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Old 01-15-2010, 02:48 PM   #1
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low T3, T4 normal TSH - docs won't reach diagnosis

Hello everyone, I'm new here on the low carb friends forum. I have commented on a paleo low-carb forum here about my thyroid discovery before coming here. This looks like the best place to discuss about thyroid and low-carb.

I have been on a nearly zero-carb ( < 30g / day ) diet, strictly, for at least 1-2 years now. It's more protein than fat, since that's the type of food I like.

As I continue with my weight loss/maintenance on a low-carb diet I've started to notice severe episodes of "brain fog" start mid-day and last the rest of the day. Also my eyelids start to go half-closed which I think is a symptom. I get lethargic and my limbs feel heavier.

I went to my PCP and then was referred to an endocrinologist and after 5 visits to them and 4 lab results, and even when I've mentioned the possibility of hypothyroidism to my docs, it has gone ignored.

My TSH for all my labs is within the normal range. My T4 read below normal (T4, 4.5ug/dL) and low-normal (Free T4, 0.95ng/dL). My most recent results are:

Total T3 = 0.62 ng/ml (LOW)
TSH = 1.21 uIU/ml
T-UPTAKE = 32%
T4 = 5.7 ug/dL (improvement from last test)
FTI = 1.82
TOTAL testosterone = 290 ng/dl
%FREE test = 1.43 (LOW)

I've had to take leave from work every time to see these docs who insist that my thyroid function is normal. This "brain fog" is interfering with my work from all this leave and when I'm actually at work I'm half as productive as I could be. These docs haven't been able to come up with ANY diagnosis of ANYTHING to help me, yet all the indicators are pointing to thyroid (or testosterone).

I'm worried I may lose my job any day now because of this and I haven't gotten the right help. What do you guys think I should do?

Last edited by MCT; 01-15-2010 at 02:55 PM..
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Old 01-15-2010, 03:23 PM   #2
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You will need to post the lab ranges along with your results as each lab has different ranges.
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Old 01-15-2010, 03:38 PM   #3
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You might try adding iodine to your diet. I follow a cardiologists blog, theheartscanblog, which can be seen here:

The Heart Scan Blog: Thyroid health

The doctor writes often about different ways to test your thyroid performance, the most important being morning temperature he says, along with other treatment options. Dr. Davis has been having success with some of patients by just using iodine supplements. Iodine of course is used to prevent goiters - a malfunctioning thyroid.

Good luck! Hope that might be of help.
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Old 01-15-2010, 03:42 PM   #4
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Originally Posted by Irishway View Post
You might try adding iodine to your diet. I follow a cardiologists blog, theheartscanblog, which can be seen here:

The Heart Scan Blog: Thyroid health

The doctor writes often about different ways to test your thyroid performance, the most important being morning temperature he says, along with other treatment options. Dr. Davis has been having success with some of patients by just using iodine supplements. Iodine of course is used to prevent goiters - a malfunctioning thyroid.

Good luck! Hope that might be of help.

Iodine supps can actually cause those with Hashi's to get worse but Pam will chime in on this. No amount of iodine shrunk my nodules-there hasn't been a case of iodine deficiency in the US in 90 years (I belive this was the info I read).
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Old 01-15-2010, 05:00 PM   #5
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It is interesting everything that Dr Davis is finding out. I could go into detail on what has been said and learned in his blog and patients responding, but it would be easier if you had a chance to check it out your self.

Basically though, with our nation's sodium phobia - you might have seen in the news New York this week is even looking to mandate lower sodium amounts in foods - that we are obtaining less iodine. (Much of our salt is fortified with iodine) And as a result more people are developing thyroid issues Dr Davis is finding.

Personally, my thyroid was testing fine. But I did have a problem with body temperature being cool. After taking a few kelp tablets a day, I'm doing fine testing wise still and my thermal regulation is improved. This chilly winter weather has been easy to handle which is a welcome change.
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Old 01-15-2010, 09:16 PM   #6
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It's not interesting to me. I have Hashimoto's, the most common form of hypothyroidism in the world. It's autoimmune. Although thyroids (um, not diseased ones) use iodine to make hormones, if you have hypothyroidism, the thyroid is damaged, and you can take iodine and it can't utilize it. And Kelp is disastrous to the antibodies that Hashimoto's produces, I ended up in hospital at one time because of that. But this is all solid research.

