Episode 22 of the Living Life Well Show: Thyroid Treatment: the What, When, and How of it
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[00:00:00] Welcome to the Living Life Well Show, the intersection of God's Word, today's science, and healthy living with common sense application, all based on the truth of the Word of God. I'm your host, Dr. Jon Skelton. Now let's get straight to the truth. Welcome back to the living life. Well show today, I wanted to discuss. Thyroid treatment the what, when and how of it. So I would recommend before listening to this episode, if you haven't listened to my previous episode episode 11, I believe. We were talking about thyroid health in general and talk about testing and all the things that are involved there. And really some of the supplementation aspects will cover some of that again, in this episode today.
But I would really recommend going back and listening to that [00:01:00] episode so you can really get a full picture for yourself. So with that, let's go ahead and get started.
okay, so when we talk about what we're talking about, what are we taking? And so what are we doing? Well, quite honestly, That depends. What you need to take very much depends on what your lab results have shown. So let's take an example. So you have an elevated TSH.
You maybe have a low T4 and basically low T3 and, but it seems to be in proportion. Your T4 appears to be converting to T3 appropriately. For the amount that you have? Well, so what you would typically do, what a you know, routine practice would be within traditional medicine, anytime they see this kind of scenario would be to put you on levothyroxine.[00:02:00]
Levothyroxine is T four. This makes the assumption that your body is then going to convert that T four to. T3. And in this scenario with your lab work, if it's been extensive and appropriate, that may be just fine. That may be what you need. But you have to take that with a grain of salt.
So there's a few different preparations for levothyroxine. There's generic name, Levothyroxine, there's Synthroid, which you've probably heard about. And then of course there's Tyrosine. Tyrosine would be another form of T4 as well. Now, you can also get your thyroid hormone compounded if you need to.
So, the way insurance will pay for this is if you're compounding it in a concentration that isn't commercially available otherwise. So a very high concentration or a very low concentration [00:03:00] or kind of an odd concentration that would be what you would do. And so you would go to a a compounding pharmacy and your physician might be able to do that.
You can also compound combos of T4 and T3. So you're talking like in NP thyroid, armor thyroid these combination things. Now. A lot of supplements will have essentially animal thyroid gland that has been ground up in there. And so that's going to have components of T4 we'll also have some components of T3 in it as well.
And so you can look at supplementing with that potentially as well. So when you are looking at actually adding in a medication, you really want to understand, and or supplement for that fact, you really want to understand where the issue lies with your thyroid. Is it that [00:04:00] you aren't producing enough thyroid overall?
And so we need to add in thyroid medication. We need to add in T4. Is it that you produce plenty of thyroid medication but you're not converting it? Or is it that you're producing plenty of thyroid medication and you're converting it but you have antibodies that are then Not allowing your T three, that active form of thyroid to really get to where it needs to go.
They're essentially blocking the path. And so you've really gotta understand what you need to take based on what your lab results are. And if you have something like Hashimoto. That may change over time that may change from month to month year to year, and so you really need to be cognizant of what is going on with your antibodies, cognizant of your symptoms that you're [00:05:00] having, and so there may need to be changes.
up, down and, or with supplementation. And so these are going to be things that again, are going to be determined, the what is going to be determined by your laboratory data. So just speaking of that in general what I recommend is a couple of things is that When you get diagnosed with thyroid disease, or if you've already been diagnosed with thyroid disease, then it gets checked regularly.
So, when you're in the initial stages of thyroid treatment, this needs to be about four weeks After the initial dose of treatment is given so whether that be a supplement whether that be a prescription medication or compounded medication or if you're trying to just supplement with different foods you want to wait about four weeks and see How that has resulted.
You may [00:06:00] feel improved. You may not. Thyroid may be only one of the contributing factors to why you aren't feeling well. And so you really want to recheck in about four weeks to see where you are in that process. Are those levels increasing? Are those antibodies decreasing? What really is going on there?
Am I converting properly? So you want to check and you want to recheck. And so. I recommend doing this when you're initially starting out at about four weeks after the initial dose and any time there is a change in dose and or treatment. Once you get to where you're feeling well and things appear to be stable, I recommend checking again.
Again at three months and then again at six months and about every six months. I really recommend checking those labs to see where you are and making sure that we don't need to go up or [00:07:00] down on your dose or and or add in any type of other supplementation and or prescription products for that fact so Again, when we're looking at how we're going to treat, we'll get to that in a minute.
We want to talk about the, what especially with regards to supplementation thyroid health helping that conversion of T4 to T3 and helping hormone synthesis in general. Again, Things that you want to look at besides just the thyroid are going to be those vitamin D levels. You want to see what your iron levels are.
