thyroid and vitamin d

Thyroid Disease Support Information
===================================

NEWS: There is an accurate TSH home test available from Blood Test At
Home for $25.99. While TSH may not be helpful to titrate ongoing
treatment it is an excellent screening tool to monitor your need for
treatment. TSH should be below 2.0, typically 1.3 or so in healthy
persons. If yours is higher, consult your physician. If you need to
monitor your treatment (how much thyroid do you need?) thyroid panels
are available from Private MD (link is to a standard panel but for
monitoring treatment consider the "TSH, free T3 and free T4" combo
which you will find by clicking on the test categories / thyroid)
Private MD Labs offers a 15% discount (discount link on their home
page) so a TSH, free T3 and free T4 panel ($78) will be only $67.

As February of 2009 a reformulation of Armour thyroid in the US seems
to have dramatically reduced its effectiveness. The manufacturer
increased the amount of cellulose which in fact can bind
nutrients/elements. It is possible to find natural thyroid, Westhroid
and Naturethroid, in the US but they seem to be in short supply and
are more expensive. This is devastating to many people who have worked
so hard to 'get well'. Hopefully Armour will reconsider and return to
their old formula. Do let them know you care. It is possible to find
dessicated thyroid outside the US.

Disclaimer: I am not a physician and do not diagnose disease. The
statements made here are for educational purposes only. Please see
your health care professional before making changes in your diet or
medications. Any of the information you may choose to use is your
responsibility. Thyroid disease can be life-threatening and is not to
be taken lightly. Treatment of some kind is critical and necessary.

Please note: Low levels of dietary protein, omega-3, potassium, zinc,
copper, lithium, selenium, and magnesium affect your thyroid gland
function. It is possible to test positive for hypo, hyper or
auto-immune thyroid disease and yet correct the abnormal tests with
excellent nutrition. Unless your thyroid disease symptoms are severe
or life threatening you may want to try improving your nutrition
before you commit to life long use of thyroid hormone. If you already
take thyroid medication a good nutritional program will help you be as
healthy as possible and allow your medication to work better. Do not
stop medication without notifying your physician. Autoimmune thyroid
disease almost always requires medication ongoing.

You have been diagnosed as having some form of thyroid disease. You
may be hypothyroid, hyperthyroid, have Graves Disease or Hashimoto's
Thyroiditis. This information has not been prepared to take the place
of being monitored by your physician. It is to help you help your
physician determine your correct dose of thyroid medication and help
you both maintain the correct dose.

A CAUTIONARY NOTE: It is important to make sure your symptoms and
blood work are not a result of adrenal insufficiency. Depressed
thyroid and depressed adrenal symptoms are very similar. Cortisol, a
primary adrenal hormone that is elevated under stress and depressed
when the adrenal gland is exhausted, alters TSH and thereby T4 and T3.
Alterations in adrenal function alter thyroid function but treating
the thyroid will not make the underlying adrenal condition, if it
exists, better and may make the situation much worse. A simple, and
relatively inexpensive, 24 hour salivary cortisol and DHEA test can
rule out (or in) adrenal involvement. Also consider this test if you
are currently being treated for thyroid and the results are not what
you expected. If you have thyroid disease and are treated with a good
combination of T3 and T4 your symptoms should resolve rapidly. Your
symptoms will remain, alter, or become worse if adrenal dysfunction is
present. The cortisol/DHEA test is available from your physician. It
is important that the health care professional you are working with
understand this testing, how to interpret it, and how to treat the
results, or the testing will be of no value to you.

A second cautionary note is that there is now recognized in the
literature a 'thyroid resistance syndrome' similar in character to
'insulin resistance'. This manifests as symptoms of low thyroid
function but normal thyroid blood work. An imbalance of
omega-3/omega-6 fatty acids can contribute to this condition. Lowering
omega-6 fats and dramatically increasing omega-3 (fish oil NOT flax)
has improved or normalized thyroid function in some persons. A small
dose (not less than 200 mcg nor greater than 400 mcg) of yeast based
selenium (methylselenocysteine) may also improve this condition.

