Treatment Guidelines

“Road conditions” are also an important consideration. A patient may be in the midst of starting a new business, selling his house, moving, and taking care of his hospitalized mother’s affairs, all at the same time. Under such conditions, it may be preferable not to add to the patient’s challenges by making a lot of adjustments in his the WT3 protocol, especially if the preoccupying conditions are not expected to last very long. It is sometimes better to weather out the storm in one city before proceeding to the next one. The goal of T3 therapy is to use the treatment to artificially reset the system while providing sufficiently normal and steady levels of the WT3 protocol. The body is given the opportunity to maintain naturally what has been accomplished artificially. This cannot always be accomplished in one step or “cycle.”

There can be setbacks in progress. Since stress and starvation are some of the things that can precipitate Wilson’s Temperature Syndrome in the first place, they can also impair the body’s ability to maintain naturally what has been established artificially. So again, if the patient is satisfactorily improved, then it might be preferable for him to weather out the conditions of stress and/or starvation (or perhaps significant dieting or exercise) before proceeding to his final destination.

Let’s suppose a patient who has been staying in a “city” wherein her symptoms are improved, but her temperature is around 98.0, chooses to move on the next “city”. Since the patient is more likely to need less medicine with the next cycle the closer her body temperature approaches 98.6, if the patient is not having any complaints, it may be preferable to increase the WT3 protocol in an attempt to “punctuate” the cycle by attempting to bring her body temperature pattern up closer to 98.6 prior to weaning. Of course, the WT3 protocol may be weaned if the patient develops any side effects, if the temperature goes above 98.6, or if the symptoms are not satisfactorily improved even if the temperature is averaging 98.6. Cycling and getting on less T3, is generally the “road” that leads to the final destination.

Ripples
Patients can usually manage ordinary fevers due to colds or flu’s in the usual way (without changing the T3 dosage) if being maintained well on a certain level of the WT3 protocol. Remember that each change in the dose of T3 causes ripples the way a tap on the edge sends a ripple through an entire water bed, and these ripples can last for up to two weeks or more before settling down. These ripples may not be noticed in any side effects, and maybe not even in the body temperature patterns, but may be detected in terms of lost potential benefit.

Typical Responses To the WT3 protocol
These principles may make it easier to understand typical patterns of response to the WT3 protocol:

1. When patients begin the first cycle of the WT3 protocol, they sometimes feel better in the first week of treatment than they do as the cycle proceeds. This is understandable since in the beginning, the WT3 protocol is building upon the steady foundation of the body’s T3 with temperatures closer to normal being achieved with relatively small doses which are easier to keep steady. But as one increases the dosage in working towards the subgoals of therapy, the more one takes, the harder it is to keep it steady, and so understandably the improvement in the symptoms may not remain as great.
2. Some patients notice more improvement in their symptoms of MED [Multiple Enzyme Dysfunction] as they wean off a cycle of the WT3 protocol than they ever did going on. This is understandable since the body sometimes maintains naturally the level of body temperature achieved artificially more steadily than was accomplished artificially.
3. Different levels of improvement can be achieved with subsequent cycles. For example, a patient may achieve 60% resolution of his or her symptoms with the first cycle with the symptoms remaining persistently improved to a 60% degree even after the therapy has been discontinued. Then sometime later with a second cycle, the level of improvement may be brought up to 75%, which may persist even after the cycle has been discontinued. And still another cycle may bring the results up to 90% resolution of the symptoms. However, at any time, if the patient is faced with significant stress or starvation conditions, then the level of improvement may relapse back down to, say, 40% resolution.
4. The symptoms of MED [Multiple Enzyme Dysfunction] are improved by the body temperature being more normal and steady. The balance of these two factors determines the level of correction of the symptoms. Patterns that are less normal but more steady may result in increased benefit as compared to patterns that are more normal and less steady. But patterns that are both normal and steady are most preferable and most likely to result in a correction of the symptoms of MED [Multiple Enzyme Dysfunction].
5. It is difficult to compare the body temperature patterns of one person to another to predict the degree of improvement of MED symptoms. The body temperature of one person compared to himself, however, can be quite useful in predicting improvement in the symptoms of MED. For example, if a patient’s body temperature patterns become more normal and more steady with the WT3 protocol, one can expect an improvement in the symptoms of MED even if the patient’s body temperature patterns are not as normal and not as steady as the body temperature patterns that were necessary to alleviate the symptoms of some other patient.

