Thyroid RX/Rapid weight gain/Labs - Advice please!

[evie23]

I’m hoping someone can offer some insight into my thyroid situation. I’m feeling very discouraged and not sure what to do.

I’m a 38 year old female. I was on 100mcg T3 (cytomel) daily for nearly 10 years as prescribed by endocrinologist. It was life changing to me, I finally felt human again!

Last year I saw a new endocrinologist and she felt my dose was too high based on TSH and FT4 results and wanted me get me to a ‘euthyroid state’ with my labs. Reluctantly I followed her advice and have not been well since.

To my understanding as per research and my previous endo, supplemental T3 causes FT4 and TSH suppression and what’s most important is that T3 is in range (upper third I have read is ideal). My blood tests always reflect that, but my FT3 has always been in range on Cytomel. I felt good, no hyper symptoms and my weight was stable.

Since the changes to meds in October I have felt like death - I have no energy, my hair is drastically falling out, I’m freezing cold all the time, puffy face, my mood is very low and anxiety high and I have rapidly GAINED 22 pounds within 3 months despite no changes to diet whatsoever. I follow a primarily pro-metabolic style diet and have been for the past 3 years. When I mentioned this to my endo she was unconcerned and wants to lower my dosage again. Again, she is going by FT4 and TSH only.

May 2022
100mcg T3 (Cytomel)/day
TSH: 0.01
FT4: 1.3
FT3: 5.7 pmol/L (3.9-6.7)
Weight stable, felt great!
New endo changed dosage to 75mcg T3 (Cytomel) + 50mcg T4 (Synthroid)

July 2022
TSH: 0.01
FT4: 5.0
Thyroid antibodies: negative
did not test FT3
Lowered dosage to 50mcg T3 + 50mcg T4
*this is where I started to feel extreme fatigue and lowered mood

October 2022
TSH: 0.02
FT4: 6.7
FT3: 2.6 (3.9-6.7)
Thyroid ultrasound: tissue health good, no nodules but ‘small size thyroid’.
This is where it showed my FT3 dropped very low. Despite that my endo lowered dosage to 50mcg T4 + 25mcg T3

Since October I have rapidly gained 22 pounds and feel absolutely awful. But my endo wants to increase Synthroid to 88mcg and drop Cytomel to 5mcg despite that. She thinks I am still hyper based on TSH and FT4. It makes no sense! I cannot keep gaining weight and feeling this way.

Any insight or advice is welcome. How can I convince my endo to put me back on 100mcg Cytomel?

 

[mostlylurking]

I’m hoping someone can offer some insight into my thyroid situation. I’m feeling very discouraged and not sure what to do.

I’m a 38 year old female. I was on 100mcg T3 (cytomel) daily for nearly 10 years as prescribed by endocrinologist. It was life changing to me, I finally felt human again!

Last year I saw a new endocrinologist and she felt my dose was too high based on TSH and FT4 results and wanted me get me to a ‘euthyroid state’ with my labs. Reluctantly I followed her advice and have not been well since.

To my understanding as per research and my previous endo, supplemental T3 causes FT4 and TSH suppression and what’s most important is that T3 is in range (upper third I have read is ideal). My blood tests always reflect that, but my FT3 has always been in range on Cytomel. I felt good, no hyper symptoms and my weight was stable.

Since the changes to meds in October I have felt like death - I have no energy, my hair is drastically falling out, I’m freezing cold all the time, puffy face, my mood is very low and anxiety high and I have rapidly GAINED 22 pounds within 3 months despite no changes to diet whatsoever. I follow a primarily pro-metabolic style diet and have been for the past 3 years. When I mentioned this to my endo she was unconcerned and wants to lower my dosage again. Again, she is going by FT4 and TSH only.

May 2022
100mcg T3 (Cytomel)/day
TSH: 0.01
FT4: 1.3
FT3: 5.7 pmol/L (3.9-6.7)
Weight stable, felt great!
New endo changed dosage to 75mcg T3 (Cytomel) + 50mcg T4 (Synthroid)

July 2022
TSH: 0.01
FT4: 5.0
Thyroid antibodies: negative
did not test FT3
Lowered dosage to 50mcg T3 + 50mcg T4
*this is where I started to feel extreme fatigue and lowered mood

October 2022
TSH: 0.02
FT4: 6.7
FT3: 2.6 (3.9-6.7)
Thyroid ultrasound: tissue health good, no nodules but ‘small size thyroid’.
This is where it showed my FT3 dropped very low. Despite that my endo lowered dosage to 50mcg T4 + 25mcg T3

Since October I have rapidly gained 22 pounds and feel absolutely awful. But my endo wants to increase Synthroid to 88mcg and drop Cytomel to 5mcg despite that. She thinks I am still hyper based on TSH and FT4. It makes no sense! I cannot keep gaining weight and feeling this way.