Recent research has determined selenium is critically important to
thyroid function and selenium is being used to treat both Graves
Disease and Hashimoto's Thyroiditis. Excess iodine is frequently
implicated in autoimmune thyroid disease, especially Hashimoto's
Thyroiditis.

Iodine is critically important for healthy thyroid function and heart
function. Iodine excess increases the possibility of autoimmune
thyroid disease. Selenium effectively treats iodine excess. Selenium
and iron both play an important role in normal thyroid function.
Mercury toxicity also alters thyroid function and increases the need
for selenium. You need the 'right' amount of a nutrient, not too much,
not too little.

Confused? Your thyroid needs iodine but it also needs other nutrients
to function normally. Trace elements and minerals such as mercury,
toxic at any dose, and iron, selenium, copper, and zinc, essential for
health but toxic is excessive amounts, alter thyroid function. You
need enough of everything you need but not too much. You may check
your iron by monitoring your ferritin levels. Optimal ferritin is
70-90, not lower or higher, no matter what the lab normal is. Zinc
supplementation usually remains between 15-50 mg. Daily doses higher
than 70 mg are excessive and may suppress your immune system and not
in a good way. Ethical Nutrients makes an oral zinc test, Zinc Status,
that will help you monitor your need for zinc.

You need a balanced diet with balanced minerals and trace elements to
support your thyroid. No one mineral or trace mineral or ‘pill’ will
do. Low protein and/or inappropriate fatty acids also decrease your
body’s ability to produce hormones or increase cellular resistance to
hormones. Making sure your diet contains adequate protein and
potassium (see other pages) and that your supplements contain enough
but not too much of essential elements may restore thyroid function,
will support thyroid disease treatment and likely protect the healthy
thyroid from disease.

In addition lithium orotate, as mentioned in the supplement list to
follow, has been very successful in reversing this syndrome in some
persons. The dose used is very low (120 mg of lithium orotate
containing 4.8 mg of lithium), not anywhere near the dose used by
physicians to treat bi-polar disorders (800-2400 mg of lithium
carbonate daily). In 'resistance syndrome' lithium is being used as a
trace element, currently recognized as conditionally essential, to
restore membrane sensitivity. This information is from the work of
Hans Neiper,  M.D. More information is available from the Brewer
Science Library.

If you decide to try lithium use only the orotate and use only a small
dose such as the one suggested below or less. More is not better.
There is some evidence that low dose lithium may also restore membrane
sensitivity to glucose and insulin in hypoglycemics and diabetics.
Lithium Orotate is available from Complementary Prescriptions online
or 888-401-1105. Use my PIN number, 230288,  to register at checkout. 

YOUR TREATMENT PROTOCOL: Initially your doctor will ask you to
increase your thyroid medication dose gradually. Your medication will
usually be raised every 3-4 weeks. Do not raise your dose faster
without your doctor's permission. When your thyroid's function has
been impaired for an extended period of time there can be
deterioration in many of the organ systems in your body, one of the
most important being the heart. There may also be changes in the
central nervous system. Because of these changes, increasing your dose
too quickly could have serious consequences. Even though your
maintenance dose may be much higher than that with which you start,
INCREASE SLOWLY with your doctor's permission and monitoring. (I would
modify this in some cases to suggest increasing your dose more rapidly
may actually save you. If you know your body well and are able to
tolerate some symptoms and will check your pulse, blood pressure, and
temperature several times a day getting your thyroid back to 'normal'
may improve heart function).

The maintenance dose, arrived at slowly, is 100-300 mcg. of Synthroid
or Levothroid (T4) or 60-120 mg of Armour or Westhroid (whole
thyroid). There is a great difference in these doses and blood work is
always the best indicator that you have reached your ideal dose. 1
grain means about 100 mcg of Synthroid or 60 mg of Armour. 1.5 grain
(150 mcg Synthroid or 90 mg Armour) is a typical maintenance dose.
Dose is usually increased in increments of 25-50 mcg (15-30 mg whole
thyroid) until your TSH falls within normal range, currently thought
to be 2.0 or less..

