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<blockquote data-quote="Marco N Cognito" data-source="post: 89239" data-attributes="member: 13"><p>Many thanks for the in-depth replies to my concerns and putting things in a common sense perspective.</p><p></p><p>According to the authors of a clinical trial <a href="https://clinicaltrials.gov/ct2/show/NCT01769157" target="_blank">https://clinicaltrials.gov/ct2/show/NCT01769157</a> , L-carnitine and thyroid hormone tended to antagonize reciprocally in human body. This is obviously a conundrum for anyone who is hypothyroid but that has benefited from taking L-carnitine. By the way, here are the papers regarding thyroid hormone suppression of L-carnitine: </p><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/15591013" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/15591013</a></p><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/11201848" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11201848</a> </p><p></p><p>Given the above, do you still think the reported suppressive effects can be "overridden" by thyroid replacement dosage adjustment?</p><p></p><p>One other issue of concern regarding L-carnitine is some recent data which shows that in the gut it transforms to TMAO which has some cardiac toxicity: <a href="https://www.ncbi.nlm.nih.gov/pubmed/25636076" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/25636076</a></p><p></p><p>Thyroid optimization is a big focus of mine right now (long time struggling with this). I recently tried adding some T4 to my 1 grain natural desiccated thyroid and I felt worse and my rT3 increased. I cannot seem to get my ferritin levels up no matter how much iron I take, for one, as I know how important that is for thyroid function. I feel I have been and still am chronically under-dosed, but it's a catch-22 at this point when increasing thyroid replacement with either NDT or T4 may backfire if there are other possible imbalances making replacement work against me (on a side note, I have already tried both T3 and T4 monotherapy as well as T3 added to NDT). In addition, I have a genetic methylation defect (MTHFR C677T +/+) and am taking various supplements to support proper methylation, however, it would be great to get some insight with respect to supplement navigation. Even guys like me that have a lot of knowledge still need a coach.</p><p></p><p>As far as consideration of TRT, one huge hold-back is that I suffered from an "idiopathic" DVT that presented out of nowhere back in 2012 and have been on anticoagulant prophylaxis (Xarelto 10mg qd) since 2014. I am at a standstill of what to do or not to do next, as I have not been able to determine the cause of the thrombophilia in the first place (had every test under the sun to date and we cannot determine whether it's familial, acquired, or a combination). I am not even sure if I should remain on an anticoagulant and most hematologists aren't of any help since they really only treat existing pathologies (all are also oncologists). I am looking into getting with a research facility with a major university for a more extensive workup and evaluation to determine the etiology, but even then, I may reach a dead end. While it may not change my direction whether to use TRT or not, at least knowing the cause would put things in perspective. I don't know if Clomid would make any difference with respect to this.</p><p></p><p>Would you consider your practice and treatment approach to be in the realm of functional medicine?</p><p></p><p>Again would appreciate your thoughts.</p></blockquote><p></p>
[QUOTE="Marco N Cognito, post: 89239, member: 13"] Many thanks for the in-depth replies to my concerns and putting things in a common sense perspective. According to the authors of a clinical trial [URL]https://clinicaltrials.gov/ct2/show/NCT01769157[/URL] , L-carnitine and thyroid hormone tended to antagonize reciprocally in human body. This is obviously a conundrum for anyone who is hypothyroid but that has benefited from taking L-carnitine. By the way, here are the papers regarding thyroid hormone suppression of L-carnitine: [URL]https://www.ncbi.nlm.nih.gov/pubmed/15591013[/URL] [URL]https://www.ncbi.nlm.nih.gov/pubmed/11201848[/URL] Given the above, do you still think the reported suppressive effects can be "overridden" by thyroid replacement dosage adjustment? One other issue of concern regarding L-carnitine is some recent data which shows that in the gut it transforms to TMAO which has some cardiac toxicity: [URL]https://www.ncbi.nlm.nih.gov/pubmed/25636076[/URL] Thyroid optimization is a big focus of mine right now (long time struggling with this). I recently tried adding some T4 to my 1 grain natural desiccated thyroid and I felt worse and my rT3 increased. I cannot seem to get my ferritin levels up no matter how much iron I take, for one, as I know how important that is for thyroid function. I feel I have been and still am chronically under-dosed, but it's a catch-22 at this point when increasing thyroid replacement with either NDT or T4 may backfire if there are other possible imbalances making replacement work against me (on a side note, I have already tried both T3 and T4 monotherapy as well as T3 added to NDT). In addition, I have a genetic methylation defect (MTHFR C677T +/+) and am taking various supplements to support proper methylation, however, it would be great to get some insight with respect to supplement navigation. Even guys like me that have a lot of knowledge still need a coach. As far as consideration of TRT, one huge hold-back is that I suffered from an "idiopathic" DVT that presented out of nowhere back in 2012 and have been on anticoagulant prophylaxis (Xarelto 10mg qd) since 2014. I am at a standstill of what to do or not to do next, as I have not been able to determine the cause of the thrombophilia in the first place (had every test under the sun to date and we cannot determine whether it's familial, acquired, or a combination). I am not even sure if I should remain on an anticoagulant and most hematologists aren't of any help since they really only treat existing pathologies (all are also oncologists). I am looking into getting with a research facility with a major university for a more extensive workup and evaluation to determine the etiology, but even then, I may reach a dead end. While it may not change my direction whether to use TRT or not, at least knowing the cause would put things in perspective. I don't know if Clomid would make any difference with respect to this. Would you consider your practice and treatment approach to be in the realm of functional medicine? Again would appreciate your thoughts. [/QUOTE]
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