Fatigue, lethargy, mental sluggishness, difficulty tolerating heat and cold, depression, joint pain, headaches, morning stiffness…the list goes on and on. It’s almost a perfect match for chronic fatigue syndrome (ME/CFS) or fibromyalgia (FM) but it’s not either – it’s hypothyroidism; one of the trickiest conditions that people with either disease have to deal with.
If a hypothyroid diagnosis was done purely symptomatically, most if not all people with ME/CFS and FM would be considered hypothyroid. Dr. Teitelbaum’s description of the thyroid gland as the body’s “gas pedal” regulating its metabolic rate resonates strongly with ME/CFS and FM. Few studies on this have been done in FM and almost none have been done in ME/CFS.
Most perplexing for the patient is the considerable disagreement among doctors regarding what constitutes low thyroid and how to treat it. The problem is that giving thyroid hormone to someone who doesn’t need it is can cause their thyroid gland to shut down, leaving them dependent upon thyroid medication for life. Plus, other factors such as low cellular energy production or autonomic nervous system problems can cause similar symptoms.
MD’s with an holistic health slant, including prominent ME/CFS/FM practitioners such as Dr. Jacob Teitelbaum, Dr. Kent Holtorf, Dr. Sara Myhill and Dr. Ginerva Liptan – argue that flawed thyroid tests vastly underestimate the amount of hypothyroidism present, and by doing so, keep patients from potentially helpful drugs.
Dr. Teitelbaum in a blog titled “The High Cost of Missed Hypothyroid Diagnosis” calls hypothyroidism “horribly under-diagnosed”. He believes that undiagnosed or poorly treated thyroid problems contribute to unnecessary disability in millions of people with fibromyalgia, chronic fatigue syndrome, and chronic pain.
Most doctors, however, probably believe hypothyroidism is rare in ME/CFS and thyroid supplementation is unnecessary and possibly harmful.
A few simple concepts:
- Thyroid hormones – affect the activity of virtually every cell in the body. They regulate the basal metabolic rate, protein, fat and carbohydrate metabolism, bone growth, affect protein synthesis and others. Low thyroid levels can lead to fatigue, mental slowness, pain, depression, weight gain and more.
- Thyroid Stimulating Hormone (TSH) – is produced by the pituitary gland to stimulate the production of thyroid hormones by the thyroid.
- Thyroxine (T4) – is a prohormone produced by the thyroid gland which is broken down by deiodinase enzymes to produce the active form of thyroid hormone (T3).
- Triiodothyronine (T3) – The active form of thyroid hormone. Note that most T3 is produced outside of the thyroid in the liver and other tissues.
Dr. Holtorf’s View of Hypothyroidism
- Hormones in Wellness and Disease Prevention: Common Practices, Current State of the
Evidence, and Questions for the Future. Erika T. Schwartz, MDa,*, Kent Holtorf, MDb - “Thyroid Disorders” by Kent Holtorf in The LDN Book, ed. by Linda Elsegood
Dr. Holtorf has probably done more work in hypothyroidism than any other ME/CFS/FM practitioner. Please note this overview presents an alternative view of this subject; most doctors which take a traditional approach to thyroid will probably disagree.
Most if not all, patients who suffer from chronic fatigue syndrome, fibromyalgia, diabetes, insulin resistance, depression and stress have immune dysfunction that results in low tissue levels of thyroid hormone. Kent Holtorf
Most doctors rely on TSH and/or T4 test results to determine if thyroid levels are normal. Testing for TSH is an indirect measure of thyroid status but since TSH triggers thyroid production by the pituitary, testing for it seems to make sense. If TSH levels are high, then thyroid hormone levels are probably low. In that case doctors will then test for T4 – the inactive form of thyroid; if T4 levels are low then thyroid hormone is prescribed.
Not so fast says Dr. Holtorf. Holtorf believes that, at times, serum thyroid levels tell us little about thyroid levels in the tissues and cells. Two of those times are when people have fibromyalgia and/or chronic fatigue syndrome.
The Pituitary / Thyroid Issue
The pituitary gland produces thyroid stimulating hormone (TSH) which tells the thyroid gland to produce more thyroid when levels of pituitary T3 decline. The pituitary/thyroid connection is just one source of thyroid hormone though. Over 70% of thyroid hormone is actually produced by the liver.
Holtorf asserts that the pituitary gland is able to maintain or even increase its thyroid production while thyroid levels in the tissues around it are plummeting.
