I wonder if anybody can enlighten me to the latest research / theories on which factors assist / prevent T3 to enter cells and therefore make them work.
The reason I ask is that I have got my B12, folate, vit D3, and iron to the optimal levels suggested here on these forums. I have also got myself to mid range FT4 and near max FT3 with suppressed TSH. I have measured my cortisol with a 4 point saliva test over 24 hours and it was as people suggest here - well in the range. As far as I know this is as optimal as it gets. My resting heart rate is stuck at ~60 bpm and many of my other symptoms won't budge either.
I am feeling a little better, but still far from feeling that I'm thriving. It's like there is a blocked drain, and I'm trying to unblock it using my hand and some water is now coming through, but what's needed is a plunger to unclog the drain to let the full flow through. Has anyone felt like that? Anyone found a solution?
I have briefly heard about copper, zinc, and magnesium. However, it doesn't seem to be consistent or common. So I don't know if there are reliable tests to measure those properly and whether they truly and significantly affect T3 cellular absorption.
The other thing I thought about is my liver. A lot of hormone synthesis happens there and I know with my slow caffeine and alcohol metabolism, my liver seems to be slow to work. But who knows if it's just because of my general hypo state or something on top of that. Are there tests to measure something of note in the liver that is commonly low (or high) in some hypo patients? If that something is found, can it be easily addressed via supplementation?
It seems that I'm missing something vital in the equation to get my body (and mind) to thrive, rather than limp along through life. It's 2019, are there any breakthroughs or new theories / tests / supplements in this area? Keen to find some new avenues to go down.
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ak_83
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T3 (or T4 then converted to T3) enters cells. There are rare genetic mutations that can inhibit transport into cells but these would be obvious from childhood and produce severe signs and symptoms. If there were nutritional deficiencies that could magically prevent T3 getting into cells it would prevent T3 getting into pituitary cells and TSH would be very high.
It's more likely you need a higher dose of thyroid hormone or there are other problems not related to thyroid. There are cases of resitance to thyroid hormone (RTH) but this gets complicated. Do you have your thyroid blood test results from when you were initially diagnosed?
Yes, I do, although I think I've had this from early childhood.
In 2005 I had
FT4: 13.1 ( 12.8 - 20.4 )
TSH: 5.30 ( 0.4 - 3.8 )
FT3: 3.8 ( 4.0 - 6.8 )
My results now are:
FT4: 16.5 ( 12.8 - 20.4 )
TSH: 0.05 ( 0.4 - 3.8 )
FT3: 6.5 ( 4.0 - 6.8 )
I agree that I don't think I have the genetic defect that people talk about, otherwise things would have been pretty severe much early on. I think it's more that I'm missing a factor or two that synergetically would unclog the drain...
Your TSH was quite low for someone with marginal fT4 and low fT3. Normally as fT4 falls TSH rises dramatically and this stimulates the thyroid and also promotes T4 to T3 conversion. So you would need T3 supplementation to compensate but I note your are taking NDT which has a good amount of T3.
If you were experiencing hypothyroid symptoms the answer would be to increase your dose but a (very) quick glance at another post mentioned angina like symptoms. If you get angina symptoms you should see your doctor and reduce your thyroid medication. Sorry, I can't be more help but putting forward nutritional solutions may give you hope but are unlikely to be of any benefit.
I can’t directly answer your question. But I too have a less than perfect liver function. So I take Milk Thistle drops (by Vogel) to support the liver. I understand that this is a traditional herbal remedy.
Do you consume soy in any form? And, remember that processed foods a jam-packed with soy protein, soy oil, soy flour, etc. and that 99.9% of bread in the UK is made with soy flour. Soy will impede the uptake of thyroid hormones by the cells.
In addition to vitamin D3 and methylated B vitamins I take selenium and I’ve been told that it helps with the conversion. I believe it’s true because as soon as I started taking selenium (200mcg per day) my doctor said I needed to reduce NTD - he reduced it by almost half. There’s a whole cellular function that goes on with the methylation process. It has to do with genetics and how cells accept and release various waste / nutrients. I know for sure that I have this genetic predisposition (MFTHR gene) but more related to your question, When I started taking methylated B vitamins I felt like the dam broke loose just like you’re talking about. Somehow folic acid (if not methylated) can cause all kinds of problems for some of us. I’m sure the grasp that I have on this whole thing is only slim at best.
