I found this article, published in Circulation, The American Heart Association journal, interesting. Contrary to the popular belief that T3 causes heart attacks, the researchers found that those with low T3 were more likely to have a heart attack and die from one. ahajournals.org/doi/full/10...
Cardiac deaths higher in those with low T3 - Thyroid UK
Cardiac deaths higher in those with low T3
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vocalEK
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Dr Broda Barnes said that a long, long time ago.
Low T3 syndrome occurs during heart attacks and lower T3 levels are associated with increased mortality. It’s not know if this mechanism is protective or pathogenic. i.e. does the low T3 help the patient survive or does it increase the risk of death. A double blind clinical trial would reveal the answer but understandably there are major ethical objections.
It would be wrong to deduce this paper shows that a low T3 leads to increased risk of cardiac harm in the general population. There is a link between low T3 and mortality in cardiac patients but nobody knows whether this low T3 is protective or harmful.
I can't remember the reference but I did see a paper which showed that both low and high T3 levels produced alterations in heart structure. So, it’s a reasonable assumption that an fT3 outside it’s reference interval (high or low) damages the heart.
So if threatened with withdrawal of T3, is it reasonable to insist on a cardiac referral ?
On if fT3 is below the lower limit of it's reference interval and levothyroxine does not restore fT3. I'm in favour of prescribing L-T3 but the answer to your specific question is no.
I most definitely agree with you that too much of anything is not beneficial nor conducive for our hearts /anything . Buyer be ware and don't buy into anything unless that's what works well for individuals . From my own experiences . After my TT I was dosed with T4 Sole and had terrible palpitations . I am not a good T4 to T3 converter . Dosing with a low dose NDT for my T3 mix made a Huge difference for me . The heart has T3 receptor sights . I have no doubt there are some and I know greygoose for eg. her *Optimal* is with high doses of T3 . We are all different with different needs to make us *Optimal*. Being mindful and honest with our self's about our thyroid meds and how we feel is the only way to go .
And the usual reaction to something like palpitations when on T4 is for medical personnel to conclude you need to reduce your T4 dose, which makes you even more undermedicated if what you need is T3.
Personally I did need to reduce my T4 a bit to allow me some NDT for my T3 . Being that NDT has some T4 it was really a minute amount . My TSH was so very suppressed already with my T4 dose .
Hi I have a pacemaker for periods of asystole (21s) shown on implantable loop recorder which resulted in the pacemaker the following day. I have recently been diagnosed with hypothyroidism with TPO antibodies, though the TSH was high and the antibodies were positive in 2012, but GP wished to wait and see what happened. I had symptoms of hypothyroidism for many years along with depression and anxiety.
A couple of years ago as I was required to attend an event which was extremely anxiety provoking I was given propranolol. This is often given for anxiety but also is used for hyperthyroidism as it reduces the peripheral conversion of T4 to T3. Rather than take it for the first time on the day I was advised to try it beforehand. Two tablets were taken in total which resulted in a worsening of the cardiac arrhythmia but also my blood pressure became unstable. There was a period of postural hypotension / low bp which was later replaced with hypertension.
The last tablet was taken on the Saturday and the event which I needed to attend was on the Monday. The result was that on the day I lost consciousness, as bp dropping when standing (not just initially on standing) and an ambulance was called and I was taken to hospital. At this point my blood pressure was by now high. The next two days felt like hell, bp over 200 at times, strong anxiety, unable to sleep, and a feeling that a stroke or heart failure was imminent. My ankles swelled up to such an extent that my shoes did not fit.
Previously due to hypothyroid symptoms and long standing depression but having no diagnosis I had purchased some T3 but had not been taking it. At the time it was tucked away at the back of the cupboard gathering dust. Having a history of depression I had been prescribed antidepressants over many years.
