Re: Question - Do we know what signals the body to begin the conversion of T4 to T3?

[Guest guest]

Yes.. it's part of the feedback loop.. that's why there is so much of a delayed response in how the meds affect us and we need that 4 to 6 weeks period between a dosage adjustment and labs. It's a built in protection our bodies have to make the hormone levels gradually adjust over time and not do surges during a given day or week. The reason that Hashi's swings are so hard on folks is that it's too quick a change in the hormone balance for the body to adjust to smoothly.

The feedback loop looks first at the active hormone levels (T3, T2, T1) to determine if they are adequate, then determines how much T4 is stored and available for conversion, then determines how consistently hormone is being introduced to the body, either from the thyroid gland or from the pills that we take). From there it can determine how much of the stored hormone can be used for conversion and how much must remain in the tissues for use in the future.

All mixed up in there is how efficiently the receptors are picking up hormones... that goes for the active hormones (T3, T2, T1), the stored hormone (T4) and the TSH.

If that isn't enough. For folks whose conversion ability is challenged... adding T3 (via natural thyroid, like Armour, or via direct T3, like Cytomel) will stimulate the major processes of the body to a point where the body starts to convert again... the variable is how much of the conversion efficiency returns.. for some it kicks back in just fine.. those are the folks that do well with a single dose in the morning.... and with others it doesn't get back up to par and we end up multi-dosing.

When my over all daily dose is low, when my levels are low I need to dose in smaller amounts and more frequently. When my levels are up, when my total daily dose is high enough I can take a higer dose at a time and farther apart... That's what got me looking into saturation levels and the chemistry on what triggers what.

That and my original thyroid issue... genetically flawed TSH receptors... my TSH receptors don't work.. so my gland never got the instruction in needed via TSH to increase or decrease production... it ended up, in my case, that several emotional/physical crises, starting with puberty, triggered my gland to up production on it's own.. With no instruction via TSH to reduce that over production each new crisis event caused the gland to kick up even more... so from the age of 9 until I started into storm in my early 30's my endo and I were actually able to map out these shifts based on my activity levels, eating patterns, growth spurts, manic over exercise....etc to actually 'see' when these all happened.... resulting in the thyroid storm.

The doc that diagnoses me was able to spot the storm by site in mere seconds, confirmed it with the notes in my chart from 10 months previously and confirmed it with my lab results from the blood taken that day.

Fascinating stuff to study.... a lot of it is in the Thyroid Manager (www.thyroidmanager.org is the link, me thinks) and the rest I've gleened online and from my own notes on how my system reacts as compared to what I've read.. relating the two together.

Anyway... it's this lag time as the body acknowledge the levels of the hormones in the various locations and states as well as new hormone introduced to the system and how the body is functioning (this includes metabolic rate, activity levels, stress levels... all that happy stuff) that we all have to learn to deal with. Patience is a HARD thing to have with all this stuff.. giving the body the time it needs to get itself working right again.

Just my thoughts and observations on stuff....

Topper ()

*16 years post RAI, self treating since July '02*www.thyrophoenix.comwww.toppers-place.com

On Thu, 18 Jan 2007 07:18:49 -0800 (PST) Judy P writes:

I understand that TSH is a pituitary hormone that signals the thyroid to release hormone. I also understand that of the hormones released, most is T4 and some is T3. I also understand that T4 is converted to T3 in the body and that selenium is necessary for the conversion.

My question is: Do we know what signals the body to begin the conversion of T4 to T3? Is there a set-point for T3 that is used to determine when it's time to convert some more? Is T3 conversion affected by the feedback loop? In other words, if I take a T3 drug, does that suppress whatever is used to signal the conversion from T4? I haven't seen anything written about it.

JudyP – What others think of me is none of my business!

[Guest guest]

I presume that if we have trouble converting T4 to T3, we also have trouble

converting T3 to T2, and T2 to T1, no ? May sound elementary, but I just

wanted it confirmed. lol What always amazes me is that docs, etc, pay so

little heed to T2 and T1. They're obviously there for a purpose, so why do

they think it's irrelevent to suppliment them ? Or am I getting this all

wrong ? Enlightenment, please !

