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How to dose levothyroxine to achieve optimal hormonal levels and control ldl-receptor activity ?

Commented on February 05, 2014
Created February 04, 2014 at 8:12 PM

When ldl-receptor activity is low, ldl can't be taken into cells efficiently and ldl and therefore all lipoproteins and all cholesterol numbers rise in blood and only cholesterol numbers can commonly be tested. Lipoproteins starts to remain in the blood longer and become a subject to oxidation longer, and this must at least be a major factor behind cardivascular risks.

One of the things that regulate ldl-receptor activity is thyroid hormones.

THE STORY BEHIND THE QUESTIONS:

My mother had normal cholesterol levels long ago but some day most of the left side of her thyroid was removed and later her cholesterol numbers rose and she was prescribed statins and advised to use them. Last results related to her thyroid hormones show that her free t3 and free t4 levels are close to the insides of low ends of the normal ranges with values 2,72 and 1,14 respectively and her tsh is 0,95 and anti-tg and anti-tpo levels were probably not detectable(they are shown with <20,0 and <10,0). She was taking her prescribed daily dose of her 100 mcg levothyroxine in about 6 days of a week before that test. That time her cholesterol numbers and triglycerides were also measured and her total, ldl, hdl cholesterol and triglyceride numbers were 317, 222, 58, and 185 and she says she had not been using the prescribed Lipitor for about 6 months before the test. She never had a cardiovascular event as far as we can tell so she is almost certainly in the group that is commonly prescribed statins for primary prevention. She also has hypertension.

She does not want to use statins knowing what I summarize from reading authors like Chris Masterjohn, Chris Kresser etc and their references. She recognized the effects of statins on her cognition/memory etc. herself.

She also said she sometimes got depressed and used antidepressants, I think it's like using antidepressants rarely without the control of a doctor but I guess she knows the level of her depression enough to use it only when necessary because they were prescribed with a diagnosis once and if I remember correctly her doctor prescribed the drugs knowing the way she uses them. She most likely doesn't get enough vitamin d but I can't persuade her enough to get the necessary sunshine.

HER DIET AND ACTIVITIES

She nowadays eats bread which is generally a mostly rye flour bread, tahini, carob syrup, eggs cooked in butter with runny yolks, fruits, pressure-cooked legumes with tomato paste and onion and she adds olive oil to it later, walnuts, some raw spinach and chia seeds waited in water as far as I can tell. Spinach is a recent addition and she started chia yesterday though she ate it rarely before also. I'm constantly advising her ways to improve her diet but she can change very little very slowly if she can at all with my persuasion.

We are convinced dietary cholesterol and saturated fat are actually helpful in the way she gets them. Though the only salt we use is Himalayan rock salt she is determined to lower her salt intake as much as she can and I'm actually a little concerned that she reduces it to a level that is less than optimal. I told her that increasing her dark green leafy vegetable intake and caring less about the amount of the himalayan rock salt she uses may be both healthier and better tasting.

She often walks some distance and she does all the cleaning of the house she is in which is generally one with only 2 rooms one of which is connected with kitchen and entrance and one bathroom and she also helps my food preparation very much.

OUR OBJECTIVE: We are seeking ways to make her healthier, happier and lengthen her lifetime.

QUESTIONS

So we want to know, what are the optimal levels of thyroid hormones ?

How can she try to achieve them using the prescribed levothyroxine drug ?

Can it be beneficial for her to use more of the levothyroxine drug than what is required to achieve the optimal levels of thyroid hormones to lessen cardiovascular risks ?

If it's advisable to use more of the levothyroxine drug than what is required to achieve the optimal levels of thyroid hormones to lessen cardiovascular risks, how shall she try to adjust the dose of the levothyroxine drug ?

The levothyroxine drug is totally covered in her insurance and that's why the topic is mostly about levothyroxine but what about other ways to regulate ldl-receptor sensitivity and/or reduce cardiovascular risks ?