To the OP: I need the lab ranges and I need to know where you are (those look like foreign tests to me, are you in Canada, or the UK or somewhere else?) and Free T4 and Free T3 are the modern tests, we know longer have to do FT1 and compute.

T3 uptake isn't even a T3 test, it's a test for binding T4. So, you might want to give ranges, and let us know where you are so that you might want to see a doctor who is well versed in treating with hormone, and who KNOWS that just giving kelp and iodine don't really do much if you have thyroid disease. Kind of like putting gas in a car that has no motor.

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Old 01-16-2010, 03:52 AM   #7
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I'm sorry to hear that you had such a hard time with iodine pam. And from what I've read on Dr Davis's blog, in some cases iodine did worsen a thyroid condition. The autoimmune disease Hashimotos is talked about there.

In a majority of his patients though iodine helped their condition. I don't see why the doctor and his patients would be liars.
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Old 01-16-2010, 07:13 AM   #8
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Check out the conclusions of the scientific study he is quoting saying there is an iodine deficiency.

"CONCLUSIONS: These findings affirm the stabilization of the UI level and the adequate iodine nutrition in the general U.S. population since 2000."

Iodine status of the U.S. population, National Hea... [Thyroid. 2008] - PubMed result

It also states some subgroups such as pregnant women need to be studied further. You have to go beyond what someone writes and check out their sources to make an informed decision IMHO.
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Old 01-16-2010, 07:19 AM   #9
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TWO out of every TEN women in the USA have Hashimoto's. And are all of us liars too because we go through no less than FIVE endo's before we find a doctor to treat us for it? And are THEY liars too because instead of using FT4, FT3 to diagnose and treat they just use TSH and it can be 'anywhere at all in range' before they do? And are they liars because they hand out iodine and supplements/and anti depressants before they do those tests? No, they just haven't had the precious 23 years of research I and others have had.

You don't know my background, and I don't know yours. My Mother died at the age of 49. She was first painted with iodine, than given supplements, then psychotropic drugs (and then pushed to a few mental institutions and misdiagnosed as schizoid and bipolar ..as MANY Hashimoto's patients are) and then died. We found out upon autopsy that she developed Hashimoto's Encephalopathy, not mental disease.

If you are going to research and learn about thyroid disease, than read ALL the books, not call 'names' like 'liar'. And because iodine 'helped' a few patients (I get letters, emails, posts all the time from women, mainly, who kind of 'fade off' to other doctors because their doc doesn't give T4/T3, they give iodine and supplements...you can't say they were 'helped' until you are looking squarely at their beginning FT's, TPO AB's, and all those tests and then see a cross match for over a couple of YEARS proving it 'helped'. Most of us just decide to find a doctor who actually treats us...the first and second and third doctors I went to probably are still unaware that they didn't help me.

So, I'm not calling foolish 'names' like 'liar liar pants on fire' I'm saying I like to see proof, especially after having a family member die and being so sick I was in intensive care and cross matching MY research with thousands of other cases just like it.

I can name at least five OTHER doctor who have best selling books with patients comments who don't even DO what their books say should be done (one that comes to mind is the famous author, Ridha Arem (I'm sure you know HIS book if you are interested in thyroid disease! ). That book is one of MY personal favorites yet I have email and face to face discussion of that particular doctor NOT doing what is outlined in the book...with over 100 patients in the book exclaiming what he writes of WORKS. And it does. If the doctor actually follows those principles.

ETA: I'm not trying to disprove your book, I'm trying to get one more person to actually take notice of thyroid disease and the TREATMENT of it (that's called 'replacement hormones given to optimization'). I only have 23 years research and background education (and a few years in medical field) myself. Many have more. But so many of us need adequate treatment. And adequate testing. The sad fact is that with so many millions of women having Hashimoto's, their thyroid is 'eaten away' and destroyed by the andibodies so that you could give them iodine, reach an adequate intake, and STILL their thyroid's cannot utilize it to make hormones. So...it's not enough to just give iodine and then test for levels of THAT, they have to test FT's levels and TPO AB and TSI. My iodine level is MORE than adequate. But my thyroid is a shriveled little walnut from the antibodies, it's not able to USE IT. AS I said, it's like putting gas in a car with no motor...it's not going anywhere.

Pam

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Old 01-16-2010, 08:31 AM   #10
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Check out the conclusions of the scientific study he is quoting saying there is an iodine deficiency.

"CONCLUSIONS: These findings affirm the stabilization of the UI level and the adequate iodine nutrition in the general U.S. population since 2000."

