The People's Perspective on Medicine

Bonus Interview: Dr. Antonio Bianco Describes His Remarkable Thyroid Research

Dr. Bianco's thyroid research helps explain why some people may feel better with a combination of T3 and T4 to treat their hypothyroid condition.
Doctor palpates patient’s neck to check thyroid gland

You will hear the highlights of Dr. Bianco’s discussion of the genetic differences among human beings that have an impact on thyroid well being on Show 1015: Thyroid Mysteries, Controversies and the Latest Research. His thyroid research shows that these alterations in our genetic makeup affect how easily we convert the four-iodine thyroid hormone T4 (levothyroxine) to the active three-iodine thyroid hormone T3 (triiodothyronine). What effects do these changes have on the standard tests for thyroid function and on patients’ feelings of wellbeing?

There just wasn’t enough time for his entire interview in the show, so we offer it here. You can listen to the entire unedited interview and learn more about the thyroid gland and thyroid research than you ever imagined.

The Guest:

Antonio Bianco, MD, PhD, is head of the division of Endocrinology and Metabolism at Rush University Medical Center. His articles include: “Coordination of hypothalamic and pituitary T3 production regulates TSH expression.” Journal of Clinical Investigation, April, 2013; “Cracking the code for thyroid hormone signaling.” Trans American Clinical and Climatological Association, 2013; “Defending plasma T3 is a biological priority.” Clinical Endocrinology, Nov. 2014; “Differences in hypothalamic type 2 deiodinase ubiquitination explain localized sensitivity to thyroxine.” Journal of Clinical Investigation, Feb. 2015; “Coupling between nutrient availability and thyroid hormone activation.” Journal of Biological Chemistry, online Oct. 23, 2015; and many others.

Dr. Bianco also co-chaired an American Thyroid Association task force that updated the guidelines for treating hypothyroidism. They were published in the journal Thyroid.

More Listening:

If you enjoy Dr. Bianco’s interview, you may also want to listen to Dr. Ridha Arem on how to achieve thyroid balance.

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    As a biologist and a thyroid patient, I really enjoyed Dr. Bianco’s balanced and science-based remarks.

    I’m currently at dosage 0.75 synthroid. I’m 70. I had a thyroidectomy at age six, no medication was prescribed until age 26. At age 27 I was given a complete MRI testing in thyroid which showed a hack job on my right thyroid gland. I was prescribed synthetic thyroid. The dosage increases went up/down throughout the years until I stopped voluntarily after a prescription ran out.

    I continued without synthetic thyroid medicine for nearly 3 years. During that time period I lost weight more easily (nearly 100 lbs), back down to 135 lbs my standard adult weight. After having had a physical at age 42 an extreme low thyroid was discovered so I resumed synthetic thyroid med. … which too, included intermittent changed dosages of medication. My doctor treats my complaints as age related. I’m looking for an Endocrinologist since my requests for one have fallen on deaf ears. I have all the typical (complaints), symptoms, others have mentioned, especially the drying of skin and all over body aches.

    CoQ10 really help to alleviate soreness. A probiotic helps with stomach problems. I drink plenty of clear fluids and eat healthy. I do suffer from obesity (again) and continued edema in both legs below the knee area which started in my early thirties after an ankle injury. As long as I’m able to keep my weight at a certain level my blood pressure stabilizes and my glucose test is negative otherwise I’m a borderline type 2 diabetes risk at which I presently have miraculously been able to avoid other prescribed medications. How do I convince my doctor to prescribe Armour? I feel it may be of benefit. Finding a new doctor is difficult if not impossible due to new challenges in insurance changes and long waiting lists. The only med I take is Synthetic Thyroid…Synthroid.

    I’m currently at dosage 0.75 synthroid. I’m 70. I had a thyroidectomy at age six, no medication was prescribed until age 26. At age 27 I was given a complete MRI testing in thyroid which showed a hack job on my right thyroid gland. I prescribed synthetic thyroid. The dosage increases were up/down throughout the years until I stopped after medication ran out and no available transportation for an hour drive to pc physician.

    I did without synthetic thyroid for nearly 3 years, losing nearly 100 lbs. I had a physical at age 42 and discovery of extreme low thyroid so resumed synthetic thyroid med. which too included intermittent changed dosages. My doctor treats my complaints as age related. I’m looking for an Endocrinologist since my requests for one have been denied. I have all the typical (complaints) symptoms others have mentioned especially the drying of skin and all over body aches.

    CoQ10 really help to alleviate soreness. A probiotic helps with stomach problems and any constipation flare ups. I drink plenty of water for dry mouth. I do suffer from obesity (again) and continued edema in both legs below the knee area. How do I convince my doctor to try Armour? Finding a new doctor is difficult since my primary insurance is now Medicare (age related) versus my former employer insurance which was lifelong insurance upon retirement. Many doctors won’t accept Medicare or there are several years waiting list. In my community.

    Dr Antonio Bianco: Have hypothyriodism (5 years) — currently on about 90 MCG (cutting pills) per day. Four endocrinologists (Albuquerque NM) and two primary physicians claim I’m OK! But I’m not. Latest labs = TSH 1.7, T4 free 1.6 and T3 free 2.1. yielding severe fatigue, foggy brain, sensitivity to cold, scaly dry skin and other symptoms. Am 88 yrs old, living in Phoenix AZ and have read many of your papers on the advantages of dual meds (t4 and t3)vs monotherapy. Any guidance would be greatly appreciated. Thank you.

