyroxine as compared with thyroxine plus

triiodothyronine in patients with hypothyroidism. N Engl J Med.1999; 340:

424-9.

When T3 and T4 are

both supplemented to the food simultaneously with goitrogens, a much better

prevention of goiter is obtained than when solely T4 is added, even if T4 is

given at doses 7 times higher those of T3-T4 treatments

10. Devlin WF, Watanabe

H. Thyroxin-triiodothyronine concentrations in thryoid powders. J Pharm

Sci. 1966 Apr;55(4):390-3

In humans, T4-T3

treatments reduce serum cholesterol and increase the speed of the Achilles

tendon reflexes better than T4 treatments alone

11. Alley RA,

Danowski TS, Robbins T JL, Weir TF, Sabeh G, and Moses CL. Indices during

administration of T4 and T3 to euthyroid adults. Metabolism. 1968;17(2):97-104

A study in rats

rendered hypothyroid shows that cellular euthyroidism is only obtained in the

target organs of hypothyroid rats if T3 is added to the classic T4 medication

12. Escobar-Morreale HF,

del Rey FE, Obregon MJ, de Escobar GM. Only the combined treatment with

thyroxine and triiodothyronine ensures euthyroidism in all tissues of the

thyroidectomized rat. Endocrinology. 1996 Jun;137(6):2490-502

13. Escobar-Morreale

HF, Obregon MJ, Escobar del Rey F, Morreale de Escobar G. Replacement therapy

for hypothyroidism with thyroxine alone does not ensure euthyroidism in all

tissues, as studied in thyroidectomized rats. J Clin Invest. 1995

Dec;96(6):2828-38

Anxiety: the improvement with thyroid treatment

71. Saravanan P,

DJ, Greenwood R, s TJ, Dayan CM. Partial substitution of thyroxine (T4)

with tri-iodothyronine in patients on T4 replacement therapy: results of a

large community-based randomized controlled trial. J Clin Endocrinol Metab.

2005 Feb;90(2):805-12

72. Venero C,

Guadano-Ferraz A, Herrero AI, Nordstrom K, Manzano J, de Escobar GM, Bernal J,

Vennstrom B. Anxiety, memory impairment, and locomotor dysfunction caused by a

mutant thyroid hormone receptor alpha1 can be ameliorated by T3 treatment.

Genes Dev. 2005 Sep 15;19(18):2152-63