Is there a formula for supplementing thyroid?

[bookshelf]

How does someone know how much thyroid is ok to take? Is there a formula for T4 and/or T3? Maybe a starting point? Or if your TSH, or whatever thyroid numbers, equal x then you could conceivably take so much of y and z. Or, if your temp and pulse are a and b, then you could safely take this much of T3/T4...

How do endocrinologists and doctors figure it out? I'd have to think there is some sort of blood lab rubric to guide them but, with my (well deserved) lack of confidence in many of them, it makes me wonder sometimes if they just guess. What else do these wizards factor in?

I know no one can prescribe on here. I'm just wondering how doses are calculated or is it just arbitrary? 'uh, you look like you're in a good mood today, and are wearing a nice shirt, your tsh is actually "normal" but, since you are insisting on thyroid medication (weirdo), I think your heart could survive 240 mcgs of T3 and 60 mcgs of T4...so, let's start there.'

What say you?

 

[FitnessMike]

GO with NDT or thyroid glandular, you start to slow and let your body adapt to changes, increase every 2-4 weeks, according to your symptoms/ resting pulse/temperature and blood thyroid levels/reverse t3.

There is plenty of info on the forum about it, you need to search fam.

 

[bookshelf]

GO with NDT or thyroid glandular, you start to slow and let your body adapt to changes, increase every 2-4 weeks, according to your symptoms/ resting pulse/temperature and blood thyroid levels/reverse t3.

There is plenty of info on the forum about it, you need to search fam.

Good to know. I've been reading the forums and listening to RP. He seemed to lean toward the synthetics in recent history since the NDTs and glandulars aren't consistent anymore. Other notable, respected opinions seem to share/echo his sentiments. I like the idea of natural but his remarks, especially, have me rethinking the synthetics. Truth be told, I hate it all - hate that any of us have to use any of it but I believe our thyroids have been manipulated and, in many cases, destroyed and the only way out of it for the time being is to rely on supplementing. But I digress...

 

[cremes]

One way out of hypothyroid is to achieve EFAD (essential fatty acid deficiency). Take a look at the Kempner rice diet or the Potato diet as examples of how to achieve it. Spoiler alert: no fat for 30+ days to eliminate your body's store of PUFA. With the amount many people carry around, it's more likely to take 4-6 months these days.

I'm ~7 days into a low fat diet myself (targeting 0 grams but generally achieving 13g and under daily). I'm taking vitamin E to help ameliorate PUFA peroxidation from my fat stores.

EFAD should lead to eventual HYPERthyroid at which point you can adjust your diet to compensate.

 

[bookshelf]

One way out of hypothyroid is to achieve EFAD (essential fatty acid deficiency). Take a look at the Kempner rice diet or the Potato diet as examples of how to achieve it. Spoiler alert: no fat for 30+ days to eliminate your body's store of PUFA. With the amount many people carry around, it's more likely to take 4-6 months these days.

I'm ~7 days into a low fat diet myself (targeting 0 grams but generally achieving 13g and under daily). I'm taking vitamin E to help ameliorate PUFA peroxidation from my fat stores.

EFAD should lead to eventual HYPERthyroid at which point you can adjust your diet to compensate.

Fascinating! I don't know that I can live without fat (saturated, not pufa - I know to stay away from that) but I guess I could try. Good luck to you on that. Please let us know how it ultimately goes for you. I only have half a thyroid and have a lower fat composition (I'm not a big person) so I wonder how much PUFAs I'm really storing and how hard a fast from fats like that would be on my constitution. Seeing that I am at a glandular deficit by 50% and I am no spring chicken, I don't think I can "fix" my hypothyroidism completely without the use of supplementation.

I am still wondering how do the "experts" arrive at their dosages. Years of experience or some sort of chart to guide their prescriptions?

 

[mostlylurking]

How does someone know how much thyroid is ok to take? Is there a formula for T4 and/or T3? Maybe a starting point? Or if your TSH, or whatever thyroid numbers, equal x then you could conceivably take so much of y and z. Or, if your temp and pulse are a and b, then you could safely take this much of T3/T4...

