New hypo dude.

[Frowman]

I was recently diagnosed as hypo. Tsh was 87! 9 days in at 125 mcg levo. ( t4 was .44 which was out of range - .8 and t3 was 2.3 and the range on the low end was 2.0.) I'm 5 9 180 probably 11 percent body fat. Yes, I feel some symptoms, but they seem subjective. The reason I was tested was because of a muscle cramp/ spasm in my left calf would not go away. It stopped me from surfing, as the cold and pointing of my toes as I paddled into a wave caused full calf lock. I do feel my strength is not where it should be for musculature. Does t3 increase atp regulation? My job depends on my physical fitness I'm a wildland fire fighter in California. Thankyou. I have alot of questions...

[Frowman]

I'm curious if this really could solve my calf cramping issue its decreased my athletism significantly. I've heard that t3 , t4 helps with atp and slow fast twitch muscle's contractions. My doctor thinks so.

[tattybogle]

Hi Frowman... "9 days in at 125 mcg levo. ( t4 was .44 which was out of range - .8 and t3 was 2.3 and the range on the low end was 2.0.) "

Does this mean you tested bloods after 9 day on Levo ? ..... (if so, the results don't tell you anything useful ~ it's not enough time for the blood levels to respond to the dose.. and it's also too soon to feel the effect of that dose levo ... therefore also too soon to consider adding any T3)

You cant really rush the process of replacing/ rebalancing thyroid hormones too much , 'tortoise and hare' ...and all that. Give the 125mcg dose 6 weeks , and then see where you are once it's had time to settle in , and your body has had time to re-adjust how much T3 it can convert from the levo .TSH has quite a long delay in reacting to a change in thyroid hormone levels , (hence the 6 weeks wait for a blood test), but TSH also affects you conversion from T4 to T3.... until its settled you won't know if you need any 'extra' T3.

Increasing Levo dose or adding T3 without allowing the first dose to settle in properly can really easily lead to overmedication creeping up on you , as you 'miss the sweet spot' by going up too fast ... overmedication can be tricky to identify, symptoms are not always as obvious as you'd think ...but you don't want to go there .. identifying it and then fixing it again just makes the whole process of finding the right dose take longer ... you may do fine of Levo , or you may need some T3 added , but if you try adding it before you know what dose of levo to use , you can get lost in the woods really easily .

[tattybogle in reply to tattybogle]

i meant ..... TSH has 'an effect' on Conversion, it doesn't 'inhibit' it.... here is the long version ....lol

It's like a 'boost' function........ when hypothalamus & pituitary detect your thyroid hormone levels are too low for you , they increase the TSH signal to thyroid (Thyroid Stimulating Hormone).

The Thyroid gland then increases its levels of both T4 and T3 production (well, it tries to.... yours obviously couldn't manage to increase them enough because it's damaged, hence your TSH having to 'yell so loud' )

1) ..... The clever part is that when TSH increases from 'your normal' ( usually around 1-2 ish ) ...this also stimulates the thyroid to increase the proportion of 'ready made' T3 it makes

(T3 is active straight away, T4 is more of a storage /transport form, like a reservoir ~to enable delivery of T3 to cells to remain constant ~ T4 can be converted to T3 by cells as needed, as different organs , heart , muscles ,brain . skin, digestive system etc need T3 at different rates )

2) ...... The other clever part of this 'boost' function is that the de -iodinases (they convert T4 to T3 / T3 to T2 etc) will make conversion of T4 into T3 in the cells more efficient when TSH is higher than it's usual level .

The efficiency of different de-iodinases is also effected by T4 / T3 levels, speeding up or slowing down conversion to T3 ,or inactivation to rT3 ,or recycling to T2 as needed depending on T4 /T3 levels .

So because of this complexity in the regulating system , as the TSH / fT4 / fT3 levels change over a few weeks (eg. in response to taking some extra T4 from Levo).. the efficiency of conversion from T4 to T3 also changes .... and until the TSH is back to something like it's 'usual' , you can't tell how well you will be converting T4 to T3 when the system has rebalanced itself and is settled .

Your fT4 levels will show the effect of adding the extra levo within about 2 weeks, but then as the TSH level changes . ( it's slower to respond) that new TSH level will then change the fT4 and also the fT3 levels you get as a result of that dose .

