Understanding the use and function of thyroid medications: Thyroid health, Part 3

Author’s note: Many subjects will be covered in this four-article series about thyroid health and healthy metabolism. In Part 1, we covered iodine requirements, associated drugs, self-care, medical and home treatment, and medical repercussions are covered. Although it is hard to cover every piece of information, a broad overview will be provided in each section. Low thyroid issues are prevalent in many patients. Part 2 went in-depth with more information about the function and problems of the thyroid. Today, in Part 3 will be about the use and functions of medications T2 & T3 & T4 as well as doctors’ information. Part 4 will conclude with the “Bad News”.

By Garnett Stewart

We have had inactive thyroid supplements, T4, for approximately 100 years. T4 (euthyroid hormone) is simple to prescribe, has few adverse effects, is low-cost, and worked to induce the thyroid hormones when needed. T4 is a storage hormone that is activated and converted to T3. It aided sufferers of sluggish and low metabolism. The best benefits are weight loss and added energy but it does leech minerals from your bones to work in the absence of supplements.

We have known for decades that Iodine and Boron were microelements and minerals required as cofactors of these hormones. Some multivitamin with mineral formulations may contain less than promised. And absorption is much less than that listed on the label.

Remember that supplements are called supplements because they are meant to supplement your diet. They must be taken with food and liquids in order to break down those tough tablets into absorbable nutrients. It is believed that you absorb only 20-30% of the items on the label. The manufacturers incorporate more than the RDA in their pills now.

Generic levothyroxine T4 costs about 2 two cents per day in Ecuador. Most pharmacies only carry one medication: Euthyroid in English or Eutiroideo en español.

A very fascinating thyroid medicine for people with inadequate thyroid levels was discovered a few decades ago. Cytomel is the commercial name for T3, often known as active thyroid. But because T3 has both positive and negative side effects, some of which can be deadly and the doctors who prescribe it need to be properly trained.  T3 costs roughly 40 cents each pill, and the usual dose is half a pill.

Farmacia Eloy Alfaro on Ordonez Lasso sells sealed bottles of 100 pills of T3 for around $40. It’s difficult to come by. Before I had to acquire it in Malaysia and have it brought here from the states.

How to use Thyroid medications

Take your thyroid medication at least 1 hour before breakfast, as well as any calcium or iron supplements. In this case, an empty stomach enhances absorption. If you wish to take it before bedtime, wait at least 3 hours after eating or taking calcium or iron supplements.

Assume a senior with heart difficulties takes a greater dose of T3 without consulting a doctor.  Could it lead to a fatal outcome?  Yes, it could.

These drugs are not suitable for weight loss since they have detrimental effects on teeth, bones, and internal organs.  Too much T3 may cause thyroid spikes as well as other negative effects. Be sure to seek treatment from an expert endocrinologist.

Armor thyroid was often used in the states and it is a combination of T3 and T4. In Ecuador, you need both medicines to get these results and an endocrinologist trained to prescribe them.

People frequently ask about me about medical facilitators. I can speak both medical and general Spanish fluently, albeit occasionally incorrect. Medicine is not the same as calling for a taxi. Doctors, nurses, medical students, and other medically trained personnel who speak both English and Spanish can make excellent facilitators if they prepare and communicate well.

I advise using a medical facilitator but NOT a translator. You provide thorough medical information so your facilitator can aid in your care.  Give your facilitator authority to take action on your behalf. But a recent story was shared that a “facilitator” not medically trained made incorrect statements. The doctor reflected on the next visit the data given and it was not accurate. The patient was a prescribing provider in the states and this so-called facilitator did deplorable service.

This video above explains that T2 is being investigated and sold over the counter in the states. When it arrives in Ecuador, our top Endocrinologists may be the first to know and understand combining T2, T3 and T4.

Most medical conditions and concerns are thoroughly explained on WebMD. I encourage you to read and learn more about this subject. It is impossible to cover everything that is required, but these articles will provide an excellent general education. I read scientific papers and they are far too detailed for most people. However, WebMD and others are now writing for laypeople.

In 2017, Dr Cordero was the only endocrinologist in Cuenca with this training. I was overjoyed to discover another doctor in Cuenca.

Dr Marcelo Hernando Cordero Loyola speaks some English. His office is near St Ines and Hospital del Rio. Tel. 07-245-5314. He has his own lab and pharmacy. 098 025 9900. Email Marcelo.cordero@delrio.com.ec

Although he lacks the specific training, Dr. Carlos Tigsi is another local doctor who is very knowledgeable in the treatment of thyroid problems. He speaks Spanish only. His office is near Isabel la Catholica and Don Bosco. Tel. 096 907 1272. Email   carlitotigsi@gmail.com

He will accept any private labs and works at IESS. Getting free T3 and free T4 labs can be very helpful. TSH is compulsory. Often, I spend $50 is private lab fees since not all labs are a covered IESS expense. The building is filled with other family members who are all practicing physicians.

Ecuadorian doctors are not taught about active thyroid T3 use or diagnosis. You must enquire since they will not tell you.

Only your endocrinologist should change the doses if you are taking both drugs. We require expert consultations now more than ever. Monitoring three thyroid meds is a hard endeavor, and having a skilled doctor is analytically needed.

Please! If you know of any other endocrinologists who have been specifically educated in the administration and dose of active T3 Cytomel, please let me know. I will gladly post that doctor’s name and contact information. Of course, I’ll confirm the references. For more information, click here.
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Garnett Stewart is a permanent resident of Ecuador. She is a retired Adult Medicine Nurse Practitioner with a specialty in Cardiology and Cardiovascular Surgery and is the author of several published articles. She holds Bachelors and Masters degrees in nursing. Her undergraduate university studies focused on biochemistry and biophysics. She can be contacted at Ecuador.advice@gmail.com