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News from Dr. Gina S. Honeyman
and the Center for Metabolic Health, LLC
In This Issue
Guidance in safely and effectively using thyroid hormone
Supply versus utilization of thyroid hormone
Updated Vitamin D Recommendations
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September 2008
Guidance in safely and effectively using
thyroid hormone...

One of the most important topics I educate people about is how to recognize the signs and symptoms of taking an excessive dosage of thyroid hormone.  You may already know that the TSH and thyroid hormone levels are not effective ways to determine adequate dosing.  Learning what signs and symptoms to watch for is effective.  

For the past seven years patients have been using my form titled "Are you overstimulated?" to track any changes that could be problematic.  I created the form to facilitate communications between us and to document their consideration of the possiblity of having any overstimulation symptoms.  
I ask people to fill out the "Are you overstimulated?" form even before they start using thyroid hormone so we can get a baseline set of data to use as a reference point.  Mo
st people have some of the signs or symptoms even before they start using thyroid hormone.  I recently revised the form so be sure that you have the current version.
One glimmer of change I have seen over the passage of time is that more and more physicians are contacting me to get permission to use my form.  It's copyrighted, but I'm glad to share the form with anyone who wants to use it.  Feel free to download it from my website and share it with whomever you like.  And, please share this and your other monitoring forms with your other physicians.  When he or she realizes that you are complying well with my metabolic rehab protocol you are likely to get better cooperation from them.
Click here for "Are you overstimultated?" form

Another way you can help your prescribing doctor is to suggest safety testing.  I encourage you to get an electrocardiogram or bone densitometry if he or she suggests that using higher dosages of thyroid hormone might adversely affect your heart or bones. 
And, be sure to fully engage in all of the components of metabolic rehab.  In addition to the right type and amount of thyroid hormone, take your nutritional supplements, eat a wholesome diet, exercise to tolerance, and get physical treatment as needed. 
Supply vs. utilization of thyroid hormone
As I was reviewing articles for current thinking in vitamin D requirements I ran across one that got my attention for a different reason.  In addition to questioning how best to measure the the body's supply of vitamin D, the authors, Prentice, et al, discuss the need to measure the body's functional and health outcomes as well.  They make the statement "However, a single biomarker of vitamin D status or threshold value is unlikely to be valid in all situations."  How refreshing to find critical thinking skills alive and well in that statement! 

Another excerpt states, "It draws attention to the importance of distinguishing between biomarkers of supply, function, and outcome and of considering the many factors that could influence interpretation, such as life stage, ethnicity, body mass index, liver and kidney function, and dietary calcium and phosphorus intake."   --American Journal of Clinical Nutrition. 2008 Aug;88(2):500S-506S.     
Now, if endocrinologists would consider TSH, free T4 and free T3 levels with the same clarity of thought we might move forward in the treatment of people with impaired thyroid hormoen regulation. At present, their standard of care is only concerned with the production or supply of thyroid hormone and ignores the function, or utilization at the tissue level.   
Be sure to ask your prescribing doctors to please consider that changes in your symptoms are better indicators of tissue utilization of thyroid hormone than are your TSH or thyroid hormone levels. 
Updated Vitamin D Recommendation
Studies are showing that we need more vitamin D than previously thought.  According to the American Journal of Clinical Nutrition, a dosage of vitamin D3 between 1000 - 4000 IU per day can raise blood levels of 25-hydroxy vitamin D to high normal levels without causing toxic reactions.  Vitamin D3 is the natural form and has less potential for toxicity.     Link to article... 
I suggest using 1000 - 2000 IU of vitamin D3 per day and sitting in the sunlight for 15 minutes daily.  Besides dietary intake, our skin manufactures vitamin D and one hour of sun exposure can generate up to 10,000 IU.  Studies have shown that sunlight/skin generated vitamin D does not build up to a toxic level.  Avoiding the sun and using sunscreens are partly responsible for our decreasing vitamin D levels.  Elderly (over 74 years of age) people's ability to make vitamin D in their skin decreases by 50% so supplementation becomes even more important for them.   

Adequate vitamin D intake is important for:

  • Bone health
  • Immune system function
  • Digestive system
  • Reproductive system
  • Decreased incidence of colon cancers
  • Blood pressure regulation
  • Reduced incidence or in relapses in MS patients who use vitamin D supplement.   

If you use the Fruit Antioxidant formula of All-One Vitamin Powder as part of your metabolic rehab, you're getting 500 IU of vitamin D2, also called ergocalciferol, per serving.  Since you should be using 2 servings per day you will get 1000 IU.  This should be adequate along with your 15 minutes in the sun.  Vitamin D2, the synthetic form, has a greater risk of toxicity from excess dosing so it's best not to push it over 1000 - 1200 IU per day.  If you do decide to add more vitamin D for a total of 2000 IU per day, please use the D3 form. 

What's on your mind?  My goal with my newsletters is to give you information that can help you get healthy and stay healthy.  Please feel free to email your questions or topics of interest so I can address them for you.
Kind regards, 

Dr. Gina S. Honeyman
Center for Metabolic Health, LLC
303.413.9100 (clinic)
720.379.8300 (fax)