RE: Question for my mother

[Guest guest]

Hi

Yes, what you read is correct. Thyroxine (T4) is an INACTIVE

thyroid hormone. It is actually called a prohormone, meaning that it has to

convert in the kidneys, liver, brain, skin and other numerous thyroid hormone

receptors throughout the body into the ACTIVE thyroid hormone triiodothyronine

(T3). It is T3 that every cell in your body and brain need to make them

function, NOT T4. For the majority of sufferers of the symptoms of

hypothyroidism, T4-only works fine, or at least, it appears to work fine, but

for a very large minority of sufferers, they are unable to convert for many and

various reasons, and these people need either synthetic T3 adding to their dose

of T4, T3 alone or natural thyroid extract.

When T4 doesn't convert, it remains in the blood with nowhere to

go, causing symptoms of toxicity. The pituitary gland, that secretes Thyroid

Stimulating Hormone recognises that there is sufficient thyroid hormone in the

BLOOD so doesn't need to send out any TSH to tell the thyroid to secrete more

T4, so the TSH becomes suppressed. It is likely that your Mum's TSH was

suppressed and her free T4 was too high that makes her GP believe she is

becoming hyPERThyroid. So he wants to cut down her dose.

What he needs to do is to get the local laboratory to test your

Mum's free T3 - because if the T4 is not converting to this active thyroid hormone,

her free T3 will be right at the bottom of the reference range, or be outside

the bottom of the reference range. In which case, your Mum must be prescribed

T3.

Read the two rebuttals I wrote to the British Thyroid

Association's misleading (and in parts incorrect) 'Statements on T4/T3

combination therapy versus T4-only' and Armour Thyroid versus T4-only therapy'

and a lot of your questions you will find answered there. http://www.tpa-uk.org.uk/tpa_responds1.php

The RCP has written a more recent Statement on the diagnosis and

management of Primary Hypothyroidism where they state that patients with

hypothyroidism should be treated with levothyroxine-only, but they do NOT take

into account those suffering with resistance to thyroid hormone at the cellular

level - who should be treated with T3.

Too high a dose of thyroxine causes osteoporosis, especially

when the thyroxine is not being used. She needs to be referred to a

rheumatologist to get a correct diagnosis and she needs to ask for such a

referral from her GP. Best to put down all such requests in writing and ask for

her request to be placed into her medical notes.

Your Mum might have to fight her corner on this , and she

needs to ask for a referral to an endocrinologist of her choice, and to this

end, I have sent you a list of doctors who will prescribe with other thyroid

hormone apart from levothyroxine-only. I would also urge your Mum to get the

following specific nutrients tested, because if any of these are low in the

range, she needs to get whatever is low supplemented before thyroid hormone can

be fully utilised by the cells. These are iron, transferrin %, ferritin,

vitamin B12, vitamin D3, magnesium, folate, copper and zinc.

Luv - Sheila

last year I suggested to my mother that she try increasing her levo as

she is still suffering lots of hypo symptoms on 150mcg. Being a very cautious

person, and because her GP has put the fear of God into her saying too much

would give her a heart attack, basically, she decided to take an extra half a

tablet every other day. The next time she had a blood test her GP got very

serious and said she had had a result that meant she might need to cut down her

thyroxine as the T4 was high. She had not had any extra for several days at

this point, thinking it best to cut down the extra before her test.

Recently I was reading on here I think that T4 can build up if it is not being

utilised. Could this blood test result possibly indicate that my mother is not

properly utilising the thyroxine she is taking? I can't recall the post it was

in but it gave me a kind of " ah-ha! " moment. Also I am afraid I could

not tell you exactly which T4 test this was - the standard one used by

conventional GPs when monitoring thyroxine doseage I would guess. I also don't

know about the TSH level - my mother does not really understand all these

things.

On another note, a new member of the practice has just told my mother

that she has osteo-arthritis in her hands, when it is plainly rheumatoid

arthritis, totally classic, hot joints, bend knuckles, came on very quickly

last year, both sides, where osteo generally is wear and tear in larger joints

and can be one-sided if someone has abused one knee more than the other, for

example. I thought this was particularly worrying as there are potential

treatments for one that would be no good with the other, and all they have

given her so far is ibuprofen cream to rub in as she already suffers from

gastric reflux. I couldn't believe it!

