- This topic is empty.
-
Posts
-
anonymous wrote:Please review and let me know the right course for the treatment, and please also let know if my sexual issues can be fix or not.
Age: 39 , 5’6″ , and 160 lbs.
For last six months I started feeling like a 100 year old man in the morning with energy to get out of bed to get ready for work. I thought this is aging and my lack workout so I joined a gym and found myself even miserable after workout unable to recover from the workout fatigues. I started to realized myself that I am suffering from a depression based on my analysis on how I felt in the morning such as confused, dizzy , and felt like an Alzheimer patient 🙂 …….. I contacted an experienced Psychiatrist and after couple sessions he prescribed me Effexor XR 75 mg once a day. ……..
Please keep in mind all my life I have been very healthy and I didn’t remember when was the last time when I have seen a doctor, but now I became so worried about my health and started investigating myself on health issues during my life that could relate to my suffering……………
In 1995 when I was 25 years old I noticed an change in my genital my penis shrink (atrophy) as well as testicles and beside that I didn’t notice anything else such as low libido (14 years ago). I visited a physician and after few blood tests and examination he told me I am just fine and I am going through some physical change and it is just fine don’t need to be worried. After few days doctor called me since he received one blood test bit late and he told me that I laser thin ‘Hypothyroid’ and there is no need to worry about it as well he didn’t prescribed any medication and told for this low level reading I don’t need to take anything it will get better by itself AND he didn’t related my sexual problems with my low thyroid at all.
My Psychiatrist order some blood test and it came out I am indeed ‘Hypothyroid’. Below is the result:
TSH: 22.67 Ref: (0.400 – 4.610)
T4 Free 0.76 Ref (0.94 – 1.65)I have been referred to another physician who prescribed me Synthroid 150 mcg once a day. At this point I am taking Effexor 75 mg and Synthroid 150 mg daily for about a month. I am still waiting to see a positive change.
All my life I have been the most talented and intelligent student, worker etc. won lots of prices highly paid because of my intelligence but NOW I am having hard time hold on to it and mostly I feel real dumb. Even at this moment I am having hard time to put my thoughts here in this forum.
I have all of the below symptoms (taken from another site) and for a while I thought It is aging or my gene.
NO sex drive
Premature Ejaculation
Less stamina than others
Less energy than others
Long recovery period after any activity
Arms feeling like dead weights after activity
Chronic Low Grade Depression
Often feeling cold
Cold hands and feet
Bizarre and Debilitating reaction to exercise
Hard stools
Constipation
Dry Hair
Hair Loss and dandruff
Requires naps in the afternoon
Sleep Apnea (snores a lot )
Inability to concentrate or read long periods of time
Forgetfulness
Foggy thinking
Inability to function in a relationship with anyone
Exhaustion in every dimension–physical, mental, spiritual, emotional
Inability to work full-time
Complete lack of motivation
Broken/peeling fingernails
Major anxiety/worry
Ringing in ears
Carpal tunnel symptomsWhen treating hypothyroidism, no matter what the treatment, good targets to achieve are the following in an adult male, assuming no big problems in the other systems.
1. TSH <= 1.0
2. Total T4 between 8.0 and 12.0
3. Free T3 between 3.3 and 3.9Achieving these targets makes thyroid replacement a lot simpler to do conceptually.
Total T4 is the most important target. Using total T4 makes it a lot easier to know how much Synthroid to dose. When it is reached but there are still problems, then there are problems in the rest of the system – e.g. adrenal problems, metabolic problems such as insufficient iron or vitamin A or B-vitamins, selenium, zinc, magnesium, excessive immune system activation, etc. etc. for thyroid hormone to work. Thyroid hormone requires adequate nutrition, nervous system and hypothalamic-pituitary-adrenal function to work.
When using Armour Thyroid, the T3 component will suppress native T4 production. Thus T4 can actually be lower. In this case, using Free T3 may be more useful to help determine dosing. However, in some circumstances, this may not work well. The patient may still be physiologically hypothyroid despite adequate Free T3. In this case, it may be useful to add T4 to treatment with Armour Thyroid to help achieve the Total T4 goal. Note that this is particularly important in the brain, which is a separate component from the body, where T4 is what may be preferentially passed through the blood brain barrier, to be activated to T3 by the brain’s astrocytes.
Sometimes higher dose targets are used – particularly in psychiatry.
When the nervous system is not functioning well, TSH can be off. It can be lower than the actual deficit of thyroid hormone present. When a person has a mental illness, this is particularly true. Thus it is important to measure what thyroid hormone is actually there to determine the course of treatment. Endocrinologists and primary care providers swear by TSH. But it makes the huge assumption that the nervous system is working well. They may not realize this.
