Re: Does taking T3+T4 exacerbate a rT3 problem?

[Guest guest]

Hello J,

To answer your question in the subject heading - yes, it would. If you really had an rT3 problem, you would need T3-only for a while to clear the blockage.

However, perhaps you simply have caught a virus; especially with us `thyroidians' this can very much upset the apple cart.

I'm afraid there is absolutely no point in speculating what might be the cause. There could be any number of reasons why you get those symptoms other than rT3 or cell resistance. Please find below a list (by Dr. Peatfield) which refers to Levothyroxine, but the very same is true for ANY kind of thyroid medication. If the meds are not working as they should, chances are that one or more of the below possibilities are at play. Each and every point below could be responsible for the symptoms you are experiencing.

Rather than to guess and experiment, systematically check out and eliminate each of the points below. For rT3 you would need a private blood test; I don't think this can be done on NHS.

With best wishes,

In case you have not already seen the information below, I am posting it again so you can check through all of this by way of a process of elimination in case you might have any of these associated conditions.

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. Should your GP or endocrinologist try to tell you that there is no association between low levels of these specific minerals and vitamins and low thyroid status, print off the information at the bottom of this message to show him just some of the references to research/studies to show that there is.***

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.

Should your GP or endocrinologist tell you that there is no connection between these minerals or vitamin levels and hypothyroidism, then copy the following links out to show him/her

Good luck!

***Low iron/ferritin: Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (1-4). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present (1-4)).

1. Dillman E, Gale C, Green W, et al. Hypothermia in iron deficiency due to altered triiodithyroidine metabolism. Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381.

2. SM, PE, Lukaski HC. In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of dietary fat. Life Sci 1993;53(8):603-9.

3. Zimmermann MB, Köhrle J. The Impact of Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry and Relevance to Public Health. Thyroid 2002;12(10): 867-78.

4. Beard J, tobin B, Green W. Evidence for Thyroid Hormone Deficiency in Iron-Deficient Anemic Rats. J. Nutr. 1989;119:772-778.

Low vitamin B12: http://www.ncbi.nlm.nih.gov/pubmed/18655403

Low vitamin D3: http://www.eje-online.org/cgi/content/abstract/113/3/329 and http://www.goodhormonehealth.com/VitaminD.pdf

Low magnesium: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292768/pdf/jcinvest00264-0105.pdf

Low folate: http://www.clinchem.org/cgi/content/full/47/9/1738 and http://www.liebertonline.com/doi/abs/10.1089/thy.1999.9.1163

Low copper http://www.ithyroid.com/copper.htm

http://www.drlwilson.com/articles/copper_toxicity_syndrome.htm

http://www.ithyroid.com/copper.htm

http://www.rjpbcs.com/pdf/2011_2(2)/68.pdf

http://ajplegacy.physiology.org/content/171/3/652.extract

Low zinc:http://www.istanbul.edu.tr/ffdbiyo/current4/07%20Iham%20AM%C4%B0R.pdf and http://articles.webraydian.com/article1648-Role_of_Zinc_and_Copper_in_Effective_Thyroid_Function.html

Ferritin levels for women need to be between 100 and 130 for women (for men around between 150 and 170)

Vitamin B12 needs to be at the top of the range.

D3 levels need to be top of the range.

Magnesium levels need to be at the top of the range, it's one thing that often gets missed.

[Guest guest]

The other issue you are up against is that anything that lowers the TSH will

reduce conversion rate. The cells in the liver that convert T4 to T3 do use TSH

and alter the conversion rate based on whether TSH is high or low. The addition

of T3 will cause the TSH to reduce and hence the conversion rate.

Everyone needs the right level of T3 and rT3 that is appropriate for them. By

altering the T4 and T3 ratio you may be able to find a better balance. There are

two ways to do this - more T4 or more T3. You should talk to your own doctor

about which route might be better for you.

The initial response you had of improvement followed by a downturn is something

that is terribly common and often is a necessary step before progressing to

something that works.

Good luck,

>

> Have been on Nature Throid (T3+T4) for nearly 3 weeks now and built up

[Guest guest]

Hiya,I take erfa and thyroxine and I usually feel really awful if I catch a cold or anything like that and it can take me weeks to get back to normal afterwards (my colds usually last three or more weeks - and that is just for a cold) and it knocks me for six. I would suggest that you don't make any changes yet but monitor how you are feeling and give it a few weeks -

additionally if you've only been on it for three weeks that is not really long enough to make a judgement - t4 takes longer than that (about 6 weeks I believe) to be fully effective. You need to give it a chance before worrying that you might be resistant to it - I definitely would not stop taking it. Hope that helps a bitDawn M From: diythyroid <j.benson-bunch@...> thyroid treatment

Sent: Monday, 26 December 2011, 14:10 Subject: Does taking T3+T4 exacerbate a rT3 problem?

