Let me begin by saying that I am not an endocrinoligist.  I am not even a
medical professional so do what you will with the following info.  Just for
the record though, none of the experts in the field of endocrinology agree
on how to treat low thyroid so, if they don't know how to treat it, I'll
just go ahead and offer my opinion on what to do...

HOW THE THYROID WORKS:
The Hypothalamus sends a signal to the Pituitary.  Then the Pituitary
secretes TSH (thyroid stimulating hormone) which causes the Thyroid to
secrete T4.  T4 circulates in the blood stream and is converted to T3 by the
liver.  **Important point: T3 is the thyroid hormone that is key to pay
attention to.**

A FEW NOTES:
T4, T1, and T2 are all *inactive* thyroid hormones.  T1 and T2 aren't all
that important, so I'm not even going to get into those.  T4 is the 2nd most
active thyroid hormone (2nd to T3), but it is still estimated to be 10-20
times less active than T3.  The bottom line is this: as far as thyroid
functioning is concerned, 90% or more of your BMR (basal metabolic rate) is
going to be determined by your T3 levels -- or more specifically, the Free
T3 levels circulating in your blood (hint: maybe a Free T3 serum blood test
would be a good idea!).

A QUICK RANT ON ENDOCRINOLIGSTS:
Why are endocrinologists checking levels of T4 and TSH then?  Answer:
They're morons and lack even a fundamental understanding of how the thyroid
works.  Your T1, T2, T4, and TSH levels can all be absolutely perfect, but
if the Free T3 levels circulating in your bloodstream aren't optimal, then
your metabolic rate will *not* be optimal.

HERE WE GO:
If you think you have low thyroid, then the first thing you should do is
look at your symptoms.  Do you have fatigue, feel not as mentally sharp as
you used to, depression, weight gain (or inability to lose weight when on a
proper diet & exercise routine), constipation, aching joints, low blood
pressure, high cholesterol, low libido, dry skin, brittle nails, hair loss,
sensativity to cold, etc?
You do not have to have all of these symptoms to be suffereing from low
thyroid.  Maybe you've been doing a low cal, low carb diet combined with
weights and cardio and you can't lose weight.  Chances are that you have, to
one degree or another, low thyroid.  Women over 40 are almost always
suffering from low thryoid.  They usually suffer from subclincial
hypothyroidism which means it's in the normal range, but, more accurately,
the low-normal range so it's often not detected by a standard blood test.
This is why once people hit the upper ages they start to notice symptoms of
aging.  Almost of these symptoms are related to hormones such as thyroid,
testosterone, estrogen, growth hormone, etc. (Maybe I'll have to write a
post on these at a later date.)

MOVING ALONG:
Now it's time for the medication bit.  Maybe your thyroid is just running a
little slow and you need to help it along a little.  If so, you can go with
a supplement called Metabolic Thyrolean which is sold by Prolab Nutrition at
http://www.hononline.com (it's under the weight loss link).  Will Brink has
an article on Metabolic Thyrolean at
http://www.brinkzone.com/thyrolean.html.  Metabolic Thyrolean is unique in
that it is *not* an exogeneous form of thyroid hormones so you won't be
supressing your bodies natural production of these hormones. Rather it
causes your body to produce higher levels of T4 and it also helps the liver
convert T4 to T3 (remember that T3 is the important one).  I have never
tried Metabolic Thyrolean and have no idea if it works.  I'm merely
mentioning it for those who want to try kick starting their own bodies
production of thyroid hormones before they jump into medications.

MEDICATIONS:
Here is where you get into exogeneous thyroids.  In other words, once you
get on these medications your thyroid gland shrinks and will not come back
inline after you've used exogeneious thyroid for a certain amount of time.
Once you start taking these meds, you are going to be on them for the rest
of your life so make sure you know what your getting into.