The pituitary/thyroid issue revolves around the enzymes which activate and deactivate thyroid hormone. Two of these enzymes, D1 (liver) and D2 (pituitary), convert the inactive form of thyroid hormone (T4) to its active form (T3). While most of the body including the liver uses D1 to convert inactive thyroid hormone (T4) to its active form (T3), the pituitary gland uses D2.
But what if the D1 enzyme is not doing its job? Simply testing TSH – the thyroid stimulating hormone induced by the D2 enzyme – will miss the fact that everywhere outside the pituitary thyroid levels could be down.
Dr. Holtorf believes conditions like fibromyalgia, chronic fatigue syndrome, stress, pain, autoimmune diseases, inflammation, depression, toxins, etc. suppress and down regulate D1 levels in the tissues, causing the levels of the active form of thyroid hormone to plummet.
To make matters worse Holtorf believes that the pituitary levels of the active thyroid hormone (T3) are unaffected by conditions such as fibromyalgia and chronic fatigue syndrome – resulting in the false negatives he sees on standard thyroid tests, He also believes that because women tend to have lower levels of the DI enzyme they’re more likely to suffer from hidden thyroid problems.
Holtorf asserts that assessing your thyroid hormone levels by measuring TSH is like measuring the temperature of your refrigerator by measuring the temperature of the kitchen. TSH, of course, is what most doctors test for to determine thyroid hormone status.
Holtorf reported on a typical patient of his: a woman suffering from what appears to be the symptoms of hypothyroidism (fatigue, inability to lose weight, cold intolerance, etc.) who often has low-normal TSH, high-normal free T4, low-normal free T-3, high normal reverse T-3, plus markers of thyroid resistance and low resting metabolic rates.
Holtorf believes the levels of active thyroid (free T3) in ME/CFS and FM patients should optimally be in the upper 25th percentile of normal.
Reverse T3 (RT3)
A third enzyme, D3, complicates matters further. During high levels of T4, D3 converts the inactive form of thyroid hormone (T4) to a form of thyroid hormone called reverse T3 (RT3). Holtorf, however, believes that in some conditions such as fibromyalgia and ME/CFS, RT3 becomes pathological and blocks the active form (T3) from binding to thyroid receptors in the body.
Higher RT3 levels and/or higher RT3/T3 ratio’s, then, may indicate poor availability of the active form of thyroid (T3).
The pituitary gland is also the only tissue in the body which does not contain D3, the enzyme which converts inactive thyroid hormone (T4) to reverse T3. TSH levels, then, have no bearing at all on reverse T3 levels. RT3 levels can be high even when TSH levels are normal. Most doctors, however, do not test for RT3.
Reverse T3 is actually an “antithyroid” — T3 is the active thyroid that goes to the cells and stimulates energy and metabolism. Reverse T3 is a mirror image — it actually goes to the receptors, sticks there, and nothing happens. So it blocks the thyroid effect. Reverse T3 is kind of a hibernation hormone, in times of stress and chronic illness, it lowers your metabolism. So many people seemingly have normal thyroid levels, but if they have high Reverse T3, they’re actually suffering from hypothyroidism. Holtorf
Because even small increases in reverse T3 can block the active form of the thyroid hormone from having an effect, Holtorf believes that severe hypothyroidism can be present even when standard thyroid tests are normal.
Transport in the Cells and Stress
Holforf also cites culture work indicating that physiological or emotional stress can inhibit the transport of inactive thyroid hormone into the cell. This suggests that T4 levels can be normal or even high when little T4 is making it into the cells. At these times neither T4 nor TSH levels reflect this reduced uptake into the cells.
Besides, inflammation and physiological stress, glucocorticoid drugs such as prednisone also suppress the levels of active thyroid hormone in the tissues and increase levels of reverse T-3.
Testing
Dr Holtorf on Thyroid Testing
“…. extreme caution should be used in relying on TSH or serum thyroid levels to rule out hypothyroidism in… A wide range of conditions including stress, chronic fatigue syndrome, fibromyalgia, inflammation, autoimmune diseases, depression, diabetes, insulin resistance, and systemic illnesses. Holtorf
More traditional sources of medical information such as WebMD mention only TSH and T4 testing. The Mayo Clinic suggests that most doctors should stop at TSH testing if TSH levels are normal.
Dr. Liptan – a fibromyalgia specialist – tests for TSH, T3 and T4.
