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[Allies]

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Last few results plus the latest ones:

 

12 June 2018 - on 1.25mg carbimazole every second day
TSH: 0.46 (0.5 - 4.5)
FT3: 3.6 (3.0 - 6.7)
FT4: 15.6 (10.0 - 21.0)

 

Stopped taking carbimizole in mid/late June

 

27 July 2018
TSH: 0.53 (0.5 - 4.5)
FT3: 4.0 (3.0 - 6.7)
FT4: 15.3 (10.0 - 21.0)

 

7 September 2018
TSH: 0.59 (0.5 - 4.5)
FT3: 3.7 (3.0 - 6.7)
FT4: 15.2 (10.0 - 21.0)

 

Started taking thyroid support 13 September (contains iodine 145mg, tyrosine 500mg, selenium 75mg, zinc 12.5mg, vitamin c 20mg and ashwaganda 1.5mg) started slow and worked up to two of these per day over the course of around 2 weeks

 

7 November 2018
TSH: 0.13 (0.5 - 4.5)
FT3: 4.0 (3.0 - 6.7)
FT4: 17.6 (10.0 - 21.0)

 

TRAB range <1.8
15 March 2018: 8.9
27 July 2018: 11.7
2 November 2018: 10.2

 

A word about the iodine, since i know this is a tricky area with autoimmune thyroid disorders. Firstly i didn't go into such supplementation lightly; i had my urinary levels tested and the result showed a mild defficiency.

 

Urine iodine levels
Not iodine deficient >100 ug/L
Mild iodine deficiency 50 - 100 ug/L
Moderate iodine deficiency 20 - 49 ug/ L
Severe iodine deficiency <20ug/L

 

3 June 2016: 91
7 September 2018: 70

 

In many areas of Australia the soils are reported to be iodine deficient (Western Australia and Queensland seem to be exceptions to this). Since i no longer eat any grains, dairy products or manufactured, highly processed foods, major sources of iodine are absent from my diet. I had been thinking about iodine and because i actually prefer to get nutrients through dietary sources rather than supplements; i started cautiously adding seaweeds to my diet about 5 months ago (mixing a very small amount with sea salt in a salt grinder). I started with nori which is usually reported to have a low concentration of iodine. I switched this to wakame (moderate iodine) and eventually changed it to kelp flakes (reportedly high iodine concentration). I think i was way too cautious though as my iodine levels still came back as being mildly deficient, lower than they were two years ago before all these dietary interventions were in place, while i was still taking carbimazole. Elaine Moore explained to me at that time that antithyroid drugs play a part in preventing iodine metabolism and probably had a role in the initial mild deficiency.

 

I was becoming pretty desparate by September to get my free ts to move up by hook or by crook. The main choices seemed to be tackling the issue directly by thyroid hormone supplementation, or ensuring that my body had the building blocks to create these hormones by itself. I decided to try the iodine approach first as it fits my philosophy better - even though it scared me a little bit.

 

So-ooo, the results of this experiment are a little surprising

 

My FT4 has improved, my FT3 hasn't changed much and my TRAB has moved down just a smidge. Frankly i suspected that if this approach did improve my thyroid hormone levels it would probably be because it stimulated antibody production, but on the face of it that doesn't appear to be the case . I've reduced the thyroid support to one pill a day and have increased the amount of kelp flakes i am adding to my food as i'm not so scared of doing this now (i'm still trying not going overboard with it though). I'm about to run out of the thyroid support supplement and instead of buying more i think i will continue with the seaweed approach and resume the selenium drops and see what happens

 

With the stresses of xmas fast approaching, i'm a little concerned that instead of levelling out at a more comfortable place my FT4 might continue going up. I really need to figure out how to stop stressing about these things!

 

I know this is a long post, sorry folks - but i do have a little more to add and that's in regards to sex hormones and sex hormone binding globulin (SHBG). It turns out my estrogen, testosterone and progesterone are a bit low even for menopause - which is presumably where i'm at given my age and a couple of years since my last period (sorry if that's TMI). My SHBG is above the range the test can detect and my doctor tells me that this means the sex hormones i do have are more than likely bound to proteins and thus not available for my body to use.

