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<blockquote data-quote="Castaneda" data-source="post: 141331" data-attributes="member: 36807"><p>The problem with the thyroid labs is that they are hard to interpret in isolation. You made a passing remark about low cortisol and high DHEA, but would you mind sharing some specifics? For example, what kind of cortisol measurement was it? If it was a 4-point salivary measurement, did it show low cortisol throughout the day or only in the morning? Further, if the test doesn't look at cortisone, then we are really guessing altogether, because we need to see total metabolized cortisol which includes THE and THF. DUTCH Test does that, albeit not in the most scientific way (i.e spot urine).</p><p></p><p>That being said, your thyroid numbers look good except for free T4, which I prefer to see over 1.5. I don't even flag RT3 as a problem until it goes above 15, although the lower the better in most cases.</p><p></p><p>You can certainly try NDT, but given your free T3 is in the optimal zone, you could run the risk of jacking up your T4 and raising RT3 even higher. It could be that your thyroid receptors are not well expressed (sorry, I'm a geneticist, so that's just how I think). So even with adequate T3 levels, you are more sensitive to that small amount of RT3 clogging them up. In any case, NDT is going to raise your T4 and likely your RT3 as well.</p><p></p><p>One other thing I have seen in my practice is the tendency for high serotonin (and low dopamine) to cause body temperature to drop. I know, I know -- everyone thinks serotonin positively regulates body temps, but that's not my experience (and certainly not the experience of anyone that has ever had serotonin syndrome). Let me explain.…</p><p></p><p>When animals hibernate, their lack of food supply puts stress on their bodies, and this increases serotonin production.</p><p></p><p><a href="https://www.sciencedirect.com/science/article/pii/0091305781903609" target="_blank">https://www.sciencedirect.com/science/article/pii/0091305781903609</a></p><p></p><p>The same things happens with humans in winter (think seasonal depression). The psychiatrists have it all wrong. Serotonin (and lack of dopamine) causes depression in most cases. Most people out there taking SSRIs are overloading themselves. When serotonin elevates, it lowers temperature by decreasing metabolic rate. Google it if you don’t believe me… tryptophan and melatonin are also hypothermic. That’s why hypothyroid people need more medication in the winter. And here’s another tidbit: high estrogen will also raise serotonin, which is why pre-menopausal women are more frequently hypothyroid than men. And men with high aromatase expression tend to have lower body temps. Just a fact. All these things go hand in hand: low dopamine, lower metabolic rate, higher body fat, higher estrogen, etc.</p><p></p><p>Not to rant, but how is your mood? Dopamine agonists like Bromocriptine (or even L-DOPA / Mucuna) can have a heat generating effect. When my temps go south of 98 during the day, I can faithfully get them back to 98.6 or higher by pushing dopamine up. Coffee does that (and also increases cAMP which will push more T4 to T3). Forskolin does it. Exogenous androsterone will do it, though I’d not touch it with T therapy, as that would just tank estrogen.</p><p></p><p>Something else to think about – when there is excessive gut inflammation / irritation, enterochromaffin cells just explode with serotonin (and histamine). Most of the body’s serotonin is made in the gut and all these people out there complaining of low temps with normal thyroid labs never look at the gut. Sometimes, a simple stool test will show a Candida overgrowth, or something more sinister like E. Coli. And as soon as they run a course of antimicrobials, their serotonin goes back down, dopamine comes up, and temps stabilize. So looking at things from the perspective of thyroid can be misleading. Thyroid tends to adjust itself depending on what’s happening elsewhere in the body (with the exception of antibodies).</p><p></p><p>If you want my two cents, I’d take some high-powered Forskolin first thing in the morning as an experiment to see what happens. You don’t want to abuse it (i.e. don't take it more than 12 weeks at a stretch) due to liver stress, but I can tell you this: I didn’t need any thyroid support during the weeks in winter I was using Forskolin. I was taking cold showers and generating heat like a furnace. Why? Because it was pushing all my excess T4 to T3. And it raises dopamine too. </p><p></p><p>You don’t have a whole lot of T4 running around, but that could just be your “normal set point”. It’s still within range. As I said before, you might just be dealing with a metabolic problem outside the realm of thyroid. The body is complex. There are a lot of other things that could cause the problem. Low insulin output, for example. And that happens on low carb / high fat diets. I know a ton of people that have induced hypothyroidism with keto diets. Shoot me for saying that, but labs don’t lie.</p></blockquote><p></p>
