Polly: Thyroid glandulars are the ground up and dried whole thyroid gland. The product isn’t as processed as the prescription desiccated thyroids. Yet, it may still contain the active hormones. Several years ago, a bill passed in the US congress made it legal to buy and sell thyroid glandulars without a prescription, even if they still contained some of the thyroid hormones. However, the FDA is not too pleased with making thyroid glandulars available. There is a chance that the public will abuse the product and someone will get hurt. Therefore, the FDA does its best to monitor the way the glandulars are marketed. If you sell this product, then you cannot imply that it will help a person with any physical or mental problem.
Because the FDA is especially strict with this product, it is difficult to find a source for it. Most glandulars on the market have been denatured. (Denatured means that the thyroid hormones have been removed.) The only place that I’ve found to purchase the undenatured thyroid glandular by itself is through Nutri-meds. It is a good product. Some people are even getting better results with this thyroid glandular than they did with their prescription dessicated thyroids.
Starting Thyroid Supplements¾ Precautions
Polly: When starting a thyroid supplement, you and your doctor should be aware of certain possible consequences. This knowledge will help you participate in the presevation of your own health and exercise some common sense. Here is a list of precautions that I’ve found to date.
1) Watch for symptoms of too much thyroid. Symptoms of too much thyroid include heart palpitations and perhaps chest pain, excessive sweating, heat intolerance, or nervousness.
2) Most people have no problem starting thyroid supplements. However, a few people will have symptoms of anxiety or palpitations when they first start. You are more likely to have this reaction if you have thyroiditis (antibodies to thyroid), if you are already having problems with anxiety, or if your adrenals are weak. These reactions to thyroid may be due to an increased sensitivity to adrenaline.  If you happen to have high adrenaline, the thyroid supplement should gradually help bring your adrenaline levels back down to normal. With time, you will adjust. If you have anxiety or palpitations upon starting a small dose of thyroid, you can stop the thyroid and go on some adrenal support for a while, and then try again. Or you can use a lower dose of thyroid and give your body more time to adjust. A quarter grain is usually tolerated, but once in a while, even less must be used to start. Stephan Langer, MD, starts some patients out on as little as 0.025 grain of thyroid in a liquid form. Dr. Langer also suggests that vitamin D, calcium and magnesium may help a person eliminate the palpitations or anxiety symptoms. In his book on hypothyroidism, Solved the Riddle of Illness, he suggests that if you are not getting sunlight then you might need as much as 2000-4000 IU of vitamin D. (The RDA is 400 IU.) Another suggestion—Jacob Teitelbaum, MD, suggests that taking 100 mg to 200 mg of vitamin B1 each day may help your body adjust to taking thyroid.  Dr. John Lowe suggests that you may have to eliminate narcotics/opiates. (Also see this article by Mary Shomon about antibodies to thyroid.) http://www.anapsid.org/cnd/diffdx/thyroid2.h tml
3) People with heart disease or who are extremely hypothyroid must start out very slowly with a half grain or less. Less is especially appropriate if you have problems with anxiety or thyroiditis. The heart needs to get use to working harder gradually. You never start on any thyroid hormone within a month after a heart attack. Your doctor may decide to be a bit more conservative on your final maintenance dose too. A doctor had my mom on a half grain of thyroid for a year before he finally increased her dose to a grain. That is more conservative than Broda Barnes, MD would have probably done, but Thyroid 31 you get the picture. Also, just because you have heart problems, you shouldn’t avoid taking thyroid. Heart irregularities/problems can result from not enough thyroid too.
4) T4 and desiccated thyroid take weeks to build up in your body. So you will not find the proper dose by experimenting with a different dose each day. To find the proper dose, you start with a relatively low dose and keep it there for at least two weeks before deciding to increase it. (Eg, start with a half grain or less and keep it there for at least two weeks.) Then you stay at the increased dose for at least another two weeks before you consider increasing the dose again. If at any time you get symptoms of a rapid heartbeat, you back down on the dose. Broda Barnes would usually start a relatively healthy woman out on 1 grain a day for a month before considering increasing the dose. With some of the larger men, he would start them on 2 grains a day. This is where your doctor’s experience and guidance are so important. However, your observations and common sense play a very big part in this too. When in doubt, go slow.
