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  #1   ^
Old Mon, Oct-19-09, 02:09
Becs101's Avatar
Becs101 Becs101 is offline
Senior Member
Posts: 130
 
Plan: Atkins
Stats: 149/149/126 Female 5'4
BF:
Progress: 0%
Location: Midlands, England
Default Going to self prescribe - advice needed! :0)

Hi guys,

I have been suffering with the symptoms of an underactive thyroid for years and years. I did get to see a private doc a year ago where he prescribed Levothyroxine but then my GP told me not to take it as he would not continue to prescribe it. But after another year of problems I am going to take action.

I eat now about 800 cals a day or less and work out (heavy CV) Spinning, 5-6 times a week. Yet no weight loss, hair thinning still, hands freezing cold and feet all the time, and severe digestion problems. I can't take any more.

I have decided to buy Synthroid online. I am a bit worried about causing myself some harm but wanted to know what you think? I am going to start off taking the Levothyroxine that the private docs prescribed for me, and just start with a low dose and take it from there? What do you think?

Any advice would be great.

I am coming to my end with all of this and just don't know what else to do. My finance and friends cannot believe how little I eat....but I am still 5ft 3 and 10 and a half stone.....over my recommended BMI for my height...despite everything I do.


I have added test results for you from my last pricate test - what do you think?
TSH : 2.66 REFERENCE RANGE 0-4-4.0 (HIGH)
FREE T3: 2.60 REFERENCE RAGE 2.86.5 (LOW)
FREE T4 / FREE T3 RATIO: 6.58 REFERENCE RANGE 3.0-5.0 (LOW)
FREE T4: 17.1 REFERENCE RANGE 10-22 (NORMAL)

Bec
x

Last edited by Becs101 : Mon, Oct-19-09 at 05:23. Reason: have added test results
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  #2   ^
Old Mon, Oct-19-09, 07:12
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,886
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

Exercising as much as you do might further slow down the thyroid. You're basically in starvation mode from the low calories and making it worse with the exercise. I think it's particularly bad for people with low or marginal thyroids.

Anyway, whatever changes you make to your hormones, do it VERY slowly or you're going to suffer a few weeks later if you overshoot the dose. Give it a good 4 weeks to take effect.
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  #3   ^
Old Thu, Oct-22-09, 06:58
Becs101's Avatar
Becs101 Becs101 is offline
Senior Member
Posts: 130
 
Plan: Atkins
Stats: 149/149/126 Female 5'4
BF:
Progress: 0%
Location: Midlands, England
Default

Hi Nancy thanks for your reply...

I was thinking of starting with just 25mg as thats the lowest does and just seeing how I get on with that for the next few weeks. What do you think?

The private doc before was starting me off on 50mg and then 75 and then finally 100mg.....so think I should be safe taking the lower dose.

I was also going to get blood tests done after a month to check what was happening and monitor it myself like that through private blood tests...
x
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  #4   ^
Old Thu, Oct-22-09, 10:36
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 25,886
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

Yeah, that sounds wise.
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  #5   ^
Old Thu, Oct-22-09, 22:46
awriter's Avatar
awriter awriter is offline
Registered Member
Posts: 1,096
 
Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Default This is not a happy road you're on

Quote:
Originally Posted by Becs101
I eat now about 800 cals a day or less and work out (heavy CV) Spinning, 5-6 times a week. Yet no weight loss, hair thinning still, hands freezing cold and feet all the time, and severe digestion problems. I can't take any more.

Well, I hate to be the bearer of bad news, but as long as you continue the two activities that is causing the problem -- starvation level calories combined with over-exercise -- you will continue giving yourself the problem. So I guess you will have to continue to "take it."

Quote:
I have decided to buy Synthroid online. I am a bit worried about causing myself some harm

You won't do yourself some harm. You will do yourself a lot of harm.

Quote:
I have added test results
TSH : 2.66 REFERENCE RANGE 0-4-4.0 (HIGH)
FREE T3: 2.60 REFERENCE RAGE 2.86.5 (LOW)
FREE T4 / FREE T3 RATIO: 6.58 REFERENCE RANGE 3.0-5.0 (LOW)
FREE T4: 17.1 REFERENCE RANGE 10-22 (NORMAL)

Well, let's see. Your TSH is high. Your Free T3 is low. Your Free T4 is actually high -- and the one test you really need is missing: rT3.

It's an especially important test for you because it looks like (not surprisingly, given your history of under-eating and over-exercising) a classic case of a Reverse T3 problem.

