Thyroid Hormone Resistance

jyb

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Charlie mentioned http://www.raypeatforum.com/forum/viewtopic.php?f=51&t=1103 this interesting article http://toopoopedtoparticipate.com/blog/dr-john-c-lowe-speaks/

The author, Dr John Lowe, believes he himself suffered not from the usual hypothyroidism but from "thyroid hormone resistance" aka "type 2 hypothyroidism". The condition seems more rare, but it even has an entry on Wikipedia.

The author claims it can be solved by taking a much greater dose of T3. This is different from the "reverse T3" condition and protocols found online. I don't think RP ever mentions this type of resistance, because he suggests small physiological doses of T3, which would be impossible with 150mcg T3 daily.

For all those who don't seem to respond to thyroid supp, it would be good to find an appropriate test one could do to see if one has the above. Need to know how to divide that 150mcg T3 dose, if one needs to build up to that dose in a certain fashion etc.
 

narouz

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jyb said:
Charlie mentioned http://www.raypeatforum.com/forum/viewtopic.php?f=51&t=1103 this interesting article http://toopoopedtoparticipate.com/blog/dr-john-c-lowe-speaks/

The author, Dr John Lowe, believes he himself suffered not from the usual hypothyroidism but from "thyroid hormone resistance" aka "type 2 hypothyroidism". The condition seems more rare, but it even has an entry on Wikipedia.

The author claims it can be solved by taking a much greater dose of T3. This is different from the "reverse T3" condition and protocols found online. I don't think RP ever mentions this type of resistance, because he suggests small physiological doses of T3, which would be impossible with 150mcg T3 daily.

For all those who don't seem to respond to thyroid supp, it would be good to find an appropriate test one could do to see if one has the above. Need to know how to divide that 150mcg T3 dose, if one needs to build up to that dose in a certain fashion etc.

jyb-
I've just started experimenting with this theory/treatment.
And yes...it does not seem to easily fit in with Dr. Peat's thyroid views.

I don't know a whole lot about Dr. Lowe.
I'm not sure if the "thyroid resistance" theory originates with him.

The theory is pretty well laid out over at a Yahoo group called RT3_T3 (or something like that).
The gist is that some people don't respond or stop responding to thyroid supplements
because they are sortuv OD'ed on T4,
which causes excess RT3 to be produced,
which in turn clogs T3 receptors (I think I've got that approximately right)
making one hypothyroid.
The way to clear or unclog those receptors, they believe, is to supplement with only T3 for some months,
and maybe forever.

So how much T3?
This is where it gets a little dicey. :)
The RT3 group's general suggestion is to stop all T4
and start taking just T3 at about the same dosage
you were getting in your combined T4/T3 supp.
So, let's say you were taking two grains of Armour,
which has about 9 mcgs per grain.
You would have been getting about 18 mcgs per day of T3.
So that is what you'd start with on straight T3.

Then you watch your body signs, as in Peat, temps and pulses etc,
and you gradually ramp up your T3 dosage.
They (the Yahoo group instructions) say most people top out at somewhere between 75--125mcg, I believe.
It might take some weeks to get there.
They say the excess, clogging RT3 caused by too much T4 usually clears at about 12 weeks.
It gets interesting here;
they say one must be especially careful and self-observant at that 12 week point
because things suddenly change:
the thyroid supplement starts actually getting received by the unclogged receptors,
and one can suddenly go skyrocketing into hyperthyroid status.
When that change occurs, you cut back severely or even stop taking T3 for a bit,
and then when resume at a much reduced rate.

I may have some of that a bit wrong, but...that's a rough intro.

I balked at first because Peat says we only make, endogenously, about 5mcg per hour of T3.
How then can we handle 75-125mcg per day!?
I'm not sure.
I think it may be explained by the Yahoo group's general view
that the exogenously consumed T3 clears the excess T4 (which in turn creates the RT3).
Once that clears, then I'm not sure how much T3 those folks take.
It would appear to be a much reduced dose.
So if they end up taking like 40mcg per day...well, that sounds somewhat reasonable.

Then again, Dr. Lowe said he had been doing great on 150mcg per day for decades!
Again--don't know Lowe originated the thyroid resistance ideas the the Yahoo group outlines.
I apologize for my ignorance...as I say I've just started this experiment.

And Peat doesn't, to my knowledge, seem to go for Only T3 therapy.
He said he himself had problems when he tried taking only T3--
said his heart would stop like every sixth beat.
Peat does say that some people do better with a combined T4/T3 supplement
which contains a ratio of T4 to T3 closer to the human ratio of 3:1.
Thus his suggestion to some to try nibbling on a little straight T3 throughout the day
in addition to a combo T4/T3 supp.

