T3 improved my sleep dramatically

[PearlGirl26]

In addition to adhering to a strict sleep hygiene protocol that included turning off TV at 9pm, 3mg melatonin, and magnesium supplementation before hitting the hay at 11pm, I noticed that as soon as I started taking a small staggered dose of Cytomel for T3 issues 2x/day, my sleep became deeper than it has been in years. I still wake up @3-4x/night to pee, but I can fall back to sleep easily. Also, 4am tachychardia, heart palps, and panic attacks have completely subsided.

If you have existing thyroid issues and take T4 (Synthroid/Tirosint/etc.), please make sure your doctor tests your free T3 and T4, in addition to TSH. Your body may not be converting the hormone correctly.

 

[CFS_for_19_years]

I had to beg my primary doc to give me T3 when I wasn't responding to T4 - idiots!

There is a website and book devoted to describing the use of T3 when T4 doesn't do the job:

http://recoveringwitht3.com

Here's a good review of a peer-reviewed article in the Journal of Orthomolecular Medicine:

http://www.prnewswire.com/news-rele...sm-finds-peer-reviewed-article-213477061.html

BERKELEY SPRINGS, W.Va., June 28, 2013 /PRNewswire/ -- Over one million people—90% are women—in the US suffer (Saravanan, 2002) needlessly from medical guidelines on hypothyroidism that ban T3 treatments. Eric Pritchard's editorially acclaimed, peer-reviewed article (http://tpauk.com/images/docs/reduce-scope-final.pdf) published by the Journal of Orthomolecular Medicine (www.orthomed.org), exposes the underlying improper science.

As the article states, the guidelines work for the large majority of people, because the prescribed T4 treats deficiencies of the thyroid gland (hypothyroidism). But, T4 doesn't work for many people (Means,1954) whose symptoms are caused by deficient post-thyroid physiology. These people require the operative post-thyroid hormone, T3 (Goldberg, 1960; Baisier, 2001; Wrutniak-Cabello, 2001) or related supplements. For many, T3—an FDA-approved medicine—is a life-giving elixir. Their active, attractive lives are seemingly resurrected!

Using text analysis (Justice Scalia), Pritchard shows how the guidelines do NOT address post-thyroid functions. They lack any or a proper definition for "hypothyroidism" (Pritchard, 2006) and the ban on T3 prescriptions improperly broaden these guidelines and force suffering upon post-thyroid deficient patients.

Why don't physicians simply ignore the guidelines? Although some have, the Supreme Court (Goldfarb, 1975) and a federal appeals court (Wilk, 1983) have ruled that enforced guidelines are effectively mandatory. Thus, physicians must choose between unethical patient suffering with the T4-only therapy OR prescribing T3 and risk losing their practices, claims Pritchard.

How can medical associations reject reams of scientific evidence? Pritchard states they simply ignore counterexamples. According to its great philosopher, Sir Karl Popper, science is best proved by THE LACK OF counterexamples. Medicine—alone among the sciences—IGNORES counterexamples. Or, they use the Orwellian-sounding evidence-based medicine to dismiss approximately 98% of thyroid-related research (Grozinsky-Glasberg, 2006) including all post-thyroid and most thyroid-related studies—literally hundreds!

It is difficult to overstate the suffering and despair unscientific hypothyroidism guidelines have caused and continue to cause. For patient well-being and medical rectitude, Pritchard presents convincing arguments advocating the reduction of hypothyroidism guideline scope to their scientific basis—to the thyroid gland.

 

[PearlGirl26]

I am now a convert! I truly believe that the lack of conversion was a major contributing factor to developing cfs as my adrenals were overstimulated as a result. So much calmed down when I started T3. That being said, It does come with side effects and the drop off is terrible. I'm considering going on Armour instead. Do you have any experience with it?

 

[CFS_for_19_years]

I am now a convert! I truly believe that the lack of conversion was a major contributing factor to developing cfs as my adrenals were overstimulated as a result. So much calmed down when I started T3. That being said, It does come with side effects and the drop off is terrible. I'm considering going on Armour instead. Do you have any experience with it?