I generally look for these problems from the start. Often they are simultaneously there. It usually takes multisystem and metabolic problems to occur simultaneously before a mental illness can occur.
Often, when hypothyroid, adrenal fatigue will occur as the sympathetic nervous system and adrenal glands work together to compensate for the loss of thyroid hormone. It is when the adrenal glands become exhausted (as per Hans Selye) does a person develop problems and can no longer compensate for the loss of thyroid hormone. Adrenal fatigue is NOT a recognized diagnosis by endocrinologists or internists. In psychiatry, it is generally recognized that mood disorders generally have problems with the hypothalamic-pituitary-adrenal axis as one of the causes of the mental illness. This is the analog to adrenal fatigue/exhaustion. However, nothing is often done about it directly – much to the detriment of patients. One will have to study about it to help improve response to treatment since few physicians outside of alternative medicine would know how to deal with it.
Adrenal fatigue will limit how much thyroid hormone one can use. A sign of this is the uncomfortable sensation that the heart is bouncing in the chest like a ball. I would call this a palpitation. Thus when both thyroid and adrenal problems are present, the adrenal problems need to be addressed simultaneously or first in order to make it possible to optimize thyroid hormone.
It is important to obtain follow up labs to help gauge progress in treatment.
T4 (synthroid) needs to be taken on an empty stomach and apart from iron and heavy proteins (such as caseinate proteins from milk) to have the best absorption.
Synthroid can be used just as Armour Thyroid. The key is achieving target dosing then looking for problems in the rest of the system that keep thyroid hormone from doing its job. Some people have difficulty converting T4 to T3 – particularly in the brain – which is a separate compartment from the body (where a person can have normal thyroid levels but low brain levels of T3). In this case, Armour Thyroid or combinations of T3 (cytomel) and T4 may be used.
Dr. M
Regarding low thyroid brain levels, i have noticed that when i took cortisol 10mg/day (was experimenting to see if i felt better with adrenal fatigue) i developed a hypothyroid state with TSH reaching 4.8 and free T3 went down to 2.0. At that time my head would blast from headaches and i felt so sluggish. I never understood why this would happen (maybe it was the previous use of a very strong antibiotic that is said to impede thyroid function >> CIPRO) but endocrinologists told me it was due to cortisol supplementation since it causes hypothyroidism. !!!
@Shaolin 324 wrote:
Regarding low thyroid brain levels, i have noticed that when i took cortisol 10mg/day (was experimenting to see if i felt better with adrenal fatigue) i developed a hypothyroid state with TSH reaching 4.8 and free T3 went down to 2.0. At that time my head would blast from headaches and i felt so sluggish. I never understood why this would happen (maybe it was the previous use of a very strong antibiotic that is said to impede thyroid function >> CIPRO) but endocrinologists told me it was due to cortisol supplementation since it causes hypothyroidism. !!!
Under stress, more cortisol is produced by the adrenal glands.
This higher level of cortisol may, temporarily up to a few weeks, either reduce TSH production or impair T4 to T3 conversion.
After a given amount of time (no longer than a few weeks), even with continued stress and elevated cortisol levels, TSH production and T4 to T3 conversion returns to normal.
There is little evidence of TSH production or T4 to T3 conversion remaining inhibited (this unverified state was called Wilson’s Temperature Syndrome).
I haven’t observed this phenomenon often in my own patients since their cortisol levels tend to be low – indicating a failure to produce cortisol under high stress levels. But perhaps the reduction in thyroid hormone from cortisol treatment (albeit temporary) may explain why cortisol treatment alone may not work in some patients when there is hypothalamic-pituitary-adrenal axis dysregulation.
Other thoughts:
If a 10 mg dose of cortisol contributes to a hypothyroid state, perhaps it represents a high dose for that particular person, and a lower dose is indicated or that dose needs to be divided into smaller doses and spread through the day to avoid inhibiting thyroid hormone production and activation.
Perhaps for that particular person, a 10 mg dose of cortisol inhibits adrenal cortex activity enough to substantially reduce the output of pregnenolone, progesterone, estradiol, testosterone, DHEA, or aldosterone. Perhaps the reduction in one or more of these may alter thyroid hormone production or thyroid binding proteins altering free T3 resulting in a rise in TSH.
Possibly it is worth investigating RT3 and T3 levels
Correcting RT3 may result in combination dosing of Armour Thyroid and Cytomel(T3)
http://jcem.endojournals.org/cgi/reprint/90/12/6403.pdf
================================================== =====
Looking at Fig 1, page #4, the healty people (elderly men) are in upper left quadrant.