When you stress your thyroid by not eating enough calories, or really pile it on by not eating enough AND exercising too much -- your T4 begins to build up, and instead of converting to the metabolically active T3 (the thyroid hormone that does all the work, unlike T4), it converts to Reverse T3 -- a metabolic black hole that does nothing whatever to support the thyroid. What will make this really bad situation even worse? Why, taking synthroid -- which is pure T4.

Basicaly, Bec -- you've trashed your metabolism. It can be healed, but it's now going to take you a long time and it will mean making major changes to your life. Real food, lots of it. No more exercise for some time - months. And then, about once a week. And of course, you need to get your rT3 tested and do the ratio between it and Free T3. That ratio (T3/rT3) should be over 20. I suspect yours will be closer to 7. If so, you will need to make the changes listed above, and take pure T3, which is cytomel -- until your deep well of rT3 empties -- about 12 weeks.

Quote:
Any advice would be great.

Taking you at your word, here's some good advice: stop causing your thyroid to fail. Stop exercising. Start eating. A lot. Get the medical tests you need. And don't rely only on medicine to turn this around, because real behavioral change will also be required. I know I sound harsh here, but while I'm sure that people in your life who care about you have spoken out about what you're doing to yourself, I'm not sure you heard them. So since you asked for advice, I'm giving it honestly -- and harshly enough to hope you can hear this. I wish you luck and hope you can turn this around.

What you can't do without more serious harm -- is take any more synthroid.

Lisa
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  #6   ^
Old Fri, Oct-23-09, 05:55
Becs101's Avatar
Becs101 Becs101 is offline
Senior Member
Posts: 130
 
Plan: Atkins
Stats: 149/149/126 Female 5'4
BF:
Progress: 0%
Location: Midlands, England
Default Thank you Lisa

Lisa,

Firstly, 'thank you' for your reply.

Its very strange but just seeing what I was doing to myself in your words made me finally realise....I haven't started out to be like this but I think the fear of gaining weight has done it for me, and I have got worse and worse over time.

I have stopped taking the Synthoid and I am going to start eating, and eating well and I am going to get the tests done you have suggested. No one has suggested this before and I am eager to get it done ASAP.

Can I ask if you would still suggest LC given what I have been doing?

Thank you again for you advise....I needed to hear what you said.

Becs
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  #7   ^
Old Fri, Oct-23-09, 09:26
awriter's Avatar
awriter awriter is offline
Registered Member
Posts: 1,096
 
Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Default

Quote:
Originally Posted by Becs101
Its very strange but just seeing what I was doing to myself in your words made me finally realise....I haven't started out to be like this but I think the fear of gaining weight has done it for me, and I have got worse and worse over time.

Becs, I'm so glad you were able to see this. It's understandable that when we want something very badly we will do almost anything to get it, but sometimes the 'it' takes over our lives without our even realizing it. Now that you've seen and admitted it openly, you can change it. You have that power.

Quote:
I have stopped taking the Synthoid

Terrific. And now you understand why your doctor said he would no longer prescribe it. He could have done a much better job of explaining it to you!

Quote:
I am going to start eating, and eating well and I am going to get the tests done you have suggested. No one has suggested this before and I am eager to get it done ASAP.

Please post the results here when you get them, and make sure you give the range (as you did before) as well as the score. Along with rT3 problems stemming from v. LC and v. low calories, it can also stem from or be exacerbated by low ferritin and/or low or high cortisol.

The ferritin is tested by blood, but the cortisol needs to be done via saliva. I'd be stunned if, given the stress starvation puts on the body, you didn't also have either or both of these problems -- which MUST be fixed before T3 (Cytomel) supplementation can begin. If not, you won't be able to tolerate the Cytomel. The cortisol issue is especially important, because if not addressed can completely burn out your adrenals. If your regular blood bank test doesn't have a DHEA report on it, add that to the list.

To understand this a bit better, go to:
http://www.chronicfatigue.org/ASI%20Normal.html

At the bottom of each page you can click through from stages 1 to 7 -- there may be information there that rings a bell with you.

More 'food' for thought: From The Type 2 Diabetes Diet Book page 54:

"Thyroid function is sensitive to dietary influences. During starvation a
significant reduction in circulating T3 is always observed. The SAME OCCURS in
subjects on a carbohydrate-restricted diet, as a result of decreased reduction
of T4 to T3. Normal serum levels of TSH and T4 indicate that these subjects are
not hypothyroid in the usually accepted sense of the term."

Quote:
Can I ask if you would still suggest LC given what I have been doing?

As long as it's very high in fat (mostly animal/dairy - saturated fat), with a decent amount of animal protein, especially organ meats (I suspect your ferritin test will probably show you low in iron if not anemic) -- and with enough carbs to keep you out of ketosis. That would probably be about 50 - 70 carbs a day, a small portion of which should be from glucose foods like potato or rice.

