How To Determine If You Need Thyroid Medication

[Jsaute21]

I have recently discovered that i have some hypothyroid symptoms. (Constipation, low pulse rate & low basal body temp being the primary factors at play). I am strong, lean and in good shape and have improved my diet since coming across Ray Peat & Anabolic Men (which praises good advice for men looking to naturally maximize hormonal health). I was formally fasting 18 hours a day, which once i found out i was relatively hypo, i realized was a bad recipe. For the last month i have started eating more frequently, while tapering down portion size, including more OJ, dairy, gelatin, while reducing without eliminating muscle meats, starches, and monounsaturated fats. (Have been off PUFA's for a while). Problem is i still suffer from about 5-6 bowel movements a week (most are hard and too big) coupled with a low pulse and low basal temperature. I am wondering if i should hop on thyroid medication. I don't trust ENDO's and or most doctors as they usually seem to be relatively uneducated when it comes to the significance of certain hormones. I used to be on a bodybuilder type diet which probably threw off my digestion quite a bit. @haidut recommended a CO2 and cholesterol test which i will try, but i also want to gage other opinions.

 

[Nighteyes]

including more OJ, dairy

Just thought I would throw some thoughts out there:

Dairy (and thus calcium I believe is the main trigger) can slow down peristalsis in my experience (and others' I seem to remember reading).. I also have many of the same symptoms as you such as low pulse and often constipation. I have been tested several times and thyroid number remain semi-optimal (meaning slightly high tsh but otherwise normal numbers). I have tried both pure T3 and Tiromix and both seem to do little/nothing. I think for many it is more a matter of making the body use the thyroid hormone in the blood more efficiently, rather than add more hormone. For me this means using lots of progesterone, selenium and magnesium.. The magnesium is a great tool if it is indeed the calcium causing the constipation. It often is for me. Sometimes too little sleep can do it too by lowering body temperature and pushing eveything out of wack! only a good nights sleep sets things straight again..

Anywho good luck! Maybe add some magnesium and see if it helps!

 

[Jsaute21]

Thanks @Nighteyes. I am always hesitant to go with un natural hormones and supplementation as i am a believer the human body is capable of somewhat amazing things. Below are my test results from a full hormone panel run a couple of months ago. Please feel free to comment... My TSH doesn't seem to be low either...but my body temp and pulse are low. Now in doing research, it appears that many elite athletes have low pulses and resting heart rates. As a former high level athlete, i undoubtedly conclude the two are related.

Total t: 813 Reference: 250-1100
Free t: 161.8 Reference: 35-155
FSH: 4.5 Reference: 1.27-19.26
LH: 3.5 Reference: 1.2-8.6
Cortisol 12.5 Reference: 6.7-22.6
Estradiol 12.1 Reference: 23.8 -52.2
TSH: 2.28 Refernece: 0.3-5.0

 

[Nighteyes]

I am no expert by any means, but your TSH looks a little on the high end. Ray has mentioned that TSH < 1 is best. Mine is slightly above 1. I should clarify that when I wrote that my numbers are semi-optimal I mean that my TSH is slightly too high.. Your testosterone looks high whereas mine was low.. I am sure there are others here with more knowledge who can chime in :)

Just like you I used to be very active (mid-distance runner) so I am sure you are right that this could be affecting the heart and thus resting pulse.. even long after

 

[Blossom]

Ray Peat quote on TSH from WiKi

TSH (Thyroid Stimulating Hormone)
I think it's best to keep the TSH around 0.4

I think it's good to have TSH below 0.4, and that probably contributes to loss of hair.

I think it's good to have lower TSH. It contributes to some of the circulatory and inflammatory problems seen in hypothyroidism. People with TSH below 0.4 were the freest from thyroid cancer. The amount of body fat contributes to both prostate and breast cancer, largely because it's a chronic source of estrogen, by converting the protective androgens. Milk drinkers tend to be the least obese (e.g., the Masai people). One study saw an association of skimmed milk with prostate cancer, but not whole milk, probably because fat people avoid whole milk. Powdered eggshells are a good alternative source of calcium, but milk and cheese are better. When the TSH is lower, the estrogen will probably be lower too.

 

[Maretch]

I felt that there is something wrong with my thyroid and that i need some medications when i started to sweat all the time and the smell was unusual and at the same time i started to gain weight. So after some analysis i found out that i need to treat it. Hope it will never happen again!

 

[Dante]

Thanks @Nighteyes. I am always hesitant to go with un natural hormones and supplementation as i am a believer the human body is capable of somewhat amazing things. Below are my test results from a full hormone panel run a couple of months ago. Please feel free to comment... My TSH doesn't seem to be low either...but my body temp and pulse are low. Now in doing research, it appears that many elite athletes have low pulses and resting heart rates. As a former high level athlete, i undoubtedly conclude the two are related.