But Peat does believe that, in some people,
excess T4 can suppress thyroid function.
He just doesn't, as far as I know, seem to think that taking T3 only
is the way to go in terms of fixing that suppression.
At least I don't think I've ever seen him recommend it.
It would seem that his answer--in addition of course to all of his dietary and light ideas--
would be to maybe back down a bit on the T4/T3 combo supp
while at the same time adding in some straight T3.

Ray-Z and I were discussing this a while back.
Where are ye, Ray-Z!?
He, I think, takes only straight T3.

Yesterday I tried stopping my CynoPlus T4/T3 (I was taking about one tab per day
which contains 120mcg of T4 and 30mcg of T3).
Instead I substituted about 40 mcg of T3 (Cynomel)
split up in doses through the day.
I didn't feel bad,
but I did see a somewhat marked decrease in my temps and pulses.
I'll increase slowly to see if I can get those up.

You know, if I'm right in thinking Peat said we normally should make about 5mcg of T3 per day...
well, 24hrs x 5mcg = 120mcg.
So...maybe taking 75-150mcg per day is not that weird. :roll:

Oh yeah:
here's the Yahoo groups prime diagnostic for thyroid resistance.
You take your Free T3.
You take your Reverse T3.
You divide RT3 into FT3.
The resulting number (is that called the "dividend"?) should be over 20.
If it's under, then you're a candidate for their T3 treatment.
My number was 12.8
 

Ray-Z

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narouz said:
And Peat doesn't, to my knowledge, seem to go for Only T3 therapy.
He said he himself had problems when he tried taking only T3--
said his heart would stop like every sixth beat.
Peat does say that some people do better with a combined T4/T3 supplement
which contains a ratio of T4 to T3 closer to the human ratio of 3:1.
Thus his suggestion to some to try nibbling on a little straight T3 throughout the day
in addition to a combo T4/T3 supp.

But Peat does believe that, in some people,
excess T4 can suppress thyroid function.
He just doesn't, as far as I know, seem to think that taking T3 only
is the way to go in terms of fixing that suppression.
At least I don't think I've ever seen him recommend it.
It would seem that his answer--in addition of course to all of his dietary and light ideas--
would be to maybe back down a bit on the T4/T3 combo supp
while at the same time adding in some straight T3.

Ray-Z and I were discussing this a while back.
Where are ye, Ray-Z!?

[Cue montage of Ray-Z's latest Peating activities, including: feeding pregnenolone to hamsters with immense brains; ascending Mt. Everest on a sedan chair carried by mutinous sherpas; winning a maple syrup-chugging competition at a diner; accidentally electrocuting himself with an "earthing" mat; battling little kids in a watermelon-seed fight; modifying an advertisement for corn oil to tout its cancer-promoting effects; and attempting to eat charcoal powder in a strong wind.]

Here I am, Narouz. :mrgreen:

narouz said:
He, I think, takes only straight T3.

Right. I had problems with NDT. I see Ray Peat's case for a mixture of T4 & T3, but am doing OK on T3 alone and haven't bothered to experiment with adding back T4.

Let me throw in some more wrinkles...Peat has said (p. 77 of Female Hormones in Context) that as a "defensive" response, the liver may convert excess T3 to RT3. He has also said that cancer patients may need larger doses of T3 than others. (Can't find a citation at the moment.)

narouz said:
You know, if I'm right in thinking Peat said we normally should make about 5mcg of T3 per day...
well, 24hrs x 5mcg = 120mcg.
So...maybe taking 75-150mcg per day is not that weird. :roll:

Yes, all those nibbles really add up. :mrgreen:
 

narouz

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Ray-Z said:
narouz said:
Ray-Z and I were discussing this a while back.
Where are ye, Ray-Z!?

[Cue montage of Ray-Z's latest Peating activities, including: feeding pregnenolone to hamsters with immense brains; ascending Mt. Everest on a sedan chair carried by mutinous sherpas; winning a maple syrup-chugging competition at a diner; accidentally electrocuting himself with an "earthing" mat; battling little kids in a watermelon-seed fight; modifying an advertisement for corn oil to tout its cancer-promoting effects; and attempting to eat charcoal powder in a strong wind.]

Here I am, Narouz. :mrgreen:

narouz said:
He, I think, takes only straight T3.

Right. I had problems with NDT. I see Ray Peat's case for a mixture of T4 & T3, but am doing OK on T3 alone and haven't bothered to experiment with adding back T4.

