Amazon in the UK are having some administrative problems with ‘The CT3M Handbook’.
Often, when searched for, ‘CT3M Handbook’ is either listed with either old versions without the small white butterfly on the the cover, or used rather than new copies, or there is no way to put the book into the Amazon basket and buy it direct from Amazon.
However there are no supply issues at all. To obtain the correct version of ‘The CT3M Handbook’, please use my website page for the book: https://paulrobinsonthyroid.com/the-ct3m-handbook
Then click on ‘Choose Your Retailer’ and use either ‘Wordery UK’ or ‘Bookshop.Org UK” or ‘Waterstones UK’. They all have ‘The CT3M Handbook’ in stock. Alternative European online bookshops are also available.
‘The Thyroid Patient’s Manual’ is easily found on Amazon in the UK and other online booksellers without any issue.
‘Recovering with T3’ is also easily found on Amazon and other online booksellers.
I will post another update when the current issue with Amazon is resolved.
Best wishes, Paul
Hi Paul,
Really appreciate the important work you are doing! I’ve recently purchased two of your books and I’m fascinated by the CT3M approach. I wonder if it would work in my case: I have high morning cortisol which seems to plunge rather steeply as the day goes on. Mid range noon, low both evening and night. I’ve “crashed” after simple dental procedures in the past and have many other low cortisol symptoms. I know I’ve had untreated hypothyroidism most of my adult life.
I’ve been wondering what my cortisol pattern reveals besides the vague “adrenal dysfunction” as my report states…
Also, if I use CT3M, would it raise my morning cortisol further? Or is it simply helping my body make more to “store” for later in the day?
Appreciate any thoughts you might have!
Sarah, I honestly don’t know. The usual pattern is either low during the day or elevated after a low morning cortisol.
Was morning blood cortisol high at 9:00am – going just on saliva cortisol is risky! They can be very, very different… and when they are it can mean something.
I suspect (just suspect ok) that this is more complex. I would have to know far more about your thyroid, cortisol and other labs to assess anything usefully.
So, based on what you’ve said I would NOT try CT3M.
I do 1-1 consults if you get utterly stuck. Hopefully, you will figure this out.
Best wishes, Paul
Thank you for your reply Paul!
To answer your question: morning blood cortisol has also been elevated in the past (slightly higher than upper range).
I have a family history of thyroid problems. Every single member on mom’s side had either Graves, Hashimoto’s, or nodules. My TSH has been between 5 and 10 for many years but symptoms were mild until recently. Most recently FT3 was mid range, FT4 lower half. RT3 was high. Antibodies were low (I’ve gone gluten free because of family history). Iron and B12 were slightly low and I’m supplementing.
Trying to understand the science here too: does the higher than average morning cortisol indicate my body has been making enough cortisol in that last four hours of the sleep window? Or is it more indicative of some stress response? Why do you feel that CT3M might not be the right fit?
Any ideas to point me in the right direction would be greatly appreciated! Thank you!
Sarah,
I suggest you use my Contact Us button on the website homepage as this is going to be far too detailed to deal with on the website.
However, if your rT3 is high given low FT4 and mid-range FT3 then the stress of the body in shifting FT4 to rT3 can cause high cortisol – I have seen this in others.
Simply changing your treatment to raise T3 without raising T4 could actually help.
Use my Contact Us button on the website.
Best wishes, Paul
Thank you Paul. I’m probably going to do some additional testing and will contact you if one on one consultation becomes necessary.
A more general question about thyroid hormone replacement: judging from the very low TSH for many patients on T3 (alone or partial), are they essentially suppressing their own thyroid function (if some function remains), either partially or in many cases near totally? Why is this ok when suppressing, say, one’s adrenal functional by taking HC a major concern? What does this do to your thyroid in the long term? Will it also atrophy? I guess another way to ask this question is: is preserving one’s own thyroid function a priority in treatment of hypothyroidism, especially when there’s no active autoimmunity going on? Hope that makes sense…My husband is feeling nervous about “shutting off my thyroid” by starting medication and I don’t really have a good answer to that!
Hi Sarah,
You only take T3 if you either cannot have your own thyroid produce enough T4/T3 and then have the T4 convert to enough FT3.
If you have enough FT3 and you don’t have symptoms then don’t take T3.
If you have symptoms that don’t go away on T4 meds then you have to take some T3 if your want enough FT3 and to recover. That’s the end of it.
T4 meds suppress TSH. T3 meds suppress TSH if you take enough. They both do.
You only use T3 if you need it to get well.
Suppressing TSH doesn’t damage the thyroid gland by the way. But if your thyroid isn’t working well enough or you are a terrible converter of T4 to T3 then you’ve a choice of using T3 and getting well or staying sick.
HC on the other hand can often be avoided if other approaches are used e.g. T3 medication can often be used to improve a person’s own cortisol if they do not have Addison’s disease.
HC often doesn’t work well. In addition, once someone is on HC, the person’s adrenals are suppressed and if they have an accident or are under stress and they don’t stress dose with HC then they can have an Addisonian crisis and die – quite a different situation. So, HC needs to be recorded as being necessary on someones medical records to avoid a crisis should they be taken into hospital for instance.
If you don’t want to use T3 – then don’t. But if you aren’t converting T4 meds to enough FT3 then you are likely to remain unwell.
T3 and T4 both lower TSH – depending on the dose. That is just the way the system works.
Hope this helps.
Best wishes, Paul
p.s. I’ve been on 60 mcg of T3 for around 25 years with a suppressed TSH – does it worry me? NO. I’m fine and can do what I want like tennis, golf, walking holidays (doing that at the moment). Happy days!