Well I went to the doctor today for my thyroid recheck. But it turned out the reason she wanted to recheck was that my blood test from two weeks ago when I went for a physical showed a TSH value of 9!!! Eeek, right off the charts. How weird, too. I mean my thyroid has always been sort of borderline but tending to just full into the right side of normal range. So it's really weird to see it suddenly so *totally* off the charts now. I wonder what on earth can have caused it? Could it possibly be related to VLC? Overall I feel excellent on VLC and have lost 18 pounds in a month since going VLC, but I know there is some argument that VLC can suppress thyroid function. Need to investigate further.

In the meantime I had a bunch of blood drawn and will be talking to my doctor about it again on Monday.

Well, middle age is the time most people get thyroid issues. It is an autoimmune disease (unless it's caused by lack of iodine). Personally I feel there's something environmental causing all the thyroid disease (Hasimoto's and Graves). Whether it's a lack of something like D3, or something like that jet fuel additive that's in our water. I also know a lot of people go into remission when they eliminate gluten completely. And gluten intolerance is linked to lots of other autoimmune illnesses.

So who knows what really causes it? It's becoming very common though, especially in middle-aged women.

True it was not until middle age that *both* my parents got diagnosed with hypothyroidism. Lots of stuff seems to manifest itself in middle age.

Merpig did you read Lisa's thread on reverse T3?

I've read it. It was not a test I could get my doctor to agree to today. In fact I saw the lab sheet where you mark off the required tests, and reverse T3 was not even an option on the list. But since my TSH is so out of whack right now I think I will try to address that first and see what happens next. I've lost the link to Lisa's post, but a lot of the things I dredged up about reverse T3 seemed to be related to what to do if you feel like you have hypothyroid symptoms yet your TSH is normal - which mine clearly is not!

Interesting. Thank you for letting us in on your investigations. I would not have expected that either.

Or, in the never-never land about what we learn about nutrition versus conventional wisdom, maybe 9 is good. Just kidding, I would look into it too.

RT3 is what they measure for sub-clinical hypothyroid, I think. In other words, the TSH is fine but RT3 is high.

Deb, this is nothing to play around with. If your doctor won't order a RT3 (and I'm assuming your doctor is an Endo), you MUST get an online test and get that number. If he's not an Endo, get to one immediately. He or she WILL order that test and more, and you need much more before any treatment can start. Here's why:

With a TSH of 9 your doctor will want put you on Synthroid (generic or brandname; doesn't matter) -- which is pure yet synthetic T4. If you have no rT3 problem (and yes, you CAN have that even with, or sometimes because of what the high TSH is telling you) -- the T4 may work for you. Or not.

What's far better for MOST hypo sufferers though (assuming NO rT3 problem) is a dessicated thyroid med like Nature-Throid, which has all four of the thyroid hormones: T1, T2, T3, T4 -- and in the proper mix. I believe the T4/T3 is something like 3 to 1. Do NOT let your doctor give you the "low fat diets are best for you" equivalent for thyroid and tell you that "Armour and Nature-Throid doses aren't standardized" -- because they are. Read any thyroid forum on the net and you'll see the same messages from hundreds of thousands of people that you read on these forums: conventional medical wisdom in this area is 40 years behind the facts. Actually, according to the Endo who gave an online interview about this last week -- he said the practice and standards of treating thyroid in this country has not changed for forty years. And that's a quote.

But -- if you are rT3, you can't take T4 (it will make you much, much worse, and much, much fatter) OR Nature-Throid. You will need pure T3 (Cytomel) for about 12-16 weeks first, to completely drain the reservoir of rT3 without any T4 getting in the way. Synthroid will ensure that your rT3 gets worse. Once the reservoir is gone you can go onto Nature-Throid for several months after that, which will help the conversion of T4 into T3 -- because the cell receptors will no longer be blocked by the rT3.

