T3 Help Please

[Hoodlt]

I am currently on 3 1/2 grains of Naturethroid. Some hypo symptoms returning and I would like to cut this dose down and add T3. I have 25 mg tablets from a Greek pharmacy. At least that is how I am reading it! Can someone help with dosing? Thanks!

 

[marsaday]

Well 3 1/2 grains = 108 T4 and 31.5 T3

The issue with NTH is that you have to take T4 and T3 in a SET ratio. This cannot be easily altered.

Some people need this ratio, but many people actually need much less T3 in relation to the T4, but they never try this out.

Dr Blanchard in his functional thyroid book thinks most people need a ratio of 98:2. Even 1mcg T3 is very powerful. So many people are over using T3.

Now the thing to understand is that we are all different. So i am NOT saying a low dose T3 protocol will work for you, but it is important to understand the different protocols out there.

This is why i prefer T4 / T3 synthetic because you can work out your own ratio. My ratio is about 95:4.5

 

[cyclops]

"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day. Keeping a 14-day chart of pulse rate and temperature allows you to see whether the dose is producing the desired response. If the figures aren't increasing at all after a few days, the dose can be increased, until a gradual daily increment can be seen, moving toward the goal at the rate of about 1/14 per day" - Peat

 

[Steve]

Well 3 1/2 grains = 108 T4 and 31.5 T3

The issue with NTH is that you have to take T4 and T3 in a SET ratio. This cannot be easily altered.

Some people need this ratio, but many people actually need much less T3 in relation to the T4, but they never try this out.

Dr Blanchard in his functional thyroid book thinks most people need a ratio of 98:2. Even 1mcg T3 is very powerful. So many people are over using T3.

Now the thing to understand is that we are all different. So i am NOT saying a low dose T3 protocol will work for you, but it is important to understand the different protocols out there.

This is why i prefer T4 / T3 synthetic because you can work out your own ratio. My ratio is about 95:4.5

Dr Peat says more T3, but Dr Blanchard says more T4. Then you have the T3-only people & the T4-only people, and they all sound equally intelligent.
How on earth do you figure this out? I

'm taking 2 grains of NDT & 100 mcg T4. My labs look better since I added the T4, but my temp & pulse have never changed..........exactly the same as before I started thyroid meds.
Is there a methodical way I can figure out what combo I should be taking & why my temp & pulse won't move?

 

[marsaday]

Dr P doesn't say more T3, he says to use some as opposed to T4 mono therapy which is the standard approach by doctors all over the world.

Most patients will benefit from the intro of some T3. This is why so many patients like NTH. But the magic ingredient is the T3.

All the above approaches are just different protocols which will work for different people. There is not one standard approach which gets patients fully better because we all have specific requirements.

Forums like this allow us to try different approaches, but in the future medicine will be tailor made to suit a specific patient. It is already happening in certain areas of medicine, but i can't remember the specifics. So one day we will get analyses in a different way and a doc will be able to say you need x T4 amount and x T3 amount plus more vitamin D and you should get fully better.

So you are taking 172mcg T4 and 18mcg T3. Did you know how much thyroid medication was in 1 grain of NDT ? Lots of people don't seem to know what they are actually taking.

What are the labs ?

When do you take the thyroid meds ?

What is your adrenal system like ? Have you had a 24h spit test done for cortisol ?

 

[Steve]

Dr P doesn't say more T3, he says to use some as opposed to T4 mono therapy which is the standard approach by doctors all over the world.

Most patients will benefit from the intro of some T3. This is why so many patients like NTH. But the magic ingredient is the T3.

All the above approaches are just different protocols which will work for different people. There is not one standard approach which gets patients fully better because we all have specific requirements.

Forums like this allow us to try different approaches, but in the future medicine will be tailor made to suit a specific patient. It is already happening in certain areas of medicine, but i can't remember the specifics. So one day we will get analyses in a different way and a doc will be able to say you need x T4 amount and x T3 amount plus more vitamin D and you should get fully better.

So you are taking 172mcg T4 and 18mcg T3. Did you know how much thyroid medication was in 1 grain of NDT ? Lots of people don't seem to know what they are actually taking.

What are the labs ?

When do you take the thyroid meds ?

What is your adrenal system like ? Have you had a 24h spit test done for cortisol ?