Zinc may be necessary to check as well. I typically don't check iodine or selenium levels. I look at really that conversion of T4 to T3 to tell me If it is being handled appropriately, I also look at your antibodies. So [00:08:00] this is going to tell me whether I need to support you with iodine or selenium as well.
And so. Again, we've spoken before, where can you really get that iodine and selenium, you know, really fish, I think is your best category to go to like yellowfin tuna some sardines different things like this. There are Brazil nuts obviously contain selenium table salt.
includes iodine. You can also have seaweed to a certain degree. But again some of the plant nut products, there's going to be more variable concentrations in general with that. And so you may not get as much in one batch as you do another. And so there can be kind of a bit of a roller coaster in that regard.
Fish tends to be in general, a little bit more balanced chicken beef again, they're going to have lower levels but they still will have. pretty consistent levels of selenium and iodine in [00:09:00] them to really help you get some sort of a consistent amount of both of those.
in your diet. So selenium really helps iodine become active to allow that conversion to take place. And so that's why the two are really going to be important. And one of the things that you really want to look at when you're talking about thyroid health. So one of the other examples that you may give is that You know, you've got that, that TSH that's normal.
You've got a good T4 and maybe just a little bit of low T3. Well, this might be the scenario in which just increasing the iodine and selenium in the diet would be the appropriate step as opposed to. putting you on a prescription medication. This may help that conversion of T4 to T3. As that T3 [00:10:00] increases those symptoms of fatigue and you know, depression and those things may lift to a large degree and you may notice a boost.
And so that may be a scenario which just diet and lifestyle changes alone can be supported. But as I said, you really other supplements that you really want to look at, you want to make sure that those vitamin D levels are at about 50 or so 50 or higher is really kind of what I like to look at. You want to look at the iron levels, make sure there's no sign of anemia anything going on there.
You want to look at zinc and support that as well. All of these are going to be important for. really helping to maintain your thyroid synthesis as well as the iodine and selenium helping that conversion to happen. And so, those are all going to be important factors regardless of whether you are on just supplementation [00:11:00] or whether you're on prescription plus supplementation you're going to want to be aware of what your body has for resources with regards to those things.
So that takes us through the what of it. The second thing is going to be the when of it. So one of the first things I want to talk about is testing. Okay. So I mentioned a little bit, the timing of testing with regards to starting an intervention and then checking again because that's how we really need to know how we are doing, what we are feeling.
It is it. Is it a good outcome or do we need to go up or down on that dose? Have we overshot it a little bit and we need to back off? So what do we need to be taking and when do we really need to look at that? So, To do that, we've got to be very specific with how we take it and when we take it.
So [00:12:00] the, when we take this blood work so that we can get accurate levels needs to be four hours. after you have ingested whatever you're taking . So if you are just doing diet, you're not taking any supplements really doesn't matter as much, right? So you're going to be eating throughout the day through a 24 hour cycle.
And those things, hopefully you're following a 12 hour fasting window in general. But it will be in your daily routine that you are getting the supplementation that you're looking for in a daily fashion throughout the entire day, as opposed to relying on a specific oral supplement.
or something like that. So, so if you're just doing diet, the timing is less important. Okay. Now, if you are taking specific supplementation we want to wait at least about four hours [00:13:00] after we've taken that supplement and or thyroid hormone. If you are doing a prescription medication before we draw labs, the reason is we want to get an accurate measure of the absorption.
and the conversion that's taking place. If you do this too early or too late you're going to get some levels that aren't as accurate. Now, if you do it at three and a half or five hours, is that okay? Yes, but you don't want to do it an hour after you've taken it or two hours after you've taken it, you don't want to do it eight hours later.
That will also not be quite as good information as if we can get it within right around that. for our time frame. So if you are going in for labs and you're planning on getting labs drawn at 7 a. m. You need to take your medication at 3 a. m. And that is going to be very important. And that is going to give your physician the best, most [00:14:00] accurate information as to what your levels are.
And then how to do that. Now, the when to take your medication. Now, some people you know, have a really hard time going back to sleep after getting woken up. I'm one of those people. I could not, you know, wake up and then take my medication and immediately go back to sleep. This is what I recommend for a lot of people if they can do that.
The reason is because we want to wait a minimum of 45 minutes to an hour after we've taken our thyroid medication, before we then eat anything or drink anything other than a sip of water, or, you know, something, brushing our teeth So you want to wait that minimum hour to two hours before you kind of really start on breakfast and your morning coffee and those things.
The reason is we want to make sure that we're getting really good absorption. So we, [00:15:00] And again, that's predicated on kind of that four hour window. So we want to make sure as much as possible that four hour level is actually going to be accurate as to how we kind of do things on a daily basis as well.