Iodine status of the U.S. population, National Hea... [Thyroid. 2008] - PubMed result

It also states some subgroups such as pregnant women need to be studied further. You have to go beyond what someone writes and check out their sources to make an informed decision IMHO.
I'm confused, Dr Davis quotes studies that there are iodine deficiencies while the study says the opposite? From what I see he states many times in his posts that from his observation as an MD that in his patients some thyroid conditions have improved with iodine supplementation. If you do not want to believe the doctor, well, it is a free country. Please avoid his blog.
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Old 01-16-2010, 08:33 AM   #11
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I'm confused, Dr Davis quotes studies that there are iodine deficiencies while the study says the opposite? From what I see he states many times in his posts that from his observation as an MD that in his patients some thyroid conditions have improved with iodine supplementation. If you do not want to believe the doctor, well, it is a free country. Please avoid his blog.

That is a quote from the study he gave as his source-I followed his link. What he writes contradicts the study he is quoting. It has nothing to do with being in a free country-his facts are false and he misquoted a study he gave a link to-I didn't make this up. Follow his link and check out the info yourself. Always be wary of blogs with tons of links for products like his has-he is an affiliate for these products and will get a monetary kickback for people clicking them. The more clicks the more money he makes. Also how can we trust what he reports about his patients being correct when he posted untrue facts about a scientific study?
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Last edited by lisabinil; 01-16-2010 at 08:45 AM..
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Old 01-16-2010, 08:35 AM   #12
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labs reposted with normal ranges

OK everyone let me repost the labs (I can only give the tests that the MDs requested. I'm male in 20's. I live in VA.)

10/27/2009
Total T4 = 4.5 ug/dL. normal is 5.0-12.5
free thyroxine index (FTI) = 1.5. normal is 1.0-3.9
TSH = 1.655. normal is 0.350 - 4.500 uIU/mL
triglyceride = 29. normal is < 150 mg/dL
HDL = 94. normal is > 39 mg/dL

12/04/2009
free T4 = 0.95 ng/dL. normal is 0.89-1.80
total testosterone = 152.54 ng/dL. normal is 350-890.
free testosterone = 16.1 pg/mL. normal is 47.0 - 244.0
SHBG = 75 nmol/L. normal is 13-71.

12/24/2009
]total T3 = 0.62 ng/mL. normal is 0.70-1.90
T4 = 5.7 ug/dL. normal is 4.7-13.3
TSH = 1.21 uIU/mL. normal is 0.34-4.82.
T-UPTAKE = 32%. normal is 31-39%
FTI = 1.82%. normal is 1.46-5.20
total testosterone = 290 ng/dL. normal is (reference range expanded this time) 250-1100ng/dL
free testosterone = 41.5 pg/mL. normal is (reference range expanded this time) 35.0-155.0 pg/mL
%free testosterone = 1.43. normal is 1.50-2.20%
DHT = 23 ng/dL. normal is 25-75.

For iodine I am currently taking the WAL-MART multivitamin cap with 100% RDA Iodine several times a day.

I've read on forums and in PubMed studies that total carbohydrate intake directly influences T3 especially during weight loss. If thyroid meds are for life, meaning once you start you can never go back, does anyone think it would be wiser to raise the carbs a little first before going on thyroid meds?
Does anyone think I really have a thyroid or testosterone problem or is this just me?

Last edited by MCT; 01-16-2010 at 08:52 AM.. Reason: help clarify
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Old 01-16-2010, 08:39 AM   #13
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You could try this-I did and it didn't help me but that is just my particular case. If your thyroid is damaged no amount of carbs will restore it.
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Old 01-16-2010, 08:41 AM   #14
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TWO out of every TEN women in the USA have Hashimoto's. And are all of us liars too because we go through no less than FIVE endo's before we find a doctor to treat us for it? And are THEY liars too because instead of using FT4, FT3 to diagnose and treat they just use TSH and it can be 'anywhere at all in range' before they do? And are they liars because they hand out iodine and supplements/and anti depressants before they do those tests? No, they just haven't had the precious 23 years of research I and others have had.

You don't know my background, and I don't know yours. My Mother died at the age of 49. She was first painted with iodine, than given supplements, then psychotropic drugs (and then pushed to a few mental institutions and misdiagnosed as schizoid and bipolar ..as MANY Hashimoto's patients are) and then died. We found out upon autopsy that she developed Hashimoto's Encephalopathy, not mental disease.