I thought Dr Peat often recommended NDT & then adding some extra T3 in most cases.
Yes, I know how much T4 & T3 I'm taking.............I have it all in a spreadsheet. I first tried NDT & monitored my temp & pulse.
Nothing changed so I tried Elaine Moore's approach of optimizing Free T3 & Free T4, and I did that by adding the T4. But still no change in temp & pulse. I have noticed my dizziness has been a little better most days.
I've been on this new dose for 2 1/2 months. I take 1/2 in the morning, 1/2 at night.

TSH 0.006
Free T3 4.3 (2-4.4)
Free T4 1.84 (0.82-1.77)
Total T4 7.1 (4.5-12)

Cortisol Test (February 2017)
DHEA 5.7 (2-23)
Cortisol AM 6.8 (3.7-9.5)
Cortisol Noon 2.6 (1.2-3.0)
Cortisol Evening 2.1 (0.6-1.9) - High
Cortisol Night 0.7 (0.4-1.0)

 

[cyclops]

I heard you mention of a 1:3 or even 1:2 T3 to T4 ratio as more optimal than a 1 to 4 ratio. When would the 1:2 be preferred to 1:3; is it only in a particular type of person (older for example), or would it also be preferred in a younger person?

Dr. Peat: "Women and older people generally have reduced conversion of T4 to T3, but anyone with liver malfunction is similar.

"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day."

 

[marsaday]

I thought Dr Peat often recommended NDT & then adding some extra T3 in most cases.
Yes, I know how much T4 & T3 I'm taking.............I have it all in a spreadsheet. I first tried NDT & monitored my temp & pulse.
Nothing changed so I tried Elaine Moore's approach of optimizing Free T3 & Free T4, and I did that by adding the T4. But still no change in temp & pulse. I have noticed my dizziness has been a little better most days.
I've been on this new dose for 2 1/2 months. I take 1/2 in the morning, 1/2 at night.

TSH 0.006
Free T3 4.3 (2-4.4)
Free T4 1.84 (0.82-1.77)
Total T4 7.1 (4.5-12)

Cortisol Test (February 2017)
DHEA 5.7 (2-23)
Cortisol AM 6.8 (3.7-9.5)
Cortisol Noon 2.6 (1.2-3.0)
Cortisol Evening 2.1 (0.6-1.9) - High
Cortisol Night 0.7 (0.4-1.0)

I suppose you still feel unwell. I don't pay much attention to temps and HR, unless i am ill.

My HR will never raise and i am well and temps are fully normal. But HR will not come up from a 44 resting area. Always been low even before i had thyroid issues. I don't think i can base my entire health system on this one measurement though.

Your TSH is very suppressed and for me this says you are not absorbing the thyroid hormones well enough. Only once the conveyor belt of thyroid uptake improves will the TSH raise. Mine was suppressed for many years on different protocols and i wasn't well. It wasn't until i paid attention to the adrenal system that things improved. Specifically i started on progesterone and this has supplied me the missing cortisol i needed. Ever since my TSH has stayed at a healthy 0.3.

A TSH of 0.5-1 is the desirable goal, but 0.3 is fine by me.

So after i started the progesterone the TSH raised. This tells you that the uptake of the T4 has increased and so the conveyor belt of thyroid has started to work correctly (TSH will go up when the body thinks it needs more T4/T3 because it is now using it up more).

Dr P does use NTH, but he also uses T3 only, T4 only etc. He looks at the patient and goes from there. I saw him many years ago, but he couldn't help me as i was doing everything he was recommending anyway. Bit of a wasted consult really. He was still learning off his patients and asked me to let him know want worked for me as time went on.

My mistake in the early days of thyroid treatment was going to high to quickly on NTH. I got up to 5 grains back in 2008. Ever since then my body was using high T4 and T3 doses either in NTH or T4/T3. I did high T4 only, high T3 only. Anyway it has taken me many years to figure out my body likes T4 mostly, but also needs a little T3. The smaller T3 dose is a key addition. Using T4 to get the FT4 into the top 1/3 of the range or just over is a key goal as well.

It was only last year that i stumbled on Dr Blanchards book and he was advocating the protocol i had been using for a good while.

