2

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Hack my Miracle! Bloodwork Included

Answered on August 19, 2014
Created August 28, 2011 at 9:58 PM

In the years when I had health insurance, I had several thyroid panels done because I presented clinically with hypothyroidism but the TSH test was always "normal." Basically I was told I would feel better on antidepressants or I should diet and exercise even more to the lose the weight I was steadily gaining. Last year, feeling like death warmed over, I made a very expensive appointment with a functional medicine MD hoping to get some help. Unfortunately, unbeknownst to me, she was also a homeopath and decided homeopathy was the was to go. She said nothing about this b/w (9/2010) which I found rather alarming.

Vit D 34.2ng/ml

Cholesterol, Total 240 mg/dl
Triglycerides 179
HDL 61
LDL Chol Calc 143
VLDL Chol Calc 36

TSH 1.970 uIU/ml (0.450-4.5)
Thyroxine (Free T4) 1.22 ng/dl (0.82-1.77)
T3 122 ng/dl (71-180)

Reverse T3 289 pg/ml (90-350)
triiodothyronine,
free serum 3.0 pg/ml (2.0-4.4)

I went to another Dr. who actually physically examined me and was prescribed Nature Throid (similar to Armour). I also adopted a lowish carb Paleo diet (have since added occasional heavy cream, butter, ghee), added supplements, began walking again (at least 30 miles a week) and doing CrossFit 3x a week. The difference is practically miraculous! My b/w six months later looked like this:

Cholesterol, Total 230 mg/dl
Triglycerides 58
HDL 71
LDL Chol Calc 147
VLDL Chol Calc 12

TSH <0.006 uIU/ml (0.450-4.5)
Thyroxine (Free T4) .92 ng/dl (0.45-1.2)
T3 192 ng/dl (71-180)
T3 Uptake 37% (24-39)
Free Thyroxine Index 3.4 (1.2-4.9)

Now the brain fog and lethargy have dissipated, I'm not satisfied because I think I can feel better. The miraculous is not optimal! So as I prepare for my appointment next month, which blood tests should I request (please bear in mind I pay for everything out of pocket and bloodwork is very expensive) in addition to the above? I'll get the standard CBC, CMP, and fasting glucose.

Also if anyone can explain the thyroid panels actually mean, please do. Now the TSH indicates hyperthyroidism.

Additional information, female, post menopausal, still at least 30lb of extra fat. I did lose about 40lbs (approximately 1 lbs/wk) over the first 7 months but I've been stalled since March. In an effort to get back on the weight loss train I've upped carbs, lowered carbs, increased training, stopped training, fasted, blacked out my bedroom windows, and increased my deadlift to 180lbs.

020053fd576e93d1d8fa20bfb10979b9

(410)

on August 29, 2011
at 01:58 PM

Lab normal ranges in parentheses. I was taking 3 grains when the last b/w was done. I've since reduced the dosage to 2 grains. Vit D was within "normal" range, 32-100, but I have been supplementing aggressively and hope it's in the 50-60 range now. I got blown off last time about the antibody test but will insist this time. Dr K aka The Quilt writes about RT3 but I'm not sure how much is considered high. Thanks for the TSH drop explanation applying dope slap now.

461a9cf5ca78123a4788c7c599066fbc

(40)

on August 29, 2011
at 01:55 PM

Lab normal ranges in parentheses. I was taking 3 grains when the last b/w was done. I've since reduced the dosage to 2 grains. Vit D was within "normal" range, 32-100, but I have been supplementing aggressively and hope it's in the 50-60 range now. I got blown off last time about the antibody test but will insist this time. Dr K aka The Quilt writes about RT3 but I'm not sure how much is considered high.

9e20abb05f3f6e3cc4bb107f8980aecd

(5939)

on August 29, 2011
at 01:00 PM

Hi PaleoChimp, there are many possible causes but usually it's infections or toxins, either directly damaging the thyroid or indirectly generating an autoimmune attack on the thyroid. Occasionally it's selenium, iodine, copper, or magnesium deficiency. The trick is to clear infections, eliminate toxin exposure, improve the gut flora, and be well nourished. It typically takes a while to fix - often several years - but you can usually see gradually improvements from early on.