Seroxat side effects in my case being vomiting and loss of consciousness on standing, it was stopped as I was unable to walk to the kitchen to make a sandwich or get food. Doxepin another antidepressant resulted in increased blackouts with the occasional head injury. The latter apparently increased the QT period and as my QTc was borderline with a suspicion of long QT in the family. Investigation via loop recorder showed blackouts with asystole.
It was only after I retrieved the T3 from the cupboard 2 days later and I started taking them again that the symptoms settled.
Depression in some cases has been found to respond better if the antidepressant is given with T3. If my experiences are anything to go by it is not the antidepressant having the beneficial effect it is the T3 and it is the low T3 that has a damaging effect on my cardiovascular system and mental health. However rather than prescribing thyroid replacement they prescribed antidepressants alone.
A friend has congenital hypothyroidism and has been referred to cardiology and endocrinology (first time). The endocrinologist considers the symptoms probably a result of sub optimal thyroid replacement and low vitamin D. His symptoms bear a remarkable similarity to my own even down to the periods of asystole during the night and the suggestion that a pacemaker may be required in the future. He has no thyroid and has been on thyroid replacement since a baby which comprises T4 alone. He is reliant on peripheral conversion of T4 to T3.
It would have been far better to insist on a cardiac referral rather than relying on the reference interval which fails to take into account the complexities of individual situations, the symptoms experienced and the potential consequences.
That's interesting. I'm convinced I have thyroid problems and I'm waiting for DNA test results from Blue Horizon.
Did a bit of family research, blood relatives I've never known, women all died from heart attacks --- one at 41. I started to think there could be a connection ( but I know there are a lot of other causes of heart problems)
That’s a really helpful article. Nearly 5x higher mortality rate with low T3 cardiac patients.
Thank you it's interesting I have printed it out to read later on.
Hi interesting read but it must also be taken into account that high T3 can also cause a heart attack - I had to come off NDT because of the T3 component that caused me to be breathless and blood pressure through the roof - sometimes I understand why Doctors don't get involved in depth with thyroid patients because it is SO complicated a science. I don't agree with it but in my case I baffle myself let alone the medical profession.
Hi - just re-read your document and forgot to say that on research I was doing on Sepsis I found interesting articles (which I can't find at the moment when I do I will post) that when the body is in fighting a critical illness the thyroid function decreases to conserve energy for the patient - something I sent to Sepsis UK - if they then give the antibiotic Ciprofloxacin which further depletes T3 - patients would be seriously depleted and it was my opinion that this could be the cause of so many deaths from Sepsis - when I went in with Sepsis twice I made sure I could tell the Drs NO Ciprofloxacin and they listened or I wouldn't be here I was so ill - two hours away apparently from making it the first time. Also on research I found that Vitamin C can stop the cytokine storm that occurs which proves to me that the adrenals are also heavily involved as the highest requirement for Vitamin C in the body are the adrenals - so Scurvy IMO was an adrenal gland disease and so is Type II Diabetes but that is another story.
I have been of the same mindset for a while.. It is certainly of relevance that adrenal support will enhance T3 production as well.
in reply to HLAB35
But without getting a blood test (which I'm sure a GP wouldn't do unless there was strong evidence), how can you know if your adrenals are under strain?
HLAB35 in reply to
You're quite right, they don't tend to offer saliva cortisol as they are only interested in the worst case scenario i.e. Addison's.
V interesting and from my own experience accurate too regarding thyroid function during critical illness.
Other than vitamin C anything else that supports the adrenals ?
Thanks
Certainly salt helps (which goes against popular thinking about low salt diets). Better to have unrefined sea salt that contains more minerals. Also, b5 - has been proven to be beneficial to many going through very stressful periods in their lives. Magnesium in combination with Zinc and B6 (ideally as p-5-p) are also very good.
B-Complex , B-12/folate , Vitamin "D"/K2 , Vitamin "C" , B-5 , Iron if one tests low . Celtic Sea Salt for electrolytes/ Adrenals . Going gluten sugar, soy, coffee ,dairy free . Lots of rest and laughter .
