Mistakes Patients Make (or their Doctors make for them!)
I sought permission from Janie on the American Natural Thyroid Hormone site to post this information on my website as I think many readers here will benefit. Thank you, Janie:
Revised STTM book is out!
These are the most common mistakes patients, or their doctors, make when a switch has been made to desiccated natural thyroid (NDT)or when you are working to improve your hypothyroid state. You can avoid them by being familiar with these reasons and making sure your doctor understands them, too. Can you find yourself below? Teach this to your doctor.
***These are covered in the revised STTM book, which can be taken right into your doctors office, bookmarked and highlighted.
STICKING WITH TOO LOW A DOSE. For a myriad of reasons, this happens often. Have one of these been true of you? being held on a starting dose longer than two weeks (such as one grain or less)being bound by the directives of a T obsessed doctor. The TSH lab test only keeps you sick failing to get a raise of desiccated thyroid until the next labwork, which can be weeks and months away following an inaccurate Synthroid-to-Armour type conversion equivalence chart being afraid to go higher!
BEING ON AN OPTIMAL DOSE and FEELING GREAT, BUT BEING LOWERED DUE TO THE TSH LAB RANGE Similar to #2 above, this is the person that made his/her way up to an optimal dose, or the dose that simply made them feel very good and removed symptoms, but having the dose lowered by a doctor who saw your suppressed TSH (i.e. below the range). This is doctor who thinks that ink spots on a piece of paper tell the truth more than your symptoms! When on an optimal dose of desiccated thyroid (or being very near), you WILL have a suppressed TSH without being hyper. Dont let doctors hold you hostage to lab results!
THINKING NATURAL DESICCATED THYROID DOESN’T WORK BECAUSE YOU FEEL WORSE! In reality, what natural desiccated thyroid does is reveal two certain problems: adrenal insufficiency or low iron – both very common in patients who’ve remained undiagnosed for years due to the lousy TSH lab test, or were poorly treated due to any T4-only medications, or were held hostage in their treatment by the TSH lab. How does NDT reveal those problems? By a high FT3 lab result with continuing hypothyroid symptoms. Or experiencing anxiety, shakiness, fast heart rate, or other problems while on NDT.
FAILING TO MULTI-DOSE Occasionally, some patients take their natural thyroid all at once in the morning and say they do fine. But, most individuals will notice much better results by multi-dosing. For example, a person on 3 1/2 grains might take 2 grains in the morning, and 1 1/2 grains by mid-afternoon. Multi-dosing better imitates what your own thyroid would be doing, and gives you the direct T3 throughout the day when you most need it.
SWALLOWING NATURAL THYROID WITH ESTROGEN, CALCIUM or IRON. Estrogen, calcium and iron bind some of the thyroid hormones and makes them unusable. So, its wise to avoid swallowing these at the same time you swallow your natural thyroid.
FAILING TO CHEW UP OR PULVERIZE ARMOUR (or Naturethroid for some)Both have too much cellulose due to reformulation, which binds the desiccated thyroid. Instead, you need to chew them up to release the desiccated thyroid, or use a mortar and pestle. You can also add honey or sugar to increase absorption
TAKING DESICCATED THYROID BEFORE DOING LABWORK Bad idea! T3 starts moving up after you take desiccated thyroid, giving a false high serum result. And your doctor freaks out when he sees the lab result, and directs you to lower your thyroid. Patients have learned to take their normal desiccated thyroid the day before, then do labs the next morning.
STAYING ON A STARTING DOSE TOO LONG. The key to understanding this mistake is with the word starting dose. When first starting on any natural desiccated thyroid product, it can be wise to start on one grain or less, which is lower than you will ultimately need. Why? To help your body adjust to the direct T3. BUT, patients have found it UNWISE to stay on that low dose much longer than 2 weeks without raising. Why? Because hypothyroid symptoms can return with a VENGEANCE due to the feedback loop between the hypothalamus, pituitary and thyroid gland, i.e your hypothalamus gland senses the addition of desiccated thyroid (thinking the thyroid sent it), then sends a message to the pituitary gland, which in turn sends a message to the thyroid gland to stop producing, making you even more hypothyroid than you began.
THINKING DESICCATED THYROID IS NOT WORKING WHEN SOMETHING ARISES (OUTSIDE OF ONES ADRENALS OR IRON). Desiccated thyroid contains direct T3, and the T3 can initially aggravate certain conditions. When this happens, doctors have had patients stop the increase of their desiccated thyroid, or decreased it to give the reaction time to go away. An example is Mitral Valve Prolapse–one patient noted that with each raise, she had palps. But they went away within the first 5 days after each raise. One gal got itchy when she got on desiccated thyroid, and was so determined to blame Armour that she got off, got back on Synthroid, and is STILL itchy.