I actually got my new blood back today and TSH is 0.3 and Ft4 is just over range, but FT3 is in the top 1/3 of the range, but not over. So these are good results and i feel good, so all ok.

Your results similar to mine, but the difference is very subtle. Your FT3 is over range and TSH is suppressed. This tells me you are not sucking up the T3 efficiently (as mentioned above). So maybe have a look at some progesterone in small doses. 3mg per day may be enough to make a huge difference. This is all i take nowadays, but previously i was using 6mg per day (ProgestE).

Your cortisol profile looks ok. The shape is good ( a declining curve). Ok so you have a little jump in the late afternoon, but this is fine. DHEA is lower in range and this is common for thyroid patients. I would say you need a higher morning cortisol reading though and agin this is common with thyroid patients. We make thyroid hormones at bedtime in the first part of the night and we then make a corresponding cortisol amount in the second half of the night. So it is important to take thyroid meds at bedtime, or certainly a good percentage as you are currently doing.

So you take 50 T4 and 1 grain at bedtime. This = 86 T4 and 9 T3.

I would look at using all the T4 at bedtime and 1/2 grain. So 118 T4 and 4.5 T3 at bedtime. Then take the remaining 1 1/2 grains around noon the next day.

The timings of your doses and ratios are important, but i cannot say what specifically will work best for you. Trial and error is the way forward. If you trail any doses amounts out stick with it for 2 weeks before modifying the dosing.

Dizziness was a major issue when i first became ill. I don't think it is thyroid only, more likely thyroid/adrenal. So you want the thyroid and adrenal system to start working together more effectively. Again bedtime dosing should aid this.

Finally what is your waking temp usually ?

 

[marsaday]

I heard you mention of a 1:3 or even 1:2 T3 to T4 ratio as more optimal than a 1 to 4 ratio. When would the 1:2 be preferred to 1:3; is it only in a particular type of person (older for example), or would it also be preferred in a younger person?

Dr. Peat: "Women and older people generally have reduced conversion of T4 to T3, but anyone with liver malfunction is similar.

"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day."

Is this for me?

I have never mentioned 1:2 of T4 to T3 usage. IT is the opposite and i am really quoting DR Blanchards approach of using a 98:2 ratio of T4 to T3. So basically mostly T4 and a little T3. This certainly suits me much better.

Dr Blanchard says T3 is really powerful and an ideal starting dose would be 0.1mcg, but no one makes such small sizes. Many people think a starting dose of 6.25 (1/4 tablet) of T3 is small, but it is actually a big dose. The smallest size i can get my T3 down to is 1/8th, so 3mcg approx. This is a good starting dose.

I would also recommend taking the T3 or T4 at bedtime. The effects on the interactions with cortisol production will be much better than taking the T3 in the daytime.

 

[cyclops]

"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day.

Is this for me?

I have never mentioned 1:2 of T4 to T3 usage. IT is the opposite and i am really quoting DR Blanchards approach of using a 98:2 ratio of T4 to T3. So basically mostly T4 and a little T3. This certainly suits me much better.

Dr Blanchard says T3 is really powerful and an ideal starting dose would be 0.1mcg, but no one makes such small sizes. Many people think a starting dose of 6.25 (1/4 tablet) of T3 is small, but it is actually a big dose. The smallest size i can get my T3 down to is 1/8th, so 3mcg approx. This is a good starting dose.

I would also recommend taking the T3 or T4 at bedtime. The effects on the interactions with cortisol production will be much better than taking the T3 in the daytime.

It's for you and it's for all. Plenty of doctors have been recommending high ratios of T4:T3 or only T4 forever. Peat generally recommends higher t3 then most doctors. This is the Dr. Ray Peat forum, not the Dr. Blanchard forum. Trying to keep things in perspective.

 

[Steve]

I suppose you still feel unwell. I don't pay much attention to temps and HR, unless i am ill.

My HR will never raise and i am well and temps are fully normal. But HR will not come up from a 44 resting area. Always been low even before i had thyroid issues. I don't think i can base my entire health system on this one measurement though.

Your TSH is very suppressed and for me this says you are not absorbing the thyroid hormones well enough. Only once the conveyor belt of thyroid uptake improves will the TSH raise. Mine was suppressed for many years on different protocols and i wasn't well. It wasn't until i paid attention to the adrenal system that things improved. Specifically i started on progesterone and this has supplied me the missing cortisol i needed. Ever since my TSH has stayed at a healthy 0.3.