On the correct dose of thyroid you will have stable blood sugar
levels; normal appetite; energy; normal sleep patterns; no frequent
urination; a basal temperature of 97.8-98.2; no hair loss; good hair
texture-not coarse or fine; good circulation-warm hands and feet and
the ability to warm up quickly when you get cold; good skin
texture-not dry and thick or thin and oily; good skin color-normal,
slightly pink without abnormal flushing-the palms of the hands and
soles of the feet should not appear yellow or orange; normal size
tongue-pink with no indentations around the edges; no athletes foot;
good resistance to infection; normal mucous membranes-not excessive or
thickened mucous; improvement or elimination of environmental and food
allergies; normal perspiration patterns-not sweating without cause but
having the ability to perspire when exercising or when the temperature
rises; no night sweats; stable mood-not depressive, having curiosity
and a desire to do and to have; enjoying exercise and feeling a
benefit after working out; good short and long term memory; the
ability and desire to experience sexual satisfaction; a good sense of
taste and smell; good reflexes-neither too fast nor to slow; no
constipation or diarrhea; a normal menstrual cycle of 3-5 days without
heavy bleeding and without PMS.

Your dose of thyroid is too high (or you may have raised your dose too
quickly) if: you experience undo sweating; heart palpitations;
hunger-eating all the time without weight gain; a resting pulse above
80; quick movements; thin/fragile skin; a change in hair texture to
very fine; a basal temperature above 98.2; eye or vision changes;
headaches with no apparent reason; nervousness; tremor; unusual
increase in amount and number of bowel movements per day; diarrhea.
Ask your druggist for the written material available concerning your
medication. Read all overdose symptoms and contraindications. The
normal thyroid converts more thyroxine,T4, into T3 (the active thyroid
hormone) during stress, in colder weather and when you are ill or
injured. You may be able to adjust your dose, with your doctor's
consent, to fit the situation. To be able to do this successfully you
need a prescription for an incremental dose in addition to your
regular prescription.

Thyroid hormone consists of several fractions. The most important
fractions are T3 and T4. Armour (or Thyroid-S) contains T1, T2, T3, T4
and more, Synthroid contains only T4 and Cytomel contains only T3.
Some individuals appear to have a problem converting the inactive T4
found in Synthroid into the active T3 . Zinc, selenium, and magnesium
are required for this conversion, as well as other nutrients. Your
physician can check to see if you have a problem by monitoring your
free T3 levels. Also see the Private MD Labs testing at the top.

Please remember your needs change with age, weather, illness and
injury. What worked in the past may need adjustment today. Watch your
symptoms. They are your body's way of talking to you.

Supplements that may help: (Suggestions, not prescriptive.) 

Vitamin A (retinol as found in Cod Liver Oil or concentrate, check
 capsule) 5,000-10,000 IU. daily or liver twice a week. Persons
 with hypothyroidism do not convert beta-carotene easily. Excess
 vitamin A may suppress thyroid function. Doses of vitamin A up to
 25,000 IU daily have been determined safe even for pregnant women
 but there is no indication for most that vitamin A is needed in
 amounts greater than 10,000 IU daily and more is not better.

Vitamin D as found in Cod Liver Oil or concentrated D supplement
 such as Solgar Vitamin D 1,000 IU. 1,000-2,000 IU as determined by
 testing (see http://sunlightd.org)

B-Complex- from nutritional yeast such as Lewis Labs Brewers Yeast
 or in a supplement such as Nature's Way B-Stress

C-Complex- C 500-2,000 mg.; bioflavonoids 500-2,000 mg.; rutin
 25-500 mg.

