Vascular chest pain with T4 (Synthroid) fixed by T3 therapy: A patient narrative

In this post, I’ll give you a narrative that is focused on my own experience as a patient who developed vascular pain symptoms in direct relation to T4-treatment (Synthroid).

  • The health crisis began in February 2016.
  • Gradual transition from T4 to T3 therapy began in April 2016.
  • Full recovery was achieved on T3 only by September 2016
  • Health has been maintained on continued T3-only therapy as of Jan. 2017.

Health background

Continue reading “Vascular chest pain with T4 (Synthroid) fixed by T3 therapy: A patient narrative”

Low-T3: The huge and horrible gap in thyroid research

Many studies have been done on patients whose T3 levels are below lab reference ranges despite a TSH and T4 within range. Most of them have discovered that low serum Free T3 is a dangerous factor to have when one is ill: it is often an independent predictor of morbidity and mortality in patients with organ failure such as heart disease, liver disease and kidney disease. (See my review in this post on the Dangers of Low T3.)

The problem is that such research studies usually exclude patients diagnosed with hypothyroidism.  Why?  They always say it is to avoid confounding factors. Researchers have been mainly intrigued by the puzzle of hormonal dysregulation in patients who have a normal, functional thyroid. Studying hormone dysregulation in people with abnormal thyroids is less paradoxical and potentially more complicated.

Continue reading “Low-T3: The huge and horrible gap in thyroid research”

The dangers of Low T3

At the heart of much supposed “controversy” in endocrinology is the role of T3 thyroid hormone testing and T3-based treatments for hypothyroidism.

Perpetuating this “controversy” is the continual restatement in research articles that T3 and T4-T3 combination therapy (of which Natural Dessicated Thyroid is a sub-type) is a “controversy.” Repeatedly saying it is controversial only serves to reinforce the controversy and dismisses it, if the persons stating it are not doing anything to resolve it.

Meanwhile, clinical practice shows little sign of an actively debated controversy. Most doctors conform to the T4-only recommendations for best practice because they are easy and cheap.  Adjusting Synthroid dosage to TSH levels to “normalize the TSH” has turned into a simple game of numbers that leaves many hypothyroid patients symptomatic and at risk.

As I show in my review of a journal article by Abdalla & Bianco (2014), biology teaches that a healthy plasma T3 level must be defended, and the TSH cannot be trusted to indicate adequate T3 levels.

The dangers of low-T3 in any patient can be logically hypothesized from many studies of “Low T3 Syndrome” and “Sick Euthyroid Syndrome” and “subclinical hypothyroidism”

A recent journal article (Rhee, et al, 2015) included a table outlining the associations between Low T3 and morbidity/mortality: Continue reading “The dangers of Low T3”

T3 Thyroid hormone is a biological priority

Plasma T3 defense league
Image adapted from “Superheroes” by Martin Kas, April 26, 2008, from https://flic.kr/p/4JwJfG

Among the many excuses commonly heard from doctors about NOT measuring the T3 thyroid hormone and NOT treating hypothyroidism with T3-therapy are that “the half-life of T3 is too short” and “T3 levels vary based on too many factors.” These arguments serve to minimize the importance of the T3 hormone.

However, this 2014 article refutes these excuses:

Abdalla, S. M., & Bianco, A. C. (2014). Defending plasma T3 is a biological priority. Clinical Endocrinology, 81(5), 633–641. http://doi.org/10.1111/cen.12538

  • It teaches the biological priority of T3 over all other thyroid hormones. TSH, T4 and the deiodinases merely serve to protect and regulate healthy T3 levels.
  • It emphasizes the mechanisms that protect long-term stability and homeostasis of T3 levels in the body and refutes the misconceptions based on its short half-life.
  • It stresses the medical importance of testing T3 serum levels and treating chronic dysregulation of T3 hormones to attain the biological standard of T3-based euthyroidism.

The T3 hormone remains of paramount importance, despite the complex biological factors that can interfere with T3 metabolism and inactivation.

Continue reading “T3 Thyroid hormone is a biological priority”

Diclofenac and Celecoxib inhibit T3

Caution, if you take either of these common Non-Steroidal Anti-Inflammatory (NSAID) drugs and have Thyroid T3-hormone issues, or problems in your blood vessels!

