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Hack my thyroid test results (please)

Answered on August 19, 2014
Created June 01, 2012 at 6:51 PM

I've been experimenting with Paleo since January 2012 and in April started following a strict version of it. I have Hashimoto's Thyroiditis and am low thyroid and was hoping to improve my symptoms with this diet.

Although I have seen some weight loss and other positives, I still really struggle with energy levels and just feel generally hypothyroid despite "normal" test results. I've done quite a bit of research on this and read the "why am I still having symptoms" book...sorry, forgot the author and full title.

Anway, had a recent test last month and am comparing my results to test results from before I went Paleo:

Before Paleo:

  • TSH: 2.770 [0.45-4.500 uIu/mL]
  • T4: 10.4 [4.5-12.0 ug/dL]
  • T3 Uptake: 33 [24-39%]
  • Free Thyroxine Index: 3.4 [1.2-4.9%]
  • Triiodothyronine (T3): 110 [71-180 ng/dL]

5 months Paleo:

  • TSH: 2.370
  • T4: 9.1
  • T3 Uptake: 37
  • Free Thyroxine Index: 3.4
  • T3: 79

I was on a slightly higher dose of thryoid hormones about a year ago and my TSH was at .87 and I felt great but I changed Doctors and the new Doc made me lower my synthroid. I haven't felt good since but she won't change the dose back. Since I've gone Paleo, I see here that my TSH has gone down a little and my T3 seems to have gone down quite a bit. The range says that T3 should be 71-180 so I am certainly on the low end and went from about the middle. Should I ask to be put on T3 too? The brain fog and low energy suck! I've heard that T3 supplementation is somewhat controversial so I doubt my highly conservative doctor would even consider it...:( Does anyone know if the drop in T3 is significant?

I've read that infection and inflammation cause low T3 and feel like I am doing all I can to bring the inflammation down. I also have slightly swollen lymph nodes that a recent MRI determined were not suspicious but my doc says are likely caused by infection. Yet no treatment has been suggested. You all have any suggestions besides continuing to work on eating strict paleo and supplementing with Fish oil (which I do)?

Thank you for any insight or experience you can share!!! -

70895d2c0cd528713ffbebc052175052

(144)

on September 07, 2013
at 01:28 AM

Thanks much for all of your thoughtful answers. I've dabbled a little with those two websites but I looked into them more deeply. At this point, I feel that the treatment is in my hands to make whatever lifestyle changes I can to support a better quality of life. I'll see what my options are with another doctor, unfortunately I don't think I have any options within my insurance plan until the new year.

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 08, 2012
at 03:03 AM

Good luck Juni.

70895d2c0cd528713ffbebc052175052

(144)

on June 05, 2012
at 09:11 PM

thanks scottts--I have been experimenting with bringing my carbs up but I find that I get really intense hunger/sugar cravings when I do. I started the autoimmune paleo protocol recently, cutting out eggs, nightshades and most nuts except for 3 brazil nuts/day for selenium and I do feel better. I should read more about PHD though, been seeing it pop up a lot around the Paleo Thyroid community

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 02, 2012
at 04:09 PM

TSH seems only an insufficient test if you are a poor converter of T4 to T3. Once it was verified that I convert OK, regulating TSH seems to work just fine for me.

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 02, 2012
at 04:07 PM

No. He mentioned it but said if I'm not shaking or exhibiting other signs of hyperthyroidism that we would go by how I felt - which is great. He'd have to pry the 150 mcg T4 from my cold dead hands at this point.

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on June 02, 2012
at 08:48 AM

Synthroid kinda sucks, why don't you ask your doc for cynoplus or maybe erfa?

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on June 02, 2012
at 08:46 AM

TSH is not a waste of time...

543a65b3004bf5a51974fbdd60d666bb

(4493)

on June 02, 2012
at 08:19 AM

out of interest, did your Doc reduce your T4 dose when your TSH came back as 0.1

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 01, 2012
at 11:34 PM

I guess my point here is if you dropped your carbs really low when you went Paleo, you might experience negative effects with repsect to your thyroid. VLC may not be the best idea for us hypothyroids.

