Kenneth Blanchard On Optimal Hypothyroidism Treatment

[Peater Pan]

Sorry - need to confirm, he is insinuating the ideal ratio should be 67:1 t4/t3 ratio?

Actually 98.5:1.5, though likely higher T3 for ablation/advanced Hashi's. See my other posts in this thread.

"…take the typical ablation patient on 100 percent T4 and give them about 98 percent T4:2 percent T3 initial treatment and then gradually work the T3 percentage higher over a period of time as long as the patient keeps improving."

Blanchard, Kenneth. Functional Approach to Hypothyroidism.

 

[Apple]

Dr Blanchard is not with us anymore, but his books are great.

I take T4 only, but have tried every thyroid protcol going over the years 2008-2015. Now i take T4 only at bedtime.

I find T4 works much better if taken at bedtime. I dont have any sleep issues and i just feel it fits in with when we naturally make our own T4.

TSH peaks in the nighttime, this stimulates the body to produce the T4 for the next day. This also has a knock on effect on cortsol production. T4 and cortisol work together. Low thyroid patients often record low cortisol production in the morning, when really it should be at its highest.

So giving T4 at bedtime means you are working with your circadian rhythm.

When i used T3 with the T4 i found less was much more effective. So i would use 2.5mcg approx in the morning.

My hormone journey has been a long one and in the last year i have started testosterone treatment as well. I now realise testosterone is an important factor in getting thyroid to work well. I am doing better than ever in my life and am now aged 48.

The OP has good thyroid figures, but a high TSH. How old are you ? I assume you dont feel that well, hence you are looking to try some T4.

The thyroid journey is a long descent. I mean the thyroid starts to stutter along time before it really shows up with really bad symptoms. Lots of young people dont realise they have a thyroid issue, and instead get diagnosed with mental health problems. It happened to me aged 21 and it wasnt until i was 36 that i started to look under the thyroid bonnet.

When the tsh starts to climb it can indicate the thyroid is starting to struggle and so it ramps up conversion. Hence you get good FT3 no's and FT4 is ok as well. But going forward in time the thyroid struggles even more and TSH will go higher, but maybe conversion isnt as good and you get more symptoms.

Have you ever observed shrinking of your thyroid?

Ray Peat mentioned:
There’s almost no context in which I would speak of “an appropriate dose of T4,” since thyroxin is so effective as an antithyroid substance. It’s appropriate if you are also taking T3, or if you want to shrink your thyroid.

 

[marsaday]

How would i see shrinking exactly ? I dont notice any difference around my throat area.

Recently i have tried reducing down the T4 from 150 to 125mcg per day. Started to feel low and tired and the aches in my arms really ramped up.

Back to 150mcg last night (plus an extra 50mcg to help catch up) and feel much better today.

So i can confirm T4 for me works well. I sometimes might use 6mcg T3, but it is occasional. If i use T3 for more than one day it looses its effect. So a small top up might be what i need occasionally. Anyone else try say a little T3 per week ?

 

[Apple]

How would i see shrinking exactly ? I dont notice any difference around my throat area.

Recently i have tried reducing down the T4 from 150 to 125mcg per day. Started to feel low and tired and the aches in my arms really ramped up.

Back to 150mcg last night (plus an extra 50mcg to help catch up) and feel much better today.

So i can confirm T4 for me works well. I sometimes might use 6mcg T3, but it is occasional. If i use T3 for more than one day it looses its effect. So a small top up might be what i need occasionally. Anyone else try say a little T3 per week ?

I don't have much expierence with thyroid, just trying to understand how it works.
RP said that he took too much thyroid once and his thyroid shrinked.
At the same time supplementing thyroid can possibly restore the thyroid gland.

- Is it possible that the more you are supplementing thyroid the the more your thyroid gland shrinks with time to compensate the exogenous excess , so you constantly need to increase the dose?
- You are not afraid that your thyroid can grow too large after years of intervention if you suddenly stop taking thyroid?

 

[marsaday]

Do you need to take thyroid or is it something you are experimenting with ?

I need to take T4 because I am very unwell not taking it. As we age most human beings would benefit from taking thyroid meds. It just depends on how much you need. So i will be on thyroid for all my life.

One person saying the thyroid reduced in size does not mean this is what happens to all. I know he is aware of his body more than most, but even so.

The testicles shrink in size if on testosterone, but they will recover if you stop. Body builders do this all the time. I imagine it will be the same for thyroid.

 

[Apple]

Do you need to take thyroid or is it something you are experimenting with ?

I need to take T4 because I am very unwell not taking it. As we age most human beings would benefit from taking thyroid meds. It just depends on how much you need. So i will be on thyroid for all my life.

One person saying the thyroid reduced in size does not mean this is what happens to all. I know he is aware of his body more than most, but even so.

The testicles shrink in size if on testosterone, but they will recover if you stop. Body builders do this all the time. I imagine it will be the same for thyroid.

Something I'm experimenting with.
My tests seems ok but I got low temp and heart rate.
TSH 1.91,
T4 libre 1.25

 

[GreekDemiGod]

Anyone else having success with very small amounts of T3 added to high amounts of T4?
I've been taking 50 mcg of T4 before bed and definitely made my sleep better, even though overall I've yet to seen desired improvement. Bumped the dose to 75 mcg yesterday.
When I'm taking multiple nibbles of T3 throught the day, some days I will feel really good, but most of the days, I will often crash during the day and feel sleepy.

Thyroid dosing is so frustrating and hard to get right. If you go through the threads for Tyromix, Tyromax, Tyronenne on this forum, most reports are negative. The reports that are positive are short-lived. Very, very few long-term positive reports. Not trying to bash on Haidut's products, they are definitely high quality. It's just that hormones supplementation in general is hard to get right.