How do endocrinologists and doctors figure it out? I'd have to think there is some sort of blood lab rubric to guide them but, with my (well deserved) lack of confidence in many of them, it makes me wonder sometimes if they just guess. What else do these wizards factor in?

I'm hypothyroid and I go to a great 86+year old endocrinologist. Before finding him, I managed to give myself heart palpitations by trying to treat myself with some T3 I got from Mexico.

My endo, after chastising me severely for trying to self treat and nearly giving myself heart issues requiring hospitalization, treated me this way: he changed my brand of prescription desiccated thyroid from Armour to NP Thyroid by Acella and increased the dose by about 30%, which brought it up to 90 mg after running a full thyroid panel on me. Then he had me come back 6-8 weeks later for another thyroid panel and then increased my dose about 30mg which brought it up to 120mg and had me come back 6-8 weeks later for another thyroid panel. Then he increased the dose another 30mg which brought it up to 150mg and had me come back for another thyroid panel. Then he increased the dose yet again by 30mg which brought it up to 180 mg (=3grains) and had me come back 6-8 weeks later for another thyroid panel which he evaluated and declared me to be on my optimum dose. Note that this took around 8 months. Now I get the thyroid panel run every 6 months

Each time that I came in to go over the test with my endo he asked me how I felt and made note of my symptoms. He actually treated me to resolve my symptoms. He is a stickler for keeping my free T3 at or slightly below the top boundary of the "normal" range.

Please note that my TSH was at .02 on the first thyroid panel test that he ran on me. He said he had seen that before and if that's the case he just ignores the TSH number and treats the patient anyway.

After 5 years of being stable on 180mg of NP Thyroid, my health took a serious turn for the worse after taking Bactrim antibiotic which blocked my thiamine function. I got some better by taking thiamine hcl. However, my hypothyroid symptoms worsened, a lot. I had classic hypothyroid symptoms including low temperature, lethargy, brain fog. I got my thyroid panel run a couple of months early because I thought my med had stopped working. The test showed that my free T3 was through the roof and I was "hyperthyroid". My doctor lowered my dose to 135mg and asked me what was I doing differently. I explained that I was taking a pretty high dose of thiamine hcl. He told me that hyperthyroidism blocks thiamine function. Evidently, the thiamine supplement had improved my own thyroid's function but my symptoms were a mess.

I continued to increase my thiamine hcl dose (up to 2 grams/day now) and my thyroid function with the 135mg dose of NP thyroid is again in the very high normal spot and I feel good. I could not have figured out how to balance my thyroid medication with my high dose thiamine hcl needs without my endocrinologist (who has more than 50 years of on the job training).

One way out of hypothyroid is to achieve EFAD (essential fatty acid deficiency). Take a look at the Kempner rice diet or the Potato diet as examples of how to achieve it. Spoiler alert: no fat for 30+ days to eliminate your body's store of PUFA. With the amount many people carry around, it's more likely to take 4-6 months these days.

That assumes your hypothyroidism is caused by PUFA. Other things cause hypothyroidism; examples: heavy metal toxicity, thiamine deficiency. If you are thiamine deficient with hypothyroidism and you go on a high starch diet, you will get worse, not better because the starch converts to sugar which uses up what little thiamine you might have so the thiamine deficiency becomes worse.

Hypothyroidism and thiamine deficiency have some identical symptoms, including lethargy, weight gain, brain fog, low body temperature. This is because both thyroid and thiamine are required for oxidative metabolism. The thyroid, along with all the other organs in your body, requires thiamine to do its job.

 

[bookshelf]

I'm hypothyroid and I go to a great 86+year old endocrinologist. Before finding him, I managed to give myself heart palpitations by trying to treat myself with some T3 I got from Mexico.