Balancing With Other Systems

2.   As mentioned previously, the patients who do the best are the ones who are able to get their temperatures closer to normal on lesser amounts of T3 because, the lower the amount of T3, the easier it is to keep it steady. However, the more T4 and RT3 that may be competing with T3 at the active site, the more T3 that may be necessary in order to overcome that competition to provide more normal body temperature patterns. If less T4 and RT3 were present, then less T3 would be needed, since less competition would be present.

Wilson’ Syndrome sufferers who are being treated for hypothyroidism deserve special consideration. Hypothyroidism can cause DTSF through inadequate production of T4 from the thyroid gland, while Wilson’s Temperature Syndrome can result in DTSF because of impaired conversion of the T4 to the active thyroid hormone T3. Some patients presenting to a physician with hypothyroidism may have their hypothyroidism or low T4 production detected with thyroid hormone blood tests which are usually very useful for this purpose. Normally, hypothyroidism is corrected with T4 supplementation to the satisfying of these thyroid hormone blood tests, causing them to return to the “normal range.” In many cases, this may also resolve the patient’s DTSF since the patient may be able to adequately convert the T4 supplementation given by mouth into T3.       

One can reduce RT3 levels by reducing the levels of T4, its source. To decrease T4 levels, one may decrease T4 supplementation. T4 supplementation may be weaned from .05 – .10 milligrams per day, per week, until the T4 supplementation has been discontinued for a time. Of course, as the T4 supplementation is discontinued, levels of T3 drop as well which can result in increased symptoms of DTSF [Decreased Thyroid System Function]. Generally, it is preferable to withhold T3 supplementation for approximately seven to ten days after T4 supplementation has been discontinued, especially if there is not a worsening of the symptoms of DTSF [Decreased Thyroid System Function]. This is to allow levels of T4 and RT3 to decrease. If while the T4 therapy is being weaned, the symptoms of DTSF do worsen, then low levels of T3 supplementation may be initiated to sustain T3 levels while T4 therapy is being weaned.

It is usually best not to increase the WT3 protocol in an attempt to normalize body temperature patterns and to diminish the symptoms of DTSF [Decreased Thyroid System Function] until approximately the tenth day after T4 therapy has been discontinued, but only to prevent a worsening of the symptoms of DTSF in the meantime. In this way, one may be able to avoid inadvertently increasing the WT3 protocol to higher levels than would otherwise be necessary (lower T4 and RT3 levels resulting from the weaning of T4 therapy lower the competition against T3 for the active site so that less T3 is required to overcome it and provide more normal body temperatures). By staying on lower levels of the WT3 protocol in the first place, one may avoid having to go through as many cycles of the WT3 protocol.

Cycles of the WT3 protocol can sometimes take from two weeks to two months each. Thus, by only increasing T3 dosage levels to prevent increased levels of DTSF[Decreased Thyroid System Function] symptoms while T4 therapy is being weaned, one can often be as far along in a few weeks as he otherwise would be in six months. Of course, in Wilson’s Temperature Syndrome sufferers who also happen to be hypothyroid one must restore T4 therapy as each cycle of T3 is weaned and after the patient’s Wilson’s Temperature Syndrome has been corrected (since they don’t produce T4 sufficiently on their own). At the beginning of each cycle of the WT3 protocol in such patients, T4 therapy should again be weaned before the WT3 protocol is used to pursue normalization of body temperature patterns. So hypothyroid patients who still suffer from the symptoms of DTSF, in spite of adequate T4 therapy because they are also suffering from Wilson’s Temperature Syndrome, can often be helped. Ideally, such patients can be cycled on and off T4 and the WT3 protocol until eventually their Wilson’s Temperature Syndrome can be corrected and they may be placed back on T4 therapy and retain resolution of their symptoms of DTSF. In fact, many times they can often feel better on less T4, after T3 therapy, than they ever did on more.

