My personal experience with low thyroid

Something happened to me around October-November of last year.

I usually feel great. Ordinarily, my struggles are sleeping and relaxing. As with most people, I have too many projects on my schedule, though I find my activities stimulating and fascinating.

I blasted through a very demanding November, trying to meet the needs of a book publisher. This involved sleeping only a few hours a night for several days on end, all after a full day of office practice and hospital duties.

But it was getting tougher. My concentration was becoming more fragmented. Getting things done was proving an elusive goal. Exercise became a real chore.

Although I usually force myself to go to sleep, I was starting to fall asleep before my usual bedtime, and I was sleeping longer than usual.

It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

So I had my thyroid values checked:

Free T3: 2.6 pg/ml (Ref 2.3-4.2)
Free T4: 1.20 ng/dl (Ref 0.89-1.76)
TSH: 1.528 uUI/ml (Ref 0.350-5.500)


Normal by virtually all standards. I measured my first morning oral temperature: 96.1, 96.3, 95.9. Hmmmm.

My experience coincided with the Track Your Plaque and Heart Scan Blog conversations about low thyroid being enormously underappreciated, with the newest data on thyroid disease suggesting that a TSH for ideal health is probably 1.5 mIU or less. (More about that: Is normal TSH too high? and Thyroid perspective update .

Could this simply be a case of medical student-oma in which every beginning medical student believes he has every disease he learns about?

Despite the apparently "normal" thyroid blood tests, I took the leap and started taking Armour thyroid, beginning at 1/2 grain (30 mg), increasing to 1 grain (60 mg) after the first week.

Within 10 days, I experienced:

--Dramatic restoration of the ability to concentrate
--A boost in mood. (In fact, the last few blog posts before I replaced thyroid reflect my deepening crabbiness.)
--Large increase in energy, now restored to old levels
--Need for less sleep
--I'm warm again! (It's still <20 degrees, but I get easily stay warm while indoors.)

I am absolutely, positively convinced of the power of thyroid. I am further convinced from the clinical data, patient experiences, and now my own personal experience, that low levels of hypothyroidism are being dramatically underappreciated and underdiagnosed.

I shudder to think of what my life would have been like 6 months or a year from now without correction of thyroid hormone.

Now, the tough question: Why the heck is this happening to so many people?

Comments (31) -

  • Brock Cusick

    2/5/2009 12:57:00 AM |

    Here's one theory:

    http://wholehealthsource.blogspot.com/2008/12/omega-6-linoleic-acid-suppresses.html

  • Anonymous

    2/5/2009 1:03:00 AM |

    For my last thyroid test my TSH came back at .752 - which I believe is good.  I get cold relatively easy so figured before testing that my results would come back problematic.  

    Then again I'm thin, with little body fat.  

    Don't know if this means anything for thyroid results, but I've noticed a dramatic feeling in coldness when I eat milk products.  If I have milk product, I become deeply chilled in the winter time.  So I've avoided milk for around 20 years for that and other reasons.  

    Since a feeling of cold goes along with hypothyroidism I've wondered if cows milk can cause thyroid issues.

  • Diana Hsieh

    2/5/2009 3:15:00 AM |

    Funny, the symptoms you describe are basically the same as those of my dog when she developed thyroid problems.  She was very weary and down, unable to do much, always cold, etc.  However, I suspect that you didn't have the problems with your fur like she did.  Smile

    Going on thyroid meds gave her a new lease on life: it took years off of her life in very short order.  I can only imagine how much of a difference it made for her mental state from the inside -- and I wish that we'd caught it sooner.  

    For a person, the ordeal would have been even worse.  At least my dog didn't know any better.

  • Darcy

    2/5/2009 4:29:00 AM |

    One theory floating around in the hypothyroid circle...Antibiotics have kept more of us alive than would have prior to antibiotics being invented. Poor thyroid function will lead to poor immune system function. Take away the antibiotics we were given as children for our various ear infections and strep throat and many of us grown adults would not have made it to adulthood. Now we're just grown adults with wide-spread thyroid problems.

  • Anonymous

    2/5/2009 12:26:00 PM |

    All that stress may have caused some adrenal fatigue which will lower tissue responsiveness to thyroid hormone. It would be interesting to know what your Reverse T3 was, as adrenal fatigue will reverse the T3 making it useless at the tissue level but still measurable as a normal total T3. With continuing adrenal fatigue and exogenous thyroid hormone you may start feeling "hyper" in the future even with normal numbers. Heart palpitations were my "hyper" symptoms while on thyroid for Hashimoto's but with still lowish lab numbers. This was then misdiagnosed as "anxiety" (palpitations do cause anxiety) and I was put on an SSRI. Years later I addressed the adrenal fatigue, am off the SSRI, and can tolerate exogenous thyroid without palpitations.

