Dr Jana Perdijk

15/07/2022

12/01/2022

❤️

24/03/2021

If you do self-medicate, don't jump into big doses right off the bat. Ramp you dosages in small increments both on the way up and when coming down. Watch for symptoms and side effects that can include tremors in the hands, heart palpitations, diarrhea, significant weight loss, nausea, excessive perspiration and headaches.
Cut back on your dosage immediately to reduce or eliminate these side effects. Keep your protein intake high and seek medical attention if you don't feel right while on T3 or after you have self-medicated. When ending a T3 cycle, consider some form of post cycle therapy (PCT) specific for the thyroid to help recover its function.

Most bodybuilders have used T3 safely and effectively. There are stories of people having problems with the thyroid gland being "shut down" after T3 usage. From examining the literature, it appears that recovery is a more probable event, if there isn't a genetic predisposition for thyroid disease.

Thus, consider your family history before doing a T3 cycle. If diabetes or thyroid disease runs in your family, a T3 cycle is not recommended. Also remember that roughly 10% of the public is susceptible to thyroid disease. You may be one of the unlucky ones, consider your odds.

23/03/2021

It is remarkably common in the bodybuilding world for athletes to self medicate, especially on “fat burning” drugs such as T3/ Yohimbine/ Clenbuterol. When drug abuse and mental health issues coincide, a person is said to have co-occurring disorders or a dual diagnosis.

Mental health issues in the bodybuilding world such as body dysmorphia and eating disorders (anorexia athletica, anorexia nervosa, binge eating disorders, pica, rumination disorder, etc) are often recognised as the driving factor behind an athlete’s misuse of weight loss drugs and steroids, though the directionality or sequence of the two issues aren’t always clear.

Speaking to your physician about self-medicating on scheduled endocrine drugs can help you adequately manage your bodybuilding goals.

Self-medicating on T3 or other fat loss drugs might appear harmless but it can be very dangerous. An athlete might innocently use T3 in an effort to lose weight, and the bodybuilding culture definitely reinforces and normalises it, but it can be fatal. It is important to note that a person can quickly cross the fine line between self medicating and abusing the “prescribed” drug to achieve their aesthetic goals quicker.

23/03/2021

POWDERED THYROID
Desiccated thyroid, also known as thyroid extract, is animal thyroid gland that has been dried and powdered for medical use. It is used to treat hypothyroidism but is however less preferred than levothyroxine. Powdered thyroid contain both, T4 and T3 as well as small amounts of thyroid co-factors T1, T2, calcitonin and iodine. Some proponents say this suite of ingredients is more “natural”, which is probably why some patients just feel better on it.

The thyroid extract medications Armour, NP Thyroid, Nature-Thyroid and WP Thyroid seem to be making a comeback. The drawback with some of these powdered thyroid medications is that they have three and a half times more T3 in relation to T4 compared to the ratio produced by a healthy human thyroid gland. This could lead to too-high T3 levels, which might affect heart health, bone density and cause symptoms normally found in people with an overactive thyroid.

The manufacturing process of one of the more popular and known powdered thyroid products, Armour thyroid, ensures there is a consistently potent medication from tablet to tablet and lot to lot. Analytical tests measure actual T4 and T3 activity to ensure this consistency.
Different lots of thyroid powder are mixed together and analyzed to achieve the desired ratio of T4 to T3 in each tablet. Armour Thyroid's current ratio of T4 to T3 is 4.22:1 (4.22 parts of T4 to one part of T3).

Knowing it’s ratio makes medical management easier and more accurate.

23/03/2021

TAKING T3
Cytomel (T3) is rarely prescribed on its own to address thyroid problems; it is usually prescribed with T4. In the past, cytomel was a scheduled treatment for obesity; however, an increase in heart complications and cardiac stress forced withdrawal of T3 for that application.

T3 works at the cellular level by increasing the metabolism of protein, carbohydrates, and fats, as well as increasing heart rate and blood flow. T3 is an excellent fat burner since your metabolism is greatly increased while using it.

This benefits bodybuilders in that they can afford to be on a higher calorie pre-contest diet since they'll burn excess calories with a higher metabolic rate. But remember, T3 is catabolic (you can potentially lose significant muscle mass) and long-term use can decrease bone density as well.

Cytomel is best taken several times a day. Levels of T3 will peak roughly 2 hours after ingestion and will be depleted within 4 hours. To optimize the availability of T3 and maintenance of T3 levels throughout the day, multi-dosing is a recommended course of action.

Multi-dosing avoids having total dependence on your body converting T4 to T3.

23/03/2021

TAKING T4
T4 is the most often used medication for hypothyroid conditions. Most of the mainstream physicians and endocrinologist prescribe T4. Prescribing T4 makes establishing and maintaining a proper dosing easier, and it's a rare condition when your body cannot convert T4 to T3 at the cellular level.

