Thyroid Meds Go Up, All Good Then Slump

[marsaday]

I have recently increased my thyroid meds by 12.5 T4 per day (taking 125/150 on alternate days now). I have had a really good reaction and all has been good for about 2 weeks, but i have now run into a slump.

I have felt pretty tired as the day has gone on and it has been like this for about a week now. I have tried less T4, but no difference and more, but no improvement.

I also take progesterone in the mornings (3mg per day). This really made a difference to my health when i started using it over a year ago.

I have an idea of what may be happening so here goes. The higher T4 level has upped my metabolism and so this has been good. In this honeymoon period of 2 weeks my ability to work harder in my job and play harder at sport has placed extra demands on my other hormones. After a while the body is not able to keep up and so it has gone into this slump.

Tonight i have tried 1 extra drop of the progestE oil i use and so that means 3mg extra of progesterone per day. I feel much better tonight, so i am thinking my cortisol production needs to be raised to accommodate the higher T4 levels.

I suppose a few days on more progesterone will confirm this is what i need.

Does this sound plausible ?

Longer term would i be able to drop the progesterone, or is it going to be something i need forever, like the thyroid hormones ? I have tried dropping the progesterone before, but i miss it very quickly.

 

[DaveFoster]

You don't need it, but it would greatly improve your quality of life if you'd take it into old age.

 

[Noel Gallagher]

I don't see how you could determine your ideal dosage of t4 without taking t3. Ray recommends taking tiny doses of t3 throughout the day and then taking t4 at night. So I interpret that as you need to take the amount of t3 you take and multiply it by 4 to know the amount of t4 you take at night.

 

[marikay]

I don't see how you could determine your ideal dosage of t4 without taking t3. Ray recommends taking tiny doses of t3 throughout the day and then taking t4 at night. So I interpret that as you need to take the amount of t3 you take and multiply it by 4 to know the amount of t4 you take at night.

In the winter I need a three to one ratio of t4 to t3, sometimes even two to one. I can go back to four to one t4 to t3 in the summer. But I never take t4 without some t3.

 

[marsaday]

I don't see how you could determine your ideal dosage of t4 without taking t3. Ray recommends taking tiny doses of t3 throughout the day and then taking t4 at night. So I interpret that as you need to take the amount of t3 you take and multiply it by 4 to know the amount of t4 you take at night.

I do use T3, but a very little. It has been 5mcg per day for a good while now.

T4 dosage is usually done by the docs at 1.8mcg x kg body weight. I am very near this amount. And i take most at night. I also take 25mcg T4 in the afternoon and it seems to work well for me.

This recent change has upset my system though and so i think i need to work on the adrenal side of things.

If i take too much T3 i become very hypo. It seems to crash my system. Hence i use a little amount.

I have used T3 only and the most my body could use was 55mcg per day. After that i went hypo.

So for me the key here seems to be the adrenal performance. I was hoping someone may be able to confirm my suspicions that more T4 was driving the need for higher cortisol. I have seen this mentioned by someone before. Would appreciate any comments on this relationship.

 

[sweetpeat]

I think it's highly likely that your need for nutrients would go up as your metabolism goes up. I sometimes find my appetite increases when I increase thyroid. As a chronic under-eater, this is a good thing for me.

Have you checked your cholesterol lately or experimented with increasing vitamin A? These would be important for making your own hormones so that maybe you wouldn't have to rely on supplements.

 

[DaveFoster]

Here's one of Peat's quotes regarding progesterone use:

"Progesterone stimulates the ovaries and adrenals to produce progesterone, and it also activates the thyroid, so one dose can sometimes have prolonged effects. It shouldn't be necessary to keep using progesterone indefinitely, unless the ovaries have been removed. In slender post-menopausal women, 10 mg. per day is usually enough to prevent progesterone deficiency symptoms."

SOURCE: Progesterone Summaries - Progesterone Deceptions - Progesterone Supplementation - Dosage of Progesterone

 

[marsaday]

I think it's highly likely that your need for nutrients would go up as your metabolism goes up. I sometimes find my appetite increases when I increase thyroid. As a chronic under-eater, this is a good thing for me.

Have you checked your cholesterol lately or experimented with increasing vitamin A? These would be important for making your own hormones so that maybe you wouldn't have to rely on supplements.

My cholesterol was measured over a year ago and it was good. It is all mid range, with the LDL fat being lower. So my thyroid meds are keeping the cholesterol down. I understand this may be a bad'ish thing according to RP. Maybe i don't have enough. I do need to get some more blood tests again.

I will have a look at vitamin A. Can this vitamin on its own really make a big difference to health ?

I am feeling much better today and the T3 in the afternoon has worked again. So it is looking like i now need 2 drops of the progestE oil per day (morning and then evening).

Fingers crossed i stay balanced.

 

[sweetpeat]

I will have a look at vitamin A. Can this vitamin on its own really make a big difference to health ?

I think a deficiency in vitamin A could lead to problems. It's my understanding that vitamin A is a co-factor used in making pregnenolone from cholesterol, the LDL especially. I'm not sure exactly how it all works, but I know there's lots of info on the forum about the helpfulness of vitamin A. I believe it's also used in converting t4 into t3. So there are two processes right there using vitamin A, and there are probably more. It's one of the reasons Peat is so keen on eating liver.

Fingers crossed i stay balanced.

I hope you do. It sounds like your doing pretty well over-all using mainly t4. I'm also using mostly t4 and it's nice to find someone else doing the same. Kind of a rarity on the Ray Peat forum.

 

[marsaday]

Yes i am generally doing very well. Just finding the right balance of thyroid meds and progesterone and then throw in new higher amounts of exercise or just work activity and it all makes it a bit more complex. Basically i am trying to regulate my body according to its demands. Something which most people do day in day out without a thought.

 

[PowertothePeatple]

Have you tried thiamine? There is a study (pubmed I think) where they used thiamine to treat hypothyroid patients who were still feeling fatigued even after thyroid meds. And it worked really fast. It could be worth trying. Could be related to increased nutrient needs after raising thyroid levels.

 

[marsaday]

Not tried thiamine. I may have a look at it. Would you say take it directly or just use a good multi B supplement. It seems the B vits are the best ones to supplement.

 

[PowertothePeatple]

I am only just experimenting with this myself. I am taking it as a separate supplement but I do also take Haidut's B-complex in addition and also extra Biotin. Thiamine peaked my interest because I have still struggled with fatigue even though I am taking thyroid and my labs are fine. I have a feeling many people struggle with this. My energy levels have increased a lot in the last 6 months but I am trying so many different remedies it is hard to pinpoint which is helping.

 

[marsaday]

This is the big problem with looking at food, vitamins and hormones. What does what ?

Hormones are easier to work out because we take so few (usually thyroid), but throw in the vits and then the food and if you don't get good results you just get lost. This is why i have restricted myself to just working on the hormones. Thyroid and progesterone. In fact getting a better balance with T4 and a little T3 is taking time. I seem to do really well on T4, but need a little T3. However, it seems if i get T4 too high the T3 will then cause hypo issues. Basically i have enough hormone in the system and even a little extra T3 can tip you over the edge.

When i first posted this question about the system crashing i think it may have been due to the T3 pushing me over the edge. So i am just starting to see what a higher dose of T4 feels like, but without the T3 this time.

I will report back if this could be the answer. I don't think the answer was more progesterone. I have tried more in the last week, but i can't say it has consistently made a positive difference. So my first thoughts about needing more cortisol to match the higher T4 amount may not be right.