This small amount of glucose will allow your glycogen tank to remain filled, and allow all the protein you eat to be used for rebuilding your muscle and tissue, which are all sacrificed by the body on starvation calories. It saves the fat for last, so eating a lot of it (and I mean a LOT -- about 125 - 150g a day, which alone is a minimum of 1125 calories, and 1350 if it's the 150g) will allow your body to release some fat while building back all the muscle and other tissue you've lost.

This is going to take time, lots of it, maybe a year. You will gain weight at first (an easy 5 - 10 pounds of water because of the 4 H2O molecules attached to each carb), plus muscle and tissue weight. But once you begin to truly heal, and deal with your metabolism issues, you're going to see a leaner, far healthier body.

If the idea of gaining some healthy weight and/or waiting a year to see results seems frightening to you or impossible to do, please seek some counseling to deal with the underlying emotional issues that brought you here. There's nothing wrong in needing help or hand-holding to get you through an emotionally and/or physically difficult time. That's the epitome of strength, not weakness.

If you have any questions for me that you might prefer to be private, please PM me and I'll be happy to help or give support in any way I can.

I'm so glad you heard me.

Lisa
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  #8   ^
Old Fri, Oct-23-09, 17:06
Valtor's Avatar
Valtor Valtor is offline
Senior Member
Posts: 2,036
 
Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
BF:
Progress: 58%
Location: Québec, Canada
Default

Quote:
Originally Posted by Becs101
...I eat now about 800 cals a day or less...

That is way too low!!!

You should really read this post: http://forum.lowcarber.org/showthread.php?t=402898
Quote:
Starvation has a profound effect on thyroid function, causing a decrease in serum T3 concentration and a reciprocal increase in rT3 level.

You are worsening your metabolic problems with such a calorie deficit. And once your Reversed T3 (rT3) is too high you will have to take T3 only drugs (Cytomel) to fix this and MDs really don't like to prescribe the T3 only.

EDIT: Wow Lisa, I posted before reading your posts. I guess my advice is just a confirmation of everything you said.

Patrick
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  #9   ^
Old Fri, Oct-23-09, 18:15
awriter's Avatar
awriter awriter is offline
Registered Member
Posts: 1,096
 
Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Default

Quote:
Originally Posted by Valtor
once your Reversed T3 (rT3) is too high you will have to take T3 only drugs (Cytomel) to fix this and MDs really don't like to prescribe the T3 only.

Thank god for Mexico.

Quote:
EDIT: Wow Lisa, I posted before reading your posts. I guess my advice is just a confirmation of everything you said.

Patrick,

Here's an even bigger confirmation: http://thyroid.about.com/od/losewei...t-loss-diet.htm

All 4 pages are a fabulous read, and validates everything I've said on this forum in post after post -- warning about lowering calories and exercising to 'lose weight' -- but take a gander at page 2, wherein Dr. Holtorf writes (among other things):

Quote:
Kent Holtorf, MD: T4 can be either converted to T3, the active hormone that has a metabolic effect, or to reverse T3, which is the inactive form of T3, and actually blocks the effects of T3. Doctors -- including endocrinologists -- are taught that reverse T3 is just an inactive metabolite, but studies show that it has potent antithyroid effects. In fact, is has been shown to be a more potent inhibitor of thyroid effect than PTU, a medication used for hyperthyroidism. Reverse T3 inversely correlates with intracellular T3 levels, so it is also a marker for tissue hypothyroidism, with higher levels (or lower Free T3/RT3 ratio) indicating a more significant deficiency.

Mary Shomon:
Why do you feel reverse T3 plays a role in making it difficult for some thyroid patients to lose weight?

Kent Holtorf, MD: The reverse T3 is produced in times of stress or starvation to reduce metabolism, and with chronic stress or dieting, RT3 can remain elevated, suppressing tissue thyroid activity and metabolism. People on chronic diets -- or those who lose significant amounts of weight -- will have a lower metabolism than a person with the same weight and muscle mass who had not had not lost significant weight or drastically dieted in the past. This was demonstrated in a study by Leibel published in the journal Metabolism, titled “Diminished Energy Requirements in Reduced-Obese Patients.” This study compared the basal metabolic rate in individuals who had lost significant weight to those of the same weight who had not lost significant weight in the past. The authors found that those who had dieted and lost weight in the past had, on average, a 25% lower metabolism than the control patients who had not lost significant weight.

All those trainers and health gurus that never had a weight problem who tell you to do just as they do don’t realize what a disadvantage it is for people who have had a long-term weight problem. Of course, even these trainers would not even be able to maintain their weight with a metabolism that is 20 to 40% below normal.