However, when there is difficulty converting T4 to T3, either T3 must be added to the therapy schedule or Powdered Thyroid must be prescribed. Additionally, most alternative medicine thyroid doctors believe that the powdered is a more natural way to treat thyroid disease.

When prescribed, T4 is a once a day medication. Most people take it first thing in the morning on an empty stomach. There is an option to take it sublingually to get better absorption.

To do this, the T4 tablet can be placed under the tongue and allowed to dissolve and be absorbed at a slower pace. Sublingual absorption avoids complications with digestion.

INTERACTIONS OF T4
Be aware that when and how you take medication does influence its effectiveness. For example, thyroid medication should not be taken with calcium or iron. Both of these minerals bind with thyroid hormone and make it unavailable for your body to use. Thus, you should avoid milk products two hours before and after taking thyroid medication.

There are also some medications that alter T4 levels.
Aspirin (anti inflammatory), danazol (Androgenic hormone) and propanolol (beta blocker) have been shown to increase T4 levels and furosemide (diuretic), methadone (analgesic), lithium, aluminum-containing antacids, colestipol (bile acid sequestrant) and rifampin (antibiotic) have been shown to decrease T4 levels.

There are also some unique interactions. Progesterone and estrogen are substances that can bind with T4, but also tend to increase T3 levels. Anabolic steroids tend to decrease thyroid hormone levels. Finally, thyroid hormone can suppress insulin, an important consideration for diabetics and bodybuilders using insulin.

Finally, if diagnosed with hypothyroidism, you will be taking medication for the rest of your life.

18/03/2021

THYROID MEDICATION
Many bodybuilders take thyroid hormone in hopes of increasing their metabolism and reducing their bodyfat percentage for a contest. It is good in theory and generally harmless over a short duration, but in order to lessen the likelihood of muscle catabolism, a blood test in conjunction with use is needed.

A blood test will tell you if you are taking excess thyroid hormone and are hyperthyroid - an undesirable, catabolic condition.

There are three types of medication used to boost circulating thyroid hormone:

T4
COMMON NAMES
Synthroid, Levoxyl, Unithroid, Levothroid, and Euthyrox

T3
COMMON NAMES
Cytomel, Cynomel, Cyronine, Cytomel Tabs, Euthroid, Linomel, Liothyronin, Neo-Tiroimade, Ro-Thyronine, T3, Tertroxin, Thybon, Ti-Tre, Tiromel, Tironina, and Trijodthyronin.

POWDERED THYROID
COMMON NAMES
Armour Thyroid, S-P-T, Thyrar, Thyroid Strong (animal thyroid gland with a set T4/T3 mix).

Based on a physician’s experience, they generally prescribe either T4 or Powdered Thyroid, but generally not both. Some will prescribe T4 and T3 simultaneously. When a physician prescribes both T3 and T4, the type of abnormal thyroid condition being treated usually dictates it.

Bodybuilders prefer the active hormone, T3, when preparing for a contest because it is the more potent hormone.

16/03/2021

THYROID HORMONE BLOOD TESTS - Part 3

Other/additional thyroid blood tests:
* Thyroid antibodies
* Thyroglobulin

Thyroglobulin antibody (TGAb), Thyroid Peroxidase antibody (TPOAb) and Thyroid Stimulating Hormone Receptor antibody (TSHrAb/ Thyrotropin Receptor Antibody)

A thyroid antibodies test is used to help diagnose autoimmune disorders of the thyroid such as Hashimoto disease (most common cause of hypothyroidism) and Graves’ disease (most common cause of hyperthyroidism).

Antithyroid antibodies target specific parts of the thyroid gland, including:
Thyroid peroxidase (TPO), an enzyme that plays an important role in thyroid biosynthesis.
Thyroglobulin (Tg), a substrate that synthesises and stores thyroid hormones.
Thyroid stimulating hormone (TSH) receptor. TSH sticks to the receptor on thyroid cells, which causes the gland to synthesise and release thyroid hormone into the blood.

TG (Thyroglobulin, TG):

Thyroglobulin (Tg) acts as a substrate for the synthesis of the thyroid hormones thyroxine (T4) and triiodothyronine (T3), as well as the storage of the inactive forms of thyroid hormone and iodine within the follicular lumen of a thyroid follicle.

Thyroglobulin is a substrate produced in all healthy individuals, and normally its level in blood is low. Thyroglobulin levels increase in both benign (Graves’ disease, subacute thyroiditis, Hashimoto thyroiditis) and thyroid cancer. Therefore, it is on one hand a non-specific indicator of a thyroid dysfunction and, on the other hand, a tumor marker that can be used to monitor patients with thyroid papillary and follicular cancer after diagnosis

When getting any tests performed, you should have some background knowledge to better understand the results. Most doctors are very good, but they are not infallible. Why do you think second opinions are often recommended?