Total t: 813 Reference: 250-1100
Free t: 161.8 Reference: 35-155
FSH: 4.5 Reference: 1.27-19.26
LH: 3.5 Reference: 1.2-8.6
Cortisol 12.5 Reference: 6.7-22.6
Estradiol 12.1 Reference: 23.8 -52.2
TSH: 2.28 Refernece: 0.3-5.0

Interesting , your Estradiol is way below the normal range, wouldn't decreasing TSH forcefully tank it down even further ?
Just a question but does taking exogenous T3/T4 increase cellular uptake of thyroid hormones ?

 

[Jsaute21]

@Piyush Gaurav Great question. I have actively been trying to raise E2. (Very slightly). I am genetically blessed with somewhat high T and Low E. Too low of E is not good...associated with depression, low libido, OCD behaviors and an overall lowered sense of being. Balance is everything. A lot of people say to me "how do you get your E2 so low?!" and i tell them it feels much better @ 15-17 than it does from 9-12.

 

[Giraffe]

Problem is i still suffer from about 5-6 bowel movements a week (most are hard and too big) coupled with a low pulse and low basal temperature.

Peat thinks that hypothyroid people have difficulties to hold on to magnesium. There are a couple of threads about how to raise magnesium intake via diet (e.g. broth from leafy greens) or topical supplementation (magnesium oil / epsom salt bath). Also a little extra sodium might help.

Magnesium carbonate is often used to soften the stool. If I take 350mg (~100 mg elemental magnesium) every couple of hours it makes me feel hot. The first time I fell asleep though.

haidut recommended a CO2 and cholesterol test which i will try, but i also want to gage other opinions.

I think it doesn't hurt to practise bag breathing or short breath holds several times a day. For most people there is no need to monitor their CO2 levels.

 

[sweetpeat]

Your total t3 is in the upper range and your free t3 is off the chart, so I'd be hesitant to recommend supplemental thyroid just yet before investigating other possibilities. Forum moderator tara made a good post recently with diet and lifestyle suggestions for optimizing metabolism.
(Copying from this thread: T4 50 Times Greater Than T3?)

"That's the big question many of us are trying to figure out. :)

There are probably many ingredients to a successful solution, and which are most important for each of us individually probably depends at least in part on how we got where we are, and our current state. So we probably all need a somewhat different mix of tactics.

Ingredients:

1. If there is a specific cause of the hypothyroid state, then interrupting that cause - taking the brakes off.
Some of the things I'm aware of that can tend to lower metabolism include:
chronic undereating (approximate normal calories for a mature man are ~3000 cals, more if particularly tall or physically active) [remedy: eat enough]
chronic over-exercise [remedy: stop it for a bit, and maybe try resuming in a while with monitoring of signs like temps and pulse to check that you don't overdo it]
excess PUFA [remedy: stop consuming as far as possible, and add a little highly saturated fat to meals - eg 1tsp coconut oil, maybe add a little vit-E]
excess phytoestrogens, including soy, and xenoestrogens [remedy: avoid or minimise where possible]
excess goitrogens [remedy: reduce; cook goitrogenic veges like cabbage thoroughly]
lack of sunlight [remedy: get sunlight on skin everyday if possible; supplement with red light in winter if necessary]
epigenetic inheritance from hypothyroid mother [remedy: can't change the past; depending on how well other tactics yield results, maybe cautiously supplement thyroid]
chronic or severe life stress [remedy: attempt to resolve or improve major current stresses; use release and/or relaxation methods to help remove effects of historical stress]
I suspect chronic cold conditions, maybe also chronic sleep-deprivation [remedy: keep warm; sleep at night]

2. Supplying adequate nutrition:
Calories (I'm taking youreatopia guidelines as a rough approximation. Seem roughly inline with Peat's comments)
carbs (major fuel source)
good quality protein - favour easily digested foods, with not too high a ratio of methionine, cysteine, tryptophan if poss; milk, eggs, gelatinous cuts of meat, fruit, potatoes, possibly supplementing gelatine/collagen\ (at least 80-100 g protein for most)
minerals - daily adequate amounts of calcium, magnesium, sodium, potassium, and smaller amounts of the other all the necessary ones (eg zinc,copper, selenium, ...)
vitamins -

3. Attend to breathing and CO2 levels.

4. Get regular sunlight on skin for vit-D synthesis and for restoring cytochrome oxidase enzyme.

5. Get enough rest and sleep.

6. Develop and maintain a meaningful stimulating life, good close relationships, and at least some attention to gratitude/positives in one's life."