  • Olga

    2/5/2009 2:51:00 PM |

    Hi Dr. Davis:

    I was very interested in this post.  I have recently found out that the thyroid nodule I had excised 4 years ago was most likely a nodular goitre due to iodine deficiency.  I have never felt well since the surgery.  I was put on synthroid.  More recently I've been on Armour, since I consulted a complimentary physician.  He discovered that my iodine levels were very low.  I've started supplementing with Lugol's and now I've been able to go off the thyroid meds and I'm feeling much better.  I too have had thyroid problems every fall/winter since the surgery which resolve with the coming of spring.  Once I look forward to having my lipids rechecked once my iodine levels are normalized to see if it has any effect.  I was diagnosed with familial hypercholesterolemia 20 years ago.  Your blog has been a wealth of information.  Thanks so much.

    Olga

  • Nameless

    2/5/2009 9:40:00 PM |

    Have you considered that perhaps stress and lack of sleep simply caused your thyroid functions to become 'sluggish'?

    So instead of your thyroid being the cause of your symptoms, it was your lack of sleep + stress, which then caused your thyroid to work less effectively? Meaning... your thyroid issues, if there are any, were temporary, and restoration of sleep, etc. would result in an improvement?

    Armour would improve your symptoms under such a scenario too. But perhaps simply sleeping more, etc. would have done the same. Although this is a bad analogy, it's as if you took lots of caffeine or an amphetamine to keep yourself awake, more alert, etc. Yes, you would feel better, but taking better care of yourself, sleeping more, less stress would be the better option.

    Your hormone numbers are actually pretty good, by the way. I mean, no Endo or familty doctor would ever treat you with a TSH that close to perfect, and your hormone levels, although not perhaps ideal, really weren't that bad. And TSH, T3 and T4 all do fluctuate, not only day to day, but in the same day. Your TSH could come back close to 1.0 after a couple of night's of good sleep.

    Did you have your thyroid antibodies tested? That is the main cause of hypothyroidism, and can cause symptoms on their own, regardless of thyroid hormone levels (as least that's what I believe, but some doctors may think differently).

    I don't mean to sound negative with these comments, but I'm just playing Devil's advocate. It does sort of sound like you are finding thyroid disease everywhere, even in yourself, when it may not exist.

    Generally, for a proper  thyroid disease diagnosis, you can't go by a single test if your TSH is close to normal like that. A TSH >2-3, raised thyroid antibodies, and an ultrasound are usually used. If you come back abnormal on a couple of those, then yeah, you probably have Hashimoto's or some sort of thyroid problem.

  • Jenny

    2/5/2009 10:02:00 PM |

    If you have been low carbing, there is something I read about called Euthyroid Syndrome where your thyroid slows as response to the ketogenic state--the body thinks it is starving and slows down.

    This is different from thyroid disease. Very common.

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.  Doctors see the normal test results and refuse to prescribe.

    For me, the only cure is to up the carbs again (with insulin) since I can't get treatment.

  • Lola

    2/5/2009 10:33:00 PM |

    A lot of the Armour/natural throid fans and proponents say that your FT3 should ideally be at the top of the range, and FT4 at least in the top third. So, by the looks of it, you were in fact having something of a thyroid dip.

  • Scott W

    2/5/2009 10:39:00 PM |

    So...how do you convince a doctor to prescribe thyroid when your lab results don't support it?

  • Dr. William Davis

    2/6/2009 12:13:00 AM |

    All great comments.

    However, I've told everyone only part of the story. For instance, in patients we are seeing marked reductions in LDL and lipoprotein(a), not to mention improved energy, weight loss acceleration, and mood.

    As time passes, I am becoming more and more convinced that first a.m. oral temperature is the best way to identify low thyroid.

  • Nameless

    2/6/2009 2:12:00 AM |

    Improvements in lipid scores is another matter. It's not subjective anymore then.

    The question of why it's so common then is an interesting issue. You can't just assume it's lifestyle or lack of D, etc.  It is possible that's the cause, but it'd be a guess and not really scientific.

    I mean, we can safely assume you are following your own plan, yet  your thyroid may be sluggish there too.

    For Euthyroid Syndrome, you'd want to get your reverse T3 tested. At least that's what my doc said to test for. And as for getting treatment when your labs don't support it... umm... it's a problem. It's difficult enough getting treatment when your labs are abnormal.

