Do I really need supplementation?

[Martina]

I recently had a blood test which showed TSH 2.84 µU/mL

T3 3.20 pg/mL and T4 0.96

My therapist recommended 1/4 grain of natural desiccated thyroid, but I wonder if I really need it

I'm afraid it might cause toxicity or hyperthyroidism and I wonder if, once I start taking this kind of supplement, I'll have to take it for my entire life

Advice would be gretly appreciated

Thank you

[helvella Administrator]

Just wondering where you are? The usual UK ranges for free T3 are expressed in nmol per l and for free T4 in pmol per l.

And it would be very unusual for someone to be offered desiccated thyroid at all.

Have you got the reference ranges for the laboratory which performed these tests?

Rod

[Martina in reply to helvella]

I live in Belgium

The laboratory reference ranges are the following

TSH 2.84 µU/mL 0.3 -4.5

free T3 3.20 pg/mL 2.1 - 4.2

free T4 0.96 ng/dL 0.7 - 1.8

I had a blood test as well as a 24 hour urine test Iodine was low, so the therapist put me on Pure encapsulations Iodine and Tyrosine I have started taking this supplement

He also prescribed Natural Thyroid, 1/4 of a grain which I should order from a compounding pharmacy in Germany I suppose it's dessicated thyroid

I haven't ordered it yet because I'm not sure I need it

Thanks for your help

[helvella Administrator in reply to helvella]

Not clear why you need to use a compounding pharmacy. Quarter grain desiccated thyroid is available from, for example, RLC as Nature-Throid. As you do actually have a prescription, you can order from the US (thought I have no idea if Belgium has any rules that prohibit this). I'd certainly trust RLC more than a compoundign pharmacy as regards accuracy and consistency.

Not sure I would wish to take both added iodine/tyrosine AND desiccated thyroid. (I am always unsure about the addition of iodine, and most especially when the need for that iodine is reduced by taking the thyroid hormones directly. Others may well disagree with me here.)

What you have not done so far is explain why you went to see a therapist. What symptoms do you have?

Rod

[Martina in reply to helvella]

I also read that it's not advisable to take iodine in conjunction with desiccated thyroid.

I went to see a therapist because of a long-time fatigue.

I must say that I do feel better simply taking iodine (225mg) and L-tyrosine (500mg). Iodine was very low being at 28 µg/L, lab range 100-199

I'm afraid part of the fatigue comes from the adrenals. My therapist dismissed this possibility saying that he measured DHEA sulphate, which, according to him, is fine

Blood results 128 µg/dL, the lab range being 35-210

However, I read that a saliva test is more accurate to determine the adrenals' condition

In his book, Dr Peatfield says that it's important to support the adrenals before starting thyroid hormones

The therapist's prescription for Natural thyroid (to be ordered from the Receptura compounding pharmacy in Frankfurt) is for capsules containing natural thyroid extracts giving 9.5 mcg levothyroxine (T4) and 2.25 mcg liothyronine (T3) corresponding to one fourth grain

I confess I am very ignorant about thyroid problems, and I don't want to tamper with my hormones, I wouldn't like to interfere with them and damage my hormonal balance for good

This therapist seems to be focussed on the thyroid for every patient he sees

As I said, maybe it's the adrenals which in my case also need support

Thank you for your advice

[helvella Administrator in reply to helvella]

Martina,

You sound very sensible in trying to check things out first.

The whole subject of iodine seems to me to be controversial. Clearly lack of iodine can result in low thyroid hormone levels. You also find iodine being used to treat Graves disease.

Maybe if you are genuinely low on iodine it would be best to see the results of your iodine supplementation before starting thyroid hormone (of whichever sort)?

And have another thyroid test in a few weeks. I'd suggest having the blood draw as early as practicable in the morning.

Rod

[Martina in reply to helvella]

Yes, Rod, I agree with you

I'll have another thyroid test in a few weeks to check hormone levels

Maybe iodine supplementation was enough for me, otherwise I'll take other measures

I don't think it is wise just to dish out thyroid hormones without having first tried other paths, and in my case, sorry if I repeat myself, but I think my adrenals need support

Thank you for your help

Martina

[lm713]

The following indicate that the thyroid returns to its previous state even following doses that suppress TSH, which would be doses much higher than 1/4 grain.

ncbi.nlm.nih.gov/pubmed/808728

ncbi.nlm.nih.gov/pubmed/807596

It is generally believed that low doses of thyroid hormones will not cause harm to the thyroid.

1/4 grain is a tiny dose.

[Muffy in reply to lm713]

I would have thought that a 1/4 of a grain would just lessen your own production of thryoid thus putting you back to square one, unless of course your dose is increased.

Did you actually go to your doctor with symptoms of hypothyroidism? It makes me wonder as you said you weren't sure you needed it.

Too much thyroid hormone can cause toxicity, but not hyperthyroidism .

[helvella Administrator in reply to lm713]

Muffy,

Indeed any supplementation of thyroid hormone will tend to reduce your own thyroid hormone production. But if the supplementation was always precisely balanced by reduced production, no-one would be on less than full replacement dose. And many of us are!

If the therapist is intending to increment desiccated thyroid dosage as required, then starting at a very low dose seems sensible to me. Much better than starting off too high.

Rod

[Muffy in reply to lm713]

It only applies on low doses of supplemtation, after that the medication kicks in.

[helvella Administrator in reply to lm713]

Muffy,

What do you mean by 'low doses'? Would that be, say, 25mcg thyroxine? Or half a grain of desiccated thyroid? Or less?

And in what way do you mean 'the medication kicks in'?

Rod

[katey]

Hi Martina, I think that it depends how you are coping with your symptoms. If you are struggling then I think your therapist is quite inspired in his/her suggestions. BUt if you are nervous about the dessicated thyroid you could always try a thyroid glandular available from nutri. That contains all 4 thyroid hormones and I have found it to be really effective, and a less drastic step than the natural dessicated thryroid. You also dont need a prescription which makes the availablity much easier. Good luck. katey

[helvella Administrator in reply to katey]

Katey,

I have heard about these products many times. And each time I look them up they say that they do not contain hormones! For example:

Nutri Thyroid 180 Tablets

Hormone-Free Thyroid Concentrate. Thyroid hormones regulate metabolic rate, body temperature and cellular repair. Nutri Thyroid provides hormone-free thyroid concentrate, to nutritionally support this regulatory gland.

nutri-online1.co.uk/Patient...

If they do actually contain hormones, why do you say that they are a less drastic step than desiccated thyroid? And if they do not, well, that goes against what you say about them containing all four thyroid hormones.

Something just doesn't seem to add up.

Rod