Thyroid Disease Support Information

NEWS: There is an accurate TSH home test available from Blood Test At Home for $25.99 (and they also do Vitamin D, a nice add on to order) While TSH may not be helpful to titrate ongoing treatment it is an excellent screening tool to monitor your need for treatment. TSH should be below 2.0, typically 1.3 or so in healthy persons. If yours is higher, consult your physician. If you need to monitor your treatment (how much thyroid do you need?) thyroid panels are available from Private MD (link is to a standard panel but for monitoring treatment consider the "TSH, free T3 and free T4" combo which you will find by clicking on the test categories / thyroid) Private MD Labs offers a 15% discount (discount link on their home page) so a TSH, free T3 and free T4 panel ($78) will be only $67.

As February of 2009 a reformulation of Armour thyroid in the US seems to have dramatically reduced its effectiveness. The manufacturer increased the amount of cellulose which in fact can bind nutrients/elements. It is possible to find natural thyroid, Westhroid and Naturethroid, in the US but they seem to be in short supply and are more expensive. This is devastating to many people who have worked so hard to 'get well'. Hopefully Armour will reconsider and return to their old formula. Do let them know you care. It is possible to find dessicated thyroid outside the US.

Disclaimer: I am not a physician and do not diagnose disease. The statements made here are for educational purposes only. Please see your health care professional before making changes in your diet or medications. Any of the information you may choose to use is your responsibility. Thyroid disease can be life-threatening and is not to be taken lightly. Treatment of some kind is critical and necessary.

Please note: Low levels of dietary protein, omega-3, vitamin D, vitamin A, vitamin C, potassium, zinc, copper, lithium, selenium, and magnesium affect your thyroid gland function. It is possible to test positive for hypo, hyper or auto-immune thyroid disease and yet correct the abnormal tests with excellent nutrition. Unless your thyroid disease symptoms are severe or life threatening you may want to try improving your nutrition before you commit to life long use of thyroid hormone. If you already take thyroid medication a good nutritional program will help you be as healthy as possible and allow your medication to work better. Do not stop medication without notifying your physician. Autoimmune thyroid disease almost always requires medication ongoing.

You have been diagnosed as having some form of thyroid disease. You may be hypothyroid, hyperthyroid, have Graves Disease or Hashimoto's Thyroiditis. This information has not been prepared to take the place of being monitored by your physician. It is to help you help your physician determine your correct dose of thyroid medication and help you both maintain the correct dose.

A CAUTIONARY NOTE: It is important to make sure your symptoms and blood work are not a result of adrenal insufficiency. Depressed thyroid and depressed adrenal symptoms are very similar. Cortisol, a primary adrenal hormone that is elevated under stress and depressed when the adrenal gland is exhausted, alters TSH and thereby T4 and T3. Alterations in adrenal function alter thyroid function but treating the thyroid will not make the underlying adrenal condition, if it exists, better. A simple, and relatively inexpensive, 24 hour salivary cortisol and DHEA test can rule out (or in) adrenal involvement. You will need my PIN to order, 230288.

Also consider this test if you are currently being treated for thyroid and the results are not what you expected. If you have thyroid disease and are treated with a good combination of T3 and T4 your symptoms should resolve rapidly. Your symptoms will remain, alter, or become worse if adrenal dysfunction is present. The cortisol/DHEA test is available from your physician. It is important that the health care professional you are working with understand this testing, how to interpret it, and how to treat the results, or the testing will be of no value to you.

UPDATE 2011 February- Soon to be available 'Using Liposomal Vitamin C to Restore Adrenal Health'. If you are interested now please contact me. The basic strategy is 2,000 mg of liposomal C three times a day for 2-3 months and 1,000 mg liposonal vitamin C twice a day ongoing (very important). The best buy liposomal C may be found at Let's Have Health. Simple strategy, great scientific rationale and great results in current clients trying the protocol.

A second cautionary note is that there is now recognized in the literature a 'thyroid resistance syndrome' similar in character to 'insulin resistance'. This manifests as symptoms of low thyroid function but normal thyroid blood work. An imbalance of omega-3/omega-6 fatty acids may contribute to this condition as well as low tissue levels of vitamin C (see Liposomal C suggestions). Lowering omega-6 fats and dramatically increasing omega-3 (fish oil NOT flax, see Update on Essential Fats) has improved or normalized thyroid function in some persons.

