Butterfly Effect: The Medication Used To Boost The Thyroid Hormone

In Part I, I looked at the thyroid gland and hormones, the regulation of thyroid hormone levels, signs and symptoms of thyroid disease, and thyroid testing. If you feel that your thyroid may not be functioning optimally, based on the symptoms listed in Part I, you have some options.

You can try to fix things yourself through a change in diet and supplementation. You can obtain thyroid medication and self-medicate. Alternatively, you can seek professional assistance and medical intervention.

With all options, a blood test with thyroid panel is recommended. I'll examine these options in greater detail in this article.

Nutritional Support

Nutritional support is always a good place to start when trying to improve your health. You may be able to improve the function of your thyroid through some diet modifications. One of the earliest modifications most people use without thinking is iodized salt.

Iodized salt was first manufactured in 1924 to prevent a prevalent health problem of the time period, goiters. The tradition of iodizing salt continues to this day and provides most people with an adequate source of iodine for thyroid hormone production.

In the United States, iodized salt contains 1 part in 10,000 iodide, in the form of potassium iodine.

The basic material required for making thyroid hormone can be determined by how your body makes the hormone. The two essential items needed are iodine and the amino acid, tyrosine.

In a process known as the iodination of tyrosine, an iodine atom binds with tyrosine to form monoiodotyrosine. The addition of another iodine atom forms diodotyrosine. Finally, two diodotyrosine molecules combine to form thyroxine (T4).

With today's emphasis on healthy diets, many individuals now restrict their salt, and in-turn, iodine intake. But with the healthier diet, many of the food sources that are particularly useful for maintaining thyroid health are probably consumed.

This healthy diet should include seaweed, kelp, garlic, radishes, seafood, watercress, egg yolks, and mushrooms.

L-Tyrosine, the other part of the hormone, is a non-essential amino acid; your body makes it from phenylalanine. The L-form is the isomer found in food, and is generally the form used in our bodies.

Tyrosine is found in a wide variety of foods with fish, poultry, almonds, avocados, bananas, and most dairy products being good sources. Essential fatty acids are another food item that is recommended for improved thyroid performance.

Even if you increase your intake of these building blocks for thyroid hormone, its not automatic that more will be produced and released. Your body is pretty smart, and will only make enough thyroid hormone to fulfill use and storage demands. In addition, when dieting, your body will slow its release of thyroid hormone to avoid starvation.

Several food items have micronutrients that have been found to degrade thyroid function. It has been suggested in the literature that raw cabbage, peanuts, soybeans, turnips, mustard, cassava root, and millet be avoided or consumed in limited quantities. Cooked versions of these foods are usually fine.

Many of these foods contain isoflavones, chemicals that act as hormones once consumed. Isoflavones have been known to inhibit peroxidase, which is essential in making T3 and T4. Additionally, data has linked some isoflavones to goiter and cancer development in animals¹.

In addition to food items, some environmental factors should also be avoided. Fluoride and mercury exposure should be minimized. You can find these elements in most tap water systems, and a home water filtration system is beneficial in removing these elements.

Additionally, monitor the amount of seafood consumed to minimize potential mercury exposure from this source.

Medication

Many bodybuilders take thyroid hormone in hopes of increasing their metabolism and reducing their bodyfat percentage for a contest. It is good in theory and generally harmless over a short duration, but in order to lessen the likelihood of muscle catabolism, a blood test in conjunction with use is needed.

A blood test will tell you if you are taking excess thyroid hormone and are hyperthyroid - an undesirable, catabolic condition.

There are three types of medication used to boost circulating thyroid hormone:

T4

Common names

Synthroid, Levoxyl, Unithroid, Levothroid, and Euthyrox

T3

Common names

Cytomel, Cynomel, Cyronine, Cytomel Tabs, Euthroid, Linomel, Liothyronin, Neo-Tiroimade, Ro-Thyronine, T3, Tertroxin, Thybon, Ti-Tre, Tiromel, Tironina, and Trijodthyronin.

Powdered Thyroid

Common names

Armour Thyroid, S-P-T, Thyrar, Thyroid Strong (animal thyroid gland with a set T4/T3 mix).

Based on their experience, physicians generally prescribe either T4 or Powdered Thyroid, but generally not both. Some will prescribe T4 and T3 simultaneously. When a physician prescribes both T3 and T4, the type of abnormal thyroid condition being treated usually dictates it.

Bodybuilders prefer the active hormone, T3, when preparing for a contest because it is the more potent hormone.

Taking T4

T4 is the most often used medication for hypothyroid conditions. Most of the mainstream physicians and endocrinologist prescribe T4. Prescribing T4 makes establishing and maintaining a proper dosing easier, and it's a rare condition when your body cannot convert T4 to T3 at the cellular level.