If you are going to research and learn about thyroid disease, than read ALL the books, not call 'names' like 'liar'. And because iodine 'helped' a few patients (I get letters, emails, posts all the time from women, mainly, who kind of 'fade off' to other doctors because their doc doesn't give T4/T3, they give iodine and supplements...you can't say they were 'helped' until you are looking squarely at their beginning FT's, TPO AB's, and all those tests and then see a cross match for over a couple of YEARS proving it 'helped'. Most of us just decide to find a doctor who actually treats us...the first and second and third doctors I went to probably are still unaware that they didn't help me.

So, I'm not calling foolish 'names' like 'liar liar pants on fire' I'm saying I like to see proof, especially after having a family member die and being so sick I was in intensive care and cross matching MY research with thousands of other cases just like it.

I can name at least five OTHER doctor who have best selling books with patients comments who don't even DO what their books say should be done (one that comes to mind is the famous author, Ridha Arem (I'm sure you know HIS book if you are interested in thyroid disease! ). That book is one of MY personal favorites yet I have email and face to face discussion of that particular doctor NOT doing what is outlined in the book...with over 100 patients in the book exclaiming what he writes of WORKS. And it does. If the doctor actually follows those principles.

ETA: I'm not trying to disprove your book, I'm trying to get one more person to actually take notice of thyroid disease and the TREATMENT of it (that's called 'replacement hormones given to optimization'). I only have 23 years research and background education (and a few years in medical field) myself. Many have more. But so many of us need adequate treatment. And adequate testing. The sad fact is that with so many millions of women having Hashimoto's, their thyroid is 'eaten away' and destroyed by the andibodies so that you could give them iodine, reach an adequate intake, and STILL their thyroid's cannot utilize it to make hormones. So...it's not enough to just give iodine and then test for levels of THAT, they have to test FT's levels and TPO AB and TSI. My iodine level is MORE than adequate. But my thyroid is a shriveled little walnut from the antibodies, it's not able to USE IT. AS I said, it's like putting gas in a car with no motor...it's not going anywhere.

Pam
Wow, I can tell this is a very emotional subject for you. And rightfully so, as you state you had a family member pass away and you have been effected badly by thyroid disease. I am truly sorry to hear that. Keep spreading the word about this disease.

From what I have posted, Dr Davis has used iodine as a tool to treat some of his patients. And with that tool he had some success. Sometimes though iodine is not the best treatment, as Dr Davis mentions numerous times on his blog. With those patients he treats with drugs as I have read. I think Dr Davis would be in agreement with you that thyroid conditions have not been properly addressed by the medical establishment.

As you mention finding a good doctor willing to take seriously you concerns can be difficult. It is one of the reasons why I enjoy this doctors blog, along with a few other physicians.
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Old 01-16-2010, 08:47 AM   #15
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That is a quote from the study he gave as his source-I followed his link. What he writes contradicts the study he is quoting. It has nothing to do with being in a free country-his facts are false and he misquoted a study he gave a link to-I didn't make this up. Follow his link and check out the info yourself. Always be wary of blog with tons of links for products like his has-he is an affiliate for these products and will get a monetary kickback for people clicking them. The more clicks the more money he makes.
He sells no supplements.

Can I ask which blog post does Dr Davis references this study that has you concerned?
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Old 01-16-2010, 08:57 AM   #16
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He sells no supplements.

Can I ask which blog post does Dr Davis references this study that has you concerned?

I didn't say that-I said he was an affiliate. You are completely misunderstanding-he has links to supps all over his blog. How an affiliate works is you place a link to their product on your blog or website and you are paid by how many times people click on it-the more clicks the more money. That's how many bloggers make money. It's hidden very well-go to the section "Buy local, get a goiter" and click on the word nationwide.

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Old 01-16-2010, 09:06 AM   #17
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He sells no supplements.

Can I ask which blog post does Dr Davis references this study that has you concerned?

The study doesn't have me concerned-I have read this particular study before. What has me concerned is a blogger misleading people to buy supplements of which he is an affliate for-doctor or not. Many other thyroid experts have quoted this particular study (and did it correctly) such as Shoman and Dr. Arem.

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Old 01-16-2010, 09:16 AM   #18
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Ok, you have a nice day Irishway, and I hope you never have to seek out a doctor for hypothyroidism, but I can't spend time citing 23 years of research to someone who only reads ONE book, ONE site, etc. I need to spend my volunteer hours on helping others with thyroid disease who WILL look at the research and are yearning to have a better life.

