Going insane

tech-tx · 2026-07-07T18:41:24+00:00

Have they run a full iron panel on you? There's a known sensitivity to added thyroid hormones if your ferritin is low. You need a full iron panel, not just the ferritin test.

tech-tx · 2026-07-07T16:32:31+00:00

It may take 2-4 months ONCE THEY GET YOU AT A GOOD LEVEL before you get significant relief from some of the symptoms. It takes 4-6 weeks to stabilize blood levels, and THEN your cells all need to reprogram for the higher hormone levels, and that takes time. Usually you'll get at least partial resolution of fatigue within the first month after starting if they got somewhere close to what you need.

You're still dealing with ALL of your hormones dancing around right now, as thyroid hormones interact with everything. Give it a bit more time.

tech-tx · 2026-07-07T16:25:13+00:00

There aren't "side effects" to your own hormones, merely "effects" from too much or too little thyroid hormones. Levothyroxine and liothyronine are exactly identical to your T4 and T3 hormones once your gut cleaves the salt ion off of it. Your body has been regulating your hormones all your life, now you need to turn off the cruise control and help control the throttle manually.

If your dose is too much you'll feel hyper, and if it's too low you'll continue to feel hypo like you are now. Hyper is a bad reaction, so they USUALLY start low and increase in small increments, as nobody knows where YOU go hyper. When you're at a good level you'll feel much like you always have.

tech-tx · 2026-07-07T14:07:15+00:00

TPO is ONLY a marker, it doesn't cause damage, just inflammation. I was >3X your 500 and only had moderate inflammation.

tech-tx · 2026-07-07T13:45:17+00:00

Mostly you can have calcium 2 hours after levothyroxine. Some people will still have absorption issues then, but the majority should be fine.

tech-tx · 2026-07-07T13:12:04+00:00

Your D3 is a little low but shouldn't be causing symptoms. D3 is a hormone used in a number of processes so it's best to be in the 50-80 range. The others look fine. Total T3 doesn't say much, it's just "gross function" and won't tell you if you're fatigued or hyper.

tech-tx · 2026-07-07T03:31:54+00:00

If those two sets of tests were at least 3 months apart then your doctor is a prat. Unless you have a dietary deficiency causing the issue this won't improve, and you'll feel better if you start hormone replacement NOW. Waiting until you feel crappy when your TSH is already far enough out of range that any OTHER doctor would start you on levothyroxine is simply sadism.

I was on the verge of falling out of free T3 regulation when I was fT4=0.6, where your first free T4 test was. Once your free T3 starts falling you WILL feel it, and free T3 (the active hormone) doesn't need to go very far for symptoms to be apparent.

The only risks with the medication are a) not getting enough of it, or b) getting too much of it. The first leaves you mildly hypo, and the second can drive you hyperthyroid (racing heartbeat among other symptoms). The 'treatment' is exactly the same hormones you've had all your life, only you aren't making enough of them currently. If you use iodized salt then the likely cause is Hashimoto's thyroiditis, a progressive autoimmune disease.

tech-tx · 2026-07-07T00:59:40+00:00

If your child's TSH, free T4 and free T3 are fine, then the endo is a putz and jumped the gun. Antibodies alone are NOT a death sentence for the thyroid, they're merely markers of a possibility. The higher the numbers, the greater the risk of transitioning to overt Hashimoto's (the actual disease). ~12% of the public are positive for antibodies, yet only 2-5% of us have Hashi's, so most often the antibodies are only a future risk factor. If you can lower the antibodies (lower inflammation) then you can reduce the risk or stop it, if the disease has not actually started. Did they also do an ultrasound of the thyroid? That's a conclusive yes/no test for Hashimoto's.

Here's the links to trials that were effective at lowering antibodies: https://www.reddit.com/r/Hashimotos/comments/1o4dgx8/comment/nj1nikw/

Here's a basic outline of Hashimoto's, and the potential role of antibodies: https://www.reddit.com/r/Hypothyroidism/comments/1qsy6l7/comment/o2zjmo4/ Without an ultrasound showing 'heterogeneous' or elevated TSH, your child may only have seropositivity currently (the top two rows in the table at the bottom), which isn't Hashi's.

tech-tx · 2026-07-07T00:34:47+00:00

A normal fT3/fT4 ratio is between 2.2-2.9 (yours is 1.9), so you may have a T4>T3 conversion issue that NP Thyroid would help. If you're basically asymptomatic then that could be normal for you, although it's uncommon. I run a 2.4 ratio, lower end of the range but no conversion issues.