Have been on Nature Throid (T3+T4) for nearly 3 weeks now and built up to 1 grain. Initially I thought maybe I was feeling a little better (first few days) but the last week I have been feeling terrible. I'm not sure if i've caught a bad cold which is making me feel ill or if the hormones are making me worse. I haven't noticed any of the typical symptoms of sweating / racing heart. I just feel generally ill / weak...cold type symptoms.I think I may be thyroid hormone resistant / high rT3 although I have not had this tested yet. If I am resistant would taking T3+T4 exacerbate the problem and make me feel worse? I'm thinking maybe I need T3 only.Not sure whether to carry on with the T3 + T4 for another few weeks or if I should stop. Any comments appreciated.Best wishes,J

[Guest guest]

> The initial response you had of improvement followed by a downturn is

something that is terribly common and often is a necessary step before

progressing to something that works.

>

Thanks . Thats reassuring! So do people who have this reaction normally

continue and see improvement or does it suggest, as you point out, that a

different balance of T3 + T4 may be required?

Best wishes,

J

[Guest guest]

> However, perhaps you simply have caught a virus; especially with us

> `thyroidians' this can very much upset the apple cart.

>

Yes, it certainly does seem to hehe.

> Rather than to guess and experiment, systematically check out and

> eliminate each of the points below. For rT3 you would need a private

> blood test; I don't think this can be done on NHS.

Thanks for that list, looks great. I guess I'll have to do my rT3 just in case.

> They may be suffering with low adrenal reserve.

I have had the 24 hour saliva test. After 6 months of treatment for my adrenals

and a re test it seemed to sort itself out. I do wonder though whether it may

have gone bad again as I have not been on any thyroid treatment for the last 6

months (or adrenal support). Also my temps seem to rocket around (about 1-2

degrees C range during the day) Does this sound likely?

> Then, we have systemic candidiasis.

Tested for this and am clear.

> And then there are Food allergies. The most common food allergy is

> allergy to gluten.

I don't think this is a problem. But am gluten free anyway just in case (for

about 5 weeks so far).

> 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

Can't seem to get my magnesium / zinc up. Have been doing transdermal magnesium

(by skin) and oral for about 3 months now and it is still low. (orally for over

a year). Any ideas why I can't increase the level??

thanks for the great info!

Best wishes,

J

[Guest guest]

> I would suggest that you don't make any changes yet but monitor how you are

feeling and give it a few weeks - additionally if you've only been on it for

three weeks that is not really long enough to make a judgement

Ok thanks. I'll keep going for the moment then...

Best wishes,

J

[Guest guest]

This link may help- Iron promotes good conversion of thyroid hormones T4 to T3 (so if iron is low, your storage iron T4 will build too high.http://www.stopthethyroidmadness.com/2011/12/10/why-iron-is-so-important-milk-thistle/#--- In thyroid treatment , D Mckinley <de_mckinley@...> wrote:>> Hiya,> > I take erfa and thyroxine and I usually feel really awful if I catch a cold or anything like that and it can take me weeks to get back to normal afterwards (my colds usually last three or more weeks - and that is just for a cold) and it knocks me for six. > > I would suggest that you don't make any changes yet but monitor how you are feeling and give it a few weeks - additionally if you've only been on it for three weeks that is not really long enough to make a judgement - t4 takes longer than that (about 6 weeks I believe) to be fully effective. You need to give it a chance before worrying that you might be resistant to it - I definitely would not stop taking it. > > Hope that helps a bit> > Dawn M> > > ________________________________> From: diythyroid j.benson-bunch@...> thyroid treatment > Sent: Monday, 26 December 2011, 14:10> Subject: Does taking T3+T4 exacerbate a rT3 problem?> > > > Have been on Nature Throid (T3+T4) for nearly 3 weeks now and built up to 1 grain. Initially I thought maybe I was feeling a little better (first few days) but the last week I have been feeling terrible. I'm not sure if i've caught a bad cold which is making me feel ill or if the hormones are making me worse. I haven't noticed any of the typical symptoms of sweating / racing heart. I just feel generally ill / weak...cold type symptoms.> > I think I may be thyroid hormone resistant / high rT3 although I have not had this tested yet. If I am resistant would taking T3+T4 exacerbate the problem and make me feel worse? I'm thinking maybe I need T3 only.> > Not sure whether to carry on with the T3 + T4 for another few weeks or if I should stop. Any comments appreciated.> > Best wishes,> > J>