A TSH of 0.5-1 is the desirable goal, but 0.3 is fine by me.

So after i started the progesterone the TSH raised. This tells you that the uptake of the T4 has increased and so the conveyor belt of thyroid has started to work correctly (TSH will go up when the body thinks it needs more T4/T3 because it is now using it up more).

Dr P does use NTH, but he also uses T3 only, T4 only etc. He looks at the patient and goes from there. I saw him many years ago, but he couldn't help me as i was doing everything he was recommending anyway. Bit of a wasted consult really. He was still learning off his patients and asked me to let him know want worked for me as time went on.

My mistake in the early days of thyroid treatment was going to high to quickly on NTH. I got up to 5 grains back in 2008. Ever since then my body was using high T4 and T3 doses either in NTH or T4/T3. I did high T4 only, high T3 only. Anyway it has taken me many years to figure out my body likes T4 mostly, but also needs a little T3. The smaller T3 dose is a key addition. Using T4 to get the FT4 into the top 1/3 of the range or just over is a key goal as well.

It was only last year that i stumbled on Dr Blanchards book and he was advocating the protocol i had been using for a good while.

I actually got my new blood back today and TSH is 0.3 and Ft4 is just over range, but FT3 is in the top 1/3 of the range, but not over. So these are good results and i feel good, so all ok.

Your results similar to mine, but the difference is very subtle. Your FT3 is over range and TSH is suppressed. This tells me you are not sucking up the T3 efficiently (as mentioned above). So maybe have a look at some progesterone in small doses. 3mg per day may be enough to make a huge difference. This is all i take nowadays, but previously i was using 6mg per day (ProgestE).

Your cortisol profile looks ok. The shape is good ( a declining curve). Ok so you have a little jump in the late afternoon, but this is fine. DHEA is lower in range and this is common for thyroid patients. I would say you need a higher morning cortisol reading though and agin this is common with thyroid patients. We make thyroid hormones at bedtime in the first part of the night and we then make a corresponding cortisol amount in the second half of the night. So it is important to take thyroid meds at bedtime, or certainly a good percentage as you are currently doing.

So you take 50 T4 and 1 grain at bedtime. This = 86 T4 and 9 T3.

I would look at using all the T4 at bedtime and 1/2 grain. So 118 T4 and 4.5 T3 at bedtime. Then take the remaining 1 1/2 grains around noon the next day.

The timings of your doses and ratios are important, but i cannot say what specifically will work best for you. Trial and error is the way forward. If you trail any doses amounts out stick with it for 2 weeks before modifying the dosing.

Dizziness was a major issue when i first became ill. I don't think it is thyroid only, more likely thyroid/adrenal. So you want the thyroid and adrenal system to start working together more effectively. Again bedtime dosing should aid this.

Finally what is your waking temp usually ?

Thanks for the help & the information..........I think I'll get another adrenal test done & then try some progesterone to see if it helps. I'll also try your other recommendations & see what happens.
My waking temp is almost always 97.1.

Can you explain how the progesterone helps please? I have trouble sticking to things when I don't understand how they work.

 

[Steve]

By the way my plan is to stop taking the thyroid pills after a while. Do you think that is even remotely possible?

I only started because I wanted to get out of the hypo state so that my body would stop producing TSI antibodies which showed up on my blood test & may be blocking my thyroid hormone.
Apparently being hypo encourages TSI antibody production.

I have a really strange case. I stupidly took a 6.25 mg Iodine supplement for 2 1/2 years thinking it was a good thing to do.
I read that was a bad idea, so I stopped. A week or 2 later I became severely hyper (possible Grave's Disease). That died down, & then I went hypo.
So there was nothing wrong with me until I played around with the iodine. My TSH was 1.5 when I was normal.

I was hoping to get things humming along back to normal with the thyroid meds & then just slowly back off & hope my body doesn't notice.

 

[marsaday]

It's for you and it's for all. Plenty of doctors have been recommending high ratios of T4:T3 or only T4 forever. Peat generally recommends higher t3 then most doctors. This is the Dr. Ray Peat forum, not the Dr. Blanchard forum. Trying to keep things in perspective.

