T4 to T3 conversion when you suffer from chronic inflammation (Hashimoto's)?

I just read the following interesting article about thyroid disease:

chriskresser.com/three-reas...

Does this mean that nobody can ever expect to recover on T4 alone if suffering from Hashimoto's disease, as inflammation is said to decrease T4 to T3 conversion...?

[jimh111]

This is a truly dreadful article. The links don't work, the author has not bothered to check them. I managed to fish out a couple of the links, they refer to non-thyroidal illness. NTI occurs during severe illness such as a heart attack or cancer. It's well known that in this situation the HPT axis is down-regulated and there is less T4 to T3 conversion ('low T3 syndrome'). It's not known why this happens, but it's believed to be a defence mechanism, the body slows down to recover.

NTI is completely different to autoimmune hypothyroidism. Indeed, during the early stages of primary hypothyroidism T4 to T3 conversion increases.

I'm not aware of any evidence that inflammation reduces the quantity and 'sensitivity' of thyroid hormone receptors. Receptors are usually desensitised by extremely high levels of hormone. The document that appears to be the one in the broken reference liebertpub.com/doi/abs/10.1... is a review, not a study. It appears to refer to G protein–coupled receptors (whatever they are), not thyroid hormone receptors. This review is behind a paywall so I can't check it.

To find the bottom line go to kresserinstitute.com/adapt-... and search on 'Become a change agent.' For $9,997 you can 'get started'.

I would avoid this website. The claims are not evidenced based, the 'references' even if they worked do not evidence the claims being made.

Best to apply a little common sense. We know many patients with autoimmune hypothyroidism do very well on levothyroxine, many do not. Inflammation is common, people don't become hypothyroid every time they have inflammation.

I would avoid this website,

[Hidden in reply to jimh111]

Very true! This doctor presents himself as some kind of "thyroid guru" and I even considered buying his book...you saved me some money!

[jimh111 in reply to Hidden]

He refers to himself as a 'Functional Medicine practitioner', he is not a doctor.

[MaisieGray in reply to jimh111]

Yes, agree. He's got a general MS degree and a qualification in Acupuncture. That doesn't mean he can't subsequently have developed an expertise or knowledge base in a particular area of course, but he definitely shouldn't be assumed to be a qualified Dr.