Here are a few things that ALL of us need to know, to memorize, to repeat on command
-- without hesitation.
ThyroFeisty and ThyroGeek
Simple. Because this is the VERY BASIC info that is the basis of our care. The essence of our diagnosis, our on going care, our lives and our
QUALITY OF LIFE!
Sad to say, but many docs are not fully trained in proper thyroid care and without the proper training you could end up like so very many others...
victims of ignorant care.
This is your alphabet. From this your knowledge will build.
The Basic Hormones
**** TSH - Thyroid Stimulating Hormone ****
Released by the Pituitary gland to let the thyroid know if hormone levels need to be increased. The lower this number is the SOFTER the body is calling for hormone, the higher this number is the LOUDER the pituitary is screaming at the thyroid to produce more. Once you are on thyroid hormone replacement (meds), this number is of VERY LITTLE value in adjusting your dose. Yet docs that aren't very knowledgeable about thyroid care still believe that as long as this number is 'in normal range' that everything is fine. But for many many, many people this number can be as low as 1.5 and they want to crawl under a rock and die, yet the range can go as high as 5, depending on the ranges each clinic uses, and for some insurance companies, they won't treat you until your TSH is near 10.0... well beyond hoping for death... and the doc will continue to say that 'you're just fine - it's all in your head'...
The current acceptable lab ranges for TSH are .3 to 3.0. You can read more about that here: http://www.thyroid.org.au/Information/NormalTSH.html
Anything over 2.0 means that something is not right somewhere and further testing should be done
Most 'normal' folks are at a TSH of 1.25
Most folks on thyroid hormone replacement feel best with a TSH below 1.0
Folks that are dealing with Hashi's (Hashimoto's Thyroiditis) cycles or recovering from thyroid cancer seem to do the best with a TSH approaching zero
Individuals that no longer have a functioning thyroid gland, due to total thyroidectomy or RAI Ablation, will be able to rely on TSH levels even less.
**** T4 ****
The Storage Hormone. The major hormone produced by the thyroid gland. Stored in the body cells. Available for conversion to the active T3 hormone as needed by the body.
**** T3 ****
The Active Hormone. Used by all parts of the body from regulation of other glands, heart, lungs, organs, to brain function. Without adequate levels of it... you're a mess.
**** T2 ****
This hormone has been found to be a factor in metabolism. So? Well, metabolism is what maintains your body temp so that you don't feel cold all the time. It regulates how the calories in the food you eat are used
(for energy or for fat). It helps with how much energy you have, or don't have.
**** T1 ****
Recently they've been releasing info that T1 affects the brain function..
**** Calcitonin ****
Produced mainly in the parathyroid glands, but also, to an extent, the thyroid gland. It allows the body to take calcium out of the blood and put it back into the bones.
The Basic Replacement Hormones (Meds)
**** Synthetic T4 ****
Synthroid, Levoxyl, Levothroid, Eltroxin, and others
Contains Synthetic T4 hormone plus the fillers and binders and stuff to make it into a pill. Each different dose is color coded. Some individuals have sensitivities to some of the die colors and find that they have to use a combo of other pill dosage sizes, with different color dies to avoid allergic reactions.
Manufactured as a Synthetic replacement source for T4 hormone. Must be swallowed, with water, on an empty stomach. Calcium and iron containing supplements should be kept separate from the dosing time of synthetic T4.
A good, safe, starting dose is usually 25 to 50 mcg.
**** Synthetic T3 ****
Cytomel, Cynomel, and others
Contains only Synthetic T3 hormone plus fillers and binders and stuff to make it into a pill. It contains no color dies.
Manufactured as a Synthetic replacement source for T3 hormone. Can be swallowed with water or taken sublingually. Is short lived in the blood, 95% used up, or passed from the body in about 4 hours. After that you are dependant your your body's conversion rate to refill empty T3 hormone receptors.
A good, safe, starting dose is 5 mcg.
**** Natural Thyroid ****
Armour, Time Cap Labs, Qualitest, Thyroid-S, Thyroid, and others
Contains Whole Desiccated Thyroid Glandular made from pig thyroid with all the components that a healthy gland produces, including: T4, T3, T2, T1 and calcitonin (the element the body needs to be able to pull calcium from the blood and put it into the bones). Plus the fillers and binders and such to make it a pill. It contains no dies. The natural form of hormone is much more easily used by our bodies than artificial/synthetic sources. It can be swallowed with water or taken sublingually.
A good starting dose is 1/4 grain (15 mg) to 1/2 grain (30 mg).
There are also OTC versions that are derived from cows.
Facts To Keep In Mind
If you take T4 only... you are totally dependant on what your body is able to convert. And have no source for calcitonin, period. You must take it by swallowing on an empty stomach.
If you take Natural thyroid you have ALL the hormones so that your body isn't totally dependant on it's own conversion rate - but you still want to do all you can to promote natural conversion, it's your 'ace in the hole' when your body needs more hormones as our daily lives effect us. AND if you take natural thyroid you get calcitonin, there is no other source once your thyroid can't produce it. You can take it either by swallowing or sublingually. Sublingual dosing gives you more freedom to multi-dose your thyroid replacement and for mini-meal eating.
The Blood Tests
There is some controversy here. My personal opinion is that you will get a more accurate representation of hormone levels of you do not dose the morning of your blood draw. That way the levels will show what your body has been doing with the hormone you have been taking in rather than show what you just took. You know what you took, you want to do how well your body is using it and how well it's converting.
Whether you choose to dose before labs or not, just be consistent and do it the same way each time. Don't switch back and forth.
**** TSH ****
To see how loud your body is screaming for more hormone. Many docs mistakenly believe this is the only test required, and many are using outdated lab ranges. Once on hormone replacement this measurement doesn't give enough information to know if your replacement dosage and/or conversion is adequate.
**** Free T4 ****
Checks the level of T4 hormone that is free and available in your blood stream to be used. We also have T4 that is bound and unusable. So it's important to get FREE T4 levels checked.
**** Free T3 ****
Checks the level of T3 hormone is free and available in your blood stream to be used and also tells you how well your body is converting. We also have T3 that is bound and unusable and Reverse T3 which is not what we need to be monitoring. So it's important to get FREE T3 levels checked.
**** Thyroid Anti-bodies ****
**** Antithyroglobulin and Antithyroidperoxidase ****
Checks the levels of thyroid antibodies in your system, if any.
**** Reverse Ts ****
Shows the hormone (T4 and T3) that is formed in, more or less, a mirror image of the Free T4 and Free T3 hormones our bodies need to function. Not of much value except to those in VERY rare circumstances.
**** Total Ts ****
Shows the levels of All the T4 and All the T3 hormones. Not useful for most folks except in VERY rare circumstances. These are the total levels of hormone, including Frees and Reverse and Bound. Since our bodies can only use the Frees those are the values that are of MOST importance.
A bit of a warning here...
Some docs get very grumpy when you start showing that you know more about thyroid testing and care then they do... the amount of time docs spend learning about thyroid is counted in minutes, literally. So it's very likely that you already know more than most docs. Many of us have found that we have to fire a few docs before we are able to find one that is interested in treating us properly... others of us find that we're better off treating ourselves. We can order our own meds and our own labs...
Things to Keep in mind
when you are talking to your doc
Your doc is working for you
You are paying for a service
A Doctor is NOT a god
You are there to receive a service, diagnosis and treatment of your thyroid condition.. if the doctor is not willing to do that, is unwilling to try, is unwilling to listen...
It's time to find a new doc!!