Liothyronine Monotherapy In Euthyroid Patients
15a.Is there a role for the use of liothyronine to treat biochemically euthyroid patients with depression?
Although some uncontrolled and nonrandomized data exist concerning successful use of liothyronine in euthyroid patients with depression, larger, prospective randomized placebo-controlled studies are needed to more completely define the potential role of liothyronine in this condition, balancing the risks and benefits of therapy to measurable clinical outcomes.
Weak recommendation. Low-quality evidence.
Discussion of the clinical literature
Despite advances in our understanding of T3-mediated genomic as well as nongenomic actions at the cellular level , the role for LT3 in optimizing TH replacement therapy has not been clearly elucidated . With increased recognition of the biologic importance of T3 at the cellular level, and the concerns that biochemical euthyroidism may not equate to tissue euthyroidism, there has been an increasing dialogue regarding whether LT3 therapy may be effective in reducing symptoms seen in euthyroid patients as well as in patients with depression, obesity, and cardiovascular disease.
15b.Is there a role for the use of liothyronine to treat biochemically euthyroid patients with obesity?
Discussion of the clinical literature
Drop Your Adrenaline With Salted Orange Juice
This one simple little trick I learned from Dr. Raymond Peat has made one of the biggest differences in helping my clients improve their sleep.
Research shows , both sugar and salt help to suppress and regulate your bodys stress response.
A new perspective on glucocorticoid feedback: relation to stress, carbohydrate feeding and feeling better.
RESULTS: During the low-salt diet, 24-h urinary excretion of serotonin increased by 42%, accompanied by a 52% rise in the excretion of 5-HIAA. Salt restriction also increased noradrenaline excretion by 77% and VMA excretion by 40%.
This combination of sugar and salt can be used therapeutically to help prevent the rise of adrenaline at night and to suppress adrenaline if or when it does rise.
In other words, it can help you sleep better and longer, and if you do wake in the middle of the night it can help you to get back to sleep faster and easier.
Before going to bed, simply mix 1/8 tsp. of salt into 3 to 4 ounces of orange juice.
Sip on just one ounce before going to sleep and keep the rest within arms reach by your bedside.
If you find yourself waking in the middle of night, dont get out of bed. Just reach for and sip another ounce of the salted orange to help you get back to sleep.
Armour May Impact Your Thyroid Lab Tests Differently Than Other Thyroid Medications
Lastly, you should be aware that Armour thyroid causes some changes to your thyroid lab tests which are not necessarily the same as levothyroxine.
Because Armour contains T3 it tends to cause a more pronounced and powerful drop in your TSH.
It has been estimated that T3 is roughly 3-4x more potent than T4 at reducing the TSH.
This may cause more of a drop in your TSH than you are used to with other T4 only medications.
In addition, because it contains T3, Armour will cause a more pronounced increase in your free T3 levels.
It may also cause a drop in your free T4 levels as well.
This pattern may be confusing to newer patients so it is something you should be aware of.
The pattern itself is not necessarily an issue but it may make interpreting your lab tests slightly more difficult.
To recap, you may find the following changes to your thyroid lab tests when transitioning to Armour thyroid:
- A more pronounced drop in TSH compared to T4 only medications.
- A more pronounced rise in free T3 levels compared to T4 medications.
- The potential for a drop in free T4 levels
- The potential for a drop or rise in reverse T3
- A more pronounced rise in total T3 levels
- The potential for a drop in your thyroid antibody levels
*Note: These are only rough guidelines and may not apply to all patients.
Read Also: Does A Thyroid Test Need To Be Fasting
Alternatives To Armour Thyroid
Natural desiccated thyroid is the original treatment for hypothyroidism. It has been used for more than a century.
In the mid-1900s, a synthetic version of thyroxine one of the two primary hormones the thyroid gland produces was developed. This synthetic form of thyroxine is called levothyroxine or l-thyroxine.
Even though natural desiccated thyroid contains two key thyroid hormones thyroxine and triiodothyronine as well as other elements found in an organic thyroid gland, levothyroxine has become the preferred treatment. Brand names for levothyroxine include:
Understanding Armour Thyroid And Hypothyroidism
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Ethical Considerations In Hypothyroidism Research
18.What are the research ethics issues involved in evaluating or designing clinical trials for the treatment of hypothyroidism?
There should be recognition that there are not enough data to resolve clinical disagreement among thyroid experts regarding treatment for hypothyroidism. Clinical equipoise is disturbed only by the results of well-designed randomized controlled trials that have the statistical power to settle the question of efficacy between monotherapy and combination therapy, or other forms of therapy.