A small dose (not less than 200 mcg nor greater than 400 mcg) of yeast based selenium (methylselenocysteine) may also improve this condition.

Recent research has determined selenium is critically important to thyroid function and selenium is being used to treat both Graves Disease and Hashimoto's Thyroiditis. Excess iodine is frequently implicated in autoimmune thyroid disease, especially Hashimoto's Thyroiditis.

You need a balanced diet with balanced minerals and trace elements to support your thyroid. No one mineral or trace mineral or ‘pill’ will do. Low protein and/or inappropriate fatty acids also decrease your body’s ability to produce hormones or increase cellular resistance to hormones. Making sure your diet contains adequate protein and potassium (see other pages) and that your supplements contain enough but not too much of essential elements may restore thyroid function, will support thyroid disease treatment and likely protect the healthy thyroid from disease.

In addition lithium orotate, as mentioned in the supplement list to follow, has been very successful in reversing this syndrome in some persons. The dose used is very low (120 mg of lithium orotate containing 4.8 mg of lithium), not anywhere near the dose used by physicians to treat bi-polar disorders (800-2400 mg of lithium carbonate daily). In 'resistance syndrome' lithium is being used as a trace element, currently recognized as conditionally essential, to restore membrane sensitivity. This information is from the work of Hans Neiper,  M.D. More information is available from the Brewer Science Library.

If you decide to try lithium use only the orotate and use only a small dose such as the one suggested below or less. More is not better. There is some evidence that low dose lithium may also restore membrane sensitivity to glucose and insulin in hypoglycemics and diabetics. Lithium Orotate is available from Complementary Prescriptions online or 888-401-1105. Use my PIN number, 230288,  to register at checkout.

YOUR TREATMENT PROTOCOL: Initially your doctor will ask you to increase your thyroid medication dose gradually. Your medication will usually be raised every 3-4 weeks. Do not raise your dose faster without your doctor's permission. When your thyroid's function has been impaired for an extended period of time there can be deterioration in many of the organ systems in your body, one of the most important being the heart. There may also be changes in the central nervous system. Because of these changes, increasing your dose too quickly could have serious consequences. Even though your maintenance dose may be much higher than that with which you start, INCREASE SLOWLY with your doctor's permission and monitoring. (I would modify this in some cases to suggest increasing your dose more rapidly may actually save you. If you know your body well and are able to tolerate some symptoms and will check your pulse, blood pressure, and temperature several times a day getting your thyroid back to 'normal' may improve heart function).

The maintenance dose, arrived at slowly, is 100-300 mcg. of Synthroid or Levothroid (T4) or 60-120 mg of Armour or Westhroid (whole thyroid). There is a great difference in these doses and blood work is always the best indicator that you have reached your ideal dose. 1 grain means about 100 mcg of Synthroid or 60 mg of Armour. 1.5 grain (150 mcg Synthroid or 90 mg Armour) is a typical maintenance dose. Dose is usually increased in increments of 25-50 mcg (15-30 mg whole thyroid) until your TSH falls within normal range, currently thought to be 2.0 or less..

On the correct dose of thyroid you will have stable blood sugar levels; normal appetite; energy; normal sleep patterns; no frequent urination; a basal temperature of 97.8-98.2; no hair loss; good hair texture-not coarse or fine; good circulation-warm hands and feet and the ability to warm up quickly when you get cold; good skin texture-not dry and thick or thin and oily; good skin color-normal, slightly pink without abnormal flushing-the palms of the hands and soles of the feet should not appear yellow or orange; normal size tongue-pink with no indentations around the edges; no athletes foot; good resistance to infection; normal mucous membranes-not excessive or thickened mucous; improvement or elimination of environmental and food allergies; normal perspiration patterns-not sweating without cause but having the ability to perspire when exercising or when the temperature rises; no night sweats; stable mood-not depressive, having curiosity and a desire to do and to have; enjoying exercise and feeling a benefit after working out; good short and long term memory; the ability and desire to experience sexual satisfaction; a good sense of taste and smell; good reflexes-neither too fast nor to slow; no constipation or diarrhea; a normal menstrual cycle of 3-5 days without heavy bleeding and without PMS.

