T Nation

How to Tackle a Poor Thyroid?

So I am one of those people who started HRT (1 year ago) and although I do feel somewhat better and some symptoms are gone, I still feel very bad overall. I figured I would look deeper into my thyroid and it is not great. On top of that I have always felt there is some underlying issue with me. I am 41 and since having mono 2x…at 20 and about 18 months later at 21 I have never been the same. As the years go buy I get worse and worse. I have these episodes that last weeks where I will be in total pain in all my joints, hard to move, extreme fatigue where standing is a chore, chronic hives and the list goes on. I have been to about 50 Dr visits with these issues and no answer except sending me to a different Dr. I feel I have some autoimmune disease that is going undiagnosed. Here are some of my numbers and ranges to look at:

Iron 91 RANGE (59-158)
Ferritin 30 (30-400)
T4 6.9 (4.5-11.7)
T3 74 (80-200)
TSH 1.420 (.27-4.20)
LH .1
Free T3 2.3 (2.3-4.2)
Reverse T3 29 (8-25)

My Dr. started me on Armour Thyroid (1 grain) 2 weeks ago. Feeling no difference after 10 days he upped to 1.5 grains yesterday. So far I feel no difference. I do not think upping the dose is right for me though due to my high reverse T3. I feel that adding in some T3 only medication to the Armour may be the better route.

I am very unfamiliar with all of this so if anyone has any suggestions, experiences etc I am all ears.

What are your other numbers? T level? E2 level?

Your thyroid levels are terrible, ferritin is low and while iron is in range, you could still be iron deficient, thyroid requires ferritin 70> for optimal function. Reverse T3 is very high and blocking Free T3 at the receptors making you hypothyroid.

More often than not doctors are the problem, you should never have started on T3+T4 medicine with high Reverse T3 which essentially slows you down metabolically, the treatment calls for T3 only medicine since you have a conversion disorder. You may have to seek competent care with a private doctor in anti-aging.

You just cannot find good thyroid doctors these days in managed healthcare, Obamacare chased a lot of the good doctors out of managed healthcare. There are anti-aging clinics that do phone consultants and treat you remotely, Defy Medical has expert level thyroid doctors that will know what to do.

Iron deficiency

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. 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.

Understanding Local Control of Thyroid Hormones:

Thank you for this. I will look up Defy Medical right now and check them out!

Just talked to them and they do help in discovering and diagnosing auto immune disorders as well. So that is a definite plus. I have almost all the labs they need except for maybe 3 so I will most likely have those ordered and see how it goes working with them.

Defy Medical doctors were the ones that were looking at some of my biomarkers and was hinting at an iron deficiency, this prompted me to looked at lab testing over a 3 year period before joining Defy, I notice iron was either low normal or below range and my Kaiser doctors never said anything about it because at the time iron was at the bottom of the range, but still barely in range.

These managed healthcare doctors I find are inadequate, for the fact that they take my insurance at all is almost a guarantee doctors will be inept, typical in HMO providers.

How costly are they if you don’t mind me asking?

Defy Medical is about $1200-$2000 per year and you get away from the clueless managed healthcare doctors.

That is not too bad.

Considering it’s pay as you go and not all upfront, even better.

Are they easy to work with. For example I have found I do not do well with cypionate but reacted much better with proprionate. My Dr was open to me switching to that. So are they the same with Thyroid stuff. For example as you stated I should be on T3 meds.

Also will they also help with recommendations to diet that could be triggering some auto immune disease? I truly believe a holistic approach works for some and but not all and I feel that some people need a mix of both. I already eat extremely well and am in great shape on the outside. Which has always made it hard going to a Dr. They see me, I look late 20s early 30s, 5% body fat and are like there is nothing wrong with you your in great shape. Always annoyed with that.

Defy Medical is easy to work with, they will make recommendations but ultimately the design is yours. You will be impressed by Defy Medical doctors and will soon learn they they know far more than you or myself, you’ll feel comfortable with allow them to take the reins.

Managed healthcare doctors are a different breed, they are unconcerned when you bring stuff to their attention because it’s a system that is designed to take action after you become ill, not before and is why they show a lack of concern.

The sick care system doesn’t prevent disease, you get sick and then they offer treatment. What we all need is a healthcare system that prevents disease, this type of healthcare system is more costly and less profitable.

By going for Defy, you are going to get care that is going to prevent disease, so they are more likely to listen to your concerns and if they are any issues will offer advice or treatment.

On a side note, cypionate usually works excellent for everyone, it’s the most popular worldwide.

The propionate works well for a very small percentage and must be dosed daily.

Yes I switched sometime in the early winter to proprionate and prefer it much much much over cypionate. I feel much better with it using eod.

Since I just had labs I only needed a few more from Defy Medical which is good so hopefully I can get done tomorrow and have a conversation with them again next week.

Maybe you can help answer one more question for me that I am really having a hard time finding online. ALWAYS every blood test my Insulin is low. The past test for example was 2.5 (range 2.6-24.9). What exactly does this mean…from what I understand it is the opposite of what a diebetic would be. Anytime I google it all I can find is if that number is high. Side note I go hypoglycemic very easy. I have a very healthy diet but still consume sugar. Mostly fruit but I do have ice cream daily as well. That would be pretty much the only junk food I eat.

Compounded T3/T4 medication would be better. The T3/T4 ratio can be customized to you so you can reach optimal free T3 levels.

Completely agree. Most of this anti-aging Medics didn’t stop in time, and stopped to study and learn. Certainly they are able to do a refined tuning on your general health.

rT3 needs to be below 15 and more like 8-10 for optimal. Yours is through the roof. You need a straight T3 med like cytomel.

I have a phone call scheduled with Dr. on Wednesday. I am going to let him know this as well. I am feeling more tired on Armour Thyroid. And thyroid meds are only one piece of the puzzle. I really need to get whatever autoimmune disseaase I have under control as well since no matter what will trigger issues. I am going to start working with Defy Medical on this thanks to System Lord’s advice. After talking with them they said they do help identify and get autoimmune disseaase under control. Literally 7 plus years of Dr appointments and because I physically look in great shape they always will state things like oh why are you here your young and in great shape. Or blanket statements like get more sleep blah blah blah. Literally no Drs in my area have or will listen and I’m glad I’m finally putting the pieces together and have at least a reason why I’ve felt like this for so long.

Dr changed me to Liothyronine. What would you suggest as a starting dose? I do not trust the amount he prescribed me…lol. He told me to stop Armour for now.

I am hoping to be able to get my RT3 down T3 up and eventually switch off once everything gets straightened around…or at the least switch back to Armour.

Also with my iron and ferratin levels would you suggest supplementing with Iron? And anything else would you suggest supplementing with in regards to my numbers?

Also thanks for your help earlier as well. I am waiting on my labs from Defy Medical still. I contacted them and had some more labs done and will most likely stay with them in helping me figure out whatever autoimmune issue I am having for years and years.

Those with high Reverse T3 need T3 only medicine, this way there is no Free T4 to convert to Reverse T3. It doesn’t seem like your current doctor ever attended medical school or just didn’t retain anything.

It’s amazing the amount of trust we have in our doctors and they do not even know what they are doing.

I would do more throughout testing, CBC is also needed to check iron status, MCV and MCH if abnormally low could definitely tell if iron deficient.