Thyroid disorders -- Dr. Wierum

Thyroid disorders -- Dr. Wierum

There are 8 comments on the The Tennessean story from May 7, 2008, titled Thyroid disorders -- Dr. Wierum. In it, The Tennessean reports that:

We are online today with Dr. Wierum, an endocrinologist at Baptist Hospital here today to discuss thyroid disease. via The Tennessean

Join the discussion below, or Read more at The Tennessean.


Croydon, PA

#2 May 17, 2008
How do you feel since being on medication. Do you feel it's working?

Perhaps you need to try a different medication, which you should discuss with your doctor. One alternative is Armour which is a naturally dervide medication from dessicated thyroid. It is a prescription medication and I read testimony indicating that some who take it feel better than when taking synthetic medication such as levothyroxine.

Croydon, PA

#3 May 17, 2008
How To Monitor Your Treatment With Natural Hormone Therapy

Should You Use Synthetic Hormones?

The traditional approach is to use synthetic hormones like Synthroid/ Levoxyl/Levothroid (levothyroxine). These products only contain T4 hormone, they have no T3.

When a patient attempts to ask their physician for the natural hormone they are usually ridiculed and made to feel stupid that they would request an inferior hormone product.

The common argument the physicians give is that the synthetic provides steady hormone levels. What the doctors tend to overlook is that the vast majority of people can not convert the T4 to the active form of thyroid which is T3. This is easy to cofirm by measuring the free hormone levels, but virtually none of the doctors use these tests.

Armour Thyroid--The Natural Alternative

When one has low T3 levels, which are typical with synthetic hormone use, the brain does not work properly. It is important to use a preparation with T3 because T3 does 90% of the work of the thyroid in the body. So one should use a combination of T4 and T3 which compensates for the inability to convert T4 to T3. Armour thyroid is desiccated thyroid and has both T3 and T4.

A 1999 study published in one of the most prestigious medical journals in the world, the New England Journal of Medicine, showed that the natural hormone product, such as Armour, was far better at controlling the brain problems commonly found in hypothyroidism. Nearly all natural medicine doctors tend to use Armour thyroid which is a mixture of mono and di-iodothryonine and T3 and T4, the entire range of thyroid hormones.

Armour Thyroid Dosing-- TWICE a day.

The most common starting dose for patients with hypothyroidism is Armour thyroid, 90 mg which is cut in half with a razor blade and half is taken after breakfast and the other half after dinner. Taking it after meals also helps to reduce volatility of the blood-level of T3. If the patient has any problem breaking or cutting the pill, they should purchase a pill-cutter at the pharmacy. The TSH, Free T3 and Free T4 are then repeated in one month and the dose is adjusted.

Taking the Armour thyroid twice a day overcomes traditional medicine's major objection and resistance to using natural thyroid preparations - its variability in its blood-levels. Most doctors using Armour thyroid are not aware that Armour thyroid should be used twice daily and NOT once a day. The major reason is that the T3 component has such a short half life and needs to be taken twice daily to achieve consistent blood levels.

Dose Adjustments With Lab Monitoring

Once on hormone replacement, the dose should be increased until the TSH falls below 0.4. Then one needs to optimize the 2 thyroid hormones by using the Free T4 and Free T3 levels.

The Free T3 and Free T4 are used to monitor the treatment. They should be above the median (middle) but below the upper end of the laboratory normal reference range. The goal for healthy young adults would be to have numbers close to the upper part of the range, and for cardiac and/or elderly patients, the numbers should be in the middle of its range.

Croydon, PA

#4 May 17, 2008
The Free T3 and Free T4 levels should be checked every month and the hormone therapy readjusted until the FT3 and FT4 levels are in the therapeutic range described. Once a theraputic range is acheived the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant women may need 6-8 grains of Armour thyroid or the equivalent of thyroxine per day (counting 0.1mg of T4 as 1 grain of Armour Thyroid).

For those people who are already on once daily Armour thyroid should split their doses immediately and take half after breakfast and half after dinner. Since the only change will be in the FT3 level, which has a short half-life, the serum FT4 and FT3 levels (and TSH, if indicated) can be measured 48-72 hrs after the splitting of the doses if the patient had been on the hormone for 4-6 weeks before the splitting of the doses. This is because the Free T4 hormone is the one that takes a number of weeks to build up to its steady-state serum-level.

