Optimizing thyroid levels for longer lifespan?

#1

I feel like we don’t discuss thyroid health much on here so I’m hoping to get a discussion going.

In my personal case, I have an optimal TSH (1.6) and Free T4 (1.4), but my Free T3 runs on the low end of the normal range (2.7).

I have a bunch of links saved in my notes so I’m going to share them here.

The impact of thyroid hormone dysfunction on ischemic heart disease. 2019 study

Thyroid Dysfunction in Heart Failure and other Cardiovascular Outcomes
https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.118.005266?fbclid=IwAR0UUzJVMK5mcownP4vOEKES1urH5Vjqc-bC0krT2hR5UcPcUKBIcePi57A&

Thyroid Replacement Therapy and Heart Failure
http://circ.ahajournals.org/content/122/4/385.extract

Thyroid Hormone and Cardiac Disease: From Basic Concepts to Clinical Application

The Role of Thyroid Hormone Therapy in Acutely Ill Cardiac Patients

T3 Therapy Lowers the Incidence of Atrial Fibrillation After Cardiac Operations
http://www.annalsthoracicsurgery.org/article/0003-4975(96)00102-6/abstract

T3 Effects on Cardiovascular System in Patients with Heart Failure

Relation Between Free T3/Free T4 Ratio, Echocardiographic Parameters and Mortality in Dilated Cardiomyopathy
http://onlinelibrary.wiley.com/doi/10.1016/j.ejheart.2004.04.016/full

Low-T3 Syndrome: A Strong Prognostic Predictor of Death in Patients with Heart Disease
http://circ.ahajournals.org/content/107/5/708.full

Low Thyroid Hormone Increases Risk of Death from Heart Attack by 70%

Low T3 Syndrome: A Strong Predictor of Low Cardiac Output and Death in Patients Undergoing Coronary Artery Bypass Grafting
http://www.annalsthoracicsurgery.org/article/S0003-4975(14)00328-2/fulltext

Acute Effects of T3 Replacement Therapy in Patients with Chronic Heart Failure and Low-T3 Syndrome
http://press.endocrine.org/doi/full/10.1210/jc.2007-2210

Safety and Hemodynamic Effects of Intravenous T3 in Advanced Congestive Heart Failure

Low T3: A Strong Predictor of Outcome in Acute Stroke Patients

  1. Symptomatic Relief is Related to Serum Free Triiodothyronine Concentrations during Follow-up in Levothyroxine-Treated Patients with Differentiated Thyroid Cancer - Larisch, Midgley , Dietrich and Hoermann. See: Thieme E-Journals - Experimental and Clinical Endocrinology & Diabetes / Abstract (This paper clearly proves that FT3 concentrations are the most important in clinical decision making, as they are most closely linked to residual hypothyroid symptoms in T4- Only treated patients. It also shows that in-range TSH is not sufficient for symptom relief.).

  2. Homeostatic equilibrium between free thyroid hormones and pituitary thyrotropin are modulated by various influences including age, body mass index and treatment - Hoermann R1, Midgley JE, Giacobino A, Eckl WA, Wahl HG, Dietrich JW, Larisch R. See: Homeostatic equilibria between free thyroid hormones and pituitary thyrotropin are modulated by various influences including age, body mass index and treatment - PubMed ((This is a great paper, although complex. It shows that it is the relationships of the thyroid hormones, and how they adjust during treatment, that counts. It also makes it crystal clear that TSH should only have a supporting role in the assessment process during treatment.)

