T Nation

Some Thyroid Questions.


#1

2 years ago I was diagnosed with Thyroid cancer. I had a complete thyroid-ectomy, including 57 lymph nodes on the right side. I then had iodine radiation, and am cancer free now.

I was a no-muscle 220 when I found out I had cancer. My first Synthroid (T4) dosage was 175mcg a day. Now that I had thyroid function, I decided to loose some weight. I got down to a no-muscle 180 pounds.

On 01/08, the doc raised my Synthroid dose to 200mcg a day.

On 05/08, my TSH came back in the acceptable range, and my dosage was not changed.

Around 07/08, my eating slipped up a bit, and I gained about 15 pounds. This is also around the time I started working out.

On 12/08, my TSH was 9.2 H uIU/ml (Range 0.30-4.50.) At this point, I had been seriously in the gym, gained some LBM, and had been eating correctly, though pretty low carb. I was tired all the time, but I wasn't gaining unwanted fat. The doctor changed my dose, but some confusion happened with the prescription, and I never got it changed, just kept filling the 200mcg/day.

By 01/09, I had added more carbs to my diet, and wasn't tired any longer.

Around 02/09, I was weighing about 220, 16% BF, with my abs barely showing when flexed. This is also the month I started a 9 weeker of Test-P and Dbol. I got to 250 pounds by the end of the cycle (April.) After the water weight disappeared, I dropped back down to about 238. I have not had an unexpected rise in body fat. PCT went perfect, and everything feels back to normal. I will have my Test/Free Test/E2 levels checked in December at my next visit.

On 06/09, I'm weighing in at 242. My TSH was has gone up to 12.0 H uIU/ml (Range 0.30-4.50.) My doctor uped my dosage to 250mcg a day. This is above most standards for synthetic thyroid treatment, but I would also consider my LBM above most medical standards.

Now, from the research I have done, T4 uptake is most dependent on LBM. This is why I think my
TSH has risen, even with an increased dosage. I also pulled this from an article I found:

"The daily replacement dose of L-T4 to normalize serum TSH in adult hypothyroid subjects is, on average, 1.6 �???�??�?�µg/kg. The amount of hormone to be administered must be increased when suppressed values of serum TSH are desired. In both cases, however, individual adjustments are usually required to attain the optimal daily dose. Although the total daily requirements of L-T4 are related to body mass, unexplained difference can occur among individuals for the same age and body size, even in the absence of functioning thyroid tissue. In this regard, the role of obesity in affecting L-T4 disposal and therapy requirements has never been defined."**

My question is, is anyone here knowledgeable on Thyroid function and/or treatment? I'm not too worried about taking 'too-much' Synthroid, as I have no thyroid left to destroy, but I do not want my muscle building adventures to be in vein. I do understand that my doctor is the best person to ask. Be assured that I have talked to him, I am just looking for other views on the subject. The only thing bad about talking to him is he does not know anything about bodybuilding and/or steroids, so those subjects have not been touched. He is aware that I am in the gym, that I am eating correctly, and that I am gaining weight on purpose.

I know this is long, and my question may be somewhat abstract. Thanks for any opinions. If any more information is needed from me, just let me know.

**http://jcem.endojournals.org/cgi/content/full/90/1/124


#2

Hmmmm…i have hypothyroidism and take synthroid also…I was born with it. However, I can’t help you. Maybe you can help me though? I’ve always wondered how powerful my synthroid is? what would happen if I was to take a higher dosage? what the hell does synthroid do anyways?


#3

You’ve been taking Synthroid your whole life and don’t know what it does, or what dosage you are taking?


#4

Well…I know that it produces thyroxine or whatever…which controls my metabolism nd some other shit…but Im very limited in my knowledge on it…I’m 17 and take 150 mcg


#5

[quote]keeperbro wrote:
Hmmmm…i have hypothyroidism and take synthroid also…I was born with it. However, I can’t help you. Maybe you can help me though? I’ve always wondered how powerful my synthroid is? what would happen if I was to take a higher dosage? what the hell does synthroid do anyways?[/quote]

You stick to your prescribed dose - don’t be fucking stupid by potentially fucking yourself up more.


#6

Lol, get 'em Brook.