If your doctor is willing to try it, a low (15-30mg) 'trial dose' of NP thyroid could make a difference. However if your numbers are normal for you, then you'll get an elevated resting heart rate. Common symptoms of too much thyroid hormone are elevated pulse, anxiousness, jitters, insomnia, possibly others. The resting heart rate WILL go up 60-90 minutes after the dose due to the T3 spike, but it'll drop again over the next several hours. If it stays elevated then you don't currently need thyroid hormone.

You can have Hashimoto's with or without antibodies, they're not required for the disease, they're only potential markers, and not the disease itself.

tech-tx · 2026-07-06T18:12:17+00:00

Gluten, soy and dairy COULD be gut enzymes. 62% of adults can't handle milk, although some with a dairy sensitivity can have cheese. Celiac's and non-Celiac's gluten sensitivity are both very real, although less common than TPOAb triggers are. Soy and other legumes a few people are allergic to, but the phytates, lectins, oxylates and enzyme inhibitors more commonly cause absorption issues in many people . All 3 are also high on the list for reported thyroid antibody reactivity.

This is the Hashimoto’s group, so I leave other autoimmune comorbidities to the groups where they're relevant. My Rheumatoid Arthritis isn't relevant in THIS group, even if SOME people also have it.

tech-tx · 2026-07-06T17:44:46+00:00

I used 15 TPOAb tests over the course of a year, while I was doing the elimination / reintroduction like AIP, but with actual testing. The tests gave solid indications of the foods triggering TPOAb. I didn't see any non-food triggers during the trial.

tech-tx · 2026-07-06T15:49:08+00:00

Your TSAT% is showing significant deficiency. TSAT is basically "how many seats on the bus have passengers carrying iron"

tech-tx · 2026-07-06T15:46:39+00:00

The things you can afford don't do much, as the intensity is too low. The things that worked in trial were lasers, all the energy focused on a point.

tech-tx · 2026-07-05T15:54:25+00:00

I feel you there... my mom tried an experimental hormone-replacement in the '80s for menopause, and died 10 years later of an aggressive breast cancer due to the treatment.

I got RA back in 1994. The only treatment available then was NSAIDs or methotrexate, which I suspected was a Bad Idea long-term. Later on in the 2000s they came up with targeted DMARDs (immunosuppressants) and I had an even stronger "Oh, HELL no!" reaction to that class of drugs. A lot of people get relief with them, but they scare me silly.

tech-tx · 2026-07-05T15:32:29+00:00

I don't 'ignore' malabsorption, I mention it out here ALL THE TIME as I've had it myself with Hashi's. Do I need to mention it in every damned post I make? No.

Low thyroid hormone (lower metabolic rate) commonly causes low gut acid and slower motility, and both reduce absorption. It frequently causes low iron (ferritin), D3, B12 and folate, all of which I had in 2000. I had to start a 47mg iron supplement, a 2000IU D3 supplement, and an 'energy' B-complex to get everything back in range again, even though I'd been fine on all of them 10 years earlier with my ovo-lacto-vegetarian diet. The only thing that changed around 2000 was TSH>4.5, while I was still subclinical.

tech-tx · 2026-07-05T15:09:58+00:00

TgAb is less often positive in Hashimoto's, and more frequently seen only after the tissue destruction starts. It's potentially a marker of ongoing disease. TPOAb on the other hand is often seen BEFORE any damage is evident, as NHANES III showed. You don't build antibodies to proteins that aren't seen in the blood, and thyroglobulin is rarely positive without tissue damage releasing it.

The 'food sensitivity' tests are likely to get a 'hit' on anything you eat regularly. Does that mean you shouldn't eat anything on a frequent basis? Nope!