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Old 01-16-2010, 09:25 AM   #19
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Ok, you've seen my take on iodine. If you have a thyroid disease/deficiency than all the iodine in the WORLD isn't going to work.

Secondly, you don't have the 'correct' tests there in full. You haven't even HAD a measurement of your T3 at ALL. Again, a T3 Uptake test is an expensive, USELESS test of T4 binding. It's not a T3 test at all. Sorry. We've all gone that route with doctors who don't do good thyroid.

You need the following (and your FT4, as well as total T4 is under optimum range, but I'm not going to comment until you have a Free T3, my DH is hypothyroid, from his early TEENS and it starts with low FT4, FT3 and low free testosterone):

FT4, FT3.

Testosterone can be low FROM low thyroid and vice versa, it can also be low because of fatigued adrenals. So, a 4x in one day salivary cortisol should also be done.

Pubmed is citing Dr. Broda Barnes books that if you go very low carb combined with low calorie, it can WRECK your thyroid. Once it's WRECKED (you don't have Hashimoto's, not surprising, you're male) it doesn't work. Period, eat anything ya want, it doesn't GIVE you T4 to T3 conversion.

So, you need to have the above tests done, and to see a doctor (I'm not a doctor...) who is WELL VERSED in thyroid and adrenals and BHRT.

You can get a panel of FT's and TSH (you already have that, but this would give FT3) at Online Lab Tests: blood work, blood testing and laboratory tests for under 90 bucks or so (and give checkout code: 12345 for discount) and they send you to a lab near YOU and their doc signs the order and report back to YOU.

If then you appear to be hypothyroid, I do have lists (and so do others) of doctors who 'recognize' hypothyroidism, and who treat with hormones rather than just give iodine (which is a SUPPLEMENT, not a hormone, a precursor nor anything that would MAKE thyroid hormone if the thyroid itself doesn't need it, nor can use it).

Your testosterone and free testosterone are very low, but not as low as my DH's was before being treated for adrenals, thyroid and replacement testosterone and I'm really praying you can find a reason behind this and that it can be corrected. I hope this helps you, and if I can be of any help with FT3 testing interpretation or with lists of patient recommended doctors (not MY recommendation, except for a couple I went too, lol), please feel free to respond in this thread. Best of luck.

Pam
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Old 01-16-2010, 09:48 AM   #20
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OK everyone let me repost the labs (I can only give the tests that the MDs requested. I'm male in 20's. I live in VA.)

10/27/2009
Total T4 = 4.5 ug/dL. normal is 5.0-12.5
free thyroxine index (FTI) = 1.5. normal is 1.0-3.9
TSH = 1.655. normal is 0.350 - 4.500 uIU/mL
triglyceride = 29. normal is < 150 mg/dL
HDL = 94. normal is > 39 mg/dL

12/04/2009
free T4 = 0.95 ng/dL. normal is 0.89-1.80
total testosterone = 152.54 ng/dL. normal is 350-890.
free testosterone = 16.1 pg/mL. normal is 47.0 - 244.0
SHBG = 75 nmol/L. normal is 13-71.

12/24/2009
]total T3 = 0.62 ng/mL. normal is 0.70-1.90
T4 = 5.7 ug/dL. normal is 4.7-13.3
TSH = 1.21 uIU/mL. normal is 0.34-4.82.
T-UPTAKE = 32%. normal is 31-39%
FTI = 1.82%. normal is 1.46-5.20
total testosterone = 290 ng/dL. normal is (reference range expanded this time) 250-1100ng/dL
free testosterone = 41.5 pg/mL. normal is (reference range expanded this time) 35.0-155.0 pg/mL
%free testosterone = 1.43. normal is 1.50-2.20%
DHT = 23 ng/dL. normal is 25-75.

For iodine I am currently taking the WAL-MART multivitamin cap with 100% RDA Iodine several times a day.

I've read on forums and in PubMed studies that total carbohydrate intake directly influences T3 especially during weight loss. If thyroid meds are for life, meaning once you start you can never go back, does anyone think it would be wiser to raise the carbs a little first before going on thyroid meds?
Does anyone think I really have a thyroid or testosterone problem or is this just me?
I see my iodine info. and doctor link has gone over like a lead ballon with a couple of the posters here! Thought to mention from my experience, I can not take those synthetic multivitamins with out feeling worn down and tired. Don't know why, but they do me in. Might be worth a try avoiding them for a couple days and seeing what happens.