 

Does anyone know much about sex hormones and SHBG? Is it likely that these are squew-iff because my thyroid hormones have been too low for the past several months ? Any info, or suggestions for further research would be greatly appreciated

 

Cheers
Allies

[Allies]

Last few results, latest result, plus an iodine experiment update:

 

Stopped taking carbimizole in mid/late June 2018

 

7 September 2018 - my thyroid hormone levels had been pretty stable and at similar levels with slight fluctuations for eight or nine months - I strongly feel these were too low for my body to function properly; this seems to have been reflected in a rise in TRAB which went from 8.9 in March 2018 to 11.7 in September 2018 (ref <1.8)
TSH: 0.59 (0.5 - 4.5)
FT3: 3.7 (3.0 - 6.7)
FT4: 15.2 (10.0 - 21.0) 

 

Took "thyroid support" supplement from 13 September to 10 December 2018 (which contained iodine 145mg, tyrosine 500mg, selenium 75mg, zinc 12.5mg, vitamin c 20mg and ashwaganda 1.5mg). From early December, when i ran out of the thyroid support pills, i switched to selenium drops and added kelp flakes to my diet (usually somewhere between 1/4 to 1 teaspoon daily).

 

7 November 2018 - after around 2 months taking the "thyroid support" supplement
TSH: 0.13 (0.5 - 4.5)
FT3: 4.0 (3.0 - 6.7)
FT4: 17.6 (10.0 - 21.0)

 

During this period TRAB dropped slighly from 11.7 to 10.1 (possibly due to slightly improved FT4)

 

8 February 2019 - after around 2 months taking selenium drops and adding kelp flakes to my diet (instead of the thyroid support supplement)
TSH: 0.046 (0.5 - 4.5)
FT3: 4.1 (3.0 - 6.7)
FT4: 19.5 (10.0 - 21.0)

 

I'm pleased that the FT4 has returned to a much better level, but am a bit frustrated that my FT3 is still a bit low (FT3 has fluctuated between 3.7 and 4.1 since early 2018). Off the top of my head I can think of several possible explanations for this continuing low FT3

 

1 - FT3 might be fluctuating to higher (or lower) levels in between blood tests:
the FT3 has remained consistently low within the population reference interval for a long time now (when measured), Chances are that if it was fluctuating upwards, at least one of the tests would have caught it in the act; so i think this is the least likely explanation

 

2 - my diet is too low in carbohydrates:
there are quite a few medical papers that show low carbohydrate consumption leads to a lowered FT3, in fact my initial drop in thyroid hormones coincided with a deliberate reduction in carbohydrates (avoiding things like grains and processed foods most likely contributed to low iodine too). Communities focused on keto or very low carb diets often discuss this lowered FT3 phenomenon - their conclusion seems to be that while FT3 is usually lowered by a low carb approach it doesn't matter and actually means that FT3 is being better utilised at a cellular level and therefore the body needs less of it ( Drs Steve Phinney and Jeff Volek put forth this hypothesis). While i think that there is a good chance that my low carb approach to diet over the past year may have contributed to the low FT3, I'm not at all convinced that it doesn't matter in the presence of thyroid autoimmunity

 

3 - i've developed a problem converting FT4 into FT3
this is a problem sometimes encountered by hypothyroid people on T4 only thyroid hormone replacement. It can be a huge problem for some people since being prescribed combination therapy (T4 & T3) or natural desicated thyroid (which contains both T3 & T4) is not always well supported by the medical profession. The conversion problem seems to lie, at least partly, with an enzyme called deiodinase (there are at least 3 of these, none of which i have yet wrapped my head around other than to understand that they are pivotal players in FT4 to FT3 conversion) and perhaps some form of genetic polymorphism (again, I've not ventured into that particular realm). I'm not sure if the conversion issue is very common with Grave's, unless of course the thyroid gland has been removed or ablated in which case it does crop up from time to time on hypothyroid forums. Gut and liver health also seem to be implicated, since some of the conversion from FT4 to FT3 happens in these sites.