Let me throw in some more wrinkles...Peat has said (p. 77 of Female Hormones in Context) that as a "defensive" response, the liver may convert excess T3 to RT3. He has also said that cancer patients may need larger doses of T3 than others. (Can't find a citation at the moment.)

narouz said:
You know, if I'm right in thinking Peat said we normally should make about 5mcg of T3 per day...
well, 24hrs x 5mcg = 120mcg.
So...maybe taking 75-150mcg per day is not that weird. :roll:

Yes, all those nibbles really add up. :mrgreen:

(Damn. That was a dramatic entrance!
I think "Chariots of Fire" would be appropriate music accompaniment.
Or, for a more modern, mainstream feel, perhaps "Gangnam Style.") :D

So Ray-Z...if I may be so bold:
1. How many mcgs per day are you doing?
2. And could you remind me of the symptoms you experience when taking T4?
3. How much NDT were you taking and for how long?
4. How long have you been doing the strictly T3?
5. When doing the T3, are you able to get your temps and pulses up into a good range?

And Ray-Z, please PM me if you have any suggestions about costs.
It's pretty expensive from my pharmacy. :cry:

Oh yeah: do you have any past/present lab numbers for RT3 and FT3?
Wondering how they'd look in terms of the Yahoo group's ratio/formula/diagnostic.
 
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J

jyb

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@narouz: this is not about the reverse T3 thing commonly found online. It's about needing more T3 all other things being equal, given that the cell is less responsive due to a mutation.

In the reverse T3 protocol, you eventually lower your dose when reverse T3 decreases. But in this type of resistance, seems like you will need 150mcg T3 for life.
 

narouz

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jyb said:
@narouz: this is not about the reverse T3 thing commonly found online. It's about needing more T3 all other things being equal, given that the cell is less responsive due to a mutation.

In the reverse T3 protocol, you eventually lower your dose when reverse T3 decreases. But in this type of resistance, seems like you will need 150mcg T3 for life.

jyb-
So...would you like to devote this thread exclusively to Thyroid Resistance Due to Genetic Mutation?
That's fine with me...I just didn't take that from the thread title.
Would you like me to start a new thread for General Thyroid Resistance?
 

kiran

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narouz said:
He has also said that cancer patients may need larger doses of T3 than others. (Can't find a citation at the moment.)

This is relevant to me. I would appreciate it if you could find the reference sometime. :geek:
 

narouz

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jyb said:
@narouz: this is not about the reverse T3 thing commonly found online. It's about needing more T3 all other things being equal, given that the cell is less responsive due to a mutation.

In the reverse T3 protocol, you eventually lower your dose when reverse T3 decreases. But in this type of resistance, seems like you will need 150mcg T3 for life.

As I say, my research into thyroid resistance is in a nascent stage.
But just in terms of Lowe--I'm not at all sure he insisted that genetic mutation
is the only cause of resistance
or that he tried to pin that distinction/causation down in treatment.
Generally, he seems very distrustful of relying mostly upon lab work in diagnosing.
I would be very surprised to find
that he tested for mutations of the β (beta) form of the thyroid hormone receptor
before diagnosing thyroid resistance.

And if you take a look at the people he associated himself with,
and their ideas about thyroid resistance
(here is a link where you can see some of that:
http://psychology.wikia.com/wiki/Thyroid_hormone_resistance)
you will notice that those folks debate the origins and causes of resistance.
They all seem to agree the causes are multiple.

You know, you refer to "reverse T3 thing commonly found online."
I don't find any kind of discussion about thyroid resistance to be very "common." :D
The RT3 Thyroid Resistance Yahoo group I spoke of, for instance,
has just been in existence for a year
and they would seem to have a very limited number of members.
Most doctors would not even grant the existense of any kind of thyroid existence.
Thyroid Resistance--whatever the cause--would seem to me to be a quite obscure and eccentric theory/idea.
 

narouz

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kiran said:
narouz said:
He has also said that cancer patients may need larger doses of T3 than others. (Can't find a citation at the moment.)

This is relevant to me. I would appreciate it if you could find the reference sometime. :geek:

kiran-
That was Ray-Z, not me.
I think he said it came from one of Peat's books--"Female Hormones" or something like that?
 

charlie

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I wonder if the resistance is from PUFA's?
 

narouz

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Charlie said:
I wonder if the resistance is from PUFA's?

Personally, as a Peatian, I would think that would be one of many ways resistance occurs.
But I don't think Lowe, for instance, is very Peatian.
I've heard him talk about the helpfulness of Omega-3s.