ADDING T4 or T3 to DESICCATED THYROID Most patients report that they do perfectly fine on desiccated thyroid alone, especially when they have taken the time to raise and find their optimal dose, which might be over 3 grains for some, and has removed all hypothyroid symptoms. But some patients and their doctors feel the need to add either synthetic T4 or T3 to their natural thyroid dose to achieve a certain result . The challenge is in not adding it too soon, otherwise you miss out on the benefits of the T4, T3, T2, T1 and Calcitonin. Instead, if they had simply upped their desiccated thyroid more, they might have gotten the results they desired. Occasionally, a patient may suspect they have thyroid hormone resistance when 5-6 grains of desiccated thyroid is not doing the job. At this point, they add T3, or Cytomel, to their dose, to achieve results. Additionally, since most patients on an optimal dose of desiccated thyroid only achieve a mid-range T4, some are adding a small amount of T4 to raise the level.Bottom line: most do well with NDT alone and raising high enough.
GOING UP WITH DOSAGES WAY TOO FAST. This was observed a few years ago: a doctor put his patient on desiccated thyroid. One grain, then 2 grains, 3 grains, 4 grains, 5 grains, then 6 grains. But the problem was that he did this within 4-5 weeks! OUCH. He started to find himself majorly overdosed with symptoms to match (high heart rate, sweating). He had to stop for a few weeks then resume again at one grain and do it the right way approx. 1/2 grain raise every two weeks, slowing down in the 2-3 grain area (and for some, slowing down on even lower amounts).
BELIEVING THAT DESICCATED THYROID IS HARD TO REGULATE. Totally and completely false. Patients have found nothing hard about desiccated thyroid. You simply raise it high enough to rid yourself of symptoms, which in turn gives you a free T3 towards the top of the range and a suppressed TSH. Believing that desiccated thyroid is hard to regulate is akin to believing that tricycles are hard to ride. 282
THINKING THAT SYNTHETIC T4 ALONG WITH SYNTHETIC T3 IS JUST AS ADEQUATE AS NATURAL DESICCATED THYROID Adding synthetic T3 to your Synthroid, Levoyxl or other T4 brands is definitely a step up from being on T4 alone! We applaud that addition. But….to say it’s equal to being on desiccated thyroid taint so. Too many patients who have been on the synthetic combo, and switched to desiccated thyroid, report that the results were even better. Thats impressive. Besides, with desiccated thyroid, you are getting exactly what your own thyroid gives you T4, T3, T2, T1 and calcitonin. Makes a difference.
AVOIDING NDT BECAUSE YOU HAVE HASHIMOTOS Sadly, some doctors will state that those with Hashimotos should avoid NDT because it can increase the attack. That has not been true for a large body of Hashis patients who report doing quite well with NDT. The key is raising faster than others to counter the initial increase in antibodies, being on selenium (200-400 mcg) which is known to lower antibodies, treating low iron or low cortisol, and in some cases, using Low Dose Naltrexone, which has helped those with more severe levels of antibodies.
THINKING YOU SHOULD TRY WHATEVER SOMEONE ELSE REPORTS IS WORKING The hardest part about patient groups is the wrong influence by one patient on another and you dont really know the full story about that individual! For example, a patient may say that whatever she tried, NDT did NOT work and they are doing quite well again on T4 or another kind of combination. But what you may not know is that they never optimized their iron and/or cortisol levels to do well on NDT, for example, even if they state they did. Or, they might have an unusual cellular problem that you dont have. NDT has worked for all-too-many as long as cortisol and low iron are optimized.
THINKING THAT IF YOU HAVE HIGH RT3 (or poor ratio), ITS SIMPLY GOING ON T3 THATS NEEDED Patients have learned that high RT3 (or a poor ratio) is a symptom of a problem that needs to be addressed, NOT just lowering the RT3. There are two main reasons for too much RT3: a) a cortisol problem (do the Discovery Steps here or more in Chapter 5 of revised STTM book) or b) an iron problem (order all four iron labs here). Focus on correcting the reason, which will naturally correct the problem, not just getting on T3 as the end solution. And by the way, patients have also lowered the high RT3 by just lowering NDT. Some add T3 to the NDT. It was worked. You do NOT necessarily have to be on T3-only. Its individual.
THINKING YOUR DOCTOR KNOWS MORE THAN YOU DO. Granted, we have great respect for education, and we appreciate the knowledge that a medical school trained doctor brings to our health quest. Its important! BUT that education does NOT take away from our OWN knowledge and our OWN intuitive sense about our bodies about what works, about what doesnt work no matter what that doctor says. This website, and even more the STTM book, represents just that! So, patients have discovered that the doctor-patient relationship is best as a TEAM, with respect going BOTH directions. Doctors are not gods. They can and DO make mistakes in judgment. TEAMWORK counts. Find a good doc!!
Post Script: there are a very small percentage of patients who might have biological conversion problems with the T4 in NDT, but it would also be true on T4-only.