    I'm glad Dr. Davis mentioned that there are patients with reduced LDL after treatment. I've recently been diagnosed with Hashimoto's -- TSH routinely >3 this past year, elevated antibodies, and two abormal ultrasounds later, an Endo is finally treating me. My lipids have been extremely stubborn, even though I follow a low carb, very little wheat diet, fish oil, normalized D, exercise, etc. My trigs won't go below 150 & LDL is in the 120ish range. Thankfully my Lp(a) has always been low 4-5. We'll see after treatment (assuming my endo doses me enough) if my numbers improve.

  • Anonymous

    2/7/2009 1:45:00 AM |

    The free t3 result you posted was low.  Very low.  This can cause a spiral of damage & disease.

    I am one who had a normal TSH even when my free t3 falls below the normal range.  The HPA Axis is at fault.  

    This situation is not as rare as some doctors like to think.  

    I do not believe doctors should rely only on TSH (a pituitary hormone.)  Free t3 is THE active thyroid hormone, and deserves the strongest attention.  

    I like to keep my ft3 at or just above the midpoint of the lab's reference range.

  • Anne

    2/7/2009 1:21:00 PM |

    Dr Dach reviews the book "Stop the Thyroid Madness" and links to other books and websites concerning thyroid/synthroid/armour issues. http://jeffreydach.com/2009/02/06/stop-the-thyroid-madness-by-jamie-bowthorpe.aspx

    I have been on Synthroid for years and now wonder if I would feel better on Armour. I am always cold and my skin, although less dry, it is still dry. I lost hair at one time. I am no longer losing hair, but I never grew back what I lost.

  • Anna

    2/7/2009 7:18:00 PM |

    Not long ago my son and I were tested for gluten (IgA antibodies, anti-tissue transglutaminase IgA, and genes, and we both tested positive but with a slightly different combination of genes that predispose.  

    Then it occurred to me that the hypothyroid symptoms greatly worsened during the years when I was eating the most gluten, at the end of my "bread machine phase" (bread machine recipes often specify high gluten wheat flours and added wheat gluten to boost rising performance and enhance texture) and when I was low carbing, but consuming LC bread products that contained not only soy, but added wheat gluten to boost protein and reduce starch content.  Gluten sensitivity and thyroid conditions often are related, but of course, I was not checked for anti-thyroid antibodies at the time.  

    I still eat LC, but a few years ago I did drop the LC bread and wheat products (and basically grains altogether) because they didn't fit into my goal to eat less industrially processed (fake) foods.  I'm not entirely paleo, but definitely eat in that direction, with very good results.  Wish I could say that was enough for my thyroid function to improve without added thyroid hormone supplementation, but I still take thyroid hormone (T4 and T3) to feel better.

  • Anonymous

    2/8/2009 12:40:00 AM |

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.

    For those in jurisdictions in which importation is allowed (or for those willing to risk ordering a medication that is probably not a high priority for prosecution):

    U.K. source
    S. Africa source

  • Trinkwasser

    2/8/2009 1:08:00 PM |

    I've heard a lot of similar stories in the UK - in many areas thyroid is not treated unless TSH is over 5 or even in double figures, and T3 and T4 tests are unavailable.

    Some people simply do not do well unless TSH is around 1 and it often takes a geographical move to obtain treatment, the effects of which can be dramatic and may include improved BG and "treatment resistant" depression resolving.

    Yet others need more subtle rebalancing until T3 and T4 are in range.

    As to causal factors, no clue, but this seems commoner that it's supposed to be.

  • Anonymous

    2/8/2009 5:39:00 PM |

    Dr. Davis I'd be interested in your experiences with patients with low testosterone levels and its relation to heart disease, plaque progression and metabolic syndrome. Has restoration to "normal" levels led to improved cardiovascular health?

  • JD

    2/9/2009 2:34:00 PM |

    Regarding Euthyroid Syndrome. The full name is Euthyoid Stress Syndrome. Dr. Eades says he did not see this effect in his patients. See the comments section of this link for further information. http://www.proteinpower.com/drmike/uncategorized/vampire-myths/

  • Nancy LC

    2/15/2009 6:43:00 PM |

    People practicing CRON, calorie restriction with optimal nutrition, also report low T3 levels.  In fact, they say low T3 levels is associated with longevity and seem to think it's a good thing.

  • lynn

    3/10/2009 1:41:00 AM |

    Yes there is a school of thought that Free T3 should be at the top of the range and free T4 mid range or higher. Since this is the school of thought that actually has success with patients feeling better, I would go with that. My TSH was totally normal like yours but my antibodies were pretty high. Although, that being said I have read that a TSH over 1 in a woman and 1.5 in a man is already in the danger zone http://www.thyroid-info.com/articles/dommisse.htm. Have you had your antibodies tested?