Discussion of the clinical research literature
In evaluating published research and original studies of TH replacement, only those studies demonstrating ethically sound design and responsible conduct of research , in which there was study oversight and Institutional Review Board approval, should be considered. Well-designed small studies without the statistical power to resolve clinical disagreement, or disturb clinical equipoise , cannot be considered to be a high level of evidence of a null effect or superior or inferior efficacy.
Clinical equipoise in TH therapy
Resolving clinical equipoise: RCT design
The need to resolve collective professional uncertainty, or community of experts uncertainty, over efficacy and safety of Therapy A versus Therapy B is critically needed for patient care. However, we could not find sufficient consistent data from studies of long-term therapy to resolve these issues.
How To Take Hypothyroidism Medication The Right Way
1) Get the exact same type of thyroid medication from your pharmacy every time
The hormone levels in most thyroid replacement medications are not consistent from one drugmaker to the next. So a bottle of 100 mcg levothyroxine tablets from one drug company might not contain the same amount of thyroid hormone as a bottle of levothyroxine from another drug company. This is why your healthcare providers will urge you to stick to one drugmaker for your thyroid medications. If you do end up having to change manufacturers, your healthcare provider may end up having to change your dose a bit.
2) Take your hypothyroidism medications on an empty stomach
Its best to take your thyroid meds on an empty stomach ideally 30 minutes to an hour before your first meal of the day. Taking it on an empty stomach helps your body absorb the full dosage.
3) Dont take your medicine within 4 hours of taking iron-, aluminum-, or calcium-containing supplements or antacids
Minerals like iron, aluminum, and calcium bind to levothyroxine and keep your body from absorbing all the thyroid medication. That means you wont get the full dosage, and you may not get the relief from hypothyroidism symptoms youre looking for.
4) Avoid thyroid support supplements or herbal supplements without your doctors approval
5) Give the medication several weeks to have its full effect
6) Look out for common thyroid replacement therapy side effects
8) Dont stop taking levothyroxine suddenly
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Interactions Between Armour Thyroid And Other Medications
Armour Thyroid may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements that you are currently taking. The list below does not include all possible drug interactions with Armour Thyroid . Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Taking Synthroid With Food
You should take Synthroid on an empty stomach without food. If you do eat something, and you forget to take Synthroid, call your doctor or pharmacist. Theyll recommend how long youll need to wait after eating before you take Synthroid. This length of time may depend on the type of food you ate and whether you took any other medications.
You may need to wait 4 hours to take your Synthroid after eating. This is sometimes the case so that Synthroid doesnt interact with foods or other medications in your body.
If you have questions about when to take Synthroid around meals, talk with your doctor or pharmacist.
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Does Armour Thyroid Cause Weight Loss
Armour Thyroidcan causeweightThyroidArmour Thyroidcancause
. Also know, will Armour thyroid cause weight gain?
Armour Thyroid is used to treat hypothyroidism. Hypothyroidism can cause depression, constipation, weight gain, dry skin, and more. Thyroid medication, such as Armour Thyroid, can also cause side effects, including: irregular menstrual periods.
Also Know, what thyroid medicine is best for weight loss? Levothyroxine drugs like Synthroid are synthetic forms of the thyroid hormone thyroxine, also known as T4. When everything works perfectly, your body should convert the T4 into the second key thyroid hormone, triiodothyronine, known as T3.
In this way, will thyroid medication help me lose weight?
October 16, 2013 Decreased thyroid function, or hypothyroidism, is commonly associated with weight gain. But contrary to popular belief, effective treatment with levothyroxine to restore normal thyroid hormone levels is not associated with clinically significant weight loss in most people.
What are the side effects of Armour thyroid medication?
Armour Thyroid Side Effects
- Allergic reaction
- Changes in appetite.
- Diarrhea or increased bowel movements.
- Excessive sweating.
Synthroid And Herbs And Supplements
Certain mineral supplements may interact with Synthroid. However, there arent any herbs that have been specifically reported to interact with Synthroid. But you should still check with your doctor or pharmacist before using any herbs or supplements while youre taking Synthroid.
Synthroid and mineral supplements
Certain mineral supplements interact with Synthroid by binding to Synthroid inside your stomach. When these supplements bind to Synthroid, your body cant absorb Synthroid. This means that you wont get the full amount of Synthroid thats in your dose.
For example, the following mineral supplements are known to interact with Synthroid:
If youre taking any of these supplements, you should take them at least 4 hours before or 4 hours after your Synthroid dose. Doing so will help make sure your dose of Synthroid is absorbed like usual.
If you have any questions about taking Synthroid with mineral supplements, talk with your doctor.
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Important Facts About Armour All Thyroid Patients Should Be Aware Of
Armour thyroid is one of many available thyroid medications which your doctor can prescribe.