3. T4 Test Dose. The competition between T4 and T3 for the thyroid hormone receptor can be used handily in the management of side effects of the WT3 protocol. Side effects from 12 hour sustained-release the WT3 protocol (most commonly mild achiness, fluid retention, mild headaches, fatigue, and occasionally edginess) usually are related to unsteady levels of T3 resulting in unsteady body temperature patterns, leading to unsteady multiple enzyme function. Let us remember that T4 is about three times longer acting and is four times less active than T3. A small dose of the longer-acting, and, in a sense, more stable T4, can be used to dilute the influence of the more powerful T3 at the level of the active site, thereby, making the thyroid hormone influence at the thyroid hormone receptor more steady. A T4 test dose can decrease the side effects that a patient may be having from unsteady levels of the WT3 protocol. Interestingly, it can do it in about 45 minutes. This is possibly because it does not take long for a dose of T4 to be absorbed from the stomach into the blood stream and to be distributed to the cells of the body, thereby, having its stabilizing effect. In this respect, T4 can almost be thought of as a wet blanket, compared to T3. Many times patients are quite astonished by how quickly and completely their side effects can resolve after a small dose of T4. This may be on the order of approximately 15% to 20% of the number of micrograms of T3 the patient is currently taking each day. For example, 12.5 micrograms (.0125 milligrams) of T4 (e.g. 1/2 of the smallest strength of Synthroid…a new pair of toenail clippers are handy for cutting them in half) may be given to a patient who is currently having some side effects on 30 to 37.5 micrograms of the WT3 protocol incorporating a sustained-release vehicle being taken twice a day.

Although T4 is much more stable, it should be remembered that it can sometimes feed rather than reverse the vicious cycle that leads to Wilson’s Temperature Syndrome. It should also be noted that it is often not favorable to take the T4 therapy if it is not necessary for side effects, because it can sometimes block what one is trying to accomplish with the WT3 protocol. The T4 dose is best taken only as needed for side effects. If the side effects resolve quickly within one or two hours of the dose, it is more likely that the patient did need the dose of T4. So the dose of T4 might only need to be taken once, possibly every three days, or only every week or so, but preferably not more often than once a day. If the thyroid hormone influence cannot be easily and sufficiently steadied with doses of T4, then the patient should be gradually weaned off the the WT3 protocol and perhaps started on another cycle. Incidentally, some patients do quite well with a combination of both continuous T4 and the WT3 protocol, and a few respond better to instant release the WT3 protocol than to sustained released the WT3 protocol. So in every case, the choice of therapy and dosing considerations must be made based on individual patient response and laboratory findings.

4. In light of the information contained in this book, thyroid hormone therapy that does not take into consideration body temperature patterns is not being done correctly.

5. Likewise, considering that Wilson’s Temperature Syndrome can be precipitated or made worse by starvation conditions, the use of dietary approaches such as crash diets, low calorie diets, very low calorie diets, and protein sparing modified fasting liquid diets, without regard to body temperature patterns, in patients already suffering from symptoms of MED, can not be considered prudent. As many people are becoming increasingly aware, these measures can cause or worsen a patient’s symptoms of MED, leaving the patient to gain all of their weight back and then some. One such measure of dieting or “starvation” may precipitate persistent DTSF [Decrease Thyroid System Function]. due to the patient developing Wilson’s Temperature Syndrome, then the patient can be left with debilitating physical and functional problems that can have a profoundly adverse impact on the person’s life. Proper diet and exercise certainly are very important. And dietary systems or tools (such as certain liquid diets) do have their favorable uses. It is only inappropriate to use such tools without taking into consideration, on an ongoing basis, a patient’s body temperature patterns and symptoms that may be related to MED, DTSF, and Wilson’s Temperature Syndrome. These symptoms can be revealed through careful questioning of the patient as part of the monitoring of his dieting process.

6. Symptoms of low blood pressure such as lightheadedness, clamminess, increased heart rate, and shakiness may often actually be due to low blood sugar levels. Such symptoms can frequently be alleviated by eating a little something to bring up blood sugar levels, such as a piece of chicken, cheese and crackers, or orange juice. Refined sugars, such as candy, are usually not preferable since they may result in a rebound drop in blood sugar levels due to the body’s reaction to the sugar in the candy. Patients with Wilson’s Temperature Syndrome seem to have unstable blood sugar levels which can go too high when they are high and too low when they are low. This can be alleviated through a hypoglycemic diet and also through normalization of body temperature patterns.

7. Since mental and physical stress can lead to precipitation of the symptoms of MED and Wilson’s Temperature Syndrome, it is recommended that one should approach diseases associated with mental stress, such as anxiety and depression, while bearing in mind the patient’s body temperature patterns. Likewise, when addressing patients who are undergoing severe physical stress such as recovering from car accidents, major surgery, severe infections, or the like, one should always bear in mind the patient’s body temperature patterns, since it can have a profound influence on how he will recover. This may be especially important in cases where a patient’s recovery could go either way, being balanced on the verge of life and death, such as in intensive care units and in critically ill patients. In such circumstances, consideration of body temperature patterns can literally mean the difference between life and death.

