# Question about thyroid hormone output during physical stress...



## prettynikki5 (Dec 9, 2009)

I am wondering if anyone knows if during times of stress on our bodies, we need more thyroid hormone 'output' than usually needed on a day to day basis. The reason I ask, is that I have noticed that when I am sick, say with a cold, or right before and during my monthly cycle (sorry guys!) I feel very hypo.Then after these things pass I feel 'normal' again.
I do not have a thyroid, so I am just wondering under normal circumstances would our thyroids normally 'adjust' and provide more hormone during times of physical stress when needed? Or am I way off base here totally?
Just trying to find out why hypo symptoms pop up during these times and find a solution....
Thanks for any advice input/personal experiences


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## Andros (Aug 26, 2009)

prettynikki5 said:


> I am wondering if anyone knows if during times of stress on our bodies, we need more thyroid hormone 'output' than usually needed on a day to day basis. The reason I ask, is that I have noticed that when I am sick, say with a cold, or right before and during my monthly cycle (sorry guys!) I feel very hypo.Then after these things pass I feel 'normal' again.
> I do not have a thyroid, so I am just wondering under normal circumstances would our thyroids normally 'adjust' and provide more hormone during times of physical stress when needed? Or am I way off base here totally?
> Just trying to find out why hypo symptoms pop up during these times and find a solution....
> Thanks for any advice input/personal experiences


We do need adequate T3 for healing. Methinks that when one is stressed, T4 is more likely to convert to rT3 (reverse) and causes a rise in cortisol which also stresses the adrenal.

This effectively cuts of the availability of Free T 3 which is the unbound hormone available for cellular uptake.


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## lainey (Aug 26, 2010)

When you are sick or stressed the TSH does typically rise--which is the body calling for more T4 actually.

Keep in mind that T4 is stored. If your replacement is adequate, there should be plenty of stored T4 available to handle short term stresses--even without a thyroid, the pituitary axis still works, the difference is that the body is drawing on the stored hormone that comes from an outside source.

Sick over a period of time = increased use of stored hormone. Depleted stores = slightly hypo until homeostasis returns. If your dose is correct, that shouldn't take too long.

That said, many patients with thyroid disease report that getting over illnesses takes them longer. People also report energy changes that go with their menstrual cycles--this makes sense too, as estrogen binds thyroid hormone, during that time during the month when estrogen is high, the patient may feel more fatigued, because less than the usual amount of thyroid hormone is available.


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## prettynikki5 (Dec 9, 2009)

lainey said:


> When you are sick or stressed the TSH does typically rise--which is the body calling for more T4 actually.
> 
> Keep in mind that T4 is stored. If your replacement is adequate, there should be plenty of stored T4 available to handle short term stresses--even without a thyroid, the pituitary axis still works, the difference is that the body is drawing on the stored hormone that comes from an outside source.
> 
> ...


Thank you so much for the above insight. About 1 week before my cycle my hair starts falling out more than usual and gets very dry at the ends, oily at the roots, my body gets very achey all over (muscles, joints) and I do get tired easily, my metabolism slows down and I get VERY emotional. Then about a week after my cycle my hair is back to normal and the weight comes off and I have energy again. I know that most women have some of these issues when it's that time of the month, but these are the same symptoms I was having when I was hypo with Hashi's when I had my Thyroid still. I wonder if taking a little extra T4 around that time of month would help? Or would I have to take a little more throughout the month, since it is 'stored' hormone as you say? Or is this just something I will have to deal with forever and ever? I feel a bit like a yo-yo, lol!


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## prettynikki5 (Dec 9, 2009)

Andros said:


> We do need adequate T3 for healing. Methinks that when one is stressed, T4 is more likely to convert to rT3 (reverse) and causes a rise in cortisol which also stresses the adrenal.
> 
> This effectively cuts of the availability of Free T 3 which is the unbound hormone available for cellular uptake.