Ray peat says using small amounts of T3 per day is the way forward as i understand his perspective. I have seen his quote about nibbling on some T3 in the day every few hours. But he is not focusing on thyroid function, he is looking at the whole metabolic system. So he says a lot about many topics. His output is very thought provoking and goes against much of the medical worlds protocols.

I would certainly take on board what he says on thyroid, but for me Dr Blanchard was a thyroid specialist (now deceased sadly). His book has spoken much more sense to me than many other stuff produced by thyroid specialists.

You are asking me specifically about thyroid health because i assume you have issues in this area. I am a thyroid patient and need to take thyroid medication to have any quality of life. I would be dead much earlier if i didn't take the medication. So i speak on thyroid not from a metabolic perspective, but from an experienced patient user perspective.

I don't get why you need to mention this is a RP forum when we are talking about a specific protocol for thyroid health. It is an irrelevant point.

 

[marsaday]

By the way my plan is to stop taking the thyroid pills after a while. Do you think that is even remotely possible?

I only started because I wanted to get out of the hypo state so that my body would stop producing TSI antibodies which showed up on my blood test & may be blocking my thyroid hormone.
Apparently being hypo encourages TSI antibody production.

I have a really strange case. I stupidly took a 6.25 mg Iodine supplement for 2 1/2 years thinking it was a good thing to do.
I read that was a bad idea, so I stopped. A week or 2 later I became severely hyper (possible Grave's Disease). That died down, & then I went hypo.
So there was nothing wrong with me until I played around with the iodine. My TSH was 1.5 when I was normal.

I was hoping to get things humming along back to normal with the thyroid meds & then just slowly back off & hope my body doesn't notice.

1) Your waking temp at 36.1 C is not terrible. When you are under 36C this is where you start to have more issues. Ideally the waking temp should be starting from 36.3C . My waking temp can be around this level and i am doing well. So don't get to hung up on the temps. Broda Barnes liked to see a waking temp of 36.6C, but it doesn't always mean anything lower is poor health.

2) Iodine consumption can be dangerous. If you have antibodies this may mean you have hashimotoes. I remember your posting on iodine i think. I don't know to much about this area, but i am sure there are answers out there about it. The UK thyroid forum is very good and lots of moderator patients are very experienced in all thyroid areas and may be able to give you some better advise on what has happened, or what may happen in the future.

3) I had a friend who developed hyper T, but it settled down in time and he no longer takes any medication at all. You may have temporarily halted how your body works and so things will go back to normal, but i just don't know for sure. Have you been under any medical doc for all this ? What do they say ?

4) TSH of 1.5 is ok but it is better to also look at the result with FT4 and 3. Dr Mercado is a psychiatrist in USA and he specialises in metabolic health and the mind. I remember a posting he made on a forum and it was about TSH levels over 2 always started to show up some minor mental health issues. So for me all human beings want their TSH (if no other complicated health issues such as thyroid cancer) to be under the 2. Docs aim to get the TSH to 1 when treating hypothyroid patients as a rough rule as well.

 

[Steve]

Thank you...........you have a lot of info in your head & have given me some more things to look into. I'm sure you wish you never had to learn it all; I know that's how I feel.

I don't have Hashimotos.......been tested a few times. Even my TSI antibodies are strange.........they are supposed to show up on a TRAB test, but they don't. They only show on the TSI test.
I went to 8 different doctors hoping I'd find one I was confident in, but they all thought my case was strange & didn't really know what the hell I did to myself, and they don't know why thyroid pills seem to have no effect.
So I gave up the doctor search, & I'm just sticking with the last one as she's easy to work with & seems to have common sense.

 

[marsaday]

Ok so your case is a little tougher. Yes i do have a lot of info in my head and try and help on forums when i can. Pretty much lost 16 yrs of the first part of adult life to untreated low thyroid. Not nice being ill hour after hour and you still have to live a normal life, but the internet is great and that is the reason why i rediscovered good health.

This is the forum you should check out. They have a lot of informed patients on here and all no more about thyroid issues than endocrinologists it seems.

If you need any info feel free to message me. I am here sometime most weeks.

