This review is useful in that it does discuss the role of FT3 and the output of the failing thyroid and parameters to determine treatment. It includes our paper showing that a failing-absent thyroid leads to reduced deiodinase activity.
Frontiers in Endocrinology (downloadable)
Restoration of euthyroidism with levothyroxine: implications of etiology of hypothyroidism and the degree of residual endogenous thyroid function
Jacqueline Jonklaas
Review PUBLISHED 22 July 2022 DOI 10.3389/fendo.2022.934003
Written by
diogenes
Remembering
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Thank you for this. At last I feel vindicated when stating that Levothyroxine alone is hopeless for thyroidectomy patients. This needs to be sent to every doctor, every endocrinologist and every patient considering thyroidectomy. As far as I am concerned, thyroidectomy has been the worst decision I have made in my whole life. I suffered for six years without Liothyronine, simply because I did not know it existed. In those days it was a best kept secret. Thank you, Thyroid UK, for all the knowledge you have given me through this wonderful site.
It is criminal. I have an endocrinologist that has no patients on ndt or liothyronine as "all my patients are doing well on t4 only". And a GP who does not feel knowledgeable enough to give me an ndt prescription. But they both are fine with a resting heart rate of 115 and non-functioning days on t4 only. Keeper of the goods. They act like one is trying to get help to source cocaine from a street corner. Not a widely-used alternative to t4 mono-therapy.
I was only on levothyroxine for six months after my thyroidectomy. I could no longer write -- or edit - a sentence without multiple errors & stared at long division last month with a blank lingering look. Just switched to ndt, so levothyroxine is still in my system but suddenly I can write with more ease with minimal errors, and without the need to edit ten times and still not see errors regardless.
I too thank God for here. And thank you for the article. Christmas presents for both my doctors.
The more I read about the complicated life of a thyroid, the more I realize how serious is a thyroidectomy, yet it was suggested to me as though I might might be having a new haircut. I feel such a fool for not asking more questions but those were the days before I used the internet for information and help. I only discovered T3 existed via one of my clients, many years later. She had just had a thyroidectomy and had been given much more information than I in a private clinic in London.
I was already practising listening to my own voice, with b12 deficiency. I did it right away with success. And was blessed, as on this forum, to be enveloped with information and guidance. I thank God for this site. Many times I sigh thinking of all the people suffering, without this kind of support. A lot of them sitting in their doctor's offices knowing little has changed for them, while their doctors go "all good" .
Thank you, Diogenes, for the information and brilliant results shown here. I have complained bitterly on this site about the dearth of studies on patients with no thyroid. At last! Here it all is and I am extremely grateful to you.
'Biomarkers of euthyroidism that could reveal this tissue hypothyroidism have been investigated in animal studies (19, 20), but have not been studied in a rigorous manner in humans and deserve further attention.'
thanks diogenes do you know if NDT contains deiodinase or if there's ever been a trial of supplementing levothyroxine with deiodinase to explore effects on conversion and symptoms. I'm not even sure that's how the body works so im guessing the answer is no.
It wouldn't matter if it did. Stomach acid would destroy its action by breaking up the protein long before it got to the small intestine. That's why expecting that oral takeup of proteins or enzymes would get them into the body is a futile excercise.
Thanks for the info, thought so. I guess I’ll have to wait until someone invents a bio identical thyroid hormone patch or implant to top up my deiodinase.
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