I also heard Lowe discuss the idea of resistance caused by
mutations of the β (beta) form of the thyroid hormone receptor.
And I've heard him say that resistance has multiple causes--deficiencies, etc.
He may've believed that receptor mutation is the primary cause--I'm not sure.
But not the only cause of resistance.

And as I say,
if you went to him for treatment,
I don't think he would've tested your β (beta) form thyroid hormone receptors.
He would, I think, have diagnosed by your history and symptoms,
and would have treated for thyroid resistance if he thought you were resistant.
He wouldn't have needed to have it proven to him by lab test that you had mutated receptors.
He was a chiroprator as I understand it.
I listened a little while ago to a long interview of him by Mercola.
Lowe discussed the receptor mutation a little.
He came off as a smart, thoughtful person.

This is just my interpretation from my limited research.
 

gretchen

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Very interesting. I was thinking of starting T3 and thought I would add other things later. Thanks for the overall clarification. I have not had lab work, so I suppose that's on the list also.
 

narouz

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Ray-Z

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narouz said:
(Damn. That was a dramatic entrance!
I think "Chariots of Fire" would be appropriate music accompaniment.
Or, for a more modern, mainstream feel, perhaps "Gangnam Style.") :D

Thanks, man. BTW, Chariots of Fire is a favorite of mine, though I probably liked it better in the old days when I thought running was healthy. :D

narouz said:
So Ray-Z...if I may be so bold:
1. How many mcgs per day are you doing?
2. And could you remind me of the symptoms you experience when taking T4?
3. How much NDT were you taking and for how long?
4. How long have you been doing the strictly T3?
5. When doing the T3, are you able to get your temps and pulses up into a good range?

(1) and (5): My regimen and results appear on the first page of this thread: viewtopic.php?f=56&t=950

(2) A significant dose of T4 gives me my usual hypo symptoms: cold extremities, difficulty breathing, fatigue, foul mood.

(3) Over the course of a few months, I experimented with doses ranging from 1 (relatively weak) capsule of bovine NDT to 4 grains of porcine NDT. At the upper end of that range, I was seriously hurting! :lol:

(4) Not sure -- probably around 9-10 months.

narouz said:
And Ray-Z, please PM me if you have any suggestions about costs.
It's pretty expensive from my pharmacy. :cry:

Hmmmm...I don't think I have any ideas beyond what's in the supplement list. If anything else occurs to me, I'll PM you.

narouz said:
Oh yeah: do you have any past/present lab numbers for RT3 and FT3?
Wondering how they'd look in terms of the Yahoo group's ratio/formula/diagnostic.

I have no relevant labs.
 

Ray-Z

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narouz said:
kiran said:
narouz said:
He has also said that cancer patients may need larger doses of T3 than others. (Can't find a citation at the moment.)

This is relevant to me. I would appreciate it if you could find the reference sometime. :geek:

kiran-
That was Ray-Z, not me.
I think he said it came from one of Peat's books--"Female Hormones" or something like that?

The missing citation is p. 30 of Peat's Progesterone in Orthomolecular Medicine. I briefly summarize Peat's views on using thyroid to treat cancer here: viewtopic.php?f=3&t=1123
 

narouz

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Ray-Z,

So, did you work your way up gradually to your present 100mcg-ish dose?

Have you ever checked out the Yahoo RT3 group's method?
They say that once you get up to about your dosage of T3,
after 2 or 3 months people's dosage requirements suddenly drop,
because the T3 receptors have cleared from the excess T4 clogging.
And then only a steeply reduced dose is needed for the same effects.

I guess you haven't experienced anything like that, have you?
 

kiran

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I experienced that clearing effect a while ago. I think I was upto about 180 or 200 mcg/day when "my T3 receptors cleared".
 

narouz

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kiran said:
I experienced that clearing effect a while ago. I think I was upto about 180 or 200 mcg/day when "my T3 receptors cleared".

kiran-
Were you taking NDT or T4 before you went to T3?
If so, how long were you on it?
Did you work yourself up gradually on the dosage of T3 to that very high 180-200mcg?
How long did it take to get to that "clearing" phenomenon?
What dosage are you on now?
 

kiran

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I've always used T3 as my main thyroid hormone, pretty much, on recommendation from Dr. Peat. No NDT or T4.

I did work myself up gradually to that high dose. I did it by increasing frequency rather than increasing dosage as the site recommends. I was up to 5 mcg every 20min at one point.
I noticed the difference very early, the same dose split into 5mcg doses was far more effective than if it was taken at once.

I don't remember how long it took, sorry, it's been a while.

Right now, I take about 40mcg/day +half-grain NDT at night.
 

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