And guess what? You can't even start Cytomel until you've had the results of a Ferritin test (NOT the same as an 'iron level') and a Cortisol saliva test. Why? Because if in addition to everything else your ferritin level is below 70 and/or your cortisol is too high or too low -- you've got stressed adrenals. From your struggles with weight that you've shared with us here, I'm guessing you do. And those need to be addressed and cleared up before your body can/will even tolerate thyroid medication.

Like I said, this is very, very serious. You need an Endo who is living in the modern world. You need a battery of tests to see exactly what is going on with your entire metabolic system. The TSH is just the canary in the coal mine. It's signaling like mad that something is very wrong, and not just with your thyroid perhaps. If you don't discover and deal now with everything, and in the proper order, you may well burn out your adrenals and then almost no thyroid meds in the world will help you.

OTOH, if you get to a supportive Endo, and get the right tests, and get the treatment you need in the order you need, you will not only feel better than you have in decades, you will probably lose 100 pounds in the next year.

One thing you CAN and SHOULD do immediately, because regardless of which thyroid and/or adrenal problem/s you may have, they ALL require the same thing: more carbs! Getting onto zero or v. low carb went a long way to getting your thyroid to this state. Staying there now will only make things worse. Metabolisms with thyroid problems have been proven to require at least 50g of carbs a day. That's still low carb by any definition, but it should be just enough to keep you out of ketosis, which is what you want.

I truly hope you get the medical help you need, and will keep all digits crossed for you.

Lisa

T4 works great for a lot of folks. I did not do well with porcine thyroid meds there was way too much T3 in them for me. I felt good initially but later I started feeling both very tired and too wired. A nasty feeling.

My opinion is try the standard T4 treatment and try to get your TSH to optimal levels (below 2 at the very least). Live with that awhile and see how you are doing. It takes a long time for blood to stabilize with T4, like 4-6 weeks, so it might take a quite a few months to figure out the right dose.

Anyway, if you don't like how you feel that'd be a good time to explore taking T3 too.

Sure. "Zero Carbs" works for a lot of folks too. And it gives other folks serious metabolic problems, long term. Almost anything works 'for a lot of folks' -- but since everyone is an individual, when it comes to medical issues that's just not good enough IMO. Like T4 for 'folks' who have a real, measurable on blood tests, rT3 problem.

I've read all the medical literature on this, and they all agree: T4 given to a rT3 patient will make things better for a very short time (months), then worse. Forever worse. Patients then need to be withdrawn from T4, wait ten days and then go on T3 therapy for 12-16 weeks until the rT3 reservoir is depleted.


Cytomel contains ZERO porcine thyroid. It is synthetic T3 only, just as Synthroid is synthetic T4.


There's very little T3 in Nature-Throid, which is why it won't solve rT3 problems.


If the tests reveal a rT3 problem, T4 will NOT get TSH to 'optimal levels' since there's no biological way for it to do so. Those cell receptors are BLOCKED. T4 will in fact make the problem worse.

Seems to me the most prudent thing -- before giving someone specific therapeutic advice -- is to FIRST suggest that they get whatever tests are required to determine just what their problem is. So, you know, they don't end up taking medication that might cause their adrenals to crash, or even permanently damage the thyroid, which is exactly what taking the wrong thyroid meds can do.

Lisa

It's funny looking at lists of hypothyroid symptoms:

- severe fatigue,loss of energy - No, I seem to have fairly average energy, and work-full time and go out and do things in the evenings after work
- weight gain, difficulty losing weight - well yes, absolutely though I have been losing like gangbusters lately
- depression and depressed mood - no. As long as I keep my carbs low I don't ever have the least depression.
- joint and muscle pain, headaches - my arthritic knee does ache and so does the shoulderblade I injured stripping wallpaper, but that's about it. Never have headaches.
- dry skin, brittle nails - No, nails are strong and decent, and my skin is pretty nice also
- brittle hair, itchy scalp, hair loss - not in the least. My hair is extremely thick and glossy. Hair stylists always compliment me on my lovely hair, and no itchiness at all
- irregular periods, PMS symptoms - menopausal now, though I DID have irregular periods for 40 years!
- breast milk formation - not sure what this means???? I had plenty of breast milk when my son was a baby, but none otherwise.
- calcium metabolism difficulties - ????? no idea
- difficulty tolerating cold and lower body temperature - my body temp is a bit lower that average, but tolerating cold is never an issue. I'm usually HOT, the sort of person who has to have a fan on all the time, sleeps with my window open in the wintertime, and has to kick my feet outside the bed covers.
- constipation - never had constipation issues
- sleeping more than average - if anything I sleep much less than average, probably about 6 hours a night
- diminished sex drive - sex?
- puffiness in face and extremities - never
- hoarseness - never
- bruising/clotting problems - not that I'm aware of
- elevated levels of LDL (the “bad” cholesterol) and heightened - risk of heart disease - my LDL was 165 when recently tested. Not sure how "elevated" that would be considered by hypothyroid standards
- allergies that suddenly appear or get worse - nope
- persistent cold sores, boils, or breakouts - never
- tingling sensation in wrists and hands that mimics carpal tunnel syndrome - never
- memory loss, fuzzy thinking, difficulty following conversation or train of thought - never
- slowness or slurring of speech - never

Hmmm, wonder what other symptoms there are? Really except for weight issues there are no smoking guns.

Interestingly *both* my parents were hypothyroid. Both took synthroid and it resolved all their symptoms. They were on it for years. In fact my dad, age 81, still takes synthroid daily. You can even tell if he misses it for a couple days - he *does* get forgetful and slurred speech. But give him a synthroid and he is right as rain again.

Hmm, are our metabolisms so delicate that 4 weeks of going VLC can destroy a thyroid? I sometimes wonder that anyone manages to stay alive for more than a week or two! And yet you are always reading about people like that guy who mostly lives on candy, or the girl who lives only on white bread and fruit.

I mean the only obvious *symptoms* of going VLC have been losing 18 pounds in 4 weeks after having been stalled for several months.

Not everyone gets every thyroid symptom and sometimes they're paradoxical, like I gained weight with hyperthyroid. In fact, I didn't have most of those either. I got cold, sleepy, no energy, low appetite, weight gain.

On the other hand, a pituitary problem could cause TSH to be elevated too. It is the pituitary gland that secretes TSH and I've heard hard bumps to the head and make it screwy, or tumors.

Deb,

First, the list is incomplete. Here are the ones that matter for you:

-- Low temps
-- Inability to lose weight (and yes, that includes the 18 pounds you've lost recently). With a TSH of 9 the weight loss won't turn out to be a hundred pounds; you just haven't ground to a halt yet.
-- Family history
-- Irregular periods when you did have them.
-- And perhaps the cholesterol. The list you gave has it wrong -- it's not the LDL that gets high, it's the TC. Is yours over 200?

Second, out of that list, I only had 2 symptoms, but I sure am hypothyroid and my rT3 problem is quite large. You have 4 or maybe 5 symptoms, depending on your TC count. You do NOT need to have all the symptoms to be hypo. You're walking proof of that, because:

Third: your TSH levels SAYS you're not only Hypo, you're severely Hypo.


It may not just be your thyroid. With a TSH that high, you may well have adrenals under enormous stress. And for YOU, you may have been too LC for some time. When you were trying the Kwasniewski ratios, you were eating about 50g or 60g carbs a day. When was the last time you ate 100g of carbs a day on a daily basis and for a long time? Under 100g is considered LC, and under that amount might be V. LC (or at least too LC) for YOU.

It's good that T4 seems to alleviate your dad's symptoms. But it also indicates that he too may well be on the wrong meds, and would have done better on different meds (has he ever tried anything else?) since he needs to keep taking them!

If it is your adrenals (and only a test will tell) and/or ferritin levels, and/or rT3 -- (lots of 'ifs' there, I know) you should be able to take a course of T3 treatment for a few months that will turn everything around so that you don't need to take any more of anything. At all.

You are definitely hypothyroid, symptoms or not and if left untested and untreated, things are going to get worse, not better. Please get to an Endo ASAP.

Lisa

Oh, here's another one... missing the outer 1/3 of your eyebrows.