After trying different ideas, if you find your self still with out answers, Dr Eades, author of several low carb books has a nice blog. And he is a nice guy and will answer questions when he has time.

Health and Nutrition by Dr. Michael R. Eades, M.D.

Good luck!
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Old 01-16-2010, 09:58 AM   #21
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Originally Posted by Irishway View Post
I see my iodine info. and doctor link has gone over like a lead ballon with a couple of the posters here! Thought to mention from my experience, I can not take those synthetic multivitamins with out feeling worn down and tired. Don't know why, but they do me in. Might be worth a try avoiding them for a couple days and seeing what happens.

After trying different ideas, if you find your self still with out answers, Dr Eades, author of several low carb books has a nice blog. And he is a nice guy and will answer questions when he has time.

Health and Nutrition by Dr. Michael R. Eades, M.D.

Good luck!
I often read the Eade's blog. I was in no way meaning to be rude but I always question, research and study. You simply cannot believe everything you read without adequate research. Unfortunatey even those with medical degrees want to make a buck-that is what really irks me. Someone with a medical degree can manipulate documented scientific evidence to skew it in the favor of what he is writing about to make a buck off innocent people trying to improve their health. Hopefully you will keep reading, researching and most of all-questioning.
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Old 01-16-2010, 10:08 AM   #22
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Quote:
Originally Posted by MCT View Post
OK everyone let me repost the labs (I can only give the tests that the MDs requested. I'm male in 20's. I live in VA.)

10/27/2009
Total T4 = 4.5 ug/dL. normal is 5.0-12.5
free thyroxine index (FTI) = 1.5. normal is 1.0-3.9
TSH = 1.655. normal is 0.350 - 4.500 uIU/mL
triglyceride = 29. normal is < 150 mg/dL
HDL = 94. normal is > 39 mg/dL

12/04/2009
free T4 = 0.95 ng/dL. normal is 0.89-1.80
total testosterone = 152.54 ng/dL. normal is 350-890.
free testosterone = 16.1 pg/mL. normal is 47.0 - 244.0
SHBG = 75 nmol/L. normal is 13-71.

12/24/2009
]total T3 = 0.62 ng/mL. normal is 0.70-1.90
T4 = 5.7 ug/dL. normal is 4.7-13.3
TSH = 1.21 uIU/mL. normal is 0.34-4.82.
T-UPTAKE = 32%. normal is 31-39%
FTI = 1.82%. normal is 1.46-5.20
total testosterone = 290 ng/dL. normal is (reference range expanded this time) 250-1100ng/dL
free testosterone = 41.5 pg/mL. normal is (reference range expanded this time) 35.0-155.0 pg/mL
%free testosterone = 1.43. normal is 1.50-2.20%
DHT = 23 ng/dL. normal is 25-75.

For iodine I am currently taking the WAL-MART multivitamin cap with 100% RDA Iodine several times a day.

I've read on forums and in PubMed studies that total carbohydrate intake directly influences T3 especially during weight loss. If thyroid meds are for life, meaning once you start you can never go back, does anyone think it would be wiser to raise the carbs a little first before going on thyroid meds?
Does anyone think I really have a thyroid or testosterone problem or is this just me?
I'm really no expert but your testosterone is the FIRST thing I'd worry about. Your thyroid doesn't look that bad at all, to me, based on those ranges. Why do you think your thyroid is out of whack?

Also, FWIW, I used to be VLC to ZC and couldn't lose weight until I followed basically what Pam is citing from Barnes. I had to find the right balance of protein and carbs to jump start my loss after 2 yrs of not losing on super low calorie/low carb, Atkins and then ZC.

Now that I'm eating some carbs, I'm losing weight. Go figure. (I'm Hashimoto's too).

ETA: good link here
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Old 01-16-2010, 02:23 PM   #23
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"12/04/2009
free T4 = 0.95 ng/dL. normal is 0.89-1.80"

His FT4 is low because it's not approximately in the middle of the range, not even close and like Pam said we really need to see his FT3. My bet is that's pretty low also.

I hope MCT can find a doctor that will do the correct tests (for everything) then treat correctly. Never give up.
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Old 01-16-2010, 03:48 PM   #24
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Originally Posted by nonstickpam107 View Post
Ok, you've seen my take on iodine. If you have a thyroid disease/deficiency than all the iodine in the WORLD isn't going to work.
After my first lab which came back below normal on T4, I started taking iodized salt since then but haven't noticed any difference with or without it.