Lili

>From: topper2@...

>Reply-To: The_Thyroid_Support_Group

>To: The_Thyroid_Support_Group

>Subject: Re: Question - Do we know what

>signals the body to begin the conversion of T4 to T3?

>Date: Thu, 18 Jan 2007 09:58:58 -0600

>

>Yes.. it's part of the feedback loop.. that's why there is so much of a

>delayed response in how the meds affect us and we need that 4 to 6 weeks

>period between a dosage adjustment and labs. It's a built in protection

>our bodies have to make the hormone levels gradually adjust over time and

>not do surges during a given day or week. The reason that Hashi's swings

>are so hard on folks is that it's too quick a change in the hormone

>balance for the body to adjust to smoothly.

>

>The feedback loop looks first at the active hormone levels (T3, T2, T1)

>to determine if they are adequate, then determines how much T4 is stored

>and available for conversion, then determines how consistently hormone is

>being introduced to the body, either from the thyroid gland or from the

>pills that we take). From there it can determine how much of the stored

>hormone can be used for conversion and how much must remain in the

>tissues for use in the future.

>

>All mixed up in there is how efficiently the receptors are picking up

>hormones... that goes for the active hormones (T3, T2, T1), the stored

>hormone (T4) and the TSH.

>

>If that isn't enough. For folks whose conversion ability is challenged...

>adding T3 (via natural thyroid, like Armour, or via direct T3, like

>Cytomel) will stimulate the major processes of the body to a point where

>the body starts to convert again... the variable is how much of the

>conversion efficiency returns.. for some it kicks back in just fine..

>those are the folks that do well with a single dose in the morning....

>and with others it doesn't get back up to par and we end up multi-dosing.

>

>When my over all daily dose is low, when my levels are low I need to dose

>in smaller amounts and more frequently. When my levels are up, when my

>total daily dose is high enough I can take a higer dose at a time and

>farther apart... That's what got me looking into saturation levels and

>the chemistry on what triggers what.

>

>That and my original thyroid issue... genetically flawed TSH receptors...

>my TSH receptors don't work.. so my gland never got the instruction in

>needed via TSH to increase or decrease production... it ended up, in my

>case, that several emotional/physical crises, starting with puberty,

>triggered my gland to up production on it's own.. With no instruction via

>TSH to reduce that over production each new crisis event caused the gland

>to kick up even more... so from the age of 9 until I started into storm

>in my early 30's my endo and I were actually able to map out these shifts

>based on my activity levels, eating patterns, growth spurts, manic over

>exercise....etc to actually 'see' when these all happened.... resulting

>in the thyroid storm.

>

>The doc that diagnoses me was able to spot the storm by site in mere

>seconds, confirmed it with the notes in my chart from 10 months

>previously and confirmed it with my lab results from the blood taken that

>day.

>

>Fascinating stuff to study.... a lot of it is in the Thyroid Manager

>(www.thyroidmanager.org is the link, me thinks) and the rest I've gleened

>online and from my own notes on how my system reacts as compared to what

>I've read.. relating the two together.

>

>Anyway... it's this lag time as the body acknowledge the levels of the

>hormones in the various locations and states as well as new hormone

>introduced to the system and how the body is functioning (this includes

>metabolic rate, activity levels, stress levels... all that happy stuff)

>that we all have to learn to deal with. Patience is a HARD thing to have

>with all this stuff.. giving the body the time it needs to get itself

>working right again.

>

>Just my thoughts and observations on stuff....

>

>Topper ()

>*16 years post RAI, self treating since July '02*

>www.thyrophoenix.com

>www.toppers-place.com

>

>

>On Thu, 18 Jan 2007 07:18:49 -0800 (PST) Judy P ygroupsjp@...>

>writes:

>I understand that TSH is a pituitary hormone that signals the thyroid to

>release hormone. I also understand that of the hormones released, most

>is T4 and some is T3. I also understand that T4 is converted to T3 in

>the body and that selenium is necessary for the conversion.

>

>My question is: Do we know what signals the body to begin the conversion

>of T4 to T3? Is there a set-point for T3 that is used to determine when

>it's time to convert some more? Is T3 conversion affected by the

>feedback loop? In other words, if I take a T3 drug, does that suppress

>whatever is used to signal the conversion from T4? I haven't seen

>anything written about it.

