Medical specialists increasingly accept that some patients being treated for hypothyroidism continue to be symptomatic and â€œunhappyâ€. The degree to which patients experience this problem while on conventional treatment for hypothyroidism with levothyroxine (Synthroid, Levoxyl, Unithroid, T4) has motivated many specialists to look for other approaches to treatment such as adding T3 (Cytomel, liothyronine) or switching to desiccated thyroid extract (Armour, WPthyroid, Westhroid
Not all experts are convinced looking for new treatment options for hypothyroidism is the right approach. (more…)
Dr. Gary Pepper and Dr. Paul Aoun discuss recent findings about thyroid hormone treatment at the 15th International Thyroid Congress
According to experts, 10 to 20% of hypothyroid individuals fail to respond completely to T4-only (levothyroxine, Synthroid) treatment. Dr. Anthony Bianco, the president of the American Thyroid Association, and his associates believe this is due to genetic variations in the way thyroid hormone is converted in the body from T4 into T3. T3 is the much more potent form of thyroid hormone and unless the cells of the body receive enough T3, normal function cannot be achieved and symptoms of low thyroid such as fatigue, mental fogginess, constipation, muscle aches etc, persist. Based on the research conducted by Dr. Bianco and colleagues it is thought that in those with the genetic trait making T4 treatment ineffective, blood tests would show low T3 levels. (more…)
By Gary Pepper, M.D. The views and opinions expressed here are those of the author and may not reflect the opinions of your health professional. Please consult your own doctor before embarking on any new exercise routine.
Lack of energy and inability to lose weight are constant challenges for many people and are every day complaints encountered in the doctorâ€™s office. Studies show that almost everyone can find some relief from these problems by accessing the healing properties of physical activity. In my experience, mentioning the need for â€œmore exerciseâ€ often results in rolling of the eyes, sighing, shrugging, snorting or worse yet, the hundred yard stare. Yes, we all know exercise is important but who has the energy for that? It seems like a vicious cycle. What is surprising is that when done correctly, exercise can actually improve energy with the additional advantage of promoting weight loss, and restoring tone and stamina. It is helpful to remember that the human body was designed for a lot more physical activity and a lot less food than we are privileged to experience in present day life. It therefore takes will power and knowledge to maintain the environment required for optimal health. Here are eight steps to get in the swing of regular exercise. Some suggestions may surprise you. (more…)
A guest contributor, Jim Rollince, shares this informative article on how the amount of light in our environment can have a big impact on health.
Ambient Light During Sleep and The Affect on Metabolism
By Jim Rollince of Gym Source, distributor of home gym equipment, including treadmills, ellipticals and other home gyms.
Frustrated that your exercise routine and constantly calorie counting has not yielded any weight loss results? Are you in fact gaining more weight then before you began exercising and monitoring your food consumption? The key to your weight gain could be a result of an external factor that you never took into account, the exposure to light at night.
New research in sleep science has shown that prolonged exposure to light during the regular nighttime sleeping hours may cause weight gain. This weight gain occurs independent of daytime calorie consumption and physical activity.
These research findings came out of a study by the Proceedings of the National Academy of Sciences. The study tested animals, and the findings have begun to raise discussion from the scientific community based on whether the human body experiences metabolic sluggishness and weight gain as a result of too much light exposure at night.
A research team from Ohio State University discovered that mice exposed to a dim light during the course of a night for roughly a two-month period, gained 50 percent more body mass than mice exposed to a regular light-dark cycle. “Although there were no differences in activity levels or daily consumption of food, the mice that lived with light at night were getting fatter than the others,” said Laura Fonken, a neuroscience doctoral student at Ohio State and director of the study.
Although the lab mice were exposed to nighttime light they did not become less active nor eat more. However, they did eat at times when they normally wouldn’t. In fact, in one part of the study when the mice were exposed to light at night and then restricted from eating with the exception of their normal feeding times, they did not experience more weight gain.
“Something about light at night was making the mice in our study want to eat at the wrong times to properly metabolize their food,” Randy Nelson, professor of neuroscience and psychology at Ohio State and co-author of the study.
The researchers found that levels of the stress hormone corticosterone were not different among the mice exposed to the dim light and mice exposed to standard light-dark. This finding was surprising for the research team since corticosterone is connected to changes in metabolism. The research has shown that changes in metabolism have the potential to cause weight gain independent of corticosterone levels.
What is the link between dim light at night and fat-causing changes in oneâ€™s metabolism? The Ohio State research team postulates that the presence of light during the night works to disrupt hormone melatonin. Hormone melatonin plays a significant role in the functioning of the metabolism. To this end, light exposure at night could in fact disrupt expression of clock genes, which aid in controlling the time animals choose to be active and eat.
Dr. Nelson furthers her comments by saying that if her teamâ€™s research results are confirmed, eating late at night is a serious contributing factor to obesity. “Light at night is an environmental factor that may be contributing to the obesity epidemic in ways that people don’t expect,” he said. “Societal obesity is correlated with a number of factors including the extent of light exposure at night.”
Past research similar to this study have been prolonged television and computer use as contributing risk factors for obesity. Yet these studies were centered in the idea that engaging in prolonged television or computer usage contributed to a lack of physical activity. The current connection between weight gain and the light coming from a TV or computer, is related to the disruption of the metabolism via the negative bodily effects of getting too much light exposure at night and eating at the wrong time.
“Clearly, maintaining body weight requires keeping caloric intake low and physical activity high, but this environmental factor may explain why some people who maintain good energy balance still gain weight,” Dr. Nelsonâ€™s press statement.