However, when there is difficulty converting T4 to T3, either T3 must be added to the therapy schedule or Powdered Thyroid must be prescribed. Additionally, most alternative medicine thyroid doctors believe that the powdered is a more natural way to treat thyroid disease.

When prescribed, T4 is a once a day medication. Most people take it first thing in the morning on an empty stomach. There is an option to take it sublingually to get better absorption.

To do this, the T4 tablet can be placed under the tongue and allowed to dissolve and be absorbed at a slower pace. Sublingual absorption avoids complications with digestion.

Interactions Of T4

Be aware that when and how you take medication does influence its effectiveness. For example, thyroid medication should not be taken with calcium or iron. Both of these minerals bind with thyroid hormone and make it unavailable for your body's use.

Thus, you should avoid milk products two hours before and after taking thyroid medication. There are also some medications that alter T4 levels.

Aspirin, danazol and propanolol have been shown to increase T4 levels and furosemide, methadone, lithium, aluminum-containing antacids, colestipol, and rifampicin have been shown to decrease T4 levels.

There are also some unique interactions. Progesterone and estrogen are substances that can bind with T4, but also tend to increase T3 levels. Anabolic steroids tend to decrease thyroid hormone levels. Finally, thyroid hormone can suppress insulin, an important consideration for diabetics and bodybuilders using insulin.

Finally, if diagnosed with hypothyroidism, you will be taking medication for the rest of your life.

Taking T3

Cytomel (T3) is rarely prescribed on its own to address thyroid problems; it is usually prescribed with T4. In the past, cytomel was a scheduled treatment for obesity; however, an increase in heart complications and cardiac stress forced withdrawal of T3 for that application.

T3 works at the cellular level by increasing the metabolism of protein, carbohydrates, and fats, as well as increasing heart rate and blood flow. T3 is an excellent fat burner since your metabolism is greatly increased while using it.

This benefits bodybuilders in that they can afford to be on a higher calorie pre-contest diet since they'll burn excess calories with a higher metabolic rate. But remember, T3 is catabolic (you can potentially lose significant muscle mass) and long-term use can decrease bone density as well.

Cytomel is best taken several times a day. Levels of T3 will peak roughly 2 hours after ingestion and will be depleted within 4 hours. To optimize the availability of T3 and maintenance of T3 levels throughout the day, multi-dosing is a recommended course of action.

Multi-dosing avoids having total dependence on your body converting T4 to T3.

Self Medication

For those self-medicating, start with a low dosage, about 12.5 or 25 mcgs. per day and increase by half or one tab per day every 5th or 6th day. Ensure that you don't go over 100 mcgs. per day at the very most and use multi-dosing throughout the day.

You should also ramp down when ending a cycle of T3 to help recover thyroid function. Consider some form of post cycle therapy (PCT) specific for the thyroid that includes dietary measures, as suggested earlier, and supplements like forskolin and gugglesterones.

Although T3 is not a steroid, there is some anecdotal evidence that T3 does enhance steroid use. This may be possible because of the increased amount of protein metabolism while using T3.

You will often read of bodybuilders stacking T3 with an anabolic steroid cycle. Additionally, clenbuterol is another product that is often stacked with T3 to form a very effective, pre-contest fat-loss regime.

Most bodybuilders have used this drug safely and effectively. There are stories of people having problems with the thyroid gland being "shut down" after T3 usage. From examining the literature, it appears that recovery is a more probable event, if there isn't a genetic predisposition for thyroid disease.

Family History A Factor

Consider your family history before doing a T3 cycle. If diabetes or thyroid disease runs in your family, a T3 cycle is not recommended. Also remember that roughly 10% of the public is susceptible to thyroid disease. You may be one of the unlucky ones, consider your odds.

If you do self-medicate, don't jump into big doses right off the bat. Ramp you dosages in small increments both on the way up and when coming down. Watch for symptoms and side effects that can include tremors in the hands, heart palpitations, diarrhea, significant weight loss, nausea, very high perspiration (more than normal perspiration is expected), and headaches.

Cut back on your dosage immediately to reduce or eliminate these side effects. Keep your protein intake high and seek medical attention if you don't feel right while on T3 or after your self-medication.

Powdered Thyroid

One of the more popular and known powdered thyroid products is Armour thyroid. It is derived from desiccated pork thyroid glands. Armour Thyroid is a prescription medicine.

The manufacturing process ensures there is a consistently potent medication from tablet to tablet and lot to lot. Analytical tests measure actual T4 and T3 activity to ensure this consistency.