 

4 - correction of the FT3 is lagging behind correction of the FT4
my initial diagnosis of Grave's disease was followed shortly thereafter by an additional diagnosis of T3 toxicosis - this is where FT3 levels are high relative to FT4 levels. It took quite a long time for that to resolve. I.e. the FT4 levels came down (and settled down) a lot quicker than the FT3. I'm wondering if the same sort of thing happens in reverse?

 

Does anyone have any thoughts on the above? Or a similar experience? Any other thoughts on why the FT3 is remaining low?

 

At this point my best options seem to be being patient and see if the FT3 eventually rises in response to the improved FT4 and/or to tweak my diet a little to include more carbohydrates (or maybe more protein?)

 

IODINE

 

As far as the iodine experiment is concerned - supplementing iodine does seem to have kick-started a change in my thyroid hormone levels. My FT4 is vastly improved I'm backing off slightly on the kelp flakes - aiming for 1/4 to 1/2 a teaspoon per day in the hope that this will maintain the FT4 without causing it to rise too much more. I can't really tell as yet whether adding in iodine will effect my antibodies; last time TRAB was measured (several months after starting iodine supplementation) TRAB had fallen just slightly - this may have just been a fluke occurence, it may have been in response to the slightly improved FT4. Hopefully next time i have my TRAB tested it will shed some light here

 

I also want to point out that due to some major dietary changes, and living in an area with iodine deficient soils, I did have (a measured) mild deficiency in iodine levels - supplementing iodine, and later switching to adding kelp is a personal experiment aimed at addressing this deficiency. It seems to be working for me (so far), but it might not work for others, especially if iodine intake is already adequate

 

Overall i think there has been an improvement in my thyroid hormone levels; it hasn't fully translated into feeling a lot better yet, but this may be due to the continued low FT3

 

Rather a long post, sorry - but just in case anyone is interested in this ongoing iodine experiment - it may still backfire (and I'll let you all know if it does )

 

Cheers
Allies

[mmztcass]

Hi Allies:

 

Sounds good for what you are doing.     

 

I am wondering how much Iodine is in the Kelp flakes per teaspoon or whatever the serving size is?  It is good that you keep an eye on the FT4 from taking the Kelp flakes to assist you.

 

I know the few times I've dipped hypO due to recent illnesses from the past few years to which I struggled with the low Free Ts and I took several months up to six months before I felt better.  I aimed for increasing the Iodine from my diet instead of supplementing something that had Iodine in it.   

 

I have had struggled with low FT3 for years.  I know it is because my carbs intake are on the lower side of normal.    

 

{{{hugs}}}

[Allies]

Hi Mmztcass:)

 

I have no idea how much iodine is in the kelp In fact my doctor originally recommended the thyroid support supplement because it had a measured amount if iodine, he wasn't particularly keen on using kelp because the iodine content of sea vegetables is variable and pretty much unknown. ...but i wanted to give it a try. The measured dose of iodine in the supplement seemed to lead to improved FT4 without obviously upsetting my immune system further which gave me the courage to try kelp instead.

 

I based the dose on Terry Wahls' recommendations for the Wahls protocol because I had to start somewhere ( ) and I had been pretty much eating the way she recommends - but without the kelp/iodine (I was initially too wary to add in kelp because of the varying opinions on iodine with autoimmune thyroid disorders) BTW she recommends working slowly up to 1/4 teaspoon kelp powder per day or 1 teaspoon of kelp flakes. My experience has been that I may buy kelp flakes, but when i get towards the end of the jar that i store it in, what remains is generally powder - so i try to vary the amount accordingly. I suspect the amount of iodine i am consuming varies a little from day to day, but i guess that must be true of any vitamin or micronutrient consumed via the diet At a guess this amount of kelp seems to provide similar levels of iodine to the supplement, but it is just guesswork - based pretty much on how my FT4 is behaving

 

I've been buying locally sourced kelp, hopefully the iodine content, while unknown, is relatively stable. It's all a grand experiment

 

{{ HUGS }}

[Allies]

I just got my latest results back, well I say latest, the blood was drawn nearly a month ago, but since the TRAB was being tested I knew that could take around two weeks, so I put off making a doctor's appointment , then, you know, the time just flew past - so the results are a tad dated. I'm excited because my TRAB has moved down a bit more - and not just a smidge this time hoorah! I feel like I must be doing something right - and I'm kind of releived the iodine/kelp experiment hasn't backfired ( at least thus far)

 

Stopped taking carbimizole in mid/late June 2018 - gosh, that's close to a whole year now !