Lots of members at metabolism.com with hypothyroidism ask what is their correct thyroid hormone dosage. For those who are still confused I am posting the latest Q and A addressing this issue.
Member ecchho received radioactive iodine for hyperthyroidism (over-active thyroid) and as commonly happens, developed hypothyroidism (under-active thyroid). Despite t4 levels which appear to be normal symptoms persist, so ecchho inquires about ways of dealing with this common problem.
Here is the Q and A regarding ecchho’s post:
Hi Dr. Pepper:
I had Graves disease at 23 and then had RAI at 28 and have been on synthroid for 18 years. I did try ARmour once, but I found it had too much t3 (I think the pig’s ratio of t4 to t3 is much more potent than humans) and I actually had a real hard time regulating. I don’t have a thyroid anymore, and I take 225 synthroid. i still suffer a bit with impossible weight loss (despite running, dieting, etc) and some depression that feels quite hormonal at times. My dr. brought up adding t3 last visit and tested me, and then said, oh, you don’t need any xtra t3, you seem to be converting fine.
what are the levels that the t3 should be, and is this free t3 or t3? thanks.
My reply to Ecchho’s post:
Your question regarding the correct level for thyroid functions, is frequently raised on this website. I would respond to your question with this question, ” What is the correct shoe size?” Obviously, the answer is, whatever shoe size fits best. Similarly with thyroid function, everyone has a different “comfort zone” where their body functions best. That is their “correct” thyroid hormone level. You also refer to a t4 to t3 ratio for pigs versus humans. These ratio’s are averages of several hundred individuals (human or pig)and do not apply to any particular individual. Some people function better at a t3 to t4 ratio which is higher than the average. As pointed out in my article,https://www.metabolism.com/2009/11/07/breakthrough-discovery-thyroid-hormone-therapy-part-2/ , there is recent evidence that due to genetic differences, a percentage of the population does not convert t4 to t3 efficiently and therefore are likely to require t3 supplementation when treated for hypothyroidism.
Rather than spend the money for genetic testing to discover whether the genes for conversion of t4 to t3 are abnormal, some doctors recommend simply adding an appropriate dose of t3 to the standard t4 (levothyoxine)treatment and following the patient for improvement in clinical symptoms. You might want to consider discussing this approach with your doctor.
The mission of the The Thyroid Project is to encourage sharing of information and experience between the public and the medical community about the treatment of hypothyroidism (low thyroid function). For at least the past few decades there is a growing awareness of â€œsomething missingâ€ in the way suffers of hypothyroidism are treated for their disease.
Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
Without effective intervention the early stage of type 2 diabetes known as prediabetes carries a high risk of progressing to outright diabetes. Metabolism.com provides an up-to-date summary of recommendations from national authorities, for preventing and possibly reversing this life long affliction
Diabetes can be defined simply as elevated blood sugar levels. What exactly is high blood sugar and when should someone be concerned about their level? Does having prediabetes mean diabetes is around the corner? Metabolism.com tackles this tricky but important topic in this comprehensive review.
By Gary M. Pepper, M.D. Ozempic, Rybelsus, Trulicity, Wegovy, Saxenda are the central players in the weight loss craze sweeping across the globe. Metabolisim.com has been monitoring this phenomenon from its beginnings in 2008 with its report “Lizard Spit Reduces Blood Sugar and Appetite”, regarding the first drug in this class, Byetta (exenatide). Caught In the middle of the current chaos are the medical experts who treat diabetes and have been prescribing these medications for more than a decade. Here is a brief commentary from one such board certified endocrinologist; “I started treating Type 2 diabetics with GLP-1 agonists more than 10 years ago. In some respects, these medications have revolutionized the treatment of diabetes by lowering blood sugar effectively and promoting weight loss at the same time, a unique combination of benefits. Not everyone benefits from these drugs to the same degree unfortunately, and I have seen lots of patients experience unacceptable side effects from them. Nothing though, has prepared me for what is happening now. Too often, I find myself confronting someone who expects me to prescribe one of these drugs just so they can lose weight. Sadly, one extreme example was someone who, despite battling a life threatening medical condition, was insistent on getting a prescription. At the same time my diabetic patients are scrambling to find a place to buy their medications if they can even afford it. It is disheartening, to say the least, and I dread the negative interactions with some of my patients I now face almost daily.”
Off- Label Use
The FDA is the U.S. government’s department tasked with evaluating and approving drugs for specific medical conditions. When a new medication is approved for treating a medical condition by the FDA the agency will, at the same time, set strict guidelines for exactly which patients may use the newly approved drug. When a medication is used “off-label” it means that these limitations are being overridden by the provider for a potential benefit which outweighs the drugs risks. It is a general misconception that off-label means illegal; it does not. This practice has been going on for ages and more than 20% of prescriptions in the United States are prescribed off-label. A common example is the use of beta-blockers (approved for heart problems) for the treatment of performance anxiety.
GLP-1 agonist drugs, as discussed recently by metabolism.com. were originally approved for the treatment of Type 2 diabetes in adults. In the past few years most of these same medications have gained unprecedented popularity for their “off-label” weight loss benefit. Of the 5 GLP-1 agents presently in U.S. pharmacies only Wegovy (semaglutide) and Saxenda (liraglutide) are FDA approved for treating obesity. Of these two, Wegovy is the newer and had been much more popular that its sister drug Saxenda, probably due to being dosed only once weekly compared to daily for Saxenda and less likely to cause side effects. Due to Wegovy’s soaring popularity, its manufacturer, Novo Nordisk, increased the price of Wegovy two times since its initial release.