SPINA THYR a research tool to evaluate thyroid function, deiodinases activity, TH resistance

[pattismith]

I've been following this discussion. I'm still not clear if SPINA is any use if one has high thyroglobulin antibodies and taking T3 and T4.

Can someone run my values through SPINA and tell.me what it means please? Mubgoal is to raise my TSH if possible, buy my doctor doesn't think I'd function if we dropped the T3. I was on 75 mcg each of T3 and T4 but switched 3 montgs ago to 137 mcg T4 and 50mcg T3.

Thank you

TSH <0.006 uIU/mL 0.450-4.500 T3,Free,Serum. 3.7 pg/mL. 2.0-4.4
T4,Free(Direct) 1.40 ng/dL 0.82-1.77

I don't know if it is meaningful, your TTSI and TSHI are so low! I think it is caused by your TSH suppression which indicates that your pituitary is very sensitive to your T3/T4 intake (the negative feedback is very strong).

The dosage of TH metabolites that have antithyroid activity would be more acurate in many cases, but rT3 is the only one available for now, did you had a test for it?

 

[Gondwanaland]

Did you take it together with selenium?

I did.
After the 2nd dose I felt great, but afterwards things went downhill. I reread my log and I took the algea + selenium 4 days in a row, took a break of a few days then 2x more.

Low dose lithium orotate might help to convert T4 to T3 better, especially within CNS.
https://www.ncbi.nlm.nih.gov/pubmed/12176672

I have always thought lithium would induce hypothyroidism. Li deficiency might have played a role then.

Iodine is a very controversial issue in Hashimoto's, it's something that I'm struggling with right now since I suspect I do have true iodine deficiency.

It. is. Me too.

Does anyone have a guess at what causes anti-TG and anti-TPO antibodies?

I never had anti-TPO abs, but noticed that anti-TG abs increase with higher lectin food intake and vit D supplementation.

 

[Iritu1021]

I did.
After the 2nd dose I felt great, but afterwards things went downhill. I reread my log and I took the algea + selenium 4 days in a row, took a break of a few days then 2x more.

I have always thought lithium would induce hypothyroidism. Li deficiency might have played a role then.

It. is. Me too.

Does anyone have a guess at what causes anti-TG and anti-TPO antibodies?

I never had anti-TPO abs, but noticed that anti-TG abs increase with higher lectin food intake and vit D supplementation.

I've been wondering about that too. I didn't use to have anti-TG antibodies and then suddenly developed them. My best guess right now is that iodine deficiency increased my overall amount of thyroglobulin in the blood. But I wonder if anyone has a better idea.

Lithium - in my experience, just like iodine, has a "bipolar" effect on thyroid and the response varies from person to person. The studies on deiodinase effect seem to contradict each other which is because the effect might differ depending on specific tissue. At very high doses which are used in psychiatry lithium causes TSH to go up in some people. I'm talking about physiological doses of lithium, about 1mg per day, what people used to get from water back in the day.

 

[Iritu1021]

I've been following this discussion. I'm still not clear if SPINA is any use if one has high thyroglobulin antibodies and taking T3 and T4.

Can someone run my values through SPINA and tell.me what it means please? Mubgoal is to raise my TSH if possible, buy my doctor doesn't think I'd function if we dropped the T3. I was on 75 mcg each of T3 and T4 but switched 3 montgs ago to 137 mcg T4 and 50mcg T3.

Thank you

TSH <0.006 uIU/mL 0.450-4.500 T3,Free,Serum. 3.7 pg/mL. 2.0-4.4
T4,Free(Direct) 1.40 ng/dL 0.82-1.77

I'm not sure, why exactly does your doctor think you can't handle going off? I remember you said you have your ovaries removed but you still have your thyroid gland, right? If you have an intact pituitary and thyroid, TSH will go up once your thyroid hormones drop below certain level. Right now you are still on the high end and I presume this labwork was done when your meds already began to wear off next day. It's no fun getting through the adjustment period but lots of people got through it and survived, myself included. If you want to minimize discomfort, just do it very slowly and gradually, I'd say down by 5 mcg every 2 weeks (in other words, don't stop cold turkey and slip straight into myxedema coma the way I've done it in the past!). Remember that your body has now adjusted to living in a hyperthyroid state and it will need time to adjust back.

 

[Iritu1021]

I don't know if it is meaningful, your TTSI and TSHI are so low! I think it is caused by your TSH suppression which indicates that your pituitary is very sensitive to your T3/T4 intake (the negative feedback is very strong).

