Need Help With Thyroid Resistance

Mara77

Member
Joined
Jul 2, 2020
Messages
8
Hello,
I am new to the forum and the Ray Peat way of life. I have spent the last two weeks as time has permitted immersed in this forum and other online resources to try to find an answer to my problem, but still confused.

A bit of background: I am a 54 year old lady deep into peri-menopause. I have gone now 7 months without a cycle. In the last year I have tried the Keto/Atkins diet. On these two, my cravings for food never went away, although I was successful in losing 10 lbs. I am overweight at 210 lbs., I should weigh 140. I started to pile on the weight two years ago when suddenly I found myself in a thyroid storm after taking NDT for ten years for hypothyroidism. No issues before that. Over time in that first year, I had labs done every 3-4 months and saw different doctors to determine why I could no longer even tolerate a small amount of thyroid hormone without hyper-stimulating on it. We found no reason why-although liver enzymes were slightly elevated and I don't like the look of my A1C level ranging from 5-6. Iron in range, no elevated antibodies, all checked out. I have been on Progesterone for the last ten years as well for PCOS/fibroids and sleep issues, and low levels. That dosage has remained constant at either 20 mg. cream or 200 mg. oral dosage. At the moment, I am taking 200 mg. Prometrium at night.

All the while, my TSH is hovering at between 4-7, with small nodules I am sure are growing. I have no energy, I drag myself through the day. I feel very poorly, no motivation, no sex drive, feel like most times I'm walking underwater. I take a handful of vitamins every day-multi, D3, fish oil, magnesium, DIM, Calcium D-Glucarate. I wake up at least twice a night, I'm up by 4 a.m. I have ADHD, have since a small child, and I take no medication for it because I have heart valve issues. The ADHD is now out of control, it's very hard to concentrate and focus.

These last two years have been complete hell. I am simply out of options to try except Peat. I am going wrong somewhere, and I am missing something obvious, I'm sure. My thought is from reading here, that my estrogen is high and hiding in cells and not showing on labs. I had some genetic testing done, and I have two genes that actually do not work well at processing estrogen out of my body.

The good things I am doing are that I am walking a mile a day at the track without fail (even though it's difficult), I have changed my sources for food by finding a local farmer for grass fed beef and liver, and will be picking up a 1/4th of one to fill my freezer with for better protein. I have chickens who are grass pastured (but who still need some daily layer feed) that will be laying soon. Some veggies growing in a new garden like squashes, onions, lettuce, tomatoes, peppers, sweet/regular potatoes.

If anyone can help with ideas, and where I might be going wrong and point me in the right direction, I would appreciate it so much. I have an appointment with my doctor the 23rd of this month, and will have new labs then.
 

wintagal

Member
Joined
Jun 9, 2017
Messages
80
People who have had thyroidectomies have better results with taking replacement t4 than those with Hashimoto's. They feel fine with replacement T4. So you could inquire about a thyroidectomy. Something has definitely changed in your thyroid.
Be assertive. Get imaging of your thyroid. Get an appointment at Mayo or Cleveland Clinic. Don't bother with endocrinologists or GPs. Don't accept statins as a solution for elevated LDL cholesterol - it's due to your low thyroid.
My experience - doctors know very little about thyroid. I have Hashimoto's and pituitary damage from a head injury. My family has weird metabolic stuff that makes us unable to convert T4 to T4 so I have reverse T3 that is off the charts for no obvious reason. I've tried every vitamin, herbal supplement, diet. Now, I take T3 only. I finally have a life. It's tough to fight on but you must.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
Wintagal,
Thanks for your reply. My Cardiologist and Endo are both at the Cleveland Clinic. An ultrasound was done a little over a year ago with all nodules under 1 cm., but it's time for another ultrasound. All labs come back negative for Hashimoto's and anything else unusual going on-only a rise in TSH and low normal T3. So, the thyroid removal is not one that is prudent at this time. My cholesterol numbers are spot on perfect right now. I do not do well on T4 only. Like you, I cannot convert it. I've tried T3 only (Cytomel) and that caused the same symptoms. I just don't know why after so many years of NDT use, I cannot tolerate any now.
Whatever is going on with my thyroid is not an easy find-I've been to two family medicine docs, a functional medicine doc, an Endo, and two Gynecologists. In the two years leading up to skipping cycles I had high estrogen, lower Progesterone. I am overweight, so I know the estrogen is hiding despite lower numbers of estrogen now. What I have done this holiday weekend is continue to immerse myself here in this forum and others on Ray Peat looking for answers while I change my diet. Some things I have noticed:

1. The gelatin has helped with sleep-I'm averaging at least two extra hours at night.
2. Whole milk-I am only drinking the equivalent of 4 cups a day right now, but the feeling of fullness and contentment is keeping me from having cravings, which is a blessing.

I have ordered high Gamma E to take, and thinking of ordering Myomin. I'm pondering topical Progesterone again. The Prometrium helps better with sleep. But I want to do the best I can for myself.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
I'm so glad you have a good Endo. I hope you find an effective treatment.

Wintagal, I hope so too. Maybe someone else will chime in that might have some ideas. I think that having those labs to post later this month will help as well.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
I am also stopping the 100 mg. DIM supplement today, just in case it is interfering with my thyroid in some way. All the lady forums say it is important to take that for thyroid health and in lowering high estrogen associated with peri-menopause. I'm stopping all my other vitamins-I'll continue to take the Calcium D-Glucarate. I don't know how to make my liver work better because of the two mutations I have for lowered estrogen detoxification.
 

JKX

Member
Joined
Apr 18, 2018
Messages
374
I think removing the DIM is a good move. How's your liver function? A little K2 or taurine may be helpful for you. The vitamin E should also be helpful in lowering estrogen.

