This week’s Topic of the Week is about optimal thyroid levels and what they mean.

Each and every one of you should know where your thyroid levels are at all times. Do you know where yours are? If you were diabetic, you’d know your glucose and A1C levels. If you’re on a diet, you know what you weigh. The same is true if you’re managing an intact hyper thyroid. You must know where you are. If you’re not optimal yet, you must test every 3 weeks. Once you are optimal you can extend testing to 4 weeks and sometimes 5 or 6 weeks but only if you’re firmly stable.

You hear me say over and over that normal range is not good enough, you need to be optimal to feel good and to lower antibodies. So what is optimal?

The normal ranges used by laboratories are an average of all people. This includes hypo people, hyper people, the pregnant, the elderly… so needless to say, they’ve created far too broad a range. When we’re trying to get optimal we use a much smaller range. Normal is not good enough.

For Free T4, we look at around midrange as optimal. Some prefer to be slightly higher than midrange and others prefer to be slightly lower. It’s up to you to discover your sweet spot which is where you’re virtually symptom free.

For Free T3, we look at the top 1/3 of the range as optimal. Your FT3 must be higher in the range than your FT4 is. This shows you’re converting T4 to T3 properly.

For TSH, we look at between .5 and 2 to be optimal. But, since TSH can stay suppressed for months to years in Gravesters because of Graves antibody stimulation we ignore TSH until it responds to treatment.

Do you know where your levels are? If your goal is keeping your thyroid and full antibody remission you MUST be on top of this!

Do you need help getting your thyroid levels optimal so you can enjoy your best quality of life? Then please consider scheduling a 1 Hour Consultation with me and allowing me to manage your dose adjustments and iodine intake for a while because your doctor doesn’t know what I know. If they did, you’d be optimal.

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How often should we test thyroid levels?

Answer: Every 3 to 4 weeks. Why? The thyroid feedback loop takes 2 to 3 weeks to complete. To maintain optimal levels (not just normal range) we must test and adjust our med dose and iodine intake to force our thyroids into optimal levels. Think of it like diabetics test their insulin levels and adjust their insulin daily, sometimes several times a day, to maintain the correct levels. Since the thyroid feedback loop takes longer to complete, we can’t test and adjust any more frequently than 2 weeks. Once optimal and stable we can safely test every 4 weeks to maintain. By making frequent adjustments we avoid the yo yoing effect of too high to too low peaks and valleys that doctors cause. Yo yoing or roller coastering will not lead to antibody remission.

If you’re not optimal and stable, you’re not reducing antibodies!! MMI/CBZ has mild antibody reducing properties but we must maintain optimal levels to get that benefit.

If your doc won’t test you often enough you can order your labs through me (US only). ThyroidKeepers.com

I cannot teach you how to adjust your dose and iodine intake in the group setting. There are too many variables to consider. This must be done on an individual basis. Please consider a private consultation with me so I can help you.

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How often should we test Graves Antibodies?

Answer: Once a year is sufficient with a few exceptions. Graves antibodies will wax and wane on their own so testing any more frequently is usually unnecessary. Annual testing will show legitimate and stable reduction.

Be sure your doc is testing the correct antibodies!! I still see endos testing the wrong antibodies every day.

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How many of you have been told by your doctor that you can only be on methimazole (MMI) for 12 to 18 months then you must stop and kill or remove your thyroid? This is total bunk!!!

This is a complete and total lie started by AbbVie a subsidiary of Abbott Laboratories, the makers of Synthroid back in 1955!! This marketing plan included seminars of continuing education credits for doctors and lectures at medical colleges all over the world. This LIE was so well publicized that doctors are still spouting it today, 69 years later!!!

This is when removing the thyroid became the gold standard of the treatment of hyperthyroidism.

This bunk has ruined the lives of many Gravesters for over half a century!! Remember quality of life is always better with our own natural hormone.

Here is a 10 year study proving long term, low dose MMI is safe.

http://www.ncbi.nlm.nih.gov/m/pubmed/15879354/

Average time to get antibodies into remission is 2-4 years. It took me 5 years. We do not stop MMI until antibodies are firmly in remission for at least 6 to 12 months!!!

So why do our doctors continue to think we can only take MMI for 18 months? Four reasons:

High doses (over 15mg) long term can cause elevated liver enzymes. But, low doses typically do not. If you’re limiting iodine, low doses should control your overactive thyroid.