The dosage of TH metabolites that have antithyroid activity would be more acurate in many cases, but rT3 is the only one available for now, did you had a test for it?

View attachment 26519

@pattismith, what do you think might be some other causes of elevated TTSI besides genetic resistance? GT and GD are easy but I still have a harder time grasping TSHI/TTSI concept...

 

[pattismith]

@pattismith, what do you think might be some other causes of elevated TTSI besides genetic resistance? GT and GD are easy but I still have a harder time grasping TSHI/TTSI concept...

I have to study more deeply the genetic TH resistance. From my few readings, the high TTSI we have found in PR members are in similar ranges than people with heterozygous mutations for TH receptors

 

[Iritu1021]

I have to study more deeply the genetic TH resistance. From my few readings, the high TTSI we have found in PR members are in similar ranges than people with heterozygous mutations for TH receptors

But it also is clear that high or low TTSI is not a permanent state as you would expect in a true genetic condition - it appears to fluctuate all over the place. It seems like it is part of an adaptive response to thyroid or TSH fluctuations...

 

[Iritu1021]

it looks like lithium effect may also have a lot to do with selenium state.
https://www.ncbi.nlm.nih.gov/pubmed/27476158
https://www.ncbi.nlm.nih.gov/pubmed/27476158

My suggestion to anyone who wants to experiment with I or Li is to take selenium for two weeks prior to be on the safe side.

 

[Iritu1021]

In the original validation study, gonadotropic insufficiency and lower peak concentrations of growth hormone and cortisol in pituitary stimulation tests were associated with significantly diminished TSHI.

@Learner1 probably has low gonadotropins due to being on HRT and lower peak concentrations of cortisol due to cortisol replacement - if I remember her meds correctly. But I'm still not convinced these values are really accurate in someone who is taking thyroid replacement.

 

[Iritu1021]

More on lithium...

http://www.biologicalpsychiatryjournal.com/article/0006-3223(94)90090-6/pdf

Our results show an increase in 5'D-II activity and a decrease in 5D-Ill activity in frontal cortical homogenates after administration of lithium. 5'D-II catalyzes the deiodination of T4 to T3 and 5D-Ill the further deiodination of T3 to the inactive metabolite 3-I-T2. Thus, the lithium-induced changes in deiodinase activities should theoretically lead to an increase in the tissue concentrations of T3.

Furthermore, the effects of acute and chronic administration of lithium may differ aM effects on 5'D-II activity in hypothyroid rats (when its activity has already been stimulated to the maximum--see K~rle et al 1991 ) may also differ from the effects seen in euthyroid animal."

This might explain why I had very different reaction to lithium when I tried it without being on T3 and while on T3.

They also found that lithium dosing has a strong circadian rhythm effect. You should take it after dinner or at bedtime (assuming you have a normal circadian rhythm and your symptoms worsen in the afternoon).

It also doesn't hurt that lithium appears to have a strong suppressive effect on herpes virus!
https://www.ncbi.nlm.nih.gov/pubmed/8947995

 

[Gondwanaland]

what people used to get from water back in the day.

Unfortunately Lithium water makes my body temp fall to the floor

 

[Learner1]

Thank you for your help!

The dosage of TH metabolites that have antithyroid activity would be more acurate in many cases, but rT3 is the only one available for now, did you had a test for it?

Yes, my rT3 is 12, well within normal range. When I began T3 only, it was almost 500.

I'm not sure, why exactly does your doctor think you can't handle going off?

I remember you said you have your ovaries removed but you still have your thyroid gland, right? If you have an intact pituitary and thyroid, TSH will go up once your thyroid hormones drop below certain level. Right now you are still on the high end and I presume this labwork was done when your meds already began to wear off next day.

Because my pituitary isn't working well and I am in a shivering heap on the floor if I back off.

It's no fun getting through the adjustment period but lots of people got through it and survived, myself included. If you want to minimize discomfort, just do it very slowly and gradually, I'd say down by 5 mcg every 2 weeks (in other words, don't stop cold turkey and slip straight into myxedema coma the way I've done it in the past!). Remember that your body has now adjusted to living in a hyperthyroid state and it will need time to adjust back.

I am not hyperthyroid. I've had Hashimotos for almost 10 years.

Can you explain why I wouldn't want to take thyroid hormones?

In the original validation study, gonadotropic insufficiency and lower peak concentrations of growth hormone and cortisol in pituitary stimulation tests were associated with significantly diminished TSHI.

