Splitting NDT - SHBG and cortisol changes - help!

[Incoguto]

Hi all,

I have started splitting my Armour dose, taking less in the morning and more in the afternoon.

I had a test for ft3 ft4, but also checked cortisol and SHBG.

I was so surprised.

My ft4 is similar to where it was before splitting, my ft3 is a tad higher.

SHBG went up from 62 to 79.9.

Cortisol dropped from 18.4 or 20.4 (range 3.7-19.4) to 11.1!

I am feeling quite tired in the morning and have early evening crashes, but don't have a crazy peak around 2-3 pm when was taking my dose once.

Does anyone know if SHBG could be going up because of becoming more hypo because of splitting or because my dose is levelling out?

Also, why would cortisol go from high or over range to barely midrange on splitting?

My next step was to move more Armour from morning to afternoon for a more even split, but I'm scared of becoming more hypo and more zombie in the morning.

I take 2 grains of Armour in the morning 8:30 am and 0.5 grains at 2:30 pm (along with tiny amounts of thybon morning and PM) .

Afraid of further cortisol crashing.

[jamesal0]

Hi Incoguto Maybe you are over thinking it. Just take enough NDT so you feel good/normal. The rest will look art it's self

[Incoguto in reply to jamesal0]

Hey, I'm not, I'm having issues with taking NDT. I'd love to hear about shbg impact and cortisol. Do you split your dose? How much do you take? Curious of peoples experiences

[radd]

Incoguto,

SHBG carries oestrogen, testosterone and DHT. CBG carries glucocorticoids (cortisol, etc) and progesterone. They have an inverse correlation dictated by thyroid hormone levels (particularly T3).

SHBG levels are influenced by thyroid hormones with an increase with higher levels of thyroid hormone and decreased levels when thyroid hormone levels drop. CBG does the opposite, eg as thyroid hormone levels go up, CBG reduces and as thyroid hormones lowers, CBG will increase.

These are very simplistic explanations as these hormones are also influenced by a whole host of other factors but your results are absolutely text book.

[Incoguto in reply to radd]

Thank you radd as always 🤗🤗Just to reconfirm, as I'm a little brain foggy, splitting the dose made more t3 available, so my shbg went up and cortisol went down (due to decrease of CBG)?

Also, when I took it all as one dose as opposed to two, my shbg was lower and cortisol way higher, does that make sense?

Edit: my temps are now between 36.8 and 37.1 😳 and that's only few days splitting.

[radd in reply to Incoguto]

Incoguto,

Exactly, and because tests regarding thyroid hormones effectiveness can not be tested on a cellular level, some health professionals will use SHBG to assess tissue responsiveness for thyroid hormone.

This could also serve as a liver assessment where a proportion of thyroid hormones are converted. However, it is worth noting that SHBG can also raise with elevated oestrogen, and decrease in response to androgens and blood glucose issues/insulin resistance, so the whole picture must be considered.

How long was this test taken after your split-dose changes? If sooner than 6-8 weeks it’s worth waiting and retesting for a truer picture as hormones rebalance out. You are looking for the right amount of thyroid hormone that allows a balance of both SHBG and CBG.

Your temps look good. Why the shocked emoji?

Here is a short paper confirming what I have said … pubmed.ncbi.nlm.nih.gov/774....

[Incoguto in reply to radd]

Thank you, this is super helpful 🤗My estradiol is low in range, so it won't be increasing SHBG right now.

The test was taken about 10 days after splitting, because I wasn't sure why I was feeling so bad and I'm taking the same dose. I was surprised by SHBG and cortisol.

I stopped sleeping last night and I'm overheating a lot. I feel like I should try a more even split. Right now its 2 gr morning, 0.5 grains afternoon.

Temps look good, but I'm way too hot, my skin feels like it's burning and at night it's difficult to sleep with 37.1 degrees, I think that's too high for me.

Oh and thanks for the paper, I was reading it last night!

I found another paper indicating why some people like me, have high blood cortisol and lowish in range saliva.CBG is increased in hypo so more binding happens. Once hormones are balanced, free cortisol increases and blood decreases.

[radd in reply to Incoguto]

Incoguto,

Yes, and exactly why saliva tests that assess only the 5-10% of ‘free’ should always be viewed in conjunction with a blood test as most circulating cortisol is bound. Both CBG and SHBG are like reservoirs from which hormones can be released. There are also metabolites cortisol to cortisone, etc, which are bi-directional and allow another regulation of delivery to target tissues and inflammatory sites.