>JudyP – What others think of me is none of my business!

_________________________________________________________________

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[Guest guest]

Thank you so much, that makes a lot of sense. Here are my current labs. What do you think? It's the first time that my T3 showed low, so I'm really confused about the whole thing. I was taking 50mcg Levo and 45mg Armour. I'm very close to going back to straight Levo again. My labs weren't stellar, but they were consistent and so was the way I felt. I would truly rather run daily at 75%, then to go from 0-100 and back throughout the day. On straight Levo, my TSH was 1.18, my T4 was 12, and my T3 was 105, all in range.

Most recent labs:

TSH, .43 (.4-4.10)

T4, 8.8 (4.5-12.5)

T3, 76 (87-178)

JudyP – What others think of me is none of my business!

Finding fabulous fares is fun.Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.

[Guest guest]

> T4, 8.8 (4.5-12.5)

> T3, 76 (87-178)

>

Is that a free or total range for T4?

Your T3 sucks..sorry.. wondering though if you raised the T4 so the T4

was higher in the range if it would bring your T4 up and assist in

conversion..if that is a total for T4 then your T4 could actually be

even lower..

Sorry seem to remember the T4 range being 1-2 roughly for frees and

the 4-12 range being a T4 index, guessitamate some type of total, so

if you took labs say a week after your menstual cycle , your estrogen

levels would be higher and most of that T4 would be bound.

Kats3boys

[Guest guest]

Ok, so now what the heck does it mean that my T4 might be bound by my estrogen. My goodness LOL. I'm 54 and don't have much estrogen action going on at all. It's low, but in range for my age and I don't take HRT. So, does that mean anything? I still have my ovaries, but no uterus since 1982, so it's hard to know if I still have a cycle or not.

I know my T3 sucks LOL, that's what I'm trying to figure out. I'm really tired with playing with it and I do it so much that I can't trust my labs anyway.

These are both total T's, but better than nothing considering the stellar TSH.

JudyP – What others think of me is none of my business!

Sorry seem to remember the T4 range being 1-2 roughly for frees and the 4-12 range being a T4 index, guessitamate some type of total, so if you took labs say a week after your menstual cycle , your estrogen levels would be higher and most of that T4 would be bound.

It's here! Your new message!Get

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[Guest guest]

>

> Ok, so now what the heck does it mean that my T4 might be bound by

my estrogen. My goodness LOL. I'm 54 and don't have much estrogen

action going on at all. It's low, but in range for my age and I

don't take HRT. So, does that mean anything? I still have my

ovaries, but no uterus since 1982, so it's hard to know if I still

have a cycle or not.

>

> I know my T3 sucks LOL, that's what I'm trying to figure out. I'm

really tired with playing with it and I do it so much that I can't

trust my labs anyway.

>

> These are both total T's, but better than nothing considering the

stellar TSH.

>

>

> JudyP – What others think of me is none of my business!

>

The T4 being a total maybe falsely elevated..estrogen and the

woman's cycle is the most common cause of this.. with your T3 so low

I was guessing that the T4 was falsely elevated and a FT4 is really

in order.. my thinking is the T3 is low not so much because of

conversion issues but because your T4 sucks too..( sorry) if you do

not have enough T4 to convert to T3 then conversion is less of an

issue then the issue of raising your T4.

Hope this makes sense..

Kats3boys

[Guest guest]

You're understanding along the same line that I am... I have heard that

if the tests do exist for T2 and T1 they are very expensive... we make

the assumption that if the conversion mechanism that allows the iodine

molecule to be pulled off the T4 leaving the T3 is working correctly that

it is also working at that same efficiency for the other two hormones.

We still have docs that think having a TSH level 'in normal range' is

sufficient for adequate health.. but in reality it doesn't take long to

see that a person can have a 'normal' TSH and Free Ts far below normal

range. It all has to do with how well the feed back loop mechanism even

works.

At what point in time does a body that has struggled to survive on

insufficient hormone levels determine it's time to no longer pay

attention to that TSH, thyroid, adrenal feedback loop? My body decided to

just do it's own thing when it got no instruction to my gland while I was

still in grade school.