@Learner1 probably has low gonadotropins due to being on HRT and lower peak concentrations of cortisol due to cortisol replacement - if I remember her meds correctly.

Right. I'm not making ANY kind of hormone properly.

But I'm still not convinced these values are really accurate in someone who is taking thyroid replacement.

My question, too.

 

[pattismith]

Thank you for your help!


Yes, my rT3 is 12, well within normal range. When I began T3 only, it was almost 500.

500, it looks very high! What unit is it?

My rT3 is 0.49 µg/l (normal 0.09-0.35)

 

[Learner1]

ng/dL

Range is 9.2-24.1

 

[pattismith]

ng/dL

Range is 9.2-24.1

Ouch! did your doc had already seen such high rT3 before?

 

[Iritu1021]

Thank you for your help!


Yes, my rT3 is 12, well within normal range. When I began T3 only, it was almost 500.

Because my pituitary isn't working well and I am in a shivering heap on the floor if I back off.
I am not hyperthyroid. I've had Hashimotos for almost 10 years.

Can you explain why I wouldn't want to take thyroid hormones?

Right. I'm not making ANY kind of hormone properly.

My question, too.

You may not be hyperthyroid from metabolic perspective but your pituitary gland thinks you are, given that it stopped secreting TSH (unless you already had no TSH production BEFORE you went on thyroid).

I already expressed my feelings about suppressive dose thyroid supplementation in my blog post "Thyroid Wars", i.e. that I'm generally against it based on my own very bad experience and what I learned from reading Dr. Blanchard's book. I don't want to get into conflict about belief systems - we each find our own (and mine has changed a few times throughout this), you can PM me if you want to discuss more.

 

[Iritu1021]

Unfortunately Lithium water makes my body temp fall to the floor

Lithium in water is different than lithium orotate. The lithium in the water is unbound so it's absorbed much faster and has more of a drastic effect, while lithium bound to salts is more gentle (similar difference to iodine (kelp) vs potassium iodide).
But yes, lithium does give you a hypometabolic effect when you start taking it. It lowers your dopamine and norepinephrine and at higher doses D1 so peripheral thyroid levels will drop. This is why you need to make sure you have enough T3 on board to be able tolerate it, start at very low doses and take it at bedtime when hypometabolism is less of an issue.
Lithium is one of those drugs that makes you feel worse before it makes you feel better. Iodine on other hand makes you feel better right away and then makes you worse.
I also took phenylalanine to help me tolerate the initial drop in NE/DA.

 

[Iritu1021]

Fluoxetine is another D2 enhancing drug that I've tried.
https://www.ncbi.nlm.nih.gov/pubmed/8173980
I only used a tiny dose but the effect on the brain metabolism was rather phenomenal and pretty much immediate. Very different from any other SSRI I've tried so it might be unique in this effect and not representative of its class. Unfortunately, I didn't like the elevated serotonin levels (worsens my POTS) but the main reason I couldn't tolerate it for more than a week was because it gave me blurry vision due to its effect on muscarinic cholinergic effectors.

Of course we're all different so it might be worth a try for someone else.

 

[Gondwanaland]

but the main reason I couldn't tolerate it for more than a week was because it gave me blurry vision due to its effect on muscarinic cholinergic effectors.

When I started on LT4 I immediately had to start an anti-depressant (citalopram). Then a few months later when I switched to compounded T4+T3 I would get blurry vision and dizzyness, then I ditched the SSRI and I finally felt myself again.

I must be able to up my T3 otherwise this time around I will go for tricyclics.

 

[Iritu1021]

When I started on LT4 I immediately had to start an anti-depressant (citalopram). Then a few months later when I switched to compounded T4+T3 I would get blurry vision and dizzyness, then I ditched the SSRI and I finally felt myself again.

I must be able to up my T3 otherwise this time around I will go for tricyclics.

You sound similar to me in many ways, @Gondwanaland.

T3 appears to have a strong effect on serotonin receptors, which is good for depressed patients but people with CFS already have too much serotonin so for us it's a minus. Also, I find that at higher doses it becomes hard to separate T3 as a hormone from T3 as a neuromodulator.

Your dizziness might have been from POTS, did you check if you had an orthostatic change in blood pressure or pulse upon change from laying to standing?

Regarding tricyclics, desipramine, as I recall, also has some effect on deiodinases, and at very low dose it doesn't affect serotonin. Doxepine (also tricyclic) at very low dose has a pure anti-histamine effect, which can also become an issue on high doses of T3.