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Old 03-14-2009, 03:16 AM   #1
Charles Whitworth
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Hypothyroidism and Dialing in T-4

About a year and a half ago, my doctor discovered through a blood test that I was "slightly hypothyroid" with a 5.76 TSH. Interestingly enough it was missed by other doctors when a analysis of my test results was accomplished. For all I know, I've always been hypothyroid. I was initially started on 12.5mcgs because my current doctor believed a slow increase would be safest. Fast forward to now, and I'm about to start a dose of 75mcgs up from 50mcgs on Monday based on a 1.56 TSH. I wanted to push for a high normal TSH level, somewhere in >.50 to <1.5 range. However, despite my TSH going down, I am also somewhat low on T-4, barely in normal range. I dont know if this is because of an increased pull of T-4 by my body to support the intensity of my workouts or just another indicator that my T-4 should be increased. I would say that overall my health has improved from taking T-4 over the time period, but I want it to be better. I havent lost any fat, but then again, losing fat has not been easy for me on any strict form of dieting for the past 5-6 years. All that being said:

Has crossfit affected your hypothyroidism or caused you to have to up your dose of medication?

Have you found that dialing in your TSH to a <1.0 TSH has greatly increased your energy, fat loss, and motivation?

What about overall improvements to the way you feel at <1.0 TSH?
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Old 03-14-2009, 08:22 AM   #2
Marcus Allen
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Re: Hypothyroidism and Dialing in T-4

Charles- There is a TON of discrepancy on what a normal TSH should be. Are you working through your PCP or an endocrinologist?

I would recommend an Endo at least for a consult.

I was diagnosed about 6 years ago and started at 50 mcg with a TSH of I believe around 12. As of my last work my TSH was 3.1 and I am now upping to 175 mcg.

My Endo also pointed out that the improvements from upping the doses will take longer to realize than the initial ones.I feel great, but metabolic changes are just slow.

How's your diet? I actually do significantly better metabolically speaking when I am off grains completely and using about 75% of Zone CHO. There seems to be some research that Hypothyroidism and Metabolic Syndrome are closely related.
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Old 03-14-2009, 02:48 PM   #3
Robert Pierce
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Re: Hypothyroidism and Dialing in T-4

Don't worry to much about measured T4. Free T4, though commonly measured, is a notoriously inaccurate measure of global thyroid function. Most of us, including the endos that I know/respect, still just use the TSH.

Seeing an endo will not resolve any debate about the appropriate TSH.

Probably no harm in getting TSH under 1.0 or 1.5, but as you may know, it probably is not a good idea to get it under 0.4 or 0.5.
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Old 03-17-2009, 11:12 PM   #4
Charles Whitworth
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Re: Hypothyroidism and Dialing in T-4

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Originally Posted by Marcus Allen View Post
Charles- There is a TON of discrepancy on what a normal TSH should be. Are you working through your PCP or an endocrinologist?

I would recommend an Endo at least for a consult.

I was diagnosed about 6 years ago and started at 50 mcg with a TSH of I believe around 12. As of my last work my TSH was 3.1 and I am now upping to 175 mcg.

My Endo also pointed out that the improvements from upping the doses will take longer to realize than the initial ones.I feel great, but metabolic changes are just slow.

How's your diet? I actually do significantly better metabolically speaking when I am off grains completely and using about 75% of Zone CHO. There seems to be some research that Hypothyroidism and Metabolic Syndrome are closely related.
Unfortunately because of my job in the AF I have to go through a PCP. Once I leave this assignment, I should be able to get a endo appointment.

I'm feeling better now, but is it me or does the first 3 days of a increase make you really tired? I'm actually feeling warmer now. When they took my temp the day I started in the morning it was at 97.4.

Looking back over the past 6-8 years, the only diet that has worked well for me for fat loss is <25g carbs, for maintenance 75g or under. I've tried Paleo and it simply does not work as advertised for me. It really is all about the total amount of carbs for me. The whole good carb/bad carb idea doesnt seem to apply for me unfortunately. I am going back to <25g carb starting tomorrow.
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Old 03-17-2009, 11:17 PM   #5
Charles Whitworth
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Re: Hypothyroidism and Dialing in T-4

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Originally Posted by Robert Pierce View Post
Don't worry to much about measured T4. Free T4, though commonly measured, is a notoriously inaccurate measure of global thyroid function. Most of us, including the endos that I know/respect, still just use the TSH.

Seeing an endo will not resolve any debate about the appropriate TSH.

Probably no harm in getting TSH under 1.0 or 1.5, but as you may know, it probably is not a good idea to get it under 0.4 or 0.5.

Ok, I'm reading a book called Living Well With Hypothyroidism by Mary Shomon and in it she suggests shooting for below a 1.0 and above a .50 for people who do not have thyroid cancer/thyroid removal. That goes along with what I was thinking previously.
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Old 03-18-2009, 04:37 AM   #6
Robert Pierce
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Re: Hypothyroidism and Dialing in T-4

Charles, I don't know how old you are, but recent evidence suggests that we are wrong to look at just one normal TSH range for everyone. Rather, it may vary by age. So in a young person a TSH of 5.0 may represent hypothyroidism but in a 75 year old it may be normal (wfs): http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
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Old 03-19-2009, 10:22 AM   #7
Marcus Allen
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Re: Hypothyroidism and Dialing in T-4

Thanks for the link.

What would the advantage be for a low normal at 1 or 1.5 vs a 3?

For me, I feel great, sleep great etc. Would I like to lose weight easier? Who wouldn't?

Are there significant advantages in heading for the low normal range?
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Old 03-20-2009, 09:45 AM   #8
Charles Whitworth
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Re: Hypothyroidism and Dialing in T-4

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Originally Posted by Marcus Allen View Post
Thanks for the link.

What would the advantage be for a low normal at 1 or 1.5 vs a 3?

For me, I feel great, sleep great etc. Would I like to lose weight easier? Who wouldn't?

Are there significant advantages in heading for the low normal range?

After reading that book by Shomon, the difference in a 1.0 and a 3.0 can be exponential in the way you feel.
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Old 03-20-2009, 01:11 PM   #9
Ben Kaminski
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Re: Hypothyroidism and Dialing in T-4

I am hypo with hashimotos, the immune system attacking my thyroid. When I was diagnosed my TSH was a 12. I am on total replacement. It takes 200 mcg per day to get my TSH between 2 and 1, which is where I want it. I spent a year at 4 and I feel better now around 1.5. I have been on as high as 250 mcg in the initial years.

Starting out slow dosing will minimize side effects, there is no other benefit to my (limited) knowledge. Side effects are primarily hot flashes and heat intolerance and last 2-3 weeks before your thyroid adjusts its own output to counter the replacement.

I have varied from 125 mcg to 250 mcg max and am currently on 200 mcg - I have not noticed a large impact on my weight or body fat percent as a function of dosage over the years.

I notice a huge negative change in mood on missing a dose for any reason. I have not missed a dose in 2+ years, and I make every effort to avoid it because it derails me for a week or more. If I ever forget taking a pill in the morning and think I might have forgotton I take another one just to be sure. It is that important in my experience. Although, even taking two in one day derails me to some effect, but not nearly like missing a day.

So my recommendation is to get close to 1.0 on your TSH, regardless of how much we don't know about it, because you might as well do it and it won't hurt you.
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Old 03-20-2009, 02:38 PM   #10
Leah Turner
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Re: Hypothyroidism and Dialing in T-4

Not to hijack the thread, but for those of you who do have hypothroidism, how did you know you had it? What symptoms lead you to go to a doctor, and what type of doctor did you first visit?
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