Dr. Holtorf’s Indications of Low Thyroid Activity
- TSH =>2 = low tissue thyroid levels (Increased TSH can reflect an attempt by the brain to prod the thyroid gland to produce more thyroid. Holtorf believes TSH levels, however, are poor markers of thyroid problems in ME/CFS and FM.
- T4 (high) = may be associated with low levels of active thyroid (T3) if problems with transport into the cells are present.
- T3 = generally T3 should be in the upper 25th percentile of normal range.
- Reverse T3 should be less than 150.
- Free T3/Reverse T3 =>0.2, when the Free T3 is measured in picograms per milliliter (pg/mL).
- Sex hormone binding globulin (SHBG) = a marker of thyroid tissue levels in women – if <70, low cellular thyroid levels are likely.
- Leptin = > 12 may indicate leptin is suppressing TSH production.
- Iron / Iodine = check for deficiencies (ferritin should be above 70)
- Basal Metabolic Rate
- Relaxation Phase of Tendon Reflex – Holtorf believes this test is a more accurate measure of thyroid functioning than serum tests; should be above 110 msec
Reverse T3 level above 150 or or a Free T3/Reverse T3 ratio that exceeds 0.2 [when the Free T3 is measured in picograms per milliliter (pg/mL)] — may indicate hypothyroidism.
Treatment
If reverse T3 levels are high, then Holtorf believes that thyroid preparations containing the inactive form of the thyroid hormone (T4) should not be given. Instead, only preparations of the active form of time-released thyroid (T3) should be given.
In general, Dr. Holtorf finds that T4 preparations such as Synthroid and Levoxyl rarely work and Armour thyroid, a pig glandular product, is somewhat better, but not adequate for most patients.
That leaves combinations of T4/T3 or straight T3. Holtorf reports that T3 works the best for many of his patients, but that the main source of T3 – Cytomel, a short acting T3 drug, is a poor choice. Instead he usually recommends compounded timed release T3.
He believes, though, that standard blood tests are not a good way to assess T3 dosing regimens.
Other Factors
Reducing Inflammation – Because serum thyroid tests may be inaccurate in inflammatory states lowering inflammation and normalizing immune function can help with thyroid problems. Holtorf has found that low dose naltrexone is able to normalize thyroid functioning at times.
Because gluten can be such a potent inducer of inflammation, Dr. Liptan recommends that everyone with low thyroid embark on a gluten free diet for 8 weeks.
Iron Deficiency – Because iron deficiency impairs thyroid activity, iron levels should be checked. Dr. Liptan wants ferritin levels to be in the 50-100 range; Dr. Holtorf wants them above 70. (Note that both are well above what is often considered “low-normal” (10-50) by many doctors.)
Check out the story of one young POTS patient for whom iron infusions played a critical role in his recovery.
Recovery Story
While thyroid supplementation, when needed, is usually just one part of a treatment plan, occasionally it turns out to be the missing factor in a person’s search for health. Check out a recovery story on the Health Rising website where this turned out to be true.
A New Thyroid Subset?
Check out a 2018 Dutch study which suggested some people with ME/CFS have a thyroid condition called non-thyroidal illness syndrome (NTIC) found in starvation, sepsis and other serious illnesses.
Very interesting. I take Thyroxine, and have for several years. Low thyroid on top of ME/CFS & Fibromyalgia was a nightmare! My PCP is really a godsend, he will investigate changes and/or new symptoms. I was so lethargic and in so much pain that I didn’t leave the house for weeks! I’m usually a pretty functional person with ME/CFS and Fibromyalgia. My doctor ran a standard test, then started me on thyroid medication. I am back to functioning (as well as I can) and thank my doctor for being one of the few that really listens ?
I was diagnosed with Thyroid Cancer a year into having severe ME/CFS. My thyroid was removed because of a large tumor on the left side. After surgery my dose of Synthroid has changed many times and it has a large effect on my CFS symptoms. If my dose is too low, my fatigue is worse. If too high, the anxiety becomes unbearable. Thyroid levels can affect energy in CFS, but in my case it was not the cause of my CFS.
I think that for many people it’s just one of several or possibly many things.
“T3 – generally T3 should be in the upper 25th percentile of normal range.”
I don’t understand this. If 25% of the normal range is unhealthy, why is it part of the normal range?
