Dec 1, 2018
By Raina Kranz-Kaplan
WHAT IS the DIFFERENCE of having a thyroid gland and not having a thyroid gland when it comes to thyroid disease?
Many of you are unaware of how thyroid hormone is produced and dispersed, degraded and used by the body. The misconceptions that not having a gland is worse than having a gland is not a balanced statement. I am going to try to explain this.
1) Those of you without a thyroid gland, you lose any production of T4 and T3 ( intra-thyroidal production of both hormones) Meaning both hormones are made with in the gland ( about 80% is of T4, 20% of T3)
2) For those of you with Hashimoto's hypothyroid depending on the stage of your disease or the damage done to the gland, you may have some production still within the gland, very little production within the gland or none at all. End stage Hashimoto's usually means no thyroid hormone production at all. The gland is dead.
A healthy gland that produces enough intra-thyroidal hormones will then go through the VERY SAME PROCESS of entering other areas of the body in " TOTAL T4/T3 form ( meaning bound to a protein molecule) From there T4 and T3 further degrades and enters the blood stream as it's bio active free form ( Ft3 and Ft4)
Those of us with a gland and those of us with a destroyed gland or a end stage gland, go through the very same processes once we take our T4 medication.
3) All T4 medication is digested and absorbed in the intestines.Then it is dispersed bound to a protein molecule to organs and tissues in the body. From there T4 hormone is degraded to total T3 and rT3 and then eventually degraded further into FT3 and Ft2, Ft1 with in the blood stream.
This process is the same for everyone on T4 medication with or without a gland.
4) Those of us who still have a gland may actually still be producing some intra- thyroidal T4 and T3, but not a whole lot.
WHAT the biggest difference is for those without gland is the 20% of Total T3 that is produced in the gland. Once that is gone, you will no longer produce any thyroid hormone. If someone who does not have a gland any-longer is only T4 hormone, you have LOST that extra oomph that someone with a well functioning gland has, that 20% of T3.
Those of you with a gland, you will lose that extra oomph too, once your gland is end stage and no longer producing any hormones either.
When you have no more function from your gland (surgical or end stage hashimoto's) and you are on T4 only, you will feel under-treated.
This is how T4 hormone travels through body once you take your medicine.
1) Intestinal absorption
2) Disbursement to other organs and body tissues
3) Degradation to total T3 and rT3 within the organs and tissues.
4) Further degradation to Ft4, Ft3 and rT3 with in blood stream.
All T3 hormone medication BYPASSES entering the organs or body tissues. All T3 medication is dispersed into the blood stream and has nothing to do with conversion.
T3 medication does not replace the loss of the Total T3 that was once produced in the gland. T3 medication cannot replace total T3 that is converted from T4 hormones. All T3 medication does is increase the Free T3 levels within the blood stream. So, if you are a poor converter of T4 to T3 within the organs and body tissues, you will ultimately have lower Ft3 levels in the blood stream and may be converting more than you should to rT3. The T3 medication only increases the T3 within the blood stream.
Total T3 hormone is very important in this process. Please do not overlook that need for appropriate levels of total T3. BY adding T3 medication, only your Ft3 will be enhanced. T3 medication does not enhance Total T3 levels. Only good conversion of T4 will increase total T3 levels. Good total T3 levels will result in good further conversion to Ft3.
Most of us eventually need the addition of T3 medication and this is usually due to slower, not efficient conversion of T4 hormones. Age, Disease, Alcohol intake, other drugs and environment are all reasons why our T4 to T3 conversion within the body is diminished.
Whether or not you have a thyroid gland, does not change how the body processes T4 hormone and eventually your labs will indicate the need to add T3 medication.
The only real way to replicate what a healthy thyroid gland produces, would be to manufacture a medication that is both T4 and T3 in the right percentages 80/20 and the T3 is in a bound form like T4 medication. This way the T3 would actually go through the normal degradation, enter the body organs and tissues and then further degrade to Ft3.