Be prepared for some 'up's and down's' in how well you function for the next several months while you find the right dose and your cells start to get better levels of thyroid hormone again.

It is very common to feel an improvement for a few weeks/ months when starting Levo , but then feel feel less good again. This usually means the dose needs increasing, (or lowering if it's too much) .... this may not happen to you so much, since you've been started on a reasonably high dose straight away, but be prepared.

This 'wearing off' effect is probably because once the TSH lowers due to sensing the increased T4 from levo, the thyroid which was being shouted at to "try harder!" by the high TSH then takes it's foot off the gas..... so you get a bit less of your own T4 and T3 production , and a bit less efficient conversion.

(Very) over-simplified example:

Lets say you need '20' T4 to function;

'10' (T4 from struggling thyroid with a high TSH) + '10' (T4 from Levo) = '20' .... for a short while .

TSH then lowers ...thyroid then takes a rest, giving:

'3' (T4 from thyroid with a low TSH) + '10' (T4 from levo) = '13'.

Levo dose then needs increasing to '17'

...... Repeat until correct balance is found ,... hopefully all cells are then happy , everything works well enough , and dose required stays stable for many years... until 'something changes'.

If the reason for your hypothyroidism was autoimmune damage, then the timing of 'something changing' may be unpredictable . As the immune system attacks , more thyroid tissue is damaged, so less T4/T3 can be produced (but yours looked pretty F****d already , with TSH so high and fT4 below range)

(Autoimmune disease is the most common reason for hypothyroidism ~Hashimoto's Disease if you got a goitre/ Ord's Disease if you didn't )

[greygoose]

Did your doctor suggest you try taking magnesium for your cramp?

When we are hypo, our stomachs don't secret as much acid as they should, so digesting food and absorbing nutrients becomes difficult.

I would suggest you try taking magnesium, and at the same time, get our basic nutrients tested: vit D, vit B12, folate and ferritin. No point in testing magnesium, it's not accurate, but it's water-soluble, so any excess will be excreted.

[Frowman in reply to greygoose]

Thankyou both for your replies, I did not know tsh will inhibit conversion of t4 too t3. That is really go to know. I hope I convert well. I do take magnesium supplements but I don't even need them because my diet is very rich with magnesium. I also had blood test done. Raw Cacoa, almond butter, beets, greens, avocado, I eat alot of really healthy food.

[Frowman in reply to Frowman]

I've even gone up to a gram of magnesium a day. I've tried different types as well.

[greygoose in reply to Frowman]

When you're hypo, as I explained, it doesn't matter how good your diet is because you cannot absorb the nutrients well. And, as I said, no point in testing magnesium, because it will not give you accurate results.

tattybogle won't see this reply, because you didn't click on the blue 'Reply' button under her comments. But, I'm pretty sure she didn't say that TSH 'inhibits' conversion of T4 to T3. She said: TSH also affects you conversion from T4 to T3. What she meant was that TSH stimulates conversion of T4 to T3 - i.e. you need TSH to convert well.

[Frowman]

I'm going take more magnesium again it can't hurt.

[SlowDragon Administrator in reply to Frowman]

Magnesium supplements need to be minimum four hours away from levothyroxine

Important to test vitamin D, folate, ferritin and B12 too

[jrbarnes]

Optimal levels for FT3 are 3.8-4.4 and FT4 1.4-1.77. If your levels are like that you shouldn't have any issues with physical work. Kenneth Blanchard's 'Functional Approach to Hypothyroidism' has some interesting points on thyroid treatment as well as T3 usage. You might want to google physical activity/muscle building/workout with hypothyroidism sites for advice on athletics. I haven't seen a lot of posters that focus on that kind of stuff or are familiar with atp slow fast twitch. Check out the link below regarding optimal levels and other blogs on hypo. Also, the absorption of Levothyroxine in pill form is 80% so you may need more or maybe you need less. I haven't had calf cramps since increasing my thyroid hormone as well as B12/folate. I also drink a few glasses of whole milk with cocoa powder for extra magnesium and minerals.

restartmed.com/normal-thyro...

[Frowman in reply to jrbarnes]

My t3 was 2.3 and t4 .44 so I'm definitely low. Tsh was crazy hi. 87