So read all you can about the methylation process. Try adding selenium. I highly recommend the book Dirty Gene’s by Dr. Ben Lynch - for an understanding on the workings of the cell even at the genetic level and how we can do the simplest things to fine-tune our microbiology!
If this were me now, I would concentrate on better liver clearance. Although genes are responsible for the transcription of our methylation/salfation, nutritional state and supplements can influence these processes (NAC, milk thistle, alpha lipoic acid).
And you probably already do all this but go easy on sugar, saturated fats, coffee, alcohol, excess proteins, environmental toxins, etc … Improving liver clearance will not only improve metabolisation of hormones but helps with stuff like lowering homocysteine, recycling glutathione, controlling oxidative stress, etc and I think this is why we reach a wall in our recovery as time and patience is required to complete the healing.
You could also ensure your blood sugar levels are constant as T3 requires an adequate amount to enter the cell and become active. Investigate mitochondria and insufficient ATP for further info.
And sex hormones need to be balanced as elevations can raise the carrier proteins that transport them around the body (hypothyroid males commonly have low testosterone levels) and it can be these proteins that also bind too much thyroid hormone making our test results look good but making that amount inactive for use.
Wow, I think you may have hit the nail on the head (at least one of them anyway). Very interesting links. Maybe I need to get myself tested for homocysteine levels and MTHFR gene variation. Regardless I could (once again, but more rigorously) look at improving the liver. Maybe now that I'm optimal in a lot of other ways, some of these supplements could now work.
Regarding ATP and mitochondria. Yes, I've looked at it before, but again, something to research more into. Have I missed anything?
One, point to keep in mind (for myself) is, I've had times in the past where I've stocked up on several supplements that by their description should have made me superman, but in reality didn't do anything. I want to really do focus treatment, where I can do reliable tests, and supplement only when those are low. Blindly taking supplements is at worst hurtful and often just a waste of money.
I'll research and discuss my thoughts with my functional doctor in April and see what I do. For now, who knows, things may improve anyway as I'm on the optimal dose for longer...
radd Another important thing I should mention is that about 3 years ago I suddenly had a crash and ever since have lost my great appetite I always had. I also don't seem to get the energy I used to get from a meal. I used to always feel happy after one. This especially goes for sugar. I have a terrible sweet tooth, but I used to get such a great feeling from it. Now, after that sudden crash I still love sugar, but it has far less of an effect.
With coffee, I noticed my tolerance decreased over night. I had to start drinking half strength coffee in the morning, even that sometimes would cause jitters and anxiety and to top it off, it didn't bring half the awesome feeling it used to. Before I had a full strength barrister coffee and felt great for an hour or two. I think something similar happened to alcohol tolerance. I didn't need that many drinks before, to get drunk, but after the crash a couple of standard drinks and I'm quite drunk.
I love weight training, and I've noticed my arm vascularity even during intense bicep curls is hardly visible, probably half of what it was. Could it be that my liver is releasing less glycogen into the blood? This may also be supported by the fact that intense interval training runs feel exponentially harder too, since the crash.
Dizziness and perpetual skin itchiness have also started just after the crash.
On top of all this I now feel more plain/blank about everything. Excitement, laughter all down.
All this along with your comments is making me think, what could have happened to the liver carbohydrate (or general) digestion?
My blood liver tests are fine. I've had an abdominal ultrasound for a suspected liver or gall stone and that turned up nothing. The nurse said my liver looks great, better than most patients!
I just wonder if you have any hunches about what tests and treatment I could ask my doctor about given my OP and this additional info.
Just to reiterate, I have been hypo for years, probably since childhood / early teens, detecting it only at 21 years old. Before the crash 3 years ago I seemed to be getting better on T4 and then the crash occurred and I became worse than ever before. Now my thyroid tests are impeccable, all other standard cofactors including adrenals are great too. Yet, I can't seem to get back to even 3 years ago let alone heal completely. It's quite a conundrum...
Caffeine tremors are common & one of the first signs of compromised adrenals.
Not receiving energy from food can be due to insulin resistance. No matter how much sugar you have in your blood stream, it can't be used for energy, and no matter how much T3 you have in your blood stream, it could be hindered into becoming active in the cells. Do you feel hungry after a meal ? Do you feel cold ?