    Hello, my name is Forough and I come from Iran, South Asia. I’ve been diagnosed with Hypothyroidism 4 month ago. Three weeks ago, I’ve been on 50 mcg Levothyroixine. My lab results were as follows:
    T4= 5.3 (5.6-14.1),
    T3=.78 (.52-2) ,
    Free t4=.93 (.93-1.8) ,
    Free T3=4.78 (3.1-6.8) ,
    TPO Ab = 72
    I’m 54 years old now with good health (no chronic disease and BMI=24) and no symptoms of hypothyroidism except mild fatigue. I have been suffered from menorrhagia for 4 years and I had to control bleedings by NSAIDS (Gelofen, Mefenamic acid) for 2 years. Also, I had to use Iron supplements for 8 years. I wonder whether it is necessary for me with normal T3 to take levothyroxine because I feel more fatigued nowadays. Is it probable that taking NSAIDs and Iron supplements caused my hypothyroidism? Now my bleedings are low and I don’t take any medication except levothyroxine. What happens if I stop taking levothyroxine?

    Hello, my name is Daniela and I come from Bolivia, South America. I’ve been diagnosed with Hypothyroidism 15 years ago. I’m 44 years old now. Since then I’ve been taking Levothyroixine. some periods 75 mcg and some other 100 mcg.

    A year ago I’ve been retaining water in my body considerably. I have a low calorie diet, basically veggies and fruit, so, during week days I don’t consume salt. On the weekends I have dinner with friends, so it’s more difficult to avoid salt. On Saturdays and Sundays my water retention is terrible. Some times I can’t wear any shoes because my feet and legs are completely swollen and lately, my cheeks and my eyes are swollen as well. My skin is also very sensitive. I gets completely red when I put lotion on it or something touches but 5 minutes later that reaction disappears. I’ve been having skin reactions, like allergies that looks like a rush.

    I went to the doctor and he didn’t say too much about it. He ordered many lab tests that I haven’t got them and I’ve never talk to him again.
    I’ve been gaining weight even though my low calorie diet. I’ve been having a lot of water retention and my face, swollen cheeks and eyes. I exercise but it doesn’t help either. And of course, I have all the problems that come with Hypothyroidism.

    Researching online, I’ve found that taking iodine would help my thyroid to produce that hormone. The first time I took it, Kelp 800 mcg) my body started making away of the retained water, my period came back (didn’t have it for about 1 year). I had more energy and I was feeling cold anymore. I took it for 1 week., because I was afraid of taking it due to the side effects of it and I started retaining water again.
    After 2 months, I took it again and again same symptoms. I took it for 1 week and stopped, because I started gaining weight and retaining water and I’m afraid of the side effects as well. Something I noticed is that everytime I take IODINE, I get my period, when I don’t take it, I don’t get my periods.

    But, at the end of everything, I woke up everyday, look myself at the mirror to see the face of the day. I don’t know if I’ll wake up completely swollen or normal. Or, now, being swollen is my normal me?

    If you are experiencing something like this, please let me know what are you doing about it because I would like to know what to do to decrease the effects of this sickness.
    Thank you

    I have been taking Levothyroxin for about a year and a half. I did not have any health problems before my doctor started me on it. I do feel sluggish and tired and have a very hard time losing weight now. Also, my finger nails are starting to cloud and turn in at the sides. I do not wish to get on the downward spiral of more and more medications. I am 79 years old, and so far this is my only prescription. I don’t like what I am hearing here.

    I have been taking Synthroid since 1987 (age 29 yrs) after being diagnosed with Grave’s Disease….. and having my thyroid gland destroyed by I-131 Uptake… (radioactive iodine).
    Needless to say, I have never been quite the same since.
    Now at the age of 57, I find myself far worse off. The fatigue and brain fog are debilitating; plus numerous other problems.
    I suppose the thing that has most negatively impacted my life is the severe hair loss I have suffered. I am currently almost bald on top with an overall thinning of my hair.
    I am devastated and my self esteem has been greatly effected…. as I am now having to wear a wig.
    Please tell me where to go in the Little Rock, Arkansas area to find a doctor who will treat me for both T3 and T4. My levels will never stay within normal range for very long at a time.
    My TSH is very low and my T4 is too high as well. Thus, I have all the symptoms of hyperthyroidism. Please help!!

    Where can we get this armour thyroid supplement?

    A doctor has to write a prescription for it. Armour is available in my area (Florida) at Costco. I remember some comments at PP site from a reader that Naturethroid or Dessicated thyroid compounded works sometimes better. These are natural compounds and a Compounding Pharmacy makes them for you. You can find a pharmacy that does it online.

    Insurance does not pay for this. My wholistic MD sold me an iodine cream to apply Mondays-Fridays.
    Natural Thyroid contains both T3 and T4 which is what a normal thyroid produces. By going salt free or using sea salt, we are not getting much, if any, iodine in our diet. Table salt is fortified with iodine! You can get iodine drops and homeopathic tablets at a health store.

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