Also, does anyone have any experience with Armour Thyroid?


#7

This post was flagged by the community and is temporarily hidden.


#8

[quote]bushidobadboy wrote:
DOHCrazy wrote:
Lol, get 'em Brook.

Also, does anyone have any experience with Armour Thyroid?

Armour thyroid is a very low does of T3 and T4. Both myself and my fiancee tried it. We noticed nothing.

BBB[/quote]

What dosage did both of you take? I assume both of you have your thyroids? Have you tried T4 by itself?

From my understanding, T4 is found in greater quantities in the body, but T3 is more ‘potent.’ Because of this, wouldn’t introducing T3 from an outside source both raise my T4 levels and lower my TSH levels?


#9

You might want to ask your doc if you might respond better to either armour thyroid (combo T4 and T3) or Cytomel (T3). All the synthroid (T4) in the world won’t help you if your body doesn’t convert T4 to T3 well. T3 is felt, where T4 may or may not be, depending on how well you convert.


#10

[quote]Dynamo Hum wrote:
You might want to ask your doc if you might respond better to either armour thyroid (combo T4 and T3) or Cytomel (T3). All the synthroid (T4) in the world won’t help you if your body doesn’t convert T4 to T3 well. T3 is felt, where T4 may or may not be, depending on how well you convert.[/quote]

That is what I am thinking the problem is. Immediately after surgery I was put on Cytomel, because of its short half life (48 hours.)

After the radiation, I was switched to Synthroid, which has a 7 day half life.

I think that on my next visit if my TSH is not in the lower end of acceptable, I will talk to him about the other treatment options.

I wish thyroid treatment was easier to pinpoint.


#11

Thyroid regulation is pretty complex and the vast majority of patients do not really do too great with T4 only therapy.

T4 essentially serves a reservoir for your body to convert the hormone to T3, T2 and T1. T3 (and maybe T2) is / are the metabolically active thyroid hormones controlling metabolism etc, and are usually converted, via the removal of iodine, to the more active hormones.

Now the reason why T4 only may not always be the best option is that you rely on the body to convert this into the other hormones and any failure to do so affects the treatment. You need to make sure you are not deficient in any of the following:

Zinc, magnesium, copper, selenium, vit C; D3 and B complex

These, and in particular selenium, will affect conversion.

You also require optimal cortisol functioning - both adequate adrenal reserves and a normal circadian rhythm, for the thyroid hormones to bind to the receptor.

Most people who are hypothyroid, through surgical, natural and unnatural causes, need to look at adrenal functioning in addition to thyroid function tests. Unfortunately modern medicine doesnt really assess this optimally, choosing blood tests (which only provide a snapshot at particular time) and ACTH simulation tests. The best option would be to get a 24 hour salivary test and monitor 24 secretion.

With optimal adrenal function and adequate nutrition you are ‘primed’ for your thyroid meds to work.

Now, with a TSH that high you ARE NOT functioning properly. Although TSH by itself is a crap measurement of thryoid functioning such a high value is a problem. You need to find out your Free T3; T4 and maybe total T4 to provide a more complete picture of where you are at.

Also, you state that you ate low carb for a while. Well an extended negative energy balance, and in particular extended periods of carbohydrate restriction, may also affect your T3 levels. Some believe that extended dieting periods result in the formation of excess reverse T3, which affects T3 levels resulting in hypothryoidism.

Increasing T3 with supplementation would suppress your TSH and increase T4.

T4 is clearly not working for you and I think you would be wise to look into other treatments if possible. Maybe your Dr would consider a trial run of T3 too?

I say this because what is your Dr to do now? Increase your T4 further…something isnt working otherwise your TSH would not be that high and you would not be feeling as crap as you are. You may have a conversion problem.

This could be a concern. If you are not converting properly, due to nutritional deficieny, low cortisol levels or whatever, then increasing T4 will not do you any favours and may in fact be dangerous. If T4 levels begin to accumulate due to poor converion you may actually start to exhibit thyrotoxic symptoms despite being clinically hypothryoid (due to low free T3).