You have the option between synthetic or natural exogeneous thyroids. Armour
Thyroid (a natural thyroid) is the best form of thyroid.  It is made from
the thyroid gland of pigs and has all of the thyroid hormones (T1, T2, T4,
and T3) in a natural ratio.  This is the medication that 90% of all patients
who use medication should be on.  It's a natural from of thyroid so the
unhealthy side effects associated with synthetic thyroid use are not an
issue.  The only problem is that some people do not absorb it well at all.
This requires a higher dose so that your body can absorb adequate levels.
Unfortunately, some endorcrinologists won't give their patients anything
more than a light dose.  And that's fine for those that absorb it well, but
it sucks for those that don't.

Then we get into synthetic thyroid hormones.  We have T4 (Synthroid), T3
(Cytomel), and one that's a combination of T3 and T4 (Thyrolar).  Synthroid
(T4) sucks.  If your endocrinologists has you on this, then all he's managed
to do is knock out your bodies natural production of thyroid hormones w/o
even giving you an effective way to treat your hypothyroidism.  Cytomel and
Thyrolar, on the other hand, flat out work for fat loss!  They are both
absorbed efficiently, and they both contain T3.  Obvisouly, thyrolar is a
little more healthful than cytomel b/c you'll be getting T3 and T4.  But, if
your endocrinoligist is stubborn with giving out a high dosage, then you may
have to go with cytomel.  Even though you'll be given a dosage that's lower
in total mcg's, you'll probably be getting more T3 (notice that I keep
empasizing T3!!).

The bad part to Thyrolar and Cytomel is that they are synthetic.  They're
artificial forms of thyroid hormone; they're foreign to your body.  Is this
unhealthy?  Answer: I have no idea!!  There are so many mixed opinions on
this that I myself haven't been able to formulate my own conclusion.

SUGGESTION:
This is mainly for those who are struggling to lose weight.  First, make
sure that you're eating a low carb diet and that your doing moderate amounts
of cardio and weight training.  If this hasn't helped you lose fat, then
you'll probably want to order 2 bottles of Metabolic Thyrolean (a 40 day
supply. costs about $50).  Again, continue to stick to your diet & exercise
program.

If fat loss still isn't working, then it's time to consider medicating.
This requires a good endocrinoligist.  I don't know any, but I'm sure
there's someone on the paleo list who can post a link for finding
alternative medicine endocrinolists.  I would definitely start off with
Armour Thyroid.  Start off with a moderate dosage.  Once a week, you'll want
to get blood work done.  Make sure your endocrinologists looks at your *Free
T3* levels when analyzing the bloodwork.  You want your Free T3 levels to be
in the high-normal or normal range, not low-normal (make sure you emphasize
this to your endocrinologist).  If it's not where you want it to be, then
you need to start manipulating your dosage.  Also, Armour Thyroid should be
broken down into 2-3 dosages throughout the day to keep the levels in the
bloodstream from fluctuating.

If you still haven't been able to lose fat, then you may have a problem
other than thyroid.  Maybe you need to look into hormone replacement therapy
or GH (growth hormone) replacement therapy.  I consider myself to be far
more knowledgable about hormones and GH than thyroids so shoot me an email
if your interested in looking into these options.

ANOTHER SUGGESTION:
For those that don't want to take the time to mess with finding a good
endocrinoligist and bloodwork and such, then you can always go to
http://www.drugquest.com and get in touch with a foreign supplier of
synthetic T3.  T3 is *not* a scheduled item so it's perfectly legal to
import.  If you want to try self-medicating this way, then go right ahead,
but this is very dangerous.  If you plan on self medicating with synthetic
T3, start off with a low dose divided into 2-3 seperate dosages throughout
the day.  Then gradually taper up until you start to lose fat at an
acceptable rate.  Then, once you've reached your fat loss goal, reduce your
dosage to a maintenance dose.  You'll then remain at a maintenance dose for
the *rest of your life.*  Once you shrink the thryoid gland for a length of
time (usually about 4-5 months) the gland will never function on its own.

The self medicating route is usually what most of the competitive fitness
models do.  They import T3 and take lots of it.  This way they can eat like
crap year round and still maintain ultra low bodyfat levels.  I don't
condone this, but I just wanted to mention it so that people know it's out
there.

Feedback is welcome,
Justin Hasselman
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