When last we left the riveting story of my ongoing adventures in functional medicine, it was August, and I'd just been to my first appointment...Read More
I know everyone isn’t interested in my hormone experiments, so if you’re less than enthralled by tales of T4 and TSH, skip this one. There’s good stuff coming later for you. For my #FUThyroid friends, welcome! To get up to speed, you might want to read this post about my previous status in April before continuing on to today’s installment. (Need more context? You can read all of my previous posts about my thyroid adventures here.)
Before I get into my details, I think it’s worth repeating that all of this is about my situation. I’m glad to share my experiences with you, but we’re all different, especially regarding hormones and how our bodies behave. Remember: you are a special, special snowflake. If you think you’re experiencing something similar to me, or you’re curious about what you read here, please consult an expert. The only things on which I’m an expert are myself and how to pet Smudge’s belly without waking her up.
When I saw Dr. Sebring in April, he tested my DHEA and Reverse T3. The numbers were not good. One might even say they were bad. He started me on a bunch of supplements, encouraged me to continue with my strength training and paleo diet, and said to come back in three months. Well, it’s been three months, and at my recent followup, he re-tested my DHEA and Reverse T3; this is what we learned.
A quick reminder of what I know about DHEA, thanks to the Google oracle: Dehydroepiandrosterone (DHEA) is a hormone controlled by the adrenal gland. Hormones like estrogen, testosterone, and our old friend cortisol depend on our bodies’ production of DHEA. Low DHEA means low production of these hormones, which can lead to all kinds of lame sh*t like lack of energy, low libido, and fat gain. DHEA supplementation can help with adrenal function and is used to treat lupus, HIV, obesity, depression, menopause, and osteoporosis. I’ve been taking DHEA supplements for three months.
When we tested DHEA in April, my level was so low, it barely registered on my blood test. The expected range for DHEA is 27-206 UG/DL, and my came in at a whoppingly unimpressive <30.
I’m pleased to announce that this time, my DHEA was measured at 137. It could still move up a bit, but at least it’s near the middle of the range this time. I’m continuing with my DHEA supplements, and Dr. Sebring decided to test my testosterone level this time, too. I’m waiting on those results.
What’s Reverse T3?
In a nutshell, Reverse T3 is a by-product that is made when T4 is converted into T3. When things are working properly about 40% of T4 becomes T3, and the rest is chucked out as RT3. But… when emotional, physical, and biological stress enter the picture, those percentages can be disrupted and T3 — the active form of thyroid hormone we need — goes down. For more on this, read my previous, lengthier description.
My Reverse T3
When looking at RT3, the raw number is informative, but even more telling is the ratio of free T3 to RT3. As explained above, when the proportions of those two hormones get out of whack, mayhem ensues.
In April, my RT3 was 523. The “expected range” is 90-350, so I was way off that chart. Additionally, my ratio was lousy. Generally speaking, when comparing free T3 to RT3, a healthy ratio is 10. When I plugged in my numbers, I got a 4.
When we tested my RT3 last week, I was still, as the lab report so drily puts it, “Out of Range.” Again, the Reference Range is 90-350 pg/mL, and my measurement was 410. Not quite as bad as last time, but still too high. My new ration is 5, which is still sucky.
What I’m Doing Now
Dr. Sebring proposed a somewhat bold and controversial treatment protocol, and after lots of consideration, reading the wonderful book The Thyroid Diet Revolution (review coming soon), and discussing it with Dave and my parents, I’m giving it a try. I’ve been a little anxious about making a big change, but I had to admit that my current treatment wasn’t working. My energy is mildly better, but I’m still holding weight around my middle (cortisol!), and I don’t like knowing that my Reverse T3 is so high. Vanity about the extra body fat aside, there’s clearly something wonky going on, and I’d like to correct it.
For the next 22 days, I’m following the treatment protocol for Wilson’s Syndrome; you can learn more about it here and here. (Warning: if you Google Wilson’s Syndrome, you will read lots of stuff that says it’s not a real thing. That worried me a little until I read The Thyroid Diet Revolution.)
What it means in practical terms is that I had to stop taking all thyroid hormones for 10 days to get all of the T4 out of my system. Right now, my body really likes turning T4 into RT3, and we need to stop that cycle. I’m on Day 9 of no thyroid hormones and except for some spaciness, a little extra anxiety, and occasional feelings of needing to lie down immediately, I feel OK. I was very concerned about what might happen when I stopped my Synthroid, but so far, I don’t feel much different than I did when I was on it.
On Tuesday, I’ll start the new hormone protocol, which is T3 only, taken in gradually-increasing doses for 10 days. Then after that mid-point, the doses start ramping back down to where they started. Every day during the 21-day experiment, I also have to take my temperature and pulse three times a day. This information will help us figure out what dose of T3 is right for my body. This protocol is meant to re-set the propensity for my body to be a RT3 factory, and at the end of the 21 days, we’ll need to figure out what to do next: Keep me on T3 only? Try Armour which is a natural blend of T4 and T3? I know people who use both treatments and feel good, so it all depends on the individual.
The other slightly wacky thing about the protocol is that I have to take my daily T3 doses exactly 12 hours apart. Both Dr. Sebring and the pharmacist told me, in very serious tones, that they’re not kidding: 12 hours apart, as exact as I can make it. So I have an alarm watch set for 9:30 a.m. and 9:30 p.m., plus a special pill box to ensure I don’t mess it up. And I got a new digital thermometer and heart rate monitor to help with charting my temperature and pulse. I kinda feel like this:
I’m continuing with my other supplementation, too. I’m sharing this list for informational purposes; please talk to someone who knows what they’re doing before you start dosing yourself. This is serious stuff.
– Corti-B Plex
– Cortisol (prescription)
– I’m also still taking Vitamin D, Natural Calm
I’m sticking with my twice-a-week strength training, walking for at least 60 minutes every day, and getting at least one (but preferably two) run-walk sessions each week.
Meditation & Yoga
Right now, I’m committed to yoga 3X a week: two kundalini classes and one hatha. I’m sticking with meditation every day from now on, and I’ve learned a simple kundalini set I can do on my own, so some days, my short meditation might be replaced by an hour of solo kundalini at home. My kundalini instructor also has thyroid challenges and she said that her practice has helped her quite a bit. I’ve only been practicing kundalini for about 8 months, but I know it’s helping me, too.
I’ve been eating Whole30 style about 90% of the time for the last three weeks, and that’s going to continue from now until August 24 when I hit the road to Pennsylvania. I won’t be going off the rails completely on our trip, but there will be more occasions to indulge. For now, I’m staying focused on eating clean and continuing to eat in a 12-hour window with no snacks. My macronutrients are about 40% fat, 30% protein, 30% carbohydrates, and I’m keeping track in a notebook. Occasionally, I plug my food into FitDay to double check on my calories and ratios, but I’ve got it pretty nailed down from experience.
So that’s my story for now. I’ll update you all again when my 21-day experiment is completed — or in between if something really dramatic happens. Feel free to hit me with questions in comments, and if you’ve ever done the protocol for Wilson’s Syndrome or you only take T3 (or you take Armour), I’d love to hear from you in comments about that, too.