Any insight or advice is welcome. How can I convince my endo to put me back on 100mcg Cytomel?

I don't think your endo knows what they are doing. I think you have more insight to what is going on with your body. Doctors can be pretty arrogant and resent being told they don't know what they are doing. Your doctor appears to be relying on the usual inadequate tests that the Powers that Be have declared as the approved method.

Thyroid Function Tests | American Thyroid Association Officialdom speaks (we're in big trouble). Sometimes there's a study provided that might shed some light, if you keep the American Thyroid Association's primary goal in mind (which seems to be to keep the public sick) then you might get a kernel of two of helpful info. Like this. I think this article is a good example of pretzel logic. It seems to overlook the point that TSH is put out by the pituitary to stimulate the thyroid to spit out thyroid hormone; if there isn't any TSH being created by the pituitary (very low TSH test results) then the thyroid doesn't get the message to make any thyroid hormone (=hypothyroidism).

the opposing view to The American Thyroid Association:

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Ray Peat, PhD on Thyroid, Temperature, Pulse, and TSH – Functional Performance Systems (FPS)

Hypothyroidism : the unsuspected illness : Barnes, Broda O. (Broda Otto), 1906- : Free Download, Borrow, and Streaming : Internet Archive

Includes bibliographical references (p. 287-297)

archive.org

Here's a great Ray Peat interview about thyroid: https://www.toxinless.com/polsci-080911-thyroid-and-regeneration.mp3

TSH is a lousy test to go by because other things can affect it besides thyroid hormone levels. When I was horribly sick in 2020 with rheumatoid arthritis caused by inadequate thyroid medication, my TSH was below .02. My endo (86 at the time with 50+ years of experience) chose to ignore the TSH test results because he'd seen the issue before and treated me based on my symptoms plus tests for free T3, reverse T3, and free T4. He wound up changing my desiccated thyroid med from Armour to Accella brand NP Thyroid and over a period of 6 months he doubled the dose up to 180 mg (3 grains). I recovered from the rheumatoid arthritis and my hair grew back. My last TSH test result was .012 but my free T3 was in the ideal range and I feel good.

I think that it can be helpful to talk with pharmacists in your area and find out from them which doctors prescribe natural desiccated thyroid (Acella brand NP Thyroid actually works!). Perhaps doing this would help you find a better doctor to help you?

Keep in mind that if your estrogen is high it will keep your liver from converting T4 to the active T3. Ray Peat discussed it a lot. Here's some radio shows about progesterone with Ray Peat:

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

 

[Vileplume]

Have you taken body temps during this time?

I agree that your endo clearly seems to have made a bad call that is harming you. This is infuriating. Maybe you can get your hands on your own T3, such as from idealabs or an online pharmacy.

 

[evie23]

I don't think your endo knows what they are doing. I think you have more insight to what is going on with your body. Doctors can be pretty arrogant and resent being told they don't know what they are doing. Your doctor appears to be relying on the usual inadequate tests that the Powers that Be have declared as the approved method.

Thyroid Function Tests | American Thyroid Association Officialdom speaks (we're in big trouble). Sometimes there's a study provided that might shed some light, if you keep the American Thyroid Association's primary goal in mind (which seems to be to keep the public sick) then you might get a kernel of two of helpful info. Like this. I think this article is a good example of pretzel logic. It seems to overlook the point that TSH is put out by the pituitary to stimulate the thyroid to spit out thyroid hormone; if there isn't any TSH being created by the pituitary (very low TSH test results) then the thyroid doesn't get the message to make any thyroid hormone (=hypothyroidism).

the opposing view to The American Thyroid Association:

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Ray Peat, PhD on Thyroid, Temperature, Pulse, and TSH – Functional Performance Systems (FPS)

Hypothyroidism : the unsuspected illness : Barnes, Broda O. (Broda Otto), 1906- : Free Download, Borrow, and Streaming : Internet Archive

Includes bibliographical references (p. 287-297)

archive.org

Here's a great Ray Peat interview about thyroid: https://www.toxinless.com/polsci-080911-thyroid-and-regeneration.mp3

TSH is a lousy test to go by because other things can affect it besides thyroid hormone levels. When I was horribly sick in 2020 with rheumatoid arthritis caused by inadequate thyroid medication, my TSH was below .02. My endo (86 at the time with 50+ years of experience) chose to ignore the TSH test results because he'd seen the issue before and treated me based on my symptoms plus tests for free T3, reverse T3, and free T4. He wound up changing my desiccated thyroid med from Armour to Accella brand NP Thyroid and over a period of 6 months he doubled the dose up to 180 mg (3 grains). I recovered from the rheumatoid arthritis and my hair grew back. My last TSH test result was .012 but my free T3 was in the ideal range and I feel good.

