Synthroid, Armour Thyroid, and the battle for T3

In the last Heart Scan Blog post on thyroid issues, Is normal TSH too high?, the provocative findings of the the HUNT Study were discussed. The text of the study can be found at:

The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study

Hypothyroidism, or low thyroid that is signaled by high thyroid-stimulating hormone, TSH, is proving far more prevalent an issue than previously thought. While previous estimates put hypothyroidism as affecting only about 3% of younger populations, 10-20% of older populations (women more so), data like the HUNT Study suggest that, if lower and lower TSH levels (higher thyroid) are necessary for perfect heart health, then many more people stand to benefit than we used to think.

But another crucial issue in the world of hypothyroidism: Is T4 (thyroxine) enough? Or should we be supplementing T3 (triiodothyronine) along with T4?

Your friendly neighborhood primary care doctor or endocrinologist would likely argue vehemently that T4 (as Synthroid, Levoxyl, levothyroxine, and others) is adequate and not subject to the impurities and contaminants of natural thyroid extracts. They would also argue that T4 is effectively converted to T3 at the tissue level, and exogenous supplementation is unnecessary.

Others--most of all thyroid patients themselves, along with thyroid advocates like Mary Shomon and Janie Bowthorpe, along with some physicians--argue that supplementing T3 along with T4 can be very important. They argue that people feel better, have more physical energy, lose weight more effectively, and more completely resolve many of the phenomena of hypothryoidism with T3 added. There are also some data that argue the same.

Adding T3 to the mix may address the presumed poor conversion of T4 to T3 that is peculiar to some people. It may overcome the "reverse T3" phenomenon, the production of a useless look-alike T3 that occurs in some people. It may also (anecdotally) exert greater effects on some lipid/lipoprotein parameters, such as Lp(a).

My experiences adding T3 to T4 have been mixed: Some feel better, others do not. Some show objective improvements, others do not.

Nonetheless, hypothyroidism, or incompletely corrected hypothryoidism by way of inadequate T3, is an issue to consider in your plaque-control program.

More on this somewhat complex issue, along with practical solutions to consider, can be found on the Special Report to be released this week on the Track Your Plaque website.

Comments (2) -

  • Anonymous

    7/6/2008 7:51:00 PM |

    This is what I hate about medicine: one size fits all. Thyroid treatment should be based on symptom relief using labwork to make sure there isn't overtreatment. And all thyroid supplements should be available to the patient. Not just what the doctor gets paid (oops!) to use.

  • Anonymous

    7/7/2008 5:15:00 PM |

    Hi Dr. Davis,

    Check this link out...  The doctor at the link references your work.  Not sure if you're familiar with his.

    I've saved the link on two lines that need to be combined to paste into the browser.

    http://jeffreydach.com/2008/06/26/
    saving-tim-russert-and-george-carlin-by-jeffrey-dach-md.aspx

    The interesting thing about the article for me was this...

    I have previously noticed about 1/3 of my eyebrows had gotten thinner.  And I also have wondered about the puffiness around my eyelids.

    Sheesh...

    What do you think about that site?  If you don't answer here in comments perhaps you could address in your Special Report or at your blog?

    Thanks for all you do.

    wccaguy

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Tim Russert Revisited

Tim Russert Revisited

A Heart Scan Blog reader brought this piece by Dr. MacDougall to my attention.

Dr. MacDougall created a fictitious posthumous conversation between himself and the late Tim Russert. MacDougall paints a picture of a hardworking, hard-living man who adhered to an overindulgent lifestyle of excessive eating. He concludes that a vegetarian, low-fat diet would have saved his life.

Beyond being disrespectful, I would differ with Dr. MacDougall’s assessment. In fact, I’ve heard an interview with Mr. Russert’s primary care physician in which the doctor claimed that Mr. Russert had been counseled on the need for a low-fat diet and, in fact, adhered to it quite seriously. Far from being an overindulgent, overeating gourmand, he followed the dictates of conventional dietary wisdom according to the American Heart Association. The low-fat diet articulated by Dr. MacDougall is simply a little more strict than that followed by Mr. Russert.

What exactly could Mr. Russert have done to prolong his life? Several basic strategies:

--Added fish oil. This simple strategy alone would have reduced the likelihood of dying suddenly by almost half.

