Are herxheimers actually thyroid problems? Low T3 syndrome

my view would be that herxhiemer might upset the thyroid hormones as a downstream effect ( look up temporary thyroid hypothyroid in normally euthyroid patients after hospital stay )

but that's not quite the same as saying herxhiemer is the same as low thyroid - and fixing the thyroid hormone levels will fix the herxhiemer reaction.
rather, deviations of thyroid hormone status, if it happens at all, its just one of many downstream disturbances caused by the herxhiemer reaction.

there are quite a number of papers describing the mechanism involved in the herxhimer
they typically describe cytokine and chemokines ( inflammatory signalling molecules) released by cells of the immune system in response to immune cells consuming either live bacteria or dead bacteria / other pathogens and their by products.
so the phenomenon is largely and primarily an inflammatory event - with all the many and varied downstream effects that they normally entail.

interestingly - lyme - or rather spirochaetal infections in general - are unique in this regard - as the substance their outer membrane is made from differs from gram positive ( teichoic acids) and gram negative ( lipopolysaccharides) - as they are made of an unusual peptidoglycan - tests show this material is around 50x more immuno-stimulating to immune cells than typical bacterial lipopolysaccharides. so this goes some way towards explaining why Lyme patients react so strongly.

incidentally the biofilms produced by lyme also include these surface proteins and other highly inflammatory compounds - like extra cellular DNA - and anything which disturbs or dissolves these materials in the infected host will also drive further inflammation. thsi may be one factor explaining the long lasting herxhimer experienced by lyme patients - compared to the original stereotypical herxhiemer reported in syphilis patents lasting only a few hours.

in fact Lyme disease is best understood as a chronic inflammatory state in which many body systems fail to operate normally due to the far reaching effects of ongoing inflammation. Dr J says in his videos that the only other patient population with the same levels of inflammation as chronic Lyme patients are terminal cancer patients.

fatigue and exercise intolerance is another example of downstream effects of inflammation - people like Buhner, Dr J, Horowitz etc have written about how inflammation damages the mitochondria inside our cells that limit the cells ability to make energy and therefore power our body - and that this the driver of the extreme fatigue often seen in this patient cohort

This same damage also depletes our anti-oxidant stores and leaves us vulnerable to oxidative damage.
This is what PEM is thought to be by CFS researchers ( Dr Sarah Myhill has published papers on this topic with mitochondrial membrane potential studies ).

so basically - when the antioxidant system is depleted - and the mitochondrial membranes damaged - and we push the body to exercise anyway - it generates excess free radicals that are not mopped up by the normal antioxidant cascade and instead results in more oxidative stress and cellular damage - hence if you try to exercise when you already have PEM - you just get much worse.
its also why short busts of anaerobic exercise are more tolerable by people with PEM than long bouts of aerobic exercise
and why ketogenic diets help people with fatigue / and or PEM - as ketones burn with less free radical production than sugars - reducing the load on the depleted antioxidant system.

like the herx - there is often a delay between exercise ( another inflammatory event ) - and the onset of PEM - in fact this is part of the definition of PEM.
in both cases in the sick patient - the system is struggling to maintain homeostasis in the face of excess inflammation - a bit more from any source tends to send it over the edge into flaring symptoms.

this is anyway my current understanding based on my reading of the scientific literature on CFS, Mitochondria, PEM, Thyroid etc over the past 6-7 years

i take thyroid meds - both T3 and T4 - on the basis that the immune system is heavily regulated by its thyroid status - white blood cells for instance - so i attempt to keep them in the ideal ranges - as a kind of insurance policy to try to help the body in its ideal range from an immune function perspective - as low thyroid levels are associated with hampered immune performance - and that's the opposite of what we need in fighting chronic infection.

some people report night and day differences in their health from doing so -vs before thyroid medication - but in my case there has been no noticeable difference to my overall state - although i am moving forward very gradually in the last 2 years - so it could be that there is some subtle underlying supportive effect.


OK - that's my brain dump on the topic!

Also: Do you know your baseline glucose #'s? (Morning fasting and before / after meals.)

I ask because, when cortisol goes up daily in the AM (normal) or night, or all day (neither normal), elevated blood glucose can result.

So I tried taking 150 mcg of iodine, 200 mcg selenium and 22,5 mg zinc. I went from tired and shivering cold to a somewhat warm feeling & more energy. But then I also got a really weird warm, uneasy feeling in the front of my throat. After 2 hours I became tired again and went back to feeling cold. Now I'm kinda feeling more energy but everything feels a bit weird. So I guess it's gonna be more difficult than just taking some supplements to fix it. Which is a bummer

The hormones were better aligned because I did some things to reset the hpa axis. Somehow that made the thyroid work better too. I've repeated the proces several times, it's always the same positive effect. It's fixed in one day. I can then take whatever and have no herx.

But then I have to be careful to not take some things that can affect the hpa axis because that messes everything up again. So no caffeine or curcumin for example. Sometimes it accidentally happens. Like it did now, so I'm having herxes again. I'm unable to reset it again because of temporary complications so I need to find another way to fix it. The endocrine system is a feedback loop. Change one thing and it can change all the other hormones.

