Category Archives: health

In Treatment of Hypothyroidism Need For t3 Could Be Genetic


Do you wonder if you need t3 (Cytomel, triiodothyronine, liothyronine) added to your thyroid hormone treatment to feel normal again? The answer could be in your genes.

Recent discoveries reviewed by Antonio C. Bianco, M.D., Ph.D. at the recent American Thyroid Association meeting, reveal how genetic differences influence the effectiveness of thyroid hormone replacement. Dr. Bianco’s lecture focused on studies pinpointing inborn differences in the way people metabolism thyroid hormone to explain why t3 treatment of hypothyroidism is probably required by some to restore normal functioning of their brain, muscle and heart.

The most frustrating problem for people with hypothyroidism is being unable to convince their doctor that treatment with Synthroid, Levoxyl or similar pure t4 product, isn’t working. Continued symptoms of fatigue, weakness, inability to concentrate or think clearly, and inability to lose weight despite really trying, result in tension between the doctor and the “complainer”. When assessing the adequacy of thyroid hormone replacement therapy most doctors rely on the blood tests known as the Thyroid Function Panel. Typically this includes a measurement of t4, t3, t3RU, and TSH. Some panels may also include free t4 or free t3 measurements. If the hormone levels on these tests are “within normal limits” the doctor will often insist that the treatment is a success but it is the patient who fails to recognize this. A minority of endocrinologists know many of these “failures” can be turned into success by the addition of t3, the less utilized but much more powerful form of thyroid hormone.

Most of the biological effects of thyroid hormone in the body are due to the action of t3. The most common forms of thyroid hormone replacement however, involve giving t4 in the form of Synthroid, Levoxyl, levothyroxine etc. The t3 required by our tissues is produced by specific enzymes which convert t4 to t3 in the cells of the liver, kidney, brain, muscle, heart etc. These converting enzymes are known as deiodinases and under normal conditions they are responsible for about 80% of the body’s t3. The process
by which t3 is produced from t4 is known as peripheral conversion.

It has long been the contention of the leaders in thyroid disorders that based on their arithmetic, t4 replacement is sufficient to provide all the t3 the body needs via peripheral conversion and giving t3 supplementation doesn’t make good medical sense. Now, based on the new information provided by researchers like Dr. Bianco, the “arithmetic guys” will, in my opinion, need to revise their thinking finally allowing the way for acceptance of t3 replacement approaches.

I will continue the explanation of the new breakthrough in genetic control of thyroid hormone replacement treatment in Part 2 of this post.

Tara Struggles with Persistent Symptoms of Hypothyroidism and Her Medical Care


Sad LadyMetabolism.com received this message from one of our readers. Her story seems typical of the sort of dilemma so many people face today. The best advice usually comes from others who face the same problem. It would be helpful to hear what others would do in her situation.

Tara’s message: “I was diagnosed with Grave’s Disease in 2009, I had RAI in 2011, after my daughter turned 3 months. Being pregnant with Severe Grave’s was the scariest thing in my life at the time. I gained weight prior to my pregnancy, during, and after RAI. My family doctor told me no matter how much you ate while severe Hyperthyroid you should have been anorexic, so something else is wrong. ” Continue reading

How the Sunshine Act Will Save You Money


By Gary Pepper, M.D.

Offering Promotional Money

Have you noticed that medication costs are skyrocketing? Even if you don’t take medication these higher costs are passed along to you in your health insurance premiums. The recently enacted Sunshine Act will combat these economic forces but in ways you may not realize. The legislation requires pharmaceutical companies to report all payments made to doctors. Physicians receiving substantial amounts of money from these companies include “thought leaders” who are sponsored by the drug companies to lecture the nation’s doctors on newly approved medications. Continue reading

Are Drug Companies Paying to Control Your Doctors’ Prescription Pad?


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by Dr. S. Brown

As a physician in private practice familiar with highly skilled pharmaceutical representatives pitching the latest (and most expensive) medications, I am fairly good at separating truth from salesmanship. These clear cut interactions with the drug reps visiting my office are relatively harmless. Drug maker’s are now changing up the game however, with a new, more subversive tactic to influence doctors’ prescribing habits.

I have been compiling a “medical propaganda” file, consisting of emails directed to my work and personal address offering cash for my time. In less than a year, I count over 500 of these emails. Here are twenty from the past week. Some details are blacked out for legal reasons. Continue reading

7 Ways to Boost Your Metabolism When Quitting Smoking


smoker (1)Gaining weight after quitting smoking is a common and dreaded experience.  Fear of weight gain often discourages people from trying to take the first steps toward giving up the smoking habit. What is the reason for this unwelcome “side-effect”? Perhaps most importantly, smoking raises the heart rate substantially.

While smoking a cigarette, the heart rate increases 10-20 more beats per minute. (This can lead to heart diseases in the future.) This elevated pulse boosts the metabolism because of the energy it takes to keep the body functioning at this high rate. When a smoker quits smoking, the heart rate will return to its normal, natural rate. This will cause a decrease in the metabolism. However, there are several ways to boost your metabolism after smoking cessation  to avoid the weight gain that often occurs.

Continue reading

A Look Through the Therapeutic Window


I am often asked by patients with hypothyroidism (low thyroid hormone levels), “What is the right thyroid hormone dose for me”.  Of course, a physician wants to find the appropriate dose of medication to treat each condition a patient has. When it comes to thyroid disease however, this can be a complex question. Not only is there an issue of whether T4 alone or combination T3 and T4 will be required to treat a particular individual but the therapeutic window of these hormones must also be considered. Continue reading