We test the resting metabolic rate in our thyroid patients and find it inversely correlates with the reverse T3. The higher the reverse T3, the lower the metabolism, with many such individuals having a metabolism that is 20 to 40% lower than expected for their body mass index (BMI). Nobody believes how little they eat, and they are made to feel like failures -- despite doing everything right. Until their metabolic abnormalities are addressed, diet and exercise will certainly fail to achieve long-term success.

Should I apply for my medical degree now?

Lisa
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  #10   ^
Old Fri, Oct-23-09, 18:20
Valtor's Avatar
Valtor Valtor is offline
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Posts: 2,036
 
Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
BF:
Progress: 58%
Location: Québec, Canada
Default

Well Lisa, we are reading the same material. Did you get it from http://health.groups.yahoo.com/group/RT3_T3/ ?

I've quoted this article a lot in these two threads.

http://forum.lowcarber.org/showthread.php?t=402898
http://forum.lowcarber.org/showthread.php?t=402956

Patrick
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  #11   ^
Old Wed, Jan-06-10, 06:17
Becs101's Avatar
Becs101 Becs101 is offline
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Posts: 130
 
Plan: Atkins
Stats: 149/149/126 Female 5'4
BF:
Progress: 0%
Location: Midlands, England
Default Update

Hi guys,

I had my reverse T3 done and that came back as normal....so have no idea where to go from there. Have increased calories and put on weight....also only working out once a week now...

Any advice???
x
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  #12   ^
Old Sun, Jan-10-10, 00:29
aeroangie's Avatar
aeroangie aeroangie is offline
Senior Member
Posts: 1,087
 
Plan: Dr. Eric Westman's/Atkins
Stats: 150/148/132 Female 5'-4"
BF:
Progress: 11%
Location: NC Southern Outer Banks
Default

Wow Becs101! I sure hope you get some responses soon. I suffer from hypothyroidism from Hashimoto's. The only thing I can say is my endocrinologist has me on both Synthroid and Cytomel. I haven't seen a downward trend in my weight until now, getting on the South Beach plan. I am really hoping someone can advise you once again. It seems to me some rather extreme advice they gave, but maybe they are right. I had to decide I was going to choose a more middle of the road approach to it all. I keep my calories around 1600. I work out moderately 4 days per week. I try to balance my foods and stay on the SB plan. I will report if it helps but as of now, I have seen more results this time in days rather than the months it took on Atkin's. We have sililar stats so I know how you are struggling. I also know how frustrating it feels to not have a doctor that really listens. My first endocrinologist happened to be a firend of ours personally, and I couldn't even get him to really listen to me. The people here are usually very responsive. I would private message Awriter to try to get more advice. Please keep us posted!
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  #13   ^
Old Sun, Jan-10-10, 10:44
Valtor's Avatar
Valtor Valtor is offline
Senior Member
Posts: 2,036
 
Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
BF:
Progress: 58%
Location: Québec, Canada
Default

Quote:
Originally Posted by Becs101
Hi guys,

I had my reverse T3 done and that came back as normal....so have no idea where to go from there. Have increased calories and put on weight....also only working out once a week now...

Any advice???
x

Sometimes the problem is not that rT3 are too high, but that your cells are resistant to your T3. And taking another (external) source of T3 (Cytomel) resolves the issue. But if that is the case Cytomel would have to be taken for life, so I hope it is not your case.

Patrick
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  #14   ^
Old Sun, Jan-10-10, 11:33
awriter's Avatar
awriter awriter is offline
Registered Member
Posts: 1,096
 
Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Default

Quote:
Originally Posted by aeroangie
I would private message Awriter to try to get more advice. Please keep us posted!

Angie,

Bec did write, we've been in correspondence, and it turns out that far from her RT3 being 'normal' -- she has a massive case of thyroid resistance, with RT3 the worst I've ever seen. Ditto for her temps. So my initial suspicion of HYPO caused by caloric deprivation was correct. And there's probably LR as well.

After a few more tests, Cytomel therapy (and eating a lot more food!) will probably correct the problem in several months.

Lisa
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  #15   ^
Old Sun, Jan-10-10, 12:59
aeroangie's Avatar
aeroangie aeroangie is offline
Senior Member
Posts: 1,087
 
Plan: Dr. Eric Westman's/Atkins
Stats: 150/148/132 Female 5'-4"
BF:
Progress: 11%
Location: NC Southern Outer Banks
Default

I had never heard about the reverse T3. I wonder if this is common in Hashimoto's parients? The next time I go to my endocrinolugist, what are all the tests - like for cholesterol and all of it - that I need to ask for. I really want to hear your accessment!

Thanks!!!
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