Question to Paul - too much fT3?

[Kevlin]

2. Can you explane circadian rythm and T3 and cortisol? I think I read something about the importance of circadian rythm when you take your T3? Should I consider take some of my Thyroid in the early morning/late night? Could it be vital for me?

I don't know if this is vital for you because I cannot see any data from you on the information that I usually look at.

I usually look at:
TSH, FT4, FT3
Current thyroid medication - type, amount and timings
serum iron, serum ferritin, transferrin saturation % - iron panel
B12
folate
vitamin D
cortisol - via a 24 hour adrenal saliva test or 24 hour urinary cortisol test or several serum cortisol tests
body temperature during the day
blood pressure during the day
heart rate during the day
symptoms - main symptoms someone has
their history of thyroid disease - how it started, how it developed, what medication they have used

- so I don't make random comments. Any comments I make are based on a lot of information from a person.

The circadian T3 method is explained fully in my book 'Recovering with T3'. It requires either the T3 that is found in natural desiccated thyroid or standard T3 to work. It will not work well with slow release T3.
Cortisol is produced every day. Most cortisol is made in the last four hours of a person's sleep. Free T3 also peaks around the time this cortisol production starts. So, for someone who get up at 7:00am then most of their cortisol is made between 3:0am and 7:00am. The Circadian T3 Method uses this information to add either some T3 or some NDT (natural desiccated thyroid) medication into this time period. I usually start with about 1 grain of NDT or 10 mcg of T3. I place it 1.5 hours before someone gets up and watch the results. People need to track temperature, heart rate and BP during the day - several times as well as their symptoms. If things are better but not good then it is moved back in time by one half hour earlier. This proceeds to the four hour time - perhaps to 3:00am for a 7:00am riser. If this is not enough then the process is repeated with an increase of thyroid medication. The results have been spectacular. Many people have been made completely well and others have been able to stop their hydrocortisone medication.

Hey-hey Paul

• I have used NDT since late 2009.
• And also Hydrocortisone - nearly 1,5 year.
• I don't have intrinisic factor, and take B12-injections from time to time.
• My fT3 is high (out of labs reference range) and fT4 is in the middle.

1. I wonder if my high levels of fT3 is a strain on my adrenal gland?

2. We who are using NDT or T3 (in Norway: Liothyronin): the TSH is not of interest - or do you disagree..?

• My anti-TPO has dropped from 1300 (2009) to 18 (2012)

3. Does anti-TPO dropping have any significant interest?

[Paul Robinson]

I don't care much about TSH except that when it is near zero I know that T4 conversion rate is minimised.

If you feel well, if your heart rate is normal, your blood pressure is normal (you should have a home meter), your body temperature is normal and you have good energy then I don't care about FT3 levels.

If you still have symptoms then you'd need to measure cortisol by saliva or serum/blood - taking a cortisol reading just before you are due to take HC is OK and can provide good information.

It is good that TPO has dropped - that is all.

Paul

[Vigdis]

If you feel well, if your heart rate is normal, your blood pressure is normal (you should have a home meter), your body temperature is normal and you have good energy then I don't care about FT3 levels.l

I guess you are familiar with the Docs almost hysterical responses when the FT3 is elevated, Paul. What kind of argument could be useful when you sit at the Docs office and he/she tries to convince you to lower your mediction because of the elevated FT3?

[Paul Robinson]

Vigdis - too much FT3 - if a doctor has a firm view of this then they can be dogmatic. It may be hard to change their minds. Some people have bought my book and highlighted the areas that discuss this. Others have taken some copies of my blogs in.

It may be easier to get the doctor to examine the person, listen to their heart, take their blood pressure and have the discussion about what exactly is the 'hyper' symptom that the doctor can see - there will not be one usually. Also the FT3 is a blood level hormone. Trying to make the point that this is not necessarily what is active in the cells is an important point.

Some people have given or loaned their doctor my book.

Sometimes if a doctor is stupid or rigid then you have to change doctor.

The other approach (which is more sneaky) is to fiddle the blood test by taking less thyroid hormone for 24-36 hours before the test to lower FT3 and raise TSH. For someone taking NDT or T3 this is easy to do. If it is hard to find a new doctor and you don't want the argument with someone who is stupid then doing this can be the only easy way to avoid the argument.

Blood tests can be useful for diagnostic purposes but for fine tuning of thyroid hormones invariably they are just a way of keeping doctors happy, because doctors are not using the most important data - symptoms and signs.

))