I don't have any experience with Armour but I know that some patients rely on it.

I developed lithium-induced hypothyroidism and was only on thyroid meds for about six months. Towards the end of thyroid treatment I developed palpitations that persisted for 2 years (even after stopping the T4 and T3) and I had to take atenolol during that time for the palpitations. The palpitations just recently diminished with spironolactone, a diuretic which paradoxically stimulates the adrenal gland to put out more cortisol. (My cortisol levels in the past have been low to non-existent.)

I started the spironolactone a few months ago because there was a recent study that showed it was helpful in treating fibromyalgia. I also HAD slightly elevated blood pressure (130/85) and I'm now at 115/80.

I find it interesting that your heart palps went away with T3, as that's when mine began. We are all different, to be sure.

 

[Ema]

I am now a convert! I truly believe that the lack of conversion was a major contributing factor to developing cfs as my adrenals were overstimulated as a result. So much calmed down when I started T3. That being said, It does come with side effects and the drop off is terrible. I'm considering going on Armour instead. Do you have any experience with it?

I've taken basically every variation of thyroid meds...my suggestion would be to try compounded slow release T3 before switching to Armour if you are having good luck with T3 otherwise. It is usually felt to be much weaker mcg for mcg though than regular T3 so you may find that you need to increase your dose, perhaps substantially.

 

[PearlGirl26]

I don't have any experience with Armour but I know that some patients rely on it.

I find it interesting that your heart palps went away with T3, as that's when mine began. We are all different, to be sure.

Only the 4am ones. I find they still pop up at odd times, most reliably when I wake up in the morning, but within an hour of taking T3, they go away. Still annoying to wake up to them. The shift in anxiety levels is the big thing for me.

 

[Little Bluestem]

@PearlGirl26, how much T3 are you taking? I am taking 5 mcg twice/day. I have noticed little if any benefit, but no adverse effects.

 

[PearlGirl26]

@PearlGirl26, how much T3 are you taking? I am taking 5 mcg twice/day. I have noticed little if any benefit, but no adverse effects.

I'm sorry to hear that. So much of this is hit or miss. I take 10mg like you.

 

[lazzlazz]

I also feel like T3 helped me sleep better (I take both T3 & T4). The effect was subtle, but I felt like it helped me get more deep sleep (Stages 3 & 4/Slow wave sleep), compared to when I was on T4 only. The difference was subtle but I feel it was real (of course, I can't rule out that my sleep improved for some other reason, right around the time I started taking T3). I started out alternating 5 mcg & 10 mcg every other day; when it seemed to be helping on the sleep front, we upped it to 15 mcg daily. I don't know that T3/T4 combination was better than T4 alone for any other symptoms, but it seemed to help with sleep, and as we all know, not being able to sleep is awful.

I've read a lot of peer-reviewed journal articles on hypothyroidism & I've never found any explanation of why T3 might help (or even mention of this), so it was nice to find this thread. My sleep is still fragile. Any kind of change like guests, or travel, makes it harder for me to sleep through night, and even on T3, I would not say my sleep is really refreshing (but it's better than not sleeping.

If you read the scientific literature, there is some consensus that although so far, the published studies have not shown T3 to be effective, they think it is worth pursuing T3 further. It may be that a subgroup responds to T3 for some reason. There are some studies (fairly small & not gold-standard) that show that patients on T3 subjectively report feeling better, even though objective measures did not bear this out (I'm pretty sure this study was blinded but cannot find that report right now). One possibility is that the objective measures are simply not tapping into (or not sensitive enough) whatever makes people report feeling better subjectively. If it's just a relatively small subgroup who benefits from T3, the benefit it gives them could be washed out by the others in the study who don't respond. The trick for this research is figuring out what distinguishes the responders from nonresponders - and there could be multiple differences.

With T3, you really want to make sure you take it at least 30 minutes (60 minutes better) before eating anything in the morning, and at least 4 hours after eating. I get mine (slow-release, compounded) through a compounding pharmacy (Clark's) for a really reasonable price. The pharmacist didn't feel that there was much benefit to taking it 2x per day; I think he thought that part of the reason was that if there's fiber (in particular) in the stomach/upper intestine when it's taken, it's much less effective. Thus, he advised taking only in morning (of course, I'm sure there is no research on this, but rather, it's based on what patients have told him).