I think I will be so pleased when my doc actually 'decides' it's time to try adding in some T3


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## lainey (Aug 26, 2010)

prettynikki5 said:


> Thank you so much for the above insight. About 1 week before my cycle my hair starts falling out more than usual and gets very dry at the ends, oily at the roots, my body gets very achey all over (muscles, joints) and I do get tired easily, my metabolism slows down and I get VERY emotional. Then about a week after my cycle my hair is back to normal and the weight comes off and I have energy again. I know that most women have some of these issues when it's that time of the month, but these are the same symptoms I was having when I was hypo with Hashi's when I had my Thyroid still. I wonder if taking a little extra T4 around that time of month would help? Or would I have to take a little more throughout the month, since it is 'stored' hormone as you say? Or is this just something I will have to deal with forever and ever? I feel a bit like a yo-yo, lol!


The problem is, T4 medication doesn't work that way--ie, you can't just add more for a short period--it takes weeks to build up in your system, and by then it would be too late. Thyroid medication isn't usually prescribed on an "as needed" basis.

I think, in menstruating women, a certain amount of PMS is normal for everyone, thyroid problems or not. It's one of those joys of being a girl that we all live with.

That said, T3 medication is very short acting and can give you a boost. If your free T3 numbers warrant it, this may be the solution to leveling out your symptoms somewhat.


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## prettynikki5 (Dec 9, 2009)

lainey said:


> The problem is, T4 medication doesn't work that way--ie, you can't just add more for a short period--it takes weeks to build up in your system, and by then it would be too late. Thyroid medication isn't usually prescribed on an "as needed" basis.
> 
> I think, in menstruating women, a certain amount of PMS is normal for everyone, thyroid problems or not. It's one of those joys of being a girl that we all live with.
> 
> That said, T3 medication is very short acting and can give you a boost. If your free T3 numbers warrant it, this may be the solution to leveling out your symptoms somewhat.


My labs look like I may need some T3:
T3 FREE 2.6 (2.3 - 4.2)
T4 FREE 1.6 (0.9 - 1.8)
TSH 2.73 (0.27 - 4.20)
It's funny you mention the "boost"...those were my exact words when I was emailing my doc, telling him I was overall feeling great, but I could use a little "boost", LOL! He keeps insisting though that my T3 level is fine and wants to hold off on adding T3. Wonder why it has to take so much "convincing" to get him to try the T3. Is it very dangerous when not necessary? My instinct is that I would really feel better with it, but I'm no doctor and he's pretty good.
Thanks again for all the helpful advice!


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## lainey (Aug 26, 2010)

There is a whole line of thinking out there, with research to back it that says that T3 medication is unnecessary and all the T3 that you need is made from the T4 replacement.

This is such, that T4 medication is the sole replacement (and synthetic at that) in a lot of areas of the world--Britain and other European countries and Australia are a few.

Some doctors see T3 as being a lot like "crack"-- it gives you the instant energy, and then it is gone. It's dosing does not give the stability in your levels that T4 has over the course of the day or week.

Your T3 is on the low side, but you do have some wiggle room in your T4 and TSH if he wanted to bump up your T4 a little first to see what happens.


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## Andros (Aug 26, 2009)

prettynikki5 said:


> My labs look like I may need some T3:
> T3 FREE 2.6 (2.3 - 4.2)
> T4 FREE 1.6 (0.9 - 1.8)
> TSH 2.73 (0.27 - 4.20)
> ...


Your FT3 is in sad shape. The doctor should try getting through his day w/FT3 @ 2.6. Harumph!! I also humbly think your TSH is too high.


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## prettynikki5 (Dec 9, 2009)

Andros said:


> Your FT3 is in sad shape. The doctor should try getting through his day w/FT3 @ 2.6. Harumph!! I also humbly think your TSH is too high.


Andros what is your opinion: should I look at trying a new doc? Or should I demand that he change my meds? I know that we are,essentially like paying customers and not totally at their mercy, how far should I take it?
He's not a bad doctor, but he tends to think anything within normal ranges is good enough for me, a mediocre kind of guy, lol!