You should have the basic knowledge to interpret test results. With the knowledge you can then challenge your medical professional for the most accurate assessment, and together, formulate a plan to optimize your health and bodybuilding and athletic progress.

16/03/2021

THYROID HORMONE BLOOD TESTS - Part 2

Other/additional thyroid blood tests:
* RT3
* T3U
* FTI

Reverse T3 (rT3, Reverse Triiodothyronine):

Reverse T3 (rT3) is a biologically inactive metabolite of T4 that is produced in the body particularly during periods of stress. Under normal conditions T4 will convert to both T3 and rT3 continually and the body eliminates rT3 quickly. Under certain conditions, more rT3 is produced and the desirable conversion of T4 to T3 decreases. This occurs during fasting, starvation, illness such as liver disease and during times of increased stress, as a mechanism for preserving energy. Ideally reverse T3 should be between 200-300 pmol/L and if found to be above 400 pmol/L indicates the presence of reverse T3 dominance.

T3 Uptake (T3U):

This is a measure of the unbound throxine binding globulins in the blood (unsaturated with thyroid hormone). The less thyroid hormone that is present, the more unsaturated TBG is present.
This is an indirect measure of thyroid hormone levels. It has nothing to do with T3, despite the name. The results of this test are useful only when evaluated along with other thyroid function tests.
Normal range is 25-35%.

FTI (Free Thyroxine Index, FTI, T7):

Free thyroxin (T4) can be measured directly (FT4) or calculated (FTI). The FTI is a measure of the amount of T4 in relation to the amount of thyroxine-binding globulin present. The FTI is obtained by multiplying the (Total T4) times (T3 Uptake) to obtain an index.
The FTI value can indicate when an abnormal level of thyroxin-binding globulin in the blood causes an abnormal level of T4. Typical levels range from 1.75-4.95.

13/03/2021

THYROID HORMONE BLOOD TESTS - Part 1.

If you’ve been on a “thyroid journey” for a while now, you might be familiar with some of the big names in thyroid health. There’s TSH, T4, T3 and then there’s the thyroid antibodies.

A common panel of thyroid function tests consists of:
* TT4
* FT3
* FT4
* TSH

T4 (Thyroxine):

This is a measure of all of the active form of thyroid hormone in the blood. 95% of the total is bound to plasma proteins, particularly thyroid binding globulin (TBG). 
Typical values range from 64.4-154 nmol/L.

T3 (Triiodothyronine, T3-RIA) by radioimmunoassay:

T3 is metabolically a more active form of thyroid hormone than T4, but its effects are of shorter duration.
Typical levels range between 1.0-2.6 nmol/L.

Free T3 (FT3, Free Triiodothyronine):

Free T3 is one of the determinations used to measure thyroid function. T3 is mostly bound to plasma proteins, and the remainder (FT3) is unbound. Typical levels range from 3.54-5.44 pmol/L.

Free T4 (FT4, Free Thyroxin):

Most thyroid hormone is bound to plasma proteins. Some (about 5%) is not bound ("free") and available to serve a metabolic role. Free T4 is the most accurate assessment of thyroid hormone levels, because it avoids changes in plasma protein binding capabilities. Typical ranges are between 10-30 pmol/L.

TSH (Thyroid Stimulating Hormone):

The TSH value provides an indication of how well the feedback mechanism and thyroid are functioning. Normal values are from 0.4 to 4.0 mIU/L for those with no symptoms of an under- or over-active thyroid.
Values below 0.4 are considered hyperthyroid, values 4.0 and slightly higher are considered sub clinical hypothyroid and values generally above 10 indicate full hypothyroid conditions.

12/03/2021

HYPERTHYROIDISM
Hyperthyroidism, also known as thyrotoxicosis, is a clinical condition caused by excess quantities of thyroid hormone in the body. The condition may be caused by over production by the thyroid gland or the pituitary gland releasing excessive TSH.

The excess of hormones can cause heat intolerance, increased energy, difficulty sleeping, diarrhea and anxiety and other symptoms as listed in the table.

Graves' disease is the most common condition associated with hyperthyroidism. Graves' disease is a basic defect in the immune system that causes production of antibodies that stimulate and attack the thyroid gland. This attack on the thyroid causes growth of the gland and overproduction of thyroid hormone

Factitious hyperthyroidism is another hyperthyroid condition. It is associated with ingestion of excessive amounts of thyroid hormone. Thyroid hormone preparations have been available for over a century and taking excess prescription or glandular mixtures can also cause hyperthyroid conditions.

This is a condition that bodybuilders can fall into when taking thyroid hormones.

Symptoms of Hyperthyroidism

Nervousness, anxiety and irritability
Mood swings
Difficulty sleeping
Feeling tired all the time
Heat intolerance
Rapid heartbeat
Scant menstrual periods
Diarrhoea
Infertility
Hair loss
Weight loss
Hand tremors