My endo, after chastising me severely for trying to self treat and nearly giving myself heart issues requiring hospitalization, treated me this way: he changed my brand of prescription desiccated thyroid from Armour to NP Thyroid by Acella and increased the dose by about 30%, which brought it up to 90 mg after running a full thyroid panel on me. Then he had me come back 6-8 weeks later for another thyroid panel and then increased my dose about 30mg which brought it up to 120mg and had me come back 6-8 weeks later for another thyroid panel. Then he increased the dose another 30mg which brought it up to 150mg and had me come back for another thyroid panel. Then he increased the dose yet again by 30mg which brought it up to 180 mg (=3grains) and had me come back 6-8 weeks later for another thyroid panel which he evaluated and declared me to be on my optimum dose. Note that this took around 8 months. Now I get the thyroid panel run every 6 months

Each time that I came in to go over the test with my endo he asked me how I felt and made note of my symptoms. He actually treated me to resolve my symptoms. He is a stickler for keeping my free T3 at or slightly below the top boundary of the "normal" range.

Please note that my TSH was at .02 on the first thyroid panel test that he ran on me. He said he had seen that before and if that's the case he just ignores the TSH number and treats the patient anyway.

After 5 years of being stable on 180mg of NP Thyroid, my health took a serious turn for the worse after taking Bactrim antibiotic which blocked my thiamine function. I got some better by taking thiamine hcl. However, my hypothyroid symptoms worsened, a lot. I had classic hypothyroid symptoms including low temperature, lethargy, brain fog. I got my thyroid panel run a couple of months early because I thought my med had stopped working. The test showed that my free T3 was through the roof and I was "hyperthyroid". My doctor lowered my dose to 135mg and asked me what was I doing differently. I explained that I was taking a pretty high dose of thiamine hcl. He told me that hyperthyroidism blocks thiamine function. Evidently, the thiamine supplement had improved my own thyroid's function but my symptoms were a mess.

I continued to increase my thiamine hcl dose (up to 2 grams/day now) and my thyroid function with the 135mg dose of NP thyroid is again in the very high normal spot and I feel good. I could not have figured out how to balance my thyroid medication with my high dose thiamine hcl needs without my endocrinologist (who has more than 50 years of on the job training).


That assumes your hypothyroidism is caused by PUFA. Other things cause hypothyroidism; examples: heavy metal toxicity, thiamine deficiency. If you are thiamine deficient with hypothyroidism and you go on a high starch diet, you will get worse, not better because the starch converts to sugar which uses up what little thiamine you might have so the thiamine deficiency becomes worse.

Hypothyroidism and thiamine deficiency have some identical symptoms, including lethargy, weight gain, brain fog, low body temperature. This is because both thyroid and thiamine are required for oxidative metabolism. The thyroid, along with all the other organs in your body, requires thiamine to do its job.

Wow - great insight! I am so glad you have a great endo. My experiences with them have been disappointing. The thiamine aspect is also quite interesting. Did you have a blood test that helped you learn what your thiamin level was?

 

[Risingfire]

Prior to taking supplementation, you should be testing your pulse and temperatures at waking, after breakfast and during the afternoon. Chart these metrics for a while. Are you waking up consistently below 97.8? Is your temp and pulse dropping after breakfast? These may be signs of hypothyroidism and high stress hormones.

Here's a good start:

Demystifying Thyroid Supplementation

"When doubt exists, a trial of thyroid supplementation may be the most useful diagnostic tool." — M.B. James (1981)

dannyroddy.substack.com

Remember to have oysters and 4 ounces of liver once a week.

 

[bookshelf]

Prior to taking supplementation, you should be testing your pulse and temperatures at waking, after breakfast and during the afternoon. Chart these metrics for a while. Are you waking up consistently below 97.8? Is your temp and pulse dropping after breakfast? These may be signs of hypothyroidism and high stress hormones.

Here's a good start:

Demystifying Thyroid Supplementation

"When doubt exists, a trial of thyroid supplementation may be the most useful diagnostic tool." — M.B. James (1981)

dannyroddy.substack.com

Remember to have oysters and 4 ounces of liver once a week.

Helpful, thank you!