Curcumin also regulate ldl-receptor activity and I could only read the abstract of the paper but almost certainly impractical amounts of curcumin are used.

What about other things that are used to reach better thyroid hormonal activity such as iodine, selenium, progesterone, coconut oil, vitamin d, zinc and others ?

What about antioxidants or some antioxidant rich things and exercise ?

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Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on February 05, 2014
at 10:59 PM

I agree with Matt, it is one thing to ask how to achieve optimal hormone levels, but it is another thing altogether to ask how to dose a drug to achieve these levels.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 05, 2014
at 02:32 PM

It really is beyond the scope of PH, you have to get a doctor involved that's willing to "experiment" with you, and that will be a tough sell to most doctors. I suppose you could talk about natural ways to affect thyroid hormone levels, but you need to take levothyroxine out of the question. That's MD territory.

Cf08ad26759fdd206a2c9f9385080a57

(995)

on February 05, 2014
at 09:24 AM

Fwiw, my dad had his entire thyroid removed (they left his adenoids.) He's been on synthroid (levothyroxine) and atenolol for the past decade or so and looks / feels healthy. He's mentioned to me a few times how he feels it's important to take his meds at the exact same time everyday.

47cbd166d262925037bc6f9a9265eb20

(55)

on February 05, 2014
at 09:06 AM

Her endo only cares that they are in the normal ranges and but he/she helps her in prescribing it by prescribing 2 times the dose she uses to give her some stretch time between times allowed to get the drugs again(Actually this may rather be kept secret). I don't think I know enough to change her dose myself. I'm editing how she eats and her activites in the story behind the questions.

47cbd166d262925037bc6f9a9265eb20

(55)

on February 05, 2014
at 07:19 AM

And even if we can persuade a doctor to help my mother reach optimal levels, that may not be the optimal dose for my mother because she may need to improve ldl-receptor activity further with more levothyroxine.

The doctors may not even be aware that thyroid hormonal activity regulates ldl-receptor sensitivity or effects cardiovascular risks...

47cbd166d262925037bc6f9a9265eb20

(55)

on February 05, 2014
at 07:18 AM

Good answer but the doctors won't be willing to give more then what is necessary to achieve optimal thyroid hormones, and probably even less, to the extent to the lower ends of normal ranges for free t3 and free t4, for example. If the doctor would be willing to try to correct my mother's free t3 and free t4 levels close to the lower end of the range, he would do so when he/she read the test results.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 04, 2014
at 08:50 PM

This is a question for your doctor, not for Paleo diet hobbyists.

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2 Answers

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Cf08ad26759fdd206a2c9f9385080a57

(995)

on February 05, 2014
at 08:22 AM

How's her diet, activity level, and bmi?

I don't think a bunch of random meat eaters on an internet forum are the right people to ask for sub milligram prescription drug dosing. The thyroid numbers aren't out of range, yet it sounds like you're hoping to get some validation to give her a larger dose than her endo wants her to take.

If she can't trust and respect her doctor's expertise in diagnosing and treating her condition, it's time to find someone else immediately, rather than try to treat her yourself with herbs / spices and coconut oil / basic nutrients.

47cbd166d262925037bc6f9a9265eb20

(55)

on February 05, 2014
at 09:06 AM

Her endo only cares that they are in the normal ranges and but he/she helps her in prescribing it by prescribing 2 times the dose she uses to give her some stretch time between times allowed to get the drugs again(Actually this may rather be kept secret). I don't think I know enough to change her dose myself. I'm editing how she eats and her activites in the story behind the questions.

-1
Be157308a0438e382b88d9db4c12ab30

on February 05, 2014
at 02:09 PM

Go to a good endocrinologist, I doubt there's any of them lurking around in PaleoHacks (they're probably over at PharmaHacks, just kidding). But if there are any, this would be a great time for one to provide some useful insight.

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