Now, several hours after taking those supplements, I'm having ADHD-like energy. I'm very energetic but it's unpleasant and hard to focus. The dosages were probably too high.

Vimzor said...
The hormones were better aligned because I did some things to reset the hpa axis. Somehow that made the thyroid work better too. I've repeated the proces several times, it's always the same positive effect. It's fixed in one day. I can then take whatever and have no herx.

But then I have to be careful to not take some things that can affect the hpa axis because that messes everything up again. So no caffeine or curcumin for example. Sometimes it accidentally happens. Like it did now, so I'm having herxes again. I'm unable to reset it again because of temporary complications so I need to find another way to fix it. The endocrine system is a feedback loop. Change one thing and it can change all the other hormones.

Now, several hours after taking those supplements, I'm having ADHD-like energy. I'm very energetic but it's unpleasant and hard to focus. The dosages were probably too high.

ah that might make sense

there is some evidence that the adrenal hormones have some significant effect on herx like reactions

some LLMD's use cortisol to help manage herx in bart patients - who simply cannot seem to manage treatment induced herx without it

it could be that in the absence of sufficient natural cortisol ( a powerful anti-inflammatory hormone) these sub normal levels of inflammation reducing hormone cause much greater flare in symptoms than normal during treatment ( which is already on the edge of what is tolerable in otherwise healthier people )

thyroid gland is a particularly sensitive organ to inflammation - it has been likened to the canary in the coalmine for auto-immunity - as it seems to be one of the first organs to suffer when there is runaway inflammation
we also know that thyroid hormone conversion is interconnected with the adrenal hormones and heavily influenced by inflammation

so i think you are seeing downstream effects of adrenal hormone activity simply reflected in your thyroid markers.

have you been experiencing elevated TSH ?
low T3 ?
have you had your thyroid antibodies measured recently ?

and
what did you do to try to normalise your HPA axis / cortisol as that's generally tricky to do

You might want to consider an MRI of the pituitary, they found a benign tumor on mine.

There is a downside though, I think the contrast that they use for the MRI isn't good for you, but it didn't bother me personally.

No way!? hahaha!

Well, I hope it goes well for you!

Well, yes, we're in agreement. My thyroid is acting up because of inflammation and also linked to my weird hpa axis problem. But there's nothing inherently wrong with it.

It's the third day after taking selenium and iodine. Still having more energy, less adhd-like but still a bit unpleasant. Still weird feeling in the front of my throat (which is clearly my thyroid I'm feeling). And still feeling really warm every time my cortisol goes up.

My theory now, or should I say hope, is that if I do an acth injection while supporting the thyroid I might reset everything more or less to a normal state without adverse effects this time. And I will finally be able to exercise and lift weights! :D :D :D :D

--
The MRI was without contrast. That was a bit weird. I thought brain MRIs are always with contrast.

Edit:

Found this topic about a link between bartonella and thyroid: https://www.healingwell.com/community/default.aspx?f=30&m=4149462

Post Edited (Vimzor) : 7/24/2023 5:55:44 PM (GMT-8)

I've had reverse T3 a short time during lyme treatment, while I already had Hashimoto and on thyroid med for ten years.

This was weird, my normal Free T3 was elevated (hyper) and my TSH was high (hypo); I felt very hypo at the time.

So....apparently my T3 was pooling, not getting used due to the reverse aspect of the receptors. Thats just my guess. Ive never read what the normal free T3 usually looks like when/if someone also has reverse T3 occurring.

A conventional general practitioner clinic did the blood draw it since it was in the Quest Lab catalog (very common US lab). Insurance even covered it.

I used some old Synthetic T3 cytomel then (still worked, could feel it), in addition to my NDT to unplug the stuck hormone receptors. (like forcing a plugged toilet with a plunger). The Dr didnt know what to do, I just did what I had read about.

That either worked, or it cleared itself on its own, at the same time frame. Full thyroid lab work two months later looked more normal, and improved more thereafter.

Ah, interesting about unplugging the receptors.

It's day 4 and most of the energy is finally gone. I'm also back to feeling more sad. But I still have a weird feeling in my throat. I'm starting to think the thyroid might be enlarged. It feels weird. I hope I didn't trigger something auto-immunity.

lots of small and varied anomalies in standard workups are common in bart and lyme - i have this most times around - next time i test i just get a different bunch that are on upper or lower limit or a bit outside - doctors rarely take notice unless they are way out of line.
as you say - it mainly means something is not quite right but doesn't really help.
i have also test all within range on CBC, LFT and KFT while at my sickest

i would be wary of Chat GPT with your thyroid interpretation - mainly because so much crap is written about thyroid conditions on the web - and that is what it has had access to.

post up the full thyroid panel results and i will be happy to take a look ( i have been through this with hashimoto's)
we have other thyroid experts here who will chip in too


BTW - you really need both thyroid antibodies tested - as either one can be positive - and not the other - mine were like that.

Very minimal difference between the two different months. All of these are in a very healthy range.

But, in the beginning of auto immune thyroid issues, what many doctors do not know, but alternative doctors do now know, is that you can have elevated antibodies before your actual hormone levels start to go crazy either up or down.

So it will be interesting to see your antibody results