 

[cremes]

That assumes your hypothyroidism is caused by PUFA. Other things cause hypothyroidism; examples: heavy metal toxicity, thiamine deficiency. If you are thiamine deficient with hypothyroidism and you go on a high starch diet, you will get worse, not better because the starch converts to sugar which uses up what little thiamine you might have so the thiamine deficiency becomes worse.

Hypothyroidism and thiamine deficiency have some identical symptoms, including lethargy, weight gain, brain fog, low body temperature. This is because both thyroid and thiamine are required for oxidative metabolism. The thyroid, along with all the other organs in your body, requires thiamine to do its job.

I have to disagree here and I'll explain why.

One, PUFA is part of our baseline physiology now which means pretty much all humans have 10+% PUFA in their adipose. It is well established that PUFA lowers your metabolism. Therefore, it is causative in all cases of hypothyroidism (though it may not be the sole cause).

Two, the diets I highlighted as potential avenues to EFAD (Kempner rice and Potato diet) have varying levels of B-vitamins. The original write up of the Kempner rice diet acknowledges it is vitamin poor so it included supplementation of B vitamins. We could certainly weight that supplementation more heavily towards B1 if necessary to account for the heavy starch content. The Potato diet just so happens to target a plant rich in B vitamins so the extra supplementation is likely unnecessary. Plus, the Potato diet could potentially resolve a B1 deficiency and act as a second avenue to improve thyroid efficiency in addition to the displacement of PUFA over time.

I don't know what to say about heavy metal toxicity other than to say it's probably a much smaller population of people who are hypothyroid from that cause. Almost any intervention including just switching from tap water to distilled water would be an improvement. It's almost not even a diet issue. Flushing the heavy metals could be assisted by diet but typically there is a more specific intervention taken to do that work.

Make sense?

 

[ecstatichamster]

my wife takes about 1/4 of a cynoplus per day. I am urging her to increase it but she is happy there. She also takes Progest-E at night. The combo has been very good for her. She's post menopausal.

 

[mostlylurking]

Wow - great insight! I am so glad you have a great endo. My experiences with them have been disappointing. The thiamine aspect is also quite interesting. Did you have a blood test that helped you learn what your thiamin level was?

I did not have a blood test; the test that is more accurate is not available. I tried some thiamine hcl (300-350mg) and experienced massive improvement in symptoms within 45 minutes. It was obvious to me that I had a thiamine problem. I had taken Bactrim, known to block thiamine function AND I've got mercury poisoning from mercury amalgam fillings. So I had a problem with thiamine deficiency, caused by the mercury BEFORE taking the Bactrim (even though I was taking 100mg thiamine hcl daily).

Here's some info on the testing:

Thiamine Deficiency Testing: Understanding the Labs - Hormones Matter

Understanding thiamine deficiency and the lab testing methods most appropriate for detecting abnormal thiamine chemistry.

www.hormonesmatter.com

One, PUFA is part of our baseline physiology now which means pretty much all humans have 10+% PUFA in their adipose. It is well established that PUFA lowers your metabolism. Therefore, it is causative in all cases of hypothyroidism (though it may not be the sole cause).

I've obsessively avoided all PUFA for over 8 years. I'm not overweight. I'm still hypothyroid.

Two, the diets I highlighted as potential avenues to EFAD (Kempner rice and Potato diet) have varying levels of B-vitamins. The original write up of the Kempner rice diet acknowledges it is vitamin poor so it included supplementation of B vitamins. We could certainly weight that supplementation more heavily towards B1 if necessary to account for the heavy starch content. The Potato diet just so happens to target a plant rich in B vitamins so the extra supplementation is likely unnecessary. Plus, the Potato diet could potentially resolve a B1 deficiency and act as a second avenue to improve thyroid efficiency in addition to the displacement of PUFA over time.

If you are dealing with a severe thiamine deficiency or functional blockage, the amount of thiamine in the diet won't fix it.

Which thiamine is being supplemented with the Kempner rice diet and how much?

I looked at the Kempner rice diet; sounds deadly to me. Sorry. Low salt for hypertension?