F910318b9aa27b91bcf7881f39b9eabe

(1164)

on August 29, 2011
at 10:15 AM

Sally, regarding that last paragraph, it got my atention because i took some blood today to test for Vitamin D. Thing is, i've been taking CLO these last few days... Do you think that will have a big impact on the values?

F910318b9aa27b91bcf7881f39b9eabe

(1164)

on August 29, 2011
at 10:14 AM

Sally, regarding that last paragraph, it got my atention because i took some blood today to test for Vitamin D. Thing is, i've taking CLO these last few days... Do you think that will have a big impact on the values?

957a563c7e4a165663fd3c71207c39da

on August 29, 2011
at 03:04 AM

Agree, and the lab ranges are missing plus dosage of thyroid meds. Can you edit the post please. FT3 and RT3 are the best tests to really show anything. TSH is effectively useless.

6120c989fd5b69f42a0834b69b87955b

(24553)

on August 29, 2011
at 12:40 AM

I'm not sure what your environmental/chemical exposures are, but mercury exposure is supposedly high on the list of things that can cause your thyroid to crap out on you. You might want to avoid those compact fluorescent light bulbs, avoid large amounts of big fish, and even consult with your dentist to make sure you don't have any loose amalgam fillings. After working with color photo chemicals for about 12 years, I ended up with hypothyroidism. I have no idea how effective it is but I've read that eating cilantro can help prevent the uptake of mercury in your diet.

020053fd576e93d1d8fa20bfb10979b9

(410)

on August 29, 2011
at 12:17 AM

Any suggestions as to what the underlying cause might be? It's helpful if I can go into my appointment with some "suggestions." I do take a thyroid support supplement (Thyroid Synergy) that includes selenium and iodine. I listened to your podcast with Chris Kresser while walking today! Your blog and book have been great sources of helpful information. Thank you, your work is much appreciated.

32123f4f25bdf6a7b70c9c2a719386ed

(396)

on August 28, 2011
at 11:27 PM

Kind of hard to compare the thyroid tests because you got completely different tests the second time except for the TSH and the FT4. The only tests I know anything about are the TSH, free t4, free t3 and reverse T3. It would have been interesting to see the reverse T3 as yours was kind of high in the first test indicating that your body was putting the brakes on your metabolism for some reason. Also showing the normal ranges would have been helpful. Anyway getting the tests for thyroid that I indicated give the best profile for your current function.

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2 Answers

best answer

9
9e20abb05f3f6e3cc4bb107f8980aecd

on August 28, 2011
at 10:54 PM

First, the TSH doesn't necessarily indicate clinical hyperthyroidism, just that you have an excess of T3. Try reducing your Nature Thyroid dose a bit, aim for TSH around 0.5.

I would also try supplementing selenium and iodine at a low level.

You want to fix the underlying cause and wean yourself of the thyroid extract.

6120c989fd5b69f42a0834b69b87955b

(24553)

on August 29, 2011
at 12:40 AM

I'm not sure what your environmental/chemical exposures are, but mercury exposure is supposedly high on the list of things that can cause your thyroid to crap out on you. You might want to avoid those compact fluorescent light bulbs, avoid large amounts of big fish, and even consult with your dentist to make sure you don't have any loose amalgam fillings. After working with color photo chemicals for about 12 years, I ended up with hypothyroidism. I have no idea how effective it is but I've read that eating cilantro can help prevent the uptake of mercury in your diet.

9e20abb05f3f6e3cc4bb107f8980aecd

(5939)

on August 29, 2011
at 01:00 PM

Hi PaleoChimp, there are many possible causes but usually it's infections or toxins, either directly damaging the thyroid or indirectly generating an autoimmune attack on the thyroid. Occasionally it's selenium, iodine, copper, or magnesium deficiency. The trick is to clear infections, eliminate toxin exposure, improve the gut flora, and be well nourished. It typically takes a while to fix - often several years - but you can usually see gradually improvements from early on.