  3. Recent Advances in Thyroid Hormone Regulation: Toward a New Paradigm for Optimal Diagnosis and Treatment - Hoermann, Midgley, Larisch, Dietrich. See: Frontiers | Recent Advances in Thyroid Hormone Regulation: Toward a New Paradigm for Optimal Diagnosis and Treatment

  4. Thyroid hormone replacement - a counterblast to guidelines - Dr A.D. Toft. See: http://www.rcpe.ac.uk/sites/default/files/jrcpe_47_4_toft.pdf

  5. Consensus statement for good practice and audit measures in the management of hypothyroidism and hyperthyroidism - M P J Vanderpump, J A 0 Ahlquist, J A Franklyn, R N Clayton, on behalf of a working group of the Research Unit of the Royal College of Physicians of London, the Endocrinology and Diabetes Committee of the Royal College of Physicians of London, and the Society for Endocrinology See: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2351923/pdf/bmj00557-0041.pdf

In patients with a left ventricular ejection fraction of greater than 40% (study II), triiodothyronine (T3) administration resulted in significantly improved stroke volume (p less than 0.01) and cardiac output (p less than 0.02) and reduced systemic (p less than 0.01) and pulmonary (p less than 0.05) vascular resistances. There were no adverse reactions to triiodothyronine in the dosages that were used. Triiodothyronine appears to be beneficial to all patients undergoing open heart surgery.

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#2

Thanks for starting this discussion. I re-started thyroid therapy a few months ago, after having been on it briefly about 5 years ago. It was the link to heart health that led me to more actively manage that issue. I’m having a better outcome with the Armour natural thyroid this time around as compared to the levothyroxine 5 years ago.

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#3

I got t3 of 38 on the latest test, CR decreases T3, recently on semaglutide but not long enough

#4

Ashwaghanda may affect the thyroid. From ConsumerLab.

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#5

When I used to take ashwagandha, I used to see about a 0.2 increase in Free T3 (2.7 to 2.9) which isn’t much, but it was something.

Now I take 100mcg T4 and 12.5mcg T3 and it has improved my T3 level and I feel better. No doctor would have prescribed them to me if they only went by my 1.6 TSH and 1.4 Free T4, but I definitely notice a big difference in my energy level by self medicating this way since my T3 got a bump from the lower end of normal to a more optimal level.

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#6

I’m glad there are people who understand thyroid function here! I am hypothyroid and we tinker with my t3/t4 because I have fatigue/blah issues, and this is one area where I think I could be managed better. My ADD keeps me from reading/focusing on all the numbers long enough to absorb what it all means (the I can’t read a study to save my life thing) .

I’ll post my numbers and see if anyone has anything to say, if you’d be so kind

In March
my free t4 was .9
My tsh was 2.17

We tweaked my rx and kept my t3 at 20 and bumped my t4 slightly to 110 mcg sr c (no idea what the c means!)
T3/t4 20/110 mcg (sr) (c)

I have had more energy and focus since changing, but I also started rapa, so ??

I need to retest soon, but if anyone has suggestions based on those numbers (if they should be higher or lower), I’m all ears

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#7

If you feel better and continue to sustain the better feeling. I don’t see the problem. I used to think the Free T3 level was very important but I find it to be more reliable before we start taking thyroid hormone, and unreliable when we are taking it. I am starting to see some doctors actually place more value in Total T3 as opposed to Free T3, so it might be worth checking next time.

I understand the evidence is mixed here so some of my opinions are anecdotal.

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#8

Lower T3 IS BETTER for longevity

https://www.sciencedirect.com/science/article/abs/pii/S0047637416301804

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#9

This contradicts a few of the studies I shared in the original post, so it’s a bit strange.

Low T3 levels lead to a very poor quality of life.

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#10

On the clinical side of things as to what I do … TSH upper limit of normal is 2.5 … not what the labs report up to 4.5-5.5.
Free T3 is the active hormone, and the conversion of T4 to T3 is zinc/selenium mediated.

It’s an interesting area, but if dysfunctional, AND Cortisol/Melatonin/Sex Hormones are normalized - then certainly address this, but make sure especially cortisol curve is normal before thinking Thyroid is the primary issue (unless having +Thyroid autoantibodies and low Free T3).

I think an important point for so many people is get to a point where you feel well … measure EVERYTHING hormonal; and when things seem to go badly, remeasure and see what has moved, and work on getting it back to when you were feeling great. Also, be aware, you could have something else going on, but hormones are incredibly important and it is a balance between all of them.

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#11

@ConquerAging
Mike Lustgarden just put out a new video on this

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