Salt, energy, metabolic rate, and longevity

Despite numerous publications showing that diuretics could cause the edematous problems that they were supposed to remedy, they have been one of the most profitable types of drug. Dietary salt restriction has become a cultural cliche, largely as a consequence of the belief that sodium...

raypeat.com

Ray Peat, PhD on High Blood Pressure – Functional Performance Systems (FPS)

I don't know what to say about heavy metal toxicity other than to say it's probably a much smaller population of people who are hypothyroid from that cause. Almost any intervention including just switching from tap water to distilled water would be an improvement. It's almost not even a diet issue. Flushing the heavy metals could be assisted by diet but typically there is a more specific intervention taken to do that work.

Mercury in the human thyroid gland: Potential implications for thyroid cancer, autoimmune thyroiditis, and hypothyroidism - PubMed

The proportion of people with mercury in their thyroid follicular cells increases with age, until it is present in over one-third of people aged 60 years and over. Other toxic metals in thyroid cells could enhance mercury toxicity. Mercury can trigger genotoxicity, autoimmune reactions, and...

pubmed.ncbi.nlm.nih.gov

Conclusions:
The proportion of people with mercury in their thyroid follicular cells increases with age, until it is present in over one-third of people aged 60 years and over. Other toxic metals in thyroid cells could enhance mercury toxicity. Mercury can trigger genotoxicity, autoimmune reactions, and oxidative damage, which raises the possibility that mercury could play a role in the pathogenesis of thyroid cancers, autoimmune thyroiditis, and hypothyroidism.

There are a multitude of sources for mercury exposure. It is ubiquitous.

Mercury, Parkinson's Disease, and Thiamine - Hormones Matter

The researchers who detected mercury in the brain in patients with Parkinson’s disease concluded that we should stop burning fossil fuels.

www.hormonesmatter.com

It's almost not even a diet issue.

You are uninformed.

Flushing the heavy metals could be assisted by diet but typically there is a more specific intervention taken to do that work.

Uh, no. You are woefully uninformed. As of now, there is no mercury removal product that actually works. Boyd Haley's Emeramide is believed to be the answer, but its approval has been held up by the FDA for over 14 years. The knockoffs are not safe.

The lifetime accumulation of mercury is with you for the duration.

That said, mercury is attracted to and bonds to sulfur. Thiamine hcl has sulfur as a component of its molecule. Mercury will bond to the sulfur and rip the thiamine molecule apart in the process. This causes a thiamine deficiency. I have found good improvement by taking high dose thiamine hcl; it provides a constant supply of sulfur for the mercury to bond to and there's enough thiamine left over for my body's needs. I'm taking 2 grams of thiamine hcl/day. There is no way that I could ever get that amount via diet alone.

 

[bookshelf]

my wife takes about 1/4 of a cynoplus per day. I am urging her to increase it but she is happy there. She also takes Progest-E at night. The combo has been very good for her. She's post menopausal.

Thank you, @ecstatichamster. This was very insightful, even in its simplicity.

 

[bookshelf]

I did not have a blood test; the test that is more accurate is not available. I tried some thiamine hcl (300-350mg) and experienced massive improvement in symptoms within 45 minutes. It was obvious to me that I had a thiamine problem. I had taken Bactrim, known to block thiamine function AND I've got mercury poisoning from mercury amalgam fillings. So I had a problem with thiamine deficiency, caused by the mercury BEFORE taking the Bactrim (even though I was taking 100mg thiamine hcl daily).

Here's some info on the testing:

Thiamine Deficiency Testing: Understanding the Labs - Hormones Matter

Understanding thiamine deficiency and the lab testing methods most appropriate for detecting abnormal thiamine chemistry.

www.hormonesmatter.com

Thank you. I will explore this!

 

[cremes]

You are uninformed.
<snip>
Uh, no. You are woefully uninformed.

Story of my life.

But you seem like a massive outlier.

 

[mostlylurking]

Story of my life.

But you seem like a massive outlier.