HealthUnlocked | The social network for health

 

[Steve]

@marsaday I was wondering if anyone sees anything interesting with these new labs & saliva test. I've felt better energy-wise since changing my thyroid supplements. I bought Blanchard's book, & I now take 100 mcg T4 at 8pm & 1/2 grain NDT in the morning. I was going to stop taking it but I halted at this level 2 or 3 months ago. My waking temp is still the same at 97.1 & has never moved no matter what dose of thyroid meds I take. Oh well..........I quit checking it except for today.

So with these new fasting labs the things that concern me:
Low testosterone & high cholesterol: I think this means my cholesterol is not converting into steroid hormones.
This makes me think my thyroid pills aren't really having the desired cellular effect (goes along with my temp never changing).
WBC: Not sure why this is low
Glucose: Seems high (I notice it's been in the 90's for a few years though).

TSH: 0.05
Free T3: 3.45 (2.50-3.90)
Free T4: 0.95 (0.60-1.20)
WBC: 4.0 (4.5-10.0) - Low
Glucose Fast: 96 (70-99) - Seems High
Cholesterol: 233 (150-200) - High
Triglyceride: 76 (<=149)
HDL: 70
Non-HDL: 163 (<=130) - High
LDL: 148 (68-100) - High
VLDL: 15 (4-54)
Total Testosterone: 289 (300-890) - Low

Saliva Test:
DHEAS: 5.5 (2-23) - Low
Cortisol: 7.9 (3.7-9.5)-morning
Cortisol: 2.0 (1.2-3.0)-noon
Cortisol: 0.6 (0.6-1.9)-evening
Cortisol: 0.8 (0.4-1.0)-night

So as I said I am feeling better, but I do suffer from low energy & fatigue most days (at certain times...........it'll come & go sometimes).

 

[Luckytype]

I suppose you still feel unwell. I don't pay much attention to temps and HR, unless i am ill.

My HR will never raise and i am well and temps are fully normal. But HR will not come up from a 44 resting area. Always been low even before i had thyroid issues. I don't think i can base my entire health system on this one measurement though.

Your TSH is very suppressed and for me this says you are not absorbing the thyroid hormones well enough. Only once the conveyor belt of thyroid uptake improves will the TSH raise. Mine was suppressed for many years on different protocols and i wasn't well. It wasn't until i paid attention to the adrenal system that things improved. Specifically i started on progesterone and this has supplied me the missing cortisol i needed. Ever since my TSH has stayed at a healthy 0.3.

A TSH of 0.5-1 is the desirable goal, but 0.3 is fine by me.

So after i started the progesterone the TSH raised. This tells you that the uptake of the T4 has increased and so the conveyor belt of thyroid has started to work correctly (TSH will go up when the body thinks it needs more T4/T3 because it is now using it up more).

Dr P does use NTH, but he also uses T3 only, T4 only etc. He looks at the patient and goes from there. I saw him many years ago, but he couldn't help me as i was doing everything he was recommending anyway. Bit of a wasted consult really. He was still learning off his patients and asked me to let him know want worked for me as time went on.

My mistake in the early days of thyroid treatment was going to high to quickly on NTH. I got up to 5 grains back in 2008. Ever since then my body was using high T4 and T3 doses either in NTH or T4/T3. I did high T4 only, high T3 only. Anyway it has taken me many years to figure out my body likes T4 mostly, but also needs a little T3. The smaller T3 dose is a key addition. Using T4 to get the FT4 into the top 1/3 of the range or just over is a key goal as well.

It was only last year that i stumbled on Dr Blanchards book and he was advocating the protocol i had been using for a good while.

I actually got my new blood back today and TSH is 0.3 and Ft4 is just over range, but FT3 is in the top 1/3 of the range, but not over. So these are good results and i feel good, so all ok.

Your results similar to mine, but the difference is very subtle. Your FT3 is over range and TSH is suppressed. This tells me you are not sucking up the T3 efficiently (as mentioned above). So maybe have a look at some progesterone in small doses. 3mg per day may be enough to make a huge difference. This is all i take nowadays, but previously i was using 6mg per day (ProgestE).