Now, some people have difficulty, you know, waking up, going back to sleep and or delaying their breakfast if they can't , take it right at first and first thing in the morning when they wake up they have difficulty delaying breakfast, , an hour to two hours before , really consuming something.
So. That can be a bit difficult. What I have seen in the past is some people then reverting to taking their thyroid medication at night. Well, this can be a problem, right? Because this can cause disruptions in your sleep pattern that, and then cause increasing fatigue throughout the day because now the thyroid medication is wearing [00:16:00] off.
We want our thyroid to be most active with those highest levels during our waking hours because that is going to be most beneficial to us. So taking your thyroid medication at night before bed just in general is not going to be a good idea. Even if it doesn't wake you up, you're not going to get that benefit.
the You want to make sure that you taking it on an empty stomach and you want to make sure that you taking it on an empty stomach and you want to make sure that you taking it on an empty stomach and you wanna make sure that you taking it in the morning time and so that kinda brings us to the how. So another important piece of this is that when you are taking your thyroid medication specifically, this is not necessarily supplements because supplements may or may not need to be taken with food.
Okay. So. But for your thyroid medication, those prescription thyroid medications, you want to make sure that you are taking them on an empty stomach. [00:17:00] So again, another reason why many people set an alarm take it first thing and then they go back to sleep for an hour to two hours and then that allows that absorption to occur.
Because if you start eating or drinking More , before then you're going to get decreased absorption, decreased effectiveness, increased need for more medication. Now, having said that, if. You are just unable to comply with, , taking it and an hour leaving at least an hour on an empty stomach, preferably up to two.
Then what you really need to do is when you are drawing labs, don't do it. just for that day. If you can't really do it the way that it is prescribed, then you need to get labs drawn as you would any other day. Don't try to be [00:18:00] perfect for that day and then give us a false sense because you will get higher levels now than what are actually occurring on an everyday basis because You aren't taking it the way you do every single day.
So it's very important that when you do take your labs that for rechecks that how you're taking it is how you do it 99 times out of a hundred, as opposed to doing it, the one way that you do it out of a hundred. So that's going to be very important. Okay, I've already kind of beat this to death, but we want to make sure that we are taking it as a Accurately as we can on that empty stomach in the morning so that we get the most benefit of the medication throughout the day.
But again, as I've said, if you're unable to do that, make sure that when we are doing those rechecks, whether it be at six months, whether it be at one month after a change and or three months just [00:19:00] checking then we wanna make sure that we're doing that, that accurately. Again, with the supplements, that's less important, but.
Again, we want to do that. The supplements, I typically don't really recommend you taking those on the morning of your blood draw
but be real honest with your physician as to how and when you're taking it and when. What it is that you are taking and doing for this. When you have that open conversation and when you can kind of standardize your what, when, and how of it, you will get better results because you'll get better information and it will allow your physician to help guide you more consistently as opposed to if you're doing something as a one off for that day.
Okay. So that basically covers the what, when and how of it. So just to recap, the most [00:20:00] important things is really understand all of the things that really help support. The thyroid and thyroid health the iodine and selenium containing products, the vitamin D make sure that your iron levels are good. Again, those are going to help the thyroid in general. So you also want to make sure that. When you are taking your medication and how you are taking it is very appropriate. As a, well as making sure that you're getting that retesting. So, just to recap any time there's an intervention. Be it a change in diet.
Be it a change in supplementation, Be it to change a medication, either adding something in or changing a dose. Of anything you want to recheck at about one month after that intervention has been sustained. Then you also want to make sure that on the day that you're getting it taken. You're doing it the way you do it, 99 times.
Not the way you do it. The one time. Because [00:21:00] that's going to be important. And then the best is when you are taking medication specifically. For your thyroid, you really want to make sure that you're consuming. That medication on an empty stomach with nothing other than water, giving a minimum of an 45 minutes, but preferably up to two hours before you eat or drink anything else.
So. I hope that you have found this beneficial. If you're enjoying this podcast, I would love for a subscription and, and review and, or a share on social media. Hope you have a great. A day and thanks. And God bless.
That's it for this episode of the Living Life Well Show. If you like what you've heard and want to learn more, or want to know how to put this into practice for yourself, go to livelifewellclinic.com. Until next time, this is Dr. Jon Skelton saying, go out and live the [00:22:00] truth so you can live life well. The preceding is for entertainment and educational purposes only. It is not meant to be used to prevent, diagnose, treat, or cure any condition. The information contained in this show does not substitute the need for a qualified medical professional, nor is it meant to provide medical advice or services.
If you feel information presented in this show may apply to you, we recommend you seek out the help of a qualified medical professional who can evaluate and treat your specific concerns.
