How about acupuncture and chinese medicine? Anecdotally, they will be able to help you through monitored use of chinese herbs and acupuncture.

I'd also like to add that if one can't get good thyroid care inside an HMO network or "universal" healthcare system, it can be money well spent to go "outside" the system  for private care.  Granted, paying for non-reimbursable care isn't cheap and one has to do a lot of investigating to make sure one isn't paying for more of the same inadequate care (or worse care).  But I think too many people who can afford to pay for private care suffer needlessly by doggedly sticking to inadequate care because alternatives cause a financial dent.  But in the long run, if one can find good care even though there is added expense, it can save a tremendous amount of suffering, as well as saving money.

When I was seeing a thyroid doc out of my HMO network, I was still able to get my lab work done by the HMO approved lab  and covered by my HMO insurance (the lab faxed the results to the out-of state doc without question), though the results did go into the computerized file at my HMO network, so was visible to any HMO doc.  And my HMO insurance Rx plan covered the conventional meds prescribed by the out-of-network doc without question (but not the compounded Rx).  Yes, it cost me a few hundred dollars a year to see the doc once year, a few telephone consults, and the non-covered compounded Rx, but it well worth it.  I was finally feeling and functioning better.

And when I went back to my HMO eventually (mostly because of travel scheduling difficulties in seeing the out-of-state doc), I was in a better position to make a case for similar care with the HMO endo (I told him flat out I'd had trouble getting good thyroid care from primary care physicians in the HMO and so went "private" for a couple years, but wanted to find someone local in the HMO for convenience) .  He doesn't do compounded Rx, and typically prescribes only Synthroid, but he accepted that I prefered T3 with the T4 (and he "accepted" the "odd" way I adjust my T4 dose with different amounts of 50 mcg Levoxyl on different days to get an overall weekly dose that works - the 50 mcg tablet has no dyes added and he accepted that I preferred Levoxyl over Synthroid).  So for the first time with the HMO system, I feel my thyroid care is more of a team effort that includes my input, instead of being at the mercy of whatever is dished out to me.  And if the situation changes, I will promptly go outside the HMO again.

I would also suggest using the Armour site to look for prescriber's.  Their site has a little 'doctor finder' feature.

It doesn't mean they'll necessarily treat you, but they tend to be more open-minded that doctors who prescribe Synthroid only.

Most doctors won't use body temperature as a guide, by the way. And most won't treat Hashimoto's unless your TSH is >5. I know it's wrong, but that's how it is.

Supplementing iodine may be helpful, unless you do have Hashimoto's, then it could make it worse (so you know). But you won't know you have Hashimoto's until you get your thyroid antibodies tested.

A couple of other suggestions:

Ask your doctor for Free T3/T4 AND thyroid antibodies. If your TSH >3 and your anitbodies are high, it really improves your odds of getting treatment. Many doctors ignore antibodies, but some do pay attention to them.

If your TSH or antibodies are high at all, ask your doctor for a thyroid ultrasound. If the ultrasound is abnormal at all, it improves your odds of getting treatment too.

Just going to a doctor with a TSH of 1.5-2.0 and normal T3/T4, it'd probably be close to impossible to get treatment. It really helps if you have the antibodies or ultrasound or something else to show the doctor.

No person should break the law.

However, there might be people within the arctic circle who don't have easy access to a physician who is willing to prescribe natural thyroid, including armour thyroid.

What to do in a situation like that?

One solution:  Find a site on the internet that provides for ordering and shipping thyroid, including Armour Thyroid, without a prescription.  There is at least one site that can be found via google that will do this.

Warning:  There are significant dangers in supplementing thyroid without being under a doctors care.

Thanks, Anna.

Regarding the thyroid issues Dr. Davis has been commenting on lately, and wondering why it seems so prevalent, have you considered the possibility that diet is playing a role.

And when I say diet, it's probably not in the way you think --

Carbohydrate restriction can lower thyroid hormone output, especially conversion of T4 to T3. Those who practice caloric restriction tend to have lower levels of T3 too.

If Dr. Davis is seeing somewhat low, but still in 'normal' range T3/T4, with perhaps sluggish T3 levels, in patients AFTER they change to a no wheat, low carb diet, perhaps that is the reason why? Or perhaps that's why Dr. Davis' own thyroid had somewhat sluggish numbers?

But if people all have high thyroid antibodies too, or all have crummy thyroid levels while eating tons of carbs, that wouldn't be a reason then.