E- d'alpha tocopherol with mixed tocopherols 200-400 IU. Amounts
 greater than 400 IU daily may contribute to fatigue.

Calcium- 800-1200 mg. Make sure you split this dose into two or
 more times per day.

Magnesium- 400-800 mg. watch for 'bowel' reactions and lower your
 dose if they occur. 

Zinc- 20-50 mg. Doses higher than 90 mg. per day have been
 implicated in immune system suppression. Do not exceed the
 maximum. Use the Ethical Nutrients Zinc Status to monitor your
 zinc need but do not use this for a supplement..

Copper- 1-3 mg. All minerals can be toxic in dose that are too
 high. Copper and zinc balance one another.

Lithium Orotate- 120 mg. containing 4.8 mg of lithium. Trace
 amounts of lithium may restore cellular response to thyroxine. If
 you order use my Complimentary Prescriptions referral PIN 230288.

Iron Complex- in your multiple or as an add-on with B-12 (about 1
 mg which is 1,000 mcg), folic acid (about 4 mg which is 4,000 mcg
 the new recommendation and not in any multi-vitamins currently
 available) and C in a multiple iron complex, multi-vitamin and
 mineral or from a liver supplement. Solgar Hematinic Formula is an
 excellent choice allowing a dose of 1-3 pills a day as needed, or
 Solgar Gentle Iron or Now Foods Iron Complex or Complimentary
 Prescriptions Iron Complex. Men may not need this. Test your
 ferritin and supplement if below 70. Avoid all supplemental iron
 if your ferritin exceeds 150. Ferritin testing is available from
 lef.org or privatemdlabs and results will be sent directly to you.

Taurine- 500-1,000 mg. twice a day, an amino acid for heart and
 nerves. Taurine is high in wild game, lean red meat, beef heart,
 oysters, mussels, shrimp and scallops.

Carnitine- 1,000-2,000 mg. once or twice a day. An amino acid that
 protects the heart. Both taurine and carnitine are found in beef
 heart and lean red meat. 

Trace minerals- including chromium, selenium, molybdenum, vanadium
 and boron. Trace amounts varying from 50 mcg - 400 mcg depending
 on which supplement and which mineral. Trace minerals should be
 just that, trace amounts. Do not over use. High quality
 multi-minerals often contain enough and not too much of the needed
 trace minerals. Consider Country Life Target Min Total Mins as
 one.

Avoid excess iodine. Stick with the RDA of 150 micrograms (mcg.)
 or so. If you feel you need extra iodine consider one tablet of
 dulse, a sea vegetable that is high in all trace elements, not
 just iodine. Many alternative practitioners believe giving iodine
 will help thyroid but excessive levels of iodine suppress thyroid
 function and may be a primary cause of auto-immune thyroiditis
 (Grave's and Hashimoto's) in iodine sensitive individuals..

If you order from iherb.com (links follow) and are new to them use my
code RIS664 for a $5 discount on your first order. Supplement combos I
have found easy and helpful include: Now Foods Liquid Multi-Gels,
Country Life Daily Multi-Sorb, Natrol My Favorite Multiple Original
tablets or Twinlab Mega 6 Caps, are available from iherb.com, vitacost.com
or vitaglo.com There are other multiples available with similar
composition. As long as your supplement contains most of the suggested
nutrients and you are comfortable with it, find yourself taking the
full dose daily, it is fine.

In general, supplements do not contain taurine, carnitine, or some of
the trace minerals and you may need to purchase them separately. Jarrow
SeleNext is an excellent source of food based selenium. Lewis Labs
Brewers Yeast also contains selenium and is an excellent source of
high quality protein, B vitamins, and potassium as well but if you
won't use it every day get the SeleNext.

If you have been having gallbladder discomfort or other digestive
problems, often accompanying thyroid or adrenal dysfunction, Country
Life Ultimate Fat Metabolizer 2 taken with each meal can help a great
deal. Lecithin granules can be used in place of the lipotropic- 1
rounded teaspoon per meal plus 500-1,000 mg taurine. Silymarin,
standardized extract, about 3 capsules twice a day in addition to the
lecithin and taurine may reduce or reverse liver and gallbladder
problems.