5) People with very low blood pressure (below 100 systolic) likely have poor adrenal function. It is dangerous to give thyroid when the adrenals are very weak. Thyroid clears cortisol and this could put a strain on weak adrenals. Adrenal support in the form of Cortef or mixed cortisols is often added to the thyroid treatment protocol in this case.
6) If you are taking anti-coagulants, you should have your doctor monitor your protime. He may have to reduce your blood thinning medication. Also, check your iodine status, because aspirin and other anti-coagulants can deplete iodine. (Iodine should be measured via a urine test, not blood.) See this article by Ryan Drum, PhD, entitled “Botanicals for Thyroid Function and Dysfunction.” http://www.planetherbs.com/articles/thyroid.html.
7) The package insert on your thyroid supplement may mention a possible change in insulin requirement. However, Broda Barnes did an experiment with diabetic patients and found that none of them had to adjust their insulin medication. Of course, he was using Armour thyroid, not just T4. Perhaps there is a difference. Also, Broda Barnes’s experiment was in a hospital setting, so the patients weren’t changing their exercise levels. If thyroid makes you feel more energetic, you may end up exercising more, needing more fuel for your cells, and thus may need to adjust your insulin.
8) By increasing your metabolism, thyroid may also uncover nutritional deficiencies. In particular, when thyroid is given, there is increased need for B vitamins. 
9) If you are taking prednisone for asthma, you may have to adjust your dose since thyroid clears (removes) cortisols from the blood.
10) Don’t stop medication prematurely. Some people notice a difference immediately, but most take much longer. A month or even two is often required. That is why an alternative doctor will usually give a three-month trial of thyroid.
11) After you have been on the thyroid for a few months, be sure that your doctor checks your blood thyroid levels. You can’t rely on your basal temperature or your TSH to tell you when to stop increasing the thyroid dose. Your basal temperature might not rise that much, especially at first. Sometimes the temperature will even initially decrease as a hyperadrenaline / hypervigilant state disappears and you get better sleep. If your tests show that your TSH has been Hormones, Dysbiosis and Candidiasis The Health Forum—Book 4 32 suppressed by the thyroid supplements, that might be okay, depending on the circumstances. However, you don’t want your T4 and T3 levels well out of range. Typical end-point doses are between one and two grains of desiccated thyroid for an adult.
12) Don’t take your thyroid supplement at the same time as a calcium supplement or with milk. Less thyroid will be absorbed. The thyroid absorption problem also applies to the concurrent ingestion of iron, some cholesterol lowering drugs (cholestyramine, colestipol), or antacids that contain aluminum, or sucralfate (an ulcer drug that contains aluminum). 
13) Pay attention to when you take your thyroid supplement. Personally, I can’t tell any difference between taking the thyroid with or without meals or at any particular time of the day. Yet there are others that find this quite important. Many thyroid specialists advise that T4 thyroid supplements (like Synthroid) be taken alone, first thing in the morning, and that nothing else be ingested for at least 30 to 45 minutes afterward. Some doctors suggest that the non-time release T3 supplements should be taken with meals to spread out the dose. I’ve also heard a suggestion that you just lick or nibble the regular T3 throughout the day because the time-release T3 isn’t reliable.
14) If you are switching from T4 to the natural thyroid, do so gradually to give your body a chance to adapt. Eg, start by cutting the T4 dose down by 25% and substituting 25% of the natural thyroid dose. Stay on this mixture for at least a week before changing it to a half-and-half mixture, etc. One grain of the natural thyroid is roughly equivalent in strength to 0.1 mg of pure T4. However, there can be quite a bit of variation between individuals. One grain of the natural thyroid is usually labeled 60 mg.
15) If you are coming off thyroid, do so gradually over a few months to give your body time to adjust.
16) Be sure to ask your doctor about any concerns you have with your particular situation. If you are suffering from “brain fog” write key points down on paper to remind yourself what to ask or do.
Where To Find A Doctor
Polly: Ask at your local health food store. They are an excellent referral source for the best doctors in your area. For top doctors recommended by patients, do a search at these sites.