T3>1.35 nmol/L=87.7 ng/dL
rT3< 0.32 nmol/L=20.8 ng/dL ================================================== ======
convert T3 nmol/L to ng/dL1.35 nmol/L=1.35/0.0154=87.7 ng/dL
0.32 nmol/L=0.32/0.0154=20.8 ng/dL
================================================== ======@JanSz 328 wrote:
Possibly it is worth investigating RT3 and T3 levels
Correcting RT3 may result in combination dosing of Armour Thyroid and Cytomel(T3)
http://jcem.endojournals.org/cgi/reprint/90/12/6403.pdf
================================================== =====
Looking at Fig 1, page #4, the healty people (elderly men) are in upper left quadrant.
T3>1.35 nmol/L=87.7 ng/dL
rT3< 0.32 nmol/L=20.8 ng/dL================================================== ======
convert T3 nmol/L to ng/dL1.35 nmol/L=1.35/0.0154=87.7 ng/dL
0.32 nmol/L=0.32/0.0154=20.8 ng/dL
================================================== ======The problem I have with this study is that they never measured Free T3.
All of the numbers in this study are very close. Here are some (including my preferred values for mental function):
The mean T4 total was 6.26 ug/dL –> I prefer 8 to 12
The mean T3 was 92.86 ng/dL –> I prefer > 130 to 205
The mean TSH was 1.16 uU/L –> I prefer < 1.0
The mean Free T4 was 1.29 ng/dL — > I prefer 1.3 to 1.8In general, these elderly men were hypothyroid when going by T4 and T3 alone.
The TSH indicates the brain wanted higher thyroid production.The study may have been clearer if they added the measurement for Free T3.
Also, they did not differentiate between specific illnesses the elderly men had. They lumped them all together. This is a huge complicating factor in assessment.
@DrMariano 2882 wrote:
The problem I have with this study is that they never measured Free T3.
All of the numbers in this study are very close. Here are some (including my preferred values for mental function):
The mean T4 total was 6.26 ug/dL –> I prefer 8 to 12
The mean T3 was 92.86 ng/dL –> I prefer > 130 to 205
The mean TSH was 1.16 uU/L –> I prefer < 1.0
The mean Free T4 was 1.29 ng/dL — > I prefer 1.3 to 1.8In general, these elderly men were hypothyroid when going by T4 and T3 alone.
The TSH indicates the brain wanted higher thyroid production.The study may have been clearer if they added the measurement for Free T3.
Also, they did not differentiate between specific illnesses the elderly men had. They lumped them all together. This is a huge complicating factor in assessment.
Do you have a preference for RT3?
@JanSz 2924 wrote:
Do you have a preference for RT3?
Reverse T3 is always being made. Normally, 40 % of T4 is converted to T3 and 60% of T4 is converted to Reverse T3. However, Reverse T3 levels are generally lower than T3 levels since Reverse T3 is rapidly decomposed.
If using absolute numbers, I would prefer a reverse T3 < 200 pg/dL or < 0.20 ng/mL
If the units were converted to pg/dL, then another way of approaching reverse T3 is that the ratio of Free T3 to Reverse T3 should be at or greater than 2.0. For the preferred range of Free T3 from 340 to 420 pg/dL in adults, this corresponds to a range for Reverse T3 from 170 to 210 pg/dL
Hi,
I am the original poster of this thread almost 3 years ago. I ‘d like to update this forum on my recovery. I think I am 100% healthy with the help of correct treatment, change in diet plus workout (active lifestyle). Now I run 2 miles everyday and I am regular in my cross fit gym. This forum and MESO-RX has been a great inspiration and learned a lot from all the folks on these forum.
1. I am on 150 mcg of thyroxine (synthroid) and two tablets of IODORAL 12.5 mg. I take them first thing in the morning and don’t eat anything for one hour.
2. I also changed my diet and I am on PALEO diet (google on it). I religiously follow this diet.
Please spend some time and make sure to watch this lecture by Professor Robert Lustig of University of California:
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=all
If a 10 mg serving of cortisol plays a role in a hypothyroid condition, perhaps it symbolizes a high serving for that particular person, and a reduced serving is indicated or that serving needs to be separated into lesser amounts and propagate through the day to prevent conquering hypothyroid hormonal agent generation and initial.
If a 10 mg serving of cortisol plays a role in a hypothyroid condition, perhaps it symbolizes a high serving for that particular person, and a reduced serving is indicated or that serving needs to be separated into lesser amounts and propagate through the day to prevent conquering hypothyroid hormonal agent generation and initial.
- You must be logged in to reply to this topic.