I would venture to say that that mystical point where the feed back loop

is no longer valid for us also varies from individual to individual

dependant on so many variables we'd go insane trying to track it...

So... my thinking rolls back around to our having to learn the basics of

the chemistry, understanding the inter relationships of the hormones and

then paying attention to our body's responses and applying that to what

we have learned of that chemistry and hormonal interplay.

A simple example comes to mind... most of us can't take anything

containing T3 at bed time.... it causes sleeplessness and can trigger

anxiety... for me... it allows me to sleep better... skipping a bed time

dose leaves me tossing and turning and not sleeping deeply.

I fall outside the 'norm'... but I have learned to pay attention to how

my body reacts... and pay attention to what others say about how their

bodies react.... Pull enough info together.... lay it out and stare at

it... and a picture starts to form.....

That's why I sometimes ask some questions that seem really lame.... it's

to draw out observations that don't readily come to mind.. it was a

simple comment made by someone that got me to try an 'at bedtime dose'

and that was a huge turning point for my LIFE. I don't exaggerate

that....

.... for those that aren't familiar with that wonderment for me.... I'd

been dealing with chronic pain for years. Often the simple act of going

to bed and laying down for the night caused the pain in my ribs, front

and back, and my neck and shoulders to be bad enough that some nights I

didn't even want to go to bed... sitting up all night in a chair, and not

hurting worse the next day seemed the better option... This isn't an

exaggeration.....

I adjusted the timing of my last dose from 7 pm to bedtime, about 10:30.

Just took it sublingually, as I do all my doses, and went to bed... I

slept like a rock and woke without pain. By doing something that

according to everything I've read shouldn't have made a difference...

from something, if told to a doc, would be just coincidence, or

imagined....

But if I don't get my bedtime dose... I don't sleep well... I don't sleep

deeply... I don't dream.... I wake up feeling like cahcah no matter how

much, or little I slept. This is so consistent and predictable that if I

am all snuggled and comfy in bed and realize that I had forgot my dose I

will pull my fanny out of bed, get dressed and head back down the hall to

the office and grab my pill box to take that dose....

I think SOOOO much of what is involved with feeling well with a gefunk

thyroid has to do with understand our OWN body and how it is dealing with

this hormone deficient and do what we have to do to help it the best we

can....

Finding out what type of med is best, how much, when to take it.

Finding out what supplements and foods are best for us and what

aren't....

.... just stuff like that...

One HARD thing for me is to always remember to try to keep an open mind.

I have a routine that I have found works for me.... Okay.. that's cool,

right??? But... what if someone comes up with another 'dumb' idea like

take a dose before bed .. and I decide it sounds too dumb to check out? I

might just miss THE next little magical puzzle piece that pulls my body

back into an even more functional, healthier and happier place.....

That doesn't meant that I'm the 'mad experimenter' It just means that I

listen, consider, and weigh everything I hear about.... and file it away

for the day that I need to find a better way, or for the day that maybe

the way I do it now (multi-dosing) no longer works for me.

Topper ()

www.thyrophoenix.com

www.toppers-place.com

On Thu, 18 Jan 2007 17:29:04 +0100 " liliane wise " lililiz@...>

writes:

> I presume that if we have trouble converting T4 to T3, we also have

> trouble

> converting T3 to T2, and T2 to T1, no ? May sound elementary, but I

> just

> wanted it confirmed. lol What always amazes me is that docs, etc,

> pay so

> little heed to T2 and T1. They're obviously there for a purpose, so

> why do

> they think it's irrelevent to suppliment them ? Or am I getting this

> all

> wrong ? Enlightenment, please !

>

> Lili

[Guest guest]

I've been trying to pay closer attention to something... I'll run it by you and see how it strikes you.....

You look at several sets of labs for a person over a period of time....

Compare the three 'main' levels... TSH, Free T4, and Free T3...

If the TSH and the Free T4 are staying pretty close to the same... with little or no change in the dosage, or even an increase in the dosage... yet the Free T3 drops.....

Something comes to my mind....