Quote:
You need the following (and your FT4, as well as total T4 is under optimum range, but I'm not going to comment until you have a Free T3, my DH is hypothyroid, from his early TEENS and it starts with low FT4, FT3 and low free testosterone):
The last lab listed (ordered by my endo) did get total T3 = 0.62ng/mL (normal is 0.70-1.90) and total T4 = 5.7ug/dL (normal is 4.7-13.3). But you're right - for some reason, this endo which has treated thousands of patients for hypothyroid, "happened" to leave out the FT3, FT4. Not sure if I'm allowed to list identifying info in the forums, but this endo has filed a paper with the FDA here.
Also when he spent all of 5 minutes discussing the lab with me, he effectively ignored the low T3 and low testosterone and basically said I'm healthy and should not be concerned.

Quote:
Testosterone can be low FROM low thyroid and vice versa, it can also be low because of fatigued adrenals. So, a 4x in one day salivary cortisol should also be done.

You can get a panel of FT's and TSH (you already have that, but this would give FT3) at Online Lab Tests: blood work, blood testing and laboratory tests for under 90 bucks or so (and give checkout code: 12345 for discount) and they send you to a lab near YOU and their doc signs the order and report back to YOU.
I could make sense out of this given my history. Maybe I've got adrenal fatigue from the "supplements" I've added to my diet for weeks on end: nicotine, ephedrine, caffeine with lots of cardio. I'm afraid to mention this to any doc it could just be an excuse for them to withhold medication, and the same about my low-carb diet. They'll just blame my problems on that. The irony is that I continue to (ab)use these supplements to compensate for my energy deficiencies. Cortisol on my last test was 17.6 ug/dL (normal is 10.4 - 26.4).

Quote:
FT4, FT3.
Pam if I have insurance would it be cheaper to just see a PCP, get them to order the tests? Or better to just go straight - no B.S. - for the online lab tests and get it done right the first time even if it costs more?

Quote:
If then you appear to be hypothyroid, I do have lists (and so do others) of doctors who 'recognize' hypothyroidism, and who treat with hormones rather than just give iodine (which is a SUPPLEMENT, not a hormone, a precursor nor anything that would MAKE thyroid hormone if the thyroid itself doesn't need it, nor can use it).
I did come up with this list of potentially helpful doctors from the Armour locator. My plan is to find a good-enough PCP that can just refer me to an endo on the list. I may have to take you up on that list of patient-recommended doctors.

To Pam and others, thank you for volunteering the time to help me.

If it helps (anyone) here's a list of thyroid studies I found on PubMed:
Influence of diet composition on serum triiodothyr... [J Nutr. 1981] - PubMed result
Dietary-induced alterations in thyroid hormone met... [J Clin Invest. 1979] - PubMed result
The role of dietary fat in peripheral thyroid horm... [Metabolism. 1980] - PubMed result
The effect of varying carbohydrate content of a ve... [Metabolism. 1986] - PubMed result
Effects of slimming and composition of diets on VO... [Am J Clin Nutr. 1982] - PubMed result
Effect of small doses of iodine on thyroid functio... [Horm Res. 1993] - PubMed result
Effect of a high-protein, very-low-calorie diet on resting metabolism, thyroid hormones, and energy expenditure of obese middle-aged women -- Barrows and Snook 45 (2): 391 -- American Journal of Clinical Nutrition
Low protein-high carbohydrate diet induces alterat... [Endocrinology. 1982] - PubMed result
Very-low-calorie diets with high and low protein c... [Am J Clin Nutr. 1988] - PubMed result

Last edited by MCT; 01-16-2010 at 03:52 PM..
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Old 01-16-2010, 04:54 PM   #25
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So the doc just happened to leave out FT4/FT3. Many docs just happened to leave it out unfortunately. The problem with that is that the Total T's are what's In the body. The Free T's are what's Available to be used in the body. Huge difference.
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Old 01-16-2010, 07:29 PM   #26
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Hi MCT.....

