Category Archives: general health & nutrition

In Treatment of Hypothyroidism Need For t3 Could Be Genetic


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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.

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Family Nutrition

Weight Management, Family Style


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Weight management is a key component of a healthy lifestyle although keeping one’s weight on track is often a frustrating and perplexing task. To get the whole family involved in the weight management effort may seem almost impossible.
Simply identifying a younger member of the family as overweight can be a challenge.

A 2015 study from the U.K. found that 31% of parents underestimated their child’s weight status. For a child who is “very overweight” per government guidelines there was an 80% chance the parent would classify the child as healthy weight. Teens themselves are not very good at identifying themselves as overweight as 80% of overweight teenaged boys and 71% of overweight teenaged girls perceived themselves as normal weight. Recognizing that a child is overweight is crucial to preventing the progression to adult obesity. 72% of overweight kindergartners were obese by the time they reached 8th grade. Continue reading →

Children eating more healthy

Share Childhood Food Memories to Help Combat Childhood Obesity


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Without question the eating habits we develop as kids helps determine if we are going to be a heavy adult. Almost a third of children and adolescents in the US are classified as either overweight or obese (JAMA 2014; Ogden, CL).

Many of these children become obese adults. If a child’s parents are heavy their risk is doubled for becoming an overweight adult.

Metabolism.com is involved in finding ways to reduce childhood obesity.

The first step is to raise awareness of the dangers of childhood obesity and how crucial it is for young people to learn how to eat properly. For this reason we are kicking off a Facebook and Instagram campaign called “ Food Flashback”.

Food Flashback means sharing memories of how each of us first learned about food and nutrition. Most of us have some vivid recollections of family meals, watching our parents cooking, favorite foods and snacks as a child.

Survey Reveals 84% Feel Doctors in US Overly Influenced by Pharmaceutical Industry


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survey

By Gary Pepper, M.D.

A survey by metabolism.com reveals that a vast majority of the public believe doctors in the US are overly influenced in their decisions by the pharmaceutical industry.  500 visitors to the website participated in the survey.  419 (84%) answered yes to the question, “Do you feel that US doctors’ decisions are overly influenced by pharmaceutical industry money?”  56 (11%) were not sure, and only 20 (4%) voted no to this question. Continue reading →

Highlights of the 2015 International Thyroid Congress


Categories: metabolism, T3, thyroid
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Update from the 15th International Thyroid Congress, Orlando Florida, October, 2015
By Gary Pepper, M.D.
Welcome     I just returned from Orlando, Florida, where I attended the 15th International Thyroid Congress and want to provide a report of my experience, to readers of metabolism.com. This was truly an international event with an estimated 50% of the attendees from outside the U.S. Organizers of this event describe it as, “Renowned experts in thyroid function and biology, diagnosis and management of thyroid disease, and novel therapies for treating thyroid cancer are gathering at the 15th International Thyroid Congress (ITC) to present, discuss, and debate the latest advances in thyroidology. Held every five years, the ITC is a collaborative meeting of the four world thyroid associations; the ATA (American Thyroid Association), Asia-Oceania Thyroid Association (AOTA), European Thyroid Association (ETA), and Latin American Thyroid Society (LATS).”
I was particularly excited to be attending this conference this year since my colleagues, Drs. Paul Cassanova and Kathryn Reynolds and I were presenting our study on the use of combination T3 plus T4 for the treatment of underactive thyroid (hypothyroidism).
Here are some papers I found to be of particular interest; Continue reading →

New Diabetes Medications Give Early Indication of Danger


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warning signby Gary Pepper, M.D.
Chances are, if you have diabetes you have heard about a new class of drugs to treat high blood sugar (glucose). The first of these new medications to gain FDA approval in the U.S., in 2013, is Invokana manufactured and promoted by Janssen Pharmaceuticals and Johnson & Johnson. In the last year and a half the number of these drugs known as SGLT2 inhibitors, has multiplied faster than tribbles to include Farxiga, Xigduo, Jardiance and Invokamet. Prescriptions for these medications are also showing explosive growth, increasing 300% since January 2014. A recent forecast by Express Scripts calls for this one class of drugs to be responsible for about a 20% increase in the yearly cost of prescriptions per all members per year for the next 3 years . The explanation behind the eager adoption and dissemination of this brand new class of medications may eventually serve as a tragic lesson for diabetic patients and for the medical community in general.
Continue reading →