[QUOTE="Castaneda, post: 141331, member: 36807"] The problem with the thyroid labs is that they are hard to interpret in isolation. You made a passing remark about low cortisol and high DHEA, but would you mind sharing some specifics? For example, what kind of cortisol measurement was it? If it was a 4-point salivary measurement, did it show low cortisol throughout the day or only in the morning? Further, if the test doesn't look at cortisone, then we are really guessing altogether, because we need to see total metabolized cortisol which includes THE and THF. DUTCH Test does that, albeit not in the most scientific way (i.e spot urine). That being said, your thyroid numbers look good except for free T4, which I prefer to see over 1.5. I don't even flag RT3 as a problem until it goes above 15, although the lower the better in most cases. You can certainly try NDT, but given your free T3 is in the optimal zone, you could run the risk of jacking up your T4 and raising RT3 even higher. It could be that your thyroid receptors are not well expressed (sorry, I'm a geneticist, so that's just how I think). So even with adequate T3 levels, you are more sensitive to that small amount of RT3 clogging them up. In any case, NDT is going to raise your T4 and likely your RT3 as well. One other thing I have seen in my practice is the tendency for high serotonin (and low dopamine) to cause body temperature to drop. I know, I know -- everyone thinks serotonin positively regulates body temps, but that's not my experience (and certainly not the experience of anyone that has ever had serotonin syndrome). Let me explain.… When animals hibernate, their lack of food supply puts stress on their bodies, and this increases serotonin production. [URL]https://www.sciencedirect.com/science/article/pii/0091305781903609[/URL] The same things happens with humans in winter (think seasonal depression). The psychiatrists have it all wrong. Serotonin (and lack of dopamine) causes depression in most cases. Most people out there taking SSRIs are overloading themselves. When serotonin elevates, it lowers temperature by decreasing metabolic rate. Google it if you don’t believe me… tryptophan and melatonin are also hypothermic. That’s why hypothyroid people need more medication in the winter. And here’s another tidbit: high estrogen will also raise serotonin, which is why pre-menopausal women are more frequently hypothyroid than men. And men with high aromatase expression tend to have lower body temps. Just a fact. All these things go hand in hand: low dopamine, lower metabolic rate, higher body fat, higher estrogen, etc. Not to rant, but how is your mood? Dopamine agonists like Bromocriptine (or even L-DOPA / Mucuna) can have a heat generating effect. When my temps go south of 98 during the day, I can faithfully get them back to 98.6 or higher by pushing dopamine up. Coffee does that (and also increases cAMP which will push more T4 to T3). Forskolin does it. Exogenous androsterone will do it, though I’d not touch it with T therapy, as that would just tank estrogen. Something else to think about – when there is excessive gut inflammation / irritation, enterochromaffin cells just explode with serotonin (and histamine). Most of the body’s serotonin is made in the gut and all these people out there complaining of low temps with normal thyroid labs never look at the gut. Sometimes, a simple stool test will show a Candida overgrowth, or something more sinister like E. Coli. And as soon as they run a course of antimicrobials, their serotonin goes back down, dopamine comes up, and temps stabilize. So looking at things from the perspective of thyroid can be misleading. Thyroid tends to adjust itself depending on what’s happening elsewhere in the body (with the exception of antibodies). If you want my two cents, I’d take some high-powered Forskolin first thing in the morning as an experiment to see what happens. You don’t want to abuse it (i.e. don't take it more than 12 weeks at a stretch) due to liver stress, but I can tell you this: I didn’t need any thyroid support during the weeks in winter I was using Forskolin. I was taking cold showers and generating heat like a furnace. Why? Because it was pushing all my excess T4 to T3. And it raises dopamine too. You don’t have a whole lot of T4 running around, but that could just be your “normal set point”. It’s still within range. As I said before, you might just be dealing with a metabolic problem outside the realm of thyroid. The body is complex. There are a lot of other things that could cause the problem. Low insulin output, for example. And that happens on low carb / high fat diets. I know a ton of people that have induced hypothyroidism with keto diets. Shoot me for saying that, but labs don’t lie. [/QUOTE]
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