Sorry. I would need to be on my death bed with possibility of recovery to convince me to give up my "Morning Joe". But I certainly can go along with those last two prescriptions. 
I know what you mean . It's really not easy to give up on the morning coffee . I had to stop having my coffee it was very stimulating for me and causing horrific palpitations .
I have coffee once a week now with relaxing weekend breakfast. Having a bigger breakfast on a 'day off' and taking L-theanine with it seems to be ok. It may be worth a try to have L-theanine if you struggle with coffee as long as it is more of a treat than a regular thing. I avoid coffee when I am busy.
L-Theanine is a Great supplement and I use it before my dental appointment . It really helps with keeping calm and stress free . Going to Dentists are not fun .
My last appointment was well timed though, as he managed to do a filling in time rather than a root canal job. However, I do empathise with trepidation beforehand and that is a good tip. I often get weird reactions after dental work - my mouth easily swells up and I take antihistamines to calm things down. It could be the gloves they use as I also don't get on with medical tape (gives me welts).
Isn't going to Dentists a nightmare ? I don't sleep the night before and I tense up just waiting for the dentist to walk into the room. One day I took the L-Theanine and it helped me with calming down . It's a *Winner* in my book now . Jokingly I tell my Dentist to numb me before he even checks my teeth .
There is a nice long list of drugs that interfere with thyroid medications here. You will have to scroll down to get to the list. worstpills.org/public/page....
Uh oh - what do you do if the only 2 antibiotices you are not allergic to are the Cipro family and Keflex family???? I know Keflex is not strong enough for sepsis and pneumnia can lead to sepsis as well as a UTI. I have missed out so far but with my non existent WBC no telling when sepsis is going to hit if I get an infection.
Hi I was on Augmentin and then Trimethroprim (which is a sulphur based antibiotic and has an effect on the thyroid so I did suffer with this one).
I can relate. I am allergic to the cillins, Moxifloxacin, and the mycins, which eliminates most of the doctors' go-to antibiotics. I have done OK on Flagyl, sulfa drugs, and Cipro.
So you were OK on Cipro? Well that makes me feel a little better. Are you just on Levo drug or on a combo? My doc just has my on Levoxyl and says "I am in range". She really does not want to test my FT3 anymore as she says it is like putting one of my hairs on my bathroom scale". She is still testing TT3 which I do not know where that should be to feel best or what that test really is and eventually is just going to test TSH. I had a double dose of RAI that put me in thyroid storm and was in bad shape before and after RAI for a while. Problem was no one diagnosed it until too late to try antithyroid drugs. I have Graves disease (was unknown) and almost had a heart attack - thus RAI. That was 9/17. On 75 mcg Levoxyl 4x/week and 88 mcg 3x/week and freezing ALL THE TIME, unable to sleep more than 4 hours, sometimes less, fatigued, some palps,,very dry skin and hair falling out again. Had felt better for a short time but then got pneumonia and after I recovered just wasn't so good anymore. I was on Ceclor antibiotic which did cure the pneumonia. Thank goodness it was caught early. . Endo says some of my symptoms are hypo and some are hyper so wont do T3 med. However I think she just does not want to because from what I have read you can have palps and sleep issues when you are on the hypo side also. I did go for a 2nd opinion but thar doc was even worse. Thanks for the info. I can't take sulfa either and Flagyl gave me a bd vaginal rash ( (just what I needed - a very itchy bottom). Doc didn't believe it was from Flagyl but it went away when I stopped the Flagyl and since then have seen that s an adverse reaction. How do I convince my doc to try some T3?
The itchy bottom was from Candida. We have it in our bodies all the time, but we also have certain bacteria. Some types of bacteria keep that Candida in check. Antibiotics can kill off nearly ALL the bacteria in your body, which is what allows the Candida to get strong enough to cause you problems. healthline.com/nutrition/ca...