Your dose of thyroid is too high (or you may have raised your dose too quickly) if: you experience undo sweating; heart palpitations; hunger-eating all the time without weight gain; a resting pulse above 80; quick movements; thin/fragile skin; a change in hair texture to very fine; a basal temperature above 98.2; eye or vision changes; headaches with no apparent reason; nervousness; tremor; unusual increase in amount and number of bowel movements per day; diarrhea. Ask your druggist for the written material available concerning your medication. Read all overdose symptoms and contraindications. The normal thyroid converts more thyroxine,T4, into T3 (the active thyroid hormone) during stress, in colder weather and when you are ill or injured. You may be able to adjust your dose, with your doctor's consent, to fit the situation. To be able to do this successfully you need a prescription for an incremental dose in addition to your regular prescription.

Thyroid hormone consists of several fractions. The most important fractions are T3 and T4. Armour (or Thyroid-S) contains T1, T2, T3, T4 and more, Synthroid contains only T4 and Cytomel contains only T3. Some individuals appear to have a problem converting the inactive T4 found in Synthroid into the active T3 . Zinc, selenium, and magnesium are required for this conversion, as well as other nutrients. Your physician can check to see if you have a problem by monitoring your free T3 levels. Also see the Private MD Labs testing at the top.

Please remember your needs change with age, weather, illness and injury. What worked in the past may need adjustment today. Watch your symptoms. They are your body's way of talking to you.

Supplements that may help: (Suggestions, not prescriptive.) 

• Vitamin A (retinol as found in Cod Liver Oil or concentrate, check capsule) 5,000-10,000 IU. daily or liver twice a week. Persons with hypothyroidism do not convert beta-carotene easily. Excess vitamin A may suppress thyroid function. Doses of vitamin A up to 25,000 IU daily have been determined safe even for pregnant women but there is no indication for most that vitamin A is needed in amounts greater than 10,000 IU daily and more is not better.
• Vitamin D as found in Cod Liver Oil or concentrated D supplement such as Solgar Vitamin D 1,000 IU. 1,000-2,000 IU as determined by testing (see http://sunlightd.org or http://bloodtestathome.com)
• B-Complex- from nutritional yeast such as Lewis Labs Brewers Yeast or in a supplement such as Nature's Way B-Stress
• C-Complex- C 500-2,000 mg.; bioflavonoids 500-2,000 mg.; rutin 25-500 mg. or BETTER see below liposomal C
• Liposomal Vitamin C 1,000-2,000 mg TWICE daily, important to split the dose, to restore the thyroid and adrenals and increase carnitine to help with weight loss.
• E- d'alpha tocopherol with mixed tocopherols 200-400 IU. Amounts greater than 400 IU daily may contribute to fatigue.
• Calcium- 800-1200 mg. Make sure you split this dose into two or more times per day.
• Magnesium- 400-800 mg. watch for 'bowel' reactions and lower your dose if they occur.
• Zinc- 20-50 mg. Doses higher than 90 mg. per day have been implicated in immune system suppression. Do not exceed the maximum. Use the Ethical Nutrients Zinc Status to monitor your zinc need but do not use this for a supplement..
• Copper- 1-3 mg. All minerals can be toxic in dose that are too high. Copper and zinc balance one another.
• Lithium Orotate- 120 mg. containing 4.8 mg of lithium. Trace amounts of lithium may restore cellular response to thyroxine. If you order use my Complimentary Prescriptions referral PIN 230288.
• Iron Complex- in your multiple or as an add-on with B-12 (about 1 mg which is 1,000 mcg), folic acid (about 4 mg which is 4,000 mcg the new recommendation and not in any multi-vitamins currently available) and C in a multiple iron complex, multi-vitamin and mineral or from a liver supplement. Solgar Hematinic Formula is an excellent choice allowing a dose of 1-3 pills a day as needed, or Solgar Gentle Iron or Now Foods Iron Complex or Complimentary Prescriptions Iron Complex. Men may not need this. Test your ferritin and supplement if below 70. Avoid all supplemental iron if your ferritin exceeds 150. Ferritin testing is available from lef.org or privatemdlabs and results will be sent directly to you.
• Taurine- 1,000 mg. twice a day, an amino acid for heart and nerves. Taurine is high in wild game, lean red meat, beef heart, oysters, mussels, shrimp and scallops.
• Carnitine- 1,000-2,000 mg. once or twice a day. An amino acid that protects the heart. Both taurine and carnitine are found in beef heart and lean red meat. As of 3/2011 it is preferred to use liposomal C which will naturally increase your body's production of carnitine.
• Trace minerals- including chromium, selenium, molybdenum, vanadium and boron. Trace amounts varying from 50 mcg - 400 mcg depending on which supplement and which mineral. Trace minerals should be just that, trace amounts. Do not over use. High quality multi-minerals often contain enough and not too much of the needed trace minerals. Consider Country Life Target Min Total Mins as one.
• Avoid excess iodine. Stick with the RDA of 150 micrograms (mcg.) or so. If you feel you need extra iodine consider one tablet of dulse, a sea vegetable that is high in all trace elements, not just iodine. Many alternative practitioners believe giving iodine will help thyroid but excessive levels of iodine suppress thyroid function and may be a primary cause of auto-immune thyroiditis (Grave's and Hashimoto's) in iodine sensitive individuals..