Probably about 6-7 months after starting on the T3, I also installed f.lux on my computer, which removes a lot of the blue-wave frequencies from the screen in the evening. I think this helps although there isn't research showing that with this particular program. However, the program was developed based on the scientific research out there. There's research that clearly shows exposure to artificial light in the evenings can interfere with sleep, and other research showing the blue range of the spectrum is the most interfering. There's also research suggesting it's important to get exposed to natural light in the early morning as that helps to set circadian rhythms. Of course, practice good sleep hygiene in general.

 

[CFS_for_19_years]

It's true that there is a subgroup of people who will respond to T3 when T4 fails to make any difference. I was one of those. This is the best article I've read so far regarding the treatment of T4-resistant hypothyroidism:

http://tpauk.com/images/docs/reduce-scope-final.pdf

 

[lazzlazz]

Here's one of the articles I was thinking of
Combination Treatment with T4 and T3: Toward Personalized Replacement Therapy in Hypothyroidism?
Bernadette Biondi, and Leonard Wartofsky
DOI: http://dx.doi.org/10.1210/jc.2011-3399
Full text is free http://press.endocrine.org/doi/full/10.1210/jc.2011-3399

This has the current guidelines of the AACE & ATA (full text should open). One thing this article does is make clear how limited the research in thyroid disorders in general is (the article rates the quality of the research, and very little is gold-standard research). Do a google search of the title if the link below is broken.
https://www.aace.com/files/final-file-hypo-guidelines.pdf
Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Garber JR et al. Endocr Pract. (2012)
See p. 1017 for discussion of T3 as an area for further research (bottom right corner)
See p. 999 for a discussion of how TSH levels fluctuate on a 24 hour basis.
Also on p. 999

The National Academy of Clinical Biochemists, however, indicated that 95% of individuals without evidence of thyroid disease have TSH concentrations below 2.5 mIU/L (85), and it has been suggested that the upper limit of the TSH reference range be lowered to 2.5 mIU/L (86). While many patients with TSH concentrations in this range do not develop hypothyroidism, those patients with AITD are much more likely to develop hypothyroidism, either subclinical or overt (87) (see Therapeutic endpoints in the treatment of hypothyroidism for further discussion).
​

Most physicians (including endocrinologists, esp. if they do not specialize in the thyroid) do not understand that a "reference range" is not the same as an individual's normal range. An individual's normal range is much smaller than the "reference range" used by laboratories, and the research shows that form most individuals, the "normal range" is in the bottom half of the "reference range". A patient can be within the reference range, but outside of their personal "normal", and this can produce symptoms consistent with a thyroid disorder. (Note that your TSH level is much lower in the afternoon; having a blood draw first thing in the morning gives you a better reading. A German friend of mine told me that the lab requires the blood draw be before 9 am, to get consistent readings across patients). There's a lot of peer-reviewed medical/scientific literature that talks about this; Biondi is one author to read; Wartofsky is another (but there are others). Such physicians will say to patients: "your TSH level is within the (laboratory-specialized) reference range so you cannot have a thyroid problem". However, the AACE has stated that physicians should consider treating for hypothyroid if TSH level is higher than 3, and if the patient has symptoms consistent with hypothyroidism (most physicians are unaware of this guidance).

To get full-text articles of journal publications: If you live near a major research university, you may be able to get copies simply by going to the university & using their computers (download article to your flashdrive or email it), or else, you may be able to bring your own laptop & access their wireless. Many, however, are now available free online - the NIH requires that articles be made free one year after publication, if any NIH funds at all were used to fund any contributing research, even if just one author of the article had such funding. (The journals are not required to give access to the post-copy-edited version of the article, although many do. However, the authors are required to provide a copy of the pre-copy-edited text version to the NIH repository http://www.ncbi.nlm.nih.gov/pubmed/ and these will be made available to the general public by the end of 1 year after publication.)