 

[tara]

Your total t3 is in the upper range and your free t3 is off the chart ...

Where are you seeing this?
I'm just seeing the subclinically highish TSH (similar to what mine's been).

 

[tara]

For the last month i have started eating more frequently, while tapering down portion size, including more OJ, dairy, gelatin, while reducing without eliminating muscle meats, starches, and monounsaturated fats.

Hi. Have you spelled out roughly what and how much you are typically eating in a day (incl calories)? Some of us use cronometer or similar to get a rough idea (but ignore their calorie recommendations - often too low).

 

[Jsaute21]

@tara since adopting to peats methods I eat quite a bit.

I am not crazy anal with food as that is no way to live but below is a typical day.

5:30 am 2 bananas with some salt

6 am: coffee with gelatin, sugar, salt and cream.

8:30: yogurt, banana bread and OJ.

11:30 am: chopped liver sandwich with spinach on a French roll with a side of potatoes.

2 pm: 5 prunes.

6:30: steak, gelatin, pineapples and onions cooked in coconut oil.

8 pm: vanilla ice cream with a cookie if hungry.

I need a fair amount of food and have always had a big appetite.

 

[Jsaute21]

I have a cane sugar soda with either lunch or dinner most days as well.

 

[sweetpeat]

Where are you seeing this?
I'm just seeing the subclinically highish TSH (similar to what mine's been).

AAHH! Sorry, my brain put a 3 after the t. Bad reading on my part, but the suggestions are still good.

 

[tara]

but the suggestions are still good.

Thanks.
Just thought of another of the ingredients I left out of that list:
Reducing/avoiding gut-irritants and other serotonin promoters.

 

[m_arch]

Ray Peat quote on TSH from WiKi

TSH (Thyroid Stimulating Hormone)
I think it's best to keep the TSH around 0.4

I think it's good to have TSH below 0.4, and that probably contributes to loss of hair.

I think it's good to have lower TSH. It contributes to some of the circulatory and inflammatory problems seen in hypothyroidism. People with TSH below 0.4 were the freest from thyroid cancer. The amount of body fat contributes to both prostate and breast cancer, largely because it's a chronic source of estrogen, by converting the protective androgens. Milk drinkers tend to be the least obese (e.g., the Masai people). One study saw an association of skimmed milk with prostate cancer, but not whole milk, probably because fat people avoid whole milk. Powdered eggshells are a good alternative source of calcium, but milk and cheese are better. When the TSH is lower, the estrogen will probably be lower too.

Tsh under .4 causes a loss of hair?

 

[Blossom]

Tsh under .4 causes a loss of hair?

It sounds that way from the quote but I'm wondering if in the original question the person had a higher TSH? Unfortunately we don't know the original question just his reply.

 

[m_arch]

It sounds that way from the quote but I'm wondering if in the original question the person had a higher TSH? Unfortunately we don't know the original question just his reply.

Hmm but high tsh is hypometabolic which is supposed to cause hair loss? At least according to Danny Roddy

 

[MommaBear]

Hi I'm new here but have had a few experiences with desiccated thyroid and am still learning the Peat methods so not sure my info is compatible.

My friend showed me the tweaks of properly dealing with desiccated thyroid. During our experimentation, she noticed an odd thing... her husband (not low thyroid) has annual asthma attacks that put him in the ER. This last one started and she popped a couple thyroids in his mouth. Within a short time his symptoms settled down and he was fine. She tried adding an extra dose of thyroid when suck and It seemed that thyroid boosted her body to heal faster.

Next one...
I was recently chatting with a new friend and we were discussing peating, diet, etc. He deals with gout attacks and cannot eat a lot of sugars, and other foods, without experiencing attacks. I suggested desiccated thyroid since he tried everything else. Very small doses (30 mg) for a short time and he can now eat sugar and most anything with no problem! We figure his body needed that small boost to get to a better place of healing.

Now myself... hashimotos thyroid... I had to bump up to 90 MG 3 times a day for months and only after starting the peat recommended supplements and progesterone am I able to finally be able to reduce to 90 MG a day with an occasional twice a day needed.

My 18 and 19 and 15 year old daughters have hashimotos as well and are still struggling at the higher doses of thyroid and supplements. The days they remember to take progesterone they do feel better.

My observations see that sometimes supplementing thyroid can do no harm. I see it as safe.

In times gone by they ate the thyroid when health was down to give a boost. I recall a story of a healer prescribing a thyroid sandwich for his patient consisting of an animal thyroid (raw/cooked? I can't recall) btwn two pieces of bread.