There are differences of opinion as what normal or rather a healthy level of T3 is. Most doctors think that lower levels of T3 are fine but Dr. Holtorf believes that only T3 levels in the upper 25th percentile of what is considered normal are actually healthy. T3 levels in the lower 75% of what is considered normal may indicate poor thyroid functioning.
I have raised this question with doctor after doctor for years but I cannot get anything more than the most basic TSH and T4 tests done. I lost 2/3 of one lobe of my thyroid gland to cancer 25 years ago, and then developed FM. I have the most diabolical inability to lose weight, and ability to pile it on at the rate of 2 pounds per day if I do not maintain an extremely strict diet. Surely an honest medical system (in this case a State single-provider “free health care” system) would consider me a case for more investigation?
Something else that frustrates me is that although going on a low-carb diet has helped me shed the grossest excess of weight and helped improve my FM conditions, there is a lot of evidence reported on the internet, that a low carb diet worsens hypothyroidism or even causes it. My weight is still excessive but my inability to lose any more, and the ease with which I regain it, has definitely gone to a frightful new level.
I am so much better than I used to be, but I can’t help feeling cheated of something even better still, or easier to maintain than what it is.
Something else that is interesting, from the above article, is that I have constantly shown low iron levels in hair mineral analysis testing in spite of eating a lot of red meat on my diet, and supplementing. I am still experimenting with different iron supplements and dosage levels.
Metabolism really seems to be an issue with you. It would certainly be interesting to see what your T3 levels, and reverse T3 levels are.
Supplementing with iron just doesn’t work for everyone. Some people – as witnessed by the young man in the Iron Man POTS story – need intravenous infusions to bring them up. My Uncle just had one actually; his doctor told him that iron supplementation often doesn’t work.
I didn’t know that about low carb diets though – which I am currently on….
What about me/cfs and undiagnosed hypothyroid connecting to gene mutations like mthfr, c677t and 2D6? Has that ever been considered?
I finally got T3 and T4 tested, also after many years. I would suggest it, doctor would agree and write it on the form for the lab, I would see it written there, but the lab wouldn’t do it. Finally I told the doctor I wanted to do a blood test in which we requested nothing whatsoever but T3 and T4. Then, I figured, they’d have to either do it or tell us why. And that worked! My T3 is just above the bottom quarter, and my housemates are picking up a prescription for me today. Cytomel. So I’m on here looking for what I’d better know about it.
A couple of other very important factors in the thyroid equation are the liver and the adrenals. Much of the T4 to T3 conversion takes place in the liver, and if it is not working properly, or is too bogged down with toxins, it will mess with conversion. And, the adrenals also have to be working correctly in order for the thyroid to work right. They play a huge role in the body’s deciding that it is in crisis and thus needs to convert to Reverse T3, rather than to free T3. Supporting both of these is vital, as is reducing stress (which affects the adrenals), in order to keep the thyroid working well.
I had very elevated reverse T3 years ago and tried T3 supplementation with zero effect.
Don’t you hate when that happens? I have the feeling that it takes a good doctor to be able to adjust dosages….How are your iron (ferritin) levels?
Most cases of hypothyroidism are due to autoimmunity (Hashimoto’s). Treatment with replacement thyroid hormones does not cure the autoimmunity. For most people, managing Hashimoto’s entails drastic changes in diet, lifestyle, and supplementation of the right cofactors. The goal is to reduce immune system activation and inflammation. It is hard work and takes a lot of determination, but I believe that getting a diagnosis of Hashimoto’s disease (through thyroid antibody testing) and then working aggressively to bring the autoimmunity under control (ideally with a natural medicine practitioner specializing in endocrine disorders) can bring tremendous healing. This was my experience, once I learned on my own that my CFS and Hashimoto’s symptoms were virtually the same, and I then focused in on managing autoimmunity and inflammation.
Thanks Kimberly
I was diagnosed with hyporthyroid in 1992. My doctor said I had been experiencing hyperthyroidism for about 6 months prior to my thyroid failing and becoming hypo. Since then Inhave take thyroxin. I was diagnosed with MECFS and fibromyalgia in 2012. I now have only a shadow of a thyroid, barely perceptible at all on ultrasound. Does this suggest that an underlying autoimmune disease or virus ( such as EB virus) could be at work causing both diseases?
I had high levels of RT3 when tested several years ago. The doctor put me on compounded T3, but it did nothing at all for my lack of energy, cold intolerance etc. I hope it helps some, but for me it was an expensive waste of time.