I experienced an inner heat when first introducing T3. I agree the changes seen in your results are likely a direct response to your split-dosing that has allowed a reduction in T3’s onset of rapidity and prolonged the actions duration. I also suspect you might be over medicating (which I think I’ve said previously?) Whilst splitting obviously agrees with you, and a more even split likely more beneficial, be aware it could make even more T3 available.

This evidences how small changes can make a big impact because it isn’t just about the thyroid hormone levels but how we dose that influences transport, signal transduction, excretion, and other hormonal states. As you have tested early there will further natural adjustments and your final results could end up a little closer to your pre split-dosing levels.

[Incoguto in reply to radd]

Thanks radd 🤗Things are going downhill since the split. Currently taking 1.75 grains AM and 0.75 PM. Been splitting for about 14 days.

I am at loss. I feel anxiety all day, I still have the 2 pm episodes since yesterday when I moved 1/4 grain from morning to afternoon. My head feels swimmy and and I feel fainty.

I don't have diarrhoea, not losing weight, I'm not overheating, I'm not hungry. But I feel dreadful.

[radd in reply to Incoguto]

Incognuto,

I know you can’t like me keep saying I think you are over-medicated but let me explain.

Initially too much thyroid hormone can give you symptoms of diarrhoea, weight loss, over- heating, hunger, etc but then as other enzymatic changes take place to try reducing these symptoms you might feel a short window of wellness and then things go down hill from there on in.

These changes can happen slowly over many months and a reversal of the enzymic changes can only take place if medication is reduced to a level the person can fully utilise correctly.

However, a common mistake is to add more meds that stokes the fire further that is preventing your meds from working well for you.

The lab ranges aren’t always helpful as people who are unwell have a tendency to think they must stay high in range or even over-range. They may become fixated with numbers instead of getting in tune with any small improvements.

I can explain the science further if you would like or give the appropriate links to Tania Smiths blogs.

[Incoguto in reply to radd]

Thanks radd 🤗 I reduced the dose down to 2.25 grains, my ft3 ft4 barely were in range and I started to get panic attacks and anxiety. I puffed up like a blowfish. My head was spinning badly.

I thought splitting the dose would give me some relief, but it's making me feel more hypo and I can't get out of bed for the past few days and I'm housebound.

My cholesterol is over range. I think with hyper it gets lower? That would be pointing to hypo?

I read Tanias blog about having smaller peaks and how it affects DIOs, but I'm getting no relief from that. In fact, my vision is getting blurry more and more everyday, I can't seem to be able to function at all and anxiety is through the roof and I don't feel like myself at all 😞

I know some people split and it works, some people take it all in one go even though they have peaks in blood, they feel well. Everyone is different.

I just struggle to understand what to do next since I'm deteriorating.

[JumpJiving]

What time of day were your cortisol tests done?

[Incoguto in reply to JumpJiving]

8 am

[jamesal0]

Yes I take 60 when I wake up at 4am for a pee and then 60 just before lunch if I'm not feeling too hyper. I skip lunch 60mg every few days. Don't worry about TSH and all that mumbo jumbo - just take enough NDT to feel normal. Start with 60 and work your way up slowly. If you feel tired take more. I mean be realistic dont stay up for 24 hours and take more to keep going - although you can. NDT is pretty cool - you can cheat with it. I lap swim for daily exercise - as in swim in 50m pool. And if I take 60mg 45 min before swim, it dilates your arteries and you can decimate other swimmers - we are all competing slightly in the pool. And as mentioned if you get that feeling like your battery just went flat while sitting in a restaurant - slam 60mg and you will be the life of the party after.

[radd in reply to jamesal0]

jamesal0,

OMG! You made me laugh 🤣😆. I wish NDT had that effect on me. I just get a slow steady release all day but do have a G&T (lots of ice & lemon slices) if I want to feel in party mode.

Be careful you don’t burn yourself out. Extra thyroid hormones speed up the metabolism but the rest of your body has to keep up too 😊

[jamesal0 in reply to radd]

Yes that's why people loose weight on NDT, you are over clocking the metabolism. I use my temp, tingles in the tongue tip, tingles in the feet, how hyper/hypo am I feeling all to dictate dosage. Also prediction, I'm going to be sailing today, it's cold wet and windy I'll need a 3rd 60mg today at 4pm. Or I'm sitting in a nice warm house watching TV, I'll only need 1x60mg.