Not from my perspective. I'm 73; people my age are more likely to have had mercury amalgams placed in childhood, although plenty of "silver" fillings are still being put in people's mouths today. The federal government in the U.S. promotes them and pays only for them (not composites) for people on medicare and medicaid. The idea that mercury is released via burning fossil fuels should get everybody's attention.

 

[bookshelf]

I did not have a blood test; the test that is more accurate is not available. I tried some thiamine hcl (300-350mg) and experienced massive improvement in symptoms within 45 minutes. It was obvious to me that I had a thiamine problem. I had taken Bactrim, known to block thiamine function AND I've got mercury poisoning from mercury amalgam fillings. So I had a problem with thiamine deficiency, caused by the mercury BEFORE taking the Bactrim (even though I was taking 100mg thiamine hcl daily).

Here's some info on the testing:

Thiamine Deficiency Testing: Understanding the Labs - Hormones Matter

Understanding thiamine deficiency and the lab testing methods most appropriate for detecting abnormal thiamine chemistry.

www.hormonesmatter.com

I've obsessively avoided all PUFA for over 8 years. I'm not overweight. I'm still hypothyroid.

If you are dealing with a severe thiamine deficiency or functional blockage, the amount of thiamine in the diet won't fix it.

Which thiamine is being supplemented with the Kempner rice diet and how much?

I looked at the Kempner rice diet; sounds deadly to me. Sorry. Low salt for hypertension?

Salt, energy, metabolic rate, and longevity

Despite numerous publications showing that diuretics could cause the edematous problems that they were supposed to remedy, they have been one of the most profitable types of drug. Dietary salt restriction has become a cultural cliche, largely as a consequence of the belief that sodium...

raypeat.com

Ray Peat, PhD on High Blood Pressure – Functional Performance Systems (FPS)

Mercury in the human thyroid gland: Potential implications for thyroid cancer, autoimmune thyroiditis, and hypothyroidism - PubMed

The proportion of people with mercury in their thyroid follicular cells increases with age, until it is present in over one-third of people aged 60 years and over. Other toxic metals in thyroid cells could enhance mercury toxicity. Mercury can trigger genotoxicity, autoimmune reactions, and...

pubmed.ncbi.nlm.nih.gov

Conclusions:
The proportion of people with mercury in their thyroid follicular cells increases with age, until it is present in over one-third of people aged 60 years and over. Other toxic metals in thyroid cells could enhance mercury toxicity. Mercury can trigger genotoxicity, autoimmune reactions, and oxidative damage, which raises the possibility that mercury could play a role in the pathogenesis of thyroid cancers, autoimmune thyroiditis, and hypothyroidism.

There are a multitude of sources for mercury exposure. It is ubiquitous.

Mercury, Parkinson's Disease, and Thiamine - Hormones Matter

The researchers who detected mercury in the brain in patients with Parkinson’s disease concluded that we should stop burning fossil fuels.

www.hormonesmatter.com

You are uninformed.


Uh, no. You are woefully uninformed. As of now, there is no mercury removal product that actually works. Boyd Haley's Emeramide is believed to be the answer, but its approval has been held up by the FDA for over 14 years. The knockoffs are not safe.

The lifetime accumulation of mercury is with you for the duration.

That said, mercury is attracted to and bonds to sulfur. Thiamine hcl has sulfur as a component of its molecule. Mercury will bond to the sulfur and rip the thiamine molecule apart in the process. This causes a thiamine deficiency. I have found good improvement by taking high dose thiamine hcl; it provides a constant supply of sulfur for the mercury to bond to and there's enough thiamine left over for my body's needs. I'm taking 2 grams of thiamine hcl/day. There is no way that I could ever get that amount via diet alone.

Responding to everyone who is talking about where thyroid issues come from....here's my take: We're being poisoned. I don't say that lightly. If it isn't the fillings in our mouths, it's the water, air, "medicines", food (quality and choices) and soil it's grown in, environmental exposures, and the lies they use to sell us on it all (like how we need PUFAs and raw kale). Some of us have had to have part or all of their thyroids removed for any number of reasons (but ultimately because we're being poisoned) so we can debate until we're blue in the face if it comes from this or that but, if you're missing some or all of your thyroid, replacement is necessary.

