Body Identical Substitute

[LJAMB]

Is there a body identical substitute for under active thyroid?

[SlowDragon Administrator]

Welcome to the forum

Presumably you are on levothyroxine and not feeling 100%?

Levothyroxine is identical to thyroid hormones, but there are other factors to consider

Are you on high enough dose

Do you always get same brand levothyroxine

Many people find different brands are not interchangeable

Essential to maintain OPTIMAL Vitamin levels for thyroid hormones to work well

When were vitamin D, folate, ferritin and B12 last tested

Is the cause of your hypothyroidism, autoimmune thyroid disease

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[LJAMB in reply to SlowDragon]

Thank you so much . This is very comprehensive and I didn’t realise much of what you put down. I think mine is autoimmune, only because I have other auto imune problems.

[SlowDragon Administrator in reply to LJAMB]

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Far to often only TSH is tested and is completely inadequate

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[shaws Administrator]

Your photo is lovely and thanks for posting.

I have clicked on your name (which takes me to your 'personal page') but you've given no background of your history to be diagnosed as hypothyroid.

It saves you answering the same query often and also gives members your background if they wish to respond to any query.

There used to be a replacement hormone called 'Natural Dessicated Thyroid Hormones) that contains all of the hormones a healthy gland would do. It suits some people but not everyone.

If levothyroxine (T4) doesn't improve one's symptoms some liothyronine (T3) added to levo may do the trick.

It is trial and error. Thousands do fine on T4 and they wont be searching the internet.

[LJAMB in reply to shaws]

Thank you very much . I will fill in more background.

[RedApple Administrator]

The usual prescribed medicine for underactive thyroid is Levothyroxine (T4). Sometimes Liothyronine (T3) might also be added. Both of these would be classed a 'body identical' because the active ingredients are identical to the hormones produced by a working thyroid gland.

[LJAMB in reply to RedApple]

Thank you for the explanation . I am taking body identical progesterone tablets and oestrogen gel. Hence posing the question.

[rosetrees]

You can consider natural dessicated thyroid (NDT), but that is almost never prescribed, so you would have to buy it yourself. It's usually of either porcine or bovine origin. Levothyroxine (which is what I take) has one active ingredient - T4. Liothyronine has one active ingredient - T3. NDT has the whole range of hormones produced by your thryoid, including T4, T3, T2, T1 and Calcitonin. Best to do your own research.

[RedApple Administrator in reply to rosetrees]

OP asked about 'body identical' thyroid hormone. As NDT is not an approved medicine (in the UK at least), it would probably not be classed as body identical. Might be classed as 'bio identical', which is the term used by unregulated supplement manufacturers.

[rosetrees in reply to RedApple]

Which is why I suggested the OP does their own research. I was just throwing it in as a potential option.

[tattybogle]

A healthy Human thyroid gland makes variable proportions of T4 and T3 (T4 is 4 iodine atoms , T3 is 3 iodine atoms)The replacements available are:

Levothyroxine ( LT4 ):

Liothyronine( LT3 ) tablets:

NDT (Natural Desiccated Thyroid containing T4 and T3 from pigs or occasionally cows )

.. all these forms of T4 and T3 are the same as human thyroid makes .

So in the 'chemical composition' sense they ARE identical . You are still getting 3 or 4 iodine atoms arranged in the same structure., so they still fit into the same receptors in your cells as your own T4/T3 would.

BUT the proportions of T4 /T3 in them are different to what they healthy thyroid produces , and you can't replicate the immense variability of the healthy thyroid glands production of T4/T3 (in response to feedback feed/ forward control from the HPT axis ) .

.....so treatment with them can never be truly ' identical' to human production from a properly working thyroid gland.

eg:

~ NDT contains a higher proportion of (active) T3 to (storage) T4 than a human thyroid produces.

~ Levothyroxine alone gives you no T3 at all, so forces you to rely totally on your own conversion of T4 to T3 within cells.

~ Any form of replacement depends on you taking a fixed dose each day, adjusted by reviewing blood levels and symptoms at intervals ... unlike the natural system of continual daily adjustment in response to immediate feedback.

~ Also the natural production of T4 and T3 from the thyroid, is released in small amounts over the whole day , with a circadian rhythm involved..... which is very different to taking a large dose of T4 all at once, or taking 1 /2 or 3 daily doses of T3.

( NDT might release the T4 and T3 in a slower way than LT4 /LT3 does , but i've forgotten the detail of why this is .. something to do with it being bound by thyroid binding globulins or thyroid hormone transporters ?)

~ Also LT4/LT3 /NDT obviously has to be absorbed into the blood stream via the digestive processes in the gut, which is a further process where difficulties can arise, rather than just putting the hormones straight into the blood stream as the thyroid does.

[LJAMB in reply to tattybogle]

Thank you, very informative , I was unaware of any of this and been taking levathyroxine for many years and putting up with tirednesss and puffy eyes thinking the go must know what they are doing as they keep doing a repeat prescription.

[tattybogle in reply to LJAMB]

ah well, Most GP's 'know what they are doing' in the same way that a kid on a garage forecourt knows that you need some air in your tyres and some petrol in your tank. They have had training in 'putting air in ' and 'putting petrol in' so they are very confident they know what they are doing.

But that doesn't mean the kid on a the forecourt can tell you why your engine is misfiring and won't pull the car uphill.

Most GP's interpretation of how to treat hypothyroidism is like the kid on the forecourt saying " well , the gauge says you've got air in your tyres and petrol in your tank , so according to the gauges your car is fine now ..... if it won't go uphill you must be driving it wrong "

The only difference is that the kid on the forecourt would probably have the humility to admit that they didn't understand how the engine works.

Most GP's are not blessed with this option .. they need to give the impression that they understand 'enough about everything', even when they don't.

They are trained that TSH tells them everything , and if TSH says patient's thyroid hormone level is normal now , then anything else the patient presents with is either:

a) patient not taking levo as instructed , or

b) something else, not thyroid.

They are forecourt attendants , not proper mechanics .

[StitchFairy in reply to tattybogle]

Great analogy! Sadly, the majority of the so called expert mechanics (endos) aren't any better than the 'kid on the forecourt'.

[LJAMB]

Totally agree. They can’t possibly have expert knowledge on everything