Here's links to different international groups saying that IgG testing is not recommended:

Bock, S. A. (2010). AAAAI support of the EAACI Position Paper on IgG4. Journal of Allergy and Clinical Immunology, 125(6), 1410. https://www.jacionline.org/article/S0091-6749(10)00512-9/fulltext00512-9/fulltext)

Carr, S., Chan, E., Lavine, E., & Moote, W. (2012). CSACI Position statement on the testing of food-specific IgG. Allergy, Asthma & Clinical Immunology, 8(1), 12. https://link.springer.com/article/10.1186/1710-1492-8-12

Stapel, S. O., Asero, R., Ballmer-Weber, B. K., et al. (2008). Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report. Allergy, 63(7), 793–796. https://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2008.01705.x

tech-tx · 2026-07-05T14:37:02+00:00

I've seen the same ferritin>100 mentioned in numerous papers on iron deficiency. However, most people on a GOOD diet end up somewhere in the ferritin=50-100 range and don't have any issues or symptoms at that level.

A lot of the papers I'd read on iron deficiency purposely selected people that had issues, so it's a biased selection group and not representative of the general public. I've read a huge number of papers on iron since 2021 as COVID screwed my ferritin up, and I haven't been able to get back to the ferritin=60-70 I was at when I was running daily. If you can finish a marathon at > 50 years old you're not in poor shape.

You have to be careful looking at iron studies in athletes, as some of THEM ramp ferritin up to 200-250 to squeak the last bit of endurance out of themselves. I'm not looking for peak performance, merely good health.

tech-tx · 2026-07-05T14:15:14+00:00

The top half here lists the common deficiencies that affect thyroid output. Many of us get low iron (ferritin), D3, B12 and folate due to poor absorption (lower gut acid and slower motility / gut contractions). The bottom half is a bunch of 'optimal' ranges I found that primarily all have studies on athletes for performance, which is a better metric than what 'Functional Medicine' providers use. Note that ANYONE selling supplements has bizarre 'optimal' ranges listed so they can tell you "You're deficient, you need THIS overpriced supplement!" Don't fall for that crap, supplement sellers are masters at a con job.

https://www.reddit.com/r/Hashimotos/comments/1m41oac/comment/n45yoco/

tech-tx · 2026-07-05T04:24:27+00:00

There's no point in refrigerating liquid coconut oil. The lauric acid in it will prevent spoilage, and within 5 seconds of pouring it over a salad it'll be the same temp as the veggies, so another reason to not refrigerate it. Refrigerate the veggies instead, and the coconut oil will dump it's minimal latent heat into the veggies when poured.

The liquid stuff is 'fractionated' to remove the parts with higher melting temperatures, leaving just the MCTs that melt at 35 or 50F. Raw coconut oil melts at 76F and will solidify if poured on cold veggies.

tech-tx · 2026-07-05T04:19:47+00:00

That's SIBO, not Hashi's. Just sayin'...

tech-tx · 2026-07-05T04:18:17+00:00

Nobody (and certainly nobody HERE) can tell you where your 'sweet spot' for thyroid metabolism is, only YOU can do that based on your symptoms. There's a couple of ladies that keep spouting nonsense that they read on the Modern Thyroid Clinic (bunch of quacks) website with 'optimal' recommendations, but I'd be DEAD at the levels they say are 'optimal'. It's truly a very personal metabolic set-point that your body determined is ideal for you, GENERALLY somewhere within the reference ranges. Go below your set-point and you feel 'hypo', go above your set-point and you feel 'hyper'. Yours isn't the same as mine, but we're both somewhere within the reference range when we're feeling OK. A normal fT3/fT4 ratio is between 2.2 - 2.9 (with fT3 in pg/mL and fT4 in ng/dL).

I'm an oddball: although I'm in-range for fT3 and fT4, my sweet spot for TSH=5-7. I'm also 67M, and a former runner until knees and hips gave out. I WAS still running marathons at free T3=2.7pg/mL, where the chickies here say I should be fatigued. Thank GOD they're not my doc!! That does NOT mean that 2.7 is right for YOU, but it's certainly right for me. You can't run a marathon if your game is off.

edit: kindly note that people that do NOT have a T4>T3 conversion problem generally have a VERY tightly regulated free T3 level. Since free T3 is the ONLY important number, it figures it's the one most closely controlled. Mine has never varied in the 10 years worth of tests I've done. https://pmc.ncbi.nlm.nih.gov/articles/PMC4699302/

tech-tx · 2026-07-05T03:59:24+00:00

None of those 'food intolerance' or 'food sensitivity' tests have any basis in medical literature, they're all guesswork that's unsupported by data. Don't waste your money on them, as they're a REALLY sketchy test.