--Eliminated wheat and cornstarch—Mr. Russert developed diabetes in the last few years of his life. By definition, diabetes is an inability to handle sugars and sugar-equivalents. Wheat and cornstarch yield immediate and substantial surges in blood sugar greater than table sugar; elimination causes weight to plummet, blood sugar to drop, and diabetes (at least in its early phases) can be eliminated in many people, particularly those beginning with substantial excess weight.

Just those two strategies alone would more than likely have avoided the tragic death that brought Mr. Russert’s wonderful life and career to an abrupt end.

Of course, he could have even taken his heart health program even further, as we do in the Track Your Plaque program. While the conversation has focused on how to avoid tragic events like sudden cardiac death, why not take it a step farther and ask, "How can coronary plaque be measured, tracked, and reversed?"

In that vein, Mr. Rusert could have restored vitamin D to normal levels; identified all hidden sources of heart disease using lipoprotein testing (though he had small LDL without a doubt, given his generous waist size, HDL of 36 mg/dl and high triglycerides); considered niacin. Simple, yet literally lifesaving efforts, that make reversal much more likely.

Those simple steps, in fact, would have tipped the scales heavily in Mr. Russert’s favor, making a heart attack and/or sudden death from heart disease exceptionally unlikely.

Comments (7) -

  • Anna

    11/16/2008 3:32:00 PM |

    Yes, I saw the McDougall post, too, and I also thought his fictitious  conversation was in very poor taste, not to mention very misleading and unhelpful in terms of what people could learn about avoiding a similar fate.

    It's not that we can't review and learn from what happened (and didn't happen) in Mr. Russert's case, but it's important to be factual and make sure it will actually teach something useful, not to mention not cross the line of good taste.

    Dr. Davis, I think there is a mile of difference in the way you refer to Mr Russert's untimely passing, with thoughtful commentary on what we can learn from this prominent example.  

    But Dr. McDougall's "posthumous interview" post, on the other hand, is nothing more than tacky self-promotion and yet more misleading vegetarian propaganda.

  • Jim

    11/17/2008 5:36:00 PM |

    I found a great book about Tim Russert at Walgreens.  It has stories from the people that knew him.  It sounds like he liked his beer.  I wonder if beer helped or hurt his condition.  Anyway, there is sample chapter of the book at:
    http://www.timrussertbook.com/

  • Jim

    11/17/2008 5:43:00 PM |

    I found a great book that very few people probably know about.  The book is called "Tim Russert: We Heartily Knew Ye" and it contains stories from people that knew Tim. The book is only sold in Walgreens and they even have a sample chapter on the web at:
    http://www.timrussertbook.com/
    Tim seemed to like beer a lot.  I wonder if it helped or hurt his condition?

  • Anonymous

    11/18/2008 3:58:00 AM |

    McDougall did something similar with Bill Clinton regarding his bypass surgery. Link:

    http://www.drmcdougall.com/misc/2008nl/apr/letters.htm

    I was a McDougall follower for years.  Now I have virtually no respect for the guy.  I was probably the fatest vegan you've ever met.  Could not get below 190 pounds, was hungry all the time, skin was dry and cracked,  hair was like a Brillo pad, and blood sugar was rising.

    He has nothing to offer a diabetic or anyone with metabolic syndrome.   I think initially people see change on his diet, but long term I didn't seem to benefit.

  • Anonymous

    11/18/2008 5:24:00 AM |

    Russert also had the bulging eyes and thinning eyebrows of the untreated low-thyroid sufferer.

    But the McDougall post on Russert was beyond the pale.

  • Dr. S

    11/18/2008 4:09:00 PM |

    Same old!  Russert, I am sure, did NOT eat a low fat/high carb diet.  Low fat means for sure, less than 15% and more like 10% calories from fat and near 80% from carbs.  Most research and studies etc call 25% or even 35% low fat!  That is HIGH fat AND high carb which is definitely a deadly combo, just a more toxic version of SAD because undoubtedly, in trying (and failing) to go low fat, he was eating lots of manufactured, fake, food like substances that were loaded w/ transfats and chemical preservatives, dyes (note the inadvertent homonym pun), etc.  He died of misplaced, good intentions that were aborted by faulty education and industry PR, but definitely not a low fat diet!

  • Sue

    11/21/2008 3:53:00 AM |

    The bulging eyes are a sign in hyperthyroidism - over-active thyroid.

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