How To Determine If You Need Thyroid Medication

[Jsaute21]

Thank you all for your contributions. To be specific, i had my thyroid tested recently and these were the results
TSH 3rd Generation 1.26 (Reference Range 0.40-4.00)
Free T4 0.6 (Reference Range (0.7-1.5).

Due to having a low basal temperature and pulse rate, i am trying to figure out the best next steps to improving my overall metabolism and thyroid function.

 

[Jsaute21]

@haidut and others, do you beleive raising thyroid function is doable through just nutrition? I have found some gradual success in making my meals smaller and increasing frequency. (Following Peat's standard formula). Also is an average to low pulse rate and a low temperature almost always indicative of thyroid Malfunction?

 

[marsaday]

T4 is low, so i would say do a trial of T4 medication. start on 25 per day and increase to 50 after 3 weeks. See how things go. A low dose of 50 T4 will add to your own production, so unlikely to disrupt this process as high does can. See it as micro dosing. All the top athletes do this nowadays with many hormones. You want TSH around 0.5 ideally. FT4 wants to be mid range. It would be good to see what your FT3 is like.

 

[EIRE24]

Wg

T4 is low, so i would say do a trial of T4 medication. start on 25 per day and increase to 50 after 3 weeks. See how things go. A low dose of 50 T4 will add to your own production, so unlikely to disrupt this process as high does can. See it as micro dosing. All the top athletes do this nowadays with many hormones. You want TSH around 0.5 ideally. FT4 wants to be mid range. It would be good to see what your FT3 is like.[/QUOTE
What if T4 was high and T3 was low, would you still reccomend dosing T4 rather than T3? I don't know what my RT3 is but I would suspect it is high.

 

[Jsaute21]

Free T3 is 2.6...@EIRE24.

 

[raypeatclips]

Im interested in peoples thoughts on whether diet alone is good enough to improve thyroid.

 

[Blossom]

Im interested in peoples thoughts on whether diet alone is good enough to improve thyroid.

It hasn't been for me. I'm hoping that once I reach a point where I'm more pufa depleted then diet alone might be enough but I'm in year three and just recently had to go back on thyroid after a failed experiment of being completely off it for a few months. Maybe diet alone would be enough though in someone younger with less accumulated damage and pufa to overcome?

 

[raypeatclips]

@Blossom Yeah the answer is probably "it depends" How did you find coming off thyroid? ive been thinking about whether thyroid surrogates would be better than thyroid.

 

[Blossom]

@Blossom Yeah the answer is probably "it depends" How did you find coming off thyroid? ive been thinking about whether thyroid surrogates would be better than thyroid.

Everything seemed fine when I stopped taking thyroid (I still used the surrogates) and as much as I hate to admit it I didn't see the signs that I needed to start back on thyroid until I emailed Ray about a case of what I thought might be mastitis that developed rapidly. He mentioned a few things that could help but basically said it was due to low thyroid and sure enough I was 80% improved within one week of starting back on t3. My temps and heart rate are always good so for me I can't rely on those measures as a gauge. I guess we all have our unique signs and symptoms that we are hypo and it just boils down to figuring out what those are and experimenting until we find relief.

 

[raypeatclips]

Thanks for the reply. Which were the surrogates you took throughout? I am still unsure whether to start thyroid because of the dependence which seems to develop.

 

[Blossom]

Thanks for the reply. Which were the surrogates you took throughout? I am still unsure whether to start thyroid because of the dependence which seems to develop.

Caffeine, niacinamide and aspirin. I've never had trouble stopping thyroid it's just that I usually end up needing to go back on it. I've typically not needed any thyroid at all in the summer months.

 

[Blossom]

dependence which seems to develop.

There is a Peat quote floating around (paraphrasing) that within 2 or 3 days of stopping a thyroid supplement a person's own thyroid gland returns to baseline. I'll try to find it for you.

 

[HDD]

There is a Peat quote floating around (paraphrasing) that within 2 or 3 days of stopping a thyroid supplement a person's own thyroid gland returns to baseline. I'll try to find it for you.

Here -
HOW TO STOP THYROID] If a person's thyroid gland has been inhibited by very high doses of a supplement, it takes only 2 or 3 days for the gland to resume full activity, and because it takes time for the hormone to be excreted, suddenly stopping a supplement shouldn't be noticeable, when the gland isn't being inhibited or malfunctioning.
Peatarian.com Email Exchanges - Ray Peat Forum Wiki

 

[Blossom]

Thanks @HDD!