Now one benefit of dessicated thyroid such as armour is that also contains the other thyroid hormones, such as T3, T2, T1 and calcitonin, along with the T4, that the thryoid produces. Some believe that this provides a more natural and complete index of thyroid hormones. If your thyroid is basically destroyed, then this could be a good option as you wouldnt be producing these hormones either.


#12

Thank you for your reply Dave.

[quote]Now the reason why T4 only may not always be the best option is that you rely on the body to convert this into the other hormones and any failure to do so affects the treatment. You need to make sure you are not deficient in any of the following:

Zinc, magnesium, copper, selenium, vit C; D3 and B complex

These, and in particular selenium, will affect conversion.[/quote]

I was not checked on all of those, here are some that were tested:

CA - Calcium - 8.6 - MG/DL - 8.5-10.5
NA - Sodium - 139 - MEQ/L - 135-148
K - Potassium - 4.5 - MEQ/L - 3.5-5.3

T4 - T-4 - 6.1 - ug/dl - 4.5-12.5
T3U - T-3 Uptake - 35.3 - High - % - 25-35
TSH - TSH - 12.0 - High - uIU/ml - 0.30-4.50

I was low carb for about 5 months. I have been high carb >300g/day since the end of January 2009.

Hopefully he will, but he has not brought it up yet.

I wouldn’t say I feel like crap, just not as good as I could feel.

I will express the concern with my doctor.


#13

Hey DOHcrazy and Dave Rogerson,

I just want to first preface my thoughts by saying how refreshing it is to find someone in a similar delimna. I take it though DOHcrazy you are a male. I’m a female and was diagnosed in 2003 with Thyroid Cancer and also had a thryoid ectomy and many lymph nodes removed. I have found that your hormone roller coaster ride is quite common for the first several years. I’ve finally leveled off on a dosage that seems to be working.

I concur with all the comments Dave has made as to something is not right with your absorption levels. One thing I have found that tremedously affects my absorption is the absolute basic rule of any thyroid medication. Take it first thing in the am and WAIT the hour before eating. Take no supplements within the first 4 hours of taking your meds as these could interupt your absorbtion rate.

So Dave, you seem to have a vast knowledge of the functions of the thyroid and how it may intertwine with working out (given you are on this website)? So like COHcrazy, I have not had very good luck with my docs having any good advice on nutrition/supplements for gaining lean body mass. I have worked extremely hard to lose the weight gained in my first years after my thyroid ectomy, but have hit a plateau where I still have plenty of fat to lose, but can’t seem to get past this point. I don’t want to give up and say its just not possible for me to get leaner. I have been on a very intense workout routine for the last year and have seen the results. I really would like to invest in a supplement routine to push me over this plateau, but am very skeptical of the market. It seems so many of them have thryoid stimulants…which of course in my and Crazy’s case has no bearing. Any insights would be greatly appreciated.


#14

Hey DOHcrazy and Dave Rogerson,

I just want to first preface my thoughts by saying how refreshing it is to find someone in a similar delimna. I take it though DOHcrazy you are a male. I’m a female and was diagnosed in 2003 with Thyroid Cancer and also had a thryoid ectomy and many lymph nodes removed. I have found that your hormone roller coaster ride is quite common for the first several years. I’ve finally leveled off on a dosage that seems to be working.

I concur with all the comments Dave has made as to something is not right with your absorption levels. One thing I have found that tremedously affects my absorption is the absolute basic rule of any thyroid medication. Take it first thing in the am and WAIT the hour before eating. Take no supplements within the first 4 hours of taking your meds as these could interupt your absorbtion rate.

So Dave, you seem to have a vast knowledge of the functions of the thyroid and how it may intertwine with working out (given you are on this website)? So like COHcrazy, I have not had very good luck with my docs having any good advice on nutrition/supplements for gaining lean body mass. I have worked extremely hard to lose the weight gained in my first years after my thyroid ectomy, but have hit a plateau where I still have plenty of fat to lose, but can’t seem to get past this point. I don’t want to give up and say its just not possible for me to get leaner. I have been on a very intense workout routine for the last year and have seen the results. I really would like to invest in a supplement routine to push me over this plateau, but am very skeptical of the market. It seems so many of them have thryoid stimulants…which of course in my and Crazy’s case has no bearing. Any insights would be greatly appreciated.