Thyroid Hormones

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Thyroid is your metabolic accelerator. Increase your thyroxine and the more fuel you burn, take the foot off the thyroid pedal, the less fuel you burn. However, your thyroid hormone is much more than just an accelerator pedal. It regulates how fast your brain goes, how fast your reflexes are and what your day feels like. The majority of the natural thyroid gland output is T4 ( Levothyroxine). But a good proportion of the output is also T3 (Triiodo thyronine). There are de-iodinases at the tissue level to convert T4 to T3. However some tissues depend on your thyroid gland output of T3. The activity of the deiodinase hormones depend on the tissue and on genetic factors and may well contribute to the sensitvity of individuals to different levels of thyroid hormone replacement. If the Thyroid gland has been destroyed ( Radioactive -iodine treatment/ surgery / severe thyroiditis) your body is entirely dependent on the tissue enzyme for its T3. If you were born with the wrong set of genes, however high your T4 ,your T3 may be low.

Do I need T3 prescription in addition to Levothyroxine (T4)?

The evidence regarding T3 prescription is not very clear. Very few studies have actually shown benefit. Most of the benefit has been psychological benefit. However trials are designed to study populations and may not predict the requirement for the individual. The answer to your question can only be determined after tests.

Why do I feel dreadful despite taking my tablets at the right time?

Your endocrinologist needs to spend some time with you to determine the answer to this question. Do you have any other Medical conditions? Are you absorbing your medications well? Is your Deiodinase enzyme working adequately? Are there any psychological issues? Are you sleeping well?

Did you know?

During pregnancy, the baby takes over the mother’s thyroid to ensure the baby’s brain grows properly? If you don’t have a thyroid, your baby may be at risk as your thyroid cannot increase production.

 

Science Direct 2015

What will your endocrinologist do?

  • Take a good history
  • Examine you and your thyoid
  • Check for T4, TSH, T3 and antibodies
  • Check other hormones if required

Immune Attack on the Thyroid

The Thyroid gland like other organs is susceptible to immune attack. This may occur

  • during a viral infection where the gland becomes the battlefield of your body’s robust war on a virus
  • in Autoimmune attack ( Hasimotos disease or Graves disease)

Thyroiditis

The gland may become swollen , tender and may produce more hormone initially as all the stored hormone is poured out into the blood stream. Under sustained attack, the gland gets damaged and stops producing thyroid hormone

Graves disease

This is a specific auto immune disease where the antibodies act like Thyroid Stimulating hormone (TSH). This leads yto enlargement of the gland and persistant increased production of T4 and T3 from the gland.

 

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