    There is a thyroid scandal going on all around the world where those of us with hypothyroidism are neither being diagnosed nor adequately treated.

    My temps have been in the 96's for years. God knows how long my thyroid gland has been being attacked.

    FYI it has been reported that most pateints feel their best on 3-5 grains of armour. There is even a theory that in healthy individals TSH is very, very low and that TSH only activates as a kindof emergency response.

  • mike V

    3/28/2009 12:28:00 PM |

    Here is a good NYTimes overview on treatment and controversy. 3/28/09

    http://preview.tinyurl.com/ckg6uq

    MikeV

  • ~MyGalSal~

    9/17/2009 12:42:09 PM |

    I could be a poster child for what no T3 can do to you.  I wonder if you could address the recent lack of availability of Armour thyroid and the disinformation regarding such.  I have resorted to ordering glandulars from NutriMeds but I am already suffering from a week of having to go back on levoxyl because of Armour not being available.  I have called many pharmacists and physicians and asked them what they are being told and virtually EVERYONE SAID NOTHING.  Any comments appreciated on this.  To me, this borders on criminal to abruptly stop the availability with confusing and contradicting reasons and all they will say is take a syhthetic.

  • Anna

    9/17/2009 9:27:14 PM |

    MyGalSal,

    The thyroid shortage is most acute at the corporate chain drugs stores.  They almost always order via dtisributers (middlemen) rather than direct from the maker.  

    Try a compounding pharmacy, either local or via online/mail order.  If you don't know of one, try this site:  www.iacprx.org/  Compounding pharmacies make individual preparations for all sorts of reasons.  They are often located near major medical centers.

    Many compounding pharmacies still have natural thyroid supplies (though they may be limiting refills to give everyone a chance during the shortage).  Compounding pharmacies also can compound a thyroid preparation specifically for you (though it is more naturally expensive than buying ready-made pills) if they still have a supply of the bulk thyroid extract powder, but your doctor will have to know how to write a prescription for compounded meds (my HMO endo didn't know how, I had to find out for him!).

    I've been able to get Nature-throid via a compounding pharmacy (they mail it to me), though lately I've had to be flexible and split larger dose tablets in half or take two of a smaller dose.  I don't mind, as long as I can still get Naturethroid.

    Janie Bowthorpe at Stop the Thyroid Madness blog has tips for maintaining your access to natural desiccated thyroid hormone, including having your doctor write your prescription as "broadly" as possible to so that the pharmacy can fill it with different brands or tablets cut in half, etc.  YOu may have to think outside of the "shopping center drugstore box" though.  

    I haven't tried this yet, but many people are having good luck ordering thyroid hormone from Canada (there is NO thyroid hormone shortage in Canada and Europe).  Again, Janie at STTM blog has posted specifics and communication with a Canadian manufacturer if you decide to try this route

    Good luck.

  • Anonymous

    6/16/2010 12:47:50 PM |

    It's your discovery, good job!

  • Male hormone therapy Beverly hills

    7/18/2010 8:27:14 AM |

    A fantastic read….very literate and informative. Many thanks….what theme is this you are using and also, where is your RSS button ?

  • jpatti

    7/24/2010 3:30:38 PM |

    With regards to adrenal fatigue, there’s a new web site that gathers much of the information from Val, who’s been helping people treat adrenal fatigue and hypothyroidism, including rT3 issues, for a long time: http://nthadrenalsweb.org

    Highly recommended.

  • watch

    8/17/2010 10:02:05 AM |

    Well Whattadya know, yet another great site to add to my reader!
    Hypnose or hypnosis

  • buy jeans

    11/3/2010 9:10:41 PM |

    It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

  • Megaera

    2/23/2011 9:34:53 PM |

    Pardon me for sounding bitter, but you got to resolve effortlessly symptoms I had to endure for four years (actually they were much worse, but it took 3 years of being told I had perfectly normal TSH levels, so shut up, and then another year to get an appointment with an endocrinologist who said, why yes, yes, you do have a goiter, we'll try synthroidl.  Two years on that crap, which didn't help at all, eventually some t3 which didn't either, and finally a minimal dose of Armour Thyroid (1 grain) which keeps me from feeling quite so crap, but I can't lose weight -- ever -- and can't ever stay warm in winter, or regulate my body temp in summer.  I HATE doctors.  And no, I can't change endos, there are't any more endocrinologists in this area, I'm damned lucky I got this one.