Your cortisol profile looks ok. The shape is good ( a declining curve). Ok so you have a little jump in the late afternoon, but this is fine. DHEA is lower in range and this is common for thyroid patients. I would say you need a higher morning cortisol reading though and agin this is common with thyroid patients. We make thyroid hormones at bedtime in the first part of the night and we then make a corresponding cortisol amount in the second half of the night. So it is important to take thyroid meds at bedtime, or certainly a good percentage as you are currently doing.

So you take 50 T4 and 1 grain at bedtime. This = 86 T4 and 9 T3.

I would look at using all the T4 at bedtime and 1/2 grain. So 118 T4 and 4.5 T3 at bedtime. Then take the remaining 1 1/2 grains around noon the next day.

The timings of your doses and ratios are important, but i cannot say what specifically will work best for you. Trial and error is the way forward. If you trail any doses amounts out stick with it for 2 weeks before modifying the dosing.

Dizziness was a major issue when i first became ill. I don't think it is thyroid only, more likely thyroid/adrenal. So you want the thyroid and adrenal system to start working together more effectively. Again bedtime dosing should aid this.

Finally what is your waking temp usually ?

@marsaday This is a really nice post, thanks for typing it out.

I am thinking forward in the event my docs are of minimal help.

Do you know of the potential issues with titrating a dose of thyroid either too little or too slowly?

And in your understanding would your use of prog likely have been similar if you used pregnenolone considering its pathway? I ask because im considering preg to titrate slowly with thyroid.

 

[marsaday]

Thyroid looks ok but tsh is suppressed. Did you take any thyroid meds before the blood draw?

If not you need a little more help using the thyroid meds. You would then get a more raised tsh. 0.5-1 to a good place as it shows the body is using the meds and still wanting a bit more.

Cortisol is often the issue. Your cortisol profile is good but the dhea is low which is typical in thyroid patients. The balance of cortisol to dhea wants to be 4:1.

Use cholesterol is higher. Thyroid shunts cholesterol into the steroid hormones and so cholesterol is another indicator for low thyroid.

Before looking at using more t4 I would try some progesterone. Use ProgestE as you can dose in 3mg amounts. One drop may really help you out.

Testosterone is low and this maybe the main issue. Progesterone can boost testosterone but not a huge amount.

I think you need to see if progesterone can help the thyroid performance and get a blood test.

If you take anti depressants this will crash testosterone.

The testosterone wants to be looked at as it can often be a more separate issue to thyroid. Thyroid will raise it but not that much and you are low in the range.

 

[Steve]

Thyroid looks ok but tsh is suppressed. Did you take any thyroid meds before the blood draw?

If not you need a little more help using the thyroid meds. You would then get a more raised tsh. 0.5-1 to a good place as it shows the body is using the meds and still wanting a bit more.

Cortisol is often the issue. Your cortisol profile is good but the dhea is low which is typical in thyroid patients. The balance of cortisol to dhea wants to be 4:1.

Use cholesterol is higher. Thyroid shunts cholesterol into the steroid hormones and so cholesterol is another indicator for low thyroid.

Before looking at using more t4 I would try some progesterone. Use ProgestE as you can dose in 3mg amounts. One drop may really help you out.

Testosterone is low and this maybe the main issue. Progesterone can boost testosterone but not a huge amount.

I think you need to see if progesterone can help the thyroid performance and get a blood test.

If you take anti depressants this will crash testosterone.

The testosterone wants to be looked at as it can often be a more separate issue to thyroid. Thyroid will raise it but not that much and you are low in the range.

I didn't take my 1/2 grain NDT until after the blood test.
I took 100 mcg T4 at 8pm the night before (12 hours prior to blood test).

I don't quite understand how progesterone can help with thyroid & testosterone, but I'm willing to give it a try.
I've researched that before after reading some of your posts, but I never did figure it out.

I don't take any anti-depressants or much of anything else really (currently taking D3, K2, Magnesium Malate, CoQ10).
I eat what I think is healthy. I walk or bike just about every day. Do some strength training. Have a little extra belly fat, but "look" slender with a shirt on. I'm 46 years old.
So I'm not sure what I'm doing wrong to keep my body from getting everything back into a normal, healthy range. I'll just keep trying to do healthy things & see what happens I guess. Sooner or later I'll probably die.

Do you have any posts where you've mentioned how progesterone can help with thyroid or testosterone? How long would I need to take the progesterone before I might notice something & need to get new blood tests to confirm?
Thanks!