Home » Doctor’s Manual for Wilson’s Temperature Syndrome » Frequently asked Question & Answers » How do you wean a Wilson’s Temperature Syndrome patient who is also hypothyroid?

• Doctor’s Manual for Wilson’s Temperature Syndrome
• How To Use This eManual
• A quick sketch of Wilson’s Temperature Syndrome
  • Low Thyroid Symptoms respond.
  • Wilson’s Temperature Syndrome is undiagnosable with blood tests.
  • Wilson’s Temperature Syndrome is often reversible.
  • Low body temperatures.
  • Brought on by stress.
  • The treatment of Wilson’s Temperature Syndrome.
• Doctors Comments
• Introduction
  • Bottom Line It Works
  • What’s in a name?
  • Making their day
• Case Studies
• Chapters
  • Basics
  • How Has Wilson’s Temperature Syndrome Gone Overlooked?
  • Limitations of Thyroid Blood Tests
  • Diagnosis and Pretreatment Considerations
  • If Considering a Therapeutic Trial of Thyroid, Why Not Use T4?
  • Workup for T3 Therapy
  • Treatment Principles
  • Timing of Doses, Compliance
  • Monitoring, Compliance and Steadiness
  • Unsteadiness and the T4 Test Dose
  • Risks, Benefits, and Myths
  • T3 Therapy In Hypothyroid Patients (& euthyroid patients presenting on T4-containing medicine)
  • Time Zones, Pregnancy, Surgery, Drugs, & Other T3 Therapy Tidbits
• Modules
  • Weaning T4-Containing Medicine Before Cycling on T3
  • Cycling Up
  • Plateau
  • Unsteadiness
  • T4 Test Dose
  • Wean
• Caveats
  • If the patient has no symptoms before treatment (just a low temperature).
  • Weigh pro’s and con’s of treatment (see Q2).
  • Some symptoms are more predictably responsive than others.
  • The whole trick is to start with a steady level of T3 and keep it steady (see Q13).
  • Use the percentage index to get a quick start on clinical assessment.
  • Slow compensators tolerate rapid increases better than rapid compensators tolerate slow ones (see Q6, Q7).
  • If the patient’s symptoms resolve completely with a temperature less than 98.6 (which is very seldom the case), it is not necessary to push the temperature higher (see Q14).
  • The word sufficiently pertains to the present cycle, and may or may not also pertain to the treatment in general.
  • The full benefit of a cycle, in terms of resetting the system, is obtained once the temperature has been captured (p75).
  • The closer patients’ temperatures are brought to 98.6, the less medicine they’ll need on subsequent cycles (if such cycles are needed at all) (See Q14).
  • If patient may be hypothyroid (low thyroid gland function), it may be necessary to support the patient with T4 as she is being weaned off a cycle of T3 therapy.
  • When weaning, the goal is to wean slowly enough that the patient’s temperature doesn’t drop.
  • T3 therapy can be used as symptomatic, therapeutic, or prophylactic treatment.
  • The more corrected a patient’s Wilson’s Temperature Syndrome, the less likely it is to relapse.
  • Once people have been successfully treated, and are doing well off treatment, it is usually much easier to correct their symptoms, should they relapse, than it was the first time around.
  • Patients’ symptoms can often improve in stages that stick, just as they often have worsened in stages that have stuck.
  • Subsequent cycles are promising if there is a net clinical improvement from a previous cycle.
  • Periods of great stress and/or stringent dieting are not generally the best times to wean cycles of T3 therapy.
  • Any side effects indicate less than optimal management and should be addressed.
  • It is best to address side effects early so that they can be easily nipped in the bud.
  • Patients should check their pulse rates daily and call if they go above 100 b/m.
  • The best treatment of severe side effects of T3 therapy is prevention, but…
  • T3 levels that are too high, too low, or unsteady can cause side effects.
  • The higher the dose of T3 therapy the harder it is to keep T3 levels steady.
  • Steadiness is everything.
  • Unsteady T3 levels are the most common cause of side effects, and poor clinical results.
  • It is not wise to stop the T3 medicine abruptly.
  • T3 level unsteadiness can result in decreased clinical improvement, before it results in side effects.
  • Side effects from T3 therapy are dependent mainly on how well the molecule is delivered.
• Frequently asked Question & Answers
  • How do you know it’s thyroid?
  • What are the substantive risks of T3 therapy?
  • What happens if you stop the T3 therapy abruptly?
  • Will the patient have to stay on the T3 therapy for life?
  • What is the percentage index?
  • Wouldn’t increasing the dose of T3 every three days instead of every day be easier for the patients to tolerate?
  • What if a patient’s temperature goes down with T3 therapy?
  • How high up on the medicine does one go on each cycle of T3 therapy?
  • How long should a patient stay up on a cycle before weaning back down again?
  • How fast does one go off a cycle of T3 therapy?
  • If a patient’s temperature slips while they are weaning down off the T3 therapy, should the dose be increased back up an increment before continuing to wean?
  • When weaning a cycle of T3 therapy, does one wean partway down, down to the starting dose, or all the way off?
  • How long does one stay off between cycles?
  • If the patient is feeling very well, but her temperature is still less than 98.6 when measured as indicated, is it really necessary to push the temperature up to 98.6?
  • How do you wean a Wilson’s Temperature Syndrome patient who is also hypothyroid?
  • What if a patient’s temperature and symptoms do not remain improved after the treatment is discontinued?
  • What are the risks of staying on T3 therapy for a long time?
  • How many patients can be weaned off T3 therapy?
  • What if the patient improves at first, but then stops feeling as well even though the temperature is holding?
  • What if the patient’s temperature goes up to normal and the patient still doesn’t feel very well?
  • What if the patient is feeling improved on the T3 therapy, but when the dosage is increased to bring the temperature closer to normal, the temperature drops and the patient feels worse?
  • What if a patient has a slump of fatigue or some other complaint at the same time each day?
  • How often are office visits?
  • If a patient starts having any side effects, does that mean that the treatment isn’t likely to work out very well?
  • How are side effects managed?
  • What is a T4 test dose?
  • If the T4 test dose works, how often should it be taken?
  • Do temperatures or T4 test doses have to be taken to the minute like the T3?
  • What if the treatment doesn’t work?
  • What happens if the patient’s T4 and TSH levels drop while on T3 therapy?
  • How often does one order the thyroid blood tests?
  • What would the expected thyroid blood test values be after a couple of weeks of T3 therapy?
  • What should the patients do with the T3 dosing if they miss the dosing time?
  • What if patient is up to 90 mcg BID of T3, and temp is still not up?
  • What if patient gets a fever due to a virus or cold?
• Same Principles Applied Differently
• Appendix
  • Considerations for the Future
  • Patient Education Aids, Insurance, Informed Consent
  • Review Article
  • Bibliography
• Patient Orientation Sheet