As it has been mentioned before, you do need to have the correct tests (FT4 and FT3) in order to know what your body has and converts for energy. Your FT4 is low. That much is known, but you need to now if you are converting it to FT3 and what those ranges are. Also, if you are tired and are having low testosterone levels as well, and you are taking ephedrine and other such stimulants, and doing such low low carb (basically induction) without weight loss, my guess is that your adrenals are also in pretty poor shape! (been there and still working at it!) There are lots of places to have the tests run without a doctors Rx...and they are fast. You need a 24 hour test, not the type you had done. I used The Canary Club and they are easy to find on the web...they have male profiles available and the price is about 25% of what you'd pay in a doctors office. The other lab mentioned here is also good..just not in my area, so I went the other route...same results. I did my own tests in order to know for myself what was what, and then took the test results to my physician as "my proof" and went from there...and also posted the results here. Issues with the endocrine system are not an easy, or quick fix, so be prepared to learn a lot about how your body works...knowledge is power and nobody knows your body like you. Also, read what others have said about iodine supplementation. I do use it for myself (I don't have Hashimoto's), but mine is in a sublingual drop form -- high quality specifically done for thyroid. From my understanding....stimulants and over exercise will make the adrenals more and more fatigued...it's not something to fool around with. You cannot fix your thyroid without fixing the adrenals first (or at the same time very carefully!!!) Good luck! Get the tests done! :-)
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Old 01-16-2010, 07:57 PM   #27
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Hi MCT, I use that list too (and I specifically look for doctors who use Armour and do FT's), actually, Levin is supposed to be good, I don't have firsthand experience though. So, pick your doc carefully (look for the clues, like doing FT's, and giving Armour or T4 and Cytomel combo).

Um, if I were a young man, I'd not use all the chemicals you are using and I'd be really upset if my testosterone was that low...you cannot keep overdriving the adrenals and expect to come out the other end 'healthy'. BTW, there ARE a couple of genetic disorders that give young men low testosterone too, but they are few and far between.

Your T4 is very low (no one should have T4 that low) and your T3 you give is also very low, so you're not making enough T4, and you're certainly not converting.

Pick a doc on that list that gives Armour or a combo of T4/T3, and do be HONEST with the doc, let him/her know what you are eating, etc.

Um, I'm not knocking YOU, but Pubmed is the last place I go for endocrine information. Have you explored this site: Hypothyroid Mistreatment and Thyroid Treatment Scandal | Stop The Thyroid Madness and this site: Thyroid Disease Information - Hypothyroidism - Hyperthyroidism - Thyroid Cancer - Autoimmune Disease - Hashimoto's - Graves' - Goiter - Nodules both are really good, and will give you good information.

Anyone who's doc just goes by TSH needs a new doc, and anyone that thinks a T4 that's just barely in bottom of range and a T3 that isn't at least 2/3 of range..um...isn't being treated to optimization.

Pam
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Old 01-21-2010, 02:55 PM   #28
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Hi Pam, I decided to place an order for the Thyroid Function Profile with TSH, Comprehensive using healthcheckusa.com as you suggested, instead of wasting time begging a doc to do free T3/T4. I'll let you know how it turns out. Once I've confirmed that I have a thyroid problem I'll try in-network docs first, and if the docs aren't helpful enough I'll go out-of-network.

True maybe I shouldn't have pushed myself so hard, but I felt like I had to at least try and see how far I could go.

Until the test results return, I'll be trying a very high-protein, low-fat, very-low-carb diet, and continuing exercise. If there's anything to the hypothesis that carbs affect thyroid hormones, then I'm guessing it's really related to blood glucose maybe in the same way that ketosis "turns on" after dietary/blood glucose drop, maybe thyroid levels start to "drop off" at that same point...who knows...

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Old 01-21-2010, 03:02 PM   #29
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My Ft's were always the 'same' no matter if I ate very low cals or very low carbs (adequate cals)...but I do have autoimmune hypothyroidism too.

I didn't have to go out of network for a GREAT thyroid doc, but I kind of got 'lucky' with that I do believe. I've been a lowcarber for ten years now...and I'm on a good amount of replacement hormone...although I don't go under 50 grams of carb, and usually try and stay around 80 or so grams (NO wheat, soy, sugar though, no gluten at all...) and vary my calories depending on working out....and if I have a day off or not. But I don't do much caffeine, no incoming hormones in my case at all...and I'm feeling good, thyroid wise on 3 grains natural dessicated porcine thyroid daily.

I'll look for your post MCT...best of luck to you.

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Old 01-21-2010, 06:36 PM   #30
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MCT, I'm so glad that you are going to have the tests run on your own. That's what I did and it sure did help the brain to know that you are making a move in the right direction and that you will have your own answers. Looking forward to seeing your tests, and I know you are too! :-)
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