The above mentioned ropaganda started by the makers of Synthroid to sell more Synthroid spread 69 years ago are still being quoted today. Pharmaceutical companies are responsible for million of hours of continuing education credits for doctors. They will spin research results to their own benefit to sell more of their products even when this spin is virtually not true.

If they let you keep your thyroid intact and you choose to stop managing it properly you could have a thyroid storm which can lead to heart attack, stroke, coma and even death. Doctors don’t trust you with your own care. They’d rather remove this risk than educate you on how to avoid it.

They’ve not read the above mentioned study and there is very little continuing education provided for Graves/Hyperthyroidism with the thyroid intact.

At this time, the only sure fire way to achieve antibody remission is with long term, low dose MMI to maintain optimal (not just normal range) thyroid levels combined with the correct amount of low iodine to force thyroid levels optimal. So the next time your doctor wants to limit how long you can take MMI, show him/her this post and 10 year study and offer them a nice warm cup of shut the heck up you’re your own advocate and you’re educating yourself!!

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Beginning next week I’m introducing a new series of articles to assist in teaching you to be a successful Thyroid Keeper. I’ll be doing interviews with some of my existing clients and some Gravesters who have had RAi or a thyroidectomy.

Comment below or private message me if you’d like to participate.

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Why do we give TSH the lowest priority when managing Graves/Hyperthyroidism with an intact thyroid?

It’s simple biology. The Graves antibodies (TRab – TSH Receptor Antibodies) attach to the TSH receptors on your thyroid. TSH is a pituitary hormone not a thyroid hormone. Your pituitary sends a low TSH number to your thyroid trying to tell it to stop making too much hormone. Due to these Graves antibodies attached to your TSH receptors on your thyroid, essentially hijacking this signal, your thyroid never sees it. It’s that simple.

We never, never, never manage Graves by TSH alone. If your doc is doing this it’s your big red flag that your doc is not Graves/Hyper savvy and has no idea how to manage your treatment and is ignoring the simple biology of how this disease manifests. Don’t allow it!

It can take months to years with anti thyroid med treatment for TSH to be seen by your thyroid again. Be patient.

Over medicating with anti thyroid meds to get TSH to come up is very bad and horrible mismanagement. Making you hyPO will not lead to good quality of life or will it lead to antibody remission. It also causes inflammation, goiter and increased antibodies.

Using L-Carnitine to raise TSH is a false victory. It only looks good on paper. It has not lowered thyroid hormone levels or the antibodies that are causing your hyperthyroidism. In the long run it’s actually more detrimental than beneficial.

When do we pay attention to TSH? Or, give it a higher priority? Only when it gets too high. Remember, with TSH a low number means hyPER and a high number means hyPO. It’s backwards. Once TSH does start responding again it’s very important that it never gets above 2.0. This is the only universal test range. The variances in the reference ranges for TSH is so minimal worldwide we can safely say anything over 2 will lead to inflammation, goiter, hyPOthyroidism and increased antibodies.

If your doctor is managing your Graves or Hyperthyroidism by TSH alone please get with me for a 1 Hour Consultation so I can teach you how to properly manage your disease into antibody remission for your best quality of life!

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*** Repost to cover several pending posts.

There’s a little known and often ignored Graves symptom that’s not related to your thyroid since it is antibody driven. Graves Inappropriate Histamine Response (GIHR) can manifest differently in each Gravester, even at different times. It’s an antibody driven symptom so achieving antibody remission is the best defense but that may not resolve it completely. Remission is not cured. It hasn’t completely resolved for me and many others but it’s much improved since reaching full antibody remission.

Antihistamines help and are safe to use. There’s an older antihistamine called Hydroxyzine (US) that also has anti anxiety properties if you’re having anxiety as well. It’s a great non-addictive option. Your GP can Rx it. Over the counter antihistamines work as well. I use Benadryl (diphenhydramine) at night since I don’t have the anxiety issues anymore.

GIHR can manifest in numerous different ways:

Overproduction of mucus or phlegm in the sinuses and throat. If you frequently cough from a tickle in your throat, this is likely GIHR. The tickle comes from drainage going down the back of your throat. It’s important not to swallow or allow this drainage into your lungs as it can cause stomach upset and pneumonia respectively.