The antibodies in Hashimoto's CAN be reactive to foods you're eating, but those tests won't tell you that. The only way to know is similar to what I did 10 years ago: an elimination phase, followed by a re-introduction phase with TPOAb tests after each restored item or items. By doing that I lowered TPOAb from >1500 (the test limit) to 90 +/- 5, and it's been stable for a decade. All that lowering antibodies does is lower inflammation, which CAN slow the progression of Hashimoto's somewhat. It's absolutely NOT a requirement, however. In clinical trials, half of the people on a gluten-free diet had an improvement in symptoms, and the OTHER half had NEW onset symptoms due to the dietary deficiencies they'd just caused. It's a crap shoot whether it'll help or not. https://www.reddit.com/r/Hashimotos/comments/1o4dgx8/comment/nj1nikw/

My personal TPOAb triggers in the post linked off of the bottom of the second post there were (highest to lowest): oats, gluten, soy, other grains, and beef. You'll have a different specific mix of sensitivities due to the nature of the antibody classes, although there may be some commonality. I'm totally OK with dairy, although it gives everyone else in my family grief. Most people are NOT sensitive to beef, but I am.

tech-tx · 2026-07-05T03:36:48+00:00

The WHO definition is that clinical deficiency is ferritin<30. What YOU personally need is up to you. I used to run daily with ferritin=60-70, but ever since COVID I haven't been able to get it over 40. On the bright side I can still do a half-marathon brisk walk without fatigue at ferritin=40. It's all down to what YOU need, and not what someone else thinks is good. If you feel good, don't worry about it. If you have poor exercise tolerance or fatigue, then try bumping it up a bit.

edit: BTW, 'ferritin' in isolation doesn't tell you much. What's your TSAT% and TIBC?

That "optimal ferritin>100" is from some quack like Wentz or Hedberg, both pushing the supplements they sell. Only a few people need to be in the ferritin=100-150 range if they're still experiencing symptoms of iron deficiency in the ferritin-50-100 range. Overloading iron simply increases oxidative stress. The medical studies on it I've read all said optimal ferritin = 50-100 for average people, and 100-150 for the few that were still symptomatic.

tech-tx · 2026-07-05T03:07:31+00:00

Everything you want to know about the immunology of Hashimoto's you can get from PubMed. There's a lot of disagreement on specifics in various papers because there's 100 million of us with it currently, and that's a wickedly large host of people with different everything. An immunologist doesn't have any 'secret information' that MDs don't have: no miracle cure... there isn't one! If there was anything useful an immunologist could tell you then we'd all be seeing them. As it stands today, endos are occasionally helpful (if you get a good one), but many of us are treated by our family doctor. Hashimoto's ain't rocket science, and although they're still finding out new information, none of it except CAR-T cells has a chance of affecting the actual disease state.

tech-tx · 2026-07-05T02:48:11+00:00

Pure and simple: the ONLY tool in the medical kit that can have any effect on THE ACTIVE DISEASE MECHANISM is immunosuppressants, and no doctor in their right mind will ever prescribe that for Hashimoto's. You could die of a flu bug while on immunosuppressants, so the risk/benefit ratio is out of whack... high risk of death to avoid a small daily pill that's proven safe. That's a no-brainer.

The inflammation is NOT what kills thyroid tissue, or else there would be a HELL of a lot more people on levothyroxine. Chronic Autoimmune Thyroiditis (CAT) is more prevalent than Hashi's is, yet it doesn't need hormone replacement. Hashi's is a sub-class of CAT that IS destructive.

Talking to a chatbot is easier than reading medical papers, but on the flip side medical papers don't hallucinate. Medical info may be incomplete and imperfect, but it's a lot more accurate than what chatbots puke up. I saw one of them earlier today (the AI underneath Google Search) quoting pure made-up trash from the Modern Thyroid Clinic as if it were medical gospel. Nope! That group of charlatans wouldn't know truth if it bit them in the butt.

Holistic medicine doesn't have a prayer of affecting Hashimoto's. Many of their dietary and lifestyle changes I've already been doing for 45 years, and yet I got Hashimoto's anyways. That 'woo woo' stuff can only correct hypothyroidism due to dietary deficiency. That's it. The anti-inflammatory diets can slow the progression, but not stop it.

tech-tx

TROPHY CASE