This list is not just alternative doctors. Any doctor that is exceptional can be placed on this list. There are doctors listed for many different countries there. Not all of them believe in using a natural thyroid. If you find no one on this list that is suitable, you might try finding a doctor through one of the companies that make the natural thyroid. For US doctors, Western Research will give you the name of a doctor near you who uses their Westhroid and Naturethroid products, phone (602) 482-9370. Bio-Tech will also give you the name of a doctor near you who uses their Bio-Tech product. phone 800-345- 1199 or 501-443-9148 Forrest Pharmaceuticals recently added a doctor location service at http://www.armourthyroid.com
Some of the best alternative doctors are at the Barnes Foundation. If you have a very unusual situation, you might want to contact them directly. However, they are swamped with work, Thyroid 33 and you may wait a very long time for results. Alternatively, you might write a letter to the Broda Barnes Foundation, enclose $15, and ask for their literature and a list of doctors in your area. Interview the doctors on their list about prices and tests. Prices vary widely. Some want $75 for the first visit, plus a very nominal amount for testing, and others want as much as $300 for the first visit and $500 for testing.
You can also attempt to work with an HMO or more conventional doctor. Unfortunately, HMOs are very reluctant to spend money on tests. In Mary Shomon’s book, Living Well With Hypothyroidism, she suggests that you can often get your HMO to test you if you go about it correctly. (See page 83.) If being persistence in your request doesn’t work, get a list of your hypothyroid symptoms, and some articles, and show this to your doctor. If he refuses to test you, then you have him sign a simple letter stating that even though he has reviewed your list of hypothyroid symptoms, it is his opinion that you do not need to be tested. Have him put the letter and the list in his chart. Get a signed copy for yourself. Then you can use the letter to petition the HMO for referral to a different doctor or for testing.
I suggest that you keep a copy of your test results. You don’t want to pay for these tests again if you decide to see any other doctor. Ask the receptionist for a copy. You don’t have to bother the doctor directly if you feel uncomfortable about it. In some establishments, records are very easily lost; so get a copy of the test results immediately. If you have the money, you might avoid the hassles, and go directly to an alternative doctor. Most (not all) alternative MDs will help you. In certain states, even a naturopath can prescribe thyroid.
If your doctor is unwilling to test you for thyroid function, and you are willing to spend anywhere from thirty to two hundred dollars (depending on the number of tests ordered), you can order the tests yourself. (See the section on ordering hormone tests in the chapter on Progesterone And Estrogen.)
Books And Websites
Polly: The classic book on the alternative treatment of hypothyroidism is Hypothyroidism: The Unsuspected Illness, by Broda Barnes, MD. It is very straight forward, very easy to understand and entertaining. A good place to learn about the treatment protocol is the tape “If You Want to Be Confused, Run a Blood Test for Thyroid Function” by Broda Barnes, and available from the Barnes Foundation. It is also very entertaining and easy to understand.
I love this book by Mary J. Shomon, Living Well with Hypothyroidism. She covers the subject of hypothyroidism from several different doctors’ perspectives. She also gives you the patient’s perspective. Her book is informative, entertaining, and it gives great insight into the situation. Mary J Shomon also hosts http://www.thyroid.about.com, which is one of the best websites on thyroid problems. (My other favorite website on thyroid is http://www.ithyroid.com )
There is another informative book, The Thyroid Solution, by Ridha Arem, MD. The author is very orientated to blood testing, and has a conventional viewpoint. The book will take you through some of the physical changes that happen when you are hypothyroid. He explains T3/T4 balancing, and the importance of sometimes using T3. He also explains why the TSH, T4, and T3 blood tests are not always adequate.
Since Dr. Ridha Arem’s book is written from a conventional viewpoint, you might be able to use it to convince a conventional doctor that further testing is needed, or that an addition of T3 to the usual T4 regimen could be helpful. Since Hormones, the explanation is coming from a conventional doctor, other conventional doctors might be more inclined to listen. Yet don’t get your hopes up. Doctors need both information and time to adjust their thinking. One book is usually not enough to get them to think differently.
Dr. Raymond Peat’s books are always full of the most wonderful information about the effects of nutrition on hormones. They are written in layperson’s terminology. Sometimes they can be a bit of a challenge, but they are well worth the effort. His book Nutrition for Women is still available if you write to him and send in the appropriate amount of money. Presently, it is only $10 plus $2.50 shipping.
Raymond Peat’s latest book is perhaps the easiest to read. It is From PMS to Menopause for $12 plus $2.50 shipping. Even though this latest book is relatively easy to read, I suggest that you start with one of the more introductory books on hormones by John Lee, MD. Afterwards, you may enjoy learning some more about hormones from this book by Raymond Peat.