Among thyroid medications, Armour is unique because of the hormones that it contains, how it is sourced, and how it impacts your body.
As a thyroid patient, you should be aware of all of the potential side effects that come from ANY therapy that you are taking.
In my opinion, the benefits of Armour far outweigh the potential downsides .
Let’s dive into some important facts you should be aware of…
Take Natural Desiccated Thyroid Hormone At Night
I have read that many on T4 meds feel better if they take their meds at bedtime. I am on Armour Thyroid and a very high dose . Is it wise to take all or some of it at bedtime? If I should try to take some of it at bedtime and some in the morning, should I split the dose 50-50 or take more or less at bedtime? I’d appreciate any input from members with experience in this area.Thanks a lot in advance.
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Hi Always better to split the dose. Some people find it better to take half in the evening. However I do not as I take so many drugs, PM would not work for me.General advice is to take half early before food , and then half later I cannot because of my other drugs. I take mine Am and lunch time. It is worth experimenting as safe. certainly I would split the dose even into 4. When on T3 it is advised to split the dose to 12 hours apart because of the highs. As you know Armour contains T3.I needed a very high dose of armour until T3 became available. Now I just take 2 and half grains of armour and 20mcg T3. Much more stable. FT3 now just in range.
I hope that helps.
Although it is generally recommended to take it in split doses, some people do best with one big dose in the morning. However, as you are on such a large dose you may find that you do better splitting the dose.
How are you taking it at the moment? .
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If My Tsh Level Is High Should My Synthroid Dose Be Increased Or Decreased
Usually, if your TSH level is high, your Synthroid dose needs to be increased. TSH, which stands for thyroid stimulating hormone, is made when your body needs more thyroid hormones.
When you have an elevated TSH level, your dose of Synthroid may need to be increased. On the other hand, if your TSH level is low, your dose of Synthroid may need to be decreased.
During Synthroid treatment, your doctor will order blood tests to check your TSH level. And for some people, their doctor will also check the levels of their thyroid hormones, T3 and T4. Based on the results of your blood tests, your doctor will adjust your dosage of Synthroid if needed.
If you have questions about whether your dosage needs adjusted, talk with your doctor.
What Medications Treat Hypothyroid
Whether your healthcare provider prescribes the generic or brand name, these medications help to replace the thyroid hormone your body isnt naturally producing in your blood.
It may take some time to find the right medication, or dosage that works for youand once youve figured out your treatment plan, certain things can mess with how the prescription works for you.
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How It Works For Hypothyroidism
With hypothyroidism, your body doesnt make enough thyroid hormones. The main thyroid hormones in your body are T3 and T4. By taking Synthroid, youre replacing your bodys T4. And your body then uses T4 to make T3.
Synthroid helps to bring your thyroid hormone levels back to a normal range. And it also helps reduce your symptoms of hypothyroidism.
Taking Your Thyroid Medication With Meals And Snacks
The synthetic thyroid hormone wont be absorbed properly unless you take it on an empty stomach and wait 45 to 60 minutes afterward before eating, Bianco says.
The simplest way to accomplish this is to take your thyroid medication first thing in the morning. Bianco says he has patients who set an alarm for 5 a.m., take the medication, and go back to sleep to ensure theyre taking it on an empty stomach. If you choose to take your thyroid medication at night, its important that you dont eat for four hours before taking it.
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How To Stop Hibernating And Start Sleeping Deeply
Are you sleeping or are you hibernating?
Unfortunately for most hypothyroidism sufferers, its the latter of the two.
And this is why you might feel tired no matter how much sleep you get.
Hypothyroidism affects sleep in ways other than just keeping you awake.
It affects your ability to achieve deep restful sleep too.
Weve all heard of hibernation.
In order for many animals to survive the harsh winter months, they go into a state of hibernation in order to lower their metabolism, conserve energy, and survive the cold.
But hibernation is not a form of restful sleep.
As Dr. Raymond Peat points out
Torpor is the opposite of restful sleep, and with aging, depression, hypothyroidism, and a variety of brain syndromes, sleep tends toward the hypothermic torpor.
In other words, hypothyroidism is known to promote a hibernation-like state of sleep that prevents you from reaching the deep sleep state that you need to wake up feeling refreshed.
Instead you wake up feeling like you never went to sleep in the first place.
And it has everything to do with your metabolism.
When you become hypothyroid, your otherwise healthy oxidative metabolism becomes impaired preventing your body from producing the essential nutrient carbon dioxide.
And when your carbon dioxide level falls, your serotonin production rises.
And its this rise in serotonin that decreases energy production, lowers body temperature, and promotes torpor, or this hibernation-like state of sleep.
So what can you do?