020053fd576e93d1d8fa20bfb10979b9

(410)

on August 29, 2011
at 12:17 AM

Any suggestions as to what the underlying cause might be? It's helpful if I can go into my appointment with some "suggestions." I do take a thyroid support supplement (Thyroid Synergy) that includes selenium and iodine. I listened to your podcast with Chris Kresser while walking today! Your blog and book have been great sources of helpful information. Thank you, your work is much appreciated.

best answer

2
957a563c7e4a165663fd3c71207c39da

on August 29, 2011
at 03:20 AM

Respectfully, I must correct some information from Paul Jaminet. I'm not a doctor, just a very well informed thyroid patient.

Yes, the low TSH in this instance does not necessarily indicated a hyperthyroid state (see below), however the TSH does not indicate an excess of FT3 for the following reasons:

If a person is taking thyroid medication, the pituitary gland effectively slows down its stimulation of the thyroid gland (as indicated by the TSH level) as it can detect the thyroid hormones being supplied orally. Hence it has no need to stimulate the thyroid gland, leading to a lower TSH level.

So, in this instance, the TSH should be suppressed as expected when medication is taken. It is not directly linked to FT3 in this case - the FT3 is a measure of the effects of thyroid medication itself (ie. is measures the free/available hormone that has resulted from the actual T3 in the medication plus any the T4 that has converted to T3 and is free/available).

The original post should be edited to include the lab ranges and dosage of medication. Any time RT3 is performed, the T3 measure MUST be FT3 not T3. T3 is a pretty useless measure. Your RT3 does look on the high side, but it's best compared with FT3 not T3 to give a definitive answer.


Additionally, selenium supplementation recommendations should always carry a caveat that it is toxic above 200mcg per day. I have done really well taking selenium - it effectively stopped the intense thyroid inflammation I felt which returned when I stopped selenium.But it should be taken in the right careful dose.

Regarding iodine, many patients are sensitive to iodine supplementation. Not me, personally, but many on the realthyroidhelp.com forum have reported this. Usually this is in the case of Hashimoto's disease, rather than non-autoimmune thyroid conditions.


My recommendation is to get these tests:

FT3 FT4 TSH RT3 All thyroid antibodies (you should try to find out if there's an autoimmune component to this or not - though bear in mind that blood tests are fallible and not to be relied on as the best indicator. A lot of people show either 0 or very low levels of antibodies when in fact they do have autoimmune thyroid disease).


Also your vitamin D level doesn't look optimal, can you post the lab range please. If you run the Vit D again, don't take any Vit D for 5 days before the test.


Best wishes

F910318b9aa27b91bcf7881f39b9eabe

(1164)

on August 29, 2011
at 10:15 AM

Sally, regarding that last paragraph, it got my atention because i took some blood today to test for Vitamin D. Thing is, i've been taking CLO these last few days... Do you think that will have a big impact on the values?

F910318b9aa27b91bcf7881f39b9eabe

(1164)

on August 29, 2011
at 10:14 AM

Sally, regarding that last paragraph, it got my atention because i took some blood today to test for Vitamin D. Thing is, i've taking CLO these last few days... Do you think that will have a big impact on the values?

461a9cf5ca78123a4788c7c599066fbc

(40)

on August 29, 2011
at 01:55 PM

Lab normal ranges in parentheses. I was taking 3 grains when the last b/w was done. I've since reduced the dosage to 2 grains. Vit D was within "normal" range, 32-100, but I have been supplementing aggressively and hope it's in the 50-60 range now. I got blown off last time about the antibody test but will insist this time. Dr K aka The Quilt writes about RT3 but I'm not sure how much is considered high.

020053fd576e93d1d8fa20bfb10979b9

(410)

on August 29, 2011
at 01:58 PM

Lab normal ranges in parentheses. I was taking 3 grains when the last b/w was done. I've since reduced the dosage to 2 grains. Vit D was within "normal" range, 32-100, but I have been supplementing aggressively and hope it's in the 50-60 range now. I got blown off last time about the antibody test but will insist this time. Dr K aka The Quilt writes about RT3 but I'm not sure how much is considered high. Thanks for the TSH drop explanation applying dope slap now.

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