Just throwing that out there to think about.

for those who are willing to do the research and check their tsh levels then ordering online is an option. start with a low dose 15 to 30 grains and then ck your tsh. Increase dose to normnal tsh levels.  There are multiple sites for armour and synthoid that do not require a prescription. When you take this road to self medication you must realize you are toally responsible for your actions and well being. Be sure you know what you are doing
Don

Lately I've been giving a lot of thought to the LC packaged foods that many people turn to when they first embark on a LC diet, such as low carb breads, crackers, etc.  For me, it was LC pita bread a few years ago, before I essentially went grain-free.  These products, in addition to usually having a lot of soy in them, also have added wheat gluten, to reduce the starch and boost the protein content.  Low carb they are, and generally will help with the BG control and overall weight reduction or maintenance.

Both gluten-containing and soy foods are relatively new foods to the human diet (only consumed since the age of agriculture) and modern industrial processing bypasses many of the steps that earlier humans took to render them safer to consume.  Soy can be a powerful thyroid inhibitor (goitrogen)  and gluten can trigger an auto-immune response in susceptible people (genetic predisposition to gluten sensitivity is much more common than previously thought, though how widespread is subject to debate).  There does seem to be a strong connection to autoimmune thyroid conditions and issues with gluten.

So people who eat a lot of soy and gluten-enhanced LC foods might be literally be shooting themselves in the thyroid, especially those who overconsume  consume them (dieters don't ever become overzealous, do they?  ), instead of foods that are naturally low carb and/or have a longer history in the human diet.

I think ordering prescription medication over the internet from a less than reputable pharmacy, without a prescription, is a real bad idea. And if they don't require a prescription, that pretty much automatically makes them less than reputable.

And don't assume thyroid medications are completely benign. They can have side effects too.
And especially in patients with heart disease. You have to be titrated slowly and need to be under a doctor's care.

DIY Armour/NTH treatments can be troublesome. If you are suffering from adrenal fatigue, starting immediately on thyroid replacement can cause heart palpitations and other symptoms of physical and mental anxiety. If you have low cortisol and DHEA (they invariably go together), you will probably need to take a low-dose steroid and/or DHEA replacement for a month before beginning thyroid. It is best to get these things tested first, even if you have to do it on your own. I think the Stop The Thyroid Madness author has put together some lab test packages for people to get the right things tested. And when you're taking the replacement steroids and hormones, you need to keep monitoring your levels every month at first, then every three-four months once you stabilise.

Google for the "Top Thyroid Docs" list by Mary Shomon for sympathetic doctor suggestions/review.

I forgot to add, the thyroid books by Dr Broda Barnes are good reading, easy to understand if you're a layman too. He had one on incidence of heart disease in patients with corrected thyroid function which is very interesting. I don't recall he mentioned wheat, but he certainly believed that we should eat good old saturated fats like butter, lard, coconut, etc, to support good health and thyroid.

Anecdotally along with the iodine I've heard a brazil nut per day suggested for the selenium. Where I live is not selenium deficient, thanks to the end of the Ice Age glaciation: this is reputed to be one reason for the longevity here. Next time I catch a doctor I'll ask if there's much thyroid disease here (they will diagnose and treat here, my TSH was 0.99 so something is working!)

That iodine dose may still be too low. Remember the RDA was set at a level just to prevent goiter, not for optimal health. Check out www.breastcancerchoices.org.
Healthy Japanese get 12.5mg (12500 mcg) of iodine per day. Probably we are all low in iodine and bromine competes for binding sites. Bromine is ubiquitous in our chemically laden environment and is used as a dough conditioner by commercial bakeries---they used to use iodine. The thyroid gets the bulk of our low iodine but it turns out that iodine is also concentrated in our gonads, adrenals and especially the breasts. Our epidemic of breast cancer and fibrocystic disease may be due to iodine deficiency.

If you cannot get this treatment on HMO, then you should look at going private. Believe me, it is not something that you can ignore

Dr. Davis,

I realize that you aren't in the business of diagnosing ailments or conditions via the internet, but I've recently experienced some hypothyroidism symptoms (low body temp. average of 96.7, fatigue, weight gain, hair loss, etc..) that my Doctor insists are unrelated to the disease.  In addition, he has also just put me on a combination of Crestor and Trilipix for an abnormally high triglyceride reading, despite this reading being a one-time fluke.