I'm curious what the average dosage is like for the following:
Have your thyroid
Don't have your thyroid
Have half your thyroid

I'm sure there are lots of factors - age, gender, body composition. But I am curious. I guess it goes back to my original question which is, how is it decided how much someone takes. Surely there has to be some sort of starting point from which to base initial dosage before "tweaking" with labs, symptoms, overall health.

 

[mostlylurking]

here's my take: We're being poisoned. I don't say that lightly. If it isn't the fillings in our mouths, it's the water, air, "medicines", food (quality and choices) and soil it's grown in, environmental exposures, and the lies they use to sell us on it all

my original question which is, how is it decided how much someone takes. Surely there has to be some sort of starting point from which to base initial dosage before "tweaking" with labs, symptoms, overall health.

This decision re. how much thyroid med someone takes is predicated upon what kind of education/training/intellect your health care provider has. From reading Ray Peat, and Broda Barnes, and also from personal experience (I'm hypothyroid and was diagnosed over 25 years ago), one long term belief is to start someone on one grain (=60mg) of natural desiccated thyroid. But I think that happened to me after the initial labs, not before. The following process isn't exactly "tweeking" based on the labs. It's more like stairstepping or titrating up. I'll explain:

I went through this exercise most recently in 2015 when I started with a new endocrinologist, he was around age 78-79 at the time. He called for blood tests. I had severe hypothyroid symptoms, including crippling rheumatoid arthritis. My Armour thyroid had stopped working the year before because the imbeciles who bought the company decided to take out the calcitonin and sell it as a separate product ($$$$) thereby ruining their primary product, Armour natural desiccated thyroid. So for around 9-11 months in 2014 I was taking a product that did not work and developed rheumatoid arthritis.

Anyhow, when the tests came back in, they showed that my TSH was at .02 and my T3 was in the ditch. My new endo said he had seen the low TSH before and he would just ignore it and treat my symptoms. So he switched the brand to NP Thyroid a NDT made by Acella and kept the dosage at 60mg. He tested again after about 4-6 weeks, and he increased the dose by maybe a half grain (30mg). We repeated this exercise from April-November. Each time we met he would ask me how I was doing and I'd tell him. Then in December, when my dose had been at 3 grains (=180mg) for a couple of months, he told me that I had stabilized and that my optimal dose was 180mg (= triple what the prior doctor had put me on).

The reason why it takes so long to finally reach stabilization and the optimal dose is because the body compensates for hypothyroidism by running on adrenaline. When you start off on one grain (60mg), your body will discover that it can rely on that dose and relax and stop with the adrenaline. With the lowered adrenaline, you start feeling crappy again so you have more symptoms which tells the doctor you need more thyroid hormone. When the dose is increased, you body relaxes again and lowers the adrenaline some more which makes you feel crappy again. And so on. Until you finally get to the point that the adrenals are quiet and happy and you are running on the thyroid hormone like you're supposed to. This is not an overnight event, it can take months.

Ray Peat's articles on thyroid are very informative:

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Thyroid, insomnia, and the insanities: Commonalities in disease

Ray Peat

raypeat.com

https://www.toxinless.com/polsci-080911-thyroid-and-regeneration.mp3

The problem that we find ourselves in today is that medical schools don't teach med students this stuff. The average doctor today is clueless about hypothyroidism. So if you suspect that you are hypothyroid and you need a doctor to help you (highly recommended) then it is really important to educate yourself before trying to find one who has some idea what they are doing (good luck). I've found that it can be really helpful to ask pharmacists in your area which doctors prescribe natural desiccated thyroid (NP Thyroid by Acella actually works); this can shorten your doctor search considerably.