Crashes, anxiety, etc …. all point to adrenal problems and although you advise cortisol levels are fine, a saliva stress test is only useful for evaluations of free cortisol levels, as do not show how cortisol (& other hormones) is used or excreted. If you have MTHFR issues (common in people with hypothyroidism) that result in low detoxification, it could be that levels of cortisol are falsely elevated due to your body’s inability to excrete excess efficiently. Look into the DUTCH test if you wish to investigate adrenal hormone activity further.
If you have adrenal issues, yes the liver can have problems converting glycogen (stored blood sugar) into glucose (active form), so compromising the balanced sugar levels required for good T3 activity. I have found that although my energy levels are now very good, they are strictly limited when exercising hard and if exceeded, I can feel drunk for the rest of the day.
The liver metabolises hormones & filters toxins but MTHFR issues can impair the liver’s detoxification/excretion processes. Glucoronidation is important for converting thyroid hormone & is supported by B vitamins, magnesium, etc …. Sulfation involves binding things partially broken down in the liver with sulfur containing compounds, and is one of the major detoxification pathways for neurotransmitters, toxins, and hormones (like thyroid hormones). After supplementing Milk thistle, etc for a while, I found I could reduce my thyroid meds and am one of the few on the forum who functions best with low to middle in-range thyroid hormones.
If you are still worried about your liver, have you had cholesterol, LDL, triglycerides and liver enzymes tested ? ? ..
If your body isn’t utilising T3 as it should be, it could be counter productive to do weight training, as it is the T3 that increases muscle protein synthesis by increasing the mitochondria's ability to provide energy for the muscles to work and burn calories. By causing fat cells to release free fatty acids into the bloodstream & tissues where they are burned by mitochondria, this makes the ATP that drives muscle contractions. However, this can only happen if T3 is being released from it’s binding proteins & carried inside the cells by receptors on the cell membrane, and there are many factors within adrenal issues that could prevent this from happening.
I previously supplemented GlucoFit by AllergyResearchGroup to help stabilise my blood sugar issues caused by previous poor adrenal function.
Great. Thank you. I'll take a bit of time to process your reply. It looks like it might after all be adrenal problems! False sense of security with good saliva test. Never heard of the DUTCH test. Need to research. What do you think can be done about adrenals, adrenal cortex? I'll look into blood sugar balancing supplements you suggest.
Vit D, vit B12 folate and Ferritin should all be optimal in order to support T4 to T3 conversion. But, since your T3 is at the top of the range poor conversion is unlikely to be your problem
Have you checked your basal temperature...before getting out of bed.?
Low basal temp is associated with RTH.
It is thought that RTH is more common than currently understood/diagnosed. It is a condition not to be confused with thyroid malfunction.
I have RTH and require a large dose of T3-only in order to feel well, this is taken as a single dose which, were the problem other than RTH , would quickly result in symptoms of overmedication.
I found the following e-book very useful -
It is available from Amazon for £3.56 or free if you have Amazon Prime. It is called "Impaired Sensitivity to Thyroid Hormone (Thyroid Hormone Resistance)" by Hugh A Hamilton
I also found the work of the late Dr John Lowe very helpful.
Hi, ak_83. Well done on making so many improvements to your health. Your blocked drain metaphor and interest in your liver have me wondering if you are familiar with Chris Shade (Quicksilver Scientific) and his work on detoxification. If not, you may wish to have a look. Yes, he sells expensive detox protocols, but he also makes available at no cost a lot of good information about supporting detox pathways. His 'push-catch' approach (essentially, improve bile flow to remove toxins from cells, then bind them to be excreted from the body before they can be reabsorbed) calls to mind well-functioning plumbing. The Quicksilver website has a lot of info, if you're interested.
Thank you. Yes, sounds like liver function and/or detox is something I need to attack again. With all else more or less optimal, this should be more successful this time round.
Just interested but not very knowledgeable, have you tested for the DIO 2 gene which inhibits conversion of T4 to T3. I have that faulty gene and find it difficult to convert. Now on 5mgm liothyrione. Not perfect and still on learning curve. Best of luck. You have done so much to help yourself.
No I haven't. However, I take NDT and my FT3 levels are close to the max so I think conversion isn't my issue at this time. Thanks for the thought though!
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Does this look more Euthyroid and less central hypo now?
T3 is to high
Allergic to T3
Devastated by endo appointment, he thinks I have CFS. What next?
Changed from Levothyroxine to Liothyronine. T4 to T3.