My labs are as follows:
TSH:       2.761
Thyroxine (T4): 6.4

He was not interested in doing any more thyroid testing beyond these two.

Lipids:
Total Cholesterol: 165
Triglycerides:     415
HDL:               22
LDL:               N/A

After a week on the Crestor (10mg) / Trilipx (135mg) combo, I was stricken with muscle aches and pains, tinnitus, popping ears, dizziness and a foggy out-of-it feeling.  After two weeks and finding your site, I discontinued the use of the two cholesterol medications against the Doctor's advice.  I've since starting taking an Omega 3-6-9 supplement three times daily along with my daily multi-vitamin.  I also take diazide/HCTZ for slightly elevated BP (130/96) and have recently begun following a strick low-carb diet and exercise routine.

Again, I don't expect a diagnosis from you, but would appreciate if if you could voice your thoughts on the viability of me continuing to find a doctor willing to be more open minded to thyroid issues as well as pursuing more natural remedies to lipid issues.  

Thanks for providing such a valuable resource for those of us who are getting fed up with the flawed standard of care that is currently being forced on so many people.



My labs show the following.

I agree on the iodine dose question.

The difficulty comes in trying to generate conversation through the blog for people who may or may not, for instance, have underlying Hashimoto's thyroiditis or thyroid nodules, in which case taking higher doses of iodine can trigger extreme excesses of thyroid hormone.

I had been on Sythyroid for a few years but no one had ever mentioned or tested for Hashimoto's. Still feeling horrible, I found a holistic MD, and was diagnosed with Hashimoto's and started on Armour.
Do I still have Hashimoto's or is it quiet now that I am taking a different hormone?
The holistic said it would "kill" my thyroid and move on to another area, like adrenals.
I did have a positive ANA for many years and tested for Lupus, RA, etc. many times. Then routine testing showed my ANA had returned to normal values.  
Any ideas because my current endo. sure isn't forthcoming with any and doesn't/hasn't tested for antibodies.  He feels I am just hypothyroid.
I appreciate all your information!

To test for Hashimoto's you need your TPO and TGAB antibodies tested. If they are above normal range, you probably have it. The definitive diagnosis is via a biopsy, but without a nodule that isn't usually done. An ultrasound is another diagnostic tool -- if your thyroid looks enlarged, nodular or all lumpy, along with antibodies, it's pretty safe to say you have Hashimoto's.

I have never read, or heard of, Hashimoto's 'attacking' other organs after your thyroid is burnt out. That theory seems a bit out there to me.

Antibodies can fluctuate, and with thyroid hormones usually become lower over time.  Inflammation tends to be reduces with hormones too.

OK I caught one of our GPs yesterday, the selenium in the soil connection appears to be a non-starter. Her experience was that she found hypothyroid "quite often" predominantly in post-menopausal women and with incidence increasing with age. It's impossible to compare numbers with other areas since they actively look for the condition here and don't elsewhere. Also we have a lot of local longevity so more patients with systems wearing out purely through ageing.

I always wonder about something I hear frequently - the issue of "soil mineral depletion".  Not that it isn't possible, but how significant is this and how widespread?  People don't generally eat "locally" produced food anymore; food supplies are distributed from all over the globe now, though agriculture is quite intense in some places, like the Central Valley of California, or cornfield in Iowa.  Wouldn't the shipping of food products all over sort of "average out" the minerals like iodine and selenium?  Or are  all the major agricultural regions of the world growing with depleted soil propped up with little more than NPK replacement?  

I'm actually more into local, seasonal organic food than worldwide food.  LIving near the coast, presumably there is adequate iodine in the soil, but here I am, hypothyroid anyway.  Just wondering...

Hard to tell about the soil mineral depletion thing, there are major regional variations which can show in animal diseases and require supplementation, salt licks etc. as well as human disease clusters. Deficiencies can show before "deficiency diseases"

I trialled several different supplements but none of them made any discernible difference, probably a widely varying diet helps, plus fish, and local farmers who use high levels of organic manure and feed the soil as a whole rather than (increasingly expensive) stuff out of a bag and treat the soil as a sterile growing medium. Grass-fed rather than grain-fed meat, and game, probably helps too in picking up trace elements

The downside of World Trade may be that while you get more trace elements from crops from different regions you are probably also getting more pesticides some of which are banned in the West

I've been doing so great after taking 1 1/2 gr nature-Throid brand of thyroid since october 08 and stopping all statins. Taking the Now D-3 at 5,000 per softgel. Now if I can just get back in the forums again....LOL   Dennis  still no 4th heart attack since 12/04

I wish my family doctor was open to new things. I asked him about Armour thyroid he said that he has hundreds of patients on Synthroid with no problems and I don't want to start a new prescription without my family doctor knowing about it. I'm on 75mcg of Synthroid and would really like to try Armour thyroid...might have to wait until he retires (could be soon) before I see if I can get Armour..