Raymond Peat, PhD, also has a book called Progesterone in Orthomolecular Medicine currently for $6.00 plus $2.50 shipping. This one gives you information on your adrenals, pregnenolone and thyroid too.
His newsletter is fascinating to me. It is usually fairly technical, yet it is well enough written that us lay people can catch on to a fair amount. His newsletter is currently $24 for 12 issues.
If you would like to order any of his books or subscribe to his newsletter, include your check or money order, your name, address, phone, and if available, your email address with your order. This is his website and address http://www.efn.org/~raypeat/index.html. Raymond Peat, PhD P.O. Box 5764 Eugene, OR 97405 There are several thyroid lists on http://www.yahoogroups.com Thyroid Top Doctors is at http://www.thyroid-info.com/topdrs references
1. Goumaz, MO, Kaiser CA, Burger AG, “Brain cortex reverse triiodothyronine (rT3) and triiodothyroxine concentrations under steady state infusions of thyroxine and rT3.” Endocrinology, April, 1987, 120(4): 1590-64. As mentioned in Peat, Raymond, PhD, “Thyroid: Therapies, confusion, and fraud,” Ray Peat’s Newsletter, May 2000
2. Blaurock-Bush, Elenore, PhD; and Griffin, Veronica, PhD, Mineral and Trace Element Analysis, TMI, Inc. 6545 Bunpark Drive, Suite 240, Boulder, DO 80301, Phone (303) 530-5135, email: [email protected], publishing date 1996, page 156 and 158
3. Reduced thyroid-stimulating hormone response to thyrotropin-releasing hormone in autistic boys. Dev Med Child Neurol. 1991 Apr;33(4):313-9. And Neeck G. “Neuroendocrine and hormonal perturbations and relations to the serotonergic system in fibromyalgia patients.” Scand J Rheumatol Suppl 2000;113:8-12 and Aihara R, Hashimoto T [Neuroendocrinologic studies on autism] No To Hattatsu 1989 Mar;21(2):154-62 and Brizzi G, Carella C, Foglia MC, Frigino M “Thyroid hormone plasmatic levels in rats treated with serotonin in acute and chronic way.” J Physiol Paris 1997 Dec;91(6):307-10, and of course, Dr. Lowe’s work.
4. Dunn AJ. “The role of interleukin-1 and tumor necrosis factor alpha in the neurochemical and neuroendocrine responses to endotoxin.” Brain Res Bull 1992 Dec;29(6):807-12 and Everson, speaking at a scientific workshop stated that a lack of sleep will cause central hypothyroidism. in “The neuroscience and Endocrinology of Fibromyalgia.” as reported by the NIAMS, National Institute of Arthritis and Musculoskeletal and Skin Diseases, at http://www.niams.nih.gov/ne/reports/sci_wrk/1996. Vand der Poll T, Endert E, Coyle S, Abosti J, Low;ry S Thyroid 35 “Neutralization of TNF does not influence endotoxininduced changes in thyroid hormone metabolism in humans.” Am J Physiol 1999 Feb;276(2 Pt 2):R357- 62. LPS suppresses T4, T3 and TSH, while raising rT3 in humans. Neeck G. “Neuroendocrine and hormonal perturbations and relations to the serotonergic system in fibromyalgia patients.” Scand J Rheumatol Suppl 2000;113:8-12 and Neeck G, Riedel W. “Thyroid function in patients with fibromyalgia syndrome” J Rheumatol 1992 Jul;19(7):1120-2 and this is interesting too, Brizzi G, Carella C, Foglia MC, Frigino M “Thyroid hormone plasmatic levels in rats treated with serotonin in acute and chronic way.” J Physiol Paris 1997 Dec;91(6):307-10 (Serotonin suppresses TRH and thyroid hormones.
5. Aihara R, Hashimoto T [Neuroendocrinologic studies on autism] No To Hattatsu 1989 Mar;21(2):154-62
6. Extein I, Pottash AL, Gold MS “The thyrotropinreleasing hormone test in the diagnosis of unipolar depression.” Psychiatry Res 1981 Dec;5(3):311-6 and Bartalena L, Placidi GF, Martino E, Falcone M, Pellegrini L, Dell’Osso L, Pacchiarotti A, Pinchera A. “Nocturnal serum thyrotropin (TSH) surge and the TSH response to TSH-releasing hormone: dissociated behavior in untreated depressives.” J Clin Endocrinol Metab 1990 Sep;71(3):650-5 (a lack of nocturnal TSH surge supports the case for some degree of central hypothyroidism in depression.)