 

[bookshelf]

This decision re. how much thyroid med someone takes is predicated upon what kind of education/training/intellect your health care provider has. From reading Ray Peat, and Broda Barnes, and also from personal experience (I'm hypothyroid and was diagnosed over 25 years ago), one long term belief is to start someone on one grain (=60mg) of natural desiccated thyroid. But I think that happened to me after the initial labs, not before. The following process isn't exactly "tweeking" based on the labs. It's more like stairstepping or titrating up. I'll explain:

I went through this exercise most recently in 2015 when I started with a new endocrinologist, he was around age 78-79 at the time. He called for blood tests. I had severe hypothyroid symptoms, including crippling rheumatoid arthritis. My Armour thyroid had stopped working the year before because the imbeciles who bought the company decided to take out the calcitonin and sell it as a separate product ($$$$) thereby ruining their primary product, Armour natural desiccated thyroid. So for around 9-11 months in 2014 I was taking a product that did not work and developed rheumatoid arthritis.

Anyhow, when the tests came back in, they showed that my TSH was at .02 and my T3 was in the ditch. My new endo said he had seen the low TSH before and he would just ignore it and treat my symptoms. So he switched the brand to NP Thyroid a NDT made by Acella and kept the dosage at 60mg. He tested again after about 4-6 weeks, and he increased the dose by maybe a half grain (30mg). We repeated this exercise from April-November. Each time we met he would ask me how I was doing and I'd tell him. Then in December, when my dose had been at 3 grains (=180mg) for a couple of months, he told me that I had stabilized and that my optimal dose was 180mg (= triple what the prior doctor had put me on).

The reason why it takes so long to finally reach stabilization and the optimal dose is because the body compensates for hypothyroidism by running on adrenaline. When you start off on one grain (60mg), your body will discover that it can rely on that dose and relax and stop with the adrenaline. With the lowered adrenaline, you start feeling crappy again so you have more symptoms which tells the doctor you need more thyroid hormone. When the dose is increased, you body relaxes again and lowers the adrenaline some more which makes you feel crappy again. And so on. Until you finally get to the point that the adrenals are quiet and happy and you are running on the thyroid hormone like you're supposed to. This is not an overnight event, it can take months.

Ray Peat's articles on thyroid are very informative:

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Thyroid, insomnia, and the insanities: Commonalities in disease

Ray Peat

raypeat.com

https://www.toxinless.com/polsci-080911-thyroid-and-regeneration.mp3

The problem that we find ourselves in today is that medical schools don't teach med students this stuff. The average doctor today is clueless about hypothyroidism. So if you suspect that you are hypothyroid and you need a doctor to help you (highly recommended) then it is really important to educate yourself before trying to find one who has some idea what they are doing (good luck). I've found that it can be really helpful to ask pharmacists in your area which doctors prescribe natural desiccated thyroid (NP Thyroid by Acella actually works); this can shorten your doctor search considerably.

Well this was an incredibly insightful and helpful response. THANK YOU and BLESS YOU!

 

[kimbriel]

How does someone know how much thyroid is ok to take? Is there a formula for T4 and/or T3? Maybe a starting point? Or if your TSH, or whatever thyroid numbers, equal x then you could conceivably take so much of y and z. Or, if your temp and pulse are a and b, then you could safely take this much of T3/T4...

How do endocrinologists and doctors figure it out? I'd have to think there is some sort of blood lab rubric to guide them but, with my (well deserved) lack of confidence in many of them, it makes me wonder sometimes if they just guess. What else do these wizards factor in?

I know no one can prescribe on here. I'm just wondering how doses are calculated or is it just arbitrary? 'uh, you look like you're in a good mood today, and are wearing a nice shirt, your tsh is actually "normal" but, since you are insisting on thyroid medication (weirdo), I think your heart could survive 240 mcgs of T3 and 60 mcgs of T4...so, let's start there.'

What say you?

Depends on many factors, but I would say the best way to measure if it's working is in how you feel, and your temperatures and resting pulses.

I personally have Hashi's, so I take 50mcg T3, and 1 grain of NDT (NP Thyroid). I feel fantastic. Temp is 98.2F, resting pulse about 80bpm.