The labs are checking the levels of the hormone that is free, un attached and available in the blood.

If the dosage is the same, or increased. And the TSH and T4 are close to the same but the Free T3 is lower... is that always a conversion thing in that conversion has decreased and therefore there is less Free T3 drifting around in the blood stream....

OR

Is the body picking up more in the utilization of the hormone stuff and that Free T3 in the blood is less cuz more of the Free T3 is getting picked up by the receptors and used??

I wish there were a way to test receptor and tissue saturation of thyroid hormone.. but they can't do that.. they can only check what is still in the blood and available......

Thats where I think daily journals come into play... records of how you FEEL that can be looked back on.... compared to previous labs and then to see if there is a cause/effect pattern developing....

My head goes weird places some times....

hehehhe

You're levels on straight T4... your TSH was higher.. that is suggesting that your body was telling your thyroid gland in a louder voice to kick up production..... how much gland function do you still have?

I still wonder if there is a point where blood levels can look okay, with good numbers, while the person is still among the walking dead.. not because the levels are incorrect (too low or too high) but because their hormone receptors still aren't able to pick up enough hormone for proper function.

There we're back to using both symptom observation/ how we feel AND labs to determine how we are doing... personally I have more faith in basal monitoring and how I FEEL than I do labs... but then that is me... someone that was so badly burned by bad docs.

I had a chance to get labs run in Feb of '05, the first since May of '97. I don't have copies of any of my old lab's, they've been archived cuz I've been without insurance and haven't been able to afford a doc in so long..... so I can only look at the last set I had done through Health Check. My labs showed my thyroid levels at rock bottom for both Free T4 and Free T3. I was off crutches, my pain was gone, I'd had a TON of improvement over how I had felt for all those years being treated with T4 by the docs. So the question that I have is...... If I felt that wonderful (in comparison) with labs that were that crappy, just how horrid did my labs look when I was so bad I wanted to be dead?

One of the things that will be done at the clinic (WHEN it becomes) is that I want to pick a handful of us that will get tracking labs done A LOT to compare with daily observations... to see what the correlation is... no one is bothering to do studies on this... so we will dog gone it!

Topper ()www.thyrophoenix.comwww.toppers-place.com

On Thu, 18 Jan 2007 09:15:39 -0800 (PST) Judy P writes:

Thank you so much, that makes a lot of sense. Here are my current labs. What do you think? It's the first time that my T3 showed low, so I'm really confused about the whole thing. I was taking 50mcg Levo and 45mg Armour. I'm very close to going back to straight Levo again. My labs weren't stellar, but they were consistent and so was the way I felt. I would truly rather run daily at 75%, then to go from 0-100 and back throughout the day. On straight Levo, my TSH was 1.18, my T4 was 12, and my T3 was 105, all in range.

Most recent labs:

TSH, .43 (.4-4.10)

T4, 8.8 (4.5-12.5)

T3, 76 (87-178)

JudyP – What others think of me is none of my business!

[Guest guest]

That's all of the questions that I'm dealing with right now. Mine was a total T3, so it's being low could me that it all got sucked up by the tissues. Too confusing for me, but I know that there was more consistency in how I felt on the Levothyroxine.

I have no idea how much thyroid function I have left. How can I tell? I do have a couple other labs like uptake and thyroxine index etc. Is there a test for actual thyroid function beyond the hormones? Would I have to go without meds for 6 weeks to find out?

If the dosage is the same, or increased. And the TSH and T4 are close to the same but the Free T3 is lower... is that always a conversion thing in that conversion has decreased and therefore there is less Free T3 drifting around in the blood stream....

OR

Is the body picking up more in the utilization of the hormone stuff and that Free T3 in the blood is less cuz more of the Free T3 is getting picked up by the receptors and used??

how much gland function do you still have?

We won't tell. Get more on shows you hate to love(and love to hate): Yahoo! TV's Guilty Pleasures list.

[Guest guest]

well said

Re: Question - Do we know what signals the body to begin the conversion of T4 to T3?