 

7 September 2018 -
TSH: 0.59 (0.5 - 4.5)
FT3: 3.7 (3.0 - 6.7)
FT4: 15.2 (10.0 - 21.0) 

 

7 November 2018
TSH: 0.13 (0.5 - 4.5)
FT3: 4.0 (3.0 - 6.7)
FT4: 17.6 (10.0 - 21.0)
TRAB: 10.2 (<1.8) (was 11.7 in July 2018)

 

8 February 2019
TSH: 0.046 (0.5 - 4.5)
FT3: 4.1 (3.0 - 6.7)
FT4: 19.5 (10.0 - 21.0)

 

10 May 2019
TSH: 0.064 (0.5 - 4.5)
FT3: 4.4 (3.0 - 6.7)
FT4: 19.8 (10.0 - 21.0)
TRAB: 7.0 (<1.8)

 

If I had enough energy I would jump for joy. I suspect my FT3 is still a little low, but at least it's inched upwards. I'm liking where the FT4 is, I'm happy the TRAB has moved down; I'm perplexed as to what the TSH is playing at will have to have a good think about this when my brain turns back on in the morning

 

So a question Mmztcass: do you know if Grave's antibodies more responsive to levels of FT4 levels rather than FT3?

 

I have ever so slightly upped my consumption of carbohydrates - the odd banana or apple, but more ofen via sweet potato, beetroot or carrot. I'm being cautious here because I find if I eat too much of these I start craving sweet things ...and that way madness lies

[mmztcass]

Hi Allies:

 

Nice seeing your labs are looking better.    

 

The TRAb antibodies would be both the FT3 and the FT4.  

 

Have you seen this study/article?

 

https://www.hindawi....tr/2012/182176/

 

Oh I try not to consume much carbs.  I notice that when I crave the organic macaroni and cheese, I want to have my organic dark chocolate as well.    

 

{{{hugs}}}

[Allies]

Have you seen this study/article?

 

https://www.hindawi....tr/2012/182176/

 

That one takes some wading through doesn't it!

 

While it shows the existence and even co-existence of blocking (TSBAB) and stimulating (TSAB) antibodies it seems a bit unclear how they are defining remission since they state that even with the disappearance of blocking or stimulating TRABs, hypo or hyperthyroid conditions still continued for a small percentage of the patients without these antibodies being detected (unless of course the antibodies are still present, but below a certain threshold). Would it be unrealistic to hope that remission is decided based on how the patients feel?

 

Early in the paper they show the reference ranges used for TSH, FT3 & FT4, but it seems beyond the scope of the paper to report levels of these (apart from TSH) alongside the antibodies. Worryingly the paper points out that T4 was not administered to patients who had become hypothyroid until their TSH was greater than 10! I can't help wondering how low their thyroid hormones had become at that point, but this also suggests that TSH may have been the biochemical marker they were using to adjust ATDs or replacement hormone and perhaps even to judge remission - which seems odd given the acknowledgement that these TRABS alter TSH action

 

I guess we have to keep in mind that the paper was written in 2012 and follows patients over the proceeding 10 years. TRAB tests have been improved in that time frame, clinical practice has hopefully improved as well The academic editor (Terry Davis) has co-authored several papers over the past few years which propose that neutral TRAB (not mentioned at all in this study) does in fact have biological consequences and may result in thyroid cell apoptosis; perhaps this particular TRAB plays a part in determining whether the thyoiditis is goitrous or atrophic?

 

I'm assuming at this point that if our TRAB can change from predominantly stimulating to blocking and visa versa, then the proportion of 'neutral' TRAB could also change - which could mean that it is possible to switch from goitrous to atrophic thyroidits? (Just in case I don't find anything else to worry about this week - lol)