I was on T4 only when I took Cipro, but I take a Turmeric capsule every day to keep a skin condition under control. Since the active ingredient in Turmeric is curcumin (one of the article's suggested solutions for a Candida outbreak), it could be that the Turmeric allowed me to take Cipro without a problem and to take the Flagyl I am currently on for an oral infection that refused to clear up under doxycycline. I recently had T3 added to my Levo.
Actually i was tested for yeast infection and it was negative plus no yeast symptoms (discharge, etc) and the doc was amazed that the rash spilled over on to my skin and thighs. The allergist said it was definitely a drug reaction . Idid see that it is listed as an adverse reaction but only a few cases so of course I would be one of them. However if I absolutely needed to take it again I think I would as it was uncomfortable and miserable but as i see it, not life threatening.
I am not sure which is the cause or the effect but I read that patients who survived traumatic operations tended to survive if they had high T3 whereas those who died had low T3. Maybe Low T3 was causing the heart to be failing in the first place - then the operation finished them off. Don't know, but I'm into high T3 just to have normality, if it also saves me from a terrible health trauma, well, all the better.
It would be very interesting to know if manually adding high doses T3 that works so well ? Or can dosing with low dose T3 with higher dose T4 that becomes a deiodinase enzyme that converts more T4 to T3 work just as well too ?
Not sure, but one of the factors which is not spoken of as much as others is that you need the catalyst for that T4 to T3 reaction and that is selenium. It is essential to have selenium present, in fact they are called selenoenzymes. And, of course, you also need the more well known factors, Vitamins D and B12 and minerals Ferritin and Folate at optimal levels to help the whole system to work efficiently (in some people, at all!).
Your right and I agree with you . All the vital nutrients are Always Spoken about on this Thyroid Community . SeasideSusie talks all the time about nutrients as does SlowDragon and many others . Nutrients are extremely vital with our thyroid meds . Selenium is a bit tricky personally for me . I don't do well with it and therefor had to stop supplementing with Selenium . I'm sure many others that do well with Selenium are supplementing with it .
Just eat Brazil nuts, I eat two per day. I don't want to start a discussion on the different levels of Se in any given source of nuts, all I can tell you is that 2 nuts per day works for me and I don't think I am particularly lucky with all of my nut picks. I find it better to get your metals from food sources, it makes it easier to not overdose. With one caveat, it's hard to get your supplemental iron from food only if you are deficient - I take that via a pill.
ps, it's nice to converse with someone in the US! Usually by the time I wake up and see an interesting topic it's all been thrashed out with brilliant answers before I get a look in and everyone has moved on. There is rarely a topic I can add to. Anyway, I'm off to close up the chickens, feed the cats and then I'm going to bed, not because it is bed time but because it is very cold and bed with my electric blanket is much more economical that heating this big house, so Good Night.
Great to meet You my fellow American . It's Great to be in touch with the World . There are many from USA France and more . We are all navigating our thyroid journeys together . It's great to know where not *Alone* .
btw, since you are in the US, I buy my Brazil nuts from nuts.com they cost about $10 (it varies). I had my selenium levels measured once and they are in the upper half of the scale so I guess it is a good source.
I am also in the US. Northern VA.
Hi vocalEK! I'm in California where we have had rain, rain and more rain which may have brought our terrible drought to an end - I don't know whether to laugh or cry. Anyway, welcome to HealthUnlocked.
I had heart failure on t4 only.
Ejection fraction of 38%.
Recovered on t3 only.
Keep saying that to everyone who will listen - and shout louder to those who won't.
I think you will find that is one of the research pieces in a book I often quote here - The Thyroid and Heart Failure. Available on Amazon at great expense but you can Look Inside - reading the bits you can - you will see Liithyronine/T3 is the star of the show !
The book is all research papers brought together by an Endocrinologist and a Cardiologist for the very first time.
I did bite the bullet and buy it 😊
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