What about supplementation with tyrosine along side the iodine? Tyrosine is a precursor to thyroxine, and there have been a few interesting studies, like this one:

Psychoneuroendocrine effects of combined thyroxine and triiodothyronine versus tyrosine during prolonged Antarctic residence. Sure, the tyrosine may be working indirectly (going into neurotransmitters more than thyroxine) ... but at the end of a day, it seems to reduce TSH by about a third, while raising free T3 by 6%, while improving mood.

Dr. Brownstein (Family physician, holistic doc in Michigan) in his book, "Iodine, Why You need it, Why You can't live without it" makes an interesting case for temporarily increased TSH (5-30mU/L higher) after correcting iodine deficiency.

In addition to just stimulating thyroid hormone production, TSH also increases the production of the iodine transport cells (NIS). Without more NIS available, iodine couldn't enter the cells and be utilized. Therefore, increased TSH makes sense during the initial phase of iodine correction.

As one increases their iodine consumption, they could experience this increase in TSH for as long as several months. As long as the T3 and T4 levels are normal, then the TSH elevation probably isn't a sign of hypothyroidism.

If you haven't yet read this book, it's worth the 2 hours it took me to get through it.

Thank you!!! Personally, I'd like to see all hospitals non-profit. Here in NC they advertise on TV. They advertise the hospital, and they advertise their treatment "specialty" (ie cardiac care, bariatric surgery).

Okay that is amazing...wow. Can't wait to read your book.
Jana

Wow, just wow.
I hope you are able to 1. Track these folks to see how they do over time, and if making these changes affects their outcomes and 2. You'll be able to publish the TYP information so that more 'open' cardiologists, etc, can see what you do works.
This country is involved in the biggest dietary trial in the history of the world, outside of famine and deliberate starvation of populations. Probably no other group of people has been subjected to malnutrition while being overfed. That our food supply has been so adulterated with no testing is beyond amazing to me.
I read your blog regularly and encourage others to do so, but many are still listening to their doctors and are fearful.
It's not going to happen overnight, but i wonder if there isn't a selection process going on here.

Hi, Jean--
Hmmm. Interesting notion. Evolution in action.

Rather than weeding out the weak by infection and predators, the weak will succumb to Kelloggs, Nabisco, and "healthy whole grains."

When you say small LDL is zero, are you refering to both LDL4 and LDL3 on the VAP? Or just LDL4?

Where do I find out how to do this? my husband has a current lipoprotein a of 213 nmol/L and want to lower them STAT

Hi, Amanda--

We use high-dose fish oil and thyroid normalization, specifically T3, to start, followed by hormonal manipulation, niacin, and dietary changes. I invite you to join our discussions on how to do this on the Trackyourplaque.com website, the website that this blog accompanies.

I’ve been on a daily D3 regimen now for some 2 years (4000-8000 iu), taking an occasional 1 week break. Things were fine (no apparent side effects) until recently when I started to experience strange chest sensations, especially at bedtime and upon rising in the morning. My heart felt stressed, accompanied with a slight dizziness. I also had this weak feeling of pain in my chest very occasionally during the day. One morning I had fairly strong chest pain sensations on my left side, and I decided to go to the hospital. The chest pain subsided fairly quickly, and following an extensive checkup with EKG and blood tests. it turned out that there was nothing wrong with my heart according to the doctors. However one doctor pointed out that my D3 intake was fairly high and that that chest pains like mine are sometimes one of the symptoms of D3 toxicity and suggested I suspend D3 supplements for a time on the off chance this may be the source of my problem.

Hi, John --

I think you got some bad advice. This is highly unlikely.

It would be like saying "Your chest pain is from your suntan."