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## prettynikki5 (Dec 9, 2009)

Just got a message from my doc last night that based on the lab results from Thursday, he wants to start me on Cytomel, 5 mcg daily. My recent labs were surprising to me, my TSH went up, (which may prove my theory about feeling HYPO on my monthly cycle-as I did labs during this time) my GLUCOSE is the highest it's ever been  Here are the numbers:
TSH 5.03 (0.27 - 4.20)** up from 2.73
T4 FREE 1.9 (0.9 - 1.8) **up from 1.6
T3 FREE 2.6 (2.3 - 4.2)**stayed the same
My Calcium is FINALLY at 8.8 in the normal range for the first time post TT in June!!!
This is AWESOMENESS  My potassium is increasing as well, the daily bananas and supplements have helped!
Will the T3 lower my TSH? Doc said he may even have to lower my T4 amount at some point after he starts me on the Cytomel. My current dosage is 137mcg.


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## lavender (Jul 13, 2010)

Gosh, I hope you feel better on the cytomel, and am happy to hear your doc was willing to prescribe it for you. I think the idea is that it should lower your TSH. I have no experience with it myself, but think that I could really benefit from some T3 as well and I am anxious to hear if this helps you.

Glad to hear your potassium and calcium are increasing as well!

My Christmas wish is for a doctor who calls me back days after a test was done to adjust my meds! I would stick with this guy for now.


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## prettynikki5 (Dec 9, 2009)

lavender said:


> Gosh, I hope you feel better on the cytomel, and am happy to hear your doc was willing to prescribe it for you. I think the idea is that it should lower your TSH. I have no experience with it myself, but think that I could really benefit from some T3 as well and I am anxious to hear if this helps you.
> 
> Glad to hear your potassium and calcium are increasing as well!
> 
> My Christmas wish is for a doctor who calls me back days after a test was done to adjust my meds! I would stick with this guy for now.


YES! Isn't that something special? He was checking my labs and emailing me from home on a SUNDAY NIGHT! I told him how much I appreciated him  
Thank you for the kind words, I will definitely post an update shortly on any differences, also will post labs in 6 weeks to see what has changed.
Merry Christmas!!!


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## lavender (Jul 13, 2010)

I am truly impressed. I am glad to hear that others are getting good care. Makes me know I'm not crazy for being ****ed that my doc took 3 weeks to get lab results to me, and that 2 weeks is the office standard!


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## prettynikki5 (Dec 9, 2009)

lavender said:


> I am truly impressed. I am glad to hear that others are getting good care. Makes me know I'm not crazy for being ****ed that my doc took 3 weeks to get lab results to me, and that 2 weeks is the office standard!


Oh NO! 3 weeks?! Man, that is too long to be wondering/feeling bad, whatever...I would be so frustrated. That can seem like an eternity if you are trying to get your meds/levels right. Nice. Can you fire your doc?


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## lavender (Jul 13, 2010)

Fired. Canceled appointment for today after he refused to order new labs. Can't see how he would dose me correctly on 4 week old labs. Appointment with new doc is in two weeks. Keeping my fingers crossed...


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## prettynikki5 (Dec 9, 2009)

lavender said:


> Fired. Canceled appointment for today after he refused to order new labs. Can't see how he would dose me correctly on 4 week old labs. Appointment with new doc is in two weeks. Keeping my fingers crossed...


Rock on!!! Good for you hugs6 We don't need no half-steppin doctors, they need to be on the ball so we can feel GREAT  Let us know how the new doc measures up.


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## Andros (Aug 26, 2009)

prettynikki5 said:


> YES! Isn't that something special? He was checking my labs and emailing me from home on a SUNDAY NIGHT! I told him how much I appreciated him
> Thank you for the kind words, I will definitely post an update shortly on any differences, also will post labs in 6 weeks to see what has changed.
> Merry Christmas!!!


How are you doing on the Cytomel??? I am glad this doctor is starting to think outside the box!

Let us know!


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## prettynikki5 (Dec 9, 2009)

Andros said:


> How are you doing on the Cytomel??? I am glad this doctor is starting to think outside the box!
> 
> Let us know!


Day 1 on the Cytomel, YAY!!! Here's to feeling GREAT! hugs6 I hope this is what I needed to get my levels where they need to be


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## CA-Lynn (Apr 29, 2010)

Always boggles my mind why people don't have their labs done 3 days or so prior to the appointment with the doctor. This way you have current results when you see him and adjustments can be made.


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