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 10:36 PM

Haha, yes, the brain fog *still* gets me, and my condition is very well treated/regulated. I wonder sometimes if the many years of poor treatment I endured resulted in permanent changes to my mental functioning. I'm not saying that to scare you--I'm fine--just wonder sometimes....

70895d2c0cd528713ffbebc052175052

(144)

on June 01, 2012
at 10:06 PM

meant to say "I'll look into them more deeply"---damn Brain Fog!

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:49 PM

Here is some information challenging your doctor's belief that Synthroid causes osteoporosis: http://thyroid.about.com/cs/osteoporosis/a/osteoporosis_2.htm. The problem seems to be the same as many of the studies people discuss on this site, mainly that limitations of the studies themselves make them poor predictors of risk (remember the "red meat will kill you" study recently?).

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:43 PM

^^^Revision to my previous comment: the two test *do* seem to be measuring the same things. Still, they are failing to measure some other important things (examples include Free T3, Free T4, and and thyroid antibodies).

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:33 PM

I don't think you can draw this conclusion about T3 from the information provided because the labs are missing important tests. In fact, my read of these results is that they don't even measure T3 (or specifically, "Free T3"). The T3 uptake (which doesn't measure T3 at all) might be considered like TSH, in that it's higher when thyroid hormones are lower. Also, the two tests compared don't seem to both be measuring precisely the same things. Finally, taking less T4 does not usually result in reduced TSH, but the opposite. It's good the TSH is lower post-Paleo--but it's not good enough.

70895d2c0cd528713ffbebc052175052

(144)

on June 01, 2012
at 08:50 PM

I have an HMO so I am stuck with this doctor until open enrollment changes. She said that Synthroid causes Osteoperosis and that she doesn't want me on more than I "need"...Every time I bring it up, and I've done so at least three times, she just orders more tests and then says the same thing. I'd love to know how other's have approached docs like this...

70895d2c0cd528713ffbebc052175052

(144)

on June 01, 2012
at 07:01 PM

Sure--here are lab reference ranges: TSH-uIU/mL 0.450-4.500 T4-ug/dL-4.5-12.0 T3 Uptake-% 24-39 Free thyroxine Index % 1.2-4.9 T3-ng/dL-71-180

D10ca8d11301c2f4993ac2279ce4b930

(5242)

on June 01, 2012
at 06:58 PM

Please include your labs reference ranges. They can vary from lab to lab.

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6 Answers

3
8634d4988ced45a68e2a79e69cc01835

(1617)

on June 01, 2012
at 08:01 PM

"I was on a slightly higher dose of thryoid hormones about a year ago and my TSH was at .87 and I felt great but I changed Doctors and the new Doc made me lower my synthroid. I haven't felt good since but she won't change the dose back."

That is really terrible! You feel worse, but your doctor refuses to care how you feel and only treats the numbers? That doctor should be ashamed. I would try to find a new doctor! I'm hypothyroid too, and while my numbers aren't super low, my doctor treats symptoms and adjusts based on how I feel. People aren't machines!

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:49 PM

Here is some information challenging your doctor's belief that Synthroid causes osteoporosis: http://thyroid.about.com/cs/osteoporosis/a/osteoporosis_2.htm. The problem seems to be the same as many of the studies people discuss on this site, mainly that limitations of the studies themselves make them poor predictors of risk (remember the "red meat will kill you" study recently?).

70895d2c0cd528713ffbebc052175052

(144)

on June 01, 2012
at 08:50 PM

I have an HMO so I am stuck with this doctor until open enrollment changes. She said that Synthroid causes Osteoperosis and that she doesn't want me on more than I "need"...Every time I bring it up, and I've done so at least three times, she just orders more tests and then says the same thing. I'd love to know how other's have approached docs like this...

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on June 02, 2012
at 08:48 AM

Synthroid kinda sucks, why don't you ask your doc for cynoplus or maybe erfa?