In my recent research I found a 2016 article with this title: “Evidence that diclofenac and celecoxib are thyroid hormone receptor beta antagonists.” (Zloh, et al, 2016) http://www.ncbi.nlm.nih.gov/pubmed/26792060

They analyzed the molecular structure of these drugs to confirm their “TRβ antagonistic properties.” They also measured “changes to Triiodothyronine (T3) induced vasodilation of rat mesenteric arteries” with these drugs.

They found these two drugs “significantly inhibited T3 induced vasodilation compared to controls.”

Inhibition of vasodilation is obviously NOT the effect you want if you have atherosclerosis or any problems with blood vessel spasms or constriction.

I was recently put on Diclofenac to resolve my chest arthritis AND at the same time, I was starting T3 therapy to resolve chest pain from vasoconstriction. Obviously the combination of these two therapies was contradictory.

In contrast, they tested naproxen and it did not have this TRβ inhibitory effect.

References

Zloh, M., Perez-Diaz, N., Tang, L., & Patel, P. (2016). Evidence that diclofenac and celecoxib are thyroid hormone receptor beta antagonists. Life Sciences, 146, 66–72. http://doi.org/10.1016/j.lfs.2016.01.013

Why is it so difficult to get thyroid disease diagnosed and treated?

stethoscope
We rely on doctors and technologies to prevent and treat illness. But dysfunction can occur in the medical system, not just in the human body it’s supposed to treat. Image: “2008.11.25 – The physician,” by Adrian Clark, November 25, 2008, from https://flic.kr/p/5EHjMW

I’ve created a series of blog posts that tells my story and outlines the six challenges I’ve faced as a hypothyroid patient with hormone-conversion dysfunction and various other health conditions that were worsened by this.

This post provides my summative reflections on the experience.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system, as explored by these posts:

If it has been this challenging for me, a very curious and assertive patient with a PhD and access to research databases to take initiative in my own thyroid health, how hard must it be for patients without such ornery character traits, advanced research education, and/or research resources?

Continue reading “Why is it so difficult to get thyroid disease diagnosed and treated?”

Issue 6: Lack of referral to an endocrinologist who understands

Doctor
If you are lucky enough to get referred to an endocrinologist, will they understand the importance of T3? Image: “Doctor Hand,” by Truthout.org, September 8, 2009, from https://flic.kr/p/6WMPmu

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on the fact that most family doctors are not equipped to test for or treat underlying hormonal thyroid dysfunction that may occur despite “normal” TSH and T4 levels.

Unfortunately, it also describes a disappointing consultation with an endocrinologist.

It is important for thyroid patients to have access to a specialist who can interpret abberant thyroid test data and manage conditions such as chronic Low-T3 in patients treated with Synthroid.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Continue reading “Issue 6: Lack of referral to an endocrinologist who understands”

Issue 5: Lack of testing for Free T3 and Reverse T3 levels

T3-ReverseT3
Every organ and every cell requires T3 hormone for proper function. In fact, T3 is so important that all other thyroid hormones exist mainly to protect and regulate our T3 levels. Reverse T3 mimics the molecular shape of T3 but has no effect other than plugging up cells’ T3 receptors.  Healthy levels of T3 and Reverse T3 prevent thyrotoxicosis, but if RT3 dominates T3, it can lead to T3 deprivation, which leads to a very poor prognosis in acute or chronic illness.

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on the importance of regularly testing “T3” and “Reverse T3” hormone levels in the blood of hypothyroid patients to ensure that therapy is achieving its ultimate goal of adequately replacing the most important thyroid hormone, T3.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Continue reading “Issue 5: Lack of testing for Free T3 and Reverse T3 levels”

Issue 4: Lack of regular (or any!) thyroid ultrasound testing

Ultrasound
Thyroiditis? Get an ultrasound! Image: “Ultrasound station” by Michael Coghlan, August 16, 2012, from https://flic.kr/p/cToEsJ

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on the importance of ultrasound imaging in the diagnosis and management of hypothyroidism, especially autoimmune thyroid gland disease.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Continue reading “Issue 4: Lack of regular (or any!) thyroid ultrasound testing”

Issue 3: Ignorance of Hashimoto’s thyroiditis autoimmunity

Hashimoto's Thyroiditis
Hashimoto’s Thyroiditis: an autoimmune condition.

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on the importance of understanding and diagnosing a special type of hypothyroidism, Hashimoto’s thyroiditis, which is actually the most common cause of hypothyroidism.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Continue reading “Issue 3: Ignorance of Hashimoto’s thyroiditis autoimmunity”