Food sensitivities. Certain foods may trigger the overproduction of mucus when eaten. Luckily, we can still eat these foods is this is not the same as an anaphylactic reaction which is dangerous. Just be prepared to need to blow your nose and cough to prevent the excess mucus from getting into your lungs or digestive tract.

Skin reactions and rashes. These are usually itchy and take a long time to heal. Steroid and cortisone creams help. Note: this is NOT the same as the rash that can accompany starting anti thyroid meds. This rash that usually occurs in the first few weeks of taking ATD but not the first dose or two is caused by the dose being too high. Completely different.

Suddenly being unable to take medications you’ve previously taken just fine due to the onset of a rash. We can suddenly develop a reaction to things like antibiotics, Rx meds, etc. that we’ve never had before.

The good news is Graves Inappropriate Histamine Response symptoms/reactions can disappear as suddenly as they occur. Eating corn may trigger a reaction but then a year later you’ll have no reaction whatsoever to eating corn. Crazy, huh?!?

Are you having GIHR? Then, please consider working with me to get your thyroid levels optimal and your antibodies declining down on the way to remission. That’s what will help the most in the long run.

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For more details as to why each topic is either an Always or a Never just search the group. These subjects have all been discussed many times over the years. Don’t have time to do your own searching and research? Just schedule a 1 Hour Consult with me and I’ll happily explain it all to you and answer your questions.

Always: Split your daily dose of anti thyroid meds.

Never: Manage Graves/Hyper by TSH alone.

Always: Test FT3, FT4 and TSH every 3 to 4 weeks depending on how optimal and stable you are.

Never: Guess or put a time limit on when to stop anti thyroid meds. If you’re achieving antibody remission correctly, you’ll know exactly when.

Always: Wait until you have fresh labs to adjust dose and iodine intake; don’t ever do it in the middle of the thyroid feedback loop cycle.

Never: Take ashwaganda, collagen, biotin or high iodine supplements. Or eat fresh coconut.

Always: Track your iodine intake. We can’t rely on iodine blood tests since they only show how much iodine you consumed within the previous 24 to 48 hours. This does not equate to how much iodine your thyroid has had access to within the last feedback loop cycle.

Never: Follow pseudoscience advice or diets not supported by the actual biology of this disease. All autoimmune diseases are not the same. Not even close.

Always: Follow a High Protein, Low & Controlled Iodine and Nutrient Dense diet.

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Weight Management and Diet Facts – Topic of the Week

Tapazole (TPZ)/Methimazole (MMI)/Carbimazole (CBZ) and other anti thyroid meds do not cause weight gain. We typically gain weight once starting anti thyroid meds because we’re slowing our overactive thyroids (and metabolism) to a more normal pace. We must adjust our diets to compensate for this. If your thyroid levels are optimal (not just in normal range) and you’re gaining weight your diet or caloric intake are likely the culprits.

Most doctors over medicate because they are not educated on how to use MMI properly to achieve and maintain optimal thyroid levels. They mistakenly think by slamming your thyroid levels to the bottom of the range they can raise TSH. TSH is not a thyroid hormone, it’s a pituitary hormone. As long as Graves antibodies (TSH Receptor Antibodies) which attach to the TSH receptors on your thyroid your TSH will stay suppressed. Graves causes a break in the communication that occurs within the thyroid feedback loop (pituitary to thyroid to cells to hypothalamus then back to pituitary). This is why we ignore TSH unless it’s higher than 2.0. TSH above 2 leads to inflammation, goiter and hyPOthyroidism. Low thyroid levels cause weight gain. Graves must be managed by FT3 and FT4 thyroid levels not TSH. And these levels MUST be optimal.

As Gravesters we need a high protein, low iodine, nutrient dense diet. Simply avoiding iodine is not good enough. Our goal is optimal thyroid levels and we achieve this by the correct balance of anti thyroid meds and iodine intake. These amounts of meds and iodine change month to month so we must test our levels monthly and adjust meds and iodine intake to maintain the optimal thyroid levels that lead to weight stabilization and feeling well along our path to remission. This cannot be taught in the group setting because it varies for each individual month to month. I can only help you with this one-on-one. Please consider monthly Lab Interpretations with me until you understand well enough to do it on your own.

AIP, Paleo, gluten free, grain free, vegan, Keto, blah, blah, blah, are NOT effective for us.