When T4 or T3 are low the body is less able to convert vitamin D into
the active hormone and also cannot convert beta-carotene into retinol,
the active form of vitamin A. Frequently there is low production of
hydrochloric acid which leads to malabsorption of B-12 and iron.
Following diagnosis and treatment with thyroid hormones you can help
restore body levels of nutrients by increasing the amounts of these
nutrients in food or with supplements for about 2-3 months.

If the thyroid is overactive or if you have been taking too high a
dose of thyroid hormone there may be a significant loss of muscle mass
and bone mass. All nutrients, protein and minerals and trace minerals
should be at the highest levels for 3-6 months after beginning
treatment.

If after trying everything you still find yourself suffering from
fatigue and depression visit http://stopthethyroidmadness.com

Spend some time and read the stories. You will be inspired and may
find a way to get back your 'self'. I did. Blessings, Krispin

BOOKS-

Your Thyroid A Home Reference Wood, Cooper and Ridgeway

The Thyroid Solution: A Mind-Body Program for Beating Depression
 and Regaining Your Emotional and Physical Health by Ridha Arem

Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You
 . . . That You Need to Know, Mary Shomon

Mary Shomon's thyroid column on http://about.com is a great place to
find information as is Stop The Thyroid Madness.

Thyroid disease is a life long problem. Once it has been determined
that you have or a family member has a thyroid disorder, monitored
treatment is imperative. During your lifetime your thyroid may become
hypo (low), hyper (high) or even normal. You need to be informed so
that you have the ability to take care of your own body. Your
physician is your partner in staying healthy. Use him or her to your
best advantage. The only safe use of medicine, including all hormones,
is informed use.

Please remember that thyroid disease has a high familial tendency.
Inform other family members of your condition and if suspicious
symptoms occur in any of your blood relatives suggest they have a
complete thyroid test that includes TSH, T3U, FTI, free T4, free T3
and a special test for anti-microsomal antibodies and
anti-thyroglobulin antibodies. If anti-bodies are present remember
that selenium, 200-400 mcg, and other trace elements may reduce or
correct this condition. There is a tendency among some physicians to
over-diagnose thyroid disease. Symptoms attributed to thyroid
malfunction, including a popular mis-diagnosis 'low body temperature',
may be caused by other diseases and conditions. If you are not
comfortable with your diagnosis, seek a second physician opinion. If
you need help now 1-707-769-1301 (you will be billed for a
consultation).

Reference List  

(1) Guo H, Yang X, Xu J, Hou X, Sun X. Effect of selenium on thyroid
hormone metabolism in filial cerebrum of mice with excessive iodine
exposure. Biol Trace Elem Res 2006 Dec;113(3):281-95.

(2) Farkhutdinova LM, Speranskii VV, Gil'manov AZ. Hair trace
elements in patients with goiter. Klin Lab Diagn 2006 Aug;(8):19-21.

(3) Yang XF, Hou XH, Xu J et al. Effect of selenium supplementation on
activity and mRNA expression of type 1 deiodinase in mice with
excessive iodine intake. Biomed Environ Sci 2006 Aug;19(4):302-8.

(4) Brzozowska M, Kretowski A, Podkowicz K, Szmitkowski M, Borawska M,
Kinalska I. Evaluation of influence of selenium, copper, zinc and
iron concentrations on thyroid gland size in school children with
normal ioduria. Pol Merkur Lekarski 2006 Jun;20(120):672-7.

(5) Turker O, Kumanlioglu K, Karapolat I, Dogan I. Selenium treatment
in autoimmune thyroiditis: 9-month follow-up with variable doses. J
Endocrinol 2006 Jul;190(1):151-6.