8. If a patient taking the WT3 protocol is scheduled to undergo surgery, then considering the short half-life of T3 and the potential for unsteady blood levels, it is usually advisable for the patient to gradually wean off the WT3 protocol before the surgery. the WT3 protocol may be resumed once the surgery has been completed. It is important, however, to give adequate time for the weaning process so that the T3, body temperature, blood pressure, etc. are not dropped abruptly just prior to surgery.

9. Drug interactions – Since T3 is a substance that is normally found in every person’s body, if a particular medicine does not have an adverse chemical reaction with the T3 already inside a person’s body, then it will not have a direct chemical reaction with the T3 medication taken by mouth. So, any drug interactions are usually not due to direct chemical reaction between T3 and other medicines but because of indirect effects. T3 can affect a person’s temperature, blood pressure, and pulse. In some instances, these effects can be additive, such as with antihistamines, decongestants, antidepressants, asthma medicines, etc. The body normally becomes accustomed to the WT3 protocol by making certain compensatory changes. Some medicines (such as beta blockers) may affect the body’s ability to compensate or “get used to” the WT3 protocol. Other medication such as cortisone, progesterone, estrogens, certain anti-inflammatory medicines, and the like, can oppose the purpose of the WT3 protocol, thereby, making it less effective.

10. Thyroid medicine is pregnancy category A, which is the safest category for medicines that can be taken during pregnancy. As a matter of fact, it is usually recommended that thyroid hormone medication not be stopped during pregnancy. In some cases, the thyroid hormone supplementation is important in helping the woman to conceive the pregnancy and to maintain it to full term. However, due to the short half-life of T3, I recommend that patients who become pregnant on the WT3 protocol should gradually wean off the WT3 protocol, mainly because if for some reason they were denied access to their medicine abruptly, they might have problems with their pregnancy. Fortunately, many women with Wilson’s Temperature Syndrome do their best when they are pregnant.

11. The WT3 protocol can be symptomatic (used to treat the symptoms), therapeutic (used for a time to correct the underlying problem), used as a maintenance therapy (to maintain an effective correction through the use of continued administration of the medicine), and used as prophylaxis (used intermittently to prevent relapse of Wilson’ Syndrome, especially during short periods of extreme stress typical of conditions that have precipitated relapses previously).
As mentioned previously, the considerations discussed in this chapter about the treatment of Wilson’s Temperature Syndrome are relatively thorough, but are not nearly exhaustive. Greater details on treatment considerations in various other illnesses and situations is outside the scope of this book. The treatment protocol is explained in full detail in the Doctor’s Manual for Wilson’s Temperature Syndrome. the WT3 protocol should usually be monitored every two to six weeks by a physician in person, and more frequently, if necessary, by phone (and in person, if necessary). Monitoring should be more frequent initially until one can more fully predict a patient’s response, and may be less frequent later in therapy. Although the information presented here is not exhaustive, an effort was made to give enough information to demonstrate that the thyroid system is far more dynamic than it is generally considered to be, and that thyroid medication can be thought of in terms of minutes and days, rather than weeks and months. Thyroid hormone therapy can be adjusted to accomplish much good, and can even make all the difference in a person’s life. It should not be considered in terms of merely putting a patient on a certain dosage to see how they do, and leaving the patient on that particular regimen indefinitely regardless of whether or not their symptoms are greatly benefited. To adapt a phrase from The Annals of Internal Medicine article of December, 1977, entitled Thyroidal and Peripheral Production of Thyroid Hormones, that applies both to the information presented in the article and the information presented in this book: This new information has forced a reassessment of long held views of the thyroid system and has profound clinical implications as well (To say the least!).

Resource Summary

• Wilsons Temperature Syndrome main website
• Patient Guidelines : to print and have on hand before you begin treatment
• Basic Guidelines for Doctors Using the WT3 Protocol
• You need to read the Patients E-Book (and preferably also the Doctor’s manual) and have addressed any underlying adrenal problems, before you will be permitted to participate in the protocol.
• The Doctor’s Manual is the more comprehensive manual for your doctor, though most doctors insist you read both in order to undergo treatment – a wise suggestion.