I'd definitely add the topical progesterone back in. Good sleep is essential for healing.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
JKX,
Liver enzymes: Labcorp, ALT: 37 Lab range: 0-35
AST: 40, Lab range: 0-37

Why Taurine?
Thank you!
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
JKX,
You've been a big help-I've just finished the DIM link, and I'll start to work on the new one you've sent. Thank you so much for helping me on the right path.
 
Joined
Apr 30, 2016
Messages
161
People who have had thyroidectomies have better results with taking replacement t4 than those with Hashimoto's. They feel fine with replacement T4. So you could inquire about a thyroidectomy. Something has definitely changed in your thyroid.
Be assertive. Get imaging of your thyroid. Get an appointment at Mayo or Cleveland Clinic. Don't bother with endocrinologists or GPs. Don't accept statins as a solution for elevated LDL cholesterol - it's due to your low thyroid.
My experience - doctors know very little about thyroid. I have Hashimoto's and pituitary damage from a head injury. My family has weird metabolic stuff that makes us unable to convert T4 to T4 so I have reverse T3 that is off the charts for no obvious reason. I've tried every vitamin, herbal supplement, diet. Now, I take T3 only. I finally have a life. It's tough to fight on but you must.
What is the reason that those with Hashimoto’s don’t do well with T4? I do have Hashimoto’s and have never felt well on T4 but the endos I have consulted refuse to prescribe both T4 & T3. Perhaps I can convince my current Endo if you have info on this. Thanks.
 

orewashin

Member
Joined
Jun 16, 2020
Messages
327
People who have had thyroidectomies have better results with taking replacement t4 than those with Hashimoto's. They feel fine with replacement T4. So you could inquire about a thyroidectomy. Something has definitely changed in your thyroid.
Be assertive. Get imaging of your thyroid. Get an appointment at Mayo or Cleveland Clinic. Don't bother with endocrinologists or GPs. Don't accept statins as a solution for elevated LDL cholesterol - it's due to your low thyroid.
My experience - doctors know very little about thyroid. I have Hashimoto's and pituitary damage from a head injury. My family has weird metabolic stuff that makes us unable to convert T4 to T4 so I have reverse T3 that is off the charts for no obvious reason. I've tried every vitamin, herbal supplement, diet. Now, I take T3 only. I finally have a life. It's tough to fight on but you must.
I also have Hashimoto's and respond badly to T4. I feel worse on it than off it. I'm currently on 30 mcg of T3, but I have unusually long fatigue after physical exercise.

So who do I see about it if not an endo? Is reverse T3 a recognized indicator of a poor reaction to T4? Is TSH a good indicator of thyroid status in Hashimoto's? I'm going to get tested soon, and if it's normal, I can be prescribed more T3, but I think I would need more considering my TSH isn't that high and I'm a man in my mid-twenties who can't live an active life, instead preserving energy.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
Each time I try to take NDT (a small 1/2 grain starter dose) after two weeks my RT3 increases to the point I get uncomfortable symptoms-high heart rate, high BP, severe anxiety/panic attacks, hair falls out. I was switched to T4 for a short trial, the same experience-just worse. So I believe RT3 is a indicator of a poor reaction to BOTH T4 and NDT.
 
Last edited:

taralynne

Member
Joined
Jan 8, 2019
Messages
148
Wintagal,
Thanks for your reply. My Cardiologist and Endo are both at the Cleveland Clinic. An ultrasound was done a little over a year ago with all nodules under 1 cm., but it's time for another ultrasound. All labs come back negative for Hashimoto's and anything else unusual going on-only a rise in TSH and low normal T3. So, the thyroid removal is not one that is prudent at this time. My cholesterol numbers are spot on perfect right now. I do not do well on T4 only. Like you, I cannot convert it. I've tried T3 only (Cytomel) and that caused the same symptoms. I just don't know why after so many years of NDT use, I cannot tolerate any now.
Whatever is going on with my thyroid is not an easy find-I've been to two family medicine docs, a functional medicine doc, an Endo, and two Gynecologists. In the two years leading up to skipping cycles I had high estrogen, lower Progesterone. I am overweight, so I know the estrogen is hiding despite lower numbers of estrogen now. What I have done this holiday weekend is continue to immerse myself here in this forum and others on Ray Peat looking for answers while I change my diet. Some things I have noticed:

1. The gelatin has helped with sleep-I'm averaging at least two extra hours at night.
2. Whole milk-I am only drinking the equivalent of 4 cups a day right now, but the feeling of fullness and contentment is keeping me from having cravings, which is a blessing.

I have ordered high Gamma E to take, and thinking of ordering Myomin. I'm pondering topical Progesterone again. The Prometrium helps better with sleep. But I want to do the best I can for myself.
It's great that you are exploring things on your own outside of what your doctors recommend as I feel like they never see the big picture. A lot of this is trial & error. There is no quick fix. The thing that jumps out the most to me though is the fish oil supplement. I would eliminate that immediately and stay from PUFA as much as possible. That would be a good place to start.
 
OP
Mara77

Mara77

Member
Joined
Jul 2, 2020
Messages
8
The thing is, what is causing the thyroid resistance on a cellular level? Even short term use of NDT or Cytomel causes a huge rise in RT3 and symptoms. Where is the problem? My liver with detoxing excess estrogen and it's struggling, or something else? I was on 40 mg. compounded Progesterone cream nightly for a period of two months last year to try to correct and stop bleeding I was having with my cycle-and even that didn't help me with trying to take my NDT. Questions, questions....the answer lies somewhere.
 

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