Hi everyone! Very nice forum. I'm a new member. I’ll start chelation on DMSA in a few days. I'll keep you posted on my progress in another thread. However, I just wanted to give out some useful information for those of you who might want to check out their thyroid gland status before chelating. I know that some people here have requested this kind of information. I've been suffering from Hashimoto's thyroiditis for quite a while and I've been through the works with hypothyroidism! The list of symptoms is long and IT IS related to CFS/Fibromyalgia, depression, bipolar II, psychiatric illness and of course... the culprit, as you know, is mercury toxicity. Mercury puts the immune system upside down. This is why these illness are oftenly accompanied by allergies.

The first blood test to do is called the TSH test. TSH stands for Thyroid Stimulating Hormone, produced by the pituitary gland (the hypophysis) that controls the thyroid's production. The TSH can give you an indication of your thyroid status. It is extremely important to keep in mind that the TSH test is absolutly no silver bullet. Usually, a normal TSH range is between 0.3 and 3.0 mU/L. If your TSH result is greater than 3.0 there is no doubt that you are hypothyroid (yes, this is counter-intuitive: when the TSH is near to suppression it means you are HYPERthyroid). If the TSH is between 1.5 and 3.0, you can check your Free T4 and Free T3 tests results (always have them done if possible, they give precious information). Whatever the reference range specified by the lab for these tests, if the results are not OPTIMAL, that is, not at the top of the reference range, then you are hypothyroid, and this is especially true for the Free T3 result, especially when you have a long list of symptoms. You can also do the anti-thyroperoxidase and anti-microsomal antibody titres blood tests. A high antibody titre confirms that the immune system is attacking and destroying the thyroid gland.

The thyroid produces both thyroxine (T4) and triiodothyronine (T3). Althought T4 has some active properties in itself, it acts mainly as a pro-hormone: T4 needs to be converted to T3 by an enzyme. The most metabolically active molecule is T3.

The effects of mercury on thyroid status is fourfold : 1) mercury can cause the dysfonction of the immune system, now attacking the thyroid and God knows what other organs (like the brain?!); 2) mercury has an affinity with iodine atoms (the thyroid is one big juicy iodine sponge) so it is theorized that maybe the antibodies are actually attacking the gland because there is mercury present; 3) we know for a fact that mercury inhibits the enzymatic convertion process of thyroxine (T4) into liothyronine (T3) and 4) mercury can bring the pituitary gland to ‘malfunction’, thus giving out false TSH values and an improper thyroid control resulting in either hyperthyroid or hypothyroid status, or both within a certain interval of time, causing a bipolar like symptology and psychotic-like episodes.

I have been able to confirm that I have this ‘convertion problem’ because any T4 dosage raise I do is very hard for me (it's really 6 weeks of pure hell) and my T4 supplement is not doing as good a job as my T3 supplement. I can also confirm the results from a study that stated that the brain is pretty fancy-pants, in that it likes to convert its own T4 into T3 according to its needs. I have not been able to get rid of the infamous “brain fog” with T3 alone. T4 is better at this – yet T3 still remains by far the best anti-depressant of the two.

Not everything goes away with thyroid hormone replacement therapy. Although most of the time thyroid replacement brings the adrenals back on track after a few months, I have observed that brain fog is separate from the “attention deficit” or concentration problems. The mercury, in itself, must be causing my attention deficit. Also, not all my fatigue went away but I saw a vast improvement. I am convinced that getting your hands on a thyroid supplement could help you fight candida because it re-establishes a normal ATP metabolic activity. Personally, my digestion and my stools have improved greatly since.

You can choose from many brand names. Armour Thyroid is dessicated hog thyroid that contains both T4 and rapid-release T3 (I didn’t like it and had a minor skin allergic reaction). On the synthetic side of things, for T4 there is Synthroid, Unithroid, Levoxyl and the such. The only brand of synthetic T3 available is called Cytomel. Cytomel is also a rapid-release format. That means that approx. 95% of the drug gets absorbed within an hour or so in the stomach. Thus, rapid-release is not for everyone. Usually, patients spread the dosage throughout the day, and take it 3 to 4 times a day, so to avoid mood swings, exasperation, and a general feeling of yucky-ness. It’s not very practical.

It is my experience that the really good stuff is SUSTAINED-RELEASE T3, that you must get from a compounding pharmacy. The pharmacist takes the liothyronine and mixes it with a special agent that will release the T3 over 10 to 14 hours (depending on your physionomy). The result is a really smooth feeling. If you suffer from fibromyalgia, chronic fatigue and depression, SUSTAINED-RELEASE T3 is the wonder drug you want to try out, believe me. The problem is finding a doctor willing to prescribe any T3 at all (they are all pretty much stuck within a T4 dogma these days).

The half-life of T4 is very long (14 days), so it takes quite a while to reach the dosage level in the blood stream and thus T4 can only be raised each 6 to 8 weeks. T3 has a half-life of only 2 days at most. It takes only 6 to 8 days to reach the dosage level in the blood stream. So you can safely raise T3 doses each 2 weeks. With both T4 and T3 you can get some palpitations and sweats, but these symptoms are temporary. The goal is to bring the TSH somewhere between, say, 0.5 and 1.2 depending on the symptology and to get an optimal Free T3 result.

T3 has a pretty strong effect on the central nervous system. It can cut depression pretty fast. I suggest you start with 5 to 6.25 mcg (MICROgrams) and raise by such increments each 2 weeks. T4 is easily available from a GP if the TSH is out of range. The initial dosage for T4 is 50 mcg with 25 mcg raises each 6 to 8 weeks but beware the nasty side effects during the first 4 to 6 weeks of each raise.

Don't go too fast on T3 raises. Give your adrenals time to cope. Go slowly, give your body time to adjust. Try to get your TSH back to around 1.0 and try to keep a 4:1 ratio of T4 to T3 if possible, but go with what works for you. If you feel fine with only a T4 regimen, then fine. People with convertion problems will have a higher T3 ratio, of course.

I hope this has been usefull.