 

[tara]

@haidut and others, do you beleive raising thyroid function is doable through just nutrition?

I'm with those saying sometimes. And I think it's worth trying. It's good to get nutrition up anyway before supplementing thyroid - increasing thyroid function by natural or supplemental means tends to increase nutritional requirements.

I have found some gradual success in making my meals smaller and increasing frequency. (Following Peat's standard formula).

Do you mean you've had success in raising metabolism already? Indicated by temps? If so, that's great. Which version are you meaning by a standard formula?

Also is an average to low pulse rate and a low temperature almost always indicative of thyroid Malfunction?

I think chronically low body temps and resting heart-rate probably do generally indicate reduced production and/or use of thyroid hormones, but don't I think it always indicates malfunction of the thyroid gland. AIUI, sometimes reduced thyroid function can be the normal adaptive response to a situation. For instance, it is adaptive (potentially pro-survival) for the body to reduce metabolism in the face of famine or extensive endurance training and some other kinds of stress. There are other things that can reduce thyroid function too - eg. high estrogen levels tend to lower the release of thyroid hormone into circulation, high PUFA levels can interfere with the bodies ability to use the thyroid hormones that are produced, an over-burdened liver (eg by high endotoxin or other high processing load) can have trouble converting enough T4 to T3, and specific nutrient deficiencies can create a bottle neck in cells that limits energy production even in the presence of T3.

 

[Blossom]

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

Yeah I agree. I was just speculating that the person asking the question could have had a high tsh and Peat's reply was to say first the helpful tsh (<0.4) and then mention that (their higher tsh which we don't know) could contribute to hair loss.

 

[Ahanu]

Im interested in peoples thoughts on whether diet alone is good enough to improve thyroid.

For me it defenitly was! Ray peat is not so found of supplements but he uses thyroid. I would try it with food and give it some time.. No need to hurry if there is at least some kind of Change happening.

 

[marsaday]

Free T3 is 2.6...@EIRE24.

I would need the reference range for the T3 to understand if it is low. In the uk 2.6 is low as our range is around 2.5-6.5

 

[marsaday]

I'm with those saying sometimes. And I think it's worth trying. It's good to get nutrition up anyway before supplementing thyroid - increasing thyroid function by natural or supplemental means tends to increase nutritional requirements.


Do you mean you've had success in raising metabolism already? Indicated by temps? If so, that's great. Which version are you meaning by a standard formula?


I think chronically low body temps and resting heart-rate probably do generally indicate reduced production and/or use of thyroid hormones, but don't I think it always indicates malfunction of the thyroid gland. AIUI, sometimes reduced thyroid function can be the normal adaptive response to a situation. For instance, it is adaptive (potentially pro-survival) for the body to reduce metabolism in the face of famine or extensive endurance training and some other kinds of stress. There are other things that can reduce thyroid function too - eg. high estrogen levels tend to lower the release of thyroid hormone into circulation, high PUFA levels can interfere with the bodies ability to use the thyroid hormones that are produced, an over-burdened liver (eg by high endotoxin or other high processing load) can have trouble converting enough T4 to T3, and specific nutrient deficiencies can create a bottle neck in cells that limits energy production even in the presence of T3.

Yes the thyroid will be down regulated if famine is experienced. There is a theory in the UK that many hypothyroid patients have Irish connections.

In ireland they experienced the great potato famine around 1850. Many people starved. Those who survived would have down regulated themselves. The children they have produced may also have tweaked DNA because of this famine / down regulation. This down regulation has now been passed down the lines. It is just a theory, but it is always worth asking people if they have irish ancestry. My grandfather was irish and out of 4 of his grandchildren, 2 have a low thyroid issue (me and my female cousin).

Thought i would throw this info out there.

 

[DaveFoster]

Yes the thyroid will be down regulated if famine is experienced. There is a theory in the UK that many hypothyroid patients have Irish connections.

In ireland they experienced the great potato famine around 1850. Many people starved. Those who survived would have down regulated themselves. The children they have produced may also have tweaked DNA because of this famine / down regulation. This down regulation has now been passed down the lines. It is just a theory, but it is always worth asking people if they have irish ancestry. My grandfather was irish and out of 4 of his grandchildren, 2 have a low thyroid issue (me and my female cousin).

Thought i would throw this info out there.

Great information! This might be the source for the claim (by Broda Barnes I believe) that a small proportion the U.S. population has mild hypothyroidism from birth; similar things may apply to Jews who survived the Holocaust and emigrated from Germany, Midwest winters, the Great Depression, and so on.