7. Raymond Peat, PhD, lecture tape on “Candidiasis and Endocrine System.” You can get the tape by from CDIF, PO box JF, College Station, Texas 77841-5146
8. Peat, Raymond, PhD, Nutrition for Women, 1993, page 18. This fact that thyroid production returns to its previous level is also mentioned by Broda Barnes, MD in his tapes.
9. Peat, Raymond, PhD, From PMS to Menopause: Female Hormones in Context, 1997, available from Raymond Peat, P.O. Box 5764, Eugene, Oregon 97405
10. Fujiyama K, Kiriyama T, Ito M, Kimura H, Ashizawa K, Tsuruta M, Nagayama Y, Villadolid MC, Yokoyama N, Nagataki S. “Suppressive doses of thyroxine do not accelerate age-related bone loss in late postmenopausal women. Thyroid 1995 Feb;5(1):13-7
11. Whybrow PC, “The therapeutic use of triiodothyronine and high dose thyroxine in psychiatric disorder.” Acta Med Austriaca 1994;21(2):47-52
12. Peat, Raymond, “Bone density: First do no harm,” Ray Peat’s Newsletter, June 2001
13. Lee HT, Levine M., “Acute respiratory alkalosis associated with low minute ventilation in a patient with severe hypothyroidism” Can J Anaesth 1999 andKrapf R. Jaeger P, Hulter HN, “Chronic respiratory alkalosis induces renal PTH-resistance, hyperphosphatemia and hypocalcemia in humans,” Kidney Int 1992 Sep;42(3):727-34 as mentioned in Ray Peat’s June 2001 newsletter.
14. Lee, John R., MD; Hopkins, Virginia, What your Doctor may NOT tell you about Menopause, Warner Books, January 1996
15. Smith, Evelyn, and Mclean, Franklin, “Effect of Hyperthyroidism upon Growth and Chemical Composition of Bone, Endocrinology, 1938, This reference was mentioned in a 1996 lecture by Raymond Peat given to the National Health Federation (which is now the Cancer Control Society).
16. Kumeda Y, Inaba M, Tahara H, Kurioka Y, Ishikawa T, Morii H, Nishizawa Y. “Persistent increase in bone turnover in Graves’ patients with subclinical hyperthyroidism.,” J Clin Endocrinol Metab. 2000 Nov;85(11):4157-61. Also, Lee, Lita, PhD, The Enzyme Cure, Future Medicine Publishing, Inc., 1998, page 191
17. Ima-Nirwana S, Kiftiah A, Sariza T, Gapor MT, Khalid BA. “Palm vitamin E improves bone metabolism and survival rate in thyrotoxic rats.” Gen Pharmacol. 1999 May;32(5):621-6
18. Eggersglüss B, and R +D Department of the DGF STOESS AG, Eberbach, Germany “Gelatine Hydrolysate and its Health Aspects”
19. Stejskal, Vera D. M., PhD “Human Hapten-Specific Lymphocytes: Biomarkers of Allergy in Man” Drug Information Journal, Vol. 31, pp. 1379-1382, 1997
20. PAK, C. The effect of hyperthyroidism on the action of adrenaline and ephedrine.” Chinese Jour. Physiol. 14(3): 231-248, 1939 or in more modern terms, thyroid increases the density of beta-adrenergic receptors on your cell membranes.
21. This article is a summary of Dr. Teitelbaum’s protocol for the treatment of CFIDS and fibromyalgia. http://www.immunesupport.com/fame/showarticle.cfm/ID/1 0
22. Drill, V a, and Sherwood, C R, “The effect of vitamin B1 and the B2 complex on the weight, food intake, and estrual cycle of hyperthyroid rats.” Am. J. Physiol. 124:683. 1938
23. Arem, Ridha, MD, The Thyroid Solution, Ballantine Publishing Group, 1999
24. Broda O. Barnes, MD Research Foundation, Inc., Lecture tapes. These tapes are available from the Broda O. Barnes Research Foundation, PO Box 98, Trumbull, CT 06611. Their website is http://www.brodabarnes.org, and their phone is 203-261- 2101.