You're understanding along the same line that I am... I have heard thatif the tests do exist for T2 and T1 they are very expensive... we makethe assumption that if the conversion mechanism that allows the iodinemolecule to be pulled off the T4 leaving the T3 is working correctly thatit is also working at that same efficiency for the other two hormones. We still have docs that think having a TSH level 'in normal range' issufficient for adequate health.. but in reality it doesn't take long tosee that a person can have a 'normal' TSH and Free Ts far below normalrange. It all has to do with how well the feed back loop mechanism evenworks.At what point in time does a body that has struggled to survive oninsufficient hormone levels determine it's time to no longer payattention to that TSH, thyroid, adrenal feedback loop? My body decided tojust do it's own thing when it got no instruction to my gland while I wasstill in grade school.I would venture to say that that mystical point where the feed back loopis no longer valid for us also varies from individual to individualdependant on so many variables we'd go insane trying to track it...So... my thinking rolls back around to our having to learn the basics ofthe chemistry, understanding the inter relationships of the hormones andthen paying attention to our body's responses and applying that to whatwe have learned of that chemistry and hormonal interplay.A simple example comes to mind... most of us can't take anythingcontaining T3 at bed time.... it causes sleeplessness and can triggeranxiety... for me... it allows me to sleep better... skipping a bed timedose leaves me tossing and turning and not sleeping deeply.I fall outside the 'norm'... but I have learned to pay attention to howmy body reacts... and pay attention to what others say about how theirbodies react.... Pull enough info together.... lay it out and stare atit... and a picture starts to form..... That's why I sometimes ask some questions that seem really lame.... it'sto draw out observations that don't readily come to mind.. it was asimple comment made by someone that got me to try an 'at bedtime dose'and that was a huge turning point for my LIFE. I don't exaggeratethat....... for those that aren't familiar with that wonderment for me.... I'dbeen dealing with chronic pain for years. Often the simple act of goingto bed and laying down for the night caused the pain in my ribs, frontand back, and my neck and shoulders to be bad enough that some nights Ididn't even want to go to bed... sitting up all night in a chair, and nothurting worse the next day seemed the better option... This isn't anexaggeration..... I adjusted the timing of my last dose from 7 pm to bedtime, about 10:30.Just took it sublingually, as I do all my doses, and went to bed... Islept like a rock and woke without pain. By doing something thataccording to everything I've read shouldn't have made a difference...from something, if told to a doc, would be just coincidence, orimagined.... But if I don't get my bedtime dose... I don't sleep well... I don't sleepdeeply... I don't dream.... I wake up feeling like cahcah no matter howmuch, or little I slept. This is so consistent and predictable that if Iam all snuggled and comfy in bed and realize that I had forgot my dose Iwill pull my fanny out of bed, get dressed and head back down the hall tothe office and grab my pill box to take that dose.... I think SOOOO much of what is involved with feeling well with a gefunkthyroid has to do with understand our OWN body and how it is dealing withthis hormone deficient and do what we have to do to help it the best wecan....Finding out what type of med is best, how much, when to take it.Finding out what supplements and foods are best for us and whataren't.... ... just stuff like that... One HARD thing for me is to always remember to try to keep an open mind.I have a routine that I have found works for me.... Okay.. that's cool,right??? But... what if someone comes up with another 'dumb' idea liketake a dose before bed .. and I decide it sounds too dumb to check out? Imight just miss THE next little magical puzzle piece that pulls my bodyback into an even more functional, healthier and happier place.....That doesn't meant that I'm the 'mad experimenter' It just means that Ilisten, consider, and weigh everything I hear about.... and file it awayfor the day that I need to find a better way, or for the day that maybethe way I do it now (multi-dosing) no longer works for me.Topper ()www.thyrophoenix.comwww.toppers-place.comOn Thu, 18 Jan 2007 17:29:04 +0100 "liliane wise" <lililiz (AT) hotmail (DOT) fr>writes:> I presume that if we have trouble converting T4 to T3, we also have > trouble > converting T3 to T2, and T2 to T1, no ? May sound elementary, but I > just > wanted it confirmed. lol What always amazes me is that docs, etc, > pay so > little heed to T2 and T1. They're obviously there for a purpose, so > why do > they think it's irrelevent to suppliment them ? Or am I getting this > all > wrong ? Enlightenment, please !> > Lili