Just about everyone I know with ME/CFS is taking Synthroid it seems. My hypothyroidism started at the age of 12 and was so severe my doctor started me at 9 grains a day of Armour, since that was before Synthroid existed. I’m alarmed because in the past year my TSH jumped from .94 to 8.47 on the dose of Synthroid I’ve taken for years. I just learned this yesterday. She raised the dose a tad and isn’t testing it again for 3 months, which is irritating. I know its dangerous to raise the dosage quickly but It’ll likely take many months and more dosage increases to even have a normal TSH again. I don’t feel much better, even when my TSH is normal, but at least it should remove one layer of fatigue. I don’t think she ever tests for T3 or T4, let alone any of the other tests mentioned. I wish she had ordered some kind of scan of my thyroid since thyroid cancer is one of the risks of taking Bydureon injections for my diabetes. Lately I learned that half an injection controls it just as well and I no longer take it once a week as prescribed, but only when my sugar starts climbing, but this still concerns me. I know this is off the topic of testing but I’d love to hear from anyone else who might be taking a drug such as Bydureon. I call it the lizard spit drug, basically the same as Byetta and some other new ones on the market.
These thyroid test seem important if you have been diagnosed with fibromyalgia, depression. Does anyone know the costs and will most insurance companies pay them?
I tried various dosages of T3 only, T3+T4 and T4 only without much success unfortunately. However perhaps might work for others.
One thing that I read was that some people might need support of their adrenals e.g. with hydrocortisone, if trying thyroid therapy if there were any potential problems with adrenals. There is some evidence to suggest this might be the case with some people with ME/CFS.
I gave my doc a copy of the Newsweek article about Naviaux’s study (re hypometabolism). That gave her the idea to try my on T3. Without the article I don’t think she would have agreed or suggested it.
Do you have a link to the article?
Many people with chronic fatigue and fibromyalgia patients suffer from symptoms of hypothyroidism, even though all their thyroid blood tests are normal. Dr. Denis Wilson discovered a condition which is called “Wilson’s Low Body Temperature Syndrome” or “Wilson’s Syndrome” that often occurs after periods of stress or trauma. Basically these individuals are in a survival mode where their bodies are conserving energy. The symptoms intensify with thyroid replacements in the form of T4. Wilson found that this condition can be reversed by taking for a period of time the active thyroid hormone T3. The T3 used is obtained from a compounding pharmacy that combines the hormone with a slow release agent and is taken twice a day at increasingly larger doses until the body temperature returns to normal or 98.6 degrees, then decreased gradually as the body “resets” its metabolism. Returning my body’s temperature and thyroid function to normal with this protocol was one of the big breakthroughs of recovering from chronic fatigue. It sounds like Holtorf is using a similar method. I am surprised that Wilson’s work is not discussed in this article. http://www.wilsonssyndrome.com
hi darden
i was just reading your comment and had a omg moment! i was diagnosed with fm/cfs when i was 40 i’m 59 now. i know i have something wrong with my thyroid but i can’t get any doctor to help me. i have been under tremendous stress for years more than any one person should be under and i know that years of stress had affected me. i’m losing my hair, losting weight, nails brittle and feel like i’m constantly in flight or fight mode! thanks for your response and link.
Cort I can’t thank you enough for this article on our Thyroid issues and the lack of proper testing, especially for T4, T3 and RT3. I am so fortunate to have had a Naturopath Doctor help me with this difficult problem years ago. Recently, I had 2 eye surgeries and unfortunately, the specialist prescribed prednisone eye drops for me. My hypothyroidism returned and I also developed 6 more allergies which I’ve been cleared of through NAET. I should have contacted my ND about the drops before taking them and I paid dearly for that. Thankfully I’m finally recovering. May I suggest to those who are not getting the right help with their Thyroid issues, to seek out the expertise of a functional medicine doctor. There are many MDs that have crossed over into this field and there are NDs, Homeopath Drs, etc. that can help. Just make sure they are Doctors. How many of us are still in bed because of undiagnosed thyroid problems? It just makes me so sad to even think of this! My heart goes out to all of you, because I was there once.
A list of symptoms would help.
Every time I find one and check myself, I come to the conclusion that most of them don’t apply to me (I have CFS).
Things such as dry skin. Cold intolerance. Sleep problems?
Edie I too have developed so many allergies and was thinking of NAET. Have you been free of your allergies for a long period after receiving treatment as I’ve heard sometimes they reappear.