(6) Brown LM, Helmke SM, Hunsucker SW et al. Quantitative and
qualitative differences in protein expression between papillary
thyroid carcinoma and normal thyroid tissue. Mol Carcinog 2006
Aug;45(8):613-26.

(7) Duntas LH. The role of selenium in thyroid autoimmunity and
cancer. Thyroid 2006 May;16(5):455-60.

(8) Hoption Cann SA. Hypothesis: dietary iodine intake in the etiology
of cardiovascular disease. J Am Coll Nutr 2006 Feb;25(1):1-11.

(9) Eftekhari MH, Keshavarz SA, Jalali M, Elguero E, Eshraghian MR,
Simondon KB. The relationship between iron status and thyroid hormone
concentration in iron-deficient adolescent Iranian girls. Asia Pac J
Clin Nutr 2006;15(1):50-5.

(10) Chadio SE, Kotsampasi BM, Menegatos JG, Zervas GP, Kalogiannis
DG. Effect of selenium supplementation on thyroid hormone levels and
selenoenzyme activities in growing lambs. Biol Trace Elem Res 2006
Feb;109(2):145-54.

(11) Kohrle J, Jakob F, Contempre B, Dumont JE. Selenium, the thyroid,
and the endocrine system. Endocr Rev 2005 Dec;26(7):944-84.

(12) Kohrle J. Selenium and the control of thyroid hormone metabolism.
Thyroid 2005 Aug;15(8):841-53.

(13) Baraboi VA, Shestakova EN. Selenium: the biological role and
antioxidant activity. Ukr Biokhim Zh 2004 Jan;76(1):23-32.

(14) Beckett GJ, Arthur JR. Selenium and endocrine systems. J
Endocrinol 2005 Mar;184(3):455-65.

(15) Hawkes WC, Alkan Z, Lang K, King JC. Plasma selenium decrease
during pregnancy is associated with glucose intolerance. Biol Trace
Elem Res 2004 Jul;100(1):19-29.

(16) Vrca VB, Skreb F, Cepelak I, Romic Z, Mayer L. Supplementation
with antioxidants in the treatment of Graves' disease; the effect on
glutathione peroxidase activity and concentration of selenium. Clin
Chim Acta 2004 Mar;341(1-2):55-63.

(17) Gartner R, Gasnier BC. Selenium in the treatment of autoimmune
thyroiditis. Biofactors 2003;19(3-4):165-70.

(18) Chanoine JP. Selenium and thyroid function in infants, children
and adolescents. Biofactors 2003;19(3-4):137-43.

(19) Hawkes WC, Keim NL. Dietary selenium intake modulates thyroid
hormone and energy metabolism in men. J Nutr 2003 Nov;133(11):3443-8.

(20) Kucharzewski M, Braziewicz J, Majewska U, Gozdz S. Copper, zinc,
and selenium in whole blood and thyroid tissue of people with various
thyroid diseases. Biol Trace Elem Res 2003;93(1-3):9-18.

(21) Burk RF, Hill KE, Motley AK. Selenoprotein metabolism and
function: evidence for more than one function for selenoprotein P. J
Nutr 2003 May;133(5 Suppl 1):1517S-20S.

(22) Duntas LH, Mantzou E, Koutras DA. Effects of a six month
treatment with selenomethionine in patients with autoimmune
thyroiditis. Eur J Endocrinol 2003 Apr;148(4):389-93.

(23) Rayman MP, Rayman MP. The argument for increasing selenium
intake. Proc Nutr Soc 2002 May;61(2):203-15.

(24) Gartner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW.
Selenium supplementation in patients with autoimmune thyroiditis
decreases thyroid peroxidase antibodies concentrations. J Clin
Endocrinol Metab 2002 Apr;87(4):1687-91.

(25) Brown KM, Arthur JR. Selenium, selenoproteins and human health: a
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This information is copyrighted by Krispin Sullivan, CN. You may use
it for your own benefit. You may link to this page. Do not copy and
distribute without the copyright. Last modified on: 10-02-16

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