I think that it can be helpful to talk with pharmacists in your area and find out from them which doctors prescribe natural desiccated thyroid (Acella brand NP Thyroid actually works!). Perhaps doing this would help you find a better doctor to help you?

Keep in mind that if your estrogen is high it will keep your liver from converting T4 to the active T3. Ray Peat discussed it a lot. Here's some radio shows about progesterone with Ray Peat:

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

Thank you for taking the time to offer your thoughts as well as all of those helpful links. It's frustrating beyond belief how so many doctors can be so close minded and disregard symptoms. This new endo is a young 30's doctor whom I thought surely would be more open minded and listen to me and support my health but it's been the opposite. She's very 'by the book'. I would love to find another doctor/endo but unfortunately in Canada we are very limited to access to specialists and all are on a referral basis, which can take months to a year to even be seen.

That's interesting about estrogen. My monthly cycle actually disappeared when she lowered my Cytomel and added Synthroid, so my estrogen is probably low.

 

[evie23]

Have you taken body temps during this time?

I agree that your endo clearly seems to have made a bad call that is harming you. This is infuriating. Maybe you can get your hands on your own T3, such as from idealabs or an online pharmacy.

I have, I track my waking body temps and afternoon. Before medication adjusts my waking temp ranged 97.7-98.1 and afternoon 98.6-99. With current meds waking is 96.8-97.1 and afternoon I cannot get above 97.2-97.3.

I've looked into getting my own T3 but can't find an online pharmacy in Canada or one that ships here.

 

[LadyRae]

I have, I track my waking body temps and afternoon. Before medication adjusts my waking temp ranged 97.7-98.1 and afternoon 98.6-99. With current meds waking is 96.8-97.1 and afternoon I cannot get above 97.2-97.3.

I've looked into getting my own T3 but can't find an online pharmacy in Canada or one that ships here.

Idealabs?

www.idealabs.ecwid.com

Tyronene

 

[mostlylurking]

Thank you for taking the time to offer your thoughts as well as all of those helpful links. It's frustrating beyond belief how so many doctors can be so close minded and disregard symptoms. This new endo is a young 30's doctor whom I thought surely would be more open minded and listen to me and support my health but it's been the opposite. She's very 'by the book'. I would love to find another doctor/endo but unfortunately in Canada we are very limited to access to specialists and all are on a referral basis, which can take months to a year to even be seen.

That's interesting about estrogen. My monthly cycle actually disappeared when she lowered my Cytomel and added Synthroid, so my estrogen is probably low.

Taking T4 with no T3 can actually make the situation worse. Peat talked about it. The liver can't convert T4 into T3 if it is lugged down by trying to detox high estrogen. A little T3 can give the liver the boost to do its job of converting T4 into T3 (it's like priming a pump).

Progesterone Summaries - Progesterone Deceptions - Progesterone Supplementation - Dosage of Progesterone

Ray Peat

raypeat.com

"Hypothyroidism is characterized by increased levels of both noradrenalin and serotonin, and of other stress-related hormones, including cortisol and estrogen."
If your hypothyroid symptoms have gotten worse, it is more likely that your estrogen is high, not low. Synthroid doesn't work for people who have estrogen (women). I was put on Synthroid when I was 28 and escaped the nightmare when I was around 48 when I switched doctors and the new one had enough sense to put me on Armour desiccated thyroid. I regained my brain function and got 10 years younger in a few months time.

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

"Broda Barnes, more than 60 years ago, summed up the major effects of hypothyroidism on health very neatly when he pointed out that if hypothyroid people don't die young from infectious diseases, such as tuberculosis, they die a little later from cancer or heart disease."

Hypothyroidism is a very big deal; not being treated properly for it is life threatening.

 

[Vileplume]

I have, I track my waking body temps and afternoon. Before medication adjusts my waking temp ranged 97.7-98.1 and afternoon 98.6-99. With current meds waking is 96.8-97.1 and afternoon I cannot get above 97.2-97.3.

I've looked into getting my own T3 but can't find an online pharmacy in Canada or one that ships here.