Hi Dorothy. Most of my allergies treated through N.A.E.T have not returned. Those that did return after 3 months or so, were dairy and sugar, which I chose to completely drop from my diet. I did have to get treated twice for grains as I eat them every day and am particularly sensitive to them. I had an unfortunate health crisis lately because of prednisone eye drops I had to take after 2 eye surgeries. That drug has caused me to be sensitive to bread again. I also developed another 5 new allergies as well, which have been cleared by Naet. I should have phoned my ND about the drugs I was put on and I paid big time for that. I highly recommend Naet, as I’ve been back eating the food I love. Hope this information is helpful.
Hello,
Have fibromyalgia/CFS. It started after a bad flu type virus almost 9 years ago and after the death of my father.
I am now on 100mcg of levothyroxine which has helped somewhat, but only after I had to pester my general practioner for months. They started me on 25mcg. I am in the U.K. When a teenager in the United States I was given some thyroid medication by our family doctor.
Can anyone recommend a good endocrinologist to see in London or environs?
Thank you.
One more complicating factor: Hashimoto’s, an autoimmune condition where your antibodies attack your own thyroid. There’s research that suggests 1/3 of patients with HHV-6A develop Hashimoto’s – best explanation is the antibodies can’t find HHV-6A because it is in hiding, but nobody really knows why. At any rate, I developed Hashimoto’s at least a year after my major collapse with ME.
What to do about Hashimoto’s? The answers are mixed. I was originally told (back in 1995) that we wanted to keep TSH from zapping my thyroid because it would make the problems possible from Hashimoto’s worse – the ultimate fear being thyroid cancer. Thus, my thyroid treatment has been designed to keep TSH very low – and for me, that means taking T3, because (as mentioned by several people already) we seem to have T4-T3 conversion problems (that is, your body stores mostly T4, thyroid with four molecules, but transforms it into T3, thyroid with three molecules, to use it. Which is not entirely correct, but close enough for us in 1995. So I have taken synthetic T3 (Cytomel) since then.
I learned when I started Ampligen that when you are on T3, TSH calms down – but T4 tanks. I learned that because at first they wouldn’t let me in the study with my T4 levels so low. So I also take T4. And that seems to make my T7 panels look okay. (This winter my thyroid tanked on generic thyroid, so now I’m buying the expensive stuff.)
For years all they knew about was T4, so there may be other things your thyroid is doing that we don’t know about. But if you take Amour thyroid (actual animal thyroid), you’re going to get a lot of T4 and very little T3, so that’s not much help for me. Still, I wonder what else we might be missing.
At any rate, the problem posed by Hashimoto’s – that I have to keep my thyroid organ safe from TSH – is solved for now. But I still have an abnormal ANA – probably always will.
Thanks Mary
Mary, by addressing the autoimmunity that is at the root of Hashimoto’s, in addition to the TSH, T4 and T3 levels, you may feel a whole lot better. You can search online for Hashimoto’s autoimmune diet, natural treatment for Hashimoto’s, etc.
I have fibromyalgia but I have always felt that there is something more. I have been back and forth with doctors convinced that it’s my thyroid. I have a family history (both my mom and aunt). My most recent blood test were, TSH was 2.55 and my free T4 was .82 both are in normal range but the free t4 is right on the one end of “normal”. Any feedback/suggestions?
Here’s an article by about this issue:
http://hypothyroidmom.com/top-5-reasons-doctors-fail-to-diagnose-hypothyroidism/
You can also check out The Thyroid Book by Dr. Datis Kharrazian. The kindle version from Amazon is inexpensive. This article https://www.verywell.com/best-way-to-treat-an-underactive-thyroid-3232997 is a great place to start.
Is there any literature or published papers on this topic or Wilson’s Syndrome, which I can show and present to my doctor?
For any patients who have been successful in convincing their doctor to treat their thyroid differently based on this information?
Basic testing for thyroid hormone should be not only the TSH but Free T4, Free T3 and thyroid antibodies. Also Reverse T3 is useful information.
I had my thyroid removed in sept. 2018 Hashimotoes .I am Still having trouble getting my medication correct with my GP should i go to an endocriologist.
My thyroid surgeon has retired.I also had 2 bad cases of Mono in my early twentys
and have never felt the same after that .I have had breast cancer, cervical spine surgery and RA.I am very interested in LDN.
It’s awesome to go to see this website and reading the views of all friends on the topic
of this paragraph, while I am also zealous of getting familiarity.