Different lots of thyroid powder are mixed together and analyzed to achieve the desired ratio of T4 to T3 in each tablet. Armour Thyroid's current ratio of T4 to T3 is 4.22:1 (4.22 parts of T4 to one part of T3).

There are powdered thyroid supplements available. Some of these supplements are thyroid gland specific; others are a mix of powdered glands. The drawback with these supplements are that they have unknown quantities of hormone.

However, they do provide an alternative to consider for improved thyroid function or PCT.

Hyperthyroidism Treatment

There is not much call or interest in the bodybuilding community to treat a condition that is beneficial for the sport. However, for long-term health, hyperthyroidism does need to be treated, particularly if goiters are developed.

There are four common methods of treating hyperthyroid: Anti-thyroid drugs, Radioactive Iodine, Beta-blockers and surgery². A short discussion of these methods follows.

Anti-Thyroid Drugs

The two leading anti-thyroid drugs are methimazole and propylthiouracil, trade name Tapzaol and PTU. These drugs work by blocking the thyroid gland's ability to make new hormone. Additionally, they do not cause permanent damage to the gland. However, they are not a permanent solution to hyperthyroidism.

Radioactive Iodine

Radioactive Iodine is another way to treat hyperthyroidism. Radioactive iodine is taken orally, and some uptake of the radioactive iodine by the thyroid gland will occur.

The radioactive iodine will then damage the cells that have taken it up and hopefully reduce the size of any thyroid nodules or goiter, and reduce the level of hormone in the blood stream.

The radioactive iodine remains effective in the body for a couple of months before being eliminated. One or several treatments with radioactive iodine can reduce thyroid function to a point of hypothyroidism. If the hypothyroidism condition continues, a treatment schedule for that condition will be required.

Beta-blockers

Beta adrenergic blocking agents, or beta-blockers for short, block the action of T3 in your body. These drugs include propranolol, atenolol, metoprolol and nadolol.

These drugs do not change the level of thyroid hormone in your bloodstream but will slow your heart rate, reduce palpitations and shakes, and calm the nervousness associated with hyperthyroid conditions. Like the anti-thyroid drugs, beta-blockers are not a permanent solution.

Surgery

Surgery is a permanent solution to hyperthyroidism. A surgical procedure is used to remove most or all of the thyroid, thus removing the source of the problem. Hypothyroidism will develop and the scheduled treatment for hypothyroidism would be followed.

Remaining Issues

Deiodinase Decline

I made reference to the body being pretty smart and into self-preservation. Part of that self preservation is the decline in deiodinase when carbohydrates are restricted, i.e.; the body thinks it is starving.

Deiodinase is vital in converting T4 to T3, thus, metabolism will slow and less calories expended when carbohydrates are restricted. There are conflicting data when a ketogenic diet is followed³. However, when following a balanced diet with restricted carbohydrates, expect some decrease in metabolism.

Rebounding is another topic often discussed with T3 usage. After administration of a T3 cycle, many individuals find themselves feeling sluggish, with minimal energy.

This is to be expected, as natural thyroid hormone production needs to be ramped back up from lower production levels. This is one of the reasons for ramping down T3 use at the end of a cycle.

Rebound Time

Additionally, if you are susceptible to thyroid disease, you can expect a longer rebound to normal thyroid function. Consider some of the powdered thyroid supplements or thyroid support supplements discussed below.

The body temperature test is often heard with thyroid health. The test is performed over several days to see a trend⁴. The test involves taking one's body temperature every day upon waking, before getting out of bed.

An underarm temperature provides a good indicator. Lower than average temperatures can indicate slow basal metabolism, and poor thyroid performance. The body temperature test is not infallible, but it does provide another tool in assessing thyroid performance and could be included in your self-assessment, T3 cycle monitoring or discussions with a physician.

Supplementation

Supplementation specifically for thyroid support is another issue. Much has been written and hyped about guggulsterones and forskolin. The literature states stimulating thyroid production for both products, however, the direct mechanism(s) of action has not been determined.

Several weight loss supplements use either or both products.

Personally, I believe that they contribute only slightly to improved thyroid performance and that the standard thyroid hormone feedback mechanism negates most of the benefits that may be derived. However, they may have a good role in thyroid gland function recovery after a T3 cycle.

Use of growth hormone (GH) and T3 simultaneously must also be considered. The normal increase in nitrogen retention associated with GH use is eliminated when T3 levels increase.

This effect has been attributed to T3 increasing levels of insulin like growth factor binding protein, thus reducing the bioavailability of igf-1(5). Growth hormone already has a fat burning quality to it, so it seems more cost effective not to use T3 concurrently with GH.