[Guest guest]

Hi Sheila, thankyou for that. This is what I thought, because I realised some time ago that she was not better on the thyroxine. Her GP has also told her in the past that she is on the "maximum dose" according to Government guidelines, so she was quite surprised when I told her there are people I have been in contact with who are on doses of 200 or 250! I think she is so used to feeling dreadful, believes and trusts her doctors and has too much brain fog that she won't do much about it without someone pushing. Better be me, hadn;t it?She is due some blood tests soon and I have already told her there is a blood test they can do for rheumatoid arthritis, because I have had it done myself! I will show her your email and see

if I can persuade her to ask for all of them.From: Sheila <sheila@...>thyroid treatment Sent: Sunday, 23 October 2011, 17:27Subject: RE: Question for my mother

Hi Yes, what you read is correct. Thyroxine (T4) is an INACTIVE

thyroid hormone. It is actually called a prohormone, meaning that it has to

convert in the kidneys, liver, brain, skin and other numerous thyroid hormone

receptors throughout the body into the ACTIVE thyroid hormone triiodothyronine

(T3)....

[Guest guest]

, the best way to go about this is by writing a letter to

her GP and asking for it to be placed into her medical notes. That way, she is

spared the embarrassment of having to face her GP who will do whatever he can

to confuse her with science, that will probably only serve to convince her yet

further that her GP is 'god' and knows best.

She should write down all her present symptoms and signs (check

these with those in our web site under 'hypothyroidism' www.tpa-uk.org.uk

She should take her basal temperature for 4 or 5 mornings before

getting out of bed and before having anything to eat or drink. If these are

97.8 degrees F (36.6 degrees C or less, she should list these. Low temperature

shows her metabolism is running too slowly.

She should list all the thyroid function blood tests she needs

to be done and these are TSH, free T4 and free T3 and ask for the results to be

sent to her together with the reference range for each test done. You can then

post them on the forum for us to help with interpretation.

She should ask for her iron, transferrin saturation%, ferritin,

vitamin B12, vitamin D3, magnesium, folate, copper and zinc to be tested to see

whether any of these are low in the range. If any ARE low, this will stop her

thyroid hormone from being fully utilised at the cellular level and whatever is

low MUST be supplemented.

She should ask for a trial of Liothyronine (T3) in combination

with her levothyroxine (T4) to see if that helps her. If her GP refuses, she

should then ask for a second opinion from an endocrinologist of her choice. She

does not have to go along with the NHS endocrinologist her GP chooses, but to

find the one she needs, might mean she will have to travel outside of her area.

She should lastly ask for her letter of requests to be placed

into her medical notes, and ask her GP to write acknowledging that this has

been done.

She needs as much as she can get in writing. Doctors often pay

attention to the written word, which they don't do with the spoken word, and we

know the spoken word between a doctor and patient behind closed doors can be

denied at the end of the day, whereas the written word cannot.

Good luck, and I sincerely hope your Mum listens to you, because

from one who has been on levothyroxine-only treatment and who had continuing

symptoms, and then tried natural thyroid extract where the symptoms just fell

away, I can assure you taking T3 was the miracle that gave me back my full

health.

Luv - Sheila

From: thyroid treatment

[mailto:thyroid treatment ] On Behalf Of jessica

wheatley

Sent: 23 October 2011 20:49

thyroid treatment

Subject: Re: Question for my mother

Hi Sheila,

thankyou for that. This is what I thought, because I

realised some time ago that she was not better on the thyroxine. Her GP has

also told her in the past that she is on the " maximum dose " according

to Government guidelines, so she was quite surprised when I told her there are

people I have been in contact with who are on doses of 200 or 250! I think she

is so used to feeling dreadful, believes and trusts her doctors and has too

much brain fog that she won't do much about it without someone pushing. Better

be me, hadn;t it?

She is due some blood tests soon and I have already told her there

is a blood test they can do for rheumatoid arthritis, because I have had it

done myself! I will show her your email and see if I can persuade her to ask

for all of them.

From: Sheila

<sheila@...>

thyroid treatment

Sent: Sunday, 23 October 2011, 17:27

Subject: RE: Question for my mother

Hi

Yes, what you read is correct. Thyroxine (T4) is an INACTIVE

thyroid hormone. It is actually called a prohormone, meaning that it has to

convert in the kidneys, liver, brain, skin and other numerous thyroid hormone

receptors throughout the body into the ACTIVE thyroid hormone triiodothyronine

(T3)....