1
7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 01, 2012
at 11:09 PM

I've been hypothyroid for about 12 years or so. In May of 2011 I was on 137 mcg of levothyroxine (synthetic T4) eating a diet with uncontrolled carb levels running a TSH of about 2 and a BMI just into the obese catagory. I decided to do Atkins at 25 gm/day of carb as I decided to lose 30+ pounds.

I did this for a few months and started to feel REALLY bad, like a stone. I had done Atkins in the past and knew about low-carb flu, but this was bad and lasted much longer. A couple months in I discovered Kwasneiwski's diet and bumped carbs to about 35 gm/day based on his macro nutrient ratio fomrmula. I still felt like an inanimate object.

Finally it was time for a thyroid level check and found TSH had risen to 12.7 in 6 months time while still on the 137 mcg of T4. Doctor bumped my T4 to 150 mcg. TSH fell back to about 4 after about 4 weeks. Still felt poor.

A few months later, I came across the Perfect Health Diet (PHD) by the Jaminets and read their thyroid related blog entries. I upped my carbs to about 88gm /day of starch from potato or rice. I nearly instantly began to feel better and continued to lose weight (curently down 37 lbs and near goal). At my last thyroid check my TSH came back .1 and I've felt better than I have in about a decade. The doc thinks .1 is too low, but since I have no signs of hyperthroid he let it go.

Based on my experience I'm conviced the low carb levels caused my body to produce more reverse T3 to preserve glucose levels which drove up my TSH. When I upped the carbs, my body sensed this and started properly manufacturing T3 again and my TSH plumetted. Just my opinion based on what I've read, but I can tell you I'll not be dropping carbs below 80 anytime soon.

At 88/gm starch carbs/day I still have my fat intake at about 70% of calories/day and I can easily fast for 20 hours everyday and eat only one meal without hunger or lack of energy. I can't recommend PHD enough.

Sorry for the long answer. I am still so amazed at what I've learned about my body over the past year that if it might help somebody else well then ...

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 02, 2012
at 04:07 PM

No. He mentioned it but said if I'm not shaking or exhibiting other signs of hyperthyroidism that we would go by how I felt - which is great. He'd have to pry the 150 mcg T4 from my cold dead hands at this point.

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 01, 2012
at 11:34 PM

I guess my point here is if you dropped your carbs really low when you went Paleo, you might experience negative effects with repsect to your thyroid. VLC may not be the best idea for us hypothyroids.

543a65b3004bf5a51974fbdd60d666bb

(4493)

on June 02, 2012
at 08:19 AM

out of interest, did your Doc reduce your T4 dose when your TSH came back as 0.1

70895d2c0cd528713ffbebc052175052

(144)

on June 05, 2012
at 09:11 PM

thanks scottts--I have been experimenting with bringing my carbs up but I find that I get really intense hunger/sugar cravings when I do. I started the autoimmune paleo protocol recently, cutting out eggs, nightshades and most nuts except for 3 brazil nuts/day for selenium and I do feel better. I should read more about PHD though, been seeing it pop up a lot around the Paleo Thyroid community

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 08, 2012
at 03:03 AM

Good luck Juni.

1
A2e11d01cea9160ca6a2739a3aa347bd

(10)

on June 01, 2012
at 07:34 PM

Look into selenium supplementation. Required for the conversion of T4 to T3

1
Eb547bd3d1c1653933003c34496efa26

on June 01, 2012
at 07:04 PM

Hi... you dont need to be on T3.. you just need to be on more T4, so you get your TSH back down to around 1. Where you were last year and you felt good. With out a doubt you would feel better on T3 because it is such a short burst of pure energy and joy. But you would still swing down to low after that fast acting T3 goes thru your system. More then likely your T3 is higher because your total TSH is lower because you are on less T4. T4 turns into T3. I would suggest you go back to your doc that had you on the higher dose or find a doctor that listens to how you feel instead of just looking at your numbers.

Good luck.