Symptoms of Excessive Thyroid Hormone

There are frequently only temporary during the adaptation stage. The symptoms may include: palpitations

feeling hot and sweaty
rapid weight-loss
fine tremor
clammy skin

What To Do If You Can Not Tolerate Armour Thyroid or Want To Continue Synthetic Hormones

My experience is that well over 90% of people do much better on Armour thyroid. However, there are a small number of people who do not tolerate it. This is most frequently done with Armour thyroid. However, Cytomel, which is T3 only, can be used in combination with one of the T4 only synthetic preparations mentioned above. It is important to recognize that T3 should always be prescribed twice daily due to its shorter half life. This is typically after breakfast AND supper for compliance reasons.

If you are currently taking Synthroid (thyroxine), your Free T4 level is usually at or above the high end of its normal range and your Free T3 level is usually below. In this situation, one may then add 5-12.5 mcg Cytomel (pure-T3) after breakfast and supper daily, rather than Armour Thyroid or Thyrolar (synthetic T4/T3 combo).

Once or twice daily dosing one can then optimize both the T4 and T3 levels, with whatever thyroid preparation is required. This is not possible in most hypothyroid patients with T4 only preparations.

People Who Should Not Take Cytomel

The only exception to pursue optimization of the T3 level without using Armour thyroid is in severe acute cardio-pulmonary conditions, such as congestive heart failure, when the metabolic slowing effect of a low FT3 level can actually be life-saving. However, the vast majority of hypothyroid patients do not have this problem.


ęCopyright 1997-2001 by Joseph M. Mercola, DO. All Rights Reserved.
marjn kaftousian


#6 May 24, 2008
I am 37 years old from last month i got sever dermograph hives then i asked doctor to have lab test to check my anti-Ds DNA and it was positive and anti -Thyrogluboline is 2059 but T3 T4 and TSH are normal. Do I have HAshimatos and if it is what is the best treatment to obtain best result without gainig weigh. Please le me know. [email protected]
John Brown


#8 Feb 5, 2013
I have ordered prescription drugs (without a prescription) online from about two years ago, and was pleased with the speed and quality of service.
I'm thinking of doing the same thing with my medication. The meds is expensive, but there is a generic version available overseas.
I love the idea of taking responsibility for my own health (or lack of health) and skipping the bureaucracy... to say nothing of having to drive to the doctor, wait in line, yet again, to get a prescription refilled.


#10 Apr 20, 2013
i wrote:
I have ordered prescription drugs (without a prescription) online from about two years ago, and was pleased with the speed and quality of service.
I'm thinking of doing the same thing with my medication. The meds is expensive, but there is a generic version available overseas.
I love the idea of taking responsibility for my own health (or lack of health) and skipping the bureaucracy... to say nothing of having to drive to the doctor, wait in line, yet again, to get a prescription refilled. very clear and informative site, simple ordering process and very fast delivery. All round excellent service - will use again.

Tel Aviv, Israel

#12 May 20, 2013
I am 45 years old and used eltroxine50 mg(GSK) for 7 years(after post partum HASHIMOTO).Before 18 month elthroxine was changed to Eutirox . Eutirox was not good for me (I feel dizziness).During all period the thyroid function was OK (TSH 2.5-4)and ANTI TPO ABS- 107 THYROG.ABS-17.My doctor recomendet to me change to SYNTHROIDmg. For this moment I stopped with Eutirox month ago and the TSH 4.5-5 andANTI TPO ABS- THYROG.ABS -the same.Is it mean that I can manage without treatment or thyroiditis will be stronger without treatment? Another question if I have predisposition for thiroid cancer?
Thank you in advance


Milan, Italy

#15 Sep 11, 2013
have been researching for months and reading reviews for each pharmacy and finally decided to take the plunge and order from one. After coming to the conclusion seemed the most safest and had the best feedback I ordered my pills. Was very apprehensive at first due to cc fraud, ell and they are good i would definetely recommend and purchase againspam and being generally ripped off (have not received one spam email and no cc fraud) order process and checkout was simple.
placed my order on my debit card and was charged straight away and received confirmation email immediately. choose the speedy del trackable and was advised del would be 7-9 days and order was placed on the 08/01. was just about to email them today to chase up as now 15 days but behold package had been posted through my door. packaging seems as shown on webiste. apart from small delay on advertised shipping time i have been generally please with the pharmacy.
wont be taking the pills for another few weeks yet but all going well and they are good i would definetely recommend and purchase again from them.

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