If you order from iherb.com (links follow) and are new to them use my code RIS664 for a $5 discount on your first order. Supplement combos I have found easy and helpful include: Now Foods Liquid Multi-Gels, Country Life Daily Multi-Sorb, Natrol My Favorite Multiple Original tablets or Twinlab Mega 6 Caps, are available from iherb.com, vitacost.com or vitaglo.com There are other multiples available with similar composition. As long as your supplement contains most of the suggested nutrients and you are comfortable with it, find yourself taking the full dose daily, it is fine.

In general, supplements do not contain taurine, carnitine (which you will make in your body if you use the liposomal C), or some of the trace minerals and you may need to purchase them separately. In particular sufficient selenium may be an issue. A good source is Jarrow Selenium Synergy is an excellent source of food based selenium. Lewis Labs Brewers Yeast also contains selenium and is an excellent source of high quality protein, B vitamins, and potassium as well but if you won't use it every day get the Selenium Synergy.

If you have been having gallbladder discomfort or other digestive problems, often accompanying thyroid or adrenal dysfunction, liposomal vitamin C should correct this within 3 months.

When T4 or T3 are low the body is less able to convert vitamin D into the active hormone and also cannot convert beta-carotene into retinol, the active form of vitamin A. Frequently there is low production of hydrochloric acid which leads to malabsorption of B-12 and iron. Following diagnosis and treatment with thyroid hormones you can help restore body levels of nutrients by increasing the amounts of these nutrients in food or with supplements for about 2-3 months.

If the thyroid is overactive or if you have been taking too high a dose of thyroid hormone there may be a significant loss of muscle mass and bone mass. All nutrients, protein and minerals and trace minerals should be at the highest levels for 3-6 months after beginning treatment. 

If after trying everything you still find yourself suffering from fatigue and depression visit http://www.stopthethyroidmadness.com 

Spend some time and read the stories. You will be inspired and may find a way to get back your 'self'. I did. Blessings, Krispin

BOOKS-

• Your Thyroid A Home Reference Wood, Cooper and Ridgeway
• Your Thyroid and How to Keep It Healthy Durrant
• The Thyroid Solution:  A Mind-Body Program for Beating Depression and Regaining Your Emotional and Physical Health by Ridha Arem
• Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You . . . That You Need to Know, Mary Shomon
• Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto's Disease and Hypothyroidism by Datis Kharrazian
• Stop the Thyroid Madness Bowthorpe
• Hope for Hashimoto's Haskell (watch the videos)

Mary Shomon's thyroid column on http://thyroid.about.com/ is a great place to find information as is Stop The Thyroid Madness.

Thyroid disease is a life long problem. Once it has been determined that you have or a family member has a thyroid disorder, monitored treatment is imperative. During your lifetime your thyroid may become hypo (low), hyper (high) or even normal. You need to be informed so that you have the ability to take care of your own body. Your physician is your partner in staying healthy. Use him or her to your best advantage. The only safe use of medicine, including all hormones, is informed use.

     Reference List  

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       (2)    Farkhutdinova LM, Speranskii VV, Gil'manov AZ. [Hair trace elements in patients with goiter]. Klin Lab Diagn 2006 Aug;(8):19-21.