  • Natasha

    6/13/2011 7:24:53 AM |

    I was diagnosed with Hypothyroidism April 2006. My doctor started me on 100 mc of synthetic drug a day. After being on the dose for 2 months TSH level was down to 1.4 and my area normal range is 0.2-4.5. My doctor decided to keep me on the 100mc Thyroxine a day to see how i went. 4 weeks later i started to feel alarming symptoms as if i had Hyperthyroid. So I decided to switched to bovine thyroid, so far I gained positive results.

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Lipoprotein(a)--neglected and unappreciated

Lipoprotein(a)--neglected and unappreciated


Lipoprotein(a), or just Lp(a) to its close friends and neighbors, is among the most underappreciated and neglected of causes of coronary plaque. It's the Rodney Dangerfield of lipoproteins.

Lp(a) rarely gets diagnosed before people come to my office. They've often been through the ringer: doctors have thrown their hands up in frustration because of poor response to "standard" treatment (AKA statin drugs); the patient doesn't understand why they might be thin and active yet have the high blood pressure of someone 70 lbs heavier; they have heart disease despite wonderful cholesterol values.

One blood test and the answer becomes clear: They have Lp(a). It explains all these phenomena.

They why don't more physicians order this simple test? Why don't we hear more about this prevalent (1 in 5 people with coronary plaque have it) genetic pattern that accelerates risk for heart disease?

There are a number of reasons. But I believe the most powerful reason is simply that there is no big revenue-generating drug to treat it. Statins reduce LDL cholesterol to the tune of $27 billion dollars a year (2007 revenue). There's no such blockbuster for Lp(a). Of course, Niaspan represents the relatively anemic attempt to commercialize a pharmaceutical treatment for Lp(a), but side-effects and the lack of FDA trials for the Lp(a)-reducing indication have stalled its commercial success. (Efforts to block the flush with various products, by the way, may re-invigorate niacin as a pharmaceutical agent. The drug companies smell money here.)

Another reason for Lp(a)'s unpopularity: Though there are mounds of data that document--without question--that Lp(a) is an important risk for coronary disease and other forms of atherosclerotic disease, we lack treatment trials. For instance, niacin vs. placebo for 5 years, then count the number of heart attacks and deaths. We have numerous, repetitive, overlapping, redundant trials with statins adhering to this design. We have none for niacin and the treatment of Lp(a).

Niacin is also a pain in the neck for your doctor. He/she rapidly tires of the calls about the crazy and disconcerting flushing with niacin. Most are unaware that proper hydration reduces or eliminates the flush for the majority of people. It takes too much time and energy to educate people. (By the way, prescription Niaspan makes no mention of purposeful hydration. They only suggest the nonsensical "Take with a low-fat snack," i.e., snacks that actually counter the therpaeutic effects of niacin. What they should be saying is "take with a high-fat snack" like raw almonds, foods that facilatate the benefits of niacin.)

Should someone concoct a successful pharmaceutical treatment for Lp(a), it will make the news, headlines in health magazines and health sections of the newspaper will blare about how important Lp(a) is. Yet it has been there all along, frustrating people and their physicians.

In the Track Your Plaque experience, Lp(a) clearly 1) correlates with heart scan scores, 2) correlates with progression of heart scan scores without treatment, and 3) poses special challenges for treatment. Interestingly, some of our biggest failures have been with Lp(a), as well as some of our biggest successes. (Our current record holder for the largest percentage reduction in heart scan score has Lp(a).)

If you have coronary plaque, or if there is family risk of heart disease, then Lp(a), in my view, is an absolutely essential factor to test for. Yes, treatment poses challenges. But once you know who your enemy is, then you can focus your efforts on it. Not knowing whether or not you have it leaves your efforts unfocused and generally flawed.

Track Your Plaque Members, be sure to read our in-depth Special Report, Unique Treatments for Lipoprotein(a) Reduction.



Copyright 2008 William Davvis, MD

Comments (2) -

  • Anonymous

    3/9/2008 6:36:00 PM |

    Alka-Seltzer [325 ASA, aqeous] after applesauce [3 TBS].
    High-Fiber snack plus an ASA that won`t be forgotten: It`s in the water you need to wash down the niacin, and the funny taste helps remind you:
    90% compliance if adhered to.
    Not usually required chronically,.. most flushing is "tachyphylactic".
    castelli et al An Interview with the Editor, Am J Cardiol 2005

  • buy jeans

    11/2/2010 8:53:49 PM |

    Should someone concoct a successful pharmaceutical treatment for Lp(a), it will make the news, headlines in health magazines and health sections of the newspaper will blare about how important Lp(a) is. Yet it has been there all along, frustrating people and their physicians.

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