Holly (too many people in my family have thyroid issues)

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:43 PM

^^^Revision to my previous comment: the two test *do* seem to be measuring the same things. Still, they are failing to measure some other important things (examples include Free T3, Free T4, and and thyroid antibodies).

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:33 PM

I don't think you can draw this conclusion about T3 from the information provided because the labs are missing important tests. In fact, my read of these results is that they don't even measure T3 (or specifically, "Free T3"). The T3 uptake (which doesn't measure T3 at all) might be considered like TSH, in that it's higher when thyroid hormones are lower. Also, the two tests compared don't seem to both be measuring precisely the same things. Finally, taking less T4 does not usually result in reduced TSH, but the opposite. It's good the TSH is lower post-Paleo--but it's not good enough.

0
4ef079c57d2140bba4dbf4e30240a645

on June 02, 2012
at 08:21 AM

TSH test is a waste of time and money and means nothing for a person with Hashimotos and thyroid Hrt (like you and me). The only values that need to be monitored are FREE levels of T4 and T3: TpoAb (yes you need to monitor those and get them lower via a high antioxidant diet and supplements) and Reverse T3

Everything you need to know can be found on this website: http://www.stopthethyroidmadness.com/

Also, you need to have your cortisol checked. It may well be low and contributing to both thyroid issues and fatigue.

I hope you have a good ND or Functional Medicine MD

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on June 02, 2012
at 08:46 AM

TSH is not a waste of time...

7f8bc7ce5c34aae50408d31812c839b0

(2698)

on June 02, 2012
at 04:09 PM

TSH seems only an insufficient test if you are a poor converter of T4 to T3. Once it was verified that I convert OK, regulating TSH seems to work just fine for me.

0
A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 09:22 PM

I always make the same suggestions, but here I go again:

  1. Chris Kresser on Thyroid Disorders: Chris Kresser is a measured, research driven practitioner who's done a lot of work on thyroid disorders. His information is thoughtful, thorough, and unfortunately, kind of complicated--like thyroid diseases. It's so complicated at times that, if your doctor will only discuss ONE treatment method--and it's based solely on the lab results you presented--then she doesn't understand thyroid disease well enough to treat you for it.

  2. Stop the Thyroid Madness: Kind of the opposite of Chris Kresser, in terms of tone, style, and temperament, I suggest checking this out in order to blow your mind about thyroid disease and treatment. Be forewarned that this website represents a community of pretty radicalized thyroid patients. They got that way because of the common medical malpractice that is conventional contemporary thyroid treatment. You don't have to embrace STTM's radical tone or spirited advocacy, but you will likely learn some good stuff about your thyroid, understanding how it functions, how it malfunctions, and about good treatment options that could improve your quality of life.

It shouldn't be too hard for anyone drawn to the Paleo lifestyle--and thus presumably aware of the many ways we are mislead and miseducated by the medical/pharmaceutical, health, diet, and food industries--to appreciate that thyroid disease is also treated problematically. Educating yourself is job one; finding a better doctor is job 2. In my opinion, neither one is optional, in terms of long-term health and quality of life.

Good luck to you! I hope you get back to feeling good soon!

A7768b6c6be7f5d6acc76e5efa66464c

on June 01, 2012
at 10:36 PM

Haha, yes, the brain fog *still* gets me, and my condition is very well treated/regulated. I wonder sometimes if the many years of poor treatment I endured resulted in permanent changes to my mental functioning. I'm not saying that to scare you--I'm fine--just wonder sometimes....

70895d2c0cd528713ffbebc052175052

(144)

on September 07, 2013
at 01:28 AM

Thanks much for all of your thoughtful answers. I've dabbled a little with those two websites but I looked into them more deeply. At this point, I feel that the treatment is in my hands to make whatever lifestyle changes I can to support a better quality of life. I'll see what my options are with another doctor, unfortunately I don't think I have any options within my insurance plan until the new year.

70895d2c0cd528713ffbebc052175052

(144)

on June 01, 2012
at 10:06 PM

meant to say "I'll look into them more deeply"---damn Brain Fog!

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