       (3)    Yang XF, Hou XH, Xu J et al. Effect of selenium supplementation on activity and mRNA expression of type 1 deiodinase in mice with excessive iodine intake. Biomed Environ Sci 2006 Aug;19(4):302-8.

       (4)    Brzozowska M, Kretowski A, Podkowicz K, Szmitkowski M, Borawska M, Kinalska I. [Evaluation of influence of selenium, copper, zinc and iron concentrations on thyroid gland size in school children with normal ioduria]. Pol Merkur Lekarski 2006 Jun;20(120):672-7.

       (5)    Turker O, Kumanlioglu K, Karapolat I, Dogan I. Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses. J Endocrinol 2006 Jul;190(1):151-6.

       (6)    Brown LM, Helmke SM, Hunsucker SW et al. Quantitative and qualitative differences in protein expression between papillary thyroid carcinoma and normal thyroid tissue. Mol Carcinog 2006 Aug;45(8):613-26.

       (7)    Duntas LH. The role of selenium in thyroid autoimmunity and cancer. Thyroid 2006 May;16(5):455-60.

       (8)    Hoption Cann SA. Hypothesis: dietary iodine intake in the etiology of cardiovascular disease. J Am Coll Nutr 2006 Feb;25(1):1-11.

       (9)    Eftekhari MH, Keshavarz SA, Jalali M, Elguero E, Eshraghian MR, Simondon KB. The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls. Asia Pac J Clin Nutr 2006;15(1):50-5.

     (10)    Chadio SE, Kotsampasi BM, Menegatos JG, Zervas GP, Kalogiannis DG. Effect of selenium supplementation on thyroid hormone levels and selenoenzyme activities in growing lambs. Biol Trace Elem Res 2006 Feb;109(2):145-54.

     (11)    Kohrle J, Jakob F, Contempre B, Dumont JE. Selenium, the thyroid, and the endocrine system. Endocr Rev 2005 Dec;26(7):944-84.

     (12)    Kohrle J. Selenium and the control of thyroid hormone metabolism. Thyroid 2005 Aug;15(8):841-53.

     (13)    Baraboi VA, Shestakova EN. [Selenium: the biological role and antioxidant activity]. Ukr Biokhim Zh 2004 Jan;76(1):23-32.

     (14)    Beckett GJ, Arthur JR. Selenium and endocrine systems. J Endocrinol 2005 Mar;184(3):455-65.

     (15)    Hawkes WC, Alkan Z, Lang K, King JC. Plasma selenium decrease during pregnancy is associated with glucose intolerance. Biol Trace Elem Res 2004 Jul;100(1):19-29.

     (16)    Vrca VB, Skreb F, Cepelak I, Romic Z, Mayer L. Supplementation with antioxidants in the treatment of Graves' disease; the effect on glutathione peroxidase activity and concentration of selenium. Clin Chim Acta 2004 Mar;341(1-2):55-63.

     (17)    Gartner R, Gasnier BC. Selenium in the treatment of autoimmune thyroiditis. Biofactors 2003;19(3-4):165-70.

     (18)    Chanoine JP. Selenium and thyroid function in infants, children and adolescents. Biofactors 2003;19(3-4):137-43.

     (19)    Hawkes WC, Keim NL. Dietary selenium intake modulates thyroid hormone and energy metabolism in men. J Nutr 2003 Nov;133(11):3443-8.

     (20)    Kucharzewski M, Braziewicz J, Majewska U, Gozdz S. Copper, zinc, and selenium in whole blood and thyroid tissue of people with various thyroid diseases. Biol Trace Elem Res 2003;93(1-3):9-18.

     (21)    Burk RF, Hill KE, Motley AK. Selenoprotein metabolism and function: evidence for more than one function for selenoprotein P. J Nutr 2003 May;133(5 Suppl 1):1517S-20S.

     (22)    Duntas LH, Mantzou E, Koutras DA. Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis. Eur J Endocrinol 2003 Apr;148(4):389-93.

     (23)    Rayman MP, Rayman MP. The argument for increasing selenium intake. Proc Nutr Soc 2002 May;61(2):203-15.

     (24)    Gartner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab 2002 Apr;87(4):1687-91.

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This information is copyrighted by Krispin Sullivan, CN. You may use it for your own benefit. You may link to this page. Do not copy and distribute without the copyright. Last modified on: 12-29-11

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