Based on those temp readings and Dr. Broda Barnes' findings, you were on the perfect thyroid dose before switching. I'd give Tyronene a shot, from the link LadyRae posted. It's T3 only, so you could try combining it with your current T4, or going T3-only like you used to.

 

[evie23]

Idealabs?

www.idealabs.ecwid.com

Tyronene

Thank you! I will look into that one.

 

[evie23]

Taking T4 with no T3 can actually make the situation worse. Peat talked about it. The liver can't convert T4 into T3 if it is lugged down by trying to detox high estrogen. A little T3 can give the liver the boost to do its job of converting T4 into T3 (it's like priming a pump).

Progesterone Summaries - Progesterone Deceptions - Progesterone Supplementation - Dosage of Progesterone

Ray Peat

raypeat.com

"Hypothyroidism is characterized by increased levels of both noradrenalin and serotonin, and of other stress-related hormones, including cortisol and estrogen."
If your hypothyroid symptoms have gotten worse, it is more likely that your estrogen is high, not low. Synthroid doesn't work for people who have estrogen (women). I was put on Synthroid when I was 28 and escaped the nightmare when I was around 48 when I switched doctors and the new one had enough sense to put me on Armour desiccated thyroid. I regained my brain function and got 10 years younger in a few months time.

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

"Broda Barnes, more than 60 years ago, summed up the major effects of hypothyroidism on health very neatly when he pointed out that if hypothyroid people don't die young from infectious diseases, such as tuberculosis, they die a little later from cancer or heart disease."

Hypothyroidism is a very big deal; not being treated properly for it is life threatening.

I have saved all of this information to take notes to hopefully open my endo's mind more. I really appreciate it!

Do you think it's possible that estrogen can be low but high in relation to progesterone? Since my monthly cycle disappeared with the med adjustments, would that leave estrogen dominant? Would it be better to just stop the Synthroid then? I didn't take it for 10+years but my endo convinced me it was needed for health and pregnancy.

 

[evie23]

Based on those temp readings and Dr. Broda Barnes' findings, you were on the perfect thyroid dose before switching. I'd give Tyronene a shot, from the link LadyRae posted. It's T3 only, so you could try combining it with your current T4, or going T3-only like you used to.

I thought I was doing well previously too. So frustrating. I'll look into the Tyronene. I see it's a liquid vs tablet, 8mcg/drop? Previously I was doing T3 dose split twice a day, one dose at 3am and the other early afternoon. Since the addition of T4 and low T3 dose, my endo had be taking both together once per day. Would you recommend going back to twice per day? Is there any advantage or disadvantage to continuing to use T4?

 

[LadyRae]

Yeah, Tyronene T3 is 8mcg per drop. Some people put the drop in a little water in a shot glass, drink half, (4mcg) and save the rest for later.

The very first time I took it, the liquid came out fast; I got 3 or 4 drops under my tongue! I was like, Uh-Oh! Within half an hour I was SO sleepy and took a 2 hour blissful nap...

 

[mostlylurking]

Do you think it's possible that estrogen can be low but high in relation to progesterone? Since my monthly cycle disappeared with the med adjustments, would that leave estrogen dominant? Would it be better to just stop the Synthroid then? I didn't take it for 10+years but my endo convinced me it was needed for health and pregnancy.

First off: I'm not a doctor and I don't play one on TV. I've just read a lot of Ray Peat articles and listened to his interviews.

links to Peat oriented search engines:
Bioenergetic Search (searches audio shows).
PeatSearch: a Ray Peat-specific search engine - Toxinless (the cell on the left searches Ray Peat's articles specifically).

If you stopped your monthly cycle due to lack of progesterone (this is what causes menopause), then the estrogen, that every cell in your body is able to produce, is most likely building up to high levels because there is no progesterone to oppose it. High estrogen is problematic.

If you had some T3 to go with that Synthroid (synthetic T4), you might see improvement. It is the lack of T3 that causes problems. You might also need to lower the amount of T4 that you take as it will be more effective paired with some T3.

A couple of other things: PUFA (polyunsaturated fatty acids) are estrogenic and block thyroid function. It's important to get all PUFA out of your diet. Thiamine helps the thyroid to function. Too much thyroid medication can block thiamine function. When I started taking high dose thiamine hcl I had to lower my thyroid medication because my T3 got alarmingly high. I think it is possible that you might find benefit from a little thiamine.

Ray Peat quotes on thiamine: Ray Peat On Vitamin B1 - Thiamine

 

[TAG145]

Evie-do you have an update? I am hoping you either found a new doctor or were able to get meds on your own to replicate what you were taking when you felt good!
Hope you are doing well now.