Very interesting John. I have been very open around this community about battling what sounds like the identical type of chest feeling. "My heart felt stressed" is a great description for what I have felt. For me, it comes and goes, and is often more pronounced between meals, even hours after eating. Also, I have noticed that the feeling is completely absent after a good weight lifting session and I'm not sure what to make of that. We should keep in touch somewhow incase on of us discovers something and wants to share it with the other.

-Jack Kronk

I'm a wife of a patient of Dr.Davis, also on 8000 VD/day.  I, too, notice every so often a definite heart beat.  At one of those times I was just slightly dizzy.  It's of a nature that I definitely notice it.  It comes and goes, with no particular rhythm and I can't relate it to anything I'm doing...except I'm thinking maybe stress?  I'm in very good physical health.  I don't think there is really anything wrong with me and no new stressors.   I find it puzzling.

Hi, Jack--

This leads to an off-topic idea, but I have been using the HeartMath program for such emotional/ stress effects with good--no, great--results.

Do you believe this program could be potentially helpful in my case? What does it entail and how might I find out more info about it?

Thanks Doc.

-JK

Sorry, Jack, hard to say without knowing more. But, speaking generally, I can tell you that the information we provide here and in the Track Your Plaque program, in my view, makes conventional heart health and nutrition advice look like kindergarten play time.

Two more people with zero Lp(a) today alone!

On November 16 or 17, 2011, there was an article on msnbc.msn which warned that too much vitamin D has been found to cause atrial fibrillation, a dangerous abnormal heart rhythm.  Doctors found that this side effect occurred typically in people whose blood levels of vitamin D had reached more than 100 ng/dl.  It is hoped, they said, that the atrial fibrillation is reversable once the vitamin D is stopped and the blood level of the vitamin declines.

Doc Davis, I had an NMR lipid profile in February of 2012. my scores were fair, however, did not get LP(a) score? thought this test provided ldl sub-classes. did i mis-read the test? should i get the VAP test next? my scores were: ldl-p count, 1130, small ldl-p 101, hdl-c 75, trigs., 35, ldl size 21.7, TC 209. i am 7 years out from 5x by-pass, 3 failed, 2 minor MI, one stent. i am a  56 year  old male, never any weight issues(160#). my current doctors think my cholesterol is too high. i am on a small dose of crestor (10mg). any thoughts.

Lp(a) is a separate test, it is not part of NMR.

Yes, Lp(a) must be specified on NMR.

On VAP, it is part of the standard panel.

What is the dosage and frequency of fish oil supplements you recommend?

Your Update is amazing! My triglycerides was 496 around 9 weeks back, and just with Vit D3 and Omega 3s, it came down to 283. But Vit D3 shot up from a dangerously low of 12.2 ng/ml to 239 ng/ml. I am 'trying' to be on a low-carb high dietary fat. Should I take remedial measures to 'lower' my D levels?

Sifter--

Please put "fish oil" or "omega-3" into the  site-specific search and you'll come up with the previous posts detailing this issue, a question to which there is no "___ mg" answer.

@ Ganesh Kumar
But Vit D3 shot up from a dangerously low of 12.2 ng/ml to 239 ng/ml.

The only time I've had a high reading was a faulty test. A repeat test a few weeks later showed normal readings.
The half life of D3 is about 3 weeks. Stopping D3 supplementation should allow level to drop from 240 to 120ng in 3 weeks and then to 60ng by week 6, depending on sunshine exposure.  
Postal Vitamin D testing isn't that expensive
80ng is a reasonable natural maximum level. But as I have found it could possibly be a fluke test result. However living where you do should allow sufficient vitamin D from sunshine over the next 6 weeks and so it's best to be on the safe side and avoid supplementing while your status drops and a retest is ordered.

is it realy the omega 3 yhats is to thank for low tryglicerides ,lets look from scratch from we are coming from ,we loaded ourself with denatured refined hydrogenated omega 6 oil ,vs our omega 3 are the live healthy form one ,add to this the debate outhere on the right ratio between the 3 and 6 oils ,all this may conclude that eliminating all the junk oils and consuming only live natural organic fats ,than will find that omega 6 does reducr even more tryglicerides then omega 3 does!!!

I see these commercials for Mega Red Krill Oil that are supposedly 3x more effective than fish oil.  Is this bunk?

My last lipid test showed triglycerides at 52mg/dl.

That may have something to do with my taking 1.3 grams of EPA/DHA omega-3 fish oil three times a day over the past year.

Interesting blog. I like to take 2x 300mg of omega 3 oils per day.