AIP is pure bunk, there is no one diet that’s effective for ALL autoimmune diseases. This claim is a true oxymoron when you factor in how completely differently all these diseases are in how they manifest and what they do. The only benefit from AIP is it’s mild anti inflammatory properties. Fact!

Gluten free and grain free lead to enlarged heart (this is true for your dogs and cats too, so just don’t!). A 20 year study done by Harvard Med on actual Celiac patients who must avoid gluten proves this. Study is in the files. Being a former vet tech, I still follow animal medicine and this grain free craze is shortening the lives of pets too.

Veganism does not provide the animal protein our Graves bodies need. Graves attacks muscle and our bodies need animal protein to combat that. Insect protein is even more beneficial to us than plant protein (eww, but it’s a fact!). Plus, we are omnivores not herbivores! Having Graves actually makes us need to be more carnivorous than a non-Gravester needs to be.

By nutrient dense I mean get proven healthy amounts of all the food groups within our targeted iodine limits. Don’t eliminate entire food groups as it’s not healthy for anyone.

If you need to gain weight following untreated hyperthyroidism this can be assisted by placing your thyroid levels lower in the range and increasing caloric intake. Protein shakes usually have too much iodine for us, so find your extra calories elsewhere.

Weight management for anyone with thyroid disease is tricky but we can optimize our thyroid levels and our diets to live our best Graves lives.

If you need help implementing these techniques into your path to remission plan please consider a 1 Hour Consultation with me so I can tailor the information to your specific needs.

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Because I made it my mission to learn! A lifetime of living with undiagnosed Graves created my passion. Now, 12 years into being diagnosed, years of valid research, years of following and talking to others with Graves and Hyperthyroidism and my own path to remission with proper management have made me an expert!

Doctors are only taught to remove or nuke our precious butterflies in med school. They’re not taught how to utilize the medication properly. Endos are not required to get Continuing Education credits for treating Graves and Hyperthyroidism so they don’t.

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I have Graves/Hyperthyroidism how can I be hyPO Now?

There are numerous reasons your thyroid levels may have dropped too low.

Over medicating.

Our doctors are famous for over medicating us with MMI (methimazole/carbimazole/thiamozole). Most docs just simply have no idea how to utilize MMI properly. They use doses that are too high or dose adjustments that are too big. Remember they’re not taught much at about this medication in med school. They’re simply taught to remove or ablate our precious thyroids and completely ignore the autoimmune disease of Graves and nothing more.

I also believe there are a few misguided docs that think making us hyPO through over medicating will make TSH respond. Suppressed TSH is merely a response by the pituitary to our Graves Antibody stimulation. TSH is a pituitary hormone NOT a thyroid hormone. Our TSH Receptor Antibodies (TRab) attach to the TSH receptors on our thyroids and hijack the message your pituitary is trying to send your thyroid. Never, never, never allow your doctor to manage you by TSH alone.

Approaching full antibody remission.

As we get close to antibody remission our antibodies have dropped so low there’s no longer much stimulation by them. The communication breakdown the antibodies caused is mostly resolved. It’s extremely important we stay on MMI until our antibodies are fully in remission and firmly staying there. Keep in mind, our antibodies wax and wane on their own so once we achieve full antibody remission we must continue MMI for 6 to 12 months to insure long term, firm and stable antibody remission that will last for years.

Full antibody remission has been achieved.

Once we reach full antibody remission and maintained it for a year we can stop MMI. Many peoples’ thyroid levels tend to settle in too low. This can be corrected through your low iodine diet.

How do you resolve thyroid levels that are too low?

Due to the risks involved with raising thyroid levels in a Graves Thyroid Keeper who has low thyroid levels and due the reasons stated above, I will not teach this in the group setting, I only teach this one-on-one. The resolution is very individual and attention must be paid to numerous factors when choosing how to resolve a hyPO state.

There are a variety of methods we can utilize to correct a hyPO state. I won’t go into too much detail because of the risks involved that a novice shouldn’t attempt. Yes, your doc is included when I say novice. These include microdosing MMI, proper amount of iodine in the diet and even using thyroid replacement hormone when all else has failed.

If you find yourself in a